Status of PM and DC recognized research journals of khyber pakhtunkhwa, Pakistan

The objective of this study was to know the status of PM and DC recognized journals in KhyberPakhtunkhwa. Descriptive/cross-sectional study. This study was carried out in the Department of Community Medicine, WMC, Abbottabad from January 2015 to April 2015. A self administered structured questionnaire was designed. Data obtained on eight sampled journals was analysed manually, tables and figures constructed using MS Excel 2007. Latest issues of journals provided by the respondents and literature review were used as additional sources of data. Frequencies of variables like number of issues, publication fee, recognition, accessibility, qualifications of managing team, and ethical approval of researches were calculated. One journal was indexed by MedLine, which was recognized by HEC, PM and DC and CPSP as well. Six out of eight journals had both chief editors and managing editors from clinical sciences. None of the journals had an Impact Factor. All journal hold a publication fee. In KP, medical journals need improvement in terms of recognition, indexation, research publication ethics publication fee and online availability and a uniform recognition criteria by HEC,PMDC and CPSP is missing

Smoking behavior among medical and dental students in Abbottabad, Pakistan

Objective: To assess the prevalence of smoking among young medical and dental students and explore the smoking habits and associated variables

Study Design: Cross-sectional observational study

Place and Duration of Study: The study was conducted in Frontier Medical and Dental College, Abbottabad, Pakistan during June-July, 2015

Materials and Methods: This was a cross-sectional observational study where anonymous, self-administered questionnaire was used to collect data like socio-demographic data and details about various aspects of smoking from 146 studysubjects

Results: The rate of smoking was found to be 23.28%, with male preponderance. The mean age of initiation of smoking was 18.79 +/- 1.68 years. The most common reason for starting smoking was company and peer pressure followed by stress or tension. The mean number of cigarettes smoked per day was 13.39 +/- 6.52. The commonly used product was cigarette [89.28%] among males and waterpipe[shisha], [83.33%], among females. Majority of study subjects, 63.70%, and 73.53% of smokers were aware of harmful effects of smoking. The most commonly known harmful effects included; lung cancer, carcinoma of oral cavity, respiratory and cardiovascular diseases

Conclusion: Smoking is common among medical graduates. Tobacco control measures should be introduced to reduce smoking as well as it should be made part of curricula taught at medical and dental colleges to increase awareness among students

Near total thyroidectomy; role of drain

To evaluate the role of surgical drains in near total thyroidectomy. It was a Randomized clinical trial conducted at department of surgery, DHQ teaching Hospital, Dera Ghazi Khan from Jun 2012 to May 2013. Patients were randomized into two groups by lottery method. Group A were those in which drains were placed and Group B patient were operated and no drains were placed. Inclusion criteria included all patients presenting for near total thyroidectomy for benign diseases. Those with massive goiters or nodules larger than 6 cm were excluded. 40patients were enrolled in the study. Complications, length of hospital stay, and overall cost were evaluated. In the Group B [no drain group], there was 03 days mean hospital stay with no increase in postoperative complications like swelling. While Group A [drain group] mean hospital stay was 06 days. Thyroid surgery without the use of a drain decreases the length of hospital stay, with no increase in patient morbidity. The overall cost is significantly reduced

Microflora of bile aspirates and its antibiogram

To determine the frequency of bacterial in patients presenting with Cholelithiasis. Descriptive case-series study. This study was carried out in the Surgical Unit Nishtar Hospital, Multan from October 2007 to September 2008. All adults patients aged 20 years and above who were admitted with a provisional diagnosis of cholelithiasis, over a period of one year were entered into the study. The study included 100 patients between the ages of 20 and 60 years. The 100 patients who presented with cholelithiasis underwent operation and bile was taken for culture and sensitivity. There were 88 women [88%] and 12 [12%] were men. Age was ranging from 20 to 60 years [mean 44.4 years]. 56 [56%] were operated laparoscopically while in 44 [44%] open cholecystectomy was done. Out of 100 bile culture 16 [16%] were positive while in 84[84%] cases no growth cultured. Most of the microorganisms were sensitive to ceufoxime axetil and ceftrioxaone

Survival from hepatocellular carcinoma at a cancer hospital in Pakistan.

OBJECTIVES: To determine the tumour and general characteristics, especially survival, of patients presenting with hepatocellular carcinoma at our tertiary care cancer hospital. PATIENTS AND METHODS: We retrospectively studied 584 charts of patients consecutively registered between 1995 and 2004 at the Shaukat Khanum Memorial Cancer Hospital and Research Centre, in Lahore, Pakistan. Descriptive statistics were obtained for gender, age, tumour size and morphology, alpha fetoprotein level, means of diagnosis, Child-Pugh status, risk factors, treatment given and follow-up. Survival analysis was conducted using the Kaplan-Meier method. RESULTS: Mean age at presentation was 56 years. Four hundred and forty four (76%) were male. Average tumour diameter evaluable in 412 patients was 8 cm. HCC was unifocal in 194 (33%), multifocal in 303 (52%) and unevaluable in 106. Mean AFP was 4,198 u/ml (range 1 - 278,560). Methods of diagnosis were FNA in 71, biopsy in 26, imaging/AFP > 200 in 70, lipiodol angiogram in 42, combinations of two of these in 365 and biphasic CT scans in 10. Initial Child-Pugh available for 400/584 was A in 216, B in 147 and C in 37. Evidence of prior hepatitis B infection was found in 114, and for hepatitis C in 254. Other than the four patients who had TACE followed by surgical resection, treatment was offered to 79/584 patients: among the 48 who had TACE, 26 experienced cancer progression whereas 11 had stable disease ranging from 6 - 20 months; another 11 were lost to follow-up. Of the 14 patients who underwent local resection, 2 were lost to follow-up, 7 developed recurrences but 5 remained disease free for a mean of 33 months. Following ethanol ablation in 17 patients, disease progressed in 5 but remained stable in 2 for a mean of 13 months; 10 were lost to follow-up. At the time of writing, 56 patients are alive (mean follow-up 20 months), 210 are known to have died (mean follow-up 9 months), and 318 were lost to follow-up within 3 months. Median overall survival was 10.5 months, death being the point of interest for survival analysis. Child-Pugh class stratified analysis (400/584) revealed median survival of 12 months for class A, 7.7 months for class B and 4 months for class C (p < 0.001). CONCLUSIONS: Most patients present with large, multifocal tumours, with poor liver function. Sixty one percent had evidence of prior infection with hepatitis B or C. The advanced stage at presentation, poor background liver function in many and the absence of a national liver transplantation program limit treatment options. Only 14% of patients were considered suitable for definitive treatment. Survival correlated with Child-Pugh status at presentation. Overall prognosis remains bleak. There is an urgent need to educate the public about the risks of hepatitis B and C and health professionals about early diagnosis and treatment, including possible development of a sustainable national liver transplant program.

Epithelial ovarian cancer at a cancer hospital in a developing country.

OBJECTIVES: To analyze records of patients seen with malignant epithelial ovarian cancer at a tertiary care cancer hospital in Pakistan and obtain information on factors as laterality, histology, CA-125 levels, and stage of the disease, determine age at presentation and, assess menopausal status of the patients. Also, to review results obtained in light of data published in indexed journals. PATIENTS AND METHODS: We analyzed 544 cases of malignant ovarian epithelial tumors registered at the Shaukat Khanum Memorial Cancer Hospital and Research Center from December 1994-December 2003. RESULTS: Mean age at presentation: 48.1 years (SD 13, range 4-82 years); commonest histological sub-type: serous cystadenocarcinoma (28.6%); most frequently seen stage: 3 (43.5%), followed by stage 4 (22.4%); post-menopausal: 56.8% of the women; bilateral disease: 41.2% of the women; and Cancer Antigen-125 (CA-125) level: elevated in 70% of the females. CONCLUSIONS: Stage at presentation in majority of the cases was advanced as compared to that seen in the west. With only minor variations, our findings seem consistent with those reported in other local studies. However, it is imperative to conduct an extensive population-based study to understand the impact of, and develop strategies for the management of ovarian cancer in Pakistan.

Characteristics of lung cancer patients--the Shaukat Khanum Memorial experience.

OBJECTIVES: The aims of this descriptive study were to characterize lung cancer patients by age at diagnosis, smoking status, and histology and, also to explore the histologic sub-type according to cigarette smoking, in a tertiary care setting. PATIENTS AND METHODS: A retrospective review of 830 patients for whom smoking status was available in the records was carried out at a comprehensive cancer care facility, the Shaukat Khanum Memorial Cancer Hospital and Research Center, situated in Lahore, Pakistan. RESULTS: The mean age at presentation of the 830 evaluable cases was 59.8 years (standard deviation 11.8, range 18-90). Stratifying by gender, statistically significant differences were found in the average age at diagnosis between males (60.1 years) and females (57.5 years) and, in the distributions of non-smokers, current smokers, and ex-smokers, but none for histology. CONCLUSIONS: Similar to other populations, the age of disease onset amongst females was lower than that seen in males. The proportion of smokers was higher amongst males versus females. The reversal of smoker to non-smoker ratio when stratified by gender, may highlight the importance of exploring alternate pathways implicated in the etiology of lung cancer in our population.