Obesity and response to neoadjuvant chemotherapy in breast cancer

The prevalence of obesity is rising worldwide including Sub-Saharan Africa just as the incidence of breast cancer is rising in same region with increasing morbidity and mortality. Obesity or overweight has been identified as a risk factor for breast cancer and both have been associated with poor outcome of breast cancer treatment. The objective of this study was to assess the effect of obesity /overweight on clinical response to Adriamycin Cyclophosphamide-Paclitaxel (AC-P) regimen neoadjuvant chemotherapy in patients with breast cancer. A prospective observational of 39 female patients with breast cancer. A prospective observational study of newly diagnosed breast cancer patients with palpable breast lumps on neoadjuvant chemotherapy of AC-P regime. Age of the patients, tumour size, stage, estrogen, progestogen and HER2 receptor status were noted. Height measured in metres and weight measured in Kilograms were recorded and Body Mass Index (BMI) calculated .Tumour size measured at presentation, then after first, third, sixth and eighth doses to determine response as defined by the UICC method such as complete clinical response, partial clinical response, stable disease and progressive disease. BMI was then categorized into Normal weight 25kg/m2 and Overweight 25-30kg/m2 and Obese 30kg/m2. 43.6% were obese, 33.3% were overweight and 23.1% were normal weight. Thirty percent of overweight /obese patients had complete clinical response 2 compared with 77% of low/normal weight patients and this was statistically significant (X2 =6.53, p 0.015). 76.7% of the overweight/obese were premenopausal compared with 23.3% who were post menopausal, and this is statistically significant.(X2 =5.84, p 0.024). Obesity/ overweight is associated with poorer clinical response to neoadjuvant chemotherapy in the cohort of patients studied

Comparison of statistical models used for assessing factors associated with infant mortality in Nigeria

Background: Infant mortality is a public health concern especially in developing countries, particularly Nigeria. Different models had been used independently to identify factors associated with infant mortality. Some of the used models sometimes violate the underlying assumption for the models. This study was designed to compare the models that have been previously used and identify the appropriate model using standard model selection criteria to analyse risk factors for infant mortality in Nigeria.Methods: The study utilised 2008 Nigeria Demographic and Health Survey (NDHS) data with a sample size of 7107. The NDHS was a stratified two-stage cluster design where a questionnaire was used to collect data on the birth history of women aged 15-49 years. The models employed for this study were: Logit, Probit and Clog-log. The model selection criteria were Akaike Information Criterion (AIC), Residual Deviance and Vuong test. The model with the smallest criteria was considered to be the best fit.Results: The results showed that Infant Mortality in Nigeria can be appropriately modelled by Clog-log model. The models and corresponding AIC values were: Logit (6171.1), Probit (6212.6) and Clog-log (6126.6). The residual deviance included: Logit (6135.1), Probit (6176.6) and Clog-log (6090.6). Clog-log had the smallest AIC and residual deviance values; hence, it was of the best fit. Home delivery and delivery by professionals had negative significant associations with infant mortality while women's education (primary/no education) and birth order had positive significant association, (p < 0.05). Conclusion: The best model for infant mortality evaluation in Nigeria was Clog-log. Generally, improved women's education would significantly reduce Infant Mortality in Nigeria

Prevalence of vulvovaginal candidiasis among women with diabetes mellitus in Ibadan, Oyo State, Nigeria

Background: Diabetes mellitus predisposes to both bacterial and fungal infections, including Candida species. Hitherto, Candida albicans has been identified as the most common opportunistic pathogen among patients with diabetes mellitus. More recently, Non-Candida albicans Candida (NCAC) species are increasingly recognized as the cause of candida infections.Objective: To determine the prevalence of vulvovaginal candidiasis (VVC) as well as the species of Candida frequently identified among women with diabetes mellitus in Ibadan, Nigeria.Methods: A cross-sectional study of 213 women diagnosed with diabetes mellitus was carried out in 2010. Direct microscopy and fungal cultures of high vaginal swabs were done using Sabouraud--Dextrose Agar and ChromAgar.Results: The prevalence of VVC among 213 women with diabetic mellitus was 18.8% (40/213). The predominant Candida species isolated were Candida glabrata (30.0%), C. albicans and C. tropicalis (17.5%) each and C. Gulliermondii (15.0%). Diabetic women had higher rates of moderate and heavy growth of Candida density. Twenty-nine (72.5%) patients with candidiasis were symptomatic and the most common symptom was vulval/vaginal itching 48.3% (14/29.Conclusion: This study put the prevalence rate of VVC among women with diabetes mellitus in Ibadan at 18.8%. The most common Candida species isolated was C.glabrata and majority of the patients were symptomatic