Comparison of risk factors and survival of Type-1 and Type-11 Endometrial Cancers

Objective: To compare risk factors and progression free survival of Type-1 and II endometrial cancers

Methods: A retrospective analysis of 149 patients with early stage endometrial carcinoma treated between 1997 and 2012 in Aga Khan University Hospital, Karachi was performed

Results: A total of 149 patients were analyzed. Type-l tumors accounted for 92% of cases in the study while 8% wereType-ll tumors. The mean age, BMI, parity, co-morbidities [hypertension and Diabetes], family history and history of polycystic disease were comparable in both groups. Overall better survival [113 Vs 24 months] was observed for Type-l endometrial cancer

Conclusion: Both types of endometrial cancer may share common etiologic factors. Despite the limitation of small numbers in one group this study confirms better survival in Type-l endometrial cancer

Selective lymphadenectomy in endometrial cancer: Retrospective analysis of morbidity and survival data at a tertiary care centre

To compare perioperative morbidity and survival data between patients with early-stage endometrial cancer who did or did not undergo selective lymphadenectomy. Retrospective analysis of 180 patients with early-stage endometrial carcinoma treated between 1999 and 2008 was performed in Aga Khan University Hospital, Karachi, Pakistan. Data from 180 patients were analysed. The selective lymphadenectomy group contained 108 women [60%] and the no lymphadenectomy group contained 72 women [40%]. The median number of lymph nodes removed was 9. The mean age and extent of disease, as assessed by staging, tumour size, myometrial invasion, and lymphovascular invasion were comparable between groups. Upstaging of the disease to stage 3 and 4 occurred in 11% of patients in the lymphadenectomy group. There were no significant differences in the medical or surgical complications between groups. At a median follow-up of 26 months, both groups had comparable survival [lymphadenectomy versus no lymphadenectomy: 34 versus 32 months]. Similar survival was noted for patients who underwent the removal of more or less than 5 pelvic lymph nodes. Selective lymphadenectomy offers the advantage of improved surgical staging but no therapeutic benefit in terms of overall survival

Role of magnesium sulphate in ischaemic stroke

To evaluate the role of magnesium sulphate in patients presenting with ischaemic stroke. This experimental type of interventional study was carried out at Mayo Hospital, Lahore. Within 24 hours of onset of clinically diagnosed stroke, which was later confirmed by CT scan, patients were randomized to receive either magnesium sulphate [16mmol IV over 15 minutes and 65mmol over 24 hours] or placebo. Their disability was measured by Barthel score at presentation and outcome measured after three months by death and disability and the results were compared between the two groups. Those patients who had a Barthel score of = 12 at three months were considered independent and those with a score of < 12 were considered disabled. The results were analyzed by SPSS. Fifty patients were recruited in the study. 25 patients were randomized to receive MgSO[4] and 25 received placebo. The Barthel score improved from 5.1 +/- 3.3 at presentation to 13.5 +/- 3.4 after three months in all the patients so the re was improvement whether MgSO[4] was given or not. Patients who were randomized to receive MgSO[4] had a lower Barthel score of 4.2 +/- 2.9 as compared to controls 5.9 +/- 3.5, but after three months they improved more than the controls gaining a score of 15.7 +/- 1.9 versus 11.3 +/- 3.2 [p=0.000]. The mortality rate was not statistically different in the two groups. 88% patients had a Barthel score of > 12 at three months in the MgSO[4] and 30% in the control/placebo group. Combined death and disability was 8% in MgSO[4] group and 60% in the control group. Moreover MgSO[4] was well tolerated. Magnesium sulphate therapy was safe in patients presenting with ischaemic stroke irrespective of the site of infarct. It improves prognosis regarding Barthel score at three months as well as the difference in the Barthel score at presentation and at three months. A greater percentage of magnesium treated patients led independent lives after three months

Atrial fibrillation in mitral stenosis and its correlation with age, sex and clinical symptoms

The objective of the study was to calculate the frequency of atrial fibrillation of MS and its correlation with age, sex and clinical symptoms. A prospective descriptive study. Mayo Hospital and Punjab Institute of Cardiology, Lahore. 112 patients of mitral stenosis were investigated with an ECG and an echocardiography to confirm mitral stenosis and to measure anteroposterior left atrial dimensions on M-mode. All patients who were suffering from AF due to causes other than mitral stenosis were excluded. The significance of findings were tested through standard "t"test. Atrial fibrillation is more in female patient and has a linear correlation with age. More common symptoms of shortness of breath followed by palpitation

Frequency of atrial fibrillation in mitral stenosis and its correlation with left atrial size

Chronic rheumatic heart disease is much the commonest cause of mitral stenosis. Incidence of rheumatic MS parallels that of acute rheumatic fever. Atrial fibrillation usually develops in the presence of pre-existing ECG evidence of left atrial enlargement and is related to the size of the chamber, the extend of fibrosis of the left atrial myocardium, the duration of the atriomegaly and the age of the patient. Descriptive. Mayo Hospital, Lahore and Punjab Institute of Cardiology, Lahore. Convenient. 129 consecutive cases of predominant mitral stenosis. 112 cases included in the final workup. The frequency of AF in MS in this study was calculated as 25.9%. The correlation between AF and left atrial size was significant [p = 0.000]. This was plotted on the scattergram [Figure No. 1], which shows a steep rise in the frequency of AF beyond a left atrial size of 70 mm. Frequency of AF in patients with MS is 25.9%. The correlation between AF in MS and left atrial size is significant [p = 0.000]

Prevalence and severity of viral hepatitis in Pakistani pregnant women: a five year hospital based study

A hospital based observational study was carried out on pregnant women presenting with either acute hepatitis or fulminant hepatic failure [FHF], during the past years. Of 53 patients, 20 [38%] developed FHF.Non-A, Non-B was the commonest cause [62%] followed by hepatitis B in 17% and hepatitis A in 4% cases. Eight women expired [case fatality rate 15%] with a high maternal mortality [62%] caused by NANB hepatitis. Perinatal mortality was 30%. Poor prognostic factors identified were lack of antenatal care, severity of jaundice, history of somnolence, gastrointestinal bleeding and a high grade of encephalopathy