Swat COVID Situation Report.pptx
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This document provides a COVID-19 situation report for District Swat in Pakistan as of June 25th, 2020. It includes the following key information: - There have been 8,845 total suspected cases, with 5,636 confirmed negative and 2,378 confirmed positive. The positivity rate is 26.89% and the negativity rate is 64%. - Of the positive cases, 1,160 have recovered (49% recovery rate) and 89 have died (3.6% death rate). - Charts show the trends in positive cases, negative cases, and deaths over time from week 12 to week 26. Rates have generally increased over time with some fluctuations. - Additional charts
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Diagnosis and Staging
The diagnosis of HR+ breast cancer begins with clinical evaluation, imaging, and biopsy. Imaging modalities such as mammography, ultrasound, and MRI help in assessing the extent of the disease. Histopathological examination and immunohistochemical staining of the biopsy sample confirm the diagnosis and hormone receptor status by identifying the presence of estrogen receptors (ER) and progesterone receptors (PR) on the tumor cells.
Staging involves determining the size of the tumor (T), the involvement of regional lymph nodes (N), and the presence of distant metastasis (M). The American Joint Committee on Cancer (AJCC) staging system is commonly used. Accurate staging is critical as it guides treatment decisions.
Treatment Options
Endocrine Therapy
Endocrine therapy is the cornerstone of treatment for HR+ breast cancer in postmenopausal women. The primary goal is to reduce the levels of estrogen or block its effects on cancer cells. Commonly used agents include:
Selective Estrogen Receptor Modulators (SERMs): Tamoxifen is a SERM that binds to estrogen receptors, blocking estrogen from stimulating breast cancer cells. It is effective but may have side effects such as increased risk of endometrial cancer and thromboembolic events.
Aromatase Inhibitors (AIs): These drugs, including anastrozole, letrozole, and exemestane, lower estrogen levels by inhibiting the aromatase enzyme, which converts androgens to estrogen in peripheral tissues. AIs are generally preferred in postmenopausal women due to their efficacy and safety profile compared to tamoxifen.
Selective Estrogen Receptor Downregulators (SERDs): Fulvestrant is a SERD that degrades estrogen receptors and is used in cases where resistance to other endocrine therapies develops.
Combination Therapies
Combining endocrine therapy with other treatments enhances efficacy. Examples include:
Endocrine Therapy with CDK4/6 Inhibitors: Palbociclib, ribociclib, and abemaciclib are CDK4/6 inhibitors that, when combined with endocrine therapy, significantly improve progression-free survival in advanced HR+ breast cancer.
Endocrine Therapy with mTOR Inhibitors: Everolimus, an mTOR inhibitor, can be added to endocrine therapy for patients who have developed resistance to aromatase inhibitors.
Chemotherapy
Chemotherapy is generally reserved for patients with high-risk features, such as large tumor size, high-grade histology, or extensive lymph node involvement. Regimens often include anthracyclines and taxanes.
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- 3. DISTRICT SITUATION REPORT – 25th June 2020 8845 Total Suspected: 5636 Negative: 2378 Confirmed: 831 Samples in Transit/ Awaited 64% Negativity Rate 26.89% Positivity Rate 1160 Recovered Among Positive 49% Recovery Rate 89 Deaths Among Positive: 3.6% 0 0 3 1 4 4 2 7 8 4 7 12 12 15 10 3 23 172 190 109 329 190 266 576 521 464 663 937 909 284 0 0 0 0 0 0 0 0 0 1 13 53 97 171 496 3 26 195 238 156 369 236 428 746 731 793 1025 1466 1472 961 0 3 23 48 47 40 46 162 170 209 316 309 432 392 181 Week No. 12 Week No. 13 Week No. 14 Week No. 15 Week No. 16 Week No. 17 Week No. 18 Week No. 19 Week No. 20 Week No. 21 Week No. 22 Week No. 23 Week No. 24 Week No. 25 Week No. 26 Patients COVID Cases Timeline Awaited Negative Positive Deaths +ve Cases Trend
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