Grzybowska-Szatkowska, 2018). Early stages (stage I and II) of HNCs showed favorable prognosis with increased cure rates of more than 70-90% (Hashibe et al.

Objective: To assess the frequency of lymphedema of the arm and forearm after complete axillary lymph node dissection in patients with breast cancer at one year of follow-up and see its association with body mass index among breast cancer patients presenting at a tertiary care hospital in Karachi. Study Design: Prospective longitudinal study. Place and Duration of Study: Department of Medical Oncology, Jinnah Postgraduate Medical Center, Karachi, Pakistan, from Apr 2019 to 2020. Methodology: One sixty-eight females of age 25-80 years who underwent complete axillary lymph node dissection for breast cancer were included in the study. A breast surgeon performed the axillary lymph node dissection with more than five years of experience. The patients were followed for one year post-operatively to determine the occurrence of lymphedema. All the demographic details and clinic-pathological findings were reported in the predesigned proforma. Results: About 168 females (97.6%) out of 172 have undergone complete axillary lymph node dissection. Lymphedema was the most common complication among them (38.1%). Common side effect observed after axillary lymph node dissection was pain (66.1%), followed by heaviness (59.5%), firmness/tightness (46.4%) and numbness. The patients with Body mass index ≥ 25 kg/m2, right arm involved, exposure to radiotherapy and moderately differentiated tumour (grade-2) had a significantly higher occurrence of lymphedema (p<0.05). Conclusion: Lymphedema is higher among breast cancer survivors during the first postoperative year. The risk of lymphedema can be reduced by avoiding potential factors like obesity and carefully selecting patients for postoperative radiotherapy.

Objective: To identify smokeless tobacco as a risk factor in the development of head and neck cancers and to assess the role of ethnicity in the use of smokeless tobacco in developing head and neck cancers. Study Design: Case-control study. Place and Duration of Study: Department of Medical Oncology, Jinnah Postgraduate Medical Center, Karachi Pakistan, from Dec 2018 to Jun 2019. Methodology: Three hundred patients, aged 18-85 years of either gender were included in the study. Cases were the patients visiting Oncology OPD with biopsy-proven head and neck cancers (HNCs). Controls were patients presenting at the same hospital for a routine checkup. We interviewed participants by using a pre-designed proforma. Results: The mean age of the cases and controls were reported as 49.26±13.51 years and 40.12±14.89 years, respectively. Majority of the participants were consuming pan (37.0%), gutka (22.6%), tobacco (21.3%), betel nut (19.6%), naswar (12.0%) and mainpuri (9.0%). The participants who consumed tobacco (OR:2.95), gutka (OR:2.39), mainpuri (OR:4.89), pan (OR:2.06) and betel nut (OR:2.28) were times more likely to develop HNCs than those who did not consume tobacco, gutka, mainpuri, pan and betel nut (p<0.05). Among Urdu speaking, the participants who consumed tobacco (OR: 2.49), pan (OR:10.35), and betel nut (OR:3.34), had times more likely to develop HNCs than those who did not consume tobacco, pan and betel nut. Conclusion: Mainpuri, naswar, betel quid, and betel nut significantly affect the oral health of people and are potential risk factors for the development of risk factors.