RESUMEN
This study examines the challenges Pakistani farmers face in adopting global good agricultural practices (GGAP) and highlights the limitations in infrastructure and cost-based clauses. A questionnaire based on GGAP's fruit and vegetable module version 5.0 was developed and validated by the Department of Environmental Sciences, Government College University, Faisalabad. This was a survey-based study of 15 farmers divided into 5 groups according to their annual farm turnover. The findings of the study indicated that, although the basic paperwork requirements of GGAP were implementable, clauses related to capital investment and technical record-keeping were not. Results showed that 90-100% of farmers considered risk assessments, training, and documentation on their farms. However, 42-56% of clauses related to record-keeping, installation, visual presentation, and infrastructure development, and 24-37% of clauses related to external testing, health, safety, and hygiene were declared not implementable. The study revealed a need for adapting GGAP standards to Pakistan's unique agricultural conditions, suggesting the development of localized standards for more practical implementation. The study's findings highlight crucial insights for policymakers and stakeholders in the agriculture sector and suggest the need for target strategies to overcome implementation barriers and optimize the adaptation of Global GAP in Pakistan that would help to increase exports of agricultural commodities.
RESUMEN
Locoregional recurrence is common in papillary thyroid cancer PTC and an optimal surgical treatment with respect to the multifocal nature of the disease stays controversial. It is a retrospective analytical study design. 209 diagnosed PTCs managed at our institute were grouped into macro-PTC with a size of dominant focus >1 cm (unifocal n = 106 and multifocal n = 64) and micro-PTMC if size of all foci was <1 cm; (unifocal n = 16 and multifocal PTMC n = 23). The primary endpoint is recurrence and tumor free survival in each of the four groups. Secondary endpoint is an assessment of a benefit of completion total thyroidectomy in terms of assignment of true focal status to an individual's PTC. The median follow-up was 4.1 years. Upon completion thyroidectomy, the tumor focality changed to multifocal in 31.4% of macro-PTC and 60% of micro-PTMC. Multifocality was an independent risk factor for recurrence, OR 2.41 for macro (CI 1.14-5.11), and 3.48 for micro-multifocal PTMC (CI 1.19-10.2). Disease free survival patterns on Kaplan-Meier's plots were alike for micro- and macro-unifocal groups, and similarly stayed comparable among the two multifocal groups. Our analysis showed that tumor multifocality rather than size is the significant factor determining prognosis; hence, total thyroidectomy is indicated for an optimal assessment of true focality in micro-PTC.
Asunto(s)
Carcinoma Papilar/terapia , Radioisótopos de Yodo/uso terapéutico , Recurrencia Local de Neoplasia/etiología , Radiofármacos/uso terapéutico , Neoplasias de la Tiroides/terapia , Tiroidectomía , Tiroxina/uso terapéutico , Carga Tumoral , Adolescente , Adulto , Anciano , Carcinoma Papilar/patología , Supervivencia sin Enfermedad , Femenino , Estudios de Seguimiento , Humanos , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia/patología , Recurrencia Local de Neoplasia/prevención & control , Estudios Retrospectivos , Factores de Riesgo , Cáncer Papilar Tiroideo , Neoplasias de la Tiroides/patología , Resultado del Tratamiento , Adulto JovenRESUMEN
BACKGROUND: Tongue tumour thickness has been shown to have a correlation with neck nodal metastasis and hence patient survival. Current AJCC guidelines recommend inclusion of tongue tumour thickness measurement in routine radiologic staging. Several studies have attempted to define the accuracy of MRI in measuring tongue tumour thickness. The aim of our study was to compare tongue tumour thickness measured at T2-weighted and STIR sequences with histologic tongue tumour thickness. METHODS: Twenty-eight consecutive patients of tongue cancer who had undergone glossectomy were selected retrospectively. Tumours were measured in both STIR axial and T2-weighted coronal images and compared with histologic tumour thickness on resected specimens. Pearson's analysis was performed to determine the degree of correlation. Paired samples t-test was also used for comparison of mean tumour thicknesses measured on MRI with mean histologic tumour thickness. RESULTS: Pearson correlation analysis showed good correlation of tumour thickness measured on MRI with actual histologic tumour thickness (R=0.876). CONCLUSION: MRI provides a satisfactory prediction of tongue tumour thickness which in turn can be used todetermine the need for elective neck dissection in these patients.