ABSTRACT
ABSTRACT Objectives: Different clinicopathological and molecular features have been demonstrated between right and left sided colon cancers. We aimed to characterize colon cancer and sidedness among a North-Pakistani rural population diagnosed with colon cancer in our institution. Methods: Seventy patients were included in the study that received adjuvant chemotherapy at Bannu Institute of Nuclear Medicine Oncology and Radiotherapy) Bannu, Pakistan from January 2014 to December 2017. Chi-square test was used for significance of categorical variables. p-Values less than 0.05 were considered significant. Results: Mean age at diagnosis for right side colon cancer patients was 43.94 years and for left side colon cancer, it was 49.83 with no significant difference. Male patients were presented more with right (77% vs. 54%, p = 0.044) and females with predominantly left sided tumours i.e. (46% vs. 23%, p = 0.044). Right sided cancer tended to be more poorly differentiated (20% vs. 0%, p = 0.020). Mucinous adenocarcinoma was seen mostly in right sided colon cancer (37% vs. 3%, p ≤ 0.001). There were more locally advanced presentation of right side colon cancer with more node positive (83% vs. 60%, p = 0.025) and lymphovascular invasion (51% vs. 37%, p = 0.016). Sigmoid colon was the most common tumour subsite involved. Conclusion: Our study is the first report of colon cancer in a rural population in North-Pakistan. An earlier onset of tumours (44-50 years) was observed in comparison with global data.
RESUMO Objetivo: Características clínico-patológicas e moleculares distintas foram observadas em tumores de cólon no lado direito ou esquerdo. O presente estudo teve como objetivo caracterizar o câncer de cólon e sua lateralidade em uma população rural norte-paquistanesa diagnosticada com câncer de cólon nesta instituição. Métodos: O estudo incluiu 70 pacientes que foram submetidos a quimioterapia adjuvante no Instituto Bannu de Medicina Nuclear Radioterapia Oncológica (BINOR), Bannu, Paquistão, entre janeiro de 2014 e dezembro de 2017. O teste qui-quadrado foi utilizado para mensurar a significância das variáveis categóricas. Valores de p menores que 0,05 foram considerados significativos. Resultados: A média de idade ao diagnóstico entre pacientes com câncer de cólon no lado direito foi de 43,94 anos e entre aqueles com câncer de cólon no lado esquerdo, 49,83, sem diferença significativa. Os pacientes do sexo masculino apresentaram mais tumores no lado direito (77% vs. 54%, p = 0,044) e as pacientes do sexo feminino apresentaram mais tumores no lado esquerdo (46% vs. 23%, p = 0,044). Tumores mal diferenciados foram mais comumente observados no lado direito (20% vs. 0%, p = 0,020). Adenocarcinoma mucinoso foi observado principalmente em casos de tumores no lado direito (37% vs. 3%, p ≤ 0,001). A apresentação local estava mais avançada em tumores de cólon no lado direito, com mais linfonodos positivos (83% vs. 60%, p = 0,025) e invasão linfovascular (51% vs. 37%, p = 0,016). O cólon sigmoide foi o sublocal mais comum. Conclusão: O presente estudo é o primeiro relato de câncer de cólon em uma população rural no norte do Paquistão. Em comparação com dados globais, observou-se um surgimento mais precoce dos tumores (44-50 anos).
Subject(s)
Humans , Male , Female , Colonic Neoplasms/diagnosis , Colonic Neoplasms/pathologyABSTRACT
Background: Anaemia is common in patients admitted with acute myocardial infarction [AMI] and can badly affect the short and long term outcomes. Hospital acquired anaemia [HAA] is a type of anaemia which develops in patients during hospitalization with a normal haemoglobin level at the time of admission. There is very scant data regarding the causes for hospital acquired anaemia. This study was conducted in order to determine the causes and baseline characteristics of low haemoglobin level in AMI
Methods: This descriptive study was performed in Lady Reading Hospital Peshawar from 1[st] June 2013 to 31[st] May 2014. All the patients with AMI having normal baseline haemoglobin level at admission were included. Haemoglobin was rechecked on 5[th] day of admission to see whether patient develops HAA or not
Results: A total of 456 consecutive patients with AMI were screened for low haemoglobin. Low haemoglobin level [haemoglobin 70 years were 12 [14.3%]. hypertensives were 34 [40.5%], diabetics were 24 [28.6%], CKD was seen in 11 [13.1%], dyslipidemia in 17 [20.2%], and smokers were 16 [19%]. Upper GI bleed was found in 23 [27%], lower GI bleed in 7 [8.3%], hematuria in 6 [7.1%], possible coronary intervention in 7 [8.3%], and more than one cause in 14 [16.6%] patients, while no cause was found in 27 [32.14%] patients
Conclusion: One third of patients had no discernible cause of low haemoglobin, while one fourth of patients had isolated upper GI bleed as the main cause for hospital acquired low Hb
ABSTRACT
Objective: To know the regression of right ventricular pressure after successful percutaneous transluminalmitral commissurotomy [PTMC] in patients with severe isolated mitral stenosis
Methods: This descriptive study was performed in inpatient and outpatient department of National Institute of Cardiovascular Disease from 1[st] February 2016 to 31[st] August 2016. Echocardiography of all patients with successful PTMC were recorded 24 hours and 06 months following PTMC to see for Regression of right ventricular pressure along with other baseline echocardiographic parameters
Results: A total of 99 patients with severe isolated mitral stenosis who had undergone successful PTMC were studied. Females were 65[65.7%] and males 34[34.3%]. Mean age was 27.44 +/- 6.26 years. TTE performed before and after PTMC showed significant difference in mean mitral valve area [0.89cm +/- 0.089cm[2] vs. 1.68 +/- 0.128 cm[2], p valve <0.001] and mean left atrial diameter [4.66 +/- .82cm vs. 4.46 +/- 0.65cm]. Mean mitral valve gradient pre PTMC was significantly higher [16.38 +/- 2.51 mm of Hg] than that of post PTMC 24 hours [4.75 +/- 1.31 mm of Hg] and Post PTMC 06 months [5.22 +/- 1.21 mm of Hg], p valve <0.001. Mean right ventricular systolic pressure [RVSP] pre PTMC was significantly higher 62.3 +/- 10.91 mm of Hg than that of post PTMC 24 hour's 57.51 +/- 9.67 mm of Hg and post PTMC 06 moths 46.49 +/- 7.8mm of Hg, p value 0.001. Mean LVEF 50.14 +/- 5.82
Conclusion: There was a significant regression of right ventricular pressure following successful PTMC in mid-term [06 months] follow up of severe isolated mitral stenosis patients