The remission induction rate was 70.7% in the adolescents and young adults with acute lymphoblastic leukemia at the study centre.
Dermatofibrosarcoma protuberans (DFSP) is a rare malignant neoplasm of skin, subcutaneous tissue and dermis, with more potential of local infiltration, appears most frequently on the trunk, followed by extremities, head, neck, and extremely rare in breast. It often occurs in young adults and middle-aged adults. The standard of treatment for this disease is local surgical excision with 2-3 cm wide margins. We present a case of 49-year lady with right breast well-circumscribed, firm, tender, mobile, and progressive lump that was benign-looking, on physical examination as well as on mammography. She underwent local surgical resection and diagnosed as DFSP on microscopic and immunohistochemical analysis with positive deep margin. She was referred for further multidisciplinary management. Case was discussed in tumour board meeting and planned for re-resection of involved deep margin. After re-resection, she has remained disease-free for last 3 years without any evidence of local or distant recurrence. In this case report, the importance of surgical resection with adequate margins, is highlighted and long term follow-up by physical examination and ultrasound for any local recurrence of DFSP in breast.
Introduction:Cancer patients are at risk of severe symptoms because of COVID 19 virus. Cancer patients are prone because they are immune-comprised due to their cancer and due to treatment with chemotherapy/immunotherapy. It is difficult to treat cancer patients in this pandemic due to limited data. Incidence of severe complications related to this virus in cancer patients is high then non cancer patients of same age group. They need more ICU admission and invasive ventilation. Since clinical data is relatively scarce in this perspective. This study is being carried out to perceive incidence and severity and outcome of this viral infection in cancer population in under developed country. Methods: All cancer patients who were receiving active oncological treatment and on surveillance visited the oncology clinic or required inpatient hospital care were included in this study. Aim was to assess the incidence and outcome of COVID 19 infection in oncology patients treated in our institute. Files of all adult cancer patients who were COVID positive and required inpatient care or managed at home from March 2020 till March 2021 were reviewed retrospectively. Purposive non-random sampling has been used for sampling technique. All details related to this infection have been recorded on a predesigned Proforma. Results: Total number of patients who visited Oncology clinics during 1 st wave and 2 nd wave of covid-19 were: n-7877 [M :F-1.5 :1]. During these waves total oncology patients who contracted COVID virus were: N= 170[170/ 7877=2.1 %, M: F-1.8: 1]. Only n-18 patients expired, Mortality according to severity of infection was: mild [4.7%], moderate [1.7%] and severe [4.1%]. More patients died secondary to this virus were urinary bladder [22.8%] and prostate cancer [15%] followed by GI [11.5%]. Patients with mild infection died because they had associated sepsis and uncontrolled malignancy. Mortality according to age, total [n-18], 5, 5, 8, and 0 according to age group 1, 2, 3 and 4. Mortality with co-morbidities, only chronic kidney disease [n-03], only hypertension [n-4], only ischemic heart disease [n-0], with multiple co-morbidities Afshan Asghar Rasheed et al.
Scoring systems are frequently used to predict mortality and then guiding therapeutic interventions in the patients with acute exacerbation of chronic obstructive pulmonary disease. Objective: Compare the diagnostic accuracy of Dyspnea, Eosinopenia, Consolidation, acidaemia, and atrial fibrillation and acute physiology and chronic health evaluation II scoring system to predict mortality among patients with acute exacerbation of chronic obstructive pulmonary disease. Methods: A cross sectional study was conducted during November 2017 to June 2018 in the Department of Chest Medicine, Jinnah Postgraduate Medical Center, Karachi. N=210 patients with acute exacerbation of chronic obstructive pulmonary disease, were included in the study after getting written informed consent. Patients were selected using non-probability consecutive sampling technique. Mortality scores were calculated for each patient and the individual parameters used in calculating the scores were also recorded. SPSS version 21 was used for statistical analysis. Results: The study population consisted of 210 consecutive patients, of those n=147 (70%) were males and n= 63 (30%) females. A statistically significant difference was observed between survivors and those who died in hospital related to acute exacerbation of chronic obstructive disease. The mean Dyspnea, Eosinopenia, Consolidation, acidaemia, and atrial fibrillation score 2.31 + 0.93 and acute physiology and chronic health evaluation II score 15.8 + 7.2 was recorded in whole study population. A decision threshold of Dyspnea, Eosinopenia, Consolidation, acidaemia, and atrial fibrillation score >2 was found to have a sensitivity of 84.6% and specificity of 82.3% while acute physiology and chronic health evaluation II score have sensitivity Continuous...
Background: Coronavirus disease (COVID-19) was declared as pandemic by World Health Organization (WHO) on 30th January 2020. Cancer patients are a vulnerable population with increased risk for mortality associated with COVID-19 infection. In this study, we report the impact of education for acceptance of COVID-19 vaccination in our cancer patients. Methods: This was a cross-sectional study between 1st August 2021 and 31st October 2021. All patients with diagnosis of cancer who presented to the oncology clinic were asked whether they received COVID-19 vaccine or planning to get vaccinated. Patients, who had refused the vaccine, were educated to get vaccinated. Post counseling, they were again asked if they would agree to get vaccinated. Results: Out of 512 cancer patients, 274 (53.5%) were male. Of total, 456 (89.1%) were diagnosed cases of solid malignancy. Patients who were on active oncological treatment were 406 (79.3%). Of total 512, 396 (77.3%) patients agreed for the COVID-19 vaccine while 116 (22.7%) had refused to get vaccinated. Of those 116, 75 (64.7%) patients accepted to get vaccinated post counseling. Conclusion: COVID-19 vaccine acceptance is higher among cancer patients at our institute compared to reported data. Oncologists should play a key role in encouraging their patients to get vaccine in order to reduce COVID-19 related mortality.
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