ABSTRACT
MicroRNAs [miRs] are non-coding ribonucleic acids consisting of about 18-22 nucleotide bases. Expression of several miRs can be altered in breast carcinomas in comparison to healthy breast tissue, or between various subtypes of breast cancer. These are regulated as either oncogene or tumor suppressors, this shows that their expression is misrepresented in cancers. Some miRs are specifically associated with breast cancer and are affected by cancer-restricted signaling pathways e.g. downstream of estrogen receptor-alpha or HER2/neu.Connection of multiple miRs with breast cancer, and the fact that most of these post transcript structures may transform complex functional networks of mRNAs, identify them as potential investigative, extrapolative and predictive tumor markers, as well as possible targets for treatment. Investigative tools that are currently available are RNA-based molecular techniques. An additional advantage related to miRs in oncology is that they are remarkably stable and are notably detectable in serum and plasma.Literature search was performed by using database of PubMed, the keywords used were microRNA [52 searches] AND breast cancer [169 searches]. PERN was used by database of Bahria University, this included literature and articles from international sources; 2 articles from Pakistan on this topic were consulted [one in international journal and one in a local journal]. Of these, 49 articles were shortlisted which discussed relation of microRNA genetic expression in breast cancer. These articles were consulted for this review
ABSTRACT
Background: Operative notes are an important element of documentation based quality management for clinical practice. Often narrated by surgeons, they are usually penned by hand and are crucial in case of medical and legal consequences
Objective: To assess the operative notes at a tertiary care hospital and compare them to the standards set by Royal College of Surgeons of England
Methods: An observational prospective study carried out in the department of general surgery over a time period of one month from June to July, 2014. Sixty operative notes including general surgery, urology, orthopedics and neurosurgery were included in this study and were assessed according to published guidelines of the Royal College of Surgeons of England
Results: A total of 60 operative notes were reviewed. All of them were handwritten, out of which 40 [66.7%] were written by the operating surgeon. None of the notes mentioned the time of the surgery and the type of surgery and had no diagrams to illustrate the operative findings. Almost all [96.7%] included the patients name and the procedure performed [95%] and only 66.7% mentioned the operative findings. Incomplete post-operative instructions were present in all the notes that were studied
Conclusion: Several areas were highlighted, that lacked essential information in the operative notes, including the time of the procedure, type of surgery, instructions for postoperative care, operative diagnosis, findings, and complications during the procedure indicating that the operative notes were incomplete and inadequate in many respects
ABSTRACT
To compare the results of open with laparoscopic appendectomy in terms of postoperative pain, rate of wound infection and hospital stay. This quasi-experimental study was conducted in Deprtment of Surgery, Ziauddin University Hospital, Karachi, over a period of six months. Patients undergoing surgery for acute appendicitis were randomly assigned into one of the two groups [A or B] after obtaining written and informed consent. In Group-A patients underwent open appendectomy and in Group B laparoscopic appendectomy was performed. Post operatively pain chart and wound infection was recorded and, at the time of discharge, number of days in hospital was calculated. Sixty patients [38 male, 22 female], with clinical diagnosis of acute appendicitis based on Alvarado score of six and above, were included in the study. They were randomized into 2 groups of A and B with 30 patients in each group. Group-A comprised open appendectomy procedure and Group-B comprised laparoscopic appendectomy. Mean comparison of postoperative pain by visual analogue scale, was significantly low in Group B, compared with Group A, on day 0, 1 and 2. Number of days in Hospital was 4.1 +/- 0.8 days in Group A and 1.5 +/- 0.06 days in Group B. None of the patients in Group B, while 8 [26.67%] patients in-Group A, developed postoperative wound infection at 1 week follow up. Laparoscopic appendectomy is safe and effective. Wound infection and postoperative pain is significantly lower after this mode of surgery