Background Cervical cancer has a high mortality rate worldwide; in Pakistan it kills more than 7000 women every year. Prevention is possible through vaccination against human papilloma virus, the causative agent of cervical cancer, or by screening for premalignant lesions through routine Pap smear tests. We have studied the knowledge and practices regarding cervical cancer, its risk factors, screening and prevention and the role of human papilloma virus vaccination and Pap smear testing, among young women of Karachi. Methods Information was gathered using a modified version of Cervical Cancer Awareness Measure Toolkit version 2.1 from 384 women aged 15 to 50 with no medical background attending outpatient clinics of AKUH, Karachi. Data entry was done through EpiData and analysis was done using SPSS version 22.0. Results Our respondents’ mean age was 30 (±7.6) years. Out of the 61.2% of women who had heard about cervical cancer, 47.0% had heard about Pap smear test and among them, 73% had gotten a Pap test. A total of 25.5% of women out of the 61.2%, knew that a vaccine existed for prevention and out of them only 9.8% had vaccinated against human papilloma virus. Conclusion Majority of women in our study belonged to a higher socioeconomic class and were mostly educated but their knowledge and practices regarding prevention and screening of cervical cancer were poor. This reflects that the knowledge levels as a whole would be considerably lower in the city’s general population.

No abstract

Introduction: Primary signet ring cell carcinoma (SRCC) is a rare variant of colorectal cancer, reportedly comprising 0.1%-2.6% of all colorectal cancers. Due to manifestations occurring later in the course of the disease, the overall survival is reportedly poorer than that of colorectal adenocarcinoma. The Southeast Asian region has been observed to have a higher likelihood of having the signet ring cell carcinoma variant. Objective: The following study determines the overall proportion and histopathological characteristics of colorectal cancer in a Pakistani population across a tertiary care hospital.Methods: The histopathology reports of the colon and/or rectum specimens diagnosed as primary colorectal carcinoma were identified and reviewed at the Aga Khan University Hospital (AKUH). These included all the surgical specimens submitted to AKUH from January 2002 to December 2018. Biopsies and histopathological specimens with fragmented bowel, lack of orientation of tissue, and post chemotherapeutic complete resolution of the tumor were excluded.Results: Of the 2,662 surgical specimens of colorectal carcinoma identified, 1,708 specimens met the inclusion criteria. The cohort consisted of 62.4% (n = 1065) males, with an overall mean age of 50.41 years (SD = 16.98). Among these patients, 29.5% (n = 504) were 40 years of age or younger, 19% (n = 325) were between the ages of 41 and 50, and 51.5% (n = 879) were older than 50 years (p<0.001). The frequency of signet ring cell cancer was found to be 5.4% (n = 92). The histopathological characteristics associated with worse prognosis were significantly associated with the type of tumor. Lymphovascular and perineural invasion, stage, and grade were all significantly higher in SRCC than the other types. Conclusion: Pakistani population tends to present with colorectal cancer at a younger age and with poorer prognostic features including higher rates of signet ring cell cancer.

No abstract

doi: https://doi.org/10.12669/pjms.39.4.7038 How to cite this: Siddiqui NA, Pirzada A, Virji SN. Life before limb: What about life after limb loss? A perspective from a low middle class income country: A Surgical Perspective. Pak J Med Sci. 2023;39(4):---------. doi: https://doi.org/10.12669/pjms.39.4.7038 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.