How to Cite: Khan, R. ., Ahmed, A. ., Khan, R. ., Masroor Bhatti, A. ., I n a y a t H u s s a i n , Z . . , & Q a s i m , M . ( 2 0 2 2 ) . Gastrointestinal Cancer Surgeries in COVID-19 Pandemic, Pir Abdul Qadir Shah Gelani (GIMS), Hospital, Gambat: Gastrointestinal Cancer Surgeries in COVID-19. Pakistan BioMedical Journal, 5(7). https://doi.org/10.54393/pbmj.v5i7.522

Gastrointestinal Cancer Surgeries in COVID-19 Pandemic, Pir Abdul Qadir Shah.cdr

Background: Complicated intra-abdominal infections have become a major health challenge that merits safe and efficacious therapy. Antibiotic therapy is the treatment of choice, however the duration of antibiotic use is debatable. 
Objective: To compare the safety and efficacy of the short course and long course antibiotic therapy towards the treatment and the progressive outcome of patients presented with complicated intra-abdominal infections. 
Methodology: This comparative study was carried out on 94 subjects (chosen via non-probability, consecutive sampling), who presented with complicated intra-abdominal infections, had signs and symptoms of infection along with ultrasound abdomen examination consistent with infective foci and routine blood test showing raised total leukocyte count, at the Department of Surgery - Liaquat University Hospital, Hyderabad. Subjects were divided into two groups (47 in each) through a random assignments. Group-A was kept on a short course (5-7-days) while Group-B was kept on a long course (7-10 days) antibiotic therapy. Data were documented using a structured questionnaire, including inquiries related to sociodemographic details, disease specifics, and observed for the outcome variables (mainly postoperative early resolution of infection and long hospital stay). 
Results: In Group A, resolution of infection was achieved in 59.57%, 29.79% and 10.64% patients on day 5, 6 and 7, espectively. In Group B, esoluation of infection was only reported as 42.55%, 36.17% and 21.28% on day 5, 6 and 7, respectively. The median duration of taking antibiotic was almost half in short course group than the long. Surgical site infections were commonly observed in Group B patients. There was no mortality observed in both groups. There is no significance difference observed in primary outcome of clinical cure among the groups. 
Conclusion: It can be concluded that the short course antibiotic therapy has good efficacy to treat CIAI when the primary foci of infection are surgically extracted with adequate source control.

https://www.journaljpri.com/index.php/JPRI/article/download/35398/66858

Comparative Analysis of Short-Course Vs Long Course Antibiotic Therapy among Patients with Complicated Intra-Abdominal Infections

Aim: To assess the vitamin D deficiency as a possible risk factor in breast cancer. Study design: Cross-sectional study Place and duration of study: Surgical Unit-II, Ward 5, Liaquat University of Medical & Health Sciences Jamshoro from 1stJanuary 2022 to 31st December 2022. Methodology: One hundred and twenty-seven patients with the complaints of lump/mass in the breast or nipple discharge ≥6-week duration and diagnosed as breast cancer regardless of stage/grade presented were enrolled. Results: 59.8% while the illiterate, primary, middle, secondary and higher were 36.2%, 14.2%, 17.3%, 20.5% and 11.8%. The statistical significance was observed for vitamin D deficiency in accordance with residence (p=0.03), duration of disease (p=0.05), educational status (p=0.05), hypertension (p=0.01), smoking (p=0.00), obesity (p=0.02), diabetes mellitus (p=0.04), raised CRP (p=0.00), hypocalcemia (p=0.00), ER/PR positive (p=0.01) and family history of breast cancer (p=0.04). Conclusion: Vitamin D deficiency is more prevalent in patients with breast cancer with rural population predominance. Keywords: Breast cancer, breast carcinoma, and vitamin D deficiency.

Assessment of Vitamin D Deficiency and its Possible Risk with Breast Cancer in Pakistan

One of the leading cause of deaths in women is breast cancer. The incidence and prevalence of cancer is increasing day by day. The aim of this research was to analyse the relationship between HRS (hormonal receptor status) and age in females suffering from breast cancer. It was a cross-sectional study conducted at surgical department, LUMHS, Jamshoro, Sindh, Pakistan. The 200 females diagnosed with breast cancer were included in research. The mean age of the study sample was observed to be 48.68 ± 9.54 years. Out of 200 females, 79 (39.5%) females had positive expression of “ER (estrogen receptor)” while 80, (40%) had positive “PR (progesterone receptor)” expression and 41(20.5%) females were associated with “positive expression of HER2/neu (human epidermal growth factor receptor 2)”. The age group of 41-50 years showed (30.4%) highest ratio of positive ER followed by (24%) PR and (17.5%) “HER/2 neu expression” respectively. A statistically significant correlation was found between ER expression and age and (p=0.013), PR expression and age and (p=0.002) while HER/2 neu expression showed insignificant correlation (p=0.231). The research also found that most of the females in their 40s were suffering from breast cancer also the older women had positive were “estrogen receptor (ER), progesterone receptor (PR), and HER2/neu expression” as compared to younger females but there are high chances of survival if breast cancer is diagnosed and managed timely. To do so awareness regarding self-care and self-analysis for women is important to prevent the prognosis of breast cancer. Keywords: Breast Cancer, hormonal receptor status, estrogen, progesterone

Analysis of Breast Cancer Receptors Status and Molecular Subtypes Among Female Population

Background: The harmonic scalpel, commonly used in laparoscopic surgery, now has promise for MRM dissection. The harmonic scalpel's high frequency mechanical vibrations cut and coagulate intraoperatively at the same time, generating less heat injury than electrocautery. 
Objective: To compare the outcome of modified radical mastectomy using harmonic scalpel versus electrocautery at tertiary care teaching hospital. 
Methodology: The randomized controlled trial was conducted from 12th September 2018 11th March 2019 at Department of Surgery, Liaquat University of Medical and Health Science, Jamshoro. A total of 128 patients with infiltrating ductal carcinoma undergoing modified radical mastectomy, 20 to 50 years of age were included. Chronic Hepatitis, diabetes, and neo-adjuvant treatment patients were excluded. Modified radical mastectomy employing harmonic scalpel for Group A and electrocautery for Group B. Postoperative problems such as seroma development, postoperative hematoma, marginal necrosis, lymphedema, and wound infection were also observed. 
Results: The mean age of women in group A was 39.81 ± 6.73 years and in group B was 39.45 ± 6.60 years. Mean duration of disease was 5.41 ± 1.91 months. The frequency of seroma formation in harmonic scalpel group as 7.81% vs 26.56% in electrocautery group, p=0.005), frequency of pain is 53.13% vs 68.75% respectively, p=0.070, frequency of hematoma is 1.56% vs 17.19% respectively, p=0.002), frequency of marginal necrosis was 0.0% vs 7.81% respectively, p=0.023), lymphedema 3.13% vs 14.06% respectively, p=0.027) and wound infection 17.19% vs 35.94% respectively, p=0.016. 
Conclusion: This research indicated that harmonic scalpel is superior to electrocautery in modified radical mastectomy.

A. Bhatti

Papers

Gastrointestinal Cancer Surgeries in COVID-19 Pandemic, Pir Abdul Qadir Shah.cdr

Comparative Analysis of Short-Course Vs Long Course Antibiotic Therapy among Patients with Complicated Intra-Abdominal Infections

Assessment of Vitamin D Deficiency and its Possible Risk with Breast Cancer in Pakistan

Analysis of Breast Cancer Receptors Status and Molecular Subtypes Among Female Population

Harmonic Scalpel versus Electrocautery: An Experience of Modified Radical Mastectomy at Tertiary Care Teaching Hospital