Brain metastasis from gastroesophageal adenocarcinomas (GOCs) is a rare but a devastating diagnosis. Human epidermal growth factor receptor 2 (HER2) is a prognostic and predictive biomarker in GOCs. The association of HER2 with GOC brain metastasis is not known. We performed a retrospective analysis of patients with GOCs with known HER2 status between January 2015 and November 2021. HER2 was assessed on either the primary tumour or metastasis by immunohistochemistry or in situ hybridization. The diagnosis of brain metastasis was made on standard imaging techniques in patients with symptoms or signs. HER2 results were available for 201 patients, with 34 patients (16.9%) HER2 positive. A total of 12 patients developed symptomatic brain metastasis from GOCs, of which 7 (58.3%) were HER2 positive. The development of symptomatic brain metastasis was significantly higher in the HER2-positive GOCs (OR8.26, 95%CI 2.09–35.60; p = 0.0009). There was no significant association of HER2 status and overall survival in patients with brain metastasis. Although the rate of brain metastasis remains low in GOCs, the incidence of symptomatic brain metastasis was significantly higher in patients with HER2-positive tumours.
The kidney affects “the thyroid gland causing various derangements in its function whenever the kidney is impaired, even with a minor imperfection in its job, and this makes dialysis patients more prone to thyroid disorders with subsequent increase in mortality and morbidity. Objective: To determine the frequency of hypothyroidism in ESRD patients who are on maintenance hemodialysis. Methods: A descriptive cross-sectional study was conducted at Department of Nephrology, Liaquat University of Medical and Health Sciences Jamshoro”, upon a sample of 140 patients having age between 18 to 70 years presented with end stage renal disease with 3 months or more of maintenance hemodialysis were consecutively enrolled. Investigations was advised for TSH levels, T3, T4. The presence of hypothyroidism along with baseline and clinical characteristics were noted. Results: Of 140 patients, the mean age of the sample was 62.31± 9.78 years. Majority of the sample were males as compared to females, i.e., 93 (66.4%) and 47 (33.6%). History of thyroid disorder was observed in 83 (59.3%) patients. Comorbidity showed that type 2 diabetes mellitus was observed in 65 (46.4%) and hypertension in 77 (55%) patients. The mean TSH, T3 and T4 level was found to be 4.67± 0.20, 0.97± 0.37, and 5.33± 0.69 respectively. Frequency of hypothyroidism was found to be 53 (37.9%) patients. Conclusion: A considerably higher number of patients were presented with hypothyroidism in “ESRD patients who are on maintenance hemodialysis.
Hepatitis C virus (HCV) is a significant cause of morbidity and mortality in haemodialysis patients. Patients on haemodialysis are at high risk for HCV, with frequency of infection several times higher than that in non-hemodialysis patients. Objective: To determine the frequency of HCV infection in End Stage Renal Disease (ESRD) patients on maintenance hemodialysis. Methods: The Descriptive Cross-sectional study was conducted at Department of Nephrology, Liaquat University of Medical and Health Sciences Jamshoro. All patients above 18 years of age and below 60 years of age of both gender having end stage renal disease on maintenance hemodialysis with 3 months or more of maintenance hemodialysis were consecutively enrolled. Post hemodialysis patient’s serum was checked for anti HCV antibody by enzyme linked immune-sorbent assay (ELISA). Presence of anti HCV antibodies in serum detected by ELISA was labeled as HCV positive. Results: Of 90 patients, the mean age of the patients was 46.85 ±8.21 years. There were 54 (60%) males and 36 (40%) females. The mean duration of hemodialysis was 10.39 ±3.31 months. The frequency of HCV was found to be 21 (23.3%). A significant association of HCV was found with gender (p-value 0.006) whereas age (p-value 0.597) and duration of hemodialysis (p-value 0.715) was found to be insignificant. Conclusion: The frequency of HCV infection was found to be 23% in ESRD patients on maintenance hemodialysis. Early recognition and treatment of which improves the patient outcome.
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