A heartrending burden of gynaecological cancers in advance stage at nuclear institute of medicine and radiotherapy Jamshoro Sindh.

OBJECTIVES: In Pakistan gynaecological cancers are among the leading causes of women's morbidity and mortality posing huge financial burden on families, communities and state. Due to lack of national cancer registry exact facts and figures are unknown therefore this study was planned to find out prevalence, age, site and stage of presentation of gynaecological cancers at Nuclear Institute of Medicine and Radiotherapy (NIMRA), Jamshoro. METHODS: A retrospective, cross sectional study was conducted from 1(st) January 2011 to 31(st) December 2011 at NIMRA Jamshoro. All cases of genital tract cancers were evaluated, required data was entered on predesigned performa and results were analyzed manually. RESULTS: Out of 2401 total registered cancer cases, 231 (9.6%) patients were suffering from gynaecological cancer making it third most common cancer. Ovary was commonest site followed by cervix and uterus. More than 60% cases presented in advanced stage, mostly during 4(th) and 5(th) decade of life. CONCLUSION: Gynecological cancer was among top three cancers at one of the busiest public sector cancer institute in Sindh province and significant number presented in advance stage making treatment difficult and expensive. There is urgent need for development and implementation of an effective health policy regarding cancer prevention and treatment.

Dose measurement of cobalt-60 radiotherapy beams in treatment fields.

BACKGROUND: Radiation-therapy is a complex process with multiple steps, each of which has an impact on the quality of treatment. Accurate dosimetry is a critical step during the radiotherapy of cancer patients.The aim of the present study was to measure and evaluate the doses of two cobalt- 60 (60Co) teletherapy units GWXJ80 of NPIC China and Theratron 780 of AECL Canada at various points within fields for different field sizes. METHODS: This cross-sectional descriptive study was done to measure the 60Co doses in the treatment fields.The dose measurements were done in air and 30x30x30 cm3 Phantom at 80 cm SSD by using calibrated NE 2570 Farmer Electrometer & NE 2571 Farmer Ionization Chamber and percentage of doses were calculated. RESULTS: The results showed that 60% central area of all fields ranging from 100-98.79% and 100-96.12% for GWXJ80 in the air and phantom, whereas for Theratron 780, they were ranging from 100-98.50% and 100-96.45% in air and phantom respectively. The percentages of doses at the edges for GWXJ80 and Theratron 780 in the air were 75.39-38.66% & 85.65-46.47% respectively and they were 82.22-40.39% & 49.05-24.55% respectively in phantom. CONCLUSIONS: The doses within 60% central area of fields in air were higher than phantom for both teletherapy units. The doses at field edges in air were lower in GWXJ80 than Theratron 780 whereas in phantom they were vice versa. But all were in the acceptable range as recommended by International Commission on Radiation Units and Measurements.

Multiple myeloma in younger age.

A Multiple Myeloma (MM) is rare in younger age group. We report MM in a 30-year-old female, who presented with multiple lytic areas upon skeletal survey, but with negative Bence Jones protein. Bone marrow biopsy confirmed it to be a case of multiple myeloma. Patient was put on chemotherapy and radiography to which she responded and now is ambulatory.

Role of hysterosalpingoscintigraphy in the workup of infertility.

OBJECTIVE: To assess the role of hysterosalpingoscintigraphy (HSSG) in the evaluation of fallopian tube patency and function and compare the results with hysterosalpingography (HSG) and laparoscopy (LS). DESIGN: Cross-sectional study. PLACE AND DURATION OF STUDY: The study was conducted at Multan Institute of Nuclear Medicine and Radiotherapy (MINAR), Multan from August 2004 to February 2005. PATIENTS AND METHODS: HSSG was performed after instillation of 4mCi (148 MBq) 99mTechnetium-macroaggregated albumin (99mTc-MAA) in posterior vaginal fornix in 65 patients. Serial static images were acquired in supine position at 1 hour, 2 hours, 3 hours and, if needed, at 24 hours. The results were compared to the findings on LS and HSG. RESULTS: Out of 65 patients, 37 (56.9%) patients had bilateral blocked tubes, 17 (26.1%) patients had bilateral patent tubes, 6 (9.2%) patients had blocked left tube and 5 (7.1%) patients had blocked right tube. The calculated sensitivity, specificity, positive predicted value (PPV), negative predicted value (NPV) and accuracy for HSSG were 90%, 83%, 90% and 90% respectively. The agreement between HSSG and LS was found in 32 out of 35 patients and agreement between HSG and HSSG was found in 24 out of 30 patients. CONCLUSION: This simple procedure can delineate tubal physiology; in selected cases it can replace HSG and in others augment the information gathered by HSG. HSSG should be part of the infertility workup algorithm.