ObjectivesGastrointestinal stromal tumors (GISTs) are rare tumors of gastrointestinal tract, prognosis of which largely depends upon histopathologic characteristics of resection specimens, which were not widely studied in our population. Therefore we aimed to evaluate the histopathologic characteristics of GISTs in our population and their prognostic grouping according to college of American pathologist’s guidelines.ResultsMean age of patients was 53.4 years (18–71 years). 92% of cases were of primary GISTs and stomach was the most common site (57.7%). 75% of cases were of spindle cell morphology and 53.8% belonged to high risk prognostic group. Comparison of stomach and intestinal GISTs showed that intestinal GISTs were found to be of high grade (70%) and of high risk prognostic group (75 and 80%) compared to stomach GISTs (43% were of high risk prognostic group), however this finding was not statistically significant. GISTs are infrequent gastrointestinal tumors but early diagnosis and identification of adverse histological features are key to successful treatment. We found a large majority of GISTs to be located in stomach, however intestinal GISTs were found more likely to be associated with adverse prognostic parameters. However more large scale studies are warranted to establish this finding.Electronic supplementary materialThe online version of this article (10.1186/s13104-018-3562-8) contains supplementary material, which is available to authorized users.
Background: Diarrhea founds to be the major cause of morbidity and mortality in children less than five years. Various factors are associated with diarrhea but socio-demographic factors are the main key elements, which associated with diarrhea. Methods: This study was examined association of socio-demographic factors with diarrhea in children less than five years of age of Sindh, Pakistan, using data from the Multiple Indicator Cluster Survey (MICS) conducted from January 2014 to August 2014. Data were collected for 18,108 children in whom 16,449 children had complete data of demographic variables being included in the analysis. Bivariate analysis was done using Pearson's Chi square test and multivariate analysis being done using binary logistic regression. Results: We found increased risk of diarrhea among children lives in rural areas while household wealth index quintile was also associated with diarrhea. Children in the poor, middle and fourth wealth index quintiles being at increased risk of diarrhea compared to children in the richest wealth index quintile. The highest risk of diarrhea was found for the child having mother with no education as well as children aged 12-23 months. Conclusion: Age of child, mother education and wealth index found significant with diarrhea while Male children, child aged 12-23 months, child with no mother education, child from rural areas and child from poor households found with high risk of diarrhea.
The successful outcome of allogeneic hematopoietic stem cell transplant (HSCT) in aplastic anemia patients is driven by suitable donor selection, appropriate conditioning regimen, early intervention, and optimal supportive care after transplant. Pakistan, being a developing country, faces grave economic challenges due to meager health care budget; therefore, cost constraints remain the foremost impediment in optimizing transplant facilities for socioeconomically deprived patients. We conducted a single-center retrospective analysis of aplastic anemia patients (
N
=
130
), who received matched sibling donor transplants from 2011 to 2019, treated with either fludarabine/cyclophosphamide (Flu/Cy) or antithymocyte globulin/cyclophosphamide (ATG/CY) conditioning regimen. Median age was 16 years (IQR, 11-20), and it ranged from 3 to 48 years. The median time from diagnosis to transplant was 3 months (IQR, 2 to 4), and it ranged from 1 to 8 months. The estimated overall survival (OS), relapse-free survival (RFS), and GvHD-free survival (GFS) were found to be 69.0%, 66.7%, and 64.3% in the ATG/Cy group while 76.1%, 72.7%, and 62.5% in the Flu/Cy group, respectively, after a median follow-up of 30 months (IQR, 8 to 55), and it ranged from 0 to 98 months for the study groups. The Flu/Cy regimen was well tolerated and was not associated with increased risk of GvHD. Hence, it may be an appropriate alternative conditioning regimen for developing countries with limited health care resources.
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