MedERA - Journal of CMH LMC and IOD

Frequency of Chemotherapy-Induced Myalgia in Cancer Patients using The Visual Analogue Scale

Tayyaba Kanwal — 2023-10-17

Abstract
Objective: The aim of the study was to find the frequency of chemotherapy-induced myalgia in
patients with cancer in Lahore.
Methodology: This cross-sectional study was conducted over a period of six months after ethical
approval from February to July 2021. Using a non-probability convenient sampling technique,
seventy eligible patients between 45-55 years of age with cancer were included in this study from
both public and private hospital settings on the basis of predefined eligibility criteria. A self-
structured questionnaire including a visual analogue pain scale was used for data collection. Data
was analyzed using SPSS version 21. The qualitative variables were presented with pie charts and
quantitative variables are tabulated with frequencies and percentages.
Results: Mean age±SD of participants was 53±6.9 years. Out of 70 participants, 90% were females. The
significant outcome variables included the presence of myalgia, painful girdle, intensity of pain
(visual analogue scale), duration of treatment with the chemotherapy drug, dose of chemotherapy
drug and chemotherapy sessions. Chemotherapy-induced myalgia was 94.3% among target cancer
patients in Lahore.
Conclusion: In our study, chemotherapy-induced myalgia is alarmingly high in patients with
cancers. The pain is mostly moderate in nature and affects the shoulder region. Measures should be
adopted to mitigate the chemotherapy-induced myalgia as it adversely affects the patient's already
deteriorating quality of life.
Keywords: Myalgia, Cancer, Cancer Pain, Palliative care, Chemotherapy.

Clinicopathological Correlation of Leiomyoma undergoing Myomectomy in a Tertiary Care Hospital

Javeria Mushtaq — 2023-10-17

Abstract
Objective: To evaluate clinic pathological correlation of Leiomyomas undergoing myomectomy in
tertiary care hospital.
Methodology: This cross-sectional study was conducted at Gynaecology and Obstetrics
Department, Services Institute of Medical Sciences Lahore, from June2019 to September 2022 on a
sample of 123 eligible patients. After a detailed history investigations and clinical examination, e.g.
CBC, blood grouping, fasting blood sugar, ESR, ultrasound scan, laparotomy was performed and the
size of uterus, tubal and ovaries condition and total number and location of fibroids we noted. A tubal
patency test using methylene blue was performed. Histopathological examination was performed to
confirm any endometrial pathology or degenerative process. The data was analysed SPSS 21.0.
Categorical variables like demographic profile, clinical characteristics, and location of myoma were
presented as frequency and percentages.
Results: Mean age was 25.23±5.623 years. In the study population, 69.1% were nulliparous. Heavy
menstrual bleeding was the commonest symptom, constituting 44.7%, mass in abdomen in 30.1%,
infertility in 22% and dysmenorrhea in 3.3% cases. Most common site of leiomyoma was Intramural
(51.21%), Subseroal 29.26%, and Submucous 19.51%.
Conclusion: The study concluded that leiomyoma is one of the most common diseases of
reproductive age.
Keywords: Clinicopathological correlation, leiomyomas, fibroids, uterine fibroids.

Awareness of Breast Cancer Risk Factors and Breast Self-Examination amongst Rural Women of Pakistan

Asim Raza — 2023-10-17

Abstract
Objective: To assess the awareness of major risk factors of breast cancer and understanding and
practice related to breast self-examination among rural women of Pakistan.
Methodology: 396 rural women were enrolled for this cross-sectional study from the catchment rural
areas of district Gujranwala between 15th September 2022 to 30th December 2022. A self-structured
and valid questionnaire was used to gather information regarding practice and knowledge related to
breast self-examination (BSE) and breast cancer risk factors. In this analysis, Statistical Package for
Social Sciences (SPSS) version 20 was used to analyse the data at a 95% confidence interval.
Results: Average age of 396 rural women was 32.96±11.74 years and 25.25% of females were unaware
of breast cancer. Only three out of fifteen risk factors were known by 1/3 of the participant which were
family history of breast cancer, obesity and lack of breastfeeding. Out of the total population, the
majority (84%) had no idea about breast self-examination (BSE) whereas only 16% know about the
process of BSE.
Conclusion: Most rural women were aware of breast cancer however the awareness level was low for
the associated risk factors. More importantly, despite being aware of breast cancer the vast majority
(84%) had no knowledge or training of BSE.
Keywords: Breast self-examination, risk factors, breast cancer.

Association of Interleukin-8 Levels with the Development of Uterine Leiomyomas

Masooma Talib — 2023-10-17

Abstract
Objective: To find out the relationship between Uterine Leiomyoma and IL-8 levels.
Methodology: A cross sectional study was conducted on a sample of 100 females (age ranging from
25-50 years) including 50 ultrasound confirmed cases of uterine leiomyomas and 50 healthy controls
for a duration of 6 months. Levels of plasma IL-8 were measured by ELISA technique.
Results: Irregular menstrual cycle was reported in about 44% of cases and 11% of controls. Mean
number of fibroids in females was two. 54% of women were found to have small (<2cm) sized fibroids
while 46% had large sized fibroids. Out of these 78% were intramural and 22% were sub-serosal type
of fibroids. Plasma levels of IL-8 were positively correlated (p=0.001) with Uterine Leiomyomas.
Conclusion: IL-8 levels are significantly higher in patients with uterine leiomyomas depicting a
positive correlation between IL-8 and the development of fibroids. However, further studies are
required to better understand the role of IL-8 in the development of fibroids.
Keywords: Uterine Leiomyoma; IL-8, Risk Factors

Comparison of Single vs Multiple Doses of Antibiotic Prophylaxis in Reduction Post-Caesarean Section Infection Morbidity

Kalsoom Waheed — 2023-10-17

Abstract
Objective: This study aimed to compare single vs multiple doses of antibiotic prophylaxis in patients
undergoing caesarean section to reduce morbidity linked with infection.
Methodology: A quasi-experimental study was conducted in the Department of Obstetrics and
Gynaecology, Services Hospital, Lahore from 07-09-2019 to 06-03-2020 after approval from the ethical
review committee. A total of 240 patients (120 in each group) were included in the study. Group A
received a single dose of antibiotic prophylaxis and Group B was administered multiple doses of
prophylactic antibiotics.
Results: Patients booked in the study had a mean age of 27.93±3.62 and 28.80±3.54 years in group-A
and B, respectively. In group A, the mean gestational age was 39.21±0.70 and in group B, 39.27±0.69
weeks. In group A, 9 patients (7.5%) and in group B, 11 patients (9.2%) were primigravida while 111
patients (92.5%) in group A and 109 patients (90.8%) in group B were multigravida. Febrile morbidity
was found in 8 patients (6.7%) in group-A and 6 patients (5.0%) in group B. (p=0.582). Postoperative
wound infection was observed in 11 patients (9.2%) of the group and 8 patients (6.7%) of group B
(p=0.473).
Conclusion: The study concluded that there was no statistically significant difference between the
two groups, single and multiple doses, in terms of their effectiveness in reducing infections after a
Caesarean section.
Keywords: Elective caesarean section, Febrile morbidity, postoperative wound infection.

A Case Report on Pancoast Tumor

Um-ul-Baneen — 2023-10-17

Abstract
To present and discuss a case of Pancoast Tumor: an apical lung neoplasm, and subsequently
highlight the clinical importance of chronic and progressive complaints, pertaining to this pathology,
in helping to detect it and form an early diagnosis.
Case: A 55-year-old non-smoker male patient, with a known case of gout and uncontrolled diabetes
mellitus, presented to emergency with complaints of severe right-sided pain in the chest, subscapular
and axillary regions. His electrocardiogram (ECG) and cardiac enzyme came out to be normal. Chest
X-ray showed an opacity in the apex of the right lung. On contrast-enhanced computed tomography
(CECT), there were enhancing multi-focal lesions in the apical segment of the right lung making a
diagnosis of Pancoast tumor.
Even though, it may be missed in the early stages as the tumor cannot be seen on imaging investigations
and biopsy is more specific at this time, imaging studies do play a substantial role in diagnosing this
tumor. Due to the challenges in diagnosing this rare type of lung neoplasm, it is usually diagnosed
when it has locally invaded.
Conclusion: Awareness regarding clinically important warning signs of Pancoast tumors such as
chronic and progressive neck and shoulder pain can help healthcare professionals, most notably but
not exclusively, chiropractors, in prompt identification of these signs and symptoms, thus facilitating
a timely medical and/or surgical referral and an early diagnosis of this pathology. A thorough
examination can assist in early diagnosis and lead to a subsequent decrease in mortality and an
improvement in quality of life.
Keywords: Pancoast syndrome, Neck pain, Lung neoplasms.