Objective:To determine the clinical predictors of anticipatory emesis in patients treated with chemotherapy at a tertiary care cancer hospital.Methods:This was a cross-sectional study conducted on 200 patients undergoing first line chemotherapy with minimum of two cycles at inpatient department and chemotherapy bay of Shaukat Khanum Memorial Cancer Hospital and Research Centre Pakistan. Anticipatory nausea and vomiting develops before administration of chemotherapy. Clinical signs and symptoms in patients with or without anticipatory emesis were compared using chi square test statistics.Results:The mean age of the study participants was 36.68 years (SD±12.23). The mean numbers of chemotherapy cycles administered were 3.23 (SD±1.2). Chemotherapy related nausea and vomiting was experienced by 188 (94%) patients and anticipatory nausea vomiting was reported in 90 (45%) of patients. Greater proportions of patients with anticipatory emesis were females. Fourteen (15.5%) p-value=0.031 patients with anticipatory emesis had history of anxiety and depression. Fifty nine (65.5%) p-value =< 0.0001 patients with anticipatory emesis had severe nausea after last chemotherapy cycle. Forty six (51.11%) p=<0.0001 patients had motion sickness.Conclusion:Female gender, history of motion sickness, anxiety and depression, severe nausea and vomiting experienced in pervious cycle of chemotherapy were clinical predictors of anticipatory nausea and vomiting.

Objective:Chronic lymphocytic leukemia (CLL) is a heterogeneous disease in terms of survival with and without treatment. Many chemo and immunotherapeutic agents are available to treat this indolent disease. Aim of this study was to determine the outcomes of patients with chronic lymphocytic leukemia treated with different available chemotherapeutic regimens.Methods:All patients with diagnosis of CLL from 2008 to 2013 were included. Data were collected from hospital information system. Objective response rate (ORR) in terms of complete or partial response (CR, PR), stable or progressive disease (SD, PD), overall survival (OS), and progression free survival (PFS) were calculated.Results:Fifty seven patients were included; 42 (74%) male and 15 (26%) were female. Patients with Binet stage A 10 (18%); B 20 (35%) and C were 27(47%). Median age was 50.9 years. Forty six (80%) were treated and 11(20%) remained on watch and wait. Treatment indications were B symptoms 14 (30%), symptomatic nodal disease 18(39%), thrombocytopenia 4(9%), anemia 7(15%) and doubling of lymphocyte count 3 (7%). Chemotherapy regimens used were FC in 38 (83%), FCR 5(11%), chlorambucil 2(4%) and CVP in 1(2%) patient. Twenty two (56%) patients had CR, 13(33%) PR, 3(7.6 %) SD, and 1(2.5%) had PD. ORR was 89%. Median PFS was 23.1 months and median 3 years OS was 55%.Conclusion:Majority of patients was in a relatively younger age group and presented with advanced stage disease requiring treatment. Small number of patients received rituximab due to cost. PFS and OS are comparable with published literature.

Objective:To determine the outcome of patients with early-stage (stage I-II) favorable risk classical Hodgkin lymphoma treated with chemotherapy alone or combined modality treatment (CMT) utilizing chemotherapy and involved field radiotherapy.Methods:This retrospective study was done at Department of Medical oncology, Shaukat Khanum Memorial Cancer Hospital & Research Centre, Lahore, Pakistan from January 2004 to December 2013.Results:There were 101 patients, with male predominance (71.3%). Mean age was 34 years. Sixty three (62.4%) patients received CMT and 38 (37.6%) patients had chemotherapy alone. Ninety eight percent patients had ABVD chemotherapy. Dose of radiotherapy ranged from 20 to 36 gray. Difference between baseline characteristics and major toxicities among the two groups was insignificant. Patients treated with CMT had better overall survival compared to chemotherapy alone: 100% versus 91% at five years and 96% versus 81% at 10 years, respectively (p=0.03). Progression free survival was also better with CMT against chemotherapy alone at five years (98% versus 81%) and 10 years (82% versus 71%) (p=0.01).Conclusion:Favorable risk classical Hodgkin lymphoma patients had better overall survival and progression free survival when treated with CMT against chemotherapy alone

Objectives: To determine the frequency of Hepatitis C infection in patients with ischemic Stroke at CMCH Larkana. Study Design: Cross-sectional study. Setting: Medical wards of Shaheed Mohtarma Benazir Bhutto Medical University Larkana. Period: From January 2018 to December 2018. Material & Methods: This study was conducted on 125 diagnosed ischemic stroke patient with age >18 years or both genders. Patients with sudden history of partial or complete weakness of half the body persisting for more than 24 hours and clinical examination supporting reduced power and presence of focal sign and CT brain showing hypodense area in respected blood supply. Patients were considered suffering from Hepatitis C who were reactive to anti HCV on second generation ELISA. Results: We surveyed 125 patients admitted with clinical diagnosis of ischemic stroke after exclusion criteria with mean age of 54.53 ± 10.994. In this study male were 51.2% and female were 48.8%. About 40 (32% patients were anti HCV reactive. Conclusion: It is revealed that HCV infection significantly increased the risk of stroke.

Objective: To study the pattern of existing common pathogen of Urinary Tract Infection and their drug sensitivity pattern. Methods: It was a cross sectional study held in Medical Unit-I, CMC Teaching Hospital, Shaheed Mohtarma Benazir Bhutto Medical University(SMBBMU), Larkana with collaboration of Pathology Laboratory CMC Larkana, Aga Khan University Hospital Lab, Rahila Research Lab and Chughtai Lab. All the participants meeting inclusion criteria were enrolled. The reports of Urine culture were collected from above mentioned laboratories which include bio data, causative organism, their count and drug sensitivity pattern. The results were copied on proforma by researcher himself. SPSS version 25 was applied for data analysis. Results: Total 302 participants were registered in the study. Out of them 75.8% of them were female and 24.2% were male. Mean age of the patients was 40 ± 9 years. E-coli was found in 52.3%, Enterococcus in 13.2% and Klebsiella pneumonia in 9.6% cases. Meropenem was found sensitive in 92.4%, while cefoperazone sulbactam, Amikacin and Fosfomycin were found to be sensitive in 86.6%, 85%, 76.2% respectively. Ampicillin and Vancomycin was used in 50 cases for Enterococci. Ampicillin was found sensitive in 70% of cases where as vancomycin was found sensitive in 100% of cases with no vancomycin resistant Enterococci. For Enterobacteria Moxifloxacin was found resistant in 84.4% of cases, Ampicillin in 83.5%, Nalidix acid in 78% cases. While Ceftazidime and Amoxiclav was found resistant in 71.1% and 54.1% respectively. Conclusion: E-coli, Enterococcus and klabsella were the most pathogens found in this study. The drug sensitivity pattern showed that Meropenem, Cefoperazone Sulbactam, Amikacin, Fosfomycin and Vancomycin were found commonly sensitive while Moxifloxacin, Ampicillin, Ceftazidime and Amoxiclav was found resistant. Keywords: Urinary Tract Infection, Culture and Sensitivity, Meropenem, Vancomycin, Cefoperazone Sulbactam CMC @ SMBBMU, Larkana.