Evaluation Of Normal Diameter Of Infra-Renal Aorta In A Pakistani Population Using Contrast-Enhanced Computed Tomography.

BACKGROUND: It is a common observation that the aortic size of Pakistani population is relatively less as compared to western population. Till now there is no study which has measured the dimensions of abdominal aorta in local population.The standard diameter of an artery across the body is critical for clinicians to recognize when an artery has become aneurysmal. This study aims to present the results of a local population's normal diameter of an infrarenal aorta and how it varies by age, gender, weight, height, body mass index (BMI) and body surface area (BSA). METHODS: This cross-sectional observational study was conducted in Vascular Surgery Department, at Combined Military Hospital (CMH), Peshawar, from July 2020 to November 2021.Participants in the study included all patients who underwent a contrast-enhanced computed tomography (CT) scan of the abdomen for any reason other than cardiovascular disease.The infrarenal abdominal aorta's mean internal diameter (anteroposterior and transverse diameter) was assessed. SPSS v 23 was used to analyze the data and present it as frequency and percentages. The Pearson correlation coefficient assessed the correlation between aortic diameters, weight, height, BMI, and BSA. RESULTS: Recruitment of a total of 250 patients was done in this study. Males were 194 (77.6%), while the rest were female patients. The patients' mean age was 39.6±12.8 years. The mean anteroposterior (AP) diameter of the infrarenal aorta was 16.13±2.32 mm. The mean transverse diameter (TD) was 15.96±2.34 mm. The infrarenal diameter of the aorta was smaller in women when compared to men, and the calibre of the aorta increased with the increasing age of the patients. There was a statistically significant positive relationship between their age and the average diameter of the infrarenal aorta (p<0.001) among both men and women. CONCLUSIONS: Clinicians and vascular surgeons will benefit from the findings in diagnosing and treating abdominal aortic aneurysms. Hence, thoughtful consideration should be made before formulating intervention protocols.

Comparison of three standard neoadjuvant chemotherapy regimens based on pathological tumor response in breast cancer patients.

We compared the efficacy of different neoadjuvant chemotherapy regimens and pathological factors related to higher pCR in localized breast cancer. This comparative retrospective study included 313 patients with breast carcinoma who received neoadjuvant therapy from January 2017 till July 31, 2019 at our institute. Patients were grouped in 3 different categories according to the treatment arms. In Arm A, patients received dose-dense AC [4 Cycles] followed by dose dense paclitaxel [4 Cycles]. In Arm B, 2 weekly dose dense AC [4 Cycles] followed-by paclitaxel every week [12 Cycles], while Arm C received 3 weekly AC [4 Cycles] and 3 weekly paclitaxel [4 Cycles]. pCR was seen in 135(43.1%) patients with the highest pCR in arm B i-e 33(55%), followed by 39(43.3%) in arm A, and 63(38.6%) in arm C. Triple-negative patients had the highest percentage of pCR 38 (65.5%). HER2 positive patients who received neoadjuvant Trastuzumab also had increased pCR rate of 21 (61.7%). ER/PR positive, HER2 negative patients had the lowest pCR 56 (33.5%). Dose dense AC [4 cycles] followed-by weekly Paclitaxel [12 cycles] is the most effective neoadjuvant therapy regimen for breast cancer patients, particularly if they were also triple negative and HER2 positive receiving Trastuzumab.

Histopathological Account of Obstetrical and Gynecological Specimens: Retrospective Study at a Tertiary Care Center of Peshawar.

Introduction Histopathologic specimen examination of surgically isolated organs and tissues yields valuable information regarding a disease process and plays a vital role in the future management of a patient. Our aim was to account for the common diagnosis yielded from histopathological specimens of the obstetrics and gynecology department and to determine if all the obstetric and gynecological specimens should be routinely sent for histopathology. Methods A retrospective, cross-sectional study was conducted at the histopathology unit of a tertiary care hospital in Peshawar. Data were acquired for all gynecological and obstetric specimens sent for histopathology for analysis to the histopathology unit during August 2018 and July 2019. Any sample that was not sent via surgical excision was excluded from the study. Results A total of 922 samples were sent for histopathological analysis in the tertiary care hospital. The mean age of patients who had their specimens sent for pathology was 40.78 ± 10.81 years. Most of the samples sent were of the uterus (458) and the age 31-50 years (270) had the highest proportion of histopathological specimens. Normal ovaries (64.4%) and fallopian tubes (78.8%) were the main diagnoses for these two specimens while a normal cervix (0.58%) was the least common diagnosis among samples sent for histopathology. Chronic cervicitis (92.4%) in cervix and secretory phase endometrium (30.1%) in the uterus were the other common diagnosis. All the other samples were infrequently sent. Conclusion Uterine specimens are the most common histopathological specimen sent followed by cervix and then fallopian tube. Fallopian tube and ovaries yielded the highest normal diagnosis. Cervix specimens must be biopsied. More data is needed for a certain consensus on the need for routine histopathology.