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Akhtar S, Hassan F, Ahmad S, El-Affendi MA, Khan MI. The prevalence of prostate cancer in Pakistan: A systematic review and meta-analysis. Heliyon 2023; 9:e20350. [PMID: 37767511 PMCID: PMC10520826 DOI: 10.1016/j.heliyon.2023.e20350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 09/17/2023] [Accepted: 09/19/2023] [Indexed: 09/29/2023] Open
Abstract
Background Prostate cancer is a significant public health issue, ranking as the second most common cancer and the fifth leading cause of cancer-related deaths in men. In Pakistan, the prevalence of prostate cancer varies significantly across published articles. This study aimed to determine the pooled prevalence of prostate cancer and its associated risk factors in Pakistan. Methods MEDLINE (via PubMed), Web of Science, Google Scholar, and local databases were searched from inception until March 2023, using key search terms related to the prevalence of prostate cancer. We considered a random-effects meta-analysis to derive the pooled prevalence and relative risks with 95% CIs. Two investigators independently screened articles and performed data extraction and risk of bias analysis. We also conducted meta-regression analysis and stratification to investigate heterogeneity. This study protocol was registered at PROSPERO, number CRD42022376061. Results Our meta-analysis incorporated 11 articles with a total sample size of 184,384. The overall pooled prevalence of prostate cancer was 5.20% (95% CI: 3.72-6.90%), with substantial heterogeneity among estimates (I2 = 98.5%). The 95% prediction interval of prostate cancer was ranged from 1.74%-10.35%. Subgroup meta-analysis revealed that the highest pooled prevalence of prostate cancer was in Khyber Pakhtunkhwa (8.29%; 95% CI: 6.13-10.74%, n = 1), followed by Punjab (8.09%; 95% CI:7.36-8.86%, n = 3), while the lowest was found in Sindh (3.30%; 95% CI: 2.37-4.38%, n = 5). From 2000 to 2010 to 2011-2023, the prevalence of prostate cancer increased significantly from 3.88% (95% CI: 2.72-5.23%) to 5.80% (95% CI: 3.76-8.24%). Conclusions Our meta-analysis provides essential insights into the prevalence of prostate cancer in Pakistan, highlighting the need for continued research and interventions to address this pressing health issue.
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Affiliation(s)
- Sohail Akhtar
- Department of Mathematics and Statistics, The University of Haripur, Haripur, Pakistan
| | - Fazal Hassan
- Department of Mathematics and Statistics, The University of Haripur, Haripur, Pakistan
| | - Sadique Ahmad
- EIAS: Data Science and Blockchain Laboratory, College of Computer and Information Sciences, Prince Sultan University, Riyadh, 11586, Saudi Arabia
| | - Mohammed A. El-Affendi
- EIAS: Data Science and Blockchain Laboratory, College of Computer and Information Sciences, Prince Sultan University, Riyadh, 11586, Saudi Arabia
| | - Muhammad Imran Khan
- Department of Industrial Engineering, Hanyang University, Seoul, South Korea
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2
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Vohra LM, Ali D, Hashmi SA, Angez M. Breast cancer in a teenage girl with BRCA mutation: A case report from a low middle-income country. Int J Surg Case Rep 2022; 98:107513. [PMID: 36027825 PMCID: PMC9424941 DOI: 10.1016/j.ijscr.2022.107513] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 08/09/2022] [Accepted: 08/11/2022] [Indexed: 11/03/2022] Open
Abstract
Introduction Case history Discussion Conclusion The case of the youngest known breast cancer patient in Pakistan. Genetic counseling should be readily offered in low middle-income countries. Triple assessment is a mandatory tool to diagnose a breast lump in any age group. Up-to-date guidelines should be followed for managing breast lumps,
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3
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Mirza FA, Baqai MWS, Hani U, Hulou M, Shamim MS, Enam SA, Pittman T. Comparison of Glioblastoma Outcomes in Two Geographically and Ethnically Distinct Patient Populations in Disparate Health Care Systems. Asian J Neurosurg 2022; 17:178-188. [PMID: 36120611 PMCID: PMC9473826 DOI: 10.1055/s-0042-1750779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Introduction
Variations in glioblastoma (GBM) outcomes between geographically and ethnically distinct patient populations has been rarely studied. To explore the possible similarities and differences, we performed a comparative analysis of GBM patients at the University of Kentucky (UK) in the United States and the Aga Khan University Hospital (AKUH) in Pakistan.
Methods
A retrospective review was conducted of consecutive patients who underwent surgery for GBM between January 2013 and December 2016 at UK, and July 2014 and December 2017 at AKUH. Patients with recurrent or multifocal disease on presentation and those who underwent only a biopsy were excluded. SPSS (v.25 IBM, Armonk, New York, United States) was used to collect and analyze data.
Results
Eighty-six patients at UK (mean age: 58.8 years; 37 [43%] < 60 years and 49 [57%] > 60 years) and 38 patients at AKUH (mean age: 49.1 years; 30 (79%) < 60 years and 8 (21%) > 60 years) with confirmed GBM were studied. At UK, median overall survival (OS) was 11.5 (95% confidence interval [CI]: 8.9–14) months, while at AKUH, median OS was 18 (95% CI: 13.9–22) months (
p
= 0.002). With gross-total resection (GTR), median OS at UK was 16 (95% CI: 9.5–22.4) months, whereas at AKUH, it was 24 (95% CI: 17.6–30.3) months (
p
= 0.011).
Conclusion
Median OS at UK was consistent with U.S. data but was noted to be longer at AKUH, likely due to a younger patient cohort and higher preoperative Karnofsky's performance scale (KPS). GTR, particularly in patients younger than 60 years of age and a higher preoperative KPS had a significant positive impact on OS and progression-free survival (PFS) at both institutions.
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Affiliation(s)
- Farhan A. Mirza
- Department of Neurosurgery, Kentucky Neuroscience Institute (KNI), University of Kentucky, Lexington, Kentucky, United States
- Department of Neurosurgery, The Montreal Neurological Institute (MNI), McGill University, Montreal, QC, Canada
| | - Muhammad Waqas S. Baqai
- Department of Surgery, Section of Neurosurgery, Aga Khan University Hospital, Karachi, Pakistan
| | - Ummey Hani
- Department of Surgery, Section of Neurosurgery, Aga Khan University Hospital, Karachi, Pakistan
| | - Maher Hulou
- Department of Neurosurgery, Kentucky Neuroscience Institute (KNI), University of Kentucky, Lexington, Kentucky, United States
| | - Muhammad Shahzad Shamim
- Department of Surgery, Section of Neurosurgery, Aga Khan University Hospital, Karachi, Pakistan
| | - Syed Ather Enam
- Department of Surgery, Section of Neurosurgery, Aga Khan University Hospital, Karachi, Pakistan
| | - Thomas Pittman
- Department of Neurosurgery, Kentucky Neuroscience Institute (KNI), University of Kentucky, Lexington, Kentucky, United States
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Gupta R, Gupta N, Kumar V, Garg R, Bharati SJ, Mishra S, Bhatnagar S. El-Ganzouri multivariate risk index based airway management in head and neck cancer patients: A retrospective analysis of 1000 patients in a tertiary care center. J Anaesthesiol Clin Pharmacol 2022; 38:97-103. [PMID: 35706626 PMCID: PMC9191799 DOI: 10.4103/joacp.joacp_176_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 05/02/2021] [Accepted: 05/19/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND AND AIMS Intubation in head and neck carcinoma (HNC) is difficult due to many reasons. Various guidelines recommend strategies for airway management in such anticipated difficult airway cases. However, literature is limited on airway management planning as per the level of difficulty based on airway assessment in these patients. EL-Ganzouri risk index (EGRI) has been proposed to aid in making airway management plan in HNC cases by some authors. This retrospective study was conducted to look at the data related to the pre-anesthetic airway assessment and the airway management plan executed by the anesthesiologists in 1000 patients of HNC in the previous nearly four years in order to determine how the choices made conformed to EGRI scores. MATERIAL AND METHODS Records of all the patients with oral cancer posted for surgery over four years from January 2014 to December 2017 were retrospectively analyzed for preoperative airway assessment using El Ganzouri risk index assessment (EGRI), the intraoperative technique for nasotracheal intubation, airway management plan, and any intraoperative complications. RESULTS The risk of predicted airway difficulty was low (EGRI <4) in 38 patients and was high in the rest. The EGRI score was higher in the FOB group [4-9] as compared to DL [2-3] and VL [1-6]. The patients with EGRI >7 were intubated awake and those with EGRI <7 were intubated under general anesthesia (79.8%). Overall, the technique of choice for intubation was fibreoptic bronchoscopy (54%) followed by video laryngoscopy (42.6%). CONCLUSION The airway management plan used in a tertiary care cancer center conformed to the approach suggested by the multivariate El Ganzouri risk index (EGRI). EGRI appears to be a useful means to ascertain the appropriate strategies for intubation in head and neck cancer patients.
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Affiliation(s)
- Raghav Gupta
- Department of Oncoanaesthesia and Palliative Medicine, Dr. BRAIRCH, AIIMS, New Delhi, India
| | - Nishkarsh Gupta
- Department of Oncoanaesthesia and Palliative Medicine, Dr. BRAIRCH, AIIMS, New Delhi, India
- Address for correspondence: Dr. Nishkarsh Gupta, Room no 139, First Floor, Department of Oncoanaesthesia and Palliative Medicine, Dr. BRAIRCH, AIIMS, New Delhi, India. E-mail:
| | - Vinod Kumar
- Department of Oncoanaesthesia and Palliative Medicine, Dr. BRAIRCH, AIIMS, New Delhi, India
| | - Rakesh Garg
- Department of Oncoanaesthesia and Palliative Medicine, Dr. BRAIRCH, AIIMS, New Delhi, India
| | - Sachidanand J. Bharati
- Department of Oncoanaesthesia and Palliative Medicine, Dr. BRAIRCH, AIIMS, New Delhi, India
| | - Seema Mishra
- Department of Oncoanaesthesia and Palliative Medicine, Dr. BRAIRCH, AIIMS, New Delhi, India
| | - Sushma Bhatnagar
- Department of Oncoanaesthesia and Palliative Medicine, Dr. BRAIRCH, AIIMS, New Delhi, India
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Sarwar HA, Iftikhar J, Azhar M, Munawar K, Hanif MR, Abu Bakar M, Siddiqui N. Achieving Complete Radiological and Bio-Chemical Response as a Predictor of Long-Term Survival in Stage IV Epithelial Ovarian Cancer. Cureus 2021; 13:e20017. [PMID: 34987905 PMCID: PMC8716327 DOI: 10.7759/cureus.20017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/29/2021] [Indexed: 11/05/2022] Open
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Bhatti ABH, Sheikh AAE, Mahmud US, Zeeshan S, Khan NY, Zia HH, Dar FS, Rana A. Clinical Profile and Treatment of Hepatocellular Carcinoma: A Single-Center Experience. South Asian J Cancer 2021; 10:76-80. [PMID: 34568219 PMCID: PMC8460341 DOI: 10.1055/s-0041-1729451] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Background
Very few centers in Pakistan have all established treatments for hepatocellular carcinoma (HCC) available under one roof. With a dedicated hepato-pancreato-biliary surgery and liver transplant unit, we have gathered one of the largest data on HCC in our population.
Aims
The objective of the current study was to assess the clinical spectrum of HCC in Pakistani patients.
Settings and Design
This retrospective review of patients diagnosed with HCC was conducted between 2011 and 2016.
Materials and Methods
Patients were allocated to treatment groups based on the Barcelona clinic liver cancer (BCLC) staging algorithm and our local guidelines. The treatment options were grouped as curative (radiofrequency ablation [RFA], percutaneous ethanol injection [PEI], liver resection, and liver transplantation), palliative (transarterial chemoembolization [TACE]/sorafenib), and the best supportive care (BSC).
Statistical Analysis
Kaplan–Meier curves were used for the statistical analysis.
Results
The mean age was 57.9 ± 10.1 years (range: 18–90 years). The male-to-female ratio was (1,099/391) 2.8:1. Hepatitis B and hepatitis C were the most common underlying etiological factor in 1,350 of 1,490 (90.6%) patients. Macrovascular invasion (MVI) was seen in 492 of 1,490 (33%) patients. Out of the total, 191 (12.8%) additional patients were offered potentially curative treatments when compared with BCLC recommendations. The actuarial 5-year overall survival for patients who underwent liver transplant, RFA/PEI, TACE, sorafenib, and BSC was 87, 64, 18, 5, and 0%, respectively. Alpha fetoprotein cut-off of 400 ng/mL had a significant impact on survival irrespective of treatment received (41 vs. 11%,
p
< 0.0001).
Conclusion
MVI is the most frequent poor prognostic marker in our patients with HCC. Local treatment guidelines are effective in yielding comparable outcomes to BCLC.
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Affiliation(s)
- Abu B H Bhatti
- Department of Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Shifa International Hospital, Islamabad, Pakistan
| | - Abdul A E Sheikh
- Department of Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Shifa International Hospital, Islamabad, Pakistan
| | - Umair S Mahmud
- Department of Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Shifa International Hospital, Islamabad, Pakistan
| | - Shagufta Zeeshan
- Department of Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Shifa International Hospital, Islamabad, Pakistan
| | - Nusrat Y Khan
- Department of Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Shifa International Hospital, Islamabad, Pakistan
| | - Haseeb H Zia
- Department of Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Shifa International Hospital, Islamabad, Pakistan
| | - Faisal S Dar
- Department of Hepato-Pancreato-Biliary Surgery and Liver Transplantation, Shifa International Hospital, Islamabad, Pakistan
| | - Atif Rana
- Department of Radiology, Shifa International Hospital, Islamabad, Pakistan
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Qureshi MA, Syed SA, Sharafat S. Lip and oral cavity cancers (C00-C06) from a mega city of Pakistan: Ten-year data from the Dow Cancer Registry. J Taibah Univ Med Sci 2021; 16:624-627. [PMID: 34408617 PMCID: PMC8348287 DOI: 10.1016/j.jtumed.2021.02.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 01/28/2021] [Accepted: 02/01/2021] [Indexed: 11/30/2022] Open
Abstract
Objective The objective of this report is to provide an overview of lip and oral cavity cancer in Karachi, the largest city in Pakistan. Methods This study was undertaken at the Dow Cancer Registry. During 2010–2019, all patients who were residents of Karachi who had been diagnosed with lip and oral cavity cancer were registered and recruited for this study. The data were entered in SPSS and MS Excel sheets to investigate frequencies, age-standardized-rates (ASR) and other clinicopathological parameters. The data from our study were compared with the ASR of lip and oral cavity cancer from selected Asian countries. Results During the defined period, 22,858 cancer cases were registered. Of these, 4,400 (19.2%, ASR 28.0) were lip and oral cavity cancer (the most common type found in males and the second most common type in females), of which 2,986 (67.8%) were found in males, while 1,414 (32.1%) were reported in females. Squamous cell carcinoma was the most common type (97.7%). Most tumours were moderately differentiated (67.7%) followed by poorly (16.6%), and well differentiated (15.7%). Conclusion We report an alarmingly high ASR of lip and oral cavity cancer in Karachi as compared to Pakistan as a whole and other Asian countries.
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Affiliation(s)
- Muhammad A Qureshi
- Department of Pathology, Dow International Medical College, Founding Incharge of the Dow Cancer Registry, Additional Director Dow Labs, Dow University of Health Sciences, Karachi, Pakistan
| | - Sofia Ali Syed
- Department of Oral Pathology, Dow Dental College, Dow University of Health Sciences, Karachi, Pakistan
| | - Shaheen Sharafat
- Department of Pathology, Dow International Medical College, Dow University of Health Sciences Karachi, Pakistan
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8
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Khushk M, Khan A, Rehman A, Sheraz S, Tunio YM, Rehman K, Rehman D, Ahmed M, Abbas K, Khan ME. The Role of Tumor Markers: Carcinoembryonic Antigen and Cancer Antigen 15-3 in Patients With Breast Cancer. Cureus 2021; 13:e16298. [PMID: 34405063 PMCID: PMC8352810 DOI: 10.7759/cureus.16298] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/08/2021] [Indexed: 02/06/2023] Open
Abstract
Introduction Breast cancer is a major cause of mortality among females, worldwide. The present study was intended to evaluate the significance in the management of carcinoembryonic antigen (CEA) and cancer antigen 15-3 (CA15-3) in patients with breast cancer. Methodology A cohort study was conducted at the Jinnah Postgraduate Medical Center, Karachi, Pakistan from June 2020 to May 2021. All diagnosed cases of breast cancer who underwent surgical excision of tumor were eligible to partake. Patients who had metastatic breast cancer or had a recurrence were excluded. The patient’s sociodemographic and clinical data were documented in a predefined pro forma. It included information about the age, sex, weight, as well as serum CEA and CA15-3. The CA15-3 and CEA levels for each patient were assessed by taking a 5ml blood sample and sending it to the laboratory for further workup. preoperatively on the second, seventh, and 28th postoperative days. Results A mean ± SD age of 52.6 ± 8.89 years was reported. Family history of breast cancer was positive in one-fourth of the patients. Nodal metastasis was negative in 114 (46.72%) patients. Three-fourth of patients had Stage II-IV with only a minority diagnosed with Stage I. The mean levels for CA15-3 in women with Stage I cancer was significantly lower on the seventh day and 28th postoperative day, compared to preoperative levels (p = 0.05). Similar associations were seen for stages II and III. Higher CEA levels were significantly associated with stage III breast cancer preoperatively (5.88 ng/ml, p = 0.05) compared to postoperative values. Conclusion The current study revealed that preoperative values of serum CEA and CA15-3 significantly reduced postoperatively. Moreover, patients with advanced cancers had significantly higher levels of both tumor markers than those with less advanced diseases. The current study highlighted the importance of regular assessment of serum CEA and CA15-3 in breast cancer patients. Both these biomarkers are substantially elevated in breast cancer patients, preoperatively. Determining the levels of serum CEA and CA15-3 pre- and postoperatively may determine the prognosis and aid in forming the most optimal patient care regime with respect to the stage and subtype of cancer.
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Affiliation(s)
- Maimoona Khushk
- Department of Surgery, Peoples Medical College Hospital, Nawabshah, PAK
| | - Adil Khan
- Department of Surgery, Shifa International Hospital, Islamabad, PAK
| | - Abdur Rehman
- Department of Medicine, Usman Memorial Hospital, Karachi, PAK
| | - Sehrish Sheraz
- Department of Public Health, Dow University of Health Sciences, Karachi, PAK
| | - Yar Muhammad Tunio
- Department of Medicine, Gambat Institute of Medical Science, Khairpur, PAK
| | - Kubra Rehman
- Department of Medicine, Shaheed Mohtarma Benazir Bhutto Medical College, Karachi, PAK
| | - Duaa Rehman
- Department of Medicine, Liaquat National Hospital and Medical College, Karachi, PAK
| | - Moiz Ahmed
- Department of Medicine, Jinnah Postgraduate Medical Centre, Karachi, PAK.,Department of Medicine and Surgery, Sindh Medical College, Karachi, PAK
| | - Kiran Abbas
- Department of Medicine, Jinnah Postgraduate Medical Centre, Karachi, PAK
| | - Muhammad E Khan
- Department of Oncology, Punjab Institute of Nuclear Medicine and Radiotherapy, Faisalabad, PAK
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9
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Shamsi U, Khan S, Azam I, Usman S, Maqbool A, Gill T, Iqbal R, Callen D. Patient Delay in Breast Cancer Diagnosis in Two Hospitals in Karachi, Pakistan: Preventive and Life-Saving Measures Needed. JCO Glob Oncol 2021; 6:873-883. [PMID: 32579484 PMCID: PMC7328101 DOI: 10.1200/go.20.00034] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
PURPOSE Patients with breast cancer in Pakistan commonly present with advanced disease. The objectives of this study were to evaluate the frequency and length of delays in seeking medical consultation and to assess the factors associated with them. METHODS Four hundred ninety-nine patients with newly diagnosed breast cancer were enrolled and interviewed over the period from February 2015 to August 2017. Information on sociodemographic factors, delay to medical consultation, stage of breast cancer at presentation, and tumor characteristics of the breast cancer were collected through face-to-face interviews and medical file review. RESULTS The mean (standard deviation) age of patients with breast cancer was 48.0 (12.3) years. The mean (standard deviation) patient delay was 15.7 (25.9) months, with 55.2% of women detecting a breast lump but not seeking a medical consultation because of a lack of awareness about the significance of the lump. A total of 9.4% of the women decided to seek treatment initially using complementary and alternative medicine and traditional treatment; 9.4% of the women presented to a health care provider with a breast lump but no action was taken, and they were wrongly reassured about the lump without mammography or biopsy. For 26% of the women, the delay in presentation was caused by anxiety, fears and misconceptions regarding diagnosis and treatment, and other social factors including possible adverse effects on their relationship with their husband. Multivariable analysis showed a strong association of lower socioeconomic status (odds ratio [OR], 8.11 [95% CI, 2.46 to 26.69]) and late stage of breast cancer (OR, 4.83 [95% CI, 1.74 to 13.39]) with a patient delay of ≥ 3 months. CONCLUSION Patient delay is a serious problem in Pakistan. There is an urgent need for intensive and comprehensive breast cancer education that addresses the myths and misconceptions related to breast cancer.
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Affiliation(s)
- Uzma Shamsi
- Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Shaista Khan
- Department of Surgery, Aga Khan University, Karachi, Pakistan
| | - Iqbal Azam
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Shaheryar Usman
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Amir Maqbool
- Department of Oncology, Karachi Institute of Radiation and Nuclear Medicine Hospital, Karachi, Pakistan
| | - Tiffany Gill
- Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Romaina Iqbal
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - David Callen
- Adelaide Medical School, University of Adelaide, Adelaide, Australia
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Mezgebu E, Anwarali S, Durañona M, Challinor J. Pediatric Oncology Nursing Research in Low- and Middle-Income Countries: Exemplars from Three Regions. Semin Oncol Nurs 2021; 37:151168. [PMID: 34148741 DOI: 10.1016/j.soncn.2021.151168] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE This study examined the status of pediatric oncology nursing research in three low- and middle-income countries (LMICs) as examples across three World Health Organization regions: East Africa, Eastern Mediterranean region, and Latin America. DATA SOURCES Published literature was identified from Google Scholar, PubMed, Scielo, Virtual Health Library, and reference lists of some articles. CONCLUSION The experiences of the three LMIC pediatric oncology nurses illustrate the situation of nurse research in their setting and identify relevant published literature. The authors highlight the challenges for nurses to conduct research (eg, lack of training, mentors, funding, and opportunities). Local evidence to inform nursing practice in LMICs is needed. Recommendations for ameliorating the situation include increased advanced practice nurse education, physician and hospital support, funding, and protected time. IMPLICATIONS FOR NURSING PRACTICE Pediatric oncology nursing practice is culturally and context-driven and requires locally acquired evidence to support best practices. Only when sufficient, sustainable, and local nursing research training and education is available in LMICs, will this evidence be generated. Nursing research training (eg, master's and PhD programs), funding, and protected time are three key steps to guide and motivate staff nurses as well as academic nurses to participate in research that informs the care of children and adolescents with cancer across all countries and not only those with significant resources.
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Affiliation(s)
| | - Shenila Anwarali
- Pediatric Oncology Department, Indus Hospital, Karachi, Pakistan
| | | | - Julia Challinor
- School of Nursing, University of California San Francisco, San Francisco, CA.
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11
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Hussain Qureshi MF, Shah M, Lakhani M, Abubaker ZJ, Mohammad D, Farhan H, Zia I, Tafveez R, Khan ST, Rubina G, Shamim M, Ghulam H. Gene signatures of cyclin-dependent kinases: a comparative study in naïve early and advanced stages of lung metastasis breast cancer among pre- and post-menopausal women. Genes Cancer 2021; 12:1-11. [PMID: 33868579 PMCID: PMC8018704 DOI: 10.18632/genesandcancer.209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 12/03/2020] [Indexed: 11/25/2022] Open
Abstract
The Human epidermal growth factor receptor 2 positive (HER2+) breast cancer (BC) is a more aggressive tumor with 5 years median survival rates after metastasis. Despite successful treatment, unfortunately, the majority of affected patients die. Defects in cell cycle and transcription regulation phases which are governed by cyclin-dependent kinases (CDKs) are the hallmark of many cancers that underpinning the progression of the disease. Therefore, the current study looked at the alteration of six CDKs mRNA expression levels in pre- and postmenopausal lung metastasis BC groups; the majority were HER2+. Two hundred pre-and postmenopausal lung metastasis breast cancer and healthy control blood samples were taken for RNA isolation. Quantitative PCR was done for CDKs mRNA expressions. We observed overexpression of CDK11, CDK12, CDK17, CDK18, and CDK19 in both pre- and postmenopausal groups. However, CDK20 showed progressive downregulation from early to advanced stages in both groups of patients. Collectively, this data revealed that CDKs overexpression levels may predict BC disease progression and provide further rationale for novel anticancer strategies for HER2+ BC cancers.
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Affiliation(s)
| | - Muzna Shah
- Medical Students, Ziauddin University, Clifton, Karachi, Pakistan
| | - Mahira Lakhani
- Medical Students, Ziauddin University, Clifton, Karachi, Pakistan
| | | | - Danish Mohammad
- Medical Students, Ziauddin University, Clifton, Karachi, Pakistan
| | - Hira Farhan
- Medical Students, Ziauddin University, Clifton, Karachi, Pakistan
| | - Iman Zia
- Medical Students, Ziauddin University, Clifton, Karachi, Pakistan
| | - Rida Tafveez
- Medical Students, Ziauddin University, Clifton, Karachi, Pakistan
| | | | - Ghani Rubina
- Department of Biochemistry, Sohail University, Karachi, Pakistan
| | - Mushtaq Shamim
- Department of Biochemistry, Ziauddin University, Clifton, Karachi, Pakistan
| | - Haider Ghulam
- Oncology Department, Jinnah Postgraduate Medical Center, Karachi, Pakistan
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12
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Rehman MYA, Taqi MM, Hussain I, Nasir J, Rizvi SHH, Syed JH. Elevated exposure to polycyclic aromatic hydrocarbons (PAHs) may trigger cancers in Pakistan: an environmental, occupational, and genetic perspective. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:42405-42423. [PMID: 32875453 DOI: 10.1007/s11356-020-09088-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 04/27/2020] [Indexed: 05/22/2023]
Abstract
Polycyclic aromatic hydrocarbons (PAHs) are carcinogenic compounds which are emitted through incomplete combustion of organic materials, fossil fuels, consumption of processed meat, smoked food, and from various industrial activities. High molecular mass and mobility make PAHs widespread and lethal for human health. A cellular system in human detoxifies these toxicants through specialized enzymatic machinery called xenobiotic-metabolizing (CYP450) and phase-II (GSTs) enzymes (XMEs). These metabolizing enzymes include cytochromes P450 family (CYP1, CYP2), glutathione s-transferases, and ALDHs. Gene polymorphisms in XMEs encoding genes can compromise their metabolizing capacity to detoxify ingested carcinogens (PAHs etc.) that may lead to prolong and elevated exposure to ingested toxicants and may consequently lead to cancer. Moreover, PAHs can induce cancer through reprograming XMEs' gene functions by altering their epigenetic markers. This review article discusses possible interplay between individual's gene polymorphism in XMEs' genes, their altered epigenetic markers, and exposure to PAHs in cancer susceptibility in Pakistan.
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Affiliation(s)
- Muhammad Yasir Abdur Rehman
- Environmental Biology and Ecotoxicology Laboratory, Department of Environmental Sciences, Faculty of Biological Sciences, Quaid-I-Azam University, Islamabad, PO, 45320, Pakistan
| | | | - Imran Hussain
- Department of Biotechnology, Faculty of Biological Sciences, Quaid-I-Azam University, Islamabad, PO, 45320, Pakistan
- Business Unit Environmental Resources and Technologies, Center for Energy, Austrian Institute of Technology (AIT), Vienna, Austria
| | - Jawad Nasir
- Earth Sciences Directorate, Pakistan Space and Upper Atmosphere Research Commission (SUPARCO), P.O. Box 8402, Karachi, 75270, Pakistan
| | - Syed Hussain Haider Rizvi
- Earth Sciences Directorate, Pakistan Space and Upper Atmosphere Research Commission (SUPARCO), P.O. Box 8402, Karachi, 75270, Pakistan
| | - Jabir Hussain Syed
- Department of Meteorology, COMSATS University Islamabad, Park Road, Tarlai Kalan, Islamabad, 45550, Pakistan.
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Prasad JB, Dhar M. Assessment and projection of burden of cancer due to tobacco in India till 2025. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2020. [DOI: 10.1016/j.cegh.2020.03.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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14
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Gul S, Khan A, Raza A, Khan I, Ehtisham S. Association of XPD Lys751Gln gene polymorphism with susceptibility and clinical outcome of colorectal cancer in Pakistani population: a case-control pharmacogenetic study. Genes Genomics 2020; 42:1389-1398. [PMID: 33025549 DOI: 10.1007/s13258-020-01004-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 09/19/2020] [Indexed: 12/23/2022]
Abstract
BACKGROUND XPD Lys751Gln polymorphism may modulate inter-individual variation in repair capacity of DNA, which may enhance a person's susceptibility to develop colorectal cancer (CRC). The analysis of XPD Lys751Gln polymorphism may provide important information for identifying high-risk individuals and for selecting the most appropriate treatment for poor prognostic CRC patients. OBJECTIVE The overall objective was to find out the association of XPD Lys751Gln gene polymorphism with the risk of having a colorectal cancer and the ultimate clinical outcomes. In this study a total of 300 subjects (CRC and Controls), were genotyped for XPD Lys751Gln. METHODS Using PCR-RFLP methods, the association of XPD Lys751Gln gene polymorphism with the risk of having a colorectal cancer was studied. In addition to overall risk assessment, genotyping results were also investigated with respect to the lifestyle risk factors, patients treated with oxaliplatin-based chemotherapy and clinicopathological characteristics. RESULTS The overall correlation between the XPD Lys751Gln genetic variation and the CRC risk was observed to be significant with both the homozygous variant genotype Gln/Gln as well as heterozygous genotype Lys/Gln being associated with the increased risk of CRC. Additional stratified analyses revealed that XPD Lys751Gln variants remarkably increased risk of CRC in males and younger individuals (≤ 50 years), Naswar users (8.09-fold) and high intake of red meat. CONCLUSIONS Our findings suggest that the relationship between the XPD Lys751Gln variants and lifestyle factors modulates the risk for CRC in Pakistani population.
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Affiliation(s)
- Sumera Gul
- Department of Pharmacy, University of Swabi, Swabi, 23340, Pakistan
| | - Abad Khan
- Department of Pharmacy, University of Swabi, Swabi, 23340, Pakistan.
| | - Abida Raza
- National Institute of Laser and Optronics, Pakistan Atomic Energy Commission, Islamabad, 44000, Pakistan
| | - Ismail Khan
- Department of Pharmacy, University of Swabi, Swabi, 23340, Pakistan
| | - Shumaila Ehtisham
- Department of Statistics, Islamia College Peshawar, Peshawar, 25120, Pakistan
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Qureshi MA, Khan S, Sharafat S, Quraishy MS. Common Cancers in Karachi, Pakistan: 2010-2019 Cancer Data from the Dow Cancer Registry. Pak J Med Sci 2020; 36:1572-1578. [PMID: 33235577 PMCID: PMC7674861 DOI: 10.12669/pjms.36.7.3056] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objectives To present 2010-2019 cancer data from the Dow Cancer Registry representing all districts of Karachi (~17.4 million). Methods The study was conducted at the Dow University of Health Sciences. After ethical approval, the Dow Cancer Registry was established at the largest government-run diagnostic and reference center of Karachi (Dow Labs). All cancers registered during 2010-2019 were analyzed. Patients >18years of age were labeled as adults while those with ages ≤18years were classified as children/young adults. Results During 2010-2019, a total of 22,858 cancers were registered. Of these, 9,112(39.9%) cancers were diagnosed in males while 13,746(60.1%) in females. Incidence rates for all cancers (all ages) were 108/1,00,000 for males and 188.6/1,00,000 for females. In adult males, cancer of lip and oral cavity was the most frequently diagnosed cancer (33.6%), followed by non-melanoma -skin-cancer (NMSC) (7.2%), oesophagus (6.8%), colorectum (6.7%) and stomach (4.9%). In adult females, breast cancer was the most frequently recorded malignancy (53.2%), followed by cancers of lip and oral cavity (10.4%), oesophagus (5.3%), colorectum (3.3%) and NMSC (3%). In children, most common malignancy was that of brain and nervous system (15.3%), followed by Hodgkin's lymphoma (14.2%), colorectum (8.1%), endocrine-&-related organs (8%) and non-Hodgkin's lymphoma (7.8%). Conclusion Cancers of lip and oral cavity and breast cancer were the most common malignancies in males and females respectively. In paediatric group, cancers of brain and nervous system were most common. Alarmingly, Karachi males have highest ASR of cancers of lip and oral cavity compared to any other city of Pakistan.
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Affiliation(s)
- Muhammad Asif Qureshi
- Prof. Dr. Muhammad Asif Qureshi, MBBS, PhD (Glasgow-UK), MA (IR), Postdoc (Germany), CHPE. Department of Pathology, Dow International Medical College, Dow University of Health Sciences Karachi, Karachi - Pakistan
| | - Saeed Khan
- Prof. Dr. Saeed Khan, MSc, PhD, Postdoc (USA). Department of Pathology, Dow International Medical College, Dow University of Health Sciences Karachi, Karachi - Pakistan
| | - Shaheen Sharafat
- Prof. Dr. Shaheen Sharafat, MBBS, M.Phil., PhD. Department of Pathology, Dow International Medical College, Dow University of Health Sciences Karachi, Karachi - Pakistan
| | - Mohammed Saeed Quraishy
- Prof. Dr. Mohammed Saeed Quraishy, FCPS, FRCS. Department of Surgery & Vice Chancellor, Dow International Medical College, Dow University of Health Sciences Karachi, Karachi - Pakistan
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Rozi S, Zahid N, Roome T, Lakhdir MPA, Sawani S, Razzak A, Butt ZA. Effectiveness of a School Based Smokeless Tobacco Intervention: A Cluster Randomized Trial. J Community Health 2020; 44:1098-1110. [PMID: 31267293 DOI: 10.1007/s10900-019-00689-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
To assess the effectiveness of intervention in improving knowledge, attitude and perception regarding smokeless tobacco (SLT) use and its harmful effects and intention to quit SLT among school going adolescents. A school-based cluster randomized control trial was carried out in 18 secondary schools targeting male and female students from grades 6 to 10 in Karachi. Primary outcome was knowledge about hazards of smokeless tobacco (SLT) and secondary outcomes were attitude and Perception about hazards of SLT, and intention to quit SLT. We enrolled 738 participants in intervention group and 589 in the control group. Mean score of knowledge significantly improved in intervention as compared to control group (P value < 0.01). Intention to quit was found to be proportionately higher (33%) in the intervention group as compared to control group. Generalized estimating equations were used to assess the association of factors with knowledge regarding harmful effects of SLT use. Significant predictors of increase in knowledge score were found in children: who had seen any anti SLT messages on social media in the past 30 days, who were getting information regarding harmful effects of SLT use in school or textbooks and who had friends using SLT. A school-based intervention was effective in increasing knowledge regarding the harmful effects of SLT use and intention to quit SLT use among school adolescents. Introduction of such educational programmes on a regular basis in schools or as part of school curriculum can have an impact on reducing prevalence of SLT use.Trial Registration NCT03418506. https://register.clinicaltrials.gov/NCT03418506 .
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Affiliation(s)
- Shafquat Rozi
- Department of Community Health Sciences, Aga Khan University, Stadium Road, Karachi, 74800, Pakistan.
| | - Nida Zahid
- Department of Surgery, Aga Khan University, Stadium Road, Karachi, 74800, Pakistan
| | - Talat Roome
- Department of Pathology, Dow University of Health Sciences, University Road, Karachi, 75270, Pakistan
| | - Maryam Pyar Ali Lakhdir
- Department of Community Health Sciences, Aga Khan University, Stadium Road, Karachi, 74800, Pakistan
| | - Sobiya Sawani
- Department of Community Health Sciences, Aga Khan University, Stadium Road, Karachi, 74800, Pakistan
| | - Anam Razzak
- Department of Pathology, Dow University of Health Sciences, University Road, Karachi, 75270, Pakistan
| | - Zahid Ahmad Butt
- School of Population and Public Health, University of British Columbia, Vancouver, V6T 1Z4, Canada
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Ahmad M, Shah AA. Predictive role of single nucleotide polymorphism (rs11614913) in the development of breast cancer in Pakistani population. Per Med 2020; 17:213-227. [PMID: 32320336 DOI: 10.2217/pme-2019-0086] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Aim: miRNAs play an important role in breast cancer (BC). Variations in miRNAs influence their maturation, expression and consequently regulation of their target genes. Materials & methods: In this study, single nucleotide polymorphism rs11614913 was genotyped in BC patients (n = 300) and 230 controls by employing tetra primer amplification refractory mutation system PCR and Sanger sequencing (Macrogen Korea). Results: A significant difference was observed in the genotypes through co-dominant (χ2.#x00A0;= 42.03; p < 0.0001), additive (odds ratio [OR] = 0.6441 [0.4887-0.8490, 95% confidence interval]; p < 0.0019), dominant (OR = 0.3996 [0.2809-0.5686], p < 0.0001) and recessive (OR = 0.2993 [0.1220-0.7347], p < 0.009) statistical models showed decreased risk association of C allele with BC. Conclusion: Females having CT genotype are at higher risk of BC as compared with those having CC genotype.
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Affiliation(s)
- Mushtaq Ahmad
- Department of Biotechnology, Faculty of Biological Sciences, University of Malakand, Chakdara, Pakistan
| | - Aftab Ali Shah
- Department of Biotechnology, Faculty of Biological Sciences, University of Malakand, Chakdara, Pakistan
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Shamsi U, Khan S, Azam I, Habib Khan A, Maqbool A, Hanif M, Gill T, Iqbal R, Callen D. A multicenter case control study of association of vitamin D with breast cancer among women in Karachi, Pakistan. PLoS One 2020; 15:e0225402. [PMID: 31967989 PMCID: PMC6975526 DOI: 10.1371/journal.pone.0225402] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 11/04/2019] [Indexed: 12/12/2022] Open
Abstract
Background The prevalence of vitamin D inadequacy and breast cancer are both high among women living in Karachi, Pakistan. Methods A matched case control study was conducted in two hospitals of Karachi, Pakistan to evaluate the association of vitamin D (serum 25-hydroxyvitamin D) concentrations, vitamin D supplementation and sun exposure with breast cancer among Pakistani women. A total of 411 newly diagnosed histologically confirmed primary breast cancer cases were enrolled and 784 controls, free of breast and any other cancers, were matched by age (year of birth ± 5 years), residence in the same geographic area and study site. Information was collected on sociodemographic history, history of vitamin D supplementation, past medical and obstetrical history, family history of breast cancer, sun exposure history, histopathology reports and anthropometric measurement and venous blood was collected to measure serum 25-hydroxyvitamin D (25(OH)D) concentration. Results Compared to patients with sufficient serum vitamin D (>30 ng/ml), women with serum vitamin D deficiency (<20ng/ml), had a higher risk of breast cancer (OR = 1.65, 95%CI: 1.10, 2.50). Women with history of vitamin D supplementation one year prior to enrollment, had significant protective effect against breast cancer (OR = 0.32, 95% CI: 0.24, 0.43). Conclusions and recommendation Serum vitamin D deficiency was associated with increased risk of breast cancer, while vitamin D supplementation was associated with decreased risk of breast cancer. In Pakistani women, where vitamin D deficiency is common, raising and maintaining serum vitamin D at population level is a safe and affordable strategy. It may play a role in reducing the incidence of both vitamin D deficiency and breast cancer, particularly among poor women where the breast cancer mortality is highest due to limited resources for early detection, diagnosis, and treatment. The effects of vitamin D with regard to breast cancer risk in Karachi Pakistan should be further evaluated.
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Affiliation(s)
- Uzma Shamsi
- School of Medicine, University of Adelaide, Adelaide, Australia
- * E-mail:
| | - Shaista Khan
- Department of Surgery, Aga Khan University, Karachi, Pakistan
| | - Iqbal Azam
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Aysha Habib Khan
- Department of Pathology & Laboratory Medicine, Aga Khan University, Karachi, Pakistan
| | - Amir Maqbool
- Department of Oncology, Karachi Institute of Radiation and Nuclear Medicine Hospital (KIRAN), Karachi, Pakistan
| | - Mohammad Hanif
- Department of Oncology, Karachi Institute of Radiation and Nuclear Medicine Hospital (KIRAN), Karachi, Pakistan
| | - Tiffany Gill
- School of Medicine, University of Adelaide, Adelaide, Australia
| | - Romaina Iqbal
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - David Callen
- School of Medicine, University of Adelaide, Adelaide, Australia
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Saleem S, Tariq S, Aleem I, Sadr-Ul Shaheed, Tahseen M, Atiq A, Hassan S, Abu Bakar M, Khattak S, Syed AA, Ahmad AH, Hussain M, Yusuf MA, Sutton C. Proteomics analysis of colon cancer progression. Clin Proteomics 2019; 16:44. [PMID: 31889941 PMCID: PMC6935225 DOI: 10.1186/s12014-019-9264-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 12/12/2019] [Indexed: 02/07/2023] Open
Abstract
Background The aim of this pilot study was to identify proteins associated with advancement of colon cancer (CC). Methods A quantitative proteomics approach was used to determine the global changes in the proteome of primary colon cancer from patients with non-cancer normal colon (NC), non-adenomatous colon polyp (NAP), non-metastatic tumor (CC NM) and metastatic tumor (CC M) tissues, to identify up- and down-regulated proteins. Total protein was extracted from each biopsy, trypsin-digested, iTRAQ-labeled and the resulting peptides separated using strong cation exchange (SCX) and reverse-phase (RP) chromatography on-line to electrospray ionization mass spectrometry (ESI-MS). Results Database searching of the MS/MS data resulted in the identification of 2777 proteins which were clustered into groups associated with disease progression. Proteins which were changed in all disease stages including benign, and hence indicative of the earliest molecular perturbations, were strongly associated with spliceosomal activity, cell cycle division, and stromal and cytoskeleton disruption reflecting increased proliferation and expansion into the surrounding healthy tissue. Those proteins changed in cancer stages but not in benign, were linked to inflammation/immune response, loss of cell adhesion, mitochondrial function and autophagy, demonstrating early evidence of cells within the nutrient-poor solid mass either undergoing cell death or adjusting for survival. Caveolin-1, which decreased and Matrix metalloproteinase-9, which increased through the three disease stages compared to normal tissue, was selected to validate the proteomics results, but significant patient-to-patient variation obfuscated interpretation so corroborated the contradictory observations made by others. Conclusion Nevertheless, the study has provided significant insights into CC stage progression for further investigation.
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Affiliation(s)
- Saira Saleem
- 1Basic Science Research, Shaukat Khanum Memorial Cancer Hospital and Research Centre, 7-A Block R-3, Johar Town, Lahore, 54000 Pakistan
| | - Sahrish Tariq
- 1Basic Science Research, Shaukat Khanum Memorial Cancer Hospital and Research Centre, 7-A Block R-3, Johar Town, Lahore, 54000 Pakistan
| | - Iffat Aleem
- 1Basic Science Research, Shaukat Khanum Memorial Cancer Hospital and Research Centre, 7-A Block R-3, Johar Town, Lahore, 54000 Pakistan
| | - Sadr-Ul Shaheed
- 2Institute of Cancer Therapeutics, University of Bradford, Tumbling Hill Street, Bradford, BD7 1BD UK
| | - Muhammad Tahseen
- 3Department of Pathology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, 7-A Block R-3, Johar Town, Lahore, 54000 Pakistan
| | - Aribah Atiq
- 3Department of Pathology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, 7-A Block R-3, Johar Town, Lahore, 54000 Pakistan
| | - Sadia Hassan
- 4Clinical Research Office, Shaukat Khanum Memorial Cancer Hospital and Research Centre, 7-A Block R-3, Johar Town, Lahore, 54000 Pakistan
| | - Muhammad Abu Bakar
- 5Cancer Registry and Clinical Data Management, Shaukat Khanum Memorial Cancer Hospital and Research Centre, 7-A Block R-3, Johar Town, Lahore, 54000 Pakistan
| | - Shahid Khattak
- 6Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, 7-A Block R-3, Johar Town, Lahore, 54000 Pakistan
| | - Aamir Ali Syed
- 6Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, 7-A Block R-3, Johar Town, Lahore, 54000 Pakistan
| | - Asad Hayat Ahmad
- 3Department of Pathology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, 7-A Block R-3, Johar Town, Lahore, 54000 Pakistan
| | - Mudassar Hussain
- 3Department of Pathology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, 7-A Block R-3, Johar Town, Lahore, 54000 Pakistan
| | - Muhammed Aasim Yusuf
- Department of Internal Medicine, Shaukat Khanum Mmemorial Cancer Hospital and Research Centre, 7-A Block R-3, Johar Town, Lahore, 54000 Pakistan
| | - Chris Sutton
- 2Institute of Cancer Therapeutics, University of Bradford, Tumbling Hill Street, Bradford, BD7 1BD UK
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Naeem B, Moorani KN, Anjum M, Imam U. Tumor lysis syndrome in pediatric acute lymphoblastic leukemia at tertiary care center. Pak J Med Sci 2019; 35:899-904. [PMID: 31372114 PMCID: PMC6659073 DOI: 10.12669/pjms.35.4.715] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Objectives: Tumor lysis syndrome (TLS) is common complication of acute lymphoblastic leukemia (ALL). It is characterized by presence of two or more of hyperkalemia, hyperuricemia, hyperphosphatemia and hypocalcemia. TLS may cause acute kidney injury (AKI), arrhythmias and seizures. Our objective was to determine the frequency of TLS and its biochemical abnormalities in children with ALL. Methods: A retrospective study on 91 children, aged 2-13 years with ALL was carried out in Nephrology and Oncology departments of National Institute of Child Health, Karachi from January 2016 to December 2017. Patients already received chemotherapy were excluded. Data including risk categories, immunophenotyping, laboratory parameters like complete blood picture, serum creatinine (SCr), potassium(K), calcium (Ca), phosphorus(P) and uric acid (UA) on day 0,3 and 7 after chemotherapy were collected. Data analyzed on SPSS using descriptive statistics. Independent t- test was applied to compare means and P- value<0.05 was taken as significant. Results: Ninety-one children with mean age of 6.39±3.08 years were studied. Male were 57% and 43% female. High risk ALL were 61.5%. Pre –BALL were 82.4% and 17.5% had T-cell ALL. All patients had anemia (hemoglobin7.69±2.66 g/dl) and thrombocytopenia (43.61± 18.6 x109) where as hyperleukocytosis and blast cells were observed in 20.87% and 73.6% respectively. Comparing the biochemical parameters of ALL, the difference in SCr from D0 vs D3 (0.46±0.16 vs0.54± 0.35 and D7, 0.44±0.22) was significant (p=0.001). Similarly, difference in UA (D0, 4.12±2.40 vs D3, 3.82±1.73 and D7, 3.56±1.42), SP (D0, 4.24±1.34 vs D3, 4.61±1.76 and D7,4.13±1.07mg/dl)and for K (p=0.038) was significant. There was no difference in Ca from D0 vs D3 (0.092) and D7 (0.277). TLS was found in 62.6% children, it was chemotherapy induced in 72% and spontaneous in 28%. Clinical-TLS was observed in 14% and all CTLS had AKI. Hyperuricemia and hyperphosphatemia were the most common biochemical abnormalities in laboratory-TLS and CTLS. Conclusion: TLS was found in 62.6% despite preventive measures. Early recognition and treatment is essential to avoid morbidity and mortality.
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Affiliation(s)
- Bilqis Naeem
- Bilquis Naeem, MBBS, FCPS, FCPS, Assistant Professor, Pediatric Medicine, Departments of Pediatric Nephrology, National Institute of Child Health (NICH), Jinnah Sindh Medical University (JSMU) Karachi, Pakistan
| | - Khemchand N Moorani
- Prof. Khemchand N Moorani, FCPS, MCPS, MBBS, Departments of Pediatric Nephrology, National Institute of Child Health (NICH), Jinnah Sindh Medical University (JSMU) Karachi, Pakistan
| | - Misbah Anjum
- Misbah Anjum, MBBS, FCPS, Assistant Professor, Pediatric Medicine Pediatric Medical Unit III, National Institute of Child Health (NICH), Jinnah Sindh Medical University (JSMU) Karachi, Pakistan
| | - Uzma Imam
- Uzma Imam MBBS, Senior Medical officer, Pediatric Oncology, National Institute of Child Health (NICH), Jinnah Sindh Medical University (JSMU) Karachi, Pakistan
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Tariq A, Mateen RM, Fatima I, Akhtar MW. Calreticulin is Differentially Expressed in Invasive Ductal Carcinoma: A Comparative Study. CURR PROTEOMICS 2019. [DOI: 10.2174/1570164615666180907154459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Objective: The aim of the present study was to build protein profiles of untreated breast cancer patients of invasive ductal carcinoma grade II at tissue level in Pakistani population and to compare 2-D profiles of breast tumor tissues with matched normal tissues in order to evaluate for variations of proteins among them.
Materials & Methods:
Breast tissue profiles were made after polytron tissue lysis and rehydrated proteins were further characterized by using two-dimensional gel electrophoresis. On the basis of isoelectric point (pI) and molecular weight, proteins were identified by online tool named Siena 2-D database and their identification was further confirmed by using MALDI-TOF.
Results:
Among identified spots, 10 proteins were found to be differentially expressed i.e.; COX5A, THIO, TCTP, HPT, SODC, PPIA, calreticulin (CRT), HBB, albumin and serotransferrin. For further investigation, CRT was selected. The level of CRT in tumors was found to be significantly higher than in normal group (p < 0.05). The increased expression of CRT level in tumor was statistically significant (p = 0.010) at a 95% confidence level (p < 0.05) as analyzed by Mann-Whitney. CRT was found distinctly expressed in high amount in tumor tissue as compared to their matched normal tissues.
Conclusion:
It has been concluded that CRT expression could discriminate between normal tissue and tumor tissue so it might serve as a possible candidate for future studies in cancer diagnostic markers.
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Affiliation(s)
- Asma Tariq
- Proteome Lab, School of Biological Sciences, University of the Punjab, Lahore, Pakistan
| | - Rana Muhammad Mateen
- Department of Life Sciences, School of Science, University of Management & Technology, Lahore, Pakistan
| | - Iram Fatima
- Proteome Lab, School of Biological Sciences, University of the Punjab, Lahore, Pakistan
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Prasad JB, Dhar M. Risk of major cancers associated with various forms of tobacco use in India: a systematic review and meta-analysis. J Public Health (Oxf) 2018. [DOI: 10.1007/s10389-018-0992-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Majeed MH, Nadeem R, Khokhar MA, Qaisar MN. Adequacy of Pain Control in Patients With Advanced Cancer in Pakistan. J Palliat Care 2018; 34:126-131. [PMID: 30209983 DOI: 10.1177/0825859718800490] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE: Pain is highly prevalent in advanced cancer and requires aggressive management. However, pain management in cancer is minimally investigated in Pakistan. This cross-sectional study explores the adequacy of pain management in patients with advanced stage cancer in Pakistan. METHOD: From January 2017 to May 2017, a cross-sectional study was conducted at Mayo Hospital, Lahore, Pakistan. A total of 218 patients with cancers were interviewed, and 136 patients with pain ≥5 on a Numerical Rating Scale for pain were included in the study. Demographic of patients and clinical characteristics of tumors were also evaluated. RESULTS: Only about one-third of the patients with advanced cancer reported adequate pain management. Chi-square test, χ2 (1, n = 136) = 33.038, P < .05, indicated that pain scores were inversely associated with pain control; inadequate pain control was observed in patients with higher pain score and vice versa. Of the 55.88% of patients who were prescribed morphine, only 6 patients were compliant with treatment recommendations. Most patients were prescribed nonopioid medications and tramadol and codeine, which are weak opioid medications. CONCLUSION: The rate of undertreatment of cancer pain in Pakistan is alarming. Inadequate clinicians' training, patients' and caregivers' beliefs, lack of availability of opioid medications, and socioeconomic factors are some of the barriers to effective pain control. A multidisciplinary team approach is necessary to follow the World Health Organization pain ladder guidelines for the treatment of cancer pain.
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Idrees R, Fatima S, Abdul-Ghafar J, Raheem A, Ahmad Z. Cancer prevalence in Pakistan: meta-analysis of various published studies to determine variation in cancer figures resulting from marked population heterogeneity in different parts of the country. World J Surg Oncol 2018; 16:129. [PMID: 29976196 PMCID: PMC6034324 DOI: 10.1186/s12957-018-1429-z] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 06/25/2018] [Indexed: 11/15/2022] Open
Abstract
Background Pakistan’s population is ethnically diverse with distinct ethnic groups inhabiting various parts of the country. Cancer statistics obtained from specific regions populated by distinct ethnic groups may vary considerably. There is no national cancer registry. To determine whether there are indeed significant statistical differences in cancer incidence and prevalence, data was recorded from different parts of Pakistan based on the ethnic composition of the population in those parts. Methods Ten papers (original articles) on cancer incidence and prevalence in Pakistan published in the last two decades were selected from PubMed and Google Scholar. Meta-analysis of findings of these studies was performed using Meta-analysis of Observational Studies in Epidemiology (MOOSE) checklist. χ2-based I2 test was used for evaluating heterogeneity and Forest plots were generated for calculating unadjusted prevalence estimates. Oral, gastric, prostate, breast, and colorectal cancers were selected for meta-analysis. I2 values of 75% or greater indicated high heterogeneity. Results All five types of cancer selected for meta-analysis (performed on studies carrying similar statistical weights) showed extremely high heterogeneity with I2 values of 99.7% for oral cancer, 98.6% for prostate cancer, 98.3% for gastric cancer, 99.8% for breast cancer, and 85.4% for colorectal cancer. p values for all cancers were highly statistically significant. Conclusions Our findings show that the prevalence rates of different cancer types demonstrate marked variation in different studies depending on the place of origin of the study and dominant ethnic group in that region, and these variations are highly statistically significant. A national cancer registry needs to be established as soon as possible.
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Affiliation(s)
- Romana Idrees
- Aga Khan University Hospital (AKUH), Karachi, Pakistan
| | - Saira Fatima
- Aga Khan University Hospital (AKUH), Karachi, Pakistan
| | - Jamshid Abdul-Ghafar
- Aga Khan University Hospital (AKUH), Karachi, Pakistan. .,French Medical Institute for Mothers and Children (FMIC), Kabul, Afghanistan.
| | - Ahmad Raheem
- Aga Khan University Hospital (AKUH), Karachi, Pakistan
| | - Zubair Ahmad
- Aga Khan University Hospital (AKUH), Karachi, Pakistan
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25
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Waqar S, Khan SA, Sarfraz T, Waqar S. Expression of Estrogen Receptors (ER), Progesterone Receptors (PR) and HER-2/neu receptors in Endometrial Carcinoma and their associations with histological types, grades and stages of the tumor. Pak J Med Sci 2018; 34:266-271. [PMID: 29805391 PMCID: PMC5954362 DOI: 10.12669/pjms.342.13637] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Objective: To study and detect immunohistochemical expression of Estrogen Receptors, Progestrone Receptors and HER-2/neu Receptors in Endometrial Carcinoma (EC) and to find their associations with histological types, grades and stages of the tumor. Methods: A cross sectional study of one year duration from January 2016 to January 2017 was conducted at Histopathology department of Army Medical College, Rawalpindi. A non-probability purposive sampling technique was used to include 56 cases of EC. The specimens were tested for ER, PR and HER-2/neu expression using immunohistochemical analysis. Data was analyzed in SPSS and the significance of association of expression of the receptors with histological types, grades and stages of the tumor was assessed. Results: Significant association of Her-2/neu overexpression with histological types and grades of EC was seen, whereas the association of ER and PR expression with histological types, grades and stage of EC was statistically insignificant. Conclusion: It is suggested that EC showing over expression of HER2/neu with immunohistochemistry may be treated with anti HER-2/neu treatment with better chances of survival and decreased post-treatment morbidity.
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Affiliation(s)
- Samina Waqar
- Dr. Samina Waqar, M.Phil. Department of Histopathology, Army Medical College/ Military Hospital, Rawalpindi, Pakistan
| | - Saleem Ahmad Khan
- Dr. Saleem Ahmad Khan, PhD. Department of Hematology, Army Medical College/ Military Hospital, Rawalpindi, Pakistan
| | - Tariq Sarfraz
- Dr. Tariq Sarfraz, FRC Path. Department of Histopathology, Army Medical College/ Military Hospital, Rawalpindi, Pakistan
| | - Saba Waqar
- Dr. Saba Waqar, M. Phil. Department of Dental Material, Army Medical College/ Military Hospital, Rawalpindi, Pakistan
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26
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Vallacha A, Haider G, Raja W, Kumar D. Quality of Breast Cancer Surgical Pathology Reports. Asian Pac J Cancer Prev 2018; 19:853-858. [PMID: 29582645 PMCID: PMC5980866 DOI: 10.22034/apjcp.2018.19.3.853] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background: Surgical pathology reporting of breast cancer is needed for appropriate staging and treatment decisions.
We here checked the quality of surgical pathology reports of breast cancer from different laboratories of Karachi,
Pakistan. Methods: One hundred surgical pathology reports from ten different laboratories of Karachi were assessed
for documentation of elements against a checklist adopted from the CAP guideline over a period of six months from
January, 2017 to June, 2017 in the Oncology Department, Jinnah Postgraduate Medical Centre, Karachi. Results: Out
of 100 reports, clinical information was documented in 68%, type of procedure and lymph node sampling in 84%
and 34% respectively. Specimen laterality was mentioned in 90%, tumor site in 44%, tumor size in 92%, focality in
40%, histological type in 96%, grade in 87%, LCIS in 19%, DCIS in 83%, size of DCIS in 19%, architectural pattern
in 26% , nuclear grade in 17%, necrosis in 14%, excision margin status in 91%, invasive component in 83%, DCIS in
16%, lymph node status in 91% with positive nodes in 56%, size of macro met in 54%, extranodal involvement in 48%,
lymph vascular invasion in 86%, treatment effects in 31%, and pathology reporting with TNM in 57%. Conclusion:
This study shows that the quality of surgical pathology reports for breast cancer in Karachi is not satisfactory. Therefore,
there is great need to create awareness among histopathologists regarding the importance of accurate breast cancer
surgical pathology reporting and to introduce a standardized checklist according to international guidelines for better
treatment planning.
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Affiliation(s)
- Anita Vallacha
- Department of Oncology, Jinnah Postgraduate Medical Center, Karachi, Sindh, Pakistan.
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27
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Muhammad JS, Khan MR, Ghias K. DNA methylation as an epigenetic regulator of gallbladder cancer: An overview. Int J Surg 2018; 53:178-183. [PMID: 29602013 DOI: 10.1016/j.ijsu.2018.03.053] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 03/20/2018] [Accepted: 03/21/2018] [Indexed: 12/13/2022]
Abstract
Gallbladder cancer (GBC) is a lethal health issue affecting mostly the women in their middle-age. High incidence of GBC has been reported across the world specifically in Asian countries, India and Pakistan. The exact etiology remains unknown, although several risk factors and genetic aberrations involving mutations or epigenetic changes may be involved in gallbladder carcinogenesis. This article presents a review of the published literature mainly from the year 2003 onwards. The topic of main concerns was epigenetic regulation of GBC. All relevant studies identified were included and are described according to the aforementioned subheadings. In this review, we have discussed the role of DNA methylation in GBC, clinical implication and future prospects of biomarker development for early diagnosis and therapeutic interventions.
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Affiliation(s)
- Jibran Sualeh Muhammad
- Department of Basic Medical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates; Department of Biological and Biomedical Sciences, The Aga Khan University, Karachi, Pakistan.
| | | | - Kulsoom Ghias
- Department of Biological and Biomedical Sciences, The Aga Khan University, Karachi, Pakistan
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28
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Sarwar MR, Iftikhar S, Saqib A. Availability of anticancer medicines in public and private sectors, and their affordability by low, middle and high-income class patients in Pakistan. BMC Cancer 2018; 18:14. [PMID: 29298681 PMCID: PMC5753448 DOI: 10.1186/s12885-017-3980-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 12/22/2017] [Indexed: 01/03/2023] Open
Abstract
Background Availability and affordability of anticancer medicines is a matter of great concern especially for low and middle income countries e.g., Pakistan. Prime focus of this study was to evaluate the availability of anticancer medicines in public and private sectors, and their affordability among patients with different income levels. Methods A descriptive, cross-sectional survey was conducted in 22 cancer care hospitals (18 public hospitals and 04 private hospitals) and 44 private pharmacies in Punjab, Pakistan. All (n = 4400) participants were ≥18 years of age. Data were collected at different intervals and analyzed by using Statistical Packages for Social Sciences (IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp.) Results A total of 4913 patients were approached, and 4400 responded to the survey (response rate = 89.6%). Non-hodgkin lymphoma (12.3%), breast cancer (8.6%), and leukemia (7.6%) were the most prevailing cancers. Conventional medicines like cisplatin, cyclophosphamide, and etoposide were the most prescribed medicines. Oncologists were reluctant to prescribe newer anticancer medicines due to high prices. Originator brands (OBs) were more readily available (52.5%) but less affordable (53.4%); whereas, lowest price generics (LPGs) were less available (28.1%) but more affordable (67.9%). Anticancer medicines were more affordable by the high income class patients than the low income class patients. Conclusion The availability of both OBs and LPGs was greater at private hospitals and pharmacies as compared to public hospitals. The high income class had more affordability of both OBs and LPGs; however, LPGs were more affordable for all income classes.
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Affiliation(s)
- Muhammad Rehan Sarwar
- Department of Pharmacy, The Islamia University of Bahawalpur, Bahawalpur, Punjab, Pakistan. .,Akhtar Saeed College of Pharmaceutical Sciences, Lahore, Pakistan.
| | - Sadia Iftikhar
- Akhtar Saeed College of Pharmaceutical Sciences, Lahore, Pakistan
| | - Anum Saqib
- Department of Pharmacy, The Islamia University of Bahawalpur, Bahawalpur, Punjab, Pakistan
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Habibullah G, Gul R, Cassum S, Elahi R. Experiences of the Breast Cancer Patients Undergoing Radiotherapy at a Public Hospital Peshawar Pakistan. Asia Pac J Oncol Nurs 2018; 5:184-194. [PMID: 29607379 PMCID: PMC5863428 DOI: 10.4103/apjon.apjon_70_17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Objective This study aimed to explore the experiences of female breast cancer patients undergoing radiotherapy (RT) in a public hospital in Peshawar, Pakistan. Methods This study employed a descriptive exploratory method. A purposive sample of 14 breast cancer women undergoing RT was selected for this study. Data were collected over the period of 5 months, using a semi-structured interview guide and conducting in-depth face-to-face interviews. These interviews were audio taped and transcribed by a bilingual transcriber. The translated version of the interview was coded, and the analysis was done manually. Results Four main categories emerged from data analysis, which were: feelings and perceptions of the patients, their challenges, coping strategies, and teaching and informational needs. Conclusions Women undergoing RT in this culture experience more intense psychological effects, as compared to the physical effects. Keeping in mind, the magnitude of the emotional stress experienced by the participants, recommendations for policy reforms, and training for female RT staff are suggested based on findings of this research.
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Affiliation(s)
| | - Raisa Gul
- Shifa College of Nursing, Tameer-e-Millat University, Islamabad, Pakistan
| | - Shanaz Cassum
- School of Nursing and Midwifery, Aga Khan University, Karachi, Pakistan
| | - Rehana Elahi
- Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
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30
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Aslam MS, Shaeer A, Abbas Z, Ahmed A, Gull I, Athar MA. Cell-Free DNA Quantification and Methylation Status of DCC Gene as Predictive Diagnostic Biomarkers of Lung Cancer in Patients Reported at Gulab Devi Chest Hospital, Lahore. Technol Cancer Res Treat 2017. [PMCID: PMC5762030 DOI: 10.1177/1533034616682155] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The worldwide high mortality rate of lung cancer could be reduced significantly by its noninvasive early detection. The quantitative analysis of cell-free circulating DNA in plasma presents a potential noninvasive approach for liquid biopsy of tumor. In this study, real-time polymerase chain reaction–based approach was used to quantify free circulating DNA in plasma. The concentration of free circulating DNA was checked using human telomerase reverse transcriptase gene as marker, and amplification status of oncogene RAC-β serine/threonine protein kinase along with the DNA methylation status of tumor suppressor gene (deleted in colorectal cancer) was assessed. The concentration of free circulating DNA in patients with lung cancer (22.8 ng/mL) was found approximately 6 times above than the value detected in controls (2.8 ng/mL). Considerable variation in the AKT2 copy number was observed in patients with lung cancer and controls (P < .000). Aberrant methylation of the deleted in colorectal cancer promoter was found to be highly specific (100%), as none of the control plasma samples showed aberrant methylation. The quantification of free circulating DNA along with determination of AKT2 amplification and deleted in colorectal cancer promoter methylation status appeared promising to differentiate patients with lung cancer from healthy individuals.
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Affiliation(s)
| | - Abeera Shaeer
- Institute of Biochemistry & Biotechnology, University of the Punjab, Lahore, Pakistan
| | - Zaigham Abbas
- Department of Microbiology & Molecular Genetics, University of the Punjab, Lahore, Pakistan
| | - Aftab Ahmed
- School of Biological Sciences, University of the Punjab, Lahore, Pakistan
| | - Iram Gull
- Institute of Biochemistry & Biotechnology, University of the Punjab, Lahore, Pakistan
| | - Muhammad Amin Athar
- Institute of Biochemistry & Biotechnology, University of the Punjab, Lahore, Pakistan
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31
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Denic S, Agarwal MM. Breast cancer protection by genomic imprinting in close kin families. BMC MEDICAL GENETICS 2017; 18:136. [PMID: 29157216 PMCID: PMC5696730 DOI: 10.1186/s12881-017-0498-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Accepted: 11/09/2017] [Indexed: 12/31/2022]
Abstract
Human inbreeding generally reduces breast cancer risk (BCR). When the parents are biologically related, their infants have a lower birth weight due to smaller body organs. The undersized breasts, because of fewer mammary stem cells, have a lower likelihood of malignant conversion. Fetal growth is regulated by genomically imprinted genes which are in conflict; they promote growth when derived from the father and suppress growth when derived from the mother. The kinship theory explicates that the intensity of conflict between these genes affects growth and therefore the size of the newborn. In descendants of closely related parents, this gene clash is less resulting in a smaller infant. In this review, we elucidate the different mechanisms by which human inbreeding affects BCR, and why this risk is dissimilar in different inbred populations.
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Affiliation(s)
- Srdjan Denic
- Department of Medicine, College of Medicine and Health Sciences, United Arab Emirates University, PO Box 17666, Al Ain, Abu Dhabi, UAE.
| | - Mukesh M Agarwal
- Department of Pathology, California University of Science and Medicine, 217 E Club Center Drive, San Bernardino, CA, 92408, USA
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Sikandar B, Qureshi MA, Naseem S, Khan S, Mirza T. Increased Tumour Infiltration of CD4+ and CD8+ T-Lymphocytes in Patients with Triple Negative Breast Cancer Suggests Susceptibility to Immune Therapy. Asian Pac J Cancer Prev 2017; 18:1827-1832. [PMID: 28749113 PMCID: PMC5648386 DOI: 10.22034/apjcp.2017.18.7.1827] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Background: Patients with triple negative breast cancer (TNBC) have limited therapeutic options, largely because the complex tumour environment is not well-characterized. These patients are potential, but largely un-fathomed, candidates for immunotherapy. It is therefore highly relevant to characterize leukocyte complexity in TNBCs. Objective: To investigate leukocyte complexity in tumour environment of patients with TNBCs. Materials and methods: A total of 104 consecutive breast cancer patients undergoing mastectomy were recruited in the study after ethical approval. Clinico-pathological parameters were recorded and H and E staining was performed to investigate tumour morphology. Receptor status was investigated using antibodies against ER, PgR and Her-2, and patients were classified as having TNBC or non-TNBC tumours (including Luminal A, Luminal B and Her2 overexpressing tumours). Immune-cell infiltration was investigated using special stains and antibodies: α-CD3 (T-lymphocytes), α-CD20 (B-lymphocytes), α-CD4 (helper T-lymphocytes) and α-CD8 (cytotoxic T-lymphocytes). Immune cell densities were quantified as cell/mm2 using the CAP guidelines. Results: Of the 104 breast cancer patients investigated, a total of 27 (26%) had TNBC and 77(74%) non-TNBC. Patients with TNBC showed significantly increased tumour infiltration of lymphocytes (T and B-lymphocytes) compared to the patients with non-TNBC, while myelocytic infiltration was not significantly different in the two groups. Within the TNBC group, infiltration of T-lymphocytes (equal densities of CD4+ and CD8+ T-lymphocytes) was significantly higher compared to B-lymphocytes. Conclusion: Patients with TNBC show increased lymphocytic infiltration (more T-lymphocytes compared to B-lymphocytes). This suggests higher immunogenicity of TNBCs and may indicate a higher responsiveness of these cancers to immunotherapy.
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Affiliation(s)
- Bushra Sikandar
- Department of Pathology, Dow International Medical College, Dow Diagnostic Research and Reference Laboratory, Dow
University of Health Sciences Karachi, Pakistan.
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Hashmi AA, Hussain ZF, Hashmi KA, Zafar MI, Edhi MM, Faridi N, Khan M. Latent membrane protein 1 (LMP1) expression in Hodgkin lymphoma and its correlation with clinical and histologic parameters. World J Surg Oncol 2017; 15:89. [PMID: 28427406 PMCID: PMC5397827 DOI: 10.1186/s12957-017-1147-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 04/02/2017] [Indexed: 12/02/2022] Open
Abstract
Background Hodgkin lymphoma is one of the most prevalent lymphoproliferative disorders in Pakistan; however, no risk factors for this disease have yet to be established in our population. Epstein–Barr virus (EBV) is a well-known risk factor for Hodgkin lymphoma in endemic regions of the world; however, frequency of its association in our population has not been widely studied. Latent membrane protein 1 (LMP1) expression by immunohistochemistry (IHC) is a surrogate marker of EBV in Hodgkin lymphoma. Therefore, we aimed to evaluate the frequency of expression of LMP1 in cases of Hodgkin lymphoma at our institute and its correlation with other clinical and histologic parameters. Methods The study included 66 cases of Hodgkin lymphoma diagnosed at Liaquat National Hospital over a duration of 2 years from January 2014 to December 2015. The slides and blocks of all cases were retrieved, and representative blocks were selected for LMP1 by IHC. LMP1 expression of >10% of cells was considered as positive expression and correlated with histologic subtypes and clinical parameters like age, gender, and site of involvement. Results The mean age of patients was 35.11 (+20.22). LMP1 expression was found in 68.1% (45/66) of cases of Hodgkin lymphoma. Mean age of the patients with LMP1 expression was 32.04 (+21.02). LMP1 expression was found in 40% cases of lymphocyte-rich, 66.7% of lymphocyte-depleted, 73.9% of mixed cellularity, 66.7% of nodular sclerosis, and 73.7% of classic Hodgkin lymphoma, NOS. No significant correlation of LMP1 expression with any clinical or histological parameter could be established in our studied patient population. Conclusions A high frequency of expression of LMP1 is seen in cases of Hodgkin lymphoma at our setup comparable to endemic regions of the world; therefore, preventive and treatment protocols should be designed accordingly.
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Affiliation(s)
- Atif Ali Hashmi
- Department of Pathology, Liaquat National Hospital and Medical College, Karachi, Pakistan
| | - Zubaida Fida Hussain
- Department of Pathology, Liaquat National Hospital and Medical College, Karachi, Pakistan
| | - Kashif Ali Hashmi
- Department of Cardiology, Chaudhry Pervaiz Elahi Institute of Cardiology, Multan, Pakistan
| | - Muhammad Irfan Zafar
- Department of Biostatistics, Liaquat National Hospital and Medical College, Karachi, Pakistan
| | | | - Naveen Faridi
- Department of Pathology, Liaquat National Hospital and Medical College, Karachi, Pakistan
| | - Mehmood Khan
- Department of Medicine, Dhaka University, Dhaka, Bangladesh.
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Niaz K, Maqbool F, Khan F, Bahadar H, Ismail Hassan F, Abdollahi M. Smokeless tobacco ( paan and gutkha) consumption, prevalence, and contribution to oral cancer. Epidemiol Health 2017; 39:e2017009. [PMID: 28292008 PMCID: PMC5543298 DOI: 10.4178/epih.e2017009] [Citation(s) in RCA: 107] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Accepted: 03/09/2017] [Indexed: 01/19/2023] Open
Abstract
Smokeless tobacco consumption, which is widespread throughout the world, leads to oral submucous fibrosis (OSMF), which is a long-lasting and devastating condition of the oral cavity with the potential for malignancy. In this review, we mainly focus on the consumption of smokeless tobacco, such as paan and gutkha, and the role of these substances in the induction of OSMF and ultimately oral cancer. The list of articles to be examined was established using citation discovery tools provided by PubMed, Scopus, and Google Scholar. The continuous chewing of paan and swallowing of gutkha trigger progressive fibrosis in submucosal tissue. Generally, OSMF occurs due to multiple risk factors, especially smokeless tobacco and its components, such as betel quid, areca nuts, and slaked lime, which are used in paan and gutkha. The incidence of oral cancer is higher in women than in men in South Asian countries. Human oral epithelium cells experience carcinogenic and genotoxic effects from the slaked lime present in the betel quid, with or without areca nut. Products such as 3-(methylnitrosamino)-proprionitrile, nitrosamines, and nicotine initiate the production of reactive oxygen species in smokeless tobacco, eventually leading to fibroblast, DNA, and RNA damage with carcinogenic effects in the mouth of tobacco consumers. The metabolic activation of nitrosamine in tobacco by cytochrome P450 enzymes may lead to the formation of N-nitrosonornicotine, a major carcinogen, and micronuclei, which are an indicator of genotoxicity. These effects lead to further DNA damage and, eventually, oral cancer.
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Affiliation(s)
- Kamal Niaz
- International Campus, Tehran University of Medical Sciences (IC-TUMS), Tehran, Iran.,Department of Toxicology and Pharmacology, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.,Toxicology and Diseases Group, Pharmaceutical Sciences Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Faheem Maqbool
- International Campus, Tehran University of Medical Sciences (IC-TUMS), Tehran, Iran.,Department of Toxicology and Pharmacology, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.,Toxicology and Diseases Group, Pharmaceutical Sciences Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Fazlullah Khan
- International Campus, Tehran University of Medical Sciences (IC-TUMS), Tehran, Iran.,Department of Toxicology and Pharmacology, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.,Toxicology and Diseases Group, Pharmaceutical Sciences Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Haji Bahadar
- Institute of Paramedical Sciences, Khyber Medical University, Peshawar, Pakistan
| | - Fatima Ismail Hassan
- International Campus, Tehran University of Medical Sciences (IC-TUMS), Tehran, Iran.,Department of Toxicology and Pharmacology, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.,Toxicology and Diseases Group, Pharmaceutical Sciences Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Abdollahi
- International Campus, Tehran University of Medical Sciences (IC-TUMS), Tehran, Iran.,Department of Toxicology and Pharmacology, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.,Toxicology and Diseases Group, Pharmaceutical Sciences Research Center, Tehran University of Medical Sciences, Tehran, Iran
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35
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Hara H, Misawa T, Ishii E, Nakagawa M, Koshiishi S, Amemiya K, Oyama T, Tominaga K, Cheng J, Tanaka A, Saku T. Differential diagnosis of well-differentiated squamous cell carcinoma from non-neoplastic oral mucosal lesions: New cytopathologic evaluation method dependent on keratinization-related parameters but not nuclear atypism. Diagn Cytopathol 2017; 45:406-417. [PMID: 28205345 DOI: 10.1002/dc.23685] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Revised: 01/21/2017] [Accepted: 01/24/2017] [Indexed: 12/31/2022]
Abstract
BACKGROUND The cytology of oral squamous cell carcinoma (SCC) is challenging because oral SCC cells tend to be well differentiated and lack nuclear atypia, often resulting in a false negative diagnosis. The purpose of this study was to establish practical cytological parameters specific to oral SCCs. METHODS We reviewed 123 cases of malignancy and 53 of non-neoplastic lesions of the oral mucosa, which had been diagnosed using both cytology and histopathology specimens. From those, we selected 12 SCC and 4 CIS cases that had initially been categorized as NILM to ASC-H with the Bethesda system, as well as 4 non-neoplastic samples categorized as LSIL or ASC-H as controls, and compared their characteristic findings. After careful examinations, we highlighted five cytological parameters, as described in Results. Those 20 cytology samples were then reevaluated by 4 independent examiners using the Bethesda system as well as the 5 parameters. RESULTS Five cytological features, (i) concentric arrangement of orangeophilic cells (indicating keratin pearls), (ii) large number of orangeophilic cells, (iii) bizarre-shaped orangeophilic cells without nuclear atypia, (iv) keratoglobules, and (v) uneven filamentous cytoplasm, were found to be significant parameters. All malignant cases contained at least one of those parameters, while none were observed in the four non-neoplastic cases with nuclear atypia. In reevaluations, the Bethesda system did not help the screeners distinguish oral SCCs from non-neoplastic lesions, while use of the five parameters enabled them to make a diagnosis of SCC. CONCLUSION Recognition of the present five parameters is useful for oral SCC cytology. Diagn. Cytopathol. 2017;45:406-417. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Hitoshi Hara
- Pathology Division, Yamanashi Prefectural Central Hospital, Kofu, Japan
| | - Tsuneo Misawa
- Oral Surgery Division, Yamanashi Prefectural Central Hospital, Kofu, Japan
| | - Eri Ishii
- Pathology Division, Yamanashi Prefectural Central Hospital, Kofu, Japan
| | - Miki Nakagawa
- Pathology Division, Yamanashi Prefectural Central Hospital, Kofu, Japan
| | - Saki Koshiishi
- Pathology Division, Yamanashi Prefectural Central Hospital, Kofu, Japan
| | - Kenji Amemiya
- Pathology Division, Yamanashi Prefectural Central Hospital, Kofu, Japan
| | - Toshio Oyama
- Pathology Division, Yamanashi Prefectural Central Hospital, Kofu, Japan
| | - Kazuya Tominaga
- Department of Oral Pathology, Osaka Dental University, Hirakata, Japan
| | - Jun Cheng
- Division of Oral Pathology, Department of Tissue Regeneration and Reconstruction, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Akio Tanaka
- Department of Oral Pathology, Osaka Dental University, Hirakata, Japan
| | - Takashi Saku
- Department of Oral Pathology, Osaka Dental University, Hirakata, Japan.,Division of Oral Pathology, Department of Tissue Regeneration and Reconstruction, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
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36
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Serious fungal infections in Pakistan. Eur J Clin Microbiol Infect Dis 2017; 36:949-956. [PMID: 28161741 DOI: 10.1007/s10096-017-2919-6] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 12/21/2016] [Indexed: 11/25/2022]
Abstract
The true burden of fungal infection in Pakistan is unknown. High-risk populations for fungal infections [tuberculosis (TB), diabetes, chronic respiratory diseases, asthma, cancer, transplant and human immunodeficiency virus (HIV) infection] are numerous. Here, we estimate the burden of fungal infections to highlight their public health significance. Whole and at-risk population estimates were obtained from the WHO (TB), BREATHE study (COPD), UNAIDS (HIV), GLOBOCAN (cancer) and Heartfile (diabetes). Published data from Pakistan reporting fungal infections rates in general and specific populations were reviewed and used when applicable. Estimates were made for the whole population or specific populations at risk, as previously described in the LIFE methodology. Of the 184,500,000 people in Pakistan, an estimated 3,280,549 (1.78%) are affected by a serious fungal infection, omitting all cutaneous infection, oral candidiasis and allergic fungal sinusitis, which we could not estimate. Compared with other countries, the rates of candidaemia (21/100,000) and mucormycosis (14/100,000) are estimated to be very high, and are based on data from India. Chronic pulmonary aspergillosis rates are estimated to be high (39/100,000) because of the high TB burden. Invasive aspergillosis was estimated to be around 5.9/100,000. Fungal keratitis is also problematic in Pakistan, with an estimated rate of 44/100,000. Pakistan probably has a high rate of certain life- or sight-threatening fungal infections.
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Mansha M, Saleem M, Wasim M, Tariq M. Prevalence of Known Risk Factors in Women Diagnosed with Breast Cancer at Inmol Hospital, Lahore, Punjab. Asian Pac J Cancer Prev 2017; 17:563-8. [PMID: 26925644 DOI: 10.7314/apjcp.2016.17.2.563] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Breast cancer is the most prevalent cancer in women worldwide and its frequency is increasing gradually in many countries. Over the last three decades an increase in the breast cancer has been witnessed in the earlier low-risk Asian countries including Pakistan. PURPOSE The objective of the current study was to assess the prevalence of known risk factors like early menarche, late menopause, socio economic, reproductive and demographic factors, among women diagnosed with breast cancer at INMOL hospital, Lahore, Punjab, as little information exists in this regard. MATERIALS AND METHODS A survey study was conducted on 200 women diagnosed with breast cancer who were seen at Institute of Nuclear Medicine and Oncology (INMOL) hospital, Lahore. A structured questionnaire was administered to these patients regarding the known risk factors through face to face interviews after obtaining appropriate consent. RESULTS Regarding non-modifiable risk factors, our study showed that majority of the breast cancer patients were diagnosed at 35-45 years (32.5%) or at older age (≤46) and experienced menarche at 12 years or older (66 %). Likewise, a large number of patients reached menopause at the age of 45 years (60%), had no family and personal history of breast cancer (80%) and hence fell in a low risk category. Regarding modifiable risk factors in women diagnosed with breast cancer, most of the patients fell in low risk strata as the majority were married (98%) at young age, breastfed their children for 12 months or more (88%) and bore two to three children (80%). Considering income criteria, the majority of the patients had a low risk profile as they belonged to middle class (70%), urban area (60%) and were house wives (80%). However, it was noted that a considerable number of women (34%) diagnosed with breast cancer experienced menarche at an early age (<12) and reached menopause after the age of 45 years. This situation is further augmented by environmental changes and dietary habits and places them in a high risk category.
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Affiliation(s)
- Muhammad Mansha
- Division Science and Technology, University of Education, Township Campus, Lahore, Pakistan E-mail :
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Pirzada MT, Ghauri R, Ahmed MJ, Shah MF, Nasir IUI, Siddiqui J, Ahmed I, Mir K. Outcomes of BCG Induction in High-Risk Non-Muscle-Invasive Bladder Cancer Patients (NMIBC): A Retrospective Cohort Study. Cureus 2017; 9:e957. [PMID: 28168135 PMCID: PMC5291702 DOI: 10.7759/cureus.957] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Accepted: 01/04/2017] [Indexed: 11/05/2022] Open
Abstract
Non-muscle-invasive bladder cancer (NMIBC) is categorized into high-risk and low-risk groups. Although, bacillus Calmette-Guerin (BCG) is the recommended adjuvant therapy of high-risk bladder tumor, optimal schedule (induction versus maintenance) of this therapy is a subject of debate. The objective was to evaluate outcomes of induction BCG in high-risk NMIBC patients at Shaukat Khanum Memorial Cancer Hospital & Research Centre, Pakistan and retrospective cohort study conducted in the department of urology, Shaukat Khanum Memorial Cancer Hospital & Research Centre, Pakistan. Three-year disease-free survival and progression-free survival was the main outcome measure. Data of 68 high-risk (Ta and T1 with G3 or high-grade subtype) bladder cancer patients who underwent transurethral resection followed by six-weekly intravesical BCG instillation was included in the study. Recurrence was described as biopsy-proven bladder cancer; whereas the presence of muscle invasion was considered as progression. Disease-free survival and progression-free survival were defined as time intervals elapsed between the starting date of BCG instillation and recurrence or progression, respectively. Kaplan-Meier curve was employed to estimate the three-year study end-points. Disease-free survival at three years was observed to be 66.2% and progression-free survival at 86.8%. The use of induction BCG alone for high-risk patients of NMIBC is a viable option both in terms of effective disease-free and progression-free survival rates.
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Affiliation(s)
- Muhammad T Pirzada
- Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital & Research Centre
| | - Rashid Ghauri
- Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital & Research Centre
| | - Monis J Ahmed
- Department of Surgery, Mediclinic City Hospital, Dubai, UAE
| | - Muhammad F Shah
- Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital & Research Centre
| | - Irfan Ul Islam Nasir
- Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital & Research Centre
| | - Jasim Siddiqui
- Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital & Research Centre
| | - Irfan Ahmed
- Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital & Research Centre
| | - Khurram Mir
- Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital & Research Centre
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Jetha ZA, Gul RB, Lalani S. Women Experiences of Using External Breast Prosthesis after Mastectomy. Asia Pac J Oncol Nurs 2017; 4:250-258. [PMID: 28695172 PMCID: PMC5473097 DOI: 10.4103/apjon.apjon_25_17] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Objective: The aim of this study was to identify the experiences of breast cancer patients using external breast prostheses (EBP) in the context of the Pakistani society. Methods: A qualitative descriptive exploratory design was used in the study. In-depth individual interviews were conducted with 15 postmastectomy women using EBP. A semi-structured interview guide with open-ended questions was used for the interviews. The analysis of the data was organized into four categories according to the study questions including reasons for using EBP, feeling about EBP, challenges for using EBP, and coping with lost breast. Each category was further divided into subcategories. Results: Women used EBP because they felt strange, incomplete, and embarrassed in front of other people, due to the asymmetrical shape of the chest after mastectomy. They faced several challenges with regard to obtaining and using the EBP. While EBP was used as an alternative of their lost breast, they experienced sadness and embarrassment. They found it challenging to take care of the EBP and were required to make changes in their lifestyle. However, they accepted living with their lost breast, either through rationalization, family support, or faith and prayers, which helped them to cope. Conclusions: The study findings have given insight into some real experiences of mastectomy patients. Mastectomy not only affects women's physical health but also their psychological health, as a result of which they become reluctant to socialize. Using EBP can help them to improve their body image and body posture. Health-care providers' support is very important to the families of the patients specifically where patients are very shy to openly seek information due to cultural constraints.
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Affiliation(s)
- Zohra Asif Jetha
- School of Nursing and Midwifery, Aga Khan University, Karachi, Pakistan
| | - Raisa B Gul
- School of Nursing and Midwifery, Aga Khan University, Karachi, Pakistan
| | - Sharifa Lalani
- School of Nursing and Midwifery, Aga Khan University, Karachi, Pakistan
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Rasool M, Malik A, Basit Ashraf MA, Parveen G, Iqbal S, Ali I, Qazi MH, Asif M, Kamran K, Iqbal A, Iram S, Khan SU, Mustafa MZ, Zaheer A, Shaikh R, Choudhry H, Jamal MS. Evaluation of Matrix Metalloproteinases, Cytokines and Their Potential Role in the Development of Ovarian Cancer. PLoS One 2016; 11:e0167149. [PMID: 27902750 PMCID: PMC5130238 DOI: 10.1371/journal.pone.0167149] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Accepted: 11/09/2016] [Indexed: 01/14/2023] Open
Abstract
Background Ovarian cancer is the 5th most common cause of deaths in the women among gynecological tumors. There are many growing evidences that stress and other behavioral factors may affect cancer progression and patient survival. The purpose of this study is to determine the key role of matrix metalloproteinases (MMPs), and cytokines in the aggregation and progression of ovarian cancer. Methodology Stress variables (MDA, AGEs, AOPPs, NO), profile of antioxidants (SOD, Catalase, Vitamin E & A, GSH, GRx, GPx) and inflammatory biomarkers (MMP-9, MMP-2, MMP-11, IL-1α and TNF-α) were biochemically assessed from venous blood of fifty ovarian cancer patients and twenty healthy control subjects. The results of all parameters were analyzed statistically by independent sample t-test. Results The results of the study demonstrated that the levels of stress variables like MDA (3.38±1.12nmol/ml), AGEs (2.72±0.22 ng/ml), AOPPs (128.48±27.23 ng/ml) and NO (58.71±8.67 ng/ml) were increased in the patients of ovarian cancer as compared to control individuals whereas the profile of antioxidants like SOD, Catalase, Vitamin E, Vitamin A, GSH and GRx were decreased in ovarian cancer patients (0.11±0.08 μg/ml, 2.41±1.01μmol/mol of protein, 0.22±0.04 μg/ml, 45.84±9.07μg/ml, 4.88±1.18μg/ml, 5.33±1.26 μmol/ml respectively). But the level of GPx antioxidant was increased in ovarian cancer patients (6.58±0.21μmol/ml). Moreover the levels of MMP-9 (64.87±5.35 ng/ml), MMP-2 (75.87±18.82 ng/ml) and MMP-11 (63.58±8.48 ng/ml) were elevated in the patients. Similarly, the levels of various cytokines TNF-α and IL-1α were also increased in the patients of ovarian cancer (32.17±3.52 pg/ml and 7.04±0.85 pg/ml respectively). Conclusion MMPs are commonly expressed in ovarian cancer which are potential extrapolative biomarkers and have a major role in metastasis. Due to oxidative stress, different cytokines are released by tumor associated macrophages (TAMs) that result in the cancer progression. Consequently, tissue inhibitors of matrix metalloproteinases (TIMPs) are the valuable therapeutic approaches to complement conservative anticancer strategies.
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Affiliation(s)
- Mahmood Rasool
- Center of Excellence in Genomic Medicine Research (CEGMR), King Abdulaziz University, Jeddah, Saudi Arabia
| | - Arif Malik
- Institute of Molecular Biology and Biotechnology (IMBB), The University of Lahore, Lahore, Pakistan
| | | | - Gulshan Parveen
- Institute of Molecular Biology and Biotechnology (IMBB), The University of Lahore, Lahore, Pakistan
| | - Shazia Iqbal
- Institute of Molecular Biology and Biotechnology (IMBB), The University of Lahore, Lahore, Pakistan
| | - Irfan Ali
- Akhuwat-Faisalabad Institute of Research Science and Technology, Faisalabad, Pakistan
| | - Mahmood Husain Qazi
- Centre for Research in Molecular Medicine (CRIMM), The University of Lahore, Lahore, Pakistan
| | - Muhammad Asif
- Department of Biotechnology, BUITEMS, Quetta, Pakistan
| | - Kashif Kamran
- Faculty of Life Sciences, University of Balochistan, Quetta, Pakistan
| | - Asim Iqbal
- Faculty of Life Sciences, University of Balochistan, Quetta, Pakistan
| | - Saima Iram
- Bolan Medical Hospital, Quetta, Pakistan
| | - Sami Ullah Khan
- Department of Botany, Women University of Azad Jammu & Kashmir, Bagh, Pakistan
| | | | - Ahmad Zaheer
- National Institute for Biotechnology & Genetic Engineering, Faisalabad, Pakistan
| | | | - Hani Choudhry
- Department of Biochemistry, Faculty of Science, Center of Innovation in Personalized Medicine, King Fahd Center for Medical Research, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mohammad Sarwar Jamal
- King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
- * E-mail:
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Memon ZA, Kanwal N, Sami M, Larik PA, Farooq MZ. Risk of Breast Cancer among Young Women and Importance of Early Screening. Asian Pac J Cancer Prev 2016; 16:7485-9. [PMID: 26625749 DOI: 10.7314/apjcp.2015.16.17.7485] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Breast cancer is the most common type of cancer in women throughout the world. However, in comparison with Western women, it presents relatively early in women of Asian ethnicity. Early menarche, late menopause, use of OCP's, family history of benign or malignant breast disease, exposure to radiation and BMI in the under-weight range are well known risk factors for the development of breast cancer in premenopausal women. Early detection with the use of breast self-examination (BSE) and breast cancer screening programs can lead to a reduction in the mortality rates due to breast cancer. The aim of our study was to assess the risk factors for breast cancer among young women and to emphasize the importance of early screening among them. MATERIALS AND METHODS We conducted a cross-sectional study among women aged 18 to 25 using a self- administered questionnaire. Data was collected over a period of 6 months from June to December, 2014. A total of 300 young women selected randomly from Dow Medical College and various departments of Karachi University successfully completed the survey. RESULTS Respondents were 18-25 years of age (mean age=21.5). Out of the 300 young females, 90 (30%) had at least one risk factor, 90 (30%) had two, 40 (13%) had three, 8 (2.7%) had four, 2 (0.7%) had five while one female was found to have six positive risk factors for breast cancer. Some 66 women (22%) experienced symptoms of breast cancer such as non-cyclical pain and lumps. While 222 women (74%) had never performed breast self-examination, 22 (7.3%) had had a breast examination done by a health professional while 32 (10.7%) had participated in breast screening programs. A total of 223 (74.3%) women considered breast cancer screening important for young women. CONCLUSIONS The percentage of young women with risk factors for breast cancer was found to be alarmingly high. Therefore, screening for breast cancer should start at an early age especially in high risk groups. Awareness about breast self-examination should be emphasized. Moreover, screening programs should be started to ensure early detection and reduction of mortality rates caused by breast cancer also in young Pakistani females.
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Affiliation(s)
- Zahid Ali Memon
- Surgical Unit, Civil Hospital and Dow Medical College, DUHS, Karachi, Pakistan E-mail :
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Memon ZA, Qurrat-ul-Ain, Khan R, Raza N, Noor T. Clinical Presentation and Frequency of Risk Factors in Patients with Breast Carcinoma in Pakistan. Asian Pac J Cancer Prev 2016; 16:7467-72. [PMID: 26625746 DOI: 10.7314/apjcp.2015.16.17.7467] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Breast cancer is known to be one of the most prevalent cancers among women in both developing and developed countries .The incidence of breast cancer in Pakistan has increased dramatically within the last few years and is the second country after Israel in Asia to have highest proportional cases of breast cancer. However, there are limited data for breast cancer available in the literature from Pakistan. OBJECTIVES The study was conducted to bring to light the common clinical presentation of breast cancer and to evaluate the frequency of established risk factors in breast carcinoma patients and furthermore to compare the findings between premenopausal and postmenopausal women in Pakistan. MATERIALS AND METHODS A 6 months (from July 2012 to Dec 2012) cross sectional survey was conducted in Surgical and Oncology Units of Civil Hospital, Karachi. Data were collected though a well developed questionnaire from 105 female patients diagnosed with carcinoma of breast and analyzed using SPSS version 17. Institutional ethical approval was obtained prior to data collection. RESULTS Out of 105 patients, 43 were premenopausal and 62 were postmenopausal, 99 being married. Mean age at diagnosis was 47.8 ± 12.4 years. A painless lump was the most frequent symptom, notived by 77.1%(n=81). Some 55.2% (n=58) patients had a lump in the right breast and 44.8%(n=47) in the left breast. In the majority of cases, the lump was present in upper outer quadrant 41.9% (n=44). Mean period of delay from appearance of symptoms to consulting a doctor was 5.13 ± 4.8 months, from the shortest 1 month to the longest 36 months. Long delay (> 3 months) was the most frequent figure 41.9%. Considering overall risk factors most frequent were first pregnancy after 20 years of age (41%), physical breast trauma (28.6%), lack of breast feeding(21.9%), and early menarche <11 years (19%), followed by null parity (16.2%), consumption of high fat diet (15.2%), family history of breast cancer or any other cancer in first degree relatives (9.5% and 13.3%, respectively). Some of the less common factors were late menopause >54 years (8.6%), use of oral contraceptive pills (10.5%), use of hormone replacement therapy (4.7%),smoking (4.7%) and radiation (0.96%). Significant differences (p<0.005) were observed between pre and post menopausal women regarding history of physical breast trauma, practice of breast feeding and parity. CONCLUSIONS A painless lump was the most frequent clinical presentation noted. Overall age at first child > 20 years, physical breast trauma, lack of breast feeding ,early menarche <11 were the most frequent risk factors. Physical breast trauma, lower parity, a trend for less breast feeding had more significant associations with pre-menopausal than post-menopausal onset. Increase opportunity of disease prevention can be obtained through better understanding of clinical presentation and risk factors important in the etiology of breast cancer.
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Affiliation(s)
- Zahid Ali Memon
- Surgical Unit, House Officer, Civil Hospital Karachi, Pakistan E-mail :
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Qureshi MA, Mirza T, Khan S, Sikandar B, Zahid M, Aftab M, Mohsin S, Sharafat S, Avesi L, Hassan S. Cancer patterns in Karachi (all districts), Pakistan: First results (2010-2015) from a Pathology based cancer registry of the largest government-run diagnostic and reference center of Karachi. Cancer Epidemiol 2016; 44:114-122. [PMID: 27566468 DOI: 10.1016/j.canep.2016.08.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Revised: 08/03/2016] [Accepted: 08/13/2016] [Indexed: 11/17/2022]
Abstract
National level population-based cancer data have never been published from Pakistan in seven decades since independence (1947). Therefore, generation of high-quality regional data becomes highly relevant. Cancer data for the period of 2010-2015 representing the population from all districts of Karachi (14.6 million) are presented herein. After institutional approval (Ref no. IRB-459/DUHS/-14), a Pathology based cancer registry was established at the largest government-run diagnostic and reference center of Karachi. During 2010-2015, a total of 13,508 cancers (including 686 non-melanoma-skin-cancers (NMSC)) were diagnosed. Of these, 5665 (41.9%) were in males while 7843 (58.1%) were in females. Incidence rates for all cancers (excluding NMSC) were 66.7 per 100,000 (crude) and 105.1 per 100,000 (ASR) for males and 112.0 per 100,000 (crude) and 175.8 per 100,000 (ASR) for females. In males, cancer of lip and oral cavity was the most frequently diagnosed cancer (30.8%, ASR 33.1), followed by NMSC (7.7%, ASR 9.5) and colorectum (7%, ASR 7.3). In females, breast cancer was the most frequently recorded malignancy (49.5%, ASR 87.9), followed by lip and oral cavity (11.2%, ASR 22.0) and oesophagus (5.6%, ASR 10.7). We report that Karachi has the highest incidence of cancers of breast, lip and oral cavity, oesophagus and larynx in females and cancer of lip and oral cavity and larynx (2nd only to Turkey) in males compared to any of the Asian populations. Notably, incidence of tobacco associated cancers is very high in Karachi, demanding urgent attention by relevant authorities to address the un-controlled and drastically high consumption of various forms of tobacco in the city.
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Affiliation(s)
- Muhammad Asif Qureshi
- Institute of Translational Immunology and Research Center for Immunotherapy, University Medical Center of the Johannes Gutenberg University of Mainz, Germany; Dow International Medical College, Dow University of Health Sciences, Karachi, Pakistan.
| | - Talat Mirza
- Dow International Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Saeed Khan
- Dow International Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Bushra Sikandar
- Dow International Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Maria Zahid
- Dow International Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Marium Aftab
- Jinnah Sindh Medical University, Karachi, Pakistan
| | - Sehrish Mohsin
- Dow International Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Shaheen Sharafat
- Dow International Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Lubna Avesi
- Dow International Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Saba Hassan
- Dow International Medical College, Dow University of Health Sciences, Karachi, Pakistan
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Ahmed F, Mahmood N, Shahid S, Hussain Z, Ahmed I, Jalal A, Ijaz B, Shahid A, Mujtaba G, Mustafa T. Mutations in Human Interferon α2b Gene and Potential as Risk Factor Associated with Female Breast Cancer. Cancer Biother Radiopharm 2016; 31:199-208. [PMID: 27403569 DOI: 10.1089/cbr.2016.2046] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The current study explored the potential links between breast cancer and human interferon α-2b (hIFNα-2b) gene mutations. The hIFNα-2b gene was amplified from breast cancer tumor tissue samples (N = 60) by polymerase chain reaction (PCR) and the products were subjected to gene sequencing. A total of 38 (63.3%) samples showed positive PCR amplification results. Several of these also exhibited frequent alterations (mutations) after 400 bp and, in particular, adenine was replaced by other bases. A total of 19 selected mutated amino acids were analyzed for local/general fold pattern changes. Human IFNα-2b receptor (IFNAR): ligand (hIFNα-2b protein) interactions through a Z-DOCK (3.0.2) server were also evaluated to assess the binding patterns of each ligand to receptor to induce Janus-Kinase-signal transducer and activator of transcription antiproliferative signal transduction pathway inside the cancer cells. Certain local structural and conformational changes were predicted to be induced by mutations in the ligand. The variant models of the hIFNα-2b displayed structural and conformational changes that signified that changes to hIFNα-2b may be a risk factor in addition to other known factors associated with onset/progression of female breast carcinoma. It was hoped that others might build upon the research in this study evaluating protein structural models with mutations and their consequent interactions with receptors in the development of potent immune therapeutic drugs for breast cancer that are based on recombinant hIFNα-2b.
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Affiliation(s)
- Fayyaz Ahmed
- 1 Institute of Industrial Biotechnology, GC University, Lahore , Pakistan
| | - Nasir Mahmood
- 2 Department of Allied Health Sciences and Chemical Pathology, Department of Human Genetics and Molecular Biology, University of Health Sciences , Lahore, Pakistan
| | - Saman Shahid
- 3 National University of Computer and Emerging Sciences (NUCES) , Foundation of Advancement of Science and Technology (FAST), Lahore, Pakistan
| | - Zahid Hussain
- 1 Institute of Industrial Biotechnology, GC University, Lahore , Pakistan
| | - Ishtiaq Ahmed
- 1 Institute of Industrial Biotechnology, GC University, Lahore , Pakistan
| | - Amir Jalal
- 4 Departement of Biochemistry, Sahara Medical College , Narowal, Pakistan
| | - Bushra Ijaz
- 5 National Center of Excellence in Molecular Biology, University of the Punjab , Lahore, Pakistan
| | - Abubaker Shahid
- 6 Institute of Nuclear Medicine and Oncology (INMOL) , Hospital, Lahore, Pakistan
| | - Ghulam Mujtaba
- 6 Institute of Nuclear Medicine and Oncology (INMOL) , Hospital, Lahore, Pakistan
| | - Tanveer Mustafa
- 7 Fatima Jinnah Medical College and University , Lahore, Pakistan
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Chong VH, Telisinghe PU, Chong CF. Spectrum of cancers among South Asians working in Brunei Darussalam. South Asian J Cancer 2016; 5:12-4. [PMID: 27169112 PMCID: PMC4845597 DOI: 10.4103/2278-330x.179697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Worldwide the incidence of cancers is increasing and this seen more in developing nations. This study looks at the spectrum of cancers among South Asian nationals working in Brunei Darussalam, a developing Southeast Asia nation. MATERIALS AND METHODS The cancer registry from 1994 to 2012 maintained by the State Laboratory was retrospectively reviewed. RESULTS Over the period, there was a total of 123 cancer cases diagnosed among South Asians, giving an incidence of 1.5% (n = 123/8253). The mean age at diagnosis was 42.9 ± 17.1 with a gender ratio of (male 60; female 63). Among the South Asians, Indians accounted for the most (53.7%) cases, followed by Nepalese (39.8%), Pakistani (3.3%) and Sri Lankan (2.4%). The most common cancers were cancers of the female reproductive/gynecologic organs, gastrointestinal tract, and breast. Among the two major ethnic groups; cancers of the breast was the most common among Indians followed by gastrointestinal tract where among the Nepalese, these were gastrointestinal tract followed by gynecologic (esp. cervical cancers). Among the South Asian, the Nepalese were younger at diagnosis compared to the other groups. CONCLUSION The spectrum of cancers among South Asian residing in Brunei is comparable to what have been reported from South Asia with the exception of lung cancers. The most common cancers were cancers of female reproductive/gynecologic organs, gastrointestinal tract and breast. South Asians were younger at diagnosis of cancers compared to non-South Asians.
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Affiliation(s)
- Vui Heng Chong
- Department of Medicine, RIPAS Hospital, Bandar Seri Begawan BA 1710, Brunei Darussalam
| | | | - Chee Fui Chong
- Department of Surgery, Bandar Seri Begawan BA 1710, Brunei Darussalam
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Wickramasinghe DP, Samarasekera DN. Incidence of esophageal cancer in Sri Lanka: Analysis of cancer registry data and comparison with other South Asian populations. Asia Pac J Clin Oncol 2016; 13:e271-e277. [PMID: 27030258 DOI: 10.1111/ajco.12481] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Revised: 10/20/2015] [Accepted: 01/13/2016] [Indexed: 01/10/2023]
Abstract
INTRODUCTION The objectives of this study were to report the incidence of Carcinoma of Esophagus (CaE) in Sri Lanka and to compare these values with other cancer registry data of the region and with migrant populations. MATERIALS AND METHODS We compared the data published by the National Cancer Control Program over the last two decades with data from the National Cancer Registry Programme of the Indian Council of Medical Research and Karachi Cancer Registry. SEERstat was used to analyze the surveillance, epidemiology and end results database to analyze data on Indian migrant population. RESULTS CaE was the fourth most common cancer overall and among females and third most common cancer among males. The incidence of CaE rises with age in both sexes, with a peak in the 70-74 year age group. There was a disproportionately higher number of CaE in the Tamil population (chi-square test, P < 0.00001). The commonest type of CaE in Sri Lanka was squamous cell carcinoma, Not otherwise specified (NOS) (n = 750, 70.5%), followed by adenocarcinoma, NOS (n = 83, 7.8%). India, Pakistan and Sri Lanka have comparable age-adjusted incidence and age distribution of CaE. All migrant populations had lower incidence of CaE than original population or population in their present country. Both cigarette smoking and alcohol consumption are more prevalent in Sri Lankan males than females. DISCUSSION AND CONCLUSIONS The incidence of CaE and its distribution among age groups in Sri Lanka was comparable to other countries of the region. Persons of Tamil ethnicity have a higher risk of developing CaE.
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Siddiqui AS, Dogar SA, Lal S, Akhtar S, Khan FA. Airway management and postoperative length of hospital stay in patients undergoing head and neck cancer surgery. J Anaesthesiol Clin Pharmacol 2016; 32:49-53. [PMID: 27006541 PMCID: PMC4784213 DOI: 10.4103/0970-9185.173341] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Background and Aims: General anesthesia and airway management of patients for head and neck cancer surgery is a challenge for the anesthesiologist. Appropriate assessment and planning are essential for successful airway management. Our objectives were to review airway management strategies in patients undergoing head and neck cancer surgery in our tertiary care institution and also to observe the effect of airway management techniques on postoperative length of hospital stay (PLOS). Material and Methods: A retrospective medical record review of 400 patients who underwent major head and neck cancer surgery in our institution was conducted. A special form was used, and records were searched for airway and anesthetic management in the operating room and recovery room, and for PLOS. Results: 289 (72.25%) of the patients were male, and 111 (27.75%) female. 49.8% of patients had Mallampati score of 3 and 4. Airway was managed with tracheostomy in 81 (20.25%) patients; nasal intubation was performed in 177 (44.25%) and oral intubation in 142 (35.5%) patients. Postoperative emergency tracheostomy was not done in any of the patients. Conclusion: Median postoperative hospital stay was significantly longer (P = 0.0005) in patients who had a tracheostomy performed compared with those where the airway was managed without it.
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Affiliation(s)
| | | | - Shankar Lal
- Department of Anaesthesiology, Aga Khan University, Karachi, Pakistan
| | - Shabbir Akhtar
- Department of Surgery, Aga Khan University, Karachi, Pakistan
| | - Fauzia Anis Khan
- Department of Anaesthesiology, Aga Khan University, Karachi, Pakistan
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Elidrissi Errahhali M, Elidrissi Errahhali M, Boulouiz R, Ouarzane M, Bellaoui M. Distribution and features of hematological malignancies in Eastern Morocco: a retrospective multicenter study over 5 years. BMC Cancer 2016; 16:159. [PMID: 26915519 PMCID: PMC4768409 DOI: 10.1186/s12885-016-2205-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Accepted: 02/20/2016] [Indexed: 12/22/2022] Open
Abstract
Background Hematological malignancies (HM) are a public health problem. The pattern and distribution of diagnosed hematological cancers vary depending on age, sex, geography, and ethnicity suggesting the involvement of genetic and environmental factors for the development of these diseases. To our knowledge, there is no published report on HM in the case of Eastern Morocco. In this report we present for the first time the overall pattern of HM for this region. Methods Retrospective descriptive study of patients diagnosed with HM between January 2008 and December 2012 in three centres in Eastern Morocco providing cancer diagnosis, treatment or palliative care services. The FAB (French-American-British) classification system has been taken into account in the analysis of myeloid and lymphoid neoplasms. Results In this study, a total of 660 cases of HM were registered between January 2008 and December 2012. Overall, 6075 cases of cancers all sites combined were registered during this study period, indicating that HM account for around 10.9 % (660/6075) of all cancers recorded. Among the 660 registered cases of HM, 53 % were males and 47 % were females, with a male to female ratio of 1.1. Thus, overall, men are slightly more affected with HM than women. By contrast, a female predominance was observed in the case of Hodgkin’s lymphoma (HL), myeloproliferative neoplasms (MPN), acute myeloid leukemia (AML) and the myelodysplastic syndrome (MDS). HM occur at a relatively young age, with an overall median age at diagnosis of 54 years. Non-Hodgkin’s lymphoma (NHL) was the most common HM accounting for 29.7 % of all HM, followed by HL, MPN, multiple myelomas (MM), chronic lymphocytic leukemia (CLL), AML, MDS, acute lymphoblastic leukemia (ALL), and Waldenström macroglobulinemia (WM). The majority of HM cases have been observed among patients aged 60 years and over (40.4 % of HM). Among this age group, NHL was the most common HM. In adolescents, HL was the most frequent HM. Conclusions This study provided for the first time the pattern and distribution of HM in Eastern Morocco. Our findings justify the need to establish a regional cancer registry as a first step in blood cancer control in Eastern Morocco. Electronic supplementary material The online version of this article (doi:10.1186/s12885-016-2205-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Mounia Elidrissi Errahhali
- Medical Biology Unit, Faculty of Medicine and Pharmacy of Oujda, University Mohammed the First, Oujda, Morocco.
| | - Manal Elidrissi Errahhali
- Medical Biology Unit, Faculty of Medicine and Pharmacy of Oujda, University Mohammed the First, Oujda, Morocco.
| | - Redouane Boulouiz
- Medical Biology Unit, Faculty of Medicine and Pharmacy of Oujda, University Mohammed the First, Oujda, Morocco.
| | - Meryem Ouarzane
- Medical Biology Unit, Faculty of Medicine and Pharmacy of Oujda, University Mohammed the First, Oujda, Morocco.
| | - Mohammed Bellaoui
- Medical Biology Unit, Faculty of Medicine and Pharmacy of Oujda, University Mohammed the First, Oujda, Morocco.
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Pathological Characteristics of Primary Bladder Carcinoma Treated at a Tertiary Care Hospital and Changing Demographics of Bladder Cancer in Sri Lanka. Adv Urol 2016; 2016:5751647. [PMID: 26884756 PMCID: PMC4738954 DOI: 10.1155/2016/5751647] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Revised: 12/19/2015] [Accepted: 12/31/2015] [Indexed: 11/18/2022] Open
Abstract
Objectives. The aim was to compare demographics and pathological features of bladder carcinoma treated in a urology unit with findings of previous studies done in Sri Lanka. Materials and Methods. Data of newly diagnosed patients with bladder cancer in a tertiary referral centre from 2011 to 2014 were analysed. Data on bladder cancers diagnosed from 1993 to 2014 were obtained from previous publications and Sri Lanka Cancer Registry. Results. There were 148 patients and mean age was 65 years. Male to female ratio was 4.1 : 1. Urothelial carcinoma (UC) was found in 89.2% of patients. Muscle invasion was noted in 35% of patients compared to 48.4% two decades ago. In patients with UC, 16.5% were found to have pT1 high grade tumour. It was 5.3% from 1993 to 2000. Pure squamous cell carcinoma was found in 8.1% of patients while primary or de novo carcinoma in situ (not associated with high grade pT1 tumours) was seen in one patient only. Conclusions. The percentage of squamous carcinoma is higher among Sri Lankan patients while primary carcinoma in situ is a rarity. The percentage of muscle invasive disease has decreased while the percentage of pT1 high grade tumours has increased during the last two decades in Sri Lanka.
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Hepatocellular Carcinoma in Pakistan: National Trends and Global Perspective. Gastroenterol Res Pract 2016; 2016:5942306. [PMID: 26955390 PMCID: PMC4756136 DOI: 10.1155/2016/5942306] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Revised: 01/04/2016] [Accepted: 01/05/2016] [Indexed: 02/07/2023] Open
Abstract
Hepatocellular carcinoma (HCC) ranks second amongst all causes of cancer deaths globally. It is on a rise in Pakistan and might represent the most common cancer in adult males. Pakistan contributes significantly to global burden of hepatitis C, which is a known risk factor for HCC, and has one of the highest prevalence rates (>3%) in the world. In the absence of a national cancer registry and screening programs, prevalence of hepatitis and HCC only represents estimates of the real magnitude of this problem. In this review, we present various aspects of HCC in Pakistan, comparing and contrasting it with the global trends in cancer care. There is a general lack of awareness regarding risk factors of HCC in Pakistani population and prevalence of hepatitis C has increased. In addition, less common risk factors are also on a rise. Majority of patients present with advanced HCC and are not eligible for definitive treatment. We have attempted to highlight issues that have a significant bearing on HCC outcome in Pakistan. A set of strategies have been put forth that can potentially help reduce incidence and improve HCC outcome on national level.
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