IntroductionAlternative medicine during treatment is often used to make the quality of life (QoL) better.Women with early-stage breast cancer, particularly the ones who possess lower QoL, are more prone to opt for complementary medicine.This study aims to explore the effects exerted by intravenous vitamin C (IVC) on symptoms and adverse events associated with breast cancer treatment. MethodsThis single-center, parallel-group, single-blind interventional study was conducted in the oncology ward of a tertiary care hospital in Pakistan.For this study, after informed consent was taken, breast cancer patients with Union for International Cancer Control stages IIA to IIIb were included in the study.Three hundred and fifty (n = 350) patients were randomized into two groups at a ratio of 1:1.Study group was randomized to receive 25 grams per week of IVC at a rate of 15 grams per hour for four weeks in addition to their current standard treatment, and the control group received placebo (normal saline drip with label removed) in addition to their current standard treatment. ResultsIn patients who had received IVC, there was a significant decrease in the mean severity score after 28 days for the following symptoms: nausea (2.65 ± 0.62 vs. 2.59 ± 0.68; p-value: 0.0003), loss of appetite (2.26 ± 0.51 vs. 2.11 ± 0.52; p-value: 0.007), tumor pain (2.22 ± 0.45 vs. 1.99 ± 0.40, p-value: <0.0001), fatigue (3.11 ± 0.32 vs. 2.87 ± 0.29; p-value: <0.0001), and insomnia (2.59 ± 0.35 vs. 2.32 ± 0.36, p-value: <0.0001). ConclusionOur study showed improvement in the mean severity score of nausea, fatigue, tumor pain, loss of appetite, and fatigue.More studies are also needed to assess the long-term effects of IVC in the cancer management.This shall help incorporate the use of IVC in standard practice to make the journey of cancer management comfortable for the patients.

IntroductionPainful diabetic peripheral neuropathy (PDPN) complicates 25% of type II diabetes mellitus. It has a profound impact on diabetes-related morbidity and worsens the quality of life. Both pregabalin and duloxetine may be indicated for PDPN. In this study, the efficacy of duloxetine and pregabalin was compared in patients with PDPN.MethodsIt was a single-centre open-label study conducted with patients of diabetes mellitus type II diagnosed with PDPN. Patients were randomized to receive 60 mg/daily duloxetine or 300 mg/daily pregabalin. Pain scores were recorded using visual analogue scale (VAS) on day 0, week 4, and week 12. Data was entered and analysed using SPSS version 22.0 (IBM Corp., Armonk, NY).ResultsIn the duloxetine group, the mean VAS score decreased from 6.81 +/- 0.91 to 4.01 +/- 1.12 with 12 weeks of therapy (p < 0.0001). In the pregabalin group, the mean VAS score decreased from 6.99 +/- 1.12 to 4.91 +/- 0.82 with 12 weeks of therapy (p < 0.0001). At 12 weeks, duloxetine showed lower VAS scores than pregabalin (p < 0.0001). In the duloxetine group, the mean change in VAS score over time was -2.80 and in the pregabalin group, the mean change was -2.80. Adverse events were reported in 17.9% of the participants. Lethargy/somnolence (8.1%) and peripheral edema (3.4%) were commonly reported in the pregabalin group and constipation (6.9%) and orthostatic hypotension (4.6%) were commonly reported in the duloxetine group.ConclusionsDuloxetine at a daily fixed dose of 60 mg is efficacious in the relief of neuropathic pain. Pregabalin also showed a comparable outcome. Both duloxetine and pregabalin have a promising safety profile and are well-tolerated.

PURPOSE:To study and analyze the reasons for not performing laser-assisted in-situ keratomileusis (LASIK) surgery in Pakistan.METHODS:This is a retrospective observational review of the patients who presented for LASIK surgery during January 2014 to September 2016 at the Hashmanis Hospital refractive surgery facility in Karachi, Pakistan.RESULTS:A total of 6005 eyes in 3512 patients presented for LASIK surgery. Out of these, a total of 1795 eyes (29.9%) of 899 patients (25.6%) were rejected. The most common cause for not performing LASIK surgery was found to be increased risk of postoperative ectasia seen in 534 (29.75%) eyes. In 275 (15.32%) eyes, the surgery could not be performed because of affordability of procedure or unscientific apprehensions of the patient. Keratoconus was seen in 268 (14.93%) eyes.CONCLUSION:The patients presenting for LASIK surgery need extensive screening as the large proportion of patients may have corneal structural for not performing this procedure. The cost of the procedure plays its role as does the unscientific beliefs amongst the patients.