Breast cancer: Clinical stage at the time of presentation, its correlates and quality of life after treatment

Objective: Research worldwide indicates that early presentation of breast cancer leads to early intervention and better prognosis with improved quality of life. Our objectives were to determine the clinical stage of breast cancer in Sri Lankan women at the time of presentation, its correlates and its association with their quality of life after interventions. Methods: A descriptive cross sectional study was conducted on 200 breast cancer patients attending two selected tertiary care centers in Colombo district, who have undergone treatment. A pre-piloted interviewer-administered questionnaire was used to assess stage of breast cancer at the time of presentation and its correlates. Interviewer-administered SF-36 health survey was used to assess their quality of life. Results: Early clinical staging (UICC 0, I, II) was seen in 64.6%.  Duration between noticing the first symptom and seeking medical care  is significantly (p< 0.01) associated with age, educational level, self breast examination, breast cancer screening, spouse’s influence and stigma. This duration showed a stronger association (p< 0.001) with presenting symptom, family history, monthly income, availability of transport, initial ayurveda treatment, fear of detection, fear of surgery, embarrassment, and unawareness. Mean SF 36 score was 46. Fifty nine percent of both early and late clinical staged patients had a score  above mean. Conclusion: Promotion of self breast examination and screening for breast cancer is of value in early detection and presentation. Improved awareness about breast cancer and a facilitatory health care process would improve outcome of disease.

Knowledge and practices related to standard precautions among Medical Laboratory Technologists in tertiary care hospitals in Sri Lanka

Objective: To describe knowledge and practices related to standard precautions among Medical Laboratory Technologists (MLTs) in tertiary care hospitals in Sri Lanka. Methods: This descriptive cross-sectional study was conducted among 204 MLTs in six randomly selected tertiary care hospitals (3 state sector and 3 private sector) in Western Province. A self-administered structured questionnaire and a structured observation checklist were used for data collection. Scores were assigned to responses and were used to determine the level of knowledge and practices. Results: MLTs of both state and private sectors had good knowledge (mean knowledge scores 188.22 and 182.64, respectively) and reported good practices (mean practice scores, 72.89 and 85.18 respectively). However, observations showed that wearing protective devices (clothes and gloves) was relatively poor in state sector (8% and 38%, respectively). Undesirable habits such as eating and drinking inside the laboratories were common in both sectors. Facilities provided to MLTs in both sectors for them to follow standard precautionary practices were not optimal, and were comparatively poorer in state sector. Conclusions: MLTs in both state and private sectors have a good knowledge regarding standard precautions. Overall practices regarding safety precautions are much higher among MLTs in private hospitals than those in state hospitals, probably resulting from better availability of relevant facilities in private sector. Facilities provided for the MLTs in state sector needs improvement to enable them to practice standard safety precautions.