Development of perceived prenatal maternal stress scale

Background: Pregnancy is a state, which is often associated with extreme joy and happiness. Women undergo a number of physiological and psychological changes during pregnancy, which are often stressful if aligned with other adverse life events, compromising their health and well-being. However, there exists no comprehensive psychological instruments for measuring this stress. Objectives: The study was conducted to develop a multidimensional scale to assess prenatal maternal stress (PNMS) comprehensively. Methods: The initial phase of the study focuses on developing items and assessing the content validity of these items. The second phase focuses on pilot-testing and field-testing the newly developed perceived PNMS scale (PPNMSS) among 356 pregnant women belonging to different parity and trimester from November 2015 to October 2016. Results: The underlying factor structure of the 28-item PPNMSS had explored using exploratory factor analysis. The final scale is retained with 15 items having considerable item loading under four major factors as follows: perceived social support, pregnancy-specific concerns, intimate partner relations, and financial concerns. Reliability of each of these dimensions was assessed using Cronbach's alpha. Convergent and divergent validity of the scale was assessed by correlating the scores with perceived stress scale and the World Health Organization (five) well-being index (1998 version). Conclusions: As a comprehensive scale, PPNMSS is efficient to measure PNMS, which facilitates an early detection of stress and depression among pregnant women and timely intervention by health care professionals.

Cancer pattern in Western Nepal: a hospital based retrospective study.

Information on cancer patterns is an important basis for determining the priorities for cancer control in different countries worldwide. There is no reliable information about the incidence or pattern of cancer in Nepal and hence an attempt was made to assess the situation based on hospital data which is the only source in the western region of Nepal. Cancer cases diagnosed by all methods or treated in Manipal Teaching Hospital, affiliated to Manipal College of Medical Sciences, Pokhara, during 1st January 2003 to 30th May 2005 were used for the present study. A total of 957 cancer cases were identified with a male to female ratio of 1.1:1. The median age of male and female patients was 63 and 60 years, respectively. The proportion of microscopically confirmed cases, both from primary and metastatic sites was 87.5% and tobacco-related cancers constituted 48% of all cancers among males and 28% among females. For males the leading cancer sites were lung (22.2%), larynx (9.8%) and stomach (9%) and that for females was lung (20%), cervix (19.7%) and breast (7.8%). Among males, 33.1% of all cancers were in the respiratory system followed by digestive organ cancers (23.2%). Among females, 28.4% cancers were related to the reproductive system, 22.8% to the respiratory system and 14.1% to digestive organs. The cancer pattern revealed by the present study provides valuable leads to cancer epidemiology in Nepal, particularly in the western region, and provides useful information for health planning and future research.

Cancer in women in Kerala--a transition from a less-developed state.

An epidemiologic assessment of the problem of cancer in women in Kerala based on 3 Population Cancer Registry data and a Hospital Based data is presented. Kerala's Socio-economic and demography presents an intermediate development from a less developed to a better-developed state. As yet, the women follow a tradition-based life style. Cancer incidence rate in Kerala was only 80% of urban rates than seen in Urban Metropolis in India. The pattern of site distribution has shown that GI, Breast and Cervix cancers are the predominant cancers. Oral cavity cancers also show a high frequency. Thyroid cancer has a higher incidence rate in Kerala compared to other areas. Lung cancer among women has higher incidence rate in Karunagappally women. A high prevalence of tobacco use is reported among the men in the above area. Breast cancer incidence rate in the rural areas was only 60% of the rate seen in Urban Trivandrum. Unlike in other rural and urban areas of India Cervix cancer has a low incidence rate in Kerala women. This may be due to better education and also due to the changes in marital and other life style practices. Only 15% of cancer patients attend for medical assistance in localized stage of disease. The need for public education is highlighted and focusing on tobacco use control, self-examination and screening.

Trends of head and neck cancers in urban and rural India.

BACKGROUND: The sub-site predilection of head and neck squamous cell carcinoma (HNSCC) reflects the risk profile of a community and there are suggestions that these are changing over time. OBJECTIVE: To determine the change in head and neck cancer in rural and urban populations in India. METHODS: Cancer registry data of an urban and a rural population were reviewed over a period of 13 and 11 years, respectively. Age adjusted rates (AAR) and age specific incidence rates were used for data analysis. RESULTS: Oral cancers formed the majority of the head and neck cancers with a predilection for tongue, except in rural males, in whom the pharynx was the predominant sub-site. Overall there was a reduction in the incidence of HNSCC, which was more pronounced in urban females and rural males (p< .001). Among the sub-sites, oral cavity cancers showed a decreasing trend in urban females (p< .01) and rural males (p< .01). However, the trend was towards increase of incidence of tongue cancers. Pharyngeal cancer showed reduction in urban females (p< .01), whereas it increased in rural females. The recent increase in incidence of young adults with HNSCC reported in developed countries was not observed. CONCLUSIONS: Overall, incidence of HNSCC is reducing. This may be attributed to the decreased prevalence of tobacco use.The increase in incidence of tongue cancer may suggest factors other than tobacco and alcohol in its genesis.