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Sensitivity Pattern of Salmonella Typhi from Blood Culture in Paediatric Population
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Prognostic Factors for Pulmonary Metastasectomy in Soft Tissue Sarcoma: An Integrative Review
Get PDFThe lung is one of the most common sites of metastasis from soft tissue sarcoma (STS). In the absence of a randomized control trial, pulmonary metastasectomy is commonly performed in an effort to improve survival. However, data from retrospective analysis and case series remain subject to selection bias. The aim of this study was to review the published data, especially to identify prognostic factors, to inform future clinical practice in the field of pulmonary metastasectomy for metastatic soft tissue sarcoma. We searched the SCOPUS database using the terms "pulmonary metastasectomy" or "lung resection" or "lung metastasectomy" or lung metastasectomies" and sarcoma and survival in the title, abstract, and keywords of all documents. Over the study period (1976-June 2021), a total of 438 documents of published articles were retrieved and 192 were identified for bibliometric analysis, and of those, 128 articles were included in the content analysis. No randomized trial was identified. 'Bradford's law' was applied to classify journals into 'zones' and 6 journals appeared to publish 70/192 (36.4%) of all articles, receiving 52% of the citations. The vast majority of articles 64% were retrospective cohort analyses. A total of 49 articles reported on prognostic factors. Pulmonary metastasectomy is frequently performed for lung metastases originating from STS. The literature continues to evolve in the form of retrospective cohort studies. It is important to review and utilize the prognostic factors to identify patients for pulmonary metastasectomy to enhance the survival outcome
Spectrum and Antibiotic Resistance Pattern of Uropathogens Causing Urinary Tract Infection Among Inpatients and Outpatients: An Experience of a Tertiary Care Hospital in Karachi, Pakistan
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Knowledge and Attitudes Regarding Transgender and Intersex Individuals Among Medical Students and Health Care Providers of Karachi, Pakistan
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Sexual Perversion Leads to Laparotomy
Get PDFInsertion of objects/stuff in bodily orifice is not unusual. There are many causes of penetration of bowel with different objects inserted via anus as to achieve sexual pleasure, to satisfy lust, self-injury, malingering and human trafficking is known for centuries. There are different household products used by the people to satisfy their lust/sexual desire but the objects/stuff used for this purpose mainly cylindrical and a type of soft texture. These objects are known for potential damage to gastrointestinal tract but it also affects other parts of the body and may create different inner complications, which needs to be evaluated and managed accordingly. Sometimes, management only requires local intervention, but if complications are build up like perforation develop needs laparotomy, broad-spectrum antibiotic therapy, repair of perforation with or without colostom
Frequency, factors and pattern of delayed presentation for dialysis in advanced kidney disease patients visiting tertiary care hospital
Get PDFBackground: Globally the burden of chronic kidney diseases is increasing. It is often a silent disease until the most advanced stages when symptoms develop. Late referral and presentation to nephrologist for CKD management is the major issue.
Objective: To determine the frequency, factors and pattern of delayed presentation for dialysis in advanced kidney disease patients visiting tertiary care hospital.
Methods: The current cross-sectional study was conducted in Memon Medical Institute Hospital and Dow University of Health Sciences Ojha Campus Karachi Pakistan from December 2019 to March 2020. Patients who presented in hospital for first time dialysis with advanced kidney diseases were included in the study. The threshold of patient presentation after a month of advice for dialysis is used to categorize the patient presentation as delayed or non-delayed.
Results: Total 214 participants were recruited into the study. The median age of the participants was 40 (29.75 - 53) years. Majority were male (71%) and belonged to rural area (63.1%). 50.9% of the patients presented with delay of more than a month. Delayed presentation was significant among belonging to rural area (p=0.009) with higher median creatinine (p=0.002) and lower level of education (p=0.001). The most frequent presentation was high blood pressure (89.3%), followed by oliguria (66.8%). Oliguria was significant among patients with delayed presentation (p=0.003). Patient perception for delayed presentation was looking for transplant (69.2%) and fear of needle prick (52.3%).
Conclusion: Delayed presentation for dialysis is more common in male, from rural areas, with lower level of education and with symptoms like oliguria and fluid overload. Looking for renal transplant followed by the fear of needle emerged as the potential reasons of delayed presentation
Bilateral Metachronous Breast Cancer in a Patient: A Case Report
Get PDFThe presence of breast malignancy bilaterally is not a common case scenario. With reference to the time of occurrence, a second primary malignancy can be either synchronous or metachronous. The synchronous cancer of the breast can also be present in the same breast. Usually, in metachronous bilateral breast cancer (MBBC), the histologically same type of malignancy is seen at different periods. However, we present a case of MBBC in a 62-year-old female patient who had two histologically different types of breast cancer. She presented in hospital with a lump in her right breast and a fungating mass in her left breast. On biopsy right-sided lump was invasive ductal carcinoma while the left-sided mass was borderline phyllodes tumor, at two separate biopsies from renowned histopathology labs. After chemotherapy for IDC, a simple mastectomy with a wide margin of skin was performed on the left side, while on the right side, a modified radical mastectomy was performed
Myocarditis post mRNA COVID-19 vaccine- To fear or not to fear?
Get PDFWe consider effective mass vaccination as the sole way to curb the COVID-19 pandemic. Most side effects of the vaccine are minor and self-limiting. However, a more concerning side effect, myocarditis, is also emerging. Julia et al. reported 1226 cases of post-vaccine myocarditis in which males aged 16 years or above were most vulnerable and developed symptoms following the second dose of the mRNA vaccine. Amid the prevailing myths, reports about such side effects add to the public’s fear of vaccination. Risk of myocarditis with COVID-19 infection is much greater than with the vaccine. One should also emphasise that the overall vaccine effectiveness is 94.1% and thus, the larger population can safely ignore this side effect. Thus, we believe it is important to highlight that the side effect is rare and manageable without any significant long-term damage. However, to devise population-specific guidelines, we recommend that the incidence of post-vaccine myocarditis is actively reported and published in our country, and measures taken accordingly
Areca Nut and its Products: A Culprit for Many Cancers
Get PDFThis article is to give a comprehensive review about the areca nut, different products made from it, and the important cancers associated with the use of different products of areca nut. Areca nut is a chewing substance consumed by a large population around the globe including our country Pakistan. Areca nut is a constituent of many products like supari, pan, gutkha and mawa, which are frequently used in Pakistan especially in urban areas. Areca nut is very dangerous for human health as it is associated with a large number of benign and malignant diseases. Different products of the areca nut are associated with very common cancers like mouth cancer, cancer of oesophagus, salivary gland cancer, hepatocellular cancer and different other head and neck cancer. To answer the research question “Areca nut and its products: A Culprit for many cancers” the literature review was done using Pubmed, google scholar and Medline using keywords “areca nut, paan, gutkha and cancers” and relevant articles from the year 2000 to the year 2020 were searched and relevant articles were selected in this review. The cancers of the oral cavity, oesophagus and liver develop in habitual chewers of areca nut due to the presence of some dangerous chemicals present in areca nut like arecoline which is an alkaloid. Arecoline and some other alkaloids cause cancer of the human body by inhibiting the tumor suppressor gene. Areca nut and its products should be strictly banned in Pakistan to decrease the burden of these cancers