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Background: The most common malignancy and second most common cause of death is breast cancer among women. About 2.09 million fatalities from breast cancer happened in 2018. The objective was to evaluate the elevated CA15-3 in breast cancer patients with visceral metastases presenting at the tertiary care hospital of Karachi. Methods: It was a cross-sectional study conducted at the Department of Oncology of Jinnah Postgraduate Medical Center from 15th December 2018 to 15th November 2019. Female patients aged 26-80 years diagnosed with visceral metastatic (defined as metastasis to lung, liver, brain and adrenal glands) breast cancer were included in the study. The diagnosis of breast cancer was confirmed on histopathology whereas the metastatic sites were evaluated using physical examination and imaging. The serum CA15-3 concentration was assessed using assay kits. The serum CA15-3 level of 0-32 U/ml was taken as normal range for all the patients whereas CA15-3 level greater than 32 U/L was considered as elevated CA15-3. SPSS version 23 was used to enter and analyze data. Results: A total of 139 females were included in the study. The mean age & BMI of the patients were reported as 46.5 years & 26.69 kg/m². In the majority of the patients' metastases were detected in the liver (n=54), 92 in the lungs+ parenchymal disease, 20 in adrenal glands, 12 in pleural effusion and 10 in the brain. Out of 139 patients with visceral metastases, 52(37.4%) had normal CA15-3 level whereas 87 (62.6%) had elevated serum CA15-3 levels (>32 U/L). Conclusion: The serum CA15-3 tumour marker is elevated significantly in visceral metastases and can be used as a prognostic marker in metastatic breast cancer patients. [ABSTRACT FROM AUTHOR]

Background: To evaluate the effect of Tamoxifen on plasma lipid profile in breast cancer patients presenting at tertiary care hospitals. Methods: It was a longitudinal study conducted at the Department of Oncology of Jinnah Postgraduate Medical Center from December 2018 to November 2019. Eighty-eight females aged 26-66 years diagnosed with breast cancer were included in the study using a non-probability consecutive sampling technique. Detailed gynaecological and clinical investigations and detailed history were taken. The blood samples of all the patients were collected and the plasma lipid profile was measured before initiation of Tamoxifen treatment and three- and six-months post-treatment at the clinical laboratory. The plasma lipid profile includes the measurement of Total cholesterol (mg/dl), Triglyceride(mg/dl), High-density Lipoprotein (mg/dl) & Low-density Lipoprotein (mg/dl). SPSS version 23 was used to analyse data. Results: After treatment, there was a significant reduction in serum cholesterol & Low-density Lipoprotein level by 20.54 mg/dl & 16.46 mg/dl at 3 months (p<0.05), moreover there was a significant increase in Triglyceride by 22.14 at 3 months (p<0.05). No significant difference was observed in High density lipoprotein level at 3 months after using Tamoxifen. At 6 months there was a significant reduction in serum cholesterol and low-density lipoprotein by 32.29mg/dl and 24.11 mg/dl at 6 months (p<0.05), moreover there was a significant increase in Triglyceride level by 42.19 mg/dl at 6 months (p<0.05). No significant difference was observed in High-density lipoprotein level at 6 months after using Tamoxifen. Conclusion: Total cholesterol and Low-density Lipoprotein levels showed significant reduction over the period of six months from the baseline with the use of Tamoxifen. Hence Tamoxifen should be considered to have an added advantage on lipid metabolism and therefore, can reduce the risk of cardiovascular events. [ABSTRACT FROM AUTHOR]

Objective: To see the frequency of hepatitis B and C virus among patients presenting with non-Hodgkin's lymphoma and to see its association with pathological factors in Pakistani population. Study Design: Cross sectional study. Place and Duration of the study: Department of Medical oncology, Jinnah Postgraduate Medical Center, Karachi Pakistan, from Jan 2019 to Jan 2020. Methodology: Total 251 patients of age more than 15 years of either gender with proven diagnosis of non-Hodgkin's Lymphoma were enrolled in the study. The sample of blood (15 ml) of each participants was taken and sent to laboratory for detection of virus. The HBsAg and HCV antibodies were detected using 3rd generation Enzyme-Linked Immunosorbent Assay (ELISA). The cut-off set for HBsAg as 2.0 and for HCV as 1.0 in the laboratory, respectively. The information regarding socio-demographics, comorbidities, risk factors and clinicopathological features were noted on pre-designed proforma. Results: Out of 251 patients with non-Hodgkin's Lymphoma, 8.8% had hepatitis and 4% had hepatitis B No statistically significant association was found for prevalence of hepatitis B and C with respect to stage (p=0.791 and 0.299), histological type (p=0.165 and 0.398), bone marrow involvement (p=0.692 and 0.163) and site of tumor (p=0.067 and 0.116). Conclusion: The substantial proportion of hepatitis B and C in the current study provides epidemiological evidence that such infection may play a role in NHL growth. [ABSTRACT FROM AUTHOR]

Objective: to find an association between the serum CA-125 level and the histopathological type of ovarian tumor. Study Design: Cross-sectional study. Place and Duration of Study: Medical Oncology, Jinnah postgraduate Medical Center, Karachi Pakistan from Jan 2018 to Dec 2019. Methodology: This study included 107 patients presenting with epithelial ovarian cancer. In each case, histological type, pathological stage, degree of differentiation and serum CA-125 was evaluated. The association between preoperative CA-125 and histopathological type of tumor were evaluated. Result: About 107 ovarian cancer patients were included. The mean age in our study was 50.80±10.16 years. Raised CA-125 level was found in most of the patients with serous histology 46(56.1%). Conclusion: Serum level CA-125 elevated in most patients with serous histology. A statistically non-significant association was found between raise CA-125 levels and histological types of ovarian cancer. [ABSTRACT FROM AUTHOR]

Objective: To determine the association of ABO blood groups with clinicopathological factors among gastric cancer patients. Study type, settings & duration: This cross-sectional study conducted at the Department of Medical Oncology, Jinnah Postgraduate Medical Centre, Karachi from January 2019 to March 2020. Methodology: All the patients with confirmed diagnosis of gastric cancer of age from 15-90 years and of either gender were included in the study on the basis of convenience sampling. Type of ABO blood group was identified from laboratory and from blood transfusion section of the hospital. The socio-demographic and clinicopathological data was also recorded on pre-designed proforma. SPSS version 23 was used to analyse data. Results: The mean age of the study sample was 48.31±12.36 years (range: 19-85 years). Out of 144 gastric cancer patients, 51 patients had A type 35.4%, 45 had type B 31.3%, 40 had type O 27.8% and 8 had AB type of blood (5.6%). There was statistically significant association between ABO blood type grade and stage of tumour (p =0.013) and (p =0.05) respectively. Conclusion: Blood group A is the most common blood group found in patients with gastric tumour. Pathologically well differentiated tumour grade is most common grade seen in blood group O, whereas tumour stage III is observed in blood group type B. [ABSTRACT FROM AUTHOR]

Background: Diagnostic karyotyping analysis is routinely used in acute myeloid leukaemia (AML) clinics. Categorization of patients into risk stratified groups (favourable, intermediate and unfavourable) according to cytogenetic findings can serve as a valuable independent prognostic factor. The aim of this study was to assess the one-year disease free survival rate in AML patients after induction remission presenting at tertiary care hospital of Karachi. Methods: It was a longitudinal study conducted at the department of Medical oncology of Jinnah Postgraduate Medical Center, Karachi from Jun 2017–Jan 2019. Ninety-three diagnosed cases of AML of age 15-55 years of either gender were included in the study. All patients received the first cycle of “3+7” regime for induction chemotherapy. This includes Daunorubicin 45 mg/m² on days 1 to 3 and Cytarabine in a dose of 100 mg/m² from day 1–7. Marrow response was assessed on the 21th day of induction therapy. If the bone marrow includes lesser than five percent blast cells then it was labelled as complete remission (CR). The patients who achieved CR and normal haematopoiesis were eligible to receive 4 cycles of consolidation therapy with cytarabine 3 mg/m² every 12 hour on days 1, 3 and 5. Consolidation cycles were monthly administered. All the patients who achieved CR were follow up for the duration of one year for disease free survival. On follow up monthly visits, outcomes were assessed using CBC report and physical examination. Results: After 1 year, out of 72 AML patients, 19 patients remained in complete remission, 5 patients lost to follow up, 3 relapses, 19 showed persistent disease & 28 died during consolidation. According to cytogenetic status, CR was achieved in 6 patients (50%) with favourable cytogenetic, 14 patients (28%) with intermediate cytogenetic and 2 patients (20%) with unfavourable cytogenetic status. The highest median survival time was observed in patients with favourable cytogenetic status as 5.23 months. However, there was no significant difference was observed in survival time with respect to cytogenetic status. Conclusion: The “3+7” regime of Daunorubicin & Cytarabine is effective in inducing induction remission and increases 1 year survival, however chemotherapy related morality rate was high in unfavourable cytogenetic group. [ABSTRACT FROM AUTHOR]

Objective: To determine the prevalence of histological subtypes of breast cancer and its association with age, molecular subtype, menopausal status, parity, obesity and tumor grade. Study Design: Prospective, observational study. Place and Duration of Study: The current study was conducted at Oncology Ward-4, Jinnah Postgraduate Medical Center, Karachi, Pakistan, from Apr 2018 to Sep 2019. Methodology: Non-probability convenience technique was used for the sample selection. All patients with diagnosed breast cancer presenting at Oncology ward, Jinnah Postgraduate Medical Center were included in the study. Cases with a non-confirmed diagnosis of breast cancer or those with unknown histological subtype were excluded from the study. Statistical package for Social Sciences (SPSS version 25) was used to analyze the data. Chi-Square test was used to find the association of histological subtypes with age, molecular subtype, menopausal status, parity, obesity, grade of tumor among breast cancer patients. Results: A total of 553 cases of breast cancer patients were reviewed in the study. The mean age of participants was 46.75 ± 10.852 years. We found a frequency of 91.3% of Invasive Ductal Carcinoma (not otherwise specified) among women in our setting. The other rare types of cancer included invasive lobular carcinoma 2%, metaplastic 1.4%, and invasive micropapillary carcinoma 1%. Invasive ductal carcinoma (not otherwise specified). Invasive lobular carcinoma were significantly associated with luminal A type disease (p<0.05) while metaplastic was associated with basal type disease (p=0.006). Conclusion: The most common histological subtype of breast carcinoma in our study population was invasive ductal carcinoma (not otherwise specified). However, various rarer variants of invasive ductal carcinoma were also reported. Histological subtypes play a pivotal role in predicting the behavior and clinical outcome of breast carcinomas. [ABSTRACT FROM AUTHOR]

Background: Acute myeloid leukaemia (AML) is malignant neoplasms of myeloid cells categorized by clonal expansion of hematopoietic blasts of myeloid lineage in peripheral blood and bone marrow. The aim of current study is to identify the common cytogenetic abnormalities in AML patients presenting at a tertiary care hospital of Pakistan. Methods: It was a cross-sectional study conducted at the department of Medical oncology of the Jinnah Postgraduate Medical Center, Karachi from Jun 2017- Jan 2019. The non-probability consecutive sampling technique was used to select patients. Total 92 cases of AML of age 15–55 years of either gender were included in the study. The detection of cytogenetic abnormality was done on the bone marrow biopsy. The cytogenetic abnormalities were classified into the three cytogenetic risk groups as favourable, intermediate and unfavourable. For analysis of data SPSS 23 version was used. Results: The cytogenetic abnormalities were detected in 34 (37%) of the AML patients while 58 (63%) patients had normal cytogenetic. Thirty-two females (34.8%) had a normal cytogenetic (46; XX), and 15 females (16.3%) had various cytogenetic abnormalities. Twenty-six males (28.3%) had normal cytogenetic (46; XY) and 19 males (20.7%) had various cytogenetic abnormalities. Most of the patients were in intermediate risk group (67.4%), followed by favourable (17.4%) and unfavourable risk group (15.2%). The most frequent chromosomal abnormalities observed were complex cytogenetic which was detected in 5 AML patients. Conclusion: In the present study cytogenetic abnormalities were found in 37% of AML patients. Sixty-seven of the AML patients were in intermediate risk group and five patients had complex cytogenetic. Hence the cytogenetic analysis provides significant information regarding prognosis of AML patients and the cytogenetic abnormalities are less than international literature. [ABSTRACT FROM AUTHOR]

BACKGROUND: Pre eclampsia is the commonest obstetrical complication in pregnant women. The etiology of pre eclampsia has yet not been clearly understood. It has a worldwide prevalence of 2-10% of pregnancies and one of the major causes of increase in maternal and perinatal morbidity and mortality. Zinc plays an important role in the course and eventual outcome of human pregnancy and is essential for normal embryogenesis and fetal growth. Zinc deficiency in pregnancy is thought to be associated with pre-eclampsia. OBJECTIVE: The aim of this study was to investigate the serum zinc level in pre-eclampsia. PATIENTS AND METHODS: This Hospital based study conducted at Gynecology Department of Indus Medical Collage, Tando Muhammad Khan, Sindh from October 2015 to March 2016 with the Permission of Head of the Department and Principal of Institute. The study groups consist of 40 consecutive diagnosed cases of pre eclampsia and 40 women with normal pregnancies. The serum zinc level of the subjects under this study was determined using Atomic Absorption Spectrophotometer. RESULTS: The results of our study showed that serum Zinc level among the pre-eclamptic and was statistically significantly low as compared to normotensive pregnant women. CONCLUSION: The findings of current work are statistically significant to establish that concentration of serum zinc among preeclamptic subjects is lower than in the normotensive women during pregnancy. [ABSTRACT FROM AUTHOR]

Background: To evaluate the effect of Tamoxifen on plasma lipid profile in breast cancer patients presenting at tertiary care hospitals., Methods: It was a longitudinal study conducted at the Department of Oncology of Jinnah Postgraduate Medical Center from December 2018 to November 2019. Eighty-eight females aged 26-66 years diagnosed with breast cancer were included in the study using a non-probability consecutive sampling technique. Detailed gynaecological and clinical investigations and detailed history were taken. The blood samples of all the patients were collected and the plasma lipid profile was measured before initiation of Tamoxifen treatment and three- and six-months post-treatment at the clinical laboratory. The plasma lipid profile includes the measurement of Total cholesterol (mg/dl), Triglyceride(mg/dl), High-density Lipoprotein (mg/dl) & Low-density Lipoprotein (mg/dl). SPSS version 23 was used to analyse data., Results: After treatment, there was a significant reduction in serum cholesterol & Low-density Lipoprotein level by 20.54 mg/dl & 16.46 mg/dl at 3 months (p<0.05), moreover there was a significant increase in Triglyceride by 22.14 at 3 months (p<0.05). No significant difference was observed in High density lipoprotein level at 3 months after using Tamoxifen. At 6 months there was a significant reduction in serum cholesterol and low-density lipoprotein by 32.29mg/dl and 24.11 mg/dl at 6 months (p<0.05), moreover there was a significant increase in Triglyceride level by 42.19 mg/dl at 6 months (p<0.05). No significant difference was observed in High-density lipoprotein level at 6 months after using Tamoxifen., Conclusions: Total cholesterol and Low-density Lipoprotein levels showed significant reduction over the period of six months from the baseline with the use of Tamoxifen. Hence Tamoxifen should be considered to have an added advantage on lipid metabolism and therefore, can reduce the risk of cardiovascular events.

Background: The most common malignancy and second most common cause of death is breast cancer among women. About 2.09 million fatalities from breast cancer happened in 2018. The objective was to evaluate the elevated CA15-3 in breast cancer patients with visceral metastases presenting at the tertiary care hospital of Karachi., Methods: It was a cross-sectional study conducted at the Department of Oncology of Jinnah Postgraduate Medical Center from 15th December 2018 to 15th November 2019. Female patients aged 26-80 years diagnosed with visceral metastatic (defined as metastasis to lung, liver, brain and adrenal glands) breast cancer were included in the study. The diagnosis of breast cancer was confirmed on histopathology whereas the metastatic sites were evaluated using physical examination and imaging. The serum CA15-3 concentration was assessed using assay kits. The serum CA15-3 level of 0-32 U/ml was taken as normal range for all the patients whereas CA15-3 level greater than 32 U/L was considered as elevated CA15-3. SPSS version 23 was used to enter and analyze data., Results: A total of 139 females were included in the study. The mean age & BMI of the patients were reported as 46.5 years & 26.69 kg/m2. In the majority of the patients' metastases were detected in the liver (n=54), 92 in the lungs+ parenchymal disease, 20 in adrenal glands, 12 in pleural effusion and 10 in the brain. Out of 139 patients with visceral metastases, 52(37.4%) had normal CA15-3 level whereas 87 (62.6%) had elevated serum CA15-3 levels (>32 U/L)., Conclusion: The serum CA15-3 tumour marker is elevated significantly in visceral metastases and can be used as a prognostic marker in metastatic breast cancer patients.