Presentation Delay in Breast Cancer Patients, Identifying the Barriers in North Pakistan

Khan, Muhammad Aleem,Shafique, Sehrish,Khan, Muhammad Taha,Shahzad, Muhammad Faheem,Iqbal, Sundas Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.1

Background: There is strong evidence that delayed diagnosis of breast cancer is associated with poor survival. Our objectives were to determine the frequency of breast cancer patients with delayed presentation, the reasons of delay and its association with different socio-demographic variables in our North Pakistan setting. Materials and Methods: We interviewed 315 histologically confirmed breast cancer patients. Delay was defined as more than 3 months from appearance of symptoms to consultation with a doctor. Questions were asked from each patient which could reflect their understanding about the disease and which could be the likely reasons for their delayed presentation. Results: 39.0 % (n=123) of patients presented late and out of those, 40.7% wasted time using alternative medicines; 25.2 % did not having enough resources; 17.1 % presented late due to painless lump; 10.6% felt shyness and 6.5% presented late due to other reasons. Higher age, negative family history, < 8 school years of education and low to middle socio-economic status were significantly associated with delayed presentation (p< 0.05). Education and socioeconomic status were two independent variables related to the delayed presentation after adjustment for others (OR of 2.26, 2.29 and 95%CI was 1.25-4.10, 1.06-4.94 respectively). Conclusions: Significant numbers of women with breast cancer in North Pakistan experience presentation delay due to their misconceptions about the disease. Coordinated efforts with public health departments are needed to educate the focused groups and removing the barriers identified in the study. Long term impact will be reduced overall burden of the disease in the region.

Genetic dissection of grain yield traits in a large collection of spring wheat (Triticum aestivum L.) germplasm

Khan Sultan Habibullah,Sajjad Muhammad,Gulnaz Saima,Waqar Sundas,Shahzad Munawar,Arain Saima Mir 한국작물학회 2022 Journal of crop science and biotechnology Vol.25 No.2

Understanding genetic architecture of a crop germplasm is necessary for designing a successful breeding program. Herein, we evaluated a large collection of 500 spring wheat accessions for 2 crop seasons to dissect the genetics of 11 yield components and their direct and indirect contributions to grain yield (GY). The genetic estimates of broad sense heritability (h2 ), genetic advance (GA), phenotypic correlation (rp), genotypic correlation (rg), and path coefcient analysis were performed. Signifcant genetic variation was observed for all yield traits suggesting that GY can be improved by exploiting the studied yield traits. Phenotypic coefcient of variation (Vp) was greater than genotypic coefcient of variation (Vg) for all studied traits. Higher broad sense h2 and GA were observed for grains per plant (GpP), spikes per plant (SpP), spikelets per spike (Spt/S) and grain yield (GY). The GY exhibited signifcant and positive correlation with all studied traits except with spikelet density (SptD). The GpP and TGW exhibited positive direct efect on increasing grain yield. Taking together, SpP, GpS, TGW and SDW are the major contributors to improving genetic yield potential of bread wheat with spring growth habit. The negative correlation between GY and SptD was dissected in path coefcient analysis as negative indirect efect of SptD on GY through reduced GpS and TGW. Our study provides new insights on the association of GpP, TGW and SDW in bread wheat. The GpP, TGW and SDW are infuenced by SpP, Gpt/S, G/Spt, SptD, AL and PH with indirect efects on GY. To improve yield potential in wheat, the traits with direct efects (GpP, TGW and SDW) and indirect efects (e.g., SptD) can be used as selection criteria.

Etiology of hepatocellular carcinoma and treatment through medicinal plants: a comprehensive review

Sundas Nasreen,Sobia Safeer,Kamaran Khurshid Dar,Saiqa Andleeb,Mubashir Ejaz,Muhammad Adeeb Khan,Shaukat Ali 경희대학교 융합한의과학연구소 2018 Oriental Pharmacy and Experimental Medicine Vol.18 No.3

Liver is a power house of the body for many components such as vitamins, minerals, iron and glycogen and play role in biotransformation. Some ingredients of our diet (foodstuff s may contain with afl atoxin B1, vinyl chloride, tobacco, heavy alcohol intake, fried meat, coff ee and oral contraceptives),when metabolized become tremendous for liver and leads toward hepatocellular carcinoma (HCC). HCC occurs through cyclical liver injury due to infl ammation and DNA damaging as a result of oxidative stress. Phytochemicals of medicinal plants have curative potential against liver cancer due to presence of linalool, eucalyptol, borneol, thujone, camphor, 4-terpineol, monoterpenes and α -cadinol, sophytotherapies have several advantages over conventional chemotherapies. According to literature survey Acanthus ilicifolius, Allium sativum, Artemisiaprinceps, Artemisia vulgaris, Amorphophallus campanulatus, Brucea javanica, Broussonetia luzonica, Dracocephalum kotschyi, Graptopetalum paraguayense, Nigella sativa, Petasites japonicas, Silybum marianum, Bergenia ciliata , Cassia fi stula and Picrorhiza scrophularilora have vital bioactive compounds used against hepatocellular carcinoma.

Determination and estimation of magnesium contentin the single phase magnesium-calcite [Ca(1-x)MgxCO3(s)]using electron probe micro-analysis (EPMA) and X-ray diffraction (XRD)

Muhammad Fahad Khan,Sundas Saeed 한국지질과학협의회 2018 Geosciences Journal Vol.22 No.2

Mg-calcite (MgCc) is the term used for calcite containing variable magnesium content. The correct determination of the Mg-content in the calcite is of great interest for many fields of research. This study presents the potential, accuracy and the limitations of determining Mg-content in MgCc by means of electron probe micro-analysis (EPMA) coupled with the energy dispersive and wave dispersive spectrometry (EDS/WDS), and X-ray diffractometry (XRD). These techniques were used to examine the distribution of Mg (in mol% MgCO3) in six calcite marble samples from different locations of Peshawar basin (Pakistan), a part of Lesser Himalayas. Results showed variable Mg-content averaging 0.944–1.740 mol% from the chemical analysis with EPMA/EDS of the whole rock sample. This was almost consistent with the XRD findings of 0.750–1.690 mol%. The sample NO13 with heteroblastic grain structure showed disequilibrium geometry due to the contact metamorphism, characterized by the relatively high temperature and low pressure. This caused predominantly quick re-crystallization of the carbonate phase, thus showing lower Mgcontent in the sample. It was assumed that the observed small variability in the Mg-content of the investigated calcites even with in the sample is due to the temperature dependency of the Mg incorporation into the calcites. The highest degree of accuracy in Mg-content determination was observed based on the lattice parameter a and cell volume V. For the Mg-content obtained by XRD, best correlation was observed between the lattice parameter a, cell volume V and Mg-content, with r2 = 0.991 and 0.990 respectively. The difference between the d104 values from the Rietveld refinement and the observed XRD patterns were generally < 0.002 Å.

Analysis of the clinical indications for opiate use in inflammatory bowel disease

( Youran Gao ),( Sundas Khan ),( Meredith Akerman ),( Keith Sultan ) 대한장연구학회 2017 Intestinal Research Vol.15 No.1

Background/Aims: Opiate use for inflammatory bowel disease (IBD), particularly high-dose (HD) use, is associated with increased mortality. It`s assumed that opiate use is directly related to IBD-related complaints, although this hasn`t been well defined. Our goal was to determine the indications for opiate use as a first step in developing strategies to prevent or decrease opiate use. Methods: A retrospective cohort was formed of adults who were diagnosed with IBD and for whom outpatient evaluations from 2009 to 2014 were documented. Opiate use was defined if opiates were prescribed for a minimum of 30 days over a 365-day period. Individual chart notes were then reviewed to determine the clinical indication(s) for low-dose (LD) and HD opiate use. Results: After a search of the electronic records of 1,109,277 patients, 3,226 patients with IBD were found. One hundred four patients were identified as opiate users, including 65 patients with Crohn`s and 39 with ulcerative colitis; a total of 134 indications were available for these patients. IBD-related complaints accounted for 49.25% of the opiate indications, with abdominal pain (23.13%) being the most common. Overall, opiate use for IBD-related complaints (81.40% vs. 50.82%; P =0.0014) and abdominal pain (44.19% vs. 19.67%; P =0.0071) was more common among HD than among LD. Conclusions: Our findings show that most IBD patients using opiates, particularly HD users, used opiates for IBD-related complaints. Future research will need to determine the degree to which these complaints are related to disease activity and to formulate nonopiate pain management strategies for patients with both active and inactive IBD. (Intest Res 2017;15:83-89)

SOME INEQUALITIES FOR GEOMETRICALLY PREINVEX FUNCTIONS

Muhammad Aslam Noor,Khalida Inayat Noor,SUNDAS KHAN 장전수학회 2016 Proceedings of the Jangjeon mathematical society Vol.19 No.1

In this paper, we introduce and investigate a new class of preinvex functions, which is called geometrically preinvex functions. Some new Hermite- Hadamard type inequalities are obtained. Results continue to hold for geomet- rically convex function, which can be obtained as special cases. The idea and technique of this paper may stimulate further research in this field.

The impact of corticosteroid use on inpatients with inflammatory bowel disease and positive polymerase chain reaction for Clostridium difficile

Huei-Wen Lim,Isaiah P. Schuster,Ramona Rajapakse,Farah Monzur,Sundas Khan,Keith Sultan 대한장연구학회 2019 Intestinal Research Vol.17 No.2

Background/Aims: Optimal management of inflammatory bowel disease (IBD) with concomitant Clostridium difficile infection (CDI) is controversial, especially when CDI diagnosis is made by polymerase chain reaction (PCR) testing, which may reflect colonization without infection. Methods: We performed a multicenter review of all inpatients with IBD and PCR diagnosed CDI. Outcomes included length of stay, 30- and 90-day readmission, colectomy during admission and within 3 months, intensive care unit (ICU) admission, CDI relapse and death for patients who received corticosteroid (CS) after CDI diagnosis versus those that did not. Propensity-adjusted regression analysis of outcomes based on CS usage was performed. Results: We identified 177 IBD patients with CDI, 112 ulcerative colitis and 65 Crohn’s disease. For IBD overall, CS after CDI diagnosis was associated with prolonged hospitalization (5.5 days: 95% confidence interval [CI], 1.5–9.6 days; P=0.008), higher colectomy rate within 3 months (odds ratio [OR], 5.5; 95% CI, 1.1–28.2; P=0.042) and more frequent ICU admissions (OR, 7.8; 95% CI, 1.5–41.6; P=0.017) versus no CS. CS use post-CDI diagnosis in UC patients was associated with prolonged hospitalization (6.2 days: 95% CI, 0.4–12.0 days; P=0.036) and more frequent ICU admissions (OR, 7.4; 95% CI, 1.1–48.7; P=0.036). Conclusions: CS use among IBD inpatients with CDI diagnosed by PCR is associated with poorer outcomes and would seem to reinforce the importance of C. difficile toxin assay to help distinguish colonization from infection. This adverse effect appears more prominent among those with UC. (Intest Res 2019;17:244-252)