Search

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: Tamoxifen is a selective oestrogen receptor modulator; in the breast, it decreases the growth and proliferation of breast epithelial cells. We assessed the weight change after Tamoxifen use in breast cancer patients. Methods: This was a single-centred, prospective, observational cohort study. All patients diagnosed with breast cancer with ER and/or PR positivity were enrolled in the study. Out of these, 90 patients who have been prescribed Tamoxifen treatment either in adjuvant or palliative setting gave their consent to participate. Demographic data, treatment plan, menstrual status, weight, BMI, serum fasting lipid profile, change in diet, and change in physical activity were recorded at the time of diagnosis and then quarterly until 1 year of treatment. Results: A mean age of 42.12±8.5 years was reported, and the mean weight was 62.22±10.6 kg. The majority of the patients, i.e., 68 (75.55%) had advanced tumour stages (III and IV). The study reported that the mean weight of the patients changed significantly at different time intervals during the treatment course (p<0.0005). Moreover, there was an upward trend in weight from the time of starting Tamoxifen to 3-months (62.22±1.51 kg vs 62.88±1.45 kg, respectively). There was a statistically significant increase in weight at 6-month, 9-month, and 12-month of Tamoxifen treatment (63.72±1.46 kg, 64.35±1.42 kg, 65.12±1.44 kg, respectively). Also, most of the patients gained weight as time passed by. Conclusion: This study indicated that Tamoxifen has a significant correlation with the increase in weight in hormone receptor-positive breast cancer patients in our population. [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]

Previous research into written language comprehension has been equivocal as to whether word frequency and contextual predictability effects share an early time course of processing. Target word frequency (low, high) and its predictability from prior context (low, high) were manipulated across two-sentence passages. Context sentences were presented in full, followed by word-by-word presentation (300 ms SOA) of target sentences. ERPs were analysed across left-to-right and anterior-to-posterior regions of interest within intervals from 50 to 550 ms post-stimulus. The onset of significant predictability effects (50–80 ms) preceded that of frequency (P1, 80–120 ms), while both main effects were generally sustained through the N400 (350–550 ms). Critically, the frequency-predictability interaction became significant in the P1 and was sustained through the N400, although the specific configuration of effects differed across components. The pattern of findings supports an early, chronometric locus of contextual predictability in recognising words during reading. [ABSTRACT FROM AUTHOR]

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.