Frequency of malignant solid tumors in children

Objective: To find out the frequency of malignant solid tumors in children (cTl5 years). Setting: All cases of pediatric malignant solid tumors which were diagnosed in the section of histopathology at the Aga Khan University Hospital, Karachi during the period of two years. Methods: These tumors were initially evaluated on H&E stained sections and special stains were also performed whenever indicated. The undifferentiated tumors were evaluated immunohistochemically by using a panel of antibodies on sections from routinely processed, fornialin fixed, paraffin embedded tissu.e blocks. Results: Of two hundred and fifty three (253) consecutive cases of paediatric malignant solid tumors, lyinphorna (26.1 %) was the most common tumor followed by central nervous system tumors (16,6%), osteosarcoma (7.5%), rhabdomyosarcoma (6.7%), neuroblastoma (5.1%), Wilm\\u27s tumor (5.1% %), Ewing’s sarcoma (4.7%), retinoblastoma (4.7%), germ cell tumor (4.4%) and primitive neuroectodermal tumor (4%) in order of frequency. In seven cases (2.8%), the nature of lesion remained undetermined even after immunohistochemical staining. Rest of malignant tumors (12.3%) included the rare entities like synovial sarcoma, nasopharyngeal carcinoma, leiomyosarcoma, malignant schwannoma and thyroid carcinoma, etc. Conclusion: Lymphoma was the most frequent Paediatric tumor. The frequency of childhood central nervous to the other series from different regions of Pakistan system tumors was quite high as compared

Childhood non-Hodgkin\u27s Lymphoma: An immunophenotypic analysis.

Objective: To observe the frequency of histological subtypes of childhood non-Hodgkin`s lymphoma and its immunohistochemical profile. Setting: All cases of non-Hodgkin’s lymphoma diagnosed in children (\u3c15 years) in the section of histopithology at the Aga Khan University Hospital Karachi during the period of three years. Methods: These consecutive cases were evaluated on H&E stained sections and then immunohistochemistry analysis of these tumors was performed by employing Peroxidase Anti-Peroxidase (PAP) technique. Results: The present series included 61 cases of non-Hodgkin’s lymphoma. NHL was more common in males as compared to females with male to female ratio of 5.8:1. High grade NHL comprised 87% of childhood lymphoma. The mode of presentation in majority of NHL (57%) was extranodal. Burkitt’s lymphonia (33%) was the most prevalent histological subtypes, followed by lymphoblastic (28%), diffuse large cell (15%), diffuse mix small and large cell (13%), small non cleaved Non-Burkitts (7%) and immunoblastic (4%). Immunophenotypic analysis of the childhood Non-Hodgkin’s lymphoma revealed that 67% of the Non-Hodgkin’s Iy mphoma are cell type while 33% are those of T-cell lineage. Conclusion: NHL was more common in males. Majority of NHL in children were high grade tumors. Burkitt’s lymphoma was the most frequent histological subtype. T-cell NUL comprised a significant portion of childhood lymphoma

Clinico-morphological pattern of intracranial tumors in children

Objective: The objective of present study was to observe the histopathological pattern of intracranial tumors in children (\u3c 15 yrs) and to correlate the site of lesion along with the histological diagnosis. Setting: The study included consecutive cases of intracranial tumors diagnosed in children (\u3c 15 yrs.) in the section of histopathology at the Aga Khan University Hospital, Karachi during the period of three years. Methods:The initial histological evaluation of these lesions was performed on H and E stained section of paraffin embedded tissue. Special stains and immunohistochemical analysis was done whenever indicated. Results:During the study period, fifty-four cases of intracranial tumors were diagnosed in children. The age ranged from 1-1/2 years to 4 years with male to female ratio of 1.1:1. Astrocytoma comprised 39% of all intracranial tumors of childhood. Medulloblastoma (18.6%) ranked the second most prevalent brain tumor followed by empendymoma (13%), oligodendroglioma 7.5% while non-Hodgkin\u27s lymphoma, primitive neuroblastoma 3.7% and ganglioglioma 3.7% while non-Hodgkin\u27s lymphoma, primitive neuroectodermal tumors, mixed germ cell tumor, pineoblastoma, choroid plexus carcinoma and malignant meningioma constituted 1.8% each. Conculsion: Astrocytoma was the most common pediatric brain tumor. Medulloblastoma was more common in males while pilocytic astrocytoma was more frequent in females. Posterior cranial fossa was the most common site (43.5%) of pediatric brain tumors. Low grade astrocytoma was more prevalent in posterior cranial fossa as compared to high grade astrocytoma which was more frequent in the supratentorial region

Clinico-morphological pattern and frequency of bone cancer

Objective: The present study was done to find out the frequency of malignant tumors of bone and to categorize the prevelence of various histological types of osseous malignancies with respect to age, sex and site of origin. Setting: This study included consecutive cases of malignant bone tumors, which were diagnosed in the department of pathology at the Aga Khan University Hospital, Karachi during the period of three years (1995-1997). Methods: These tumors were initially evaluated on H & E stained section from paraffin embedded tissue blocks. Special stains and immunohistochemical analysis was performed whenever required. Results: A total of 169 malignant bone tumors were diagnosed during the study period. Metastatic tumors accounted for 28.4% of all malignant tumors of bone. Osteogenic sarcoma (27.2%) was the most frequent primary tumor of bone followed by Ewing’s sarcoma (12.4%), Non- Hodgkin’s lymphoma (10.6%), Chondrosarcoma (8.3%), Plasma Cell Myeloma (8.3%) and other rare entities (4.8%) in order of frequency. Conclusion: The most common malignant neoplasm diagnosed in osseous biopsies was metastatic tumors. Osteogenic sarcoma was the most frequent primary bone tumor in this series. The bone tumors were relatively more prevalent in males. The frequency of malignant bone tumor was relatively high as compared to developed countries

Immunohistochemical evaluation of small round cell tumors of childhood

Objective: This study was done to evaluate the pediatric undifferentiated small round cell tumors with immunohistochemical staining. Setting: The present study included consecutive cases of small round cell tumors which were diagnosed in children (\u3c15 years) in the section of Histopathology at the Aga Khan University Hospital, Karachi during the period of two years. Methods: The group of undifferentiated small round cell tumors were evaluated immunohistochemically by using a panel of antibodies on sections from routinely processed, formalin fixed, paraffin embedded tissue blocks. Results: The category of undifferentiated small round cell tumors included rhabdomyosarcoma (23.2%), primitive neuroectodermal tumor (17.9%), non-Hodgkin’s lymphoma (16.1%), neuroblastoma (14.2%), Ewing’s sarcoma (10.7%) in order of frequency. Osteosarcoma (Small cell variant), retinoblastoma and medulloblastoma comprised 1.8% each. In seven cases (12.5%), the immunohistochemical analysis was inconclusive. Conclusion: Immunohistochemistry is a very valuable diagnostic tool which helps in distinguishing the undifferentiated tumors especially small round cell tumors. The immunohistochemical staining needs to be performed routinely for undifferentiated tumors in diagnostic histopathology

Relationship of BMI and age with gallstone disease

Objective: To find out the relationship of BMI and age in patients with gallstone disease.  Methodology: This is a cross-sectional study done from March 2019 to February 2020 at the Department of General Surgery PIMS, Islamabad. All patients admitted with a diagnosis of Cholelithiasis were included and patients with previous abdominal surgery were excluded from the study. Patients’ data was collected about their age, sex, dietary habits, occupation and medical history. Their weight in kilograms and heights in centimeters were measured and BMI was calculated in kg/cm2. All data was collected, recorded and analyzed using SPSS 22. Results: A total of 158 patients were included in the study with mean age was 46.2±6.7 years (18 - 83 years). Majority (63%) of the patients were between 41 and 60 age group. There were 120 females and 38 males with ratio of 3:1. The mean BMI of the study population was 25.8 ± 7.61 (Range 19.37 - 33.12). Most of the patients were healthy (n=86, 54.4%) having their BMIs between 18 and 24.9 whereas 72 (46.6%) patients were overweight and obese. Conclusion: Increased frequency of cholelithiasis is found with increasing age even with normal BMI

Multiscale damage modelling of 3D woven composites under static and impact loads

A multiscale progressive damage modelling methodology for 3-dimensional (3D) woven composites is presented. The proposed methodology is generic and can be implemented in most finite element software to create a digital twin for simulation of damage response. It uses 3D solid element (reduced integration) representation of the part for global analysis, while the local damage response, as well as matrix nonlinearity is modelled using a mesoscale constitutive unit-cell model of 3D woven composite consisting of idealised regions of polymer matrix and impregnated yarns. The idealised unit-cell model is defined based on realistic input from X-ray tomography of the 3D woven composite part and the micro-level constituent properties of the matrix and fibres. The damage model has been validated using quasi-static tensile/compression tests as well as dynamic drop-weight impact tests for both thermoset (epoxy) and thermoplastic (Elium) 3D woven composites. These simulations successfully demonstrate the accuracy and efficiency of the model for both 3D-textile composites.The authors would like to acknowledge the financial support provided by Universiti Teknologi PETRONAS (grant number 015LC0-197). The authors would also like to acknowledge the support of Dr. Pierre Gerard from Arkema and Dr. Sharp Keith from TexTech industries in acquiring Elium® resin and 3D fabric for this research work, Dr. Faiz Ahmad and Advance Functional Material (AFM) lab Universiti Teknologi PETRONAS in providing the facility for the fabrication of 3D woven composites

Prevalence and determinants of unintended pregnancies amongst women attending antenatal clinics in Pakistan

Background: Unintended pregnancies are a global public health concern and contribute significantly to adverse maternal and neonatal health, social and economic outcomes and increase the risks of maternal deaths and neonatal mortality. In countries like Pakistan where data for the unintended pregnancies is scarce, studies are required to estimate its accurate prevalence and predictors using more specific tools such as the London Measure of Unplanned Pregnancies (LMUP). Methods: We conducted a hospital based cross sectional survey in two tertiary care hospitals in Pakistan. We used a pre tested structured questionnaire to collect the data on socio-demographic characteristics, reproductive history, awareness and past experience with contraceptives and unintended pregnancies using six item the LMUP. We used Univariate and multivariate analysis to explore the association between unintended pregnancies and predictor variables and presented the association as adjusted odds ratios. We also evaluated the psychometric properties of the Urdu version of the LMUP. Results: Amongst 3010 pregnant women, 1150 (38.2%) pregnancies were reported as unintended. In the multivariate analysis age \u3c 20 years (AOR 3.5 1.1-6.5), being illiterate (AOR 1.9 1.1-3.4), living in a rural setting (1.7 1.2-2.3), having a pregnancy interval of = \u3c 12 months (AOR 1.7 1.4-2.2), having a parity of \u3e2 (AOR 1.4 1.2-1.8), having no knowledge about contraceptive methods (AOR 3.0 1.7-5.4) and never use of contraceptive methods (AOR 2.3 1.4-5.1) remained significantly associated with unintended pregnancy. The Urdu version of the LMUP scale was found to be acceptable, valid and reliable with the Cronbach\u27s alpha of 0.85. Conclusions: This study explores a high prevalence of unintended pregnancies and important factors especially those related to family planning. Integrated national family program that provides contraceptive services especially the modern methods to women during pre-conception and post-partum would be beneficial in averting unintended pregnancies and their related adverse outcomes in Pakistan

Remaining idle time aware intelligent channel bonding schemes for cognitive radio sensor networks

Channel bonding (CB) is a technique used to provide larger bandwidth to users. It has been applied to various networks such as wireless local area networks, wireless sensor networks, cognitive radio networks, and cognitive radio sensor networks (CRSNs). The implementation of CB in CRSNs needs special attention as primary radio (PR) nodes traffic must be protected from any harmful interference by cognitive radio (CR) sensor nodes. On the other hand, CR sensor nodes need to communicate without interruption to meet their data rate requirements and conserve energy. If CR nodes perform frequent channel switching due to PR traffic then it will be difficult to meet their quality of service and data rate requirements. So, CR nodes need to select those channels which are stable. By stable, we mean those channels which having less PR activity or long remaining idle time and cause less harmful interference to PR nodes. In this paper, we propose two approaches remaining idle time aware intelligent channel bonding (RITCB) and remaining idle time aware intelligent channel bonding with interference prevention (RITCB-IP) for cognitive radio sensor networks which select stable channels for CB which have longest remaining idle time. We compare our approaches with four schemes such as primary radio user activity aware channel bonding scheme, sample width algorithm, cognitive radio network over white spaces and AGILE. Simulation results show that our proposed approaches RITCB and RITCB-IP decrease harmful interference and increases the life time of cognitive radio sensor nodes

2017 update of the WSES guidelines for emergency repair of complicated abdominal wall hernias

Emergency repair of complicated abdominal wall hernias may be associated with worsen outcome and a significant rate of postoperative complications. There is no consensus on management of complicated abdominal hernias. The main matter of debate is about the use of mesh in case of intestinal resection and the type of mesh to be used. Wound infection is the most common complication encountered and represents an immense burden especially in the presence of a mesh. The recurrence rate is an important topic that influences the final outcome. A World Society of Emergency Surgery (WSES) Consensus Conference was held in Bergamo in July 2013 with the aim to define recommendations for emergency repair of abdominal wall hernias in adults. This document represents the executive summary of the consensus conference approved by a WSES expert panel. In 2016, the guidelines have been revised and updated according to the most recent available literature.Peer reviewe