Surgical decision making considering body image in post menopausal breast cancer patients

In most of the developing counties postmenopausal breast cancer cases are offered a radical form of surgery relying on their unawareness about body image. We evaluate the effect of breast cancer surgical choice; Conservative Breast Therapy [BCT] or Modified Radical Mastectomy [MRM]; on body image in Egyptian postmenopausal cases. A prospective randomized trial of 100 postmenopausal women who had stage I and II breast cancer. Half of them had BCT and the other half had MRM. Sociodemographic data were collected and pre and postoperative assessments of body image distress were done using four scales; Breast Impact of Treatment Scale [BITS], Impact of Event Scale [IES], Situational Discomfort Scale [SDS], Body Satisfaction Scale [BSS]. The patients ages ranged from 43-82 years [54.28 +/- 8.84]. Preoperative assessment shows no statistical significant difference as regarding cognitive, affective, behavioral and evaluative components of body image between both studied groups. While in postoperative assessment, women in MRM group showed higher levels of body image distress among cognitive, affective and behavioral aspects. For the evaluative aspect, there was no statistical significant difference between both groups. Body image is as important for postmenopausal women as for younger women. Even in developing countries, where the concept is ignored, we should not deprive postmenopausal breast cancer cases from their right of a less mutilating option of treatment as BCT

Assessment of heart rate variability as an index of cardiac autonomic modulation in control and depressed persons

Under steady state conditions, heart rate displays spontaneous beat-to-beat fluctuation. This fluctuation results from the continuous interaction between the neural or humoral control of cardiovascular function. The fluctuation of heart rate around its mean is called heart rate variability [HRV]. The mechanisms underlying the relationship between depression and cardiac events remain unclear. A disturbance of cardiac Sympathovagal balance is one of the most plausible candidates in depressed patients. To evaluate cardiac Sympathovagal activity in depressed, non cardiac patients. A 24-hour Holter electrocardiogram [ECG] was recorded in 15 newly diagnosed depressed patients and 15 healthy age and sex matched control subjects. Sympathovagal balance was evaluated through time domain parameters of Heart rate variability [HRV]. 15[th] patients with depression disorders were found to have elevated resting heart rate [HR], low heart rate variability [HRV]; decreased Mean NNI, SDNN, rMSSD and pNN50. There is considerable evidence of cardiac autonomic dysregalation. In depressed patients, measured by HRV parameters and these abnormalities may explain the increased cardiac morbidity and mortality rates in these patients