Approximately 80% of cases of childhood cancer occur in low- and middle-income countries and are ... more Approximately 80% of cases of childhood cancer occur in low- and middle-income countries and are associated with high mortality rates. Assessing outcomes is essential for designing effective strategies to improve outcomes equally worldwide. We implemented a real-time surveillance system, VIGICANCER, embedded in a population-based cancer registry (PBCR) to assess childhood cancer outcomes. VIGICANCER was established in 2009 as an integral part of Cali's PBCR to collect real-time data on outcomes of patients (age < 19 years) with a new diagnosis of cancer treated in pediatric oncology units in Cali, Colombia. Baseline and follow-up data (death, relapse, treatment abandonment, second neoplasms) were collected from medical records, hospital discharge logs, pathology reports, death certificates, and the National Public Health Insurance database. A quality assurance process was implemented for the system. From 2009 to 2013, data from 1,242 patients were included in VIGICANCER: 32% ...
In low-income and middle-income countries, an excess in treatment failure for children with cance... more In low-income and middle-income countries, an excess in treatment failure for children with cancer usually results from misdiagnosis, inadequate access to treatment, death from toxicity, treatment abandonment, and relapse. The My Child Matters programme of the Sanofi Espoir Foundation has funded 55 paediatric cancer projects in low-income and middle-income countries over 10 years. We assessed the impact of the projects in these regions by using baseline assessments that were done in 2006. Based on these data, estimated 5-year survival in 2016 increased by a median of 5·1%, ranging from -1·5% in Venezuela to 17·5% in Ukraine. Of the 26 861 children per year who develop cancer in the ten index countries with My Child Matters projects that were evaluated in 2006, an estimated additional 1343 children can now expect an increase in survival outcome. For example, in Paraguay, a network of paediatric oncology satellite clinics was established and scaled up to a national level and has manag...
JPMA. The Journal of the Pakistan Medical Association, 2010
Granulocytic sarcoma is an extramedullary tumour of primitive granulocytic cells. It can develop ... more Granulocytic sarcoma is an extramedullary tumour of primitive granulocytic cells. It can develop at any anatomic site and is often a forerunner to the development of acute myelogenous leukaemia. Granulocytic sarcoma of the small intestine presents with abdominal pain and obstruction. We report a case of a 17-years-old boy who presented with epigastric pain. His endoscopy revealed multiple polypoid lesions throughout the duodenum and small bowel. Histopathology and flow cytometery confirmed the diagnosis of granulocytic sarcoma associated with acute myelogenous leukaemia. To our knowledge there have been only two previous case reports of multiple granulocytic sarcomas in the small intestine, both of these were adult patients. This is the first patient in the paediatric age group with multiple granulocytic sarcomas of the small intestine.
Asian Pacific journal of cancer prevention : APJCP
To study the clinico-epidemiological profile of Hodgkin's lymphoma (HL) in Pakistan. We retro... more To study the clinico-epidemiological profile of Hodgkin's lymphoma (HL) in Pakistan. We retrospectively studied all histopathologically proven cases of HL, who presented between Dec 1995 to June 2003 at Shaukat Khanum Memorial Cancer Hospital and Research Hospital (SKMCH & RC). All the relevant information was obtained through the hospital based cancer registry and medical records of the selected patients. Six hundred and fifty eight histopathologically confirmed cases of HL were identified. There were 505 males and 153 females, with a male to female ratio of 3.3: 1. Patients ranged in age from 1 year - 84 years. The mean age at presentation was 23.8 years. Three hundred and twenty cases (48.6%) belonged to age group <or= 18 years and 338 cases (51.4%) were > 18 years of age. Histopathologically, mixed cellularity (MC) constituted 63.8% of cases, followed by nodular sclerosis (NS) 19.9%, lymphocyte predominant (LP) 7.3% and lymphocyte depleted (LD) 1.2%. Early stage (stage...
JPMA. The Journal of the Pakistan Medical Association, 2011
To analyze the common causes of death in childhood Acute Lymphoblastic Leukaemia (ALL) patients d... more To analyze the common causes of death in childhood Acute Lymphoblastic Leukaemia (ALL) patients during therapy at Paediatric Oncology Department of Shaukat Khanum Memorial Cancer Hospital. Retrospective descriptive study conducted at Paediatric Oncology department at Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore Pakistan. All registered cases of ALL from 12 months to 18 years of age who expired between May 2001 to December 2005 were included. Mortality data was collected and analyzed regarding age, sex, WBC count, immunophenotype, treatment protocol, remission, and timing of death with respect to treatment protocol and the cause of death. Out of 304 new cases of ALL registered in the study period, 74 (24%) died during treatment. During induction 39 of 74 (52.7%) died, 33 (44.5%) in first remission and 2 (2.8%) before initiation of therapy. Infection alone or in combination with other factors was responsible for deaths in 63 of 74 (85%) cases. Septicemia, pulmon...
Asian Pacific journal of cancer prevention : APJCP, 2009
Cancer registration is a neglected area in several developing countries of the world including Pa... more Cancer registration is a neglected area in several developing countries of the world including Pakistan due to funding problems and apathy of most health professionals towards reporting of cancer data. The epidemiologic review is the first of its type reporting cancers recorded at a cancer hospital in Lahore, Pakistan, in children less than 15 years of age, belonging to Lahore District, in a one year time period from January 1, 2008 to December 31, 2008. The results have been stratified by gender, 5-year age-groups (0-4, 5-9 and 10-14), and the International Classification of Childhood Cancers diagnostic groups. Crude- and age-specific-rates by age-groups were estimated and standardized by applying the direct method of age-standardization using the world standard of Segi (1960) to determine the incidence of childhood cancers per 100,000 population in one year. In order of ranking, the age-standardized incidence rates (ASR) per 100,000 were as follows: amongst boys, leukemias 1.3, ly...
To analyze the clinical characteristics of B-cell non-Hodgkin&amp;amp;amp;amp;amp;amp;amp;amp... more To analyze the clinical characteristics of B-cell non-Hodgkin&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s lymphoma (NHL) patients and the therapeutic efficacy of French-American-British Lymphoma Malins de Burkitt 96 and the recent United Kingdom Children&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s Cancer Study Group B-cell NHL guidelines in the tertiary care hospital of a developing country. Patients aged &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; or =18 years registered at our hospital between January 1995 and December 2006 with histologically proved B-Cell NHL were selected for retrospective analysis. Of the total of 131 patients registered, 122 patients were eligible for evaluation. Of these 95 had Burkitt&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s lymphoma, 22 diffuse large B-cell lymphoma and five had B-cell NHL not otherwise specified. The mean age was 8.4 years. Overall 42 children had a baseline weight less than the 10th centile. A total of 37 had uric acid…
PURPOSE Infection prevention among children with cancer is a major challenge at Children Hospital... more PURPOSE Infection prevention among children with cancer is a major challenge at Children Hospital Lahore (CHL), a public health care facility in Pakistan with 1,000 new pediatric cancer admissions annually. The objective has been to reduce infections through collaboration between CHL and the St Jude Children’s Hospital Global Infectious Disease program via a grant by the Sanofi Espoir foundation through the My Child Matters program. The aim of the current study was to describe the effect of the collaborative improvement strategy on existing infection prevention and control (IPC) standards at CHL. MATERIALS AND METHODS Our work was a prospective before-and-after study to improve IPC standards. We compared the WHO Hand Hygiene Self-Assessment Framework and four modules of the St Jude modified Infection Control Assessment Tool (ICAT) scores over a 3-year period. Our strategy included creating a multidisciplinary team of pediatric oncologists, infectious disease physicians, nurses, a mi...
Approximately 80% of cases of childhood cancer occur in low- and middle-income countries and are ... more Approximately 80% of cases of childhood cancer occur in low- and middle-income countries and are associated with high mortality rates. Assessing outcomes is essential for designing effective strategies to improve outcomes equally worldwide. We implemented a real-time surveillance system, VIGICANCER, embedded in a population-based cancer registry (PBCR) to assess childhood cancer outcomes. VIGICANCER was established in 2009 as an integral part of Cali's PBCR to collect real-time data on outcomes of patients (age < 19 years) with a new diagnosis of cancer treated in pediatric oncology units in Cali, Colombia. Baseline and follow-up data (death, relapse, treatment abandonment, second neoplasms) were collected from medical records, hospital discharge logs, pathology reports, death certificates, and the National Public Health Insurance database. A quality assurance process was implemented for the system. From 2009 to 2013, data from 1,242 patients were included in VIGICANCER: 32% ...
In low-income and middle-income countries, an excess in treatment failure for children with cance... more In low-income and middle-income countries, an excess in treatment failure for children with cancer usually results from misdiagnosis, inadequate access to treatment, death from toxicity, treatment abandonment, and relapse. The My Child Matters programme of the Sanofi Espoir Foundation has funded 55 paediatric cancer projects in low-income and middle-income countries over 10 years. We assessed the impact of the projects in these regions by using baseline assessments that were done in 2006. Based on these data, estimated 5-year survival in 2016 increased by a median of 5·1%, ranging from -1·5% in Venezuela to 17·5% in Ukraine. Of the 26 861 children per year who develop cancer in the ten index countries with My Child Matters projects that were evaluated in 2006, an estimated additional 1343 children can now expect an increase in survival outcome. For example, in Paraguay, a network of paediatric oncology satellite clinics was established and scaled up to a national level and has manag...
JPMA. The Journal of the Pakistan Medical Association, 2010
Granulocytic sarcoma is an extramedullary tumour of primitive granulocytic cells. It can develop ... more Granulocytic sarcoma is an extramedullary tumour of primitive granulocytic cells. It can develop at any anatomic site and is often a forerunner to the development of acute myelogenous leukaemia. Granulocytic sarcoma of the small intestine presents with abdominal pain and obstruction. We report a case of a 17-years-old boy who presented with epigastric pain. His endoscopy revealed multiple polypoid lesions throughout the duodenum and small bowel. Histopathology and flow cytometery confirmed the diagnosis of granulocytic sarcoma associated with acute myelogenous leukaemia. To our knowledge there have been only two previous case reports of multiple granulocytic sarcomas in the small intestine, both of these were adult patients. This is the first patient in the paediatric age group with multiple granulocytic sarcomas of the small intestine.
Asian Pacific journal of cancer prevention : APJCP
To study the clinico-epidemiological profile of Hodgkin's lymphoma (HL) in Pakistan. We retro... more To study the clinico-epidemiological profile of Hodgkin's lymphoma (HL) in Pakistan. We retrospectively studied all histopathologically proven cases of HL, who presented between Dec 1995 to June 2003 at Shaukat Khanum Memorial Cancer Hospital and Research Hospital (SKMCH & RC). All the relevant information was obtained through the hospital based cancer registry and medical records of the selected patients. Six hundred and fifty eight histopathologically confirmed cases of HL were identified. There were 505 males and 153 females, with a male to female ratio of 3.3: 1. Patients ranged in age from 1 year - 84 years. The mean age at presentation was 23.8 years. Three hundred and twenty cases (48.6%) belonged to age group <or= 18 years and 338 cases (51.4%) were > 18 years of age. Histopathologically, mixed cellularity (MC) constituted 63.8% of cases, followed by nodular sclerosis (NS) 19.9%, lymphocyte predominant (LP) 7.3% and lymphocyte depleted (LD) 1.2%. Early stage (stage...
JPMA. The Journal of the Pakistan Medical Association, 2011
To analyze the common causes of death in childhood Acute Lymphoblastic Leukaemia (ALL) patients d... more To analyze the common causes of death in childhood Acute Lymphoblastic Leukaemia (ALL) patients during therapy at Paediatric Oncology Department of Shaukat Khanum Memorial Cancer Hospital. Retrospective descriptive study conducted at Paediatric Oncology department at Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore Pakistan. All registered cases of ALL from 12 months to 18 years of age who expired between May 2001 to December 2005 were included. Mortality data was collected and analyzed regarding age, sex, WBC count, immunophenotype, treatment protocol, remission, and timing of death with respect to treatment protocol and the cause of death. Out of 304 new cases of ALL registered in the study period, 74 (24%) died during treatment. During induction 39 of 74 (52.7%) died, 33 (44.5%) in first remission and 2 (2.8%) before initiation of therapy. Infection alone or in combination with other factors was responsible for deaths in 63 of 74 (85%) cases. Septicemia, pulmon...
Asian Pacific journal of cancer prevention : APJCP, 2009
Cancer registration is a neglected area in several developing countries of the world including Pa... more Cancer registration is a neglected area in several developing countries of the world including Pakistan due to funding problems and apathy of most health professionals towards reporting of cancer data. The epidemiologic review is the first of its type reporting cancers recorded at a cancer hospital in Lahore, Pakistan, in children less than 15 years of age, belonging to Lahore District, in a one year time period from January 1, 2008 to December 31, 2008. The results have been stratified by gender, 5-year age-groups (0-4, 5-9 and 10-14), and the International Classification of Childhood Cancers diagnostic groups. Crude- and age-specific-rates by age-groups were estimated and standardized by applying the direct method of age-standardization using the world standard of Segi (1960) to determine the incidence of childhood cancers per 100,000 population in one year. In order of ranking, the age-standardized incidence rates (ASR) per 100,000 were as follows: amongst boys, leukemias 1.3, ly...
To analyze the clinical characteristics of B-cell non-Hodgkin&amp;amp;amp;amp;amp;amp;amp;amp... more To analyze the clinical characteristics of B-cell non-Hodgkin&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s lymphoma (NHL) patients and the therapeutic efficacy of French-American-British Lymphoma Malins de Burkitt 96 and the recent United Kingdom Children&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s Cancer Study Group B-cell NHL guidelines in the tertiary care hospital of a developing country. Patients aged &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; or =18 years registered at our hospital between January 1995 and December 2006 with histologically proved B-Cell NHL were selected for retrospective analysis. Of the total of 131 patients registered, 122 patients were eligible for evaluation. Of these 95 had Burkitt&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s lymphoma, 22 diffuse large B-cell lymphoma and five had B-cell NHL not otherwise specified. The mean age was 8.4 years. Overall 42 children had a baseline weight less than the 10th centile. A total of 37 had uric acid…
PURPOSE Infection prevention among children with cancer is a major challenge at Children Hospital... more PURPOSE Infection prevention among children with cancer is a major challenge at Children Hospital Lahore (CHL), a public health care facility in Pakistan with 1,000 new pediatric cancer admissions annually. The objective has been to reduce infections through collaboration between CHL and the St Jude Children’s Hospital Global Infectious Disease program via a grant by the Sanofi Espoir foundation through the My Child Matters program. The aim of the current study was to describe the effect of the collaborative improvement strategy on existing infection prevention and control (IPC) standards at CHL. MATERIALS AND METHODS Our work was a prospective before-and-after study to improve IPC standards. We compared the WHO Hand Hygiene Self-Assessment Framework and four modules of the St Jude modified Infection Control Assessment Tool (ICAT) scores over a 3-year period. Our strategy included creating a multidisciplinary team of pediatric oncologists, infectious disease physicians, nurses, a mi...
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