Correlation between stages of breast cancer and BMI in females: a multi-centre study.

OBJECTIVE: To determine the link between breast cancer and obesity in women by using body mass index at the time of diagnosis. Methods: The cross-sectional study was conducted from October 2019 to April 2020 at Pakistan Ordinance Factories Hospital, Wah Cantt, and Islamabad Medical Complex National Engineering and Scientific Commission Hospital, Islamabad, Pakistan. The sample comprised women aged 40-70 years with a recent diagnosis of breast cancer. Patients' body mass index values were calculated after they were diagnosed and additional staging examinations were carried out. Data was analysed using SPSS 21. RESULTS: There were 100 cases with a mean age of 52.24±7.47 years. There was a significant link between obesity and breast cancer (p=0.002), with higher body mass index carrying a higher risk of advanced breast cancer. CONCLUSIONS: Obesity may contribute to postmenopausal breast cancer in women.

Perioperative Intravenous Lidocaine Infusion for Postlaparoscopic Cholecystectomy Pain.

OBJECTIVE: To compare intravenous lidocaine infusion adjunct to NSAID and Acetaminophen with regular analgesics for postoperative mean pain score and mean ambulation time after laparoscopic cholecystectomy. STUDY DESIGN: Randomised controlled trial. PLACE AND DURATION OF STUDY: Department of General Surgery, Islamabad Medical Complex, (IMC), from March 2020 to December 2021. METHODOLOGY: Sixty (n=60) adult patients, both males and females between the ages of 18-60 years planned for laparoscopic cholecystectomy, were selected and randomly allocated to two groups of treatment (Lidocaine and Ringer Lactate). The control group did not receive any other placebo other than Ringer Lactate infusion. Both groups received Intramuscular Diclofenac 12 hourly and intravenous acetaminophen infusion 8 hourly. Postoperative pain 2, 6, 12 and 24 hours (h) and mean ambulation time were compared in both groups. RESULTS: Mean VAS (Visual Analogue Scale) of group 1 versus group 2 at 2 h, 6 h, 12 h and 24 h were 3.47 ± 0.82 vs. 6.27 ± 0.52 (p=<0.001), 2.7 ± 0.75 vs. 4.8 ± 0.8 (p<0.001), 2.0 ± 0.49 vs. 3.93 ± 0.94 (p<0.001), 0.73 ± 0.82 vs. 2.2 ± 0.61 (p<0.001). Time for spontaneous ambulation after surgery was 5.57 ± 1.55 hours for Group 1 versus 7.3 ± 1.9 hours for Group 2 (p<0.001). CONCLUSION: Pain scores at all-time intervals were lower, and ambulation time was shorter in patients who received intravenous infusion of lidocaine as compared to patients who received only regular analgesics for laparoscopic cholecystectomy. KEY WORDS: Ambulation time, Laparoscopic cholecystectomy, Postoperative pain.

Drug-induced duodenal perforation in the paediatric patient with thalassemia major, an unreported side effect of iron- chelating agent: A case report.

Duodenal ulcer disease is uncommon in paediatric age group. Its perforation is even rarer. However, it should be kept in mind when examining children with acute abdomen especially if there are signs of shock or possibility of upper gastrointestinal bleed. We report a case of a 6 years old female child, a known case of thalassemia major and taking oral Deferasirox since two years of age. She had atypical presentation as there was no previous history of peptic ulcer disease and she only suffered epigastric pain and vomiting for a week but due to lack of proper diagnosis at a local clinic developed duodenal ulcer perforation, which was ultimately diagnosed at a tertiary care hospital and managed with Graham Patch Closure.

Correction: Superior Mesenteric Artery Syndrome: Delayed Diagnosis of a Rare Clinical Entity With a Common Clinical Presentation.

[This corrects the article DOI: 10.7759/cureus.26728.].

Adult Retroperitoneal Mature Cystic Teratoma Masquerading as Non-Endocrine Primary Adrenal Tumor.

Teratomas belong to non-seminomatous germ cell tumors and originate from totipotent germ cells. They are mostly made up of tissues derived from all three layers, i.e., endoderm, mesoderm and ectoderm. They can be mature teratomas, which are benign or immature teratomas, having malignant potential. Extra-gonadal mature cystic teratomas are uncommon, particularly in retroperitoneum. Other sites are sacrococcygeal, mediastinal, and pineal regions. They are mostly detected in females in reproductive age group. In this case report, we discuss a female patient being worked up for persistent vomiting and food indigestion, initially managed on the line of acid peptic disease. She was found to have a large retroperitoneal mass in adrenal region producing mass effect on intestines. Later on, it was discovered to be mature cystic teratoma on histopathological evaluation. Key Words: Mature teratoma, Adrenal gland, Retroperitoneum.

Adult Necrotising Enterocolitis in a Breast Cancer Patient after First Cycle of Adjuvant Chemotherapy.

Chemotherapy-induced diarrhea has become a worrisome problem for the patients as well as the treating surgeons and oncologists because patient outcome is significantly affected. Necrotising enterocolitis is a rare disease in adults. It is now termed as neutropenic enterocolitis in adults, because it is seen more often as a complication of aggressive systemic chemotherapy. It is believed to be associated with chemotherapy-induced intestinal mucosal injury followed by a super infection, which leads to bacteremia, and majority of these patient develop neutropenia. They often have vague and nonspecific presentation which gets overshadowed by the symptoms of primary malignant disease and expected toxic side effects of chemotherapy. In this case report, we discuss the case of a middle-aged female with infiltrating ductal carcinoma of breast, who on adjuvant chemotherapy, developed necrotising enterocolitis requiring emergency exploratory laparotomy. The objective of this study is to increase awareness regarding this fatal complication of chemotherapy because very little research has been done so far. We also review literature to find out the cause of necrotising enterocolitis in reported cases. It is recommended to treat diarrhea, caused by chemotherapy, with antibiotics instead of just loperamide because of decreased immunity of the patient, which could lead to fatal complications.