Awareness and practice of breast self-examination (BSE) with its socio-demographic associates: a cross-sectional survey in the capital of Rajasthan, India

Introduction: Breast cancer is the most common cancer of women worldwide. Early diagnosis of it has a very important role in its management. Breast self-examination (BSE) is a key to the early diagnosis of breast cancer. Materials and Methods: A community-based cross-sectional study was conducted on 300 females of Jaipur city. This study was conducted by a house-to-house survey through a systematic random sampling technique in the field practice area of the Urban Health Training Centre (UHTC) of SMS medical college, Jaipur (Rajasthan), India. A predesigned semi-structured questionnaire containing predesigned questions regarding knowledge and practice of BSE was used to collect data. A Chi-square test was used to find out associations. Results: Only 18% of females were aware of BSE and 5.7% of the females were practicing BSE. Health professionals (31.03%) were the main source of knowledge. Only 50% of females who have heard the name of BSE, knew that it is performed by self. Awareness and practice of BSE both were found to be associated with religion, education, socioeconomic status, and occupation and there was no association with age and marital status. Females with higher education and socioeconomic status were more aware of BSE. The most common (94.69%) reason for not practicing BSE was the lack of awareness of steps followed by ‘find it unnecessary’. Conclusion: As knowledge and practice of BSE were observed very poor and considering the important role that can be played by BSE in the early diagnosis and management of breast cancer, there is an urgent need to implement and reinforce BSE in the existing cancer awareness and screening programs. IEC activities regarding BSE also motivated proper knowledge of BSE.

Formulation Development, Characterization and In-vitro Evaluation of Tamoxifen Loaded Liposomes

Background: The study was aimed to prepare and evaluate tamoxifen loaded controlled release liposomes to reduce the side effects of tamoxifen during cancer treatment. Methods: Different tamoxifen loaded liposomes were prepared by modified ether injection (MEIM) and thin film hydration method (TFHM) under prescribed conditions. The prepared liposomes were characterized by using optical microscopy, evaluating encapsulation efficiency, in-vitro and ex-vivo diffusion studies by using dialysis membrane and chicken intestinal sac respectively.Results: The data revealed that all of the liposomes were spherical in shape and stable under three physical conditions i.e. 4, 25 and 37 ± 2°C temperatures and 60 ±5% relative humidity. Additionally most of the liposomes followed zero order and class II release kinetics. It was also observed that with the increase of phospholipids and cholesterol, entrapment efficiency of liposome vesicles increased thus giving a controlled release drug delivery system but further increase reduced this efficiency at a certain level.Conclusion: The formulated control release liposomes might be a good drug delivery system for target oriented drug delivery with minimum side effects of tamoxifen during cancer treatment

Acute Disseminated Encephalomyelitis with Measles.

Acute disseminated encephalomyelitis is an inflammatory demyelinating illness usually associated with infections or antecedent immunization. Due to control of most vaccine preventable diseases in developed countries, most cases of acute disseminated encephalomyelitis occur in developing countries and are seen secondary to nonspecific upper respiratory tract infections. We report a case of acute disseminated encephalomyelitis associated with measles in a 2½-year-old male child despite having measles vaccination in infancy. The diagnosis was based on clinical findings and CT scan of brain. The patient was managed with high dose corticosteroids along with supportive measures. He recovered completely and follow-up for six months revealed no neurological deterioration.

A Case of Congenital Tuberculosis in a Tertiary Care Hospital.

Congenital tuberculosis is an unusual and severe clinical presentation of Mycobacterium tuberculosis (MTB) infection. It is usually difficult to diagnose and treat. We report a tenweek- old male infant who had presented with fever, difficulty in breathing, abdominal distension, convulsion, low weight gain since one month of his age. The diagnosis was made by demonstration of MTB bacilli in the gastric aspirate of baby and chest radiography. Treatment with the four drug regimen including streptomycin was initiated, but the baby died on the third day of ATT. This case gives an account of difficulties in diagnosis and therapeutic management of congenital tuberculosis and alerts for development of protocols that foresee these difficulties.

Exclusive Breastfeeding among Preterm Low Birth Weight Infants at One Month Follow-up after Hospital Discharge.

Background: Establishment and maintenance of breastfeeding in preterm low birth weight (PT LBW) neonates after discharge from hospital is challenging and may be affected by multiple factors. We designed this study to find out the association of these factors with breastfeeding in our population. Objectives: To observe the rate of exclusive breasrfeeding (EBF) among the PT LBW neonates at one month follow up and to identify the factors that are related with the maintenance of EBF. Materials and Methods: This observational study was conducted during the period from July 2009 to October 2011 in Enam Medical College Hospital (EMCH). Preterm infants ≤ 34 wks gestation, stayed in the NICU for >3 days and discharged home were eligible. Mothers were interviewed at one month follow-up after discharge. Infants who were given only breast milk up to 4 weeks were termed as “Exclusively breastfed (EBF)” and who were given formula milk in addition were labeled as “Nonexclusively breastfed (NEBF)”. Baseline information regarding maternal demography, delivery of the baby, feeding during discharge was taken from database of neonatal ward. Results: Among 89 infants, 37 (42%) were female and 52 (58%) were male, including 5 twins. Gestational age ranged from 29 to 34 weeks (mean 32±2), and birth weight ranged from 1100 to 2200 grams (mean 1763±20 g). At one month follow up visit 19% (17/89) were found to be NEBF and 81% were EBF. Factors significantly associated with EBF were shorter duration of hospital stay (p=0.001), method of feeding at discharge (p=0.001), mode of delivery (p=0.004), below average socio-economic status (p=0.03), maternal education (p=0.02), number of antenatal visits (p=0.02) and larger birth weight (p=0.038). Conclusion: A variety of factors may affect EBF in PT LBW babies. Extensive counseling of the mothers during antenatal visits, counseling of the family members regarding the advantages of exclusive breastfeeding is necessary. Support should be provided for the mothers both in the hospital and also outside the hospital for a long period.