PROSPECTS OF CANCER REGISTRATION SYSTEM AT ZIAUDDIN UNIVERSITY

Despite cancer being one of the most common causes of mortality in Pakistan, little authentic data is available regarding the status, incidence and survival of cancer in our population the reason being the non existence of a national cancer registry and major neglect in this area. A cancer registry gathers, and analyses data on individuals with cancer, to formulate directives for control. Several scientific studies are coming up regarding the putative risk factors in relation to chemical, biological and environmental carcinogens associated in cancer pathogenesis. The recent risk factor analysis based on epidemiology, molecular biology and genetics of colon cancer has given a major to its management [1]. However, information regarding these risk factors and cancer burden from our country is not adequate to formulate and implement policies for primary and secondary prevention. This makes the formation of a cancer registry crucial. In addition, standardized data maintained in cancer registries can be used not only for clinical research but also for epidemiological research and to improve quality of care by healthcare planning and monitoring [2]. As cancer registries play a major role in assessing cancer burden and formulating cancer control programs, incorrect data can have detrimental effects on the resources of a developing country like Pakistan. It is therefore of utmost importance that the data collected by cancer registries is reliable and standardized [3]

Rehabilitation: Health Research Perspectives And Challenge

Policy drives practice and Health Services Research is at the intersection of policy, practice and patient outcomes. Health Services Research in relation to disability has to reform targets to add value to rehabilitation in a policy relevant context. Medical rehabilitation research is directed towards restoration and improvement of functional capabilities lost due to injury, disease or congenital disorders along with the development of new and improved assisted technologies. Fostering stake holders’ engagement in this regard ensures patient centered focus. The crucial information from all the pertinent fields for rehabilitation generates a hub of innovative strategies leading to commercialization in Health Services Research (HSR). The investigation revolves around current resources available in this field with identification of gaps for capacity building and connectivity between all the stake holders for a meaningful bonding, making health care reforms a reality. Rehabilitation is a vital component of health services. It includes a group of interventions which intend to optimize function in those disabled and suffering from diseases so that they can interact better with their environment by living, working and learning to their best capability.There is a growing need for rehabilitation today as populations age and the occurrence of non communicable diseases and injuries increase1. The World Health Organization (WHO) reported an estimated 15% of the world’s population suffering from mental or physical disabilities[2]. Rehabilitation research being a multidisciplinary venture requires strong collaboration among a good range of fields and specialties including a few such as ergonomics, biomechanics, and physical medicine, biomedical engineering and computer sciences. Rehabilitation researchers are practitioners and investigators in the science of recovery. The level of investigation could be molecular, cellular, tissues, organ systems, the whole body or psychological domains. WHO also recognizes rehabilitation as one of its key priorities in 2017 with focus on research to not only make the cost benefits of rehabilitation known and measuring its impact but also to identify the barriers in accessing rehabilitation facilities and their underutilization along with predicting the need for health professionals required in this area3. Medical rehabilitation deals with a coordinated multidisciplinary approach to disability through a physician directing a management plan of disabling diseases and injuries. The strategy includes skilled rehabilitation nursing care, physical therapy, speech and audiology, prosthetic and orthotic devices, social, recreational and psychological services.For example, in stroke patients, physiotherapists assist in musculoskeletal issues where as speech therapists deal with language and swallowing, and occupational therapists help patients return to their daily activities2

Unusual Relapse of Primary Central Nervous System Lymphoma at Site of Lumbar Puncture

Primary CNS lymphoma (PCNSL) is a rare non-Hodgkin’s lymphoma confined to the CNS. Local relapse of this disease is common, but extracranial or subcutaneous metastasis is rare with only a few cases being reported in literature. We report a 63-year-old male patient, who responded well to treatment for PCNSL but relapsed two and half years later with a lumbosacral nodule at the site of a previous lumbar puncture due to microscopic tumor seeding. Clinicians treating patients with PCNSL must remain alert to the possibility of extracranial solitary relapse even after the resolution of initial disease because prompt treatment can result in a good outcome

Global Incidence and Risk Factors Associated With Postoperative Urinary Retention Following Elective Inguinal Hernia Repair

Importance Postoperative urinary retention (POUR) is a well-recognized complication of inguinal hernia repair (IHR). A variable incidence of POUR has previously been reported in this context, and contradictory evidence surrounds potential risk factors.Objective To ascertain the incidence of, explore risk factors for, and determine the health service outcomes of POUR following elective IHR.Design, Setting, and Participants The Retention of Urine After Inguinal Hernia Elective Repair (RETAINER I) study, an international, prospective cohort study, recruited participants between March 1 and October 31, 2021. This study was conducted across 209 centers in 32 countries in a consecutive sample of adult patients undergoing elective IHR.Exposure Open or minimally invasive IHR by any surgical technique, under local, neuraxial regional, or general anesthesia.Main Outcomes and Measures The primary outcome was the incidence of POUR following elective IHR. Secondary outcomes were perioperative risk factors, management, clinical consequences, and health service outcomes of POUR. A preoperative International Prostate Symptom Score was measured in male patients.Results In total, 4151 patients (3882 male and 269 female; median [IQR] age, 56 [43-68] years) were studied. Inguinal hernia repair was commenced via an open surgical approach in 82.2% of patients (n = 3414) and minimally invasive surgery in 17.8% (n = 737). The primary form of anesthesia was general in 40.9% of patients (n = 1696), neuraxial regional in 45.8% (n = 1902), and local in 10.7% (n = 446). Postoperative urinary retention occurred in 5.8% of male patients (n = 224), 2.97% of female patients (n = 8), and 9.5% (119 of 1252) of male patients aged 65 years or older. Risk factors for POUR after adjusted analyses included increasing age, anticholinergic medication, history of urinary retention, constipation, out-of-hours surgery, involvement of urinary bladder within the hernia, temporary intraoperative urethral catheterization, and increasing operative duration. Postoperative urinary retention was the primary reason for 27.8% of unplanned day-case surgery admissions (n = 74) and 51.8% of 30-day readmissions (n = 72).Conclusions The findings of this cohort study suggest that 1 in 17 male patients, 1 in 11 male patients aged 65 years or older, and 1 in 34 female patients may develop POUR following IHR. These findings could inform preoperative patient counseling. In addition, awareness of modifiable risk factors may help to identify patients at increased risk of POUR who may benefit from perioperative risk mitigation strategies