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Patients having esophageal cancer can experience psychological, emotional, physical, social, financial and spiritual changes following surgery. Exploration of such challenges, particularly from the Patient’s perspective has been limited in Pakistan. Objective: To explore the experiences of post-esophagectomy patients admitted in Lady Reading Hospital Peshawar Pakistan. Methods: A qualitative phenomenological study was conducted on ten patients having esophagectomy admitted at Lady Reading Hospital Peshawar. Participants were selected through None Probability purposive sampling technique. Permission was taken from concerned departments as well as from participants before data collection. An interview topic guide was used for Face-to-face individual, in-depth interviews. Audio recorded, transcribed, and analyzed through thematic analysis. Results: Five major themes were constructed i.e., Physical changes, psychological effects, social issues and support, financial issues, acceptance, and adjustment to a new changed way of life. Conclusions: Post-esophagectomy patients need full support in adjustment to their physical, psychological, emotional, social, financial, and spiritual aspects of life. Family, friends, and society could be an effective channel in this regard. Government should provide medical and financial support to such patients for their treatment as well as for their rehabilitation.

peer-reviewed, Introduction Epidemiological studies that investigate alterations in the gut microbial composition associated with smoking are lacking. This study examined the composition of the gut microbiome in smokers compared with non-smokers. Methods Stool samples were collected in a cross-sectional study of 249 participants selected from the Health Effects of Arsenic Longitudinal Study (HEALS) in Bangladesh. Microbial DNA was extracted from the fecal samples and sequenced by 16S rRNA gene sequencing. The associations of smoking status and intensity of smoking with the relative abundance or the absence and presence of individual bacterial taxon from phylum to genus levels were examined. Results The relative abundance of bacterial taxa along the Erysipelotrichi-to-Catenibacterium lineage was significantly higher in current smokers compared to never smokers. The odds ratio comparing the mean relative abundance in current smokers with that in never smokers was 1.91 (95% confidence interval [CI] = 1.36 to 2.69) for the genus Catenibacterium and 1.89 (95% CI = 1.39 to 2.56) for the family Erysipelotrichaceae, the order Erysipelotrichale, and the class Erysipelotrichi ((FDR-adjusted p-values = 0.0008 to 0.01). A dose-response association was observed for each of these bacterial taxa. The presence of Alphaproteobacteria was significantly greater comparing current with never smokers (OR = 4.85, FDR-adjusted p-values = 0.04). Conclusions Our data in a Bangladeshi population are consistent with evidence of an association between smoking status and dosage with change in the gut bacterial composition. Implications This study for the first time examined the relationship between smoking and the gut microbiome composition. The data suggest that smoking status may play an important role in the composition of the gut microbiome, especially among individuals with higher levels of tobacco exposure.