Self-care enables patients in improving quality of life and reducing hospital admissions. Research explored the experiences of patients about breathlessness, sleep problems and complication management in chronic obstructive pulmonary disease (COPD). However, the self-care experiences and the role of the family in self-care are underexplored. This study aimed to understand the self-care experiences of patients with COPD and explore the role of the family in self-care. An interpretive phenomenological inquiry was used, and 13 patients were interviewed in 2019 from two hospitals in Pakistan. The inclusion criteria were patients above 30 years of age at any stage of COPD, who received a confirmed diagnosis of COPD and were receiving the treatment, and engaged in self-care at their homes or communities. The interviews lasted for 35-60 min. Ricoeur's interpretation theory was used for data analysis comprising steps explanation, naive understanding and in-depth understanding.Self-care emerged as a complex individual and familial endeavour affected by personal, social and economic factors. Poverty was one of the core determinants of self-care. Patients emphasised the spiritual, cultural and traditional approaches to self-care. Future research is warranted to develop better understanding of spiritual and cultural self-care and how these dimensions of self-care affect patients' self-care behaviours.

Perforation peritonitis is an important cause of generalized peritonitis and pneumoperitoneum. Large bowel perforation due to swallowed artificial denture is extremely rare. Foreign body can be ingested accidentally or in a suicidal attempt. However, ingested foreign body causing sigmoid colon perforation is extremely rare. Complications caused by ingestion of foreign body in gastrointestinal tract include obstruction, perforation, bleeding, or impaction at the sites of physiological narrowing or acute angulation in gastrointestinal tract. We hereby report a case of sigmoid colon perforation due to swallowed partial denture.

Eumycetoma (“mycotic mycetoma”) is a chronic subcutaneous fungal infection of the skin and soft tissue, most often affecting the lower extremity (typically a single foot). Eumycetomas are usually confined to subcutaneous tissues but can involve fascia, bone, and regional lymph nodes via contiguous dissemination. We hereby report a case mycetoma of gluteal region, an unusual site of presentation.

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Objectives: The aim of the study was to see any change in the age incidence of colorectal carcinoma at thetime of presentation . Study Design; Retrospective analytical study. Material and methods; The study was conducted in the Northern areas of Pakistan. Two groups of patientsat an interval of five years were compared. Group "A" included 45 patients diagnosed before Jan1997 v/sgroup "B" including 45 patients diagnosed after Jan 2002. These were already diagnosed cases of colorectalcarcinoma. Two groups of patients were made as "A" and group "B".All the histopathological specimen of the patients were formalin fixed and paraffin embedded. The sectionstaken were four micron thick and stained with hematoxylin & eosin. The cases reviewed included bothexcised and sigmoidoscopic biopsies. The cases included colorectal carcinoma patients diagnosed incontinuation and no skip selection was made. The relevant data including in particular the ages of thepatients was noted from the biopsy request forms. No particular sex or histologic type of carcinomas wereselected for the purpose of study. Results: An increase in incidence in younger ages was noted in group "B" (those patients who werediagnosed five years later than group "A" patients). Conclusion : Age incidence for colorectal carcinoma shows a slight shift for the younger patients. Furtherstudies are suggested to assess for any additional carcinogens in the Northern areas of Pakistan. Key words: Colorectal carcinoma. Increase in younger age incidence.