Gastric cancer (GC) represents a major cancer burden worldwide, and remains the second leading cause of cancer-related death. Due to its insidious nature, presentation is usually late and often carries a poor prognosis. Despite having improved treatment modalities over the last decade, for most patients only modest improvements have been seen in overall survival. Recent progress in understanding the molecular biology of GC and its signaling pathways, offers the hope of clinically significant promising advances for selected groups of patients. Patients with Her-2 overexpression or amplification have experienced benefit from the integration of monoclonal antibodies such as trastuzumab to the standard chemotherapy. Additionally, drugs targeting angiogenesis (bevacizumab, sorafenib, sunitinib) are under investigation and other targeted agents such as mTOR inhibitors, anti c-MET, polo-like kinase 1 inhibitors are in preclinical or early clinical development. Patient selection and the development of reliable biomarkers to accurately select patients most likely to benefit from these tailored therapies is now key. Future trials should focus on these advances to optimize the treatment for GC patients. This article will review recent progress and current status of targeted agents in GC.

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Objective: The aim of this study was to assess the mother’s knowledge of neonatal care and their attitude towards existing preventive methods and practices. Materials and Methods: A hospital based Cross-Sectional descriptive Study was conducted on mothers who delivered recently in Fatima Hospital, Baqai Medical University and the mothers visiting with their neonate age of 28 days. Results: A total of 385 participants including the neonates of age 1 to 28 days were included in the study. We found statistically significant relationship between the mother’s age and the mother knowledge of neonatal care (P value = 0.002). Moreover, other factors that we found significantly conducive were the relationships between Illness and medication, mother’s age and breast feeding, mother’s education, and neonate vaccination (P value = 0.002). Conclusion: In this study, we observed that most of the mothers were unaware of neonatal care. Many of them were ignorant of the neonate vaccination and national immunization days. Most of them treated their sick neonates with traditional home remedies rather bringing them to the hospitals. A high proportion of mothers withheld breast feeding and top feeding during neonate illness. Their knowledge regarding infected umbilicus, neonate inactivity and lethargy was scarce. These findings indicate that there is a room of improvement in the current mother’s knowledge and practices of neonatal care. This study will facilitate the policy makers to design new care seeking practices that foster better knowledge of neonatal care among mothers. Keywords: Neonatal Care, immunization, breast feeding

Background: Palliative radiotherapy in patients with metastatic spinal cord compression is a well-known treatment modality but little is known whether it improves quality of life and performance status. Our study focusses on analyzing the impact of palliative radiotherapy on these two parameters in patients with metastatic spinal cord compression. Methods: We performed a prospective observational study from August 2020 to April 2021 to assess consecutive patients presenting to emergency department with suspected MSCC. We enrolled 24 patients in the study, and they were evaluated for their performance status and quality of life using ECOG and FACIT-PAL 14 scores respectively. Palliative radiotherapy was administered, and the patients were followed up four to six weeks later. Their ECOG and FACIT-PAL 14 scores before and after receiving palliative radiotherapy were analyzed. Results: The mean age of the patients was 48 (IQR 35–62), with 14 (58%) being male. 1 patient died soon after admission. Median dose fractionation was 2000 cGy. Median (IQR) of ECOG performance status score on admission and follow up was 2.5 (1.0–3.7) and 1.5 (1.0–3.7), p=0.719, respectively. Median (IQR) FACIT-PAL 14 score on admission and follow up were 35.5 (34.0–37.6) and 36.5 (30.2-44.7), p=0.277, respectively. Our results indicate that there was no statistically significant difference in the median ECOG performance status and FACIT PAL 14 scores before and after the administration of palliative radiotherapy. Conclusion: Our study indicates that palliative radiotherapy in patients with metastatic spinal cord compression had little benefit in objectively improving quality of life and performance status using the well-known and widely used scores. This lack of response could be due to delayed presentation of the patients. Earlier involvement of palliative care team could have improved both these parameters. Further research with larger population of patients over a longer period is needed to further assess these outcomes.

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