An educational intervention study to enhance breast cancer awareness among women and primary healthcare providers of an urban health center area, Visakhapatnam.

Background: Breast cancer is the most common malignancy in women worldwide posing greater health challenge. The poor survival rate from breast cancer in India may be attributed to lack of awareness, low rate of screening uptake and presentation of cases in advanced stage. Objectives: To assess the baseline knowledge and effectiveness of educational intervention in improving the knowledge regarding breast cancer. Materials and Methods: A quasi-experimental community-based health educational intervention study was performed among 100 women and 18 female primary healthcare providers residing in urban field practice area. Face-to-face interviews were performed using a questionnaire adapted from the Breast Cancer Awareness Measure (Breast-CAM) Version 2. Data were analyzed using SPSS version 25. To assess the difference between pre- and postintervention scores, Mc-Nemar's test and paired sample t tests were applied. Association between socio-demographic variables and difference in mean scores was assessed by using ANOVA and independent t test. P value less than 0.05 was taken as statistically significant. Results: The mean pre-intervention score of knowledge items (21 including warning signs, risk factors of breast cancer) among 100 women participants was 7.19 ± 3.45 and postintervention mean score was 18.18 ± 2.42. The mean pre-intervention score among 18 primary healthcare providers was 10.89 ± 4.59 and postintervention score was 19.89 ± 1.28. There was significant improvement in mean scores. The increase in percentage of scores in all 21 items postintervention was significant (Mc-Nemar's test). There was significant association between socio-demographic profile and increase in mean scores. The study identified various barriers for seeking medical care among women. Conclusion: The community-based educational intervention was effective in enhancing the knowledge regarding breast cancer among women.

Non-fragile output-feedback synchronization for delayed discrete-time complex-valued neural networks with randomly occurring uncertainties.

This paper is step forward to establish an exponential synchronization criterion for discrete-time complex-valued neural networks (CVNNs) having time-varying delays subject to randomly occurring uncertain weighting parameters, in order to overcome the fluctuation when the output-feedback controller imposes on its dynamics. To achieve this, Jensen's weighted summation inequalities (WSIs) and an extended reciprocal convex matrix inequality (ERCMI) are extended into the domain of complex field. By introducing some augmented vectors, a Lyapunov-Krasovskii functional (LKF) is constructed to attain an improved delay-dependent linear matrix inequalities (LMIs) constraint for the exponential synchronization phenomenon of the desired master-slave neuronal system model. For instance, the upper bound of the quadratic summation terms occurred in the finite difference of the LKF have been obtained from its linearization that has been made by the developed complex-valued WSIs and complex-valued ERCMI. The proposed results are less restrictive with the minimum number of decision variables than those obtained using existing inequalities. The designed output-feedback control gain has been determined by solving a set of complex-valued LMIs and it has been enforced with a prescribed exponential decay rate. Finally, in sight of MATLAB software, the established results have been examined via a numerical example supported by the simulation results.

State estimation for delayed genetic regulatory networks based on passivity theory.

This paper is concerned with the state estimation problem for delayed genetic regulatory networks (GRNs) based on passivity analysis approach. The main purpose of the problem is to design the estimator to approximate the true concentrations of the mRNA and protein through available measurement outputs. Time-varying delays are explicitly assumed to be non-differentiable and constraint on the derivative of the time-varying delay is less than one can be removed. Based on the Lyapunov-Krasovskii functionals involving triple integral terms, using some integral inequalities and convex combination technique, a delay-dependent passivity criterion is established for GRNs in terms of linear matrix inequalities (LMIs) that can efficiently be solved by any available LMI solvers. Finally, numerical examples and simulation are presented to demonstrate the efficiency of the proposed estimation schemes.

Association of Polycystic Ovary Syndrome with Anticonvulsant Use: ACase Report.

A 20-year-old woman with epilepsy had resolution of features of polycystic ovary syndrome on discontinuing valproic acid; they reappeared with the newer antiepileptic divalproex sodium.

Clinical association of autoimmune diseases with diabetes mellitus: analysis from southern India.

The adult form of polyglandular autoimmune syndrome (type 2) is associated with disorders of the thyroid, adrenal, and pancreas (type 1 diabetes mellitus). We profile the clinical association of autoimmune diseases among patients from our center in southern India: autoimmune diseases were diagnosed in 1.68% of persons with diabetes mellitus (147/15,523). Diabetes mellitus was diagnosed in 2.3% of persons with hypothyroidism (33/1435) and in 4.35% with thyrotoxicosis (15/345).

Hyperthyroidism in a girl with Down's syndrome.

We report an adolescent girl with Down's syndrome, who presented with hyperthyroidism. Autoimmune thyroid disorders can occur in children with Down's syndrome, hypothyroidism developing more frequently. Hyperthyroidism can also be associated with Down's syndrome, and should not be missed.

Evaluation of osteoporosis in patients with fracture neck of femur using conventional radiography.

Osteoporosis was assessed at the hip (Singh's index) and calcaneus (calcaneal index) using conventional radiography in 80 patients (31 men, 49 women) with fracture neck of femur. Forty four patients had intracapsular fracture neck of femur (ICFN), and 36 extracapsular fracture neck of femur (ECFN). Fractures occurred more with increasing age in both groups, with female preponderance in the older age group. Osteoporosis was more severe as age advanced. Singh's index decreased from 5.2 to 3 (ICFN), and from 4.1 to 2.65 (ECFN) with age. Calcaneal index decreased from 4.4 to 2.9 (ICFN) and from 4.1 to 2.6 (ECFN) with age. In summary degree of osteoporosis, assessed at the hip and calcaneus, increased with increasing age. Other recent studies have shown that calcaneal bone density is a valid method to predict future risk of hip fracture.

Hypothyroidism presenting with polycystic ovary syndrome.

During a 30 months period, two women of primary hypothyroidism (2/13; 1.04%) presented with features of polycystic ovary syndrome (PCOS). In hypothyroidism, sex hormone binding globulin levels are decreased; increased conversion of androstenedione to testosterone, and aromatization to estradiol are present, all these being an exaggeration of biochemical changes characteristic of PCOS. Besides, metabolic clearance rates of androstenedione and estrone, the putative mediators of PCOS, are reduced. Hypothyroidism can either initiate, maintain or worsen the syndrome. Correction of hypothyroidism when present, would therefore form an important aspect in the management of infertility associated with PCOS.