Breast cancer is a major cause of mortality among females, worldwide. The present study was intended to evaluate the significance in the management of carcinoembryonic antigen (CEA) and cancer antigen 15-3 (CA15-3) in patients with breast cancer. MethodologyA cohort study was conducted at the Jinnah Postgraduate Medical Center, Karachi, Pakistan from June 2020 to May 2021. All diagnosed cases of breast cancer who underwent surgical excision of tumor were eligible to partake. Patients who had metastatic breast cancer or had a recurrence were excluded. The patient's sociodemographic and clinical data were documented in a predefined pro forma. It included information about the age, sex, weight, as well as serum CEA and CA15-3. The CA15-3 and CEA levels for each patient were assessed by taking a 5ml blood sample and sending it to the laboratory for further workup. preoperatively on the second, seventh, and 28th postoperative days. ResultsA mean ± SD age of 52.6 ± 8.89 years was reported. Family history of breast cancer was positive in one-fourth of the patients. Nodal metastasis was negative in 114 (46.72%) patients. Three-fourth of patients had Stage II-IV with only a minority diagnosed with Stage I. The mean levels for CA15-3 in women with Stage I cancer was significantly lower on the seventh day and 28th postoperative day, compared to preoperative levels (p = 0.05). Similar associations were seen for stages II and III. Higher CEA levels were significantly associated with stage III breast cancer preoperatively (5.88 ng/ml, p = 0.05) compared to postoperative values. ConclusionThe current study revealed that preoperative values of serum CEA and CA15-3 significantly reduced postoperatively. Moreover, patients with advanced cancers had significantly higher levels of both tumor markers than those with less advanced diseases. The current study highlighted the importance of regular assessment of serum CEA and CA15-3 in breast cancer patients. Both these biomarkers are substantially elevated in breast cancer patients, preoperatively. Determining the levels of serum CEA and CA15-3 preand postoperatively may determine the prognosis and aid in forming the most optimal patient care regime with respect to the stage and subtype of cancer.

Background: The triple-negative tumor is a high-risk tumor as a targeted therapy to these proteins is not possible with this type of cancer. Objective: To investigate the prognostic factors that can help in treatment selection in the triple-negative phenotype breast tumors Study design: A cross-sectional study Place and duration: This study was conducted at People's University of Medical and Health Sciences Nawabshah from Nov 2021 to Nov 2022 Methodology: The present study examined numerous cases of invasive carcinoma of the breast. The patients visited for follow-up for a long time and they were examined by tissue microarray. The series was stained through concurrent immune-histochemical prognostic panels. This was done to specify the subgroups of different types of breast cancer and for the identification of prognostic markers as well as the aggressive behavior of the tumors. Results: In the beginning, a total of 280 cases were included in the study, out of which 45 (16.07%) patients had triple-negative breast cancer. Most of these cancers were grade 3 carcinomas. A strong association was seen with pushing margins, development of recurrence, large size, poorer Nottingham Prognostic Index, and distant metastasis. Moreover, the association was also seen with loss of expression of E-cadherin and androgen receptors, basal phenotype, p53, EGFR, and P-cadherin. The size of the tumor, androgen receptors, and lymph node staging were the most valuable prognostic markers. Androgen receptor and size had prognostic significance in the tumor subgroup with lymph node-positive tumors. On the other hand, the basal phenotype was the only prognostic marker in the subgroup with lymph node-negative tumors. Some other parameters considered in the present study are histological grade, size of the tumor, age of the patient, and vascular invasion. Conclusion: The most significant markers identified were basal phenotype and androgen receptor. Also, tumor size and the status of the lymph node are quite significant in low-risk and high-risk patients while selecting surgical or non-surgical treatment for the triple-negative tumors Keywords: Triple-negative, breast tumor, prognostic markers, androgen receptors

Objective: To determine the management outcome of the endoscopic bandligation in the patients with internal haemorrhoids at isra university Hospital Hyderabad Sindh.Pakistan. Materials and methods: All the patients were under went sigmoidoscopy andcolonoscopy for the complete diagnosis and the patients were excluded, if polyps or evidenceof malignancy was found at colonoscopy. Haemorrhoids were sucked with the tip of endoscopefrom the anal canal and elastic bands were applied. After first treatment session, patients wereasked to complete a questionnaire to evaluate the subjective satisfaction, which was classifiedas poor, good and best. Patients who had with multiple haemorrhoids were recalled for theligation on remaining haemorrhoids after 2 weeks, if indicated. Results: Total 100 patients wereincluded in the study, In complications, intensive pain was found in the 55% of the cases whileother complications were seen in very few patients and many patients were seen without anycomplication. Hospital stay was only one day was noted in the very few patients and mostlypatients were discharged after few hours of the procedure. Outcome of the endoscopic bandligation was found excellent in 40% of the cases, good results found in the 45% of the cases andpoor results were seen only in the 15% of the cases. Re-endoscopic band ligation was donein the 20% of the cases and recurrence of hemorrhoids was noted in the 30% of the cases.Conclusions: We concluded that the endoscopic band ligation is very good management forhaemorrhoids without typical complications, with very short hospital stay and recurrences rate.

Background: Breast cancer has recently become one of the most obsessing and life threatening issues in the world. Globally, females suffered mostly by breast cancer. Breast cancer is multifactorial etiological disorder. Trace elements are acts as cofactors and biological catalyst. They play a very essential role in the metabolic pathways. Methods: A cross sectional study with two hundred (200) subjects and divided into two groups. 50 females were normal healthy as a control while 150 females were patient with breast cancer. Blood was collected from all participant after taking history, clinical data, mammographic and histopathological findings. Consent and predesign porforma were filled by all participants of study. The trace elements (Na, K, Zn, Fe, Ca) were determined through atomic absorption spectrophotometer (ASS) and other biochemical analysis such as Total Protein, serum albumin and Total cholesterol were analyzed on Micro Lab.300. Data was entered on SPSS 22.0 version, and applied student t-test for continuous variables. Results were analyzed as Mean and standard deviation. Results: The results of serum Na+, K+, Ca++, Zn++, Cu++ and Fe in breast cancer patient were observed and found significantly fluctuated in breast cancer patients as compared to normal healthy subjects. Serum Total Protein significantly increased whereas serum Albumin decreased in patient with breast cancer. Conclusions: in Present study we found significantly abnormal concentration of Na+, K+, Ca++, Zn++, Cu++ and Fe in breast cancer these elements may contribute in early diagnosis of breast cancer. Increased body weight and total cholesterol are also risk factors of Ca breast.