Breast self examination: to do or not to do?

This is a retrospective descriptive study done to look at common presentation and method of detection of breast cancer. A total of 366 case records of patients attending the Breast and Endocrine Clinic at Hospital Kuala Lumpur were reviewed. The peak age of breast cancer presentation was 40 to 49 years (39.6%). Most (81.4%) patients presented with a lump in the breast and the lump was mainly self-detected (97.3%). The mean tumour diameter on presentation was 4.7± 3 cm. Medical staff detected the disease in 1.6% cases and 1.1% of cases were detected by mammogram. Most women detected the lump themselves, suggesting that Breast Self Examination (BSE) can be used for detection of the disease in places where there is cost and availability constrains for mammogram. Early detection with BSE can possibly offer better treatment options and quality of life despite the evidence that it does not reduce the mortality due to breast cancer

Risk determinants of peripheral neuropathy in patients with type II diabetes mellitus attending follow-up clinics at University Kebangsaan Malaysia Medical Center (UKMMC): a cross sectional study

Peripheral neuropathy is highly associated with foot complications among diabetics. This study aimed to identify risk factors associated with the development of peripheral neuropathy in diabetic patients and their association with degree of severity of peripheral neuropathy. A cross-sectional study was conducted in follow-up clinics at the Universiti Kebangsaan Malaysia Medical Centre (UKMMC), Malaysia involving 72 diabetic patients and 19 controls. Exclusion criteria were those with amputated limbs, gross foot deformity and existing peripheral neuropathy. Controls were non diabetics who walked normally, had no history of foot problem and attended the clinic as subjects’ companion. Quantitative assessment of neuropathy was done using Semmes-Weinstein monofilament. Neuropathy Disability Score (NDS) were used to quantify severity of diabetic neuropathy. Spearman’s Rank test and Mann-Whitney test were used to determine correlation between variables and their differences. Logistic regression analysis was used to determine risk factors associated with peripheral neuropathy. The mean HbA1c among diabetics was 8.6% + 4.1, and mean NDS was 7.0 + 6.0. A total of 79.1% demonstrated various level of neuropathy with presence of callus was associated with higher NDS scores. Older age (P=0.02), body weight (P=0.03), HbA1c (P=0.005) and duration of diabetes (P <0.005) showed positive correlation with NDS. Proper foot care program for diabetics should include recognition of the callus, with special emphasis given to those with heavier weight and increasing age

Prospective study of functional recovery of stroke patients at three months post admission: outcomes and implications for post sstroke care provision.

Functional recovery in the immediate post stroke period predicts the long-term prognosis of post stroke patients. Despite the advancement in stroke rehabilitation in improving the physical function of survivors, there are other factors that may influence functional recovery. We aimed to assess the functional recovery of ischaemic stroke patients attending a tertiary hospital and its associated factors in order to make recommendations for post stroke care after hospital admission. A three months prospective observational study looking at functional recovery using the Modified Barthel’s Index (MBI) and depression (Patient Heath Questionnaire-9) score of post stroke patients. There were 46 ischaemic stroke patients who were recruited for the study. At three months, only 37 patients were eligible for analysis. The mean age was 67.2 (SD 11) years with the Malays (50%) making up the majority of the patients, followed by Chinese (41.3%) and Indians (8.7%). There was a total of seven (15.2%) deaths. Hypertension was the most common risk factor (89.1%) followed by dyslipidaemia (65.2%) and diabetes mellitus (63.0%). The mean MBI difference was 45.2 (SD 27.0) with a median MBI of 17.0(IQR 33.0) at baseline compared to 85.0(IQR 42.0) at three months (p < 0.001, CI 35.98,55.45). The prevalence of depression (PHQ-9≥10) was 21.6%. Lower functional recovery was found among depressed patients (p <0.026) and among patients with recurrent stroke (p< 0.035). Significant functional recovery can be seen as early as three-months post stroke. Factors such as recurrent stroke and depression may affect functional recovery post stroke; hence should be routinely screened

Breast Self Examination: To Do or Not To Do?

ABSTRAK Ini adalah satu kajian retrospektif untuk melihat presentasi kanser payudara dan cara ianya dikesan dikalangan pesakit di Hospital Kuala Lumpur. Sebanyak 366 rekod pesakit dari Klinik Endokrin dan Payudara dianalisa. Hasil kajian menunjukan kebanyakan pesakit adalah dalam lingkungan umur 40-49 tahun (39.6%). Sebanyak 81.4% pesakit menunjukkan ketulan pada payudara dan mengesan ketulan ini sendiri (97.3%). Diameter min tumor semasa presentasi adalah 4.7± 3 cm. Sebanyak 1.6% penyakit di kesan oleh kakitangan perubatan dan 1.1% lagi dikesan melalui mamogram. Kesimpulannya, kebanyakan pesakit mengesan ketulan pada payudara mereka sendiri. Ini mencadangkan bahawa kaedah pemeriksaan sendiri payudara boleh digunakan sebagai saringan untuk mengesan tanda-tanda awal kanser payudara, sekiranya kemudahan mamogram tidak ada. Pengesanan awal melalui pemeriksaan sendiri dapat menawarkan pilihan rawatan dan kualiti hidup yang lebih baik sungguhpun terdapat bukti yang menyatakan bahawa kaedah ini tidak dapat mengurangkan mortaliti kanser payudara. Kata kunci: Kanser payudara, peperiksaan sendiri payudara ABSTRACT This is a retrospective descriptive study done to look at common presentation and method of detection of breast cancer. A total of 366 case records of patients attending the Breast and Endocrine Clinic at Hospital Kuala Lumpur were reviewed. The peak age of breast cancer presentation was 40 to 49 years (39.6%). Most (81.4%) patients presented with a lump in the breast and the lump was mainly self-detected (97.3%). The mean tumour diameter on presentation was 4.7± 3 cm. Medical staff detected the disease in 1.6% cases and 1.1% of cases were detected by mammogram. Most women detected the lump themselves, suggesting that Breast Self Examination (BSE) can be used for detection of the disease in places where there is cost and availability constrains for mammogram. Early detection with BSE can possibly offer better treatment options and quality of life despite the evidence that it does not reduce the mortality due to breast cancer