[en] To compare the pathological response to neoadjuvant chemotherapy in different molecular subtypes of breast cancer Study Design: Prospective cohort study. Place and Duration of Study: Department of Oncology Liaquat National Hospital Karachi from Jan 2013 to Dec 2014. Material and Methods: A total of 119 patients received neo-adjuvant chemotherapy for locally advanced breast cancer followed by definitive surgery. Demographic, clinical and pathological data of 101 patients were available for analysis. Tumors were divided into different molecular subtypes, luminal A, luminal B human epidermal growth factor receptor 2 (HER 2) was negative, luminal B (HER 2 positive), HER 2 over expressed and triple negative. Neoadjuvant chemotherapy was given for total of eight cycles. Primary end point was pathological response [pathological complete response (PCR) versus no PCR] after surgery. Results: A total of 101 patients data were analyzed. Seventeen (16.8%) were luminal A, thirty eight (37.6%) were luminal B, out of 38 luminal B patients, twenty one (55.2%) were HER 2 + and seventeen (44.7%) were HER 2 -ve. Sixteen (15.8%) patients were HER 2 over expressed and thirty (29.7%) were triple negative. Out of 101 patients, twenty eight (27.72%) achieved PCR. A total of 5.9% achieved PCR in luminal A, 4.8% had PCR in luminal B (HER 2 -ve type), 23.5% had in luminal B (HER 2 +ve type), 50% achieved PCR in HER-2 over expressed type and 46.7% had PCR in triple negative subtype, (p=0.001). There was no significant association of PCR with age, tumor size, lymph node status, histology or grade. Conclusion: Molecular subtypes of breat cancer were found to be statistically significant predictor of PCR after neoadjuvant chemotherapy. (author)

[en] Objective: To assess the diagnostic features of acromegaly, and analyse its management outcomes over a 15-year period in a tertiary care setting. Method: The descriptive, cohort, retrospective study was conducted at the Aga Khan University Hospital, Karachi, and comprised data of adult patients of either gender diagnosed with acromegaly based on biochemical and radiological evidence between January 2005 and December 2019. Data was retrieved from the medical records. Data was analysed using SPSS 19. Results:Of the 84 subjects, 54(64.3%) were males and 30(35.7%) were female. The overall mean age was 38.69±13.52 years. The patients presented 5.43±4.3 years after the onset of symptoms, with somatic growth features, such as enlarged hands and feet which was the most common complaint 81(96.4%). Of all the patients, 73(86.9%) underwent trans-sphenoidal surgery for the removal of the pituitary adenoma, while 11(13.1%) opted out of the surgical option. Further, 9(12.3%) patients showed biochemical and radiological remission 6 months post-surgery. Out of the remaining 64(87.7%) patients, 38(59.4%) received radiosurgery or radiotherapy, 15(23.4%) underwent repeat trans-sphenoidal surgery, and 11(17.2%) chose medical treatment. Conclusion:Majority of patients failed to achieve remission after trans-sphenoidal surgery, which is the first line of treatment. Radiotherapy/repeat surgery was generally the options taken by those with persistent disease. (author)

[en] Introduction: Colorectal cancer (CRC) is cancer that takes its origin in the large intestine (colon) or the rectum (end of the colon). CT, MRI and transrectal ultrasound are relatively new modalities for evaluation of CRC. Objective: To determine the diagnostic accuracy of spiral CT scan for colorectal carcinoma taking histopathology as gold standard. Material and Methods: Cross sectional study was carried out in Department of Radiology, Jinnah Post graduate Medical Centre, Karachi from May 03, 2017 to December, 02 2017. A total of 66 patients of CRC meeting the inclusion criteria as defined in operational definition were enrolled in the study. Spiral CT was performed using Toshiba spiral CT scanner machine, having 16 slice capabilities. Images were reviewed by consultant having more than 5 years of experience. Patients histopathological report was taken from the laboratory. Results: Mean (±SD) age was 58.4±9.1 years with Male: Female = 1.6: 1. Sensitivity, specificity, positive predictive value and negative predictive value of spiral computed tomography for colorectal carcinoma were 96.7%, 80%, 98.3% and 66.7% respectively. Diagnostic accuracy of spiral computed tomography came out to be 95.5%. Conclusion: The results of study suggested that spiral computed tomography can be used as first choice diagnostic test and has potential to replace the lengthy tiresome colonoscopic procedure in the investigation of colorectal carcinoma. (author)

[en] Objective: To investigate the relationship between plasma tryptophan and the occurrence of memory dysfunctions in male and female type 1 diabetics. Methods: The case-control study was conducted at two urban healthcare facilities in Karachi from January to June 2009, and comprised 100 diabetic subjects of among whom were 50 men and 50 women. The controls were also similar in number and gender. A questionnaire was used to evaluate the memory impairment in the subjects. Plasma tryptophan was determined by high performance liquid chromatography with ultra-violet method. Students t-test was used to analyse tryptophan data. Results: There was considerable memory impairment in the cases (n=40) compared to the controls (n=5). Results also showed a significant (p<0.01) decrease in plasma tryptophan levels in both male and female diabetic patients. Conclusions: Diabetic subjects exhibited occurrence of memory impairment with concomitant decline in plasma tryptophan levels. The findings indicate that decreased brain uptake of tryptophan and lowered brain 5-hydroxytryptamine levels may be responsible for the memory deficits seen in diabetics. (author)

[en] To study the pattern of skin diseases in hypertensive and diabetic geriatric population. Methodology: This cross-sectional retrospective study was conducted at Aga Khan University Hospital, Karachi. A total of 463 patients aged 65 years and older of either gender presenting with a skin disease were included in the study. Results: Mean age of participants was 73.12 ± 6.65 years. Eczema was dominant, found in 16% of diabetic and 19% hypertensive elderly, it was significantly linked with hypertension. Among infections, fungal diseases were most prevalent. No significant association was found between cutaneous fungal infection and diabetes. Immuno-bullous disorders (9%), viral infections (7.5%), pruritis (5.4%) and xerosis (6.48%) were also prominent dermatoses in elderly. Conclusion: Geriatric population with diabetes and hypertension had high frequency of fungal infections and eczema. Knowledge among geriatric population regarding skin care is needed to reduce the risk of skin diseases. (author)

[en] Maternal alloimmunization occurs when a pregnant woman has an immunologic response to a paternally derived red-cell antigen. Fetuses with anemia have a high cardiac output and decreased blood viscosity, resulting in high blood-flow velocities that could be used in prediction of fetal anemia. Objective: To determine the diagnostic accuracy of fetal middle cerebral artery peak systolic velocity in detection of neonatal anemia in rhesus alloimmunisation keeping neonatal hemoglobin estimation at birth as the gold standard. Setting: Department of Radiology, Jinnah Postgraduate Medical Center, Karachi. Materials and Method: Total 189 patients with Rhesus alloimmunization were included. Doppler examination of the middle cerebral artery was performed. Three measurements of peak systolic velocity at time of absent fetal body and breathing movements were taken, and the highest velocity level was recorded. A MCA-PSV of > 1.5 MoM was taken as positive. Sensitivity, specificity, and diagnostic accuracy were calculated. Stratification was done. P-value ≤0.05 was considered as significant. Results: The overall mean mother’s age was 29.29±4.42 years. 55.6% neonates were male and 44.4% were female. 40.7% patients were diagnosed neonatal anemia by MCA-PSV and 40.2% by neonatal hemoglobin estimation at birth. Sensitivity, Specificity, PPV, NPV and diagnostic accuracy were 86.8%, 90.3%, 85.7%, 91.0%, and 88.8% respectively. (author)Conclusion: The measurements of the peak velocity of blood flow provide an accurate and noninvasive means of determining the degree of anemia. (author)

[en] In the background of the current situation of breast cancer in Pakistan, with its rising incidence and mortality, non afford ability and inaccessibility to screening, diagnosis and treatment, Patel Hospital took up the task of addressing these issues at a local level, by initiating an annual free breast camp in the year 2006. In 2008 an inclusion criteria was defined to focus on high risk women for breast cancer. A comparative analysis over a period of three years was done. In the focused camps, in which 28% patients were found to have a positive family history. Most women were symptomatic. Total 11 patients were diagnosed to have cancer after evaluation. Six patients underwent definitive treatment. A problem with lack of awareness, regarding screening and treatment protocols was identified. Family history seems to be an important risk factor in our set up signifying the need to introduce extensive screening programmes. (author)

No abstract available

[en] New O:N:S and N:S donor ligands namely, S-benzoyl-N-(o-hydroxybenzaldehyde) dithiocarbazate, S-benzoyl-N-(N,N-dimethylaminobenzaldehyde ) dithiocarbazate, S-benzoyl-N(N-thiophene-2-aldehyde) dithiocarbazate and their complexes with La(III), Ce(III), Pr(III), Nd(III), Sm(III), Gd(III), Tb(III), Dy(III), Ho(III), Er(III), Yb(III), and Lu(III) have been synthesized and characterized on the basis of elemental analysis, IR, NMR and electronic spectroscopy. The nephelauxetic effect(1-βoverlined), bonding parameter, βoverlined, bsup(1/2) and Sinha covalency parameter δ, have been calculated. Their positive values indicate covalent nature of metal-ligand bond which is also supported by their molar conductances measured in nitrobenzene. Magnetic moment values exhibit paramagnetic nature of the complexes. Log K,ΔG, ΔH and ΔS values have also been ca lculated. Toxicity of the compounds has been evaluated against cockroaches and fungi(Aspergillus flavus and A. niger). The LD₅₀ and % inhibition values demonstrate greater efficacy of the complexes than that of the free bases. (author). 4 tabs., 12 refs

[en] Objective: To determine the frequency of cerebral aneurysm in patients with subarachnoid haemorrhage on CT cerebral angiography. Methods: This prospective cross-sectional study was conducted at Department of Radiology, JPMC, Karachi from 5th June 2022 to 30th January 2023. Total 176 patients with subarachnoid haemorrhage irrespective of gender were selected. CT angiography of cerebral vessels was performed. Cerebral aneurysm was noted as per operational definition and recorded. Results: Age range was from 18 to 60 years. Mean age was 39.516±6.77 years, Mean BMI 29.630±3.08 Kg/m2. and mean duration of symptoms was 7.721±2.40 days. Male patients were 80.1% and females were 19.9%. Cerebral aneurysm was observed in 91.4% female and 78.7% male patients. Aneurysmal percentage was slightly higher in younger (18-40 years) age group (84.2% vs 80.4%) as compared to older (40-60) age group but statistically not significant. Although total percentage of female was quite less 19.9% (n=35 vs n=141 male), in this lesser female percentage, aneurismal detection was higher as compared to male gender (91.4% vs 78.7%). Distribution of aneurysms according to vessel involved was; 28.7% along anterior communicating artery, 28.3% related to middle cerebral artery and, 22.9% were along posterior communicating vessel. Rest was distributed among other vessels including tip of basilar artery. Conclusion: In Our study aneurysms was seen 81.3% in patients of subarachnoid hemorrhage having CT angiography at our center in Karachi Pakistan. (author)