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Objectives: To evaluate the effect of immediate breast reconstruction with mastectomy in the local population., Methods: The quasi-experimental, control study was conducted at the Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan, and comprised patient data from April 2017 to December 2020, of breast cancer patients who underwent mastectomy with or without immediate breast reconstruction. Those who underwent mastectomy were labelled as control group A, while patients with immediate breast reconstruction were labelled as intervention group B. Data was analysed using SPSS 20., Results: Of the 66 patients, 33(50%) were in each of the 2 groups. Group B had significantly more patients aged <40 years than group A (p=0.01), more patients with graduate-level education (p=0.04), and more patients who were either unmarried or divorced (p=0.05) than group A. Group B patients had higher mean scores for satisfaction with breasts (p=0.001) and psychosocial wellbeing (p=0.001) than those in in group A. Mean scores for adverse effects of radiotherapy were significantly higher in group B than in group A (p=0.04)., Conclusions: Better health-related outcomes were reported by patients who underwent immediate breast reconstruction with mastectomy.

Objectives: To determine the effectiveness of specimen mammography in breast conserving surgery cases with respect to reduction in margin positivity rate, and to see whether the rate of secondary surgeries is decreased by intra-operative excision based on specimen mammography evaluation., Methods: The retrospective study was conducted at the Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan, and comprised data from January 2018 to December 2019 related to all female breast cancer patients who underwent mastectomy or breast conserving surgery with the involvement of specimen mammography. Sensitivity, specificity, positive predictive value and negative predictive value of specimen mammography were calculated. Data was analysed using SPSS 20., Results: Of the 226 patients initially assessed, 65(28.7%) were excluded, and the final sample comprised 161(71.2%) women with mean age 46.71±10.47 years. The sensitivity, specificity, positive predictive value and negative predictive value of specimen mammography for the sample were 65.8%, 80.8%, 54% and 87.3%, respectively. Performing specimen mammography for intra-operative margin assessment in 12 patients was likely to spare one patient from re-excision., Conclusions: Intra-operative specimen mammography was found to be a reliable tool for assessing margin status.

Objective: To determine false negative rate, negative predictive value and the factors predicting false negativity of pre-treatment axillary ultrasound., Methods: The retrospective study was conducted at Shaukat Khanum Memorial Cancer Hospital, Lahore, Pakistan, and comprised data from January 2019 to December 2020 of patients with normal lymph nodes on ultrasound, tumour stages T1, T2 or T3 having invasive cancer who underwent sentinel lymph node biopsy. Ultrasound findings were compared with the biopsy results, dividing the sample into false negative group A and true negative group B. Clinical, radiological, histopathological parameters and therapeutic strategies were compared between the two groups. Data was analysed using SPSS 20., Results: Of the 781 patients with mean age 49.39±11.51 years, 154(19.7%) were in group A and 627(80.2%) were in group B, with negative predictive value of 80.2%. Initial tumour size, histopathology, tumour grade, receptors, timing of chemotherapy, and type of surgery has significant difference between the groups (p<0.05). Multivariate analysis showed larger, high-grade, progesterone receptor negative and human epidermal growth factor receptor 2 positive tumours were significantly associated with lower false negative rate on axillary ultrasound (p<0.05)., Conclusions: Axillary ultrasound was found to be effective in ruling out axillary nodal disease, especially in patients with high-burden axillary disease, aggressive tumour biology, larger tumour size and higher timour grade.

This study was to formulate Aloevera extract loaded emulsion (O/W) based gels, by using various concentrations of rose oil, olive oil and Lemon oil as natural penetration enhancers for transdermal effect to treat skin problems. By using RSM, Aloevera emulgels were formulated and then optimized. Stability studies, physico-chemical characteristics, spreadability, skin protection factor, thermal analysis, FTIR, antimicrobial activity, in vitro drug release study (at 37ºC with 100 rpm for 180 minute in release medium at pH 5.5) and in vivo skin evaluation tests were performed. The results were then statistically analyzed. Among all formulations, G12 has shown maximum 93.53% Aloevera release at higher concentration of Olive oil with decreased concentration of Rose oil and Lemon oil. Analysis of variance (ANOVA) was conducted to evaluate the results exhibited independent variables have remarkable effects on dependent variables. Contour plot is also drawn to express the response between independent and dependent variables. All formulations have followed Korsmeyer-Peppas kinetic model. In summary, the combination of penetration enhancers in Aloevera emulgel can be successfully utilized for treatment of mild-moderate acne vulgaris and other skin problems, as optimized emulgel has shown good permeability, prolonged residence time on skin surface and proved good anti-microbial activity.

Objective: To analyse outcomes of breast conservation surgery and to identify the factors that could have affected the outcomes., Methods: The retrospective study was conducted at the Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan, and comprised data of breast conservation surgery cases done between January 2011 and October 2014 in order to cover up for the 5-year follow-up of the last enrolled patient. Data, obtained through the institutional information and database system, included disease-recurrence, 5-year disease-free survival and overall survival. Data was statistically analysed using SPSS 20., Results: Of the 553 cases, 417(75%) had no loco-regional recurrence or distant metastasis, while 136(25%) had some form of loco-regional, distant or contralateral metastasis at 5-year follow-up. In patients who had recurrence or metastasis, only progesterone receptor status, nodal status and mode of treatment showed significant association (p<0.05). Mortality at 5-year follow-up was 77(14%). Amongst the patients who died, only progesterone receptor status and nodal status had significant association (p<0.05). Five-year overall survival for the cohort was 476(86%), whereas 5-year disease-free survival was 409(74%)., Conclusion: Breast conservation surgery was found to have favourable outcomes, while progesterone status, nodal involvement and mode of treatment significantly affected the outcome.