Cancer in Faisalabad and Nankana Sahib, Pakistan: 2017-2019; An Observational Study.

Introduction: The Punjab Cancer Registry's catchment area includes the districts of Faisalabad and Nankana Sahib. It is an observational and descriptive study that covers the 3 years from 2017 to 2019, evaluating the distribution of cancer in these two districts. Material and Methods: Data on incident cancer cases diagnosed between 2017 and 2019 among residents of Faisalabad and Nankana Sahib in Pakistan, reported by the participating centres of the Registry, were reviewed retrospectively. Figures and proportions for adults, children and adolescents were computed. Results: During 2017 and 2019, 5678 cases were reported from Faisalabad and 390 from Nankana Sahib, with over 50% seen in females. In both districts combined, among adult females, cancers of the breast, reproductive system, and hepatobiliary system were commonly diagnosed, while cancer of the lip/oral cavity/pharynx, hepatobiliary system and non-Hodgkin lymphoma were the leading diagnoses among adult males. In children and young adults (0-19 years), acute lymphoblastic leukaemia, Hodgkin lymphoma and non-Hodgkin lymphoma were the most common diagnoses. Conclusion: The cancer distribution reported from Faisalabad and Nankana Sahib is of utmost importance. However, the underreporting of cancer cases cannot be ruled out. More input from the collaborators is needed to ensure the completeness of cancer surveillance in the region.

Coeliac disease in children presenting with failure to thrive.

BACKGROUND: Coeliac disease used to be considered as a disease of European and Western population but now it has emerged as a global problem. Objective of this study was to evaluate the frequency and mode of presentation of coeliac disease in children presenting with failure to thrive. METHODS: This cross-sectional descriptive study was conducted at Paediatrics Department of Madina Teaching Hospital in collaboration with Histopathology Department of University Medical and Dental College, Faisalabad over a period from April 2010 to March 2011. A total of 60 children, aged 4-6 years presenting as failure to thrive according to their height and weight, were included. Relevant investigations were done along with radiological assessment of bone age. The jejunal biopsy was taken in all the patients. Children who were suffering from primary or secondary malnutrition due to other chronic illnesses and malabsorptive syndromes were excluded from the study. The data was analysed using SPSS-17. Chi-square test was used and p < 0.05 was considered significant. RESULTS: Total 60 children, 4-16 years of age were included in the study. Twenty-four (40%) children were diagnosed as coeliac disease by jejunal biopsy showing Marsh Grade-3. Male/female ration was 1.5:1. The most frequent symptom among these coeliac patients was abdominal distension (75%, p = 0.041), followed by pallor. (71%, p = 0.048). Anaemia (Hb < 12 gm/dl) was found in all 24 patients. CONCLUSION: Coeliac disease is increasingly being recognised as presenting with atypical presentation like short stature, failure to thrive, unexplained anaemia, rickets, abdominal distension and abdominal pain.

Metastatic breast carcinoma in the sentinel lymph node: an evaluation and comparison of cytological with histopathological diagnosis.

OBJECTIVE: To evaluate the accuracy of imprint cytology in identifying metastases in the sentinel lymph node and comparing it with histopathology of the same nodes. STUDY DESIGN: Cross- sectional. PLACE AND DURATION OF STUDY: Departments of Pathology, Punjab Medical College, Faisalabad and Sheikh Zayed Hospital, Lahore and Departments of Surgery, Allied and DHQ Hospitals, Faisalabad, between July 2002 - June 2003. PATIENTS AND METHODS: Sentinel lymph node was identified in 80 cases of early (T1 and T2) breast carcinoma by a localization technique, using 1% Isosulphan Blue. Cytological evaluation of the touch imprints were compared with subsequent histopathology. RESULTS: Cytology of the lymph node, as compared to the histopathology, had 86.79% sensitivity (SE) and 100% specificity (SP). The Positive Predictive Value (PPV) was 100% and the Negative Predictive Value (NPV) was 79.41%. The accuracy was 91.2%. CONCLUSION: Current study confirms the value of imprint cytology as a rapid and reliable method of assessment of sentinel lymph node metastases in breast carcinoma. It can be used intra-operatively as an alternative to frozen section, if a Cryostat is not available in the pathology laboratory to exclude Stage I patients from extensive surgery.