Journal of the Dow University of Health Sciences (JDUHS)

Frequency of Breast Cancer in Women Under 40 Years at Ghulam Muhammad Mahar Medical College: A Cross-Sectional Study

2025-03-21T22:45:14-06:00

Objective: To assess the frequency of breast cancer in women under the age of 40 and identify associated risk factors.
Methods: A hospital-based cross-sectional study was carried out in the Department of Surgery at Ghulam Muhammad Mahar Medical College, Sukkur, Pakistan between August 2024 and January 2025. Women aged 15 to 39 years presenting with a palpable breast lump were included in the study. Breast cancer diagnosis was confirmed through histopathological examination, characterized by nuclear pleomorphism, tubular formation, and mitotic activity. Various risk factors, such as age, body mass index, marital status, smoking habits, family history of breast cancer, and duration of symptoms were recorded and analyzed to determine their association with breast cancer in this age group.
Results: Among 199 women, the mean age was 37.50 ±2.34 years. Histopathological examination confirmed malignant lesions in 21 (10.5%) participants. The risk of malignancy was significantly higher among women who smoked (adjusted odds ratio [aOR] 8.04; 95% CI: 1.20–53.97; p-value 0.032) and those with a family history of breast cancer (aOR 11.84; 95% CI: 2.01–69.72; p-value 0.006). Conversely, women aged 36 years or younger had a markedly lower risk of malignancy compared to those over 36 years (aOR 0.04; 95% CI: 0.12–0.16; p-value < 0.001)
Conclusion: A notable burden of breast cancer was found among women under 40, with a frequency of 10.5% in those presenting with palpable breast lumps. Smoking and a positive family history significantly increased the odds of malignancy.

Frequency of Rouviere's Sulcus and its Relation to the Dissection Time of Calot's Triangle

2025-03-13T01:01:36-06:00

Objective: To determine the frequency of Rouviere's Sulcus in patients undergoing laparoscopic cholecystectomy and assess its relationship with the dissection time of Calot's Triangle.
Methods: A descriptive cross-sectional study was carried out at the Department of General Surgery, Combined Military Hospital, Quetta, Pakistan, from November 2024 to January 2025. All patients undergoing elective laparoscopic cholecystectomy for uncomplicated cholelithiasis were included using non-probability consecutive sampling. Intraoperative identification of Rouviere's Sulcus was performed and classified into open, closed, and slit types. The operative dissection time of Calot's Triangle was recorded from the insertion of the last port to clipping of the cystic duct and artery.
Results: Among 52 patients, the median age was 34.5 (IQR 27-40) years. Rouviere's Sulcus was identified in 48 (92.3%) patients. Among visible Rouvière's Sulcus, the open type was most common 26 (54.2%), followed by closed 16 (33.3%) and slit types 6 (12.5%). Visibility was higher in patients ≤35 years 30 (100%) compared to >35 years 18 (81.8%). The median operative dissection time of Calot's Triangle was shorter in patients with visible Rouvière's Sulcus compared to those without 9.5 (8-13) vs. 14 (11-15) minutes.
Conclusion: Rouviere's Sulcus was visible in the majority of elective laparoscopic cholecystectomy cases, with open type being most common. Its presence was related with reduced dissection time, underscoring its role as a critical anatomical landmark for safe cholecystectomy.

Visual Outcome of Cataract Surgery in Children with Traumatic Cataract: A Cross-Sectional Study

2025-03-25T23:11:15-06:00

Objective: The study aimed to assess the visual outcomes following cataract surgery in children diagnosed with traumatic cataracts.
Methods: A cross-sectional study was conducted at the Isra Postgraduate Institute of Ophthalmology, Karachi, from December 2020 to June 2021. Children aged 5 to 15 years with traumatic cataract underwent cataract surgery were included in the study. Postoperative visual outcomes were assessed by measuring best-corrected visual acuity (BCVA) at day 1, week 1, week 4, and week 6 after surgery. Visual outcomes were categorized as ≤6/60, 6/36, 6/24, or 6/18 or better. Baseline data, including demographic details (age, gender, and residence), affected eye, type and cause of trauma, cataract morphology, preoperative IOP, and time interval between trauma and surgery (1 week to <1 month, 1 month to 1 year, >1 year) were recorded.
Results: Of total 163 children, the mean age was 9.67 ±2.34 years. At baseline, 149 (91.4%) of patients had BCVA ≤6/60. After excluding cases lost to follow-up, 110 patients remained. Postoperative visual improvement was observed progressively, with 94 (85.5%) achieving BCVA of 6/18 or better at six weeks (p-value < 0.001). Age >10 years (p-value 0.045), blunt trauma (p-value < 0.001), normal preoperative IOP (p-value < 0.001), and surgery within 1 month to 1 year post-trauma (p-value < 0.001) were significantly associated with better visual outcomes.
Conclusion: Cataract surgery in children with traumatic cataracts resulted in significant visual improvement, with better outcomes observed in those with older age, blunt trauma, normal preoperative intraocular pressure, and timely intervention.

Correlation of Oxford Classification Score with Early Response to Treatment in IgA Nephropathy: A Cross-Sectional Study

2025-02-10T00:29:52-07:00

Objective: To evaluate correlation between the Oxford classification score and early response to treatment in Immunoglobulin A nephropathy (IgAN) in a single-center study in northern Pakistan.
Methods: This cross-sectional study was conducted at Department of Nephrology, Shifa International Hospital, Islamabad, from July 2024 to January 2025. Patients aged 18 to 65 years with biopsy-proven primary IgAN were included. Baseline demographic, clinical, and laboratory data, including serum creatinine, estimated Glomerular Filtration Rate (eGFR) and proteinuria, were recorded. Renal biopsies were assessed using the Oxford classification, evaluating mesangial hypercellularity (M), endocapillary hypercellularity (E), segmental glomerulosclerosis (S), tubular atrophy/interstitial fibrosis (T) and crescents (C). Early treatment response was defined as a ≥50% reduction in proteinuria after three months.
Results: Of total 30 patients, the median age was 30.5 (24.5 – 43.5) years. The Oxford classification revealed that 19 (63.3%) patients had M1 and S1 lesions, 16 (53.3%) had E0 lesions, and 12 (40.0%) exhibited T0 lesions. A significant reduction in proteinuria was observed after treatment (p-value < 0.001), with eGFR and serum albumin levels improving significantly (p-value 0.003 and p-value 0.023) respectively. T1-2 lesions demonstrated a strong negative correlation with eGFR (ρ = -0.760, p-value < 0.001), E1 lesions were moderately correlated with proteinuria (ρ = 0.378, p-value 0.039). Treatment response was observed in 12 (40%) patients, but no significant associations were found with individual Oxford classification scores.
Conclusion: A significant reduction in proteinuria and improvement in eGFR and albumin observed post-treatment. Histopathological features correlated with renal outcomes, emphasizing significance in predicting early treatment outcomes.

Frequency and Factors of Unmet Need for Family Planning in a Rural Setting of Pakistan: A Cross-Sectional Study

2025-04-05T01:58:35-06:00

Objective: To determine the frequency of unmet need for family planning and its risk factors among married women of reproductive age.
Methods: This descriptive cross-sectional study was conducted in a rural community of Mustafabad, Pakistan, from August 2023 to August 2024, enrolling married women aged 18-49. The unmet need for family planning was defined as the proportion of married women who want to delay or avoid pregnancy but are not using contraception. The study assessed various factors, including age, religion, education, occupation, number of children, knowledge of family planning methods, challenges in accessing services, and barriers to contraceptive use.
Results: Out of 209 married women, unmet need for family planning was reported by 128 (61.2%) women. Younger women aged 18–25 and 26–35 had significantly higher odds compared to those over 35 (aOR 9.04; 95% CI: 2.77–29.55; p-value <0.001 and aOR 3.42; 95% CI: 1.30–8.86; p-value 0.011, respectively). Employed women had 77% lower odds of unmet need (aOR 0.23; 95% CI: 0.07–0.68; p-value 0.008). Women who reported easy availability of family planning services had 79% lower odds of unmet need (aOR 0.21; 95% CI: 0.06–0.67; p-value 0.017), while women facing difficulty in accessing services had 30 times higher odds of unmet need (aOR 30.28;
95% CI: 11.77–77.92; p-value <0.001).
Conclusion: The study highlights that approximately three-fifths of women have an unmet need for family planning, particularly among younger age groups, unemployed women, poor availability and those facing difficulties accessing services.