Cancer and how the patients see it; prevalence and perception of risk factors: a cross-sectional survey from a tertiary care centre of Karachi, Pakistan.

BACKGROUND: The incidence of cancer is rising but data available regarding prevalence of cancer and patient perception of the disease in Pakistan is limited. It is difficult to deal with Cancer if the main causes are negligence towards risk factors and bizarre myths. This study was aimed to investigate common cancer presentations at a government sector hospital and to gain insight into patient knowledge of the disease. METHODS: This was a cross-sectional study conducted on cancer patients from Jinnah Postgraduate Medical Centre. A self-made questionnaire was used to assess the norms related to cancer prevalence in our society, associated myths, and the most common risk factors per them. RESULTS: A total of 402 participants consented to participate in the study (mean age 42.3 ± 15.07 years), 204(50.7%) were females and 190(47.3%) were illiterate. Biomass exposure was found in 147(37%), drug abuse in 132(33%) and smoking in 63(16%). We found 103(25.6%) had positive family histories of cancer. The most common primary tumor site was breast for females 98(48%) and Head and neck 66(33.3%) for males. Patients considered fate 328(82%), gutka 284(71%) and injuries 282(70%) as the most common causes for cancer; while 222(55.5%) considered black magic and 236(58.75%) considered evil eye as a risk factor for cancer. Cancer treatment caused significant financial stress in 376(93.5%) patients. CONCLUSION: Breast and head and neck cancers were found to be prevalent among patients. It was noted that patients are negligent in daily life regarding the consumption of substances that commonly cause cancer. Individuals had diminished knowledge and majority linked cancer to unrelated causes and myths like black magic and fate. Almost all the patients complained of severe financial stress imposed by the disease.

Prevalence and Symptom Characteristics of Irritable Bowel Syndrome Among Bronchial Asthma Patients in Pakistan.

INTRODUCTION: Irritable bowel syndrome (IBS) is a common gastrointestinal disorder that leads to a variety of symptoms including abdominal discomfort and change in stool frequency and consistency. Asthma is a common disease of the airway. Some studies have suggested that a relationship between IBS and asthma exist, while others have contradicted the claim. This study aims to determine the prevalence of IBS in asthmatic patients and compare their symptoms with symptoms of IBS patients in non-asthmatic patients. METHODOLOGY: In this case-control study, 100 known and documented asthmatic patients were included as cases, and 100 non-asthmatic healthy patients were included as controls from July to August 2019. These patients were given a questionnaire based on ROME II criteria for the diagnosis of IBS. Prevalence and symptoms of IBS were compared between cases and controls. A probability level, P < 0.05 was considered significant.  Result: IBS was found in 41 out of 100 asthma patients (41%) and 18 out of 100 controls (18%) with a P-value of 0.0005 and was more common in females in both asthmatic (63.41%) and non-asthmatic patients (66.66%). Symptoms such as abdominal pain/distress (63.41% vs. 11.11%, P-value: 0.0013) and bloating (82.92% vs. 33.33%, P-value: 0.0005) were significantly higher in asthmatic patient with IBS compared to non-asthmatic patient with IBS. CONCLUSION: Prevalence of IBS among asthma patients was significantly higher as compared to non-asthmatics. Routine screening of asthma patients and further studies to understand the pathogenesis underlying association between IBS and asthma should be conducted to detect and manage such patients effectively.

Psychological Stress as a Risk Factor for Cardiovascular Disease: A Case-Control Study.

Introduction Stress is a phenomenon elicited in response to certain triggers that may be external or internal. Stress has been identified as a risk factor for various diseases, including cardiovascular disease. In this study, we aim to find an association between psychological stress and cardiovascular disease in the local setting Methods This case-control study was conducted in a tertiary care hospital in Pakistan from June 2019 to December 2019. One hundred and seventeen (117) patients with myocardial infarction and unstable angina were enrolled in the case group. One hundred and ten (110) patient's attendants were enrolled in the study as controlled. Results The risk of a cardiovascular event was higher in patients with a history of social isolation (OR, 2.47), marital stress (OR, 2.28), work stress (OR, 3.2), childhood abuse (OR, 2.78), or trauma (OR, 2.67). Conclusion Psychological stress is an important risk for cardiovascular disease, which is often overlooked. Efforts should be made to include questions related to psychological stress in the history-taking of patients at risk of a cardiovascular event and the management plan should include psychological counseling.

Comparison of Outcomes of Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting.

Introduction Percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) are two common treatment options used in patients suffering from coronary artery disease. Selection and favorability of one over the other depend on individual clinical scenarios. The purpose of this study is to compare outcomes after treatment with PCI and CABG. Methods This longitudinal observational study was conducted from April 2018 to July 2019 in a cardiovascular unit of a tertiary care hospital. Participants who were eligible for revascularization were randomized either to receive stent (PCI) or surgery (CABG). Patients were then followed up for 12 months for the development of all-cause mortality and major adverse cardiovascular events (MACEs). Results At 12 months, patients randomized to the PCI group had an increased risk of repeat revascularization (21.3% vs. 7.4%; p = 0.007), whereas a similar number of patients in both groups died (3.8% vs. 3.7%), suffered myocardial infarction (7.6% vs. 5.6%), or had a cerebrovascular accident (3.8% vs. 2.8%). Conclusions This study showed that PCI had an increased risk of repeat revascularization compared to CABG. However, both had comparable significance in the development of MACEs. Nevertheless, there is a need for further study to better assess the outcomes of either, especially in the long run.