Medicine and Health Sciences Commons^™

Karachi Cancer Registry (Kcr): Age-Standardized Incidence Rate By Age-Group And Gender In A Mega City Of Pakistan, Shahid Pervez, Adnan Jabbar, Ghulam Haider, Shamvil Ashraf, Muhammad Asif Qureshi, Fouzia Lateef, Imtiaz Bashir, Manzoor Zaidi, Mohammad Khurshid, Mohammad Saeed Quraishy

Department of Pathology and Laboratory Medicine

Objectives: To estimate the cancer incidence by age group and gender for the population of Karachi Division by analyzing the Karachi Cancer Registry data of 2017-19.
Settings: The population of Karachi division is 16.1 million according to national census 2017. 'Karachi Cancer Registry' which is a part of 'National Cancer Registry' is collecting data from eight major hospitals in Karachi since 2017. For outcome measures, cancer counts and the age standardized incidence rates (ASIR) per 100,000 population were computed for age groups (0-14, 15-19 and ≥20 years), in both genders and all cancer site/type.
Methods: The population denominators were based …

Childhood Medulloblastoma, Naureen Mushtaq, Shahzadi Resham, Muhammad Shahzad Shamim, Bilal Mazhar Qureshi, Quratulain Riaz, Eric Bouffet

Section of Haematology/Oncology

Medulloblastoma is the most common malignant brain tumour in children and is a major cause of mortality and morbidity, particularly in low- and middle-income countries. It has been risk-stratified on the basis of clinical (age, metastasis and extent of resection) and histological subtypes (classic, desmoplastic and anaplastic). However, recently medulloblastoma has been sub-grouped by using a variety of different genomic approaches, such as gene expression profiling, micro-ribonucleic acid profiling and methylation array into 4 groups, namely Wingless, Sonic hedgehog, Group 3 and Group 4. This new sub-grouping has important therapeutic and prognostic implications. After acute leukaemia, brain tumour is the …

Adult Secondary Hemophagocytic Lymphohistiocytosis, Antonina Obayo, Karishma Sharma, Caroline Mithi, Riyat Malkit, Anne Mwirigi

Internal Medicine, East Africa

Background: Hemophagocytic lymphohistiocytosis (HLH) is a syndrome of excessive inflammation and tissue destruction due to abnormal immune activation. HLH carries a very high mortality, and while delays in patients’ presentation to hospital, time to suspicion of HLH, investigation, and initiation of therapy all play a part, mortality remains high even with timely diagnosis and treatment. Classical manifestations of HLH include persistent fever, cytopenias, and liver dysfunction.

Case presentation: We present four cases of secondary HLH, highlighting the demographic and clinical characteristics of these patients, underlying triggers (including systemic lupus erythematosus, lymphoproliferative disorders, and leishmaniasis), together with challenges associated with the …

Prevalence And Determinants Of Anemia Among Women Of Reproductive Age In Thatta Pakistan: Findings From A Cross-Sectional Study, Sumera Aziz Ali, Zahid Abbasi, Babar Shahid, Ghazal Moin, K Michael Hambidge, Nancy F. Krebs, Jamie E. Westcott, Elizabeth M. Mcclure, Robert L. Goldenberg, Sarah Saleem

Community Health Sciences

Background: Anemia is a major public health concern among women of reproductive age leading to high maternal mortality in low- and middle-income countries. Of the prior studies conducted in Pakistan, most focused on large urban areas and did not explore the determinants of anemia among women of reproductive age (WRA) across socio-demographic, dietary, reproductive, and biological domains. Thus, we aimed to study the prevalence and determinants of anemia among WRA in rural Pakistan.
Methods: We conducted a cross-sectional study in the Thatta district of Pakistan from September 2018 to January 2019 and enrolled 150 non-pregnant, married women. Data collectors administered …

Follow-Up Care For Breast And Colorectal Cancer Across The Globe: Survey Findings From 27 Countries, Michelle A. Mollica, Deborah K. Mayer, Kevin C. Oeffinger, Youngmee Kim, Susan S. Buckenmaier, Sudha Sivaram, Catherine Muha, Nur Aishah Taib, Elisabeth Andritsch, Asim Jamal

Internal Medicine, East Africa

Purpose: The purpose of this study was to describe follow-up care for breast and colorectal cancer survivors in countries with varying levels of resources and highlight challenges regarding posttreatment survivorship care.

Methods: We surveyed one key stakeholder from each of 27 countries with expertise in survivorship care on questions including the components/structure of follow-up care, delivery of treatment summaries and survivorship care plans, and involvement of primary care in survivorship. Descriptive analyses were performed to characterize results across countries and variations between the WHO income categories (low, middle, high). We also performed a qualitative content analysis of narratives related to …

Cytopenia Among Cml Patients On Imatinib In Kenya: Types, Grades, And Time Course, Angela Mcligeyo, Jamilla Rajab, Mohammed Ezzi, Peter Oyiro, Yatich Bett, Andrew Odhiambo, Matilda Ong’Ondi, Sitna Mwanzi, Mercy Gatua, Naothieno Abinya

Internal Medicine, East Africa

Background: Imatinib mesylate is the gold standard for the treatment of all phases of Philadelphia-positive chronic myeloid leukemia. Patients on imatinib treatment may develop cytopenia due to drug toxicity. This study aimed to determine the types, grades, and time course of cytopenia in CML patients on imatinib at a Nairobi hospital.

Methods: This was a cross-sectional descriptive study of adult patients aged ≥18 years followed up at the Glivec International Patient Access Program (GIPAP) clinic from 2007 to 2015. Patients who developed cytopenia within 12 months of initiating imatinib were eligible. Clinical and hematologic data were retrieved from the patients’ …

Worldwide Network For Blood And Marrow Transplantation (Wbmt) Recommendations For Establishing A Hematopoietic Stem Cell Transplantation Program In Countries With Limited Resources (Part Ii): Clinical, Technical And Socio-Economic Considerations, M Aljurf, D Weisdorf, S K. Hashmi, A Nassar, E Gluckman, M Mohty, D Rizzo, M Pasquini, M Hamadani, Salman Adil

Section of Haematology/Oncology

The development of hematopoietic stem cell transplantation (HSCT) programs can face significant challenges in most developing countries because such endeavors must compete with other government health care priorities, including the delivery of basic services. While this is may be a limiting factor, these countries should prioritize development of the needed expertise to offer state of the art treatments including transplantation, by providing financial, technological, legal, ethical and other needed support. This would prove beneficial in providing successful programs customized to the needs of their population, and potentially provide long-term cost-savings by circumventing the need for their citizens to seek care …

Prevalence And Determinants Of Anemia Among Women Of Reproductive Age In Developing Countries, Sumera Aziz Ali, Umber S. Khan, Anam Shahil Feroz

Community Health Sciences

Anemia is one of the major causes of maternal mortality and morbidity across the globe, affecting around two-thirds of pregnant women in developing countries. The objective of this study was to synthesise study findings regarding the prevalence and determinants of anemia among women of reproductive age in developing countries. A total of 28 articles were reviewed by two authors for preliminary screening after removing overlapping information. Finally, 15 studies conducted from 2000 to 2015 were included in the review. The average prevalence of anemia was found to be 46.5% with a range of 18.1% to 75% in different studies. Factors …