ABSTRACT
Introduction: Breast cancer is the second most common cancer in the Indian female population. LABC and metastatic breast cancer are the most common stages at presentation in most low-resource countries. Although the incidence of LABC has decreased significantly in countries with enhanced resources thanks to widespread education and screening programs, it remains a daily encounter for surgeons and oncologists in low-resource countries. Neoadjuvant therapy has been studied widely for the treatment of LABC and is followed by locoregional therapy
Objectives: As per our hospital data, breast cancer is also found to be the second leading malignancy in women and locally advanced breast cancer is the most common type of breast cancer. Hence, we undertook this study to evaluate the clinical profile, histopathologic types and grade of the disease in our patients
Materials and Methods: This study was undertaken over a period of three years comprising of 255 patients who underwent modified radical mastectomy following neoadjuvant chemotherapy after preliminary diagnosis of carcinoma on histopathological examination of the trucut biopsy specimens. Clinicopathological evaluation was done in all of these cases following standard protocols
Results: The study comprised of 252 female patients and 3 male patients in the age range of 26 to 70 years. Majority [255, 66.6%] of the cases were within the age range of 31-60 years. Three females had bilateral breast cancer. Invasive ductal carcinoma no special type was the most common histopathologic pattern, and was seen in 254 [98.4%] cases. Most tumors were Scarff Bloom Richardson grade II and American Joint Committee on Cancer pathologic stage 3
ABSTRACT
To compare in-hospital mortality of acute myocardial Infarction in patients having normal renal functions with renal dysfunction patients. Emergency ward, Coronary care units and cardiology wards of the Punjab Institute of Cardiology Lahore. It was a comparative study. Sample size: 1000 consecutive patients presenting with acute myocardial infarction admitted to the Punjab Institute of cardiology Lahore were studied from 1st March 2004 to 15th August 2004. After fulfilling the inclusion criteria 1000 patients were studied. The mean age of the study population was 60.8+9.38 years. Total number of males in the study population was 642[64.2%] while female patients were 358[35.8%]. Patients with any degree of renal dysfunction, except those with end-stage renal disease were more likely to present with anterior MI than were patients without renal dysfunction. Patients with end-stage renal disease and more severe renal dysfunction were more likely to develop heart failure during hospitalization, to experience atrial fibrillation, and to have mechanical complications. Streptokinase therapy was used less frequently in patients with any degree of renal dysfunction than in patients without renal dysfunction, despite a similar incidence of MI. In-hospital mortality was 51[12%] in Group I patients, 46[16.6%] in Group II patients, 36[22%] in Group III patients, 35[27.7%] in Group IV patients and 5[35.7%] in Group V patients with a p value of <0.0001. Severe renal insufficiency had the maximum in-hospital mortality with OR of 5.4 and 95% confidence interval of 2.9-10.3 followed by end stage renal disease OR 5.1 [CI 2.2-12.1], moderate renal insufficiency OR 4.1 [CI 2.3-7.2] and mild renal insufficiency OR 1.9[CI 1.1-3.1] with a p value of <0.0001. Similarly congestive heart failure during hospital stay was observed in 20[4.7%] patients in Group I, 17[6.1%] patients in Group II, 15[9.4%] patients in Group III, 16[12.6%] patients in Group IV and 4[28.6%] patients in Group V. Similar trends were observed in mechanical complications and post myocardial arrhythmias in the study population, Patients with renal dysfunction who have acute MI are a high-risk population and suffer from increased mortality once they are admitted to the hospital. This is because of presence of more risk factors in this sub set of patients