Primary mammary small cell carcinoma

Neuroendocrine breast cancer was defined in 2003 by WHO as a separate and unique breast cancer subtype. Primary small cell carcinoma of the breast, an exceptionally uncommon and aggressive tumor, is frequently characterised by early progression and worse outcome. Moreover, it is essential to distinguish between small cell carcinoma arising primarily in the breast and the metastatic disease to the breast. We had a patient of primary small cell carcinoma of breast. As her initial metastatic workup was negative for disease elsewhere, so she was started on neoadjuvant chemotherapy to which she responded well. Her modified radical mastectomy [MRM] was done followed by completion of chemotherapy up to 6 cycles and local radiotherapy of chest wall. However, the disease behaved aggressively afterwards as she developed recurrence twice at 9 and 19 months interval, respectively, for which she was considered for second and third line chemotherapy. An accurate management of the primary small cell carcinoma of the breast still lacks a consensus. Relevant studies were also reviewed to enhance knowledge and expertise in diagnosis, clinicopathologic features, management, and outcome of this tumor

Vitamin D deficiency in pregnant women and their new born

Background: Vitamin D deficiency may affect the mother and its new born health

Objective: To detect the frequency of vitamin D deficiency in pregnant women and their newborn of Karachi at tertiary care hospitals, and correlating maternal vitamin D with cord blood

Patients and Methods: This cross-sectional study was conducted on 50 women in labor presenting with a singleton term pregnancy at tertiary centers in Karachi. Data was recorded on a special proforma, maternal blood was taken before delivery and cord blood was taken at delivery. All blood samples were analyzed for 25-hydroxy vitamin D levels

Results: The mean vitamin D levels were 24 ng/mL for the mothers and 20 ng/mL for the newborns. Vitamin D sufficiency was noted in 11[22%], insufficiency in 16 [32%], and deficiency in 23 [46%] of the 50 mothers whereas sufficiency and deficiency, were noted in 6 [12%] and 44 [88%] of the newborns respectively. There was a positive correlation between the vitamin D levels in maternal and cord blood [r = 0.03; P=0.003]. Maternal vitamin D levels were significantly affected by sunlight exposure [P =0.007] and quality of diet [P=0.01]

Conclusion: Vitamin D deficiency is high among pregnant urban Pakistani women and their newborns. This public health problem needs urgent attention

Oral hygiene among pregnant women; practices and knowledge

To define the self-reported oral health knowledge, attitudes and oral hygiene habits, among pregnant women getting antenatal care at Kulsoom Bai Valika Hospital Karachi. Method and A cross-sectional questionnaire-based survey was conducted at the KVSS Site Hospital antenatal clinic during the period January June 2013. The data was analyzed using the SPSS for Windows [version 16.0; SPSS Inc. Chicago. IL] statistical software package and was validated visually. Most of the respondents revealed a reasonable level of oral health knowledge and positive attitudes towards oral health. However, there were gaps in the oral health knowledge of the women surveyed. The relationship between the level of oral health knowledge and ethnicity [p=0.856], level of education [p=0.079], age category [p= 0.166], and trimester of pregnancy [p=0.219] were not statistically significant. In addition, the women's knowledge and attitude towards oral health was not reflected in their oral hygiene practices. There is a need to provide oral health education for pregnant women during antenatal care in order to highlight the significance of good oral health in achieving good health for both the mother and her baby