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Najam R.,University of Karachi | Bano N.,University of Karachi | Mateen A.,Karachi Institute of Radiotherapy and Nuclear Medicine KIRAN
Pakistan Journal of Pharmaceutical Sciences | Year: 2013

The purpose of the study is evaluation and assessment of parameters of cardiac toxicity in patients subjected to 5-FU based chemotherapy. Cardiac morbidity is a reported outcome in different 5FU/LV regimens; however none of them are definite or proximate. The bimonthly regimen of high dose leucovorin is reported to be less toxic and more effective as compared to the monthly regimen of low dose leucovorin. We report the detailed assessment of few cardiac parameter of toxicity in patients of advanced colorectal carcinoma subjected to two Schedules of high and low dose Folinic Acid, 5-Fluorouracil, bolus and continuous infusion. The correlation of elevated cardiac biomarkers, angina and hypertension is comparatively assessed in patients with normal general status, hyperglycemia and known cardiac disorders subjected to two different 5FU based chemotherapeutic regimen. Source


Uz Zaman M.,Aga Khan University | Fatima N.,Karachi Institute of Radiotherapy and Nuclear Medicine KIRAN | Sajjad Z.,Aga Khan University | Akhtar J.,Aga Khan University | And 3 more authors.
Asian Pacific Journal of Cancer Prevention | Year: 2012

Background: In papillary and follicular thyroid cancers (PTC, FTC), nodal and distant metastasis are generally considered important determinants of recurrence and survival, respectively. However, there is no consensus about the threshold primary tumour size (PTS) for these determinants. The aim of this study was to assess size relationships for developing nodal, pulmonary, bone and overall distant metastases. Methods: This prospective study covered 139 (93 females and 46 males) consecutive biopsy proven patients with PTC (114/139, mean age 41.0 ±15.7 years, M: F, 35%:65%) and FTC (25/139, mean age 39.2 ± 14.3 years, M: F: 24%:76%). Results: Average primary tumor size was 23.4 ± 11.1 mm and 26.5 ± 13.1 mm for PTC and FTC respectively (p value=0.223). Nodal metastasis was found more common in PTC than FTC (49% vs 28%, p value <0.05), whereas overall distant metastasis was approximately the same (13% and 24%, p value =0.277); however, bone metastasis was significantly higher in FTC than PTC (24% vs 5%, p value <0.05). Cumulative risk for nodal and distant metastases for FTC and PTC starts at PTS <20 mm and may indicate an unusual aggressive tumor behavior in the studied population. Highest cumulative risk for nodal and pulmonary metastases in PTC and for bone metastasis in FTC was found to be ≥50 mm PTS. Conclusion: We conclude that a PTS of <20 mm may indicate an unusual aggressive tumor behavior with highest cumulative risk for nodal and pulmonary metastases in PTC and for bone metastasis in FTC with a cutoff of ≥50 mm. Source


Bano N.,Ziauddin University | Najam R.,University of Karachi | Mateen A.,Karachi Institute of Radiotherapy and Nuclear Medicine KIRAN
Asian Pacific Journal of Cancer Prevention | Year: 2013

colorectal carcinoma treated with four different schedules of FOLFOX. Methods: The patients with histologically confirmed advanced colorectal carcinoma (CRC) were included in the study as per specified inclusion criteria. Toxicity was graded according to CTC v2.0. The frequency of grade 3 and 4 adverse effects were comparatively assessed in each treatment arm. Results: Very severe toxicity was attributed to the FOLFOX7 schedule. The difference between the incidence rate of grade 4 toxicity with all other grades for all parameters of skin and subcutaneous toxicity was highly significant (p=0.00<0.001). Grade 4 hand and foot syndrome was reported only in the FOLFOX7 treatment arm. The most frequent adverse symptom of skin and subcutaneous toxicity reported in the patients treated with modified schedule of FOLFOX was pruritus (grade 1). Frequency and onset of skin and subcutaneous toxic symptoms like alopecia (p=0.000), nail discoloration (p=0.021) and pruritis (p=0.000) was significantly different in each FOLFOX treatment arm. A few cases of oncholysis were also reported in the FOLFOX7 treatment arm. Hand and foot syndrome was fast progressing in patients with grade 1 toxicity. Conclusion: Higher frequency and severity of hand and foot syndrome and pruritus wasa found in the FOLFOX7 treatment arm. Skin and subcutaneous toxicity was comparatively low in the FOLFOX6 treatment arm. Source


Bano N.,Ziauddin University | Najam R.,University of Karachi | Mateen A.,Karachi Institute of Radiotherapy and Nuclear Medicine KIRAN
British Journal of Medical Practitioners | Year: 2013

5 Fluorouracil with leucovorin is the mainstay in the treatment of colorectal carcinoma (CRC), the third leading cause of cancer related deaths. Aims: This study is designed to assess the effects of 5FU and leucovorin chemotherapy (in continuous and intermittent schedules) on the serum biomarkers indicative of hepatic and renal functions. Methods: Biochemical profiles of patients comprising of age group 61.0 + 4.58, with histologically confirmed colorectal carcinoma, treated either with de Gramont's regimen or Mayo clinic regimen were assessed after each alternate cycle of treatment. The changes in the levels of hepatic enzymes (ALT, AST, bilirubin, AlkPo4, TGS) and renal biomarkers (serum creatinine, BUN) were comparatively assessed with the pretreatment values. Results: Changes in the serum creatinine levels from pretreatment value was significant after fourth cycle of treatment (p=0.035). Changes in AST levels were significant after the second cycle of treatment (p= 0.049) and very significant after fourth cycle of treatment (p=0.008). Conclusion: A gradual rise in mean values is assessed for serum creatinine and BUN levels indicative of progressive decline in renal functional status. Hepatic enzyme elevation is pertinent to cumulative dose intensity. Source


Fatima N.,Karachi Institute of Radiotherapy and Nuclear Medicine KIRAN | Uz Zaman M.,Aga Khan University | Sajjad Z.,Aga Khan University | Hashmi I.,General Electric
Annals of Nuclear Medicine | Year: 2011

The diagnosis of PE in pregnancy poses a challenge due to pregnancy-related physiological changes. Missing the PE or wrongly treating a pregnant woman for PE has serious clinical consequences. There has been concern over the use of radiation-based imaging modalities due to risk of teratogenicity and oncogenicity. This review is focused on various diagnostic options and risks of radiation to the fetus and mother from radiation-based procedures. © 2011 The Japanese Society of Nuclear Medicine. Source

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