Early results of oesophagectomy for carcinoma oesophagus in 1008 cases

To determine the early results of 1008 oesophagectomies done for carcinoma oesophagus over a 9 years period. This observational descriptive study was conducted at Department of Cardiothoracic Surgery, Lady Reading Hospital, and Khyber Medical Centre Peshawar from June 2002 to June 2011. All patients had apart from routine investigations, Barium studies, Endoscopy and biopsy, CT thorax/upper abdomen with oral and I/V contrast and abdominal ultrasound. The operative approaches included left thoracolaparotomy with left neck anastomosis, transhiatal, left thoracolaparotomy with Roux en-Y, McKeown with right decortication, Ivor Lewis and left thoracolaparotomy with left decortication. All operations were done by one surgical team. The hospital records and operation reports of these patients were carefully analysed for demographic feature; operative approach and outcome. Out of 1008 cases, 698 were males and 310 were females with a mean age of 51.6 years. The age range was 17-80 years. Out of 1008 cases 611 [60.61%] cases had lower one third tumours, 384 [38.09%] cases had middle one third tumours while 13 [1.28%] tumours were just below the thoracic inlet. Of the 611 lower 1/3 tumours stomach involvement was present in 271 [44.35%] cases. Adenocarcinoma was present in 516 [51.19%] cases, squamous cell carcinoma was present in 485 [48.11%], adenosquamous was 6 [0.59%] and carcinoma in situ was present in 1 case [0.09%]. Morbidity was 63/1008 [6.25%], and comprised anastomotic leaks 15, aspiration pneumonia 13, wound infection 13, hoarseness 8, and strictures 14, 30-day mortality was 23/1008 [2.28%] and causes included aspiration pneumonia-respiratory failure [5], myocardial infarction [4], anastomotic leak [6], tracheal injury [2], and presumed pulmonary embolism [6]. More than 1000 cases in 9 years is a very high oesophageal workload for malignancy. Morbidity of 6.25% and mortality of 2.28% shows that such major operations can be done safely in thoracic centres

Oesophagectomy for carcinoma esophagus- Peshawar experience of 270 cases in 4 years

To audit the results of 270 Oesophagectomies done for Carcinoma Oesophagus over a 4 year period. This observational descriptive study was conducted at Department of Cardiothoracic Surgery, Lady Reading Hospital and Khyber Medical Centre Peshawar from Sep 2002 to Sep 2006. Computerized clinical data of 270 cases of Oesophagectomy for Carcinoma Oesophagus was retrospectively analyzed. All patients had apart from routine investigations, Barium studies, Endoscopy and biopsy, CT Thorax/Upper abdomen with Oral and I/V Contrast and Abdominal ultrasound. Detailed examination of clinical record was made to determine the surgical outcome. Out of 270 cases 189 were Males 81 were Females with a mean age of 51.6 years. The age range was 17-80 years. In out of two hundred and seventy cases one hundred and sixty two [162/270] [60%] cases had lower one third tumors, one hundred and five [105/ 270] [38.88%] cases had middle one third tumors while three [3/270] [1.11%] tumors were just below the thoracic inlet. Of the one hundred and sixty two lower one third tumors stomach involvement was present in eighty one [81/162] [30%] cases. Adenocarcinoma was present in one hundred and seventeen [117/270] [43.33%] cases, Squamous cell carcinoma was present in one hundred and forty four [144/270] [53.33%], Adenosquamous was six [6/270] [2.22%], Carcinoma in situ was two [2/270] [0.74%] and Leiomyoma was one [1/270] [0.370%]. Morbidity was 28/270 [10.370%] and comprised anastomotic leaks 09, aspiration pneumonia 06, wound infection 03, hoarseness 03, and strictures 03,. Thirty day mortality was 14/270 [5.185%] and included aspiration pneumonia-respiratory failure 02, myocardial infarction 03, anastomotic leak 03, tracheal injury 02 and presumed pulmonary embolism 04. Two hundred and seventy cases in four years is a very high volume of Oesophageal work load for malignancy. Our morbidity of 10.370% and mortality of 5.18% shows that such major operations can be done safely in thoracic centers

Milk composition channges-a simple and non-invasive method of detecting ovulation in lactating women

OBJECTIVE: To assess the possibility of detecting ovulation through observing changes in composition of milk and using this as a simple and non-invasive method. METHOD: Twenty five normal lactating women [menstruating and non-menstruating], varying in age from 18-35 years and taking no hormonal contraceptives were included in this study. Hormonal estimation was done by radioimmunoassay and changes in milk composition were observed by measuring the concentration of Na+, Cl-, K+ and lactose. Changes were observed in milk composition of four menstruating women [ovulatory], characterized by significant increase in concentration of Na+ and Cl- and decrease in concentration of lactose and K+. However, in one non-menstruating woman who was found to have ovulation, these findings could not be observed. Results show that the determination of Na+, K+, Cl- and lactose in milk of lactating women have a high value for detection of ovulation

Serum cholesterol level and cancer of the oral cavity

Recent findings have raised questions about the relationship of low serum cholesterol to cancer of various sites, that of the oral site in particular. Present study was planned to establish a relationship between serum cholesterol and cancer of oral site in 50 middle aged men and women. An attempt has also been made to identify the levels of serum phospholipid, total lipid, triglyceride and lipoproteins. The 50 patients chosen for the study consisted of 30 men and 20 women. Serum cholesterol, phospholipid, total lipid and LDL-cholesterol were significantly decreased, but no significant difference was observed in either sex. Serum LDL-cholesterol level was increased in both male and female patients but no significant difference was observed when compared with control subjects. From this study we observed that an inverse association existed between serum cholesterol level and oral cancer

Are low cholesterol levels associated with cancer?

Recent findings have raised questions about the relationship of low serum cholesterol to subsequent morbidity and mortality. Present study was planned to find out a relationship between cholesterol and cancer of different sites in eighty six middle aged men and women. Out of eighty six patients, 38 had cancer of oral sites, 22 cancer of gastrointestinal tract and 26 cancer of lung. Thirty control subjects, 16 males and 14 females, were included in the study. Serum cholesterol, phospholipid, total lipids and LDL cholesterol were significantly decreased in both sexes, when compared with control subjects. Cholesterol: Phospholipid molar ratio and triglyceride levels were decreased, but no significant difference was observed in both sexes. Serum HDL cholesterol level was increased in both male and female patients, but no significant difference was observed. An inverse relationship was also observed when the variables of total number of cancer patients were compared with control subjects. From this study we concluded that an association between low serum cholesterol level and cancer of different sites is not likely to represent an etiologic link between low cholesterol and cancer, but probably reflects the advances of clinical course of cancer