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Determinants of Sleep Quality in Cancer Patients: A Tertiary Center Experience from Punjab, Pakistan
Get PDFBackground:
Cancer diagnosis and treatment can trigger and/or worsen insomnia. This is a double-edged sword as sleep disturbances then exacerbate cancer symptoms.
Objectives:
1. To determine the sleep quality in cancer patients.
2. To determine the relationship of sleep quality with socioeconomic status, financial burden, marital status, Eastern Cooperative Oncology Group (ECOG) performance status, pain, use of analgesia and type of cancer.
Materials and Methods:
An analytical cross-sectional study was carried out with 100 adult and pediatric cancer patients presenting to Mayo Hospital, Lahore. The Urdu version of Pittsburg Sleep Quality Index (PSQI-U), Numerical Rating Scale (NRS) and Eastern Cooperative Oncology Group (ECOG) score were used to determine the quality of sleep, intensity of pain, and performance status respectively.
Statistical Analysis:
Statistical analysis was carried out using through SPSS software version 26. Chi-square test was applied.
Results:
The mean PSQI score was 11.56 ± 5.70. Higher PSQI scores in older age groups (p=0.017), in patients with poor ECOG scores (p=0.016), the presence of pain (p=0.018) and greater frequency of pain throughout the day (p=0.019) significantly demonstrated poor sleep quality. Low PSQI scores in unmarried patients (p=0.036) and use of morphine and its derivatives (p=0.03) demonstrated significantly better quality of sleep.
Conclusion:
Cancer patients have poor sleep quality which is linked with advanced disease, aging, pain, and poor performance status. Medical, behavioral and psychological interventions can help in alleviating the sleep problems faced by these patients
Reasons and Associated Factors of Early Discontinuation of Implanon: A Follow-up Study from Lahore, Pakistan
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Post-Myocardial Infarction Left Ventricular Pseudoaneurysm: A Meta-Analysis
Get PDFLeft ventricular pseudoaneurysm (LVPA) is a rare complication of myocardial infarction. The clinical characteristics and treatment of choice in the current era remain to be elaborated. The present article aims to give an overview of post-infarct LVPA and discuss the management strategy and outcomes. The study was based on comprehensive retrieval of literature of the recent 10 years. Myocardial infarctions as the underlying causes of LVPAs were mostly acute myocardial infarctions. The mean time for LVPA formation was 51.7 months after myocardial infarction. Postoperative and follow-up ejection fraction values were significantly higher than preoperative. In the interventional group patients, the oversize ratio of patients in whom devices remained in position was a little larger than that of those with a migrated one, but lack of a statistical significance (1.32±0.25 vs. 1.25±0.21, p=0.707). The mortality rate was significantly higher in the conservative group than in the surgical and interventional groups. Surgical aneurysmectomy and left ventricular reconstruction are curable to post-infarct LVPAs, thereby avoiding unexpected LVPA ruptures and other fatal complications. Elderly patients and patients at high operative risk may resort to interventional therapy. The conservatively treated patients inevitably carry a considerable risk of death. An oversize ration of >1.3 might be a reference value for preventing device migration in the interventional group patients
Academic Experiences and Challenges Faced by Students at Bachelors’ of Sciences in Nursing Universities of Sindh in Pakistan
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Case series: Benefit of Angioembolization prior to surgery for Giant fibrous pleural tumors
Get PDFOnly 5% of malignant pleural neoplasms are fibrous tumors of the pleura that typically develop from sub-mesothelial mesenchymal tissue of the visceral pleura. When a tumor measures more than 15 cm, it is referred to as a "giant."
The best option for treating both benign and malignant neoplasms is surgery. We conducted a retrospective analysis of the three case series of pleural large fibrous tumors. Additionally, we will discuss our experience with pre-surgical Angioembolization, involving implanting coils and plugs, to treat spindle cell neoplasm. Surgery was completed without any issues
Burden of Hepatocellular Carcinoma and Pattern of Hepatitis B and C Presentation among HCC Patients: A Retrospective Study from a Tertiary Care Hospital in Karachi, Pakistan
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Case of Severe Infantile Seborrhoeic Dermatitis (the Cradle Cap)
Get PDFThe term infantile seborrhoeic dermatitis is used to describe as apparently particularly eczematous or psoriasiform eruption seen in infants, having a fondness for the scalp and flexures, and can be compared with atopic dermatitis. This is a very common problem in neonates. We reported a 20th-day-old male neonate brought to us with his mother having complaints of yellowish greasy scales with thick greenish crust on them. Lesions were present on the scalp and the face
The Association of Blood Groups and COVID-19 Infection in Pakistani Population with Respect to Age and Gender in a Case-Control Study
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Factors Affecting Awareness of Oral Cancer: A Cross-Sectional Study from a One-Day Free Consultation Camp in Karachi
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Neurocognitive Functions after Stereotactic Radiosurgery- An Analysis with Mini-Mental State Examination (MMSE)
Get PDFBackground: During the last decade, neuro-oncological research has increased awareness regarding the importance of cognitive functions as an outcome in different treatment modalities for primary brain tumor patients but only a few studies have addressed the issue of the possibility of cognitive dysfunction in patients who undergo stereotactic radiosurgery/stereotactic radiotherapy.
Objectives: To determine the effect of stereotactic radiosurgery/stereotactic radiotherapy on neurocognitive functions (NCF) in various brain tumors.
Methods: A prospective observational study was carried out at Neurospinal and Cancer Care Institute (NCCI), Karachi. A total of 100 patients who had undergone multisession stereotactic radiosurgery /stereotactic radiotherapy were selected after taking their written informed consent by employing convenient sampling technique. The type of tumor was classified and identified on radiological and histological basis. Neurocognitive function evaluation was carried out through Mini-Mental State Examination (MMSE) score questionnaire providing to the patient at pre-radiotherapy baseline, at 6 months, and annually thereafter until 5 years.
Results: The mean age of the patients was 37.3±15.2 years and most of them (28%) belonged to 31-40 years age group. Majority of them were males whereas the most common pathology found was glioma (31%).Moreover, both overall and in patients who had undergone prior surgery, the comparison of different MMSE score levels showed that there was a significant increase in patients with normal score levels and a significant decrease in patients with mild and moderate score levels after treatment (P=0.006 and P=0.046 respectively) at 5 years time.
Conclusion: Stereotactic radiosurgery results in improvement of neurocognitive functions. Previously known radiation related impairment of NCF should be re-explored in the light of modern radiosurgery / radiotherapy techniques with larger studies