Estrogen receptor alpha-negative and progesterone receptor-positive breast cancer: lab error or real entity?

Aretrospective study comparing the estrogen receptor (ER) alpha subtype and progesterone receptor (PR) profile of breast carcinomas amongst 1625 cases over 2.5 years was carried out. Strictly speaking it is generally believed that breast carcinomas can biochemically express PR only if they are ER-positive. However, a few ERalpha-PR+ cases do exist paradoxically. This class of tumors was the focus of our study in which we looked at the possible reasons for such an immunophenotype and compared it with a group of ERalpha+PR+ breast carcinomas. An internationally recognized immunohistochemical method employing monoclonal antibodies against estrogen and progesterone receptors was used. Correlations with established risk factors i.e. menopausal status, grade, tumor size and lymph node status were analyzed for our study group (ERalpha-PR+) and compared with a control (ERalpha+PR+). Out of the total 1625 cases, 29.91% (486) were ERalpha+PR+, 5.11% (83) were ERalpha+PR-, 56.86% (924) were ERalpha-PR- and 8.12% (132) were ERalpha-PR+. Patients\u27 age was significantly lower in the ERalpha-PR+ group (P=0.002). Statistical analysis of the grading between the two study groups revealed no significant difference (P=0.091), although the ERalpha-PR+ group contained significantly more poorly differentiated tumors than the ERalpha+PR+ one (P=0.032). Tumor size was also significantly larger in the ERalpha-PR+ than in the ERalpha+PR+ group (P=0.046). The frequency of lymph node metastases was independent of receptor profile. In conclusion, our study group does exhibit characteristics which are suggestive of a distinct breast cancer phenotype (ERalpha-PR+) with a different etiology and prognosis

IMPACT OF OPTIMISM ON POST-TRAUMATIC GROWTH OF BURN SURVIVORS: ROLE OF EMOTIONAL INTELLIGENCE, GENDER AND SEVERITY OF BURN INJURY

OBJECTIVES: To examine the mediating role of emotional intelligence (EI) between optimism and post-traumatic growth (PTG) among burn survivors and to see the interaction effects of gender and nature of injury on optimism, emotional intelligence and PTG. METHODS: This descriptive correlational study was conducted from 2nd January-30th April 2022, at in-patient department of burn centers of three public hospitals of Lahore, Pakistan. Out of 250 survivors of moderate and severe burns, selected through purposive sampling strategy, 229 completed the survey via face to face or call contacts. Participants filled out three structured questionnaires along consent form. Later, collected data was analyzed through PROCESS macro v3.5 and SPSS V23.0. RESULTS: Out of 229 patients 139 (60.7%) were males and 90 (39.3%) were females. Mean age was 32.4±3.1 years. Optimism had a direct effect on emotional intelligence, emotions perception, emotions utilization, managing self-relevant emotions, managing other’s emotions, and PTG, p<.0001. EI and all its subscales predicted PTG, the overall model explained 36% of variance in dependent variable, significant at R=.60, F (3,226) =151.30, p<.0001. Indirect effects of EI and subscales were found between optimism and PTG. Further, interaction effects of gender and nature of injury were seen for optimism, EI and PTG. CONCLUSION: Optimistic approaches and stimulating emotional expressions, managing self-relevant emotions, and utilization of positive emotions might help burn survivors in adapting to their trauma in the longer term. Further, both men and women reported post traumatic growth but severity of injury was affecting PTG in men and women equally

Coronary Artery Fistula and Pectus Excavatum Paradox

Pectus excavatum is the most common congenital chest wall deformity. Its effects on cardiopulmonary function, exercise capacity, and body image are variable across affected patients. Management practices for pectus deformity vary considerably, but most authors agree on the need for surgical correction if pectus index is >3.0 and there is evidence of cardiac compression on imaging. We encountered a case of a middle-aged man with severe pectus deformity and a coincidental large coronary artery to right atrium fistula. Despite a pectus index of 4.8 and severe right heart compression on thoracic imaging, he had not developed any symptoms or hemodynamic complication from this pectus deformity. Additionally, hemodynamic studies revealed normal left and right heart function, normal pulmonary artery pressures, and absence of any evidence of myocardial ischemia or significant left-to-right shunt. These abnormalities would have been expected with a coronary fistula of this size. His pectus deformity and coronary fistula had opposing hemodynamic effects, thus protecting him from severe complications of either. Presently, an association between congenital coronary fistulae and pectus excavatum is not known, and this is one of the very first reported cases of these two congenital abnormalities coexisting in a patient. Additionally, concurrence of these two conditions poses a unique therapeutic challenge due to their opposing hemodynamic effects

Attitude towards mental help-seeking, motivation, and economic resources in connection with positive, negative, and general psychopathological symptoms of schizophrenia: a pilot study of a psychoeducation program

IntroductionSchizophrenia is typically treated with medication as the first approach, but additional strategies are necessary to enhance the effectiveness of this treatment for better outcomes. However, it is crucial to explore methods, alongside medication, that promote a positive attitude towards seeking mental health support and alleviate symptom severity among non-institutionalized individuals of different age groups in Pakistan. Thus, this pilot study aimed to utilize a psychoeducation program to enhance patients’ motivation and attitudes toward seeking treatment, decrease symptom severity, and investigate the role of financial factors in their illness journey.MethodsIn this preliminary investigation, our focus was on individuals who had been diagnosed with schizophrenia and were receiving treatment from various hospitals and primary care clinics. Following a thorough screening process, 255 participants met the eligibility criteria, and 220 completed the psychoeducation program. The study included both male and female participants, with 143 (56.08%) being men and 112 (43.82%) being women. Regarding marital status, 123 (48.24%) were single, 98 (38.43%) were married, and 34 (13.33%) were divorced widowers or widows. The age range of the respondents varied from 18 to 52 years, with a mean age of 35.45 and a standard deviation of 10.27.ResultsThe results indicated a decrease in symptom severity following a 16-week psychoeducation program. The psychoeducation program significantly reduced the positive symptoms, negative symptoms, and general psychopathological symptoms among patients. Similarly, significant improvement was observed in patients’ motivation toward treatment and they actively participated in treatment after getting psychoeducation about the treatment. Similarly, after the psychoeducation program significant improvement was seen in patients’ attitudes towards help-seeking and perceived mental health functioning.ConclusionIn summary, the findings suggest that our psychoeducation program has the potential to positively impact the motivation and help-seeking attitudes of schizophrenia patients towards treatment. Moreover, there is a need for further exploration of psychoeducation programs for schizophrenia, particularly in countries facing economic challenges. This study paves the way for the development of an indigenous psychoeducation program tailored to Pakistani schizophrenia patients, with potential applicability for Urdu-speaking individuals.Clinical Trial Registrationhttps://www.thaiclinicaltrials.org/show/TCTR20210208003, identifier TCTR20210208003

Ant fauna (Hymenoptera: Formicidae) of Quetta, Balochistan, Pakistan

The ant fauna of Quetta, Northern Pakistan was studied using hand collected samples. A total of 1865 individuals were sampled comprising of seven species belonging to three subfamilies. A preliminary checklist of the ant species collected from Quetta city is presented. The most common subfamily observed was Myrmicinae with an abundance value of 66.8% and the most frequent species encountered was the Myrmicine Pharoah Ant, Monomorium pharaonis (60%). The least common species encountered were Solenopsis invicta (Fire ant) and Tetramorium sessile (Pavement ant), also belonging to the subfamilyMyrmicinae with an abundance value of 3.2% and 3%, respectively. The subfamilies Formicinae (3 species) and Dolichoderinae (1 species) were found to be moderately common with abundance values of 18% and 15%, respectively