National Cancer Registry of Pakistan: First Comprehensive Report of Cancer Statistics 2015-2019.

OBJECTIVE: To compile a comprehensive national cancer registry report of Pakistan by merging and analysing cancer registration data received from major functional cancer registries in various parts of Pakistan. STUDY DESIGN: Observational study. Place and Duration of the Study: Health Research Institute (HRI), National Institutes of Health (NIH), Islamabad, from 2015-2019. METHODOLOGY: Data from major cancer registries which included 'Punjab Cancer Registry (PCR), 'Karachi Cancer Registry (KCR)', 'Pakistan Atomic Energy Commission (PAEC) Cancer Registry', Armed Forces Institute of Pathology (AFIP) Cancer Registry, Nishtar Medical University Hospital Multan (NMH), and Shifa International Hospital, Islamabad (SIH) registries were pooled, cleared, and analysed at HRI. RESULTS: A total of 269,707 cancer cases were analysed. Gender-wise 46.7% were males and 53.61% were females. As per province-wise distribution, 45.13% of cases were from Punjab, 26.83% from Sindh, 16.46% from Khyber Pakhtunkhwa (KP), and 3.52% from Baluchistan. Both genders combined, 'breast cancer' 57633 (21.4%) was the most common cancer. In males, the top-5 cancers in order of frequency/percenatages were 'oral' 14477 (11.6%), 'liver' 8398 (6.73%), colorectal 8024 (6.43%), 'lung' 7547 (6.05%) and 'prostate' 7322 (5.87% cancers). In females, causes of the top-5-cancers included 'breast' 56250 (38.8%), 'ovary' 8823 (6.09%), 'oral' 7195 (4.97%), 'cervix' 6043 (4.17%), and 'colorectal' 4860 (3.36%) cancers. In children 'Leukemia' 1626 (14.50%) and in adolescents 'Bone' 880 (14%) were the leading malignancies. CONCLUSION: Breast cancer is the most common cancer in females touching epidemic proportions while 'oral cancer' which is the leading cancer in males ranks third in frequency in females. Like 'oral cancer' which shows a strong correlation with chewing, other common cancers in Pakistan including liver cancer, lung cancer, and cervical cancer are also largely preventable as showed a strong correlation with hepatitis B and C, smoking, and high-risk human papillomavirus. KEY WORDS: National Cancer Registry, Health Research Institute - NIH, Islamabad, Pakistan.

Pregnancy outcomes with confirmed SARS-CoV-2 infection during first wave: A review.

Maternal and foetal care has become an important concern in the wake of enormous global spread of coronavirus disease-2019 (COVID-19), but there is scarcity of information about maternal and perinatal outcomes. The current review was conducted from March to July 2020. Appropriate and related databases were searched electronically by using terms, like "COVID-19 and pregnancy", "pregnancy outcomes of COVID-19". Pooled analysis of the reviewed studies showed that of the 164 newborns, vertical transmission was noted in 7(2.95%). The most common element 140(84.98%) was caesarean section deliveries. COVID-19 pneumonia developed in almost 54(30.90%) of 175 women. The most common symptom of COVID-19 among women was fever 88(50.77%). Adverse maternal and foetal outcomes were found to be associated with COVID-19 in the form of severe illness, increased rates of caesarean section deliveries and worse birth outcomes. Yet, vertical transmission of COVID-19 infection remains debatable.

Vertical Transmission of SARS-CoV-2 from COVID-19 Infected Pregnant Women: A Review on Intrauterine Transmission.

BACKGROUND: Fetal safety is a major concern with the global spread of COVID-19, but there is scarce information regarding vertical transmission and how it affects the fetus. OBJECTIVE: To assess and summarize the currently available evidence on vertical transmission (probable/confirmed) of SARS-CoV-2 along with fetal outcomes. METHODS: The current review was carried out from March to October 2020. Relevant databases were searched electronically. Pertinent articles were selected according to eligibility criteria and information was compiled. RESULTS: In 16 selected articles there were total 498 COVID-19 infected pregnant women ranging in age between 15 and 45 years. Gestational age at the onset of COVID-19 symptoms ranged from 25-41 weeks. Vertical transmission (probable and confirmed) rate from series was 4.883% (23/471). Of 17 affected newborns (information available), 08 required NICU admission, 04 developed pneumonia and 04 required mechanical ventilation. CONCLUSION: There is probable intrauterine transmission of SARS-CoV-2. Few adverse fetal outcomes are associated with COVID-19.