ABSTRACT
Objective: to characterize, diagnose and to differentiate various HRCT manifestations of lung abnormalities in post chemotherapy patients
Methodology: this was a retrospective study of 50 patients conducted at Ra-diology department of Rehman Medical Institute, Peshawar. Duration of study was 6months i.e from April 2013 to September 2013. Patients were investigated using 128-slice Multidetector Computed tomography [MDCT] scanner in the Radiology department of Rehman Medical Institute Peshawar. 0.5mm reconstructed images in lung window and 3mm images in mediastinal window were viewed on workstation in axial, coronal and sagittal planes. The data was processed using Microsoft excel 2007
Results: a total of 50 patients were included. Age of the patients ranged from 6 to 70 years with a mean age of 35 years. In our study, we found five radiologic patterns on CT scan; [1]non-specific ground-glass attenuation 17[34%],[2] patchy distribution of ground-glass attenuation accompanied by interlobular septal thickening 7[14%], [3]multifocal areas of airspace consolidation 7[14%],[4]extensive bilateral ground-glass attenuation or airspace consolidations with traction bronchiectasis 4[8%], and [5] nodules of variable sizes randomly distributed in both lungs 15[30%]
Conclusion: the most common pattern was found to be patchy areas of ground-glass attenuation. Pulmonary diseases that are induced by chemotherapy represent particular challenges for radiologists due to non-specific and atypical imaging features
ABSTRACT
In this study, occurrence of adverse drug reactions in female patients receiving chemotherapy were analyzed. Various drugs prescribed for cancer patients for compensation of these adverse reactions were also noted. Study was conducted on 83 female cancer patients selected randomly from a recent record of six months in KIRAN [Karachi Institute of Radiology and Nuclear Medicine] hospital, Karachi, Pakistan. Only those cases were selected in which patients received at least three cycles of cancer chemotherapy. The collected reports were analyzed for patients' data, drug details, causality, preventability and severity of adverse effects. Causality was assessed by the World Health Organization [WHO] causality assessment scale. Preventability and severity of ADRs were assessed by Naranjo's Algorithm and modified Hartwig's and Siegel scale. Out of n=83 females, n=55 [66.26%] females were married. Majority belonged to lower socioeconomic class [n=64, 77.10%]. In the 40-49 years age group 30.12% [n=25] adverse drug reactions [ADRs] were seen whereas 26.50% [n=22] ADRs in 50-59 years of age and 25.30% [n=21] ADRs in 30-39 years of age group were observed. The cases observed were of breast cancer [n=52, 62.65%], ovarian cancer [n=l4, 16.86%], Gl Cancer [n=8, 9.63%], and others that include head and neck cancer [n=3, 3.61%], lymphomas [n=3, 3.61%], sarcomas [n=2, 2.40%] and mass on chest wall [n=l, 1.20%]. In general, the common adverse effects observed were neutropenia/pancytopenia/anemia [n=64, 77.10%], alopecia [n=51, 61.44%], nausea and vomiting [n=39, 46.98%], fatigue/anorexia [n=26, 31.32%], mouth sores [n=21, 25.30%], fever and chills [n=20, 24.09%] and diarrhea [n=12, 14.45%]. According to the three scales employed for ADRs assessment i.e. [WHO] causality assessment scale, Naranjo's Algorithm and modified Hartwig's and Siegel scale for preventability and severity of ADRs, the results are in close agreement with each other with respect to occurrence and severity of the ADRs. A number of ADRs are observed in various cancer patients receiving chemotherapy indicating high need of ADR monitoring and reporting. The problem of under-reporting of ADRs is a big issue and must not be overlooked