Obesity, Fat Topography And Risk Of Carcinoma Breast.

BACKGROUND: Carcinoma breast is most common cancer and the leading cause of cancer related deaths in women, with a multifactorial aetiology. This case control study was aimed at studying the possible link of body fat with the pathogenesis of carcinoma breast. METHODS: A case control study extending over a period of two years (2015-2016) was conducted in which the body size and shape of 56 carcinoma breast cases was studied against 168 controls who had no breast disease. RESULTS: Fifty-six women suffering from carcinoma breast had a higher BMI and fat distributed in the abdominal area A high BMI was found to be protective in pre-menopausal women (OR= 0.14 by; 95% CI: 0.02-0.77) while it was a risk factor in post-menopausal women (OR=2.39 by; 95% CI: 1.02-5.55). Waist-to-hip ratio (WHR) of ≥0.9 was associated with an increased risk of carcinoma breast compared to WHR ≤0.8 (OR=3.857 by; 95% CI: 0.875-17.05). CONCLUSIONS: the results show there is an increased risk of carcinoma breast in women having more fat cantered around the abdomen.

Prevalence of Hepatitis B core antibodies with negative Hepatitis B surface antigen in dialysis and chronic kidney disease patients.

Occult hepatitis B infection (OBI) is a potential cause of infection transmission in patients with chronic kidney disease (CKD) and dialysis-dependant patients. It is liable to be missed since the marker for OBI, hepatitis B core antibody (HBcAb), is not done routinely. We carried out a study to assess the prevalence of OBI in CKD Stage II-V or requiring renal replacement therapy. It was a cross-sectional study carried out at Fatima Memorial Hospital, Lahore, from May 2104 to May 2015. A total of 188 patients were included in this study, 124 were dialysis dependent and 64 had acute or CKD Stage II-V. About 17.55% (n = 33) of patients had isolated HBcAb positive. Nearly 33.5% (n = 63) of patients were found to have hepatitis B surface antigen positive, indicating development of immunity by exposure to virus. About 20.74% (n = 39) of patients were co-positive with HBcAb also. The prevalence of isolated HBcAb in dialysis and CKD patients is high; therefore, testing for HBcAb should be a routine part of screening in our CKD population to rule out OBI. Further confirmation with polymerase chain reaction analysis for HBV viral DNA is recommended. Considering our circumstances, a consensus statement from the hepatologists and nephrologists is needed to further plan for the management of such cases.

Small Gut Volvulus, A Rare Twist, In The Setting Of An Even Rarer Entity; Multiple Giant Jejuno Ileal Diverticula.

Small gut volvulus with multiple Jejuno-ileal diverticulosis is an unusual pathology of the small intestine with a scarce number of cases reported so far. It usually goes unnoticed because it is often asymptomatic but complications like diverticulitis, perforation, bleeding or intestinal obstruction can occur in 10-30% of the cases. Mechanical obstruction, if it occurs, can be caused by adhesions or stenosis due to diverticulitis, intussusception at the site of the diverticulum and volvulus of the segment containing the diverticula. Acute volvulus of the small bowel is a serious abdominal emergency that poses a difficulty in diagnosis and delayed operative intervention can lead to dire consequences. We herein report the case of a 42-yearold man presented at the emergency department with acute abdominal pain, absolute constipation and vomiting. Preoperative investigations followed by laparotomy revealed small gut volvulus and multiple giant jejunal and ileal diverticula.

Hyponatraemia: Epidemiology and aetiology in a tertiary care centre in Pakistan.

OBJECTIVE: To determine the incidence, aetiology and epidemiology of hospitalized patients with hyponatraemia. METHODS: Subjects were identified through hospital information system for two consecutive low sodium values (< 130 mEq/L) and charts were reviewed retrospectively. Possible etiologic factors were identified and co-morbidities documented. Management plans were also noted. RESULTS: Among the hospitalized patients the incidence of hyponatraemia was 6.72%. The mean age was 54.8±14.8 years and there were 50% males. The mean serum sodium at presentation was 122 mEq/L. Most common causes were volume depletion (30.6%) and chronic kidney disease (22.6%). Most of the patients had two or more co morbidities. Hyponatraemia at presentation and improvement or worsening during hospital stay did not affect survival of patients. CONCLUSIONS: Hypervolaemic hyponatraemia was the most common presentation in our study.

Pulmonary renal syndrome in a patient with vasculitis: Case report and review of literature.

Granulomatosis with polyangiitis (GPA) previously known as Wegner's granulomatosis, is a small vessel vasculitis that preferentially involves capillaries, arterioles and venules, presenting as multisystemic disease classically with alveolar haemorrhage and renal insufficiency. We report a case of GPA diagnosed on history, clinical findings and supported by imaging and very high levels of C-ANCA. Renal biopsy confirmed the typical histopathological findings. We discuss herein the management of the case and review of literature.