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Embryonal tumors (ET) of the central nervous system (CNS) in children encompass a wide clinical spectrum of aggressive malignancies. Until recently, the overlapping morphological features of these lesions posed a diagnostic challenge and undermined discovery of optimal treatment strategies. However, with the advances in genomic technology and the outpouring of biological data over the last decade, clear insights into the molecular heterogeneity of these tumors are now well delineated. The major subtypes of ETs of the CNS in children include medulloblastoma, atypical teratoid rhabdoid tumor (ATRT), and embryonal tumors with multilayered rosettes (ETMR), which are now biologically and clinically characterized as different entities. These important developments have paved the way for treatments guided by risk stratification as well as novel targeted therapies in efforts to improve survival and reduce treatment burden.

IntroductionA lot of radiation exposure to a population comes from medical sources. Clinicians must justify the need for radiology procedures on a request form to prevent unnecessary scans and radiation exposure. Moreover, the properly-filled form will help to identify the patient correctly and provide clinical details to make a radiological diagnosis.ObjectiveThe purpose of the study was to audit the computed tomography (CT) scan request forms and find out the adequacy of completion of the request forms at Bahawal Victoria Hospital, Bahawalpur, Pakistan.Materials and methodsWe scrutinized 300 CT scan request forms received at the tertiary care center, Bahawal Victoria Hospital. We checked the adequacy of filling of different fields in the request forms like name, address, clinical and surgical history, and the name of required examination. We also looked for the missing subjects in the CT request form currently used in our hospital like the contact numbers of the patient and the doctor, the identity of the requesting doctor, renal function tests (RFTs), last menstrual period (LMP), and history of allergy. The results were analyzed using Statistical Package for the Social Sciences 20 (SPSS 20) (IBM, NY, USA) and Microsoft Office Excel Worksheet (Microsoft Corporation, NM, USA).ResultsThe name of the patient was present in 100% of the request forms, surname in 27.66%, age in 73.33%, gender in 64.33%, date in 91.66%, bed number in 37.90%, address in 1% and the name of required examination in 99.6%. Information about diagnosis included clinical history in 50.66%, past surgical history in 1%, laboratory investigations in 1%, and clinical examination in 8.66% of the forms. All the forms had the name and signature of the referring consultant, but only 10.33% forms contained the identity of the requesting junior doctor. More than half of the request forms for CT scan provided RFTs. We found no record of the allergy, LMP, and the contact number of the doctor and the patient.ConclusionThe information provided in the CT scan request forms was inadequate. The practice of filling these forms needs to be improved to protect the patients from unnecessary radiation exposure.

IntroductionHepatitis C has emerged as a big challenge for Pakistan. Health care providers are at increased risk of being infected due to tremendous exposure.AimThe purpose of this study was to find the prevalence of hepatitis C, its risk factors especially its occupational risk factors and preventive measures practiced by health care providers of Tehsil Head Quarter Hospital, Hasilpur, Pakistan.Materials and methodsBlood samples were collected, and rapid chromatography strips were used for diagnostic purpose. A questionnaire was used for data collection. After analyzing the data, results were summarized.ResultsThe prevalence of Hepatitis was 5.17%. Those who used gloves were 67.24%. A history of needle stick injury was present in 47.41%, and 49.13% knew about the spread of Hepatitis C Virus (HCV). Just 18.96% knew about the treatment plan, and 19.83% had attended a workshop on preventive measures of infectious diseases in healthcare settings.ConclusionThe frequency of HCV among health care providers is high. Awareness programs and training workshops should be mandatory to increase knowledge about hepatitis C prevention. It will decrease the incidence of hepatitis C infection among health care workers.

Background: Overall survival of adolescents with relapsed T-cell lymphoblastic lymphoma (T-LL) remains poor with limited options for salvage therapy. The BCL-2 inhibitor venetoclax combined with hypomethylating agents like decitabine, has shown favorable responses in elderly patients with acute myeloid leukemia. Observation: We present the case of a 19-year-old adolescent with stage III relapsed and refractory T-LL who did not respond to 3 lines of salvage therapy. The patient was treated with venetoclax and decitabine and achieved a dramatic response. Conclusion: This case highlights the potential clinical activity of venetoclax and decitabine in relapsed T-LL.