Zeeshan, Rozina;Sultan, Sadia;Irfan, Syed Muhammad;Kakar, Jamaludin;Hameed, Muhammad Asif
Asian Pacific Journal of Cancer Prevention
/
v.16
no.2
/
pp.793-796
/
2015
Background: Chronic lymphoid leukemia (CLL) is not an uncommon hematological malignancy which primarily affects elderly individuals. It is more common in developed world than in developing countries. The rational of this study was to determine the clinico-hematological profile in Pakistan. Materials and Methods: In this prospective cross sectional study, sixty patients with CLL were enrolled from January 2011 to June 2013. Data were analyzed with SPSS version 21. Results: The mean age was $59.0{\pm}9.2years$ (range 40-82) and the male to female ratio was 2.1:1. Peak age group was 60-70 years (38.3%) and 18.3% were under 50 years old. Major complaints were weakness (51.7%), fever (18.3%) and abdominal discomfort (13.3%). Main clinical findings were splenomegaly (46.6%), lymphadenopathy (36.6%) and pallor (26.7%). Some 16.7% were diagnosed incidentally. The mean hemoglobin was $10.8{\pm}2.4g/dl$, with a total leukocyte count of $91.5{\pm}87.8{\times}10^9/l$ and platelets $197.8{\pm}103.2{\times}10^9/l$. Anemia and thrombocytopenia were seen in 26.7% and 21.7% of cases, respectively. High LDH and hyperuricemia were detected in 15% each and elevated serum creatinine was seen in 11.6%. According to Rai staging 11.6% were in stage 0, 13.3% stage 1, 26.7% each for stage II and stage III while 21.7% patients were in stage IV. Conclusions: CLL in our patients in Pakistan, unlike in the West, is seen in a relatively young population with male predominance. Primarily disease is of B-cell origin and about 2/3 of the patients present at advanced stage.
Background: Primary idiopathic myelofibrosis (PMF) is a clonal Philadelphia chromosome-negative myeloproliferative neoplasm characterized by extramedullary hematopoiesis and marrow fibrosis. It is an uncommon hematopoietic malignancy which primarily affects elderly individuals. The rational of this study was to determine its clinico-epidemiological profile along with risk stratification in Pakistani patients. Materials and Methods: In this retrospective cross sectional study, 20 patients with idiopathic myelofibrosis were enrolled from January 2011 to December 2014. Data were analyzed with SPSS version 22. Results: The mean age was $57.9{\pm}16.5years$ with 70% of patients aged above 50. The male to female ratio was 3:1. Overall only 10% of patients were asymptomatic and the remainder presented with constitutional symptoms. In symptomatic patients, major complaints were weakness (80%), weight loss (75%), abdominal discomfort (60%), night sweats (13%), pruritus (5%) and cardiovascular accidents (5%). Physical examination revealed splenomegaly as a predominant finding detected in 17 patients (85%) with the mean splenic span of $22.2{\pm}2.04cm$. The mean hemoglobin was $9.16{\pm}2.52g/dl$ with the mean MCV of $88.2{\pm}19.7fl$. The total leukocyte count of $17.6{\pm}19.2{\times}10^9/l$ and platelets count were $346.5{\pm}321.9{\times}10^9/l$. Serum lactate dehydrogenase, serum creatinine and uric acid were $731.0{\pm}154.1$, $0.82{\pm}0.22$ and $4.76{\pm}1.33$ respectively. According to risk stratification, 35% were in high risk, 40% in intermediate risk and 25% in low risk groups. Conclusions: The majority of PMF patients were male and presented with constitutional symptoms in our setting. Risk stratification revealed predominance of advanced disease in our series.
Kim, Hyee-Kwon;Bae, Ki-Tae;Kim, Dong-Min;Nam, Sang-Soo;Kim, Yong-Suk
Journal of Acupuncture Research
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v.23
no.6
/
pp.221-227
/
2006
Objectives : The purpose of this case is to report the improvement after treatment about tonic spasm of a transverse myelitis patient. Methods : We treated the patient with acupuncture therapy and herbal medicine from the 19th July 2006 to the 4th October 2006. At first we used Ssanghwa-tang until the 24th July 2006. After that we used Samul-tang until 2nd August. Lastly we used Yukmigihwang-tang until the 4th October 2006. And we used acupuncture at Asi points and used Sheng Ge of Liver from beginning to end. We checked the patient with frequency of tonic spasm and other symptoms. Results : After two months of treatments, frequency of tonic spasm decreased and abdominal muscle rigidity, visual disturbance, ocular discomfort and oppressed feeling in the chest were improved.
A total of 31 human diphyllobothriasis cases have been reported in Korea. Authors experienced two more human cases of Diphyllobothrium latum infection, especially due to eating raw freshwater trout. Two cases were husband and wife in a famil residing in Chunchon city, Kangwon-do, who raw fish in October 1994. A 43-year old male(husband) was 69kg in body weight and healthy. A worm (6.65m in length; 8-l3mm in width) was expelled from him after, anthelmintic treatment. The second case(wife) was a 39-year old female who weighted 56kg. She complained about gastrointestinal trouble and abdominal discomfort. A worm (5.50m in length; 9-l3mm in width) was Obtained her after anthelmintic treatment. No scolex was collected from the two worms. Two patients were administrated with praziquantel(15mg/kg of body weight) and 15gm of magnesium sulfate as a purgative. Two worms identified as D. latum, .based on the following biological characters: extermal morphologies, coiling of uterus, the number of uterine loops, position of genital opening, morphologies of cirrus and cirrus sac and seminal vesicle on the histological sections, positions of vagina and uterine pore, distribution patterns of vitellaria, and microscopical and SEM morphologies of the egg.
This study presents quantitative evaluation standards for they mobility test, conducted in the process of a slacks fit test. This study quantified the subjects' evaluation on the wearability of slacks to provide objective qualitative evaluation methods for existing mobility tests. The subjects were women of standard bodytype between the ages of 18 and 24 wearing slacks designed to test their mobility based on differences in ease in waist girth, hip girth, crotch length and knee length. A qualitative evaluation tested the wearability of slacks. Clothing pressure and gap area between the body and slacks were measured based on a quantitative evaluation. The clothing pressure and the gap area between the body and slacks (which reflect the results of the wearability test) were presented in this study as quantitative evaluation standards. Clothing pressure tended to increase as the ease of slacks decreased; however, clothing pressure standards, that induce discomfort, differed by body parts. The hip, crotch, and knee area were relatively less sensitive despite the waist and the abdominal area sensitivity to clothing pressure. This study suggests the minimum ease for the appropriate wearing comfort of slacks by region and motion as standards for the quantitative evaluation of mobility tests. These was reset in accordance to the limits of clothing pressure when the minimum ease was considered as wearable but exceeded the clothing pressure limits.
Purpose: This study was carried out to evaluate the efficacy of intravaginal pelvic floor electrical stimulation (FES) therapy on bladder irritability symptoms in stress urinary incontinent women. Materials and Methods: The evaluation before and after treatment included the Blaivas's female Bladder Questionnaire, the quality of life questionnaires and the overall satisfaction with present voiding state using visual analogue test (VAT). All patient were treated for 20 minutes, twice a week for 6 weeks, using a new intravaginal electrical stimulator with microchip (PIC16C74). Results: After the FES therapy, the overall success rate of the SUI was 50.4.% at 9 months. The bladder irritability symptoms such as frequency, nocturia, urgency, residual urine sensation and lower abdominal discomfort were improved. In particular, the symptoms of frequency, urge incontinence, dysuria were significantly improved after the FES therapy at 9 months. The VAT score of the overall satisfaction with the present voiding state was significantly lower after the FES therapy. 73.7% of patients were satisfied with the FES therapy and complications such as hemorrhage, vaginitis, urinary tract infection and pain were not encountered. Conclusion: These results suggest that FES therapy with microchip improves some bladder irritability in SUI women. Therefore, electrical stimulation therapy should be considered as a first line therapy in SUI women with bladder irritability symptoms.
Background: Polycythaemia rubra vera (PV) is a Philadelphia chromosome negative myeloproliferative neoplasm characterized by increased red cell production, independent of the mechanisms that regulate normal erythropoiesis. The aim of this study was to analyze the clinico-epidemiological profile of Pakistani patients with PV. Materials and Methods: In this retrospective cross sectional study, 26 patients with PV were enrolled from January 2010 to December 2014. They were diagnosed based on WHO criteria. Results: The mean age was $53.4{\pm}9.31years$ (range 36-72) and the male to female ratio was 2:1. Overall 30.7% of patients were asymptomatic. In symptomatic patients, major complaints were headache (30.8%), abdominal discomfort (23.1%), blurred vision (15.3%), pruritus (11.5%) and vascular incidents (11.5%). Physical examination revealed plethoric face and splenomegaly as predominant findings, detected in 34.6% and 30.7%, respectively, with the mean splenic span of $15.9{\pm}2.04cm$. The mean hemoglobin was $18.1{\pm}1.9g/dl$ with the mean hematocrit of $55.6{\pm}8.3%$. The mean total leukocyte count was $12.8{\pm}7.1{\times}10^9/l$ and the platelet count $511{\pm}341.9{\times}10^9/l$. Mean erythrocyte sedimentation rate was $3.5{\pm}1.22mm/hr$. Serum lactate dehydrogenase, serum creatinine and uric acid were $552.7{\pm}309.2$, $0.8{\pm}0.17$ and $6.60{\pm}1.89$ respectively. Conclusions: PV in Pakistani patients, unlike in the West, is seen in a moderately young population. The disease is frequently seen in male gender and primarily patients present with symptoms related to hyperviscosity.
Norsa'adah, Bachok;Nurhazalini-Zayani, Che Ghazali Che
Asian Pacific Journal of Cancer Prevention
/
v.14
no.11
/
pp.6955-6959
/
2013
The incidence of hepatocellular carcinoma (HCC) is relatively high in Southeast Asia. Globally, HCC has a high fatality rate and short survival. The objectives of this retrospective cohort study were to review the epidemiology and survival of HCC patients at a tertiary centre in north-east of Peninsular Malaysia. Subjects were adult HCC patients diagnosed by histopathology or radio-imaging. Secondary liver carcinoma was excluded. Kaplan Meier and multiple Cox proportional hazard survival analyses were used. Only 210 HCC cases from years 1987-2008, were included in the final analysis. The number of cases was increasing annually. The mean age was 55.0 (SD 13.9) years with male:female ratio of 3.7:1. Approximately 57.6% had positive hepatitis B virus, 2.4% hepatitis C virus, 20% liver cirrhosis and 8.1% chronic liver disease. Only 2.9% had family history and 9.0% had frequently consumed alcohol. Most patients presented with abdominal pain or discomfort and had hepatomegaly, 47.9% had an elevated ${\alpha}$-fetoprotein level of 800 IU/ml or more, 51.9% had multiple tumors and 44.8% involved multiple liver lobes. Approximately 63.3% were in stage 3 and 23.4% in stage 4, and 82.9% did not receive any treatment. The overall median survival time was 1.9 months (95% confidence interval (CI): 1.5, 2.3). The 1-month, 6-month, 1-year and 2-year survival rates were 71.8%, 23.3%, 13.0% and 7.3% respectively. Significant prognostic factors were Malay ethnicity [Adjusted hazard ratio (AHR) 1.6; 95%CI: 1.0, 2.5; p=0.030], no chemotherapy [AHR 1.7; 95%CI: 1.1, 2.5; p=0.017] and Child-Pugh class C [AHR 2.6; 95%CI: 1.4, 4.9; p=0.002]. HCC in our study affected a wide age range, mostly male, in advanced stage of disease, with no treatment and very low survival rates. Primary prevention should be advocated in view of late presentation and difficulty of treatment. Vaccination of hepatitis virus and avoidance of liver toxins are to be encouraged.
Irritable Bowel Syndrome(IBS) is the most common disease in the western male, and it is founded in $70{\sim}80%$ patient who has Gastrointestinal trouble. It is characterized by the formation of disorders of Gastrointestinal tract, for example, constipation, diarrhea, abdominal pain& discomfort, stool urgency, and so on. The etiology of IBS is uncertain, but the majority of patients has emotional problems. The aims of this study are to investigate and summarize the current trends of treatment for IBS so as to suggest the effective and available way to treat this disease. In Oriental Medicine, the IBS is recognized as Stagnation of the Iiver-qi(肝氣鬱結), Incoordination between the liver and the stomach(肝胃不和). So the point of treatment of IBS is Invigorating the spleen and relieving the depression of Iiver-qi(疏肝健脾), Regulating the function of the liver and the flow of qi(調肝理氣), Regulating the stomach and lowering the adverse flow(和胃降逆), and the treatment can be approached in several ways through herb drugs, acupuncture. Some of the herb drugs have substances which promote gastric and small intestinal emptying. Acupuncture and moxibustion therapies stimulate the meridian points of LR(足厥陰肝經), ST(足陽明胃經), LI(手陽明腸經), SI(手太陽小腸經) and is reported to be effective for releafing syndromes. Anal therapy, attachment of herb drug to umbilicus are annunced as the effective treatments. So, this study of the approach and application of these treatments on IBS would be necessary.
Objectives : To investigate the clinical features of drug-induced liver injury (DILI) and traditional Korean medicine (TKM) -based management. Methods : A female patient diagnosed with DILI caused by Western drugs had been treated with Oriental therapies, then the subjective clinical outcome and biochemical parameters were monitored. Results : A 73-year-old female had taken Western drugs (nonsteroidal anti-inflammatory and skeletal muscle relaxants) for about 3 months, and complained of severe abdominal discomfort and tiredness. Her RUCAM score was 9, which met the criteria for DILI (AST 90 IU/L, ALT 100 IU/L, ALP 191 IU/L, and GGT 614 IU/L). She was treated with herbal drugs, moxibustion, and acupuncture, and her symptoms completely resolved, with normalized hepatic enzymes within two weeks. Conclusions : This case report provides a clinical characteristic for a typical DILI caused by Western medicine, and shows an example of a TKM-based application.
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