ABSTRACT
To determine the problems faced by thalassemic patients in their personal, psychological and social life. A cross-sectional multi-centre survey. Karachi, Lahore and Quetta Centres of Fatimid Foundation, from October 2009 to October 2010. An indigenously developed Qualifty of Life [QoL] questionnaire modified from SF-36 questionnaire was administered to 101 transfusion dependent subjects suffering from thalassemia major. Variables were analyzed using SPSS version 15 for descriptive statistics. The mean age of the subjects was 10.5 years ranging from 6 - 21 years. Less than one third of the patients felt that their health was slightly worse as compared to last year. Forty five [44%] of the patients felt loneliness due to their disease. Parents of 36 [35.6%] of the children at times did not allow their children to play because of their disease. Twenty eight [27.7%] stated difficulty in mingling with children of their age. Seventy one [70.3%] of the patients reported that at some or all times they were worried about their future life and career while 70 [69.3%] admitted being taken extra care of by their friends and 56 [55.4%] by their teachers. The quality of life of surveyed thalassemic patients was immensely affected. Having physical impairments, social stresses, financial burdens and problems with their education and career make them very much vulnerable to psychological trauma very early in their life. All of this creates a hindrance in their way of developing into autonomous functioning adults
ABSTRACT
To evaluate the therapeutic outcomes of acute myeloid leukemia [AML] in elderly patients. This study was conducted at the Aga Khan University Hospital, Karachi, Pakistan over 11 years from January 1997 to August 2008. This was a descriptive case series study. We investigated the impact of disease biology and various treatment protocols on the outcome in this population. A total of 55 evaluable patients [>60 years of age] were diagnosed with AML including 34 [61.8%] males and 21 [38.2%] females. The median age was 67 years [range 60-86 years] at the time of presentation. The AML was preceded by myelodysplastic syndrome in 15 [27.2%] patients. High-risk cytogenetics were observed in 3 [5.4%] patients. Forty patients received palliative treatment while only 15 received chemotherapy. Of the last group with primary AML [n=10], there were 2 remitters, one showed resistant disease while 8 had induction death. The overall mean survival was 75.1 days [95% confidence interval: 46.7-103.5 days] in all patients. There was no survival advantage in patients treated with chemotherapy versus those conservatively treated. We found high mortality among aged patients with AML in our setting. Patients receiving chemotherapy were extremely intolerant to toxic drugs and succumbed earlier than patients receiving palliative care only
Subject(s)
Humans , Male , Female , Treatment Outcome , Aged , Retrospective StudiesABSTRACT
Intravascular large B-cell lymphoma [IVLBCL] is a rare subtype of extranodal large B-cell lymphoma characterized by a selective proliferation of lymphoma cells within the lumina of vessels. We report a case of an 86-year-old man who presented with fever, shortness of breath and altered mental status. The diagnosis of IVLBCL was confirmed on a bone trephine biopsy that revealed positivity of CD20 and PAX5 immuno-histochemical staining of lymphoma cells confined within the lumina of vessels. The patient had a rapidly deteriorating clinical course with a fatal outcome even before the specific treatment for the underlying disease was commenced