Awareness of Breast Cancer Risk Factors and Breast Self-Examination amongst Rural Women of Pakistan

AbstractObjective: To assess the awareness of major risk factors of breast cancer and understanding andpractice related to breast self-examination among rural women of Pakistan.Methodology: 396 rural women were enrolled for this cross-sectional study from the catchment ruralareas of district Gujranwala between 15th September 2022 to 30th December 2022. A self-structuredand valid questionnaire was used to gather information regarding practice and knowledge related tobreast self-examination (BSE) and breast cancer risk factors. In this analysis, Statistical Package forSocial Sciences (SPSS) version 20 was used to analyse the data at a 95% confidence interval.Results: Average age of 396 rural women was 32.96±11.74 years and 25.25% of females were unawareof breast cancer. Only three out of fifteen risk factors were known by 1/3 of the participant which werefamily history of breast cancer, obesity and lack of breastfeeding. Out of the total population, themajority (84%) had no idea about breast self-examination (BSE) whereas only 16% know about theprocess of BSE.Conclusion: Most rural women were aware of breast cancer however the awareness level was low forthe associated risk factors. More importantly, despite being aware of breast cancer the vast majority(84%) had no knowledge or training of BSE.Keywords: Breast self-examination, risk factors, breast cancer

Frequency of severity of disability in patients with grade iII lumbar neural foraminal stenosis on magnetic resonance imaging

Background Low back pain is a common condition and carries substantial socioeconomic implications. Magnetic resonance imaging (MRI) is the imaging modality of choice with lumbar neural foraminal stenosis being one of the most common causes of lower back pain syndromes. Studies have shown a lack of correlation between patients\u27 severity of disability and radiologically determined nerve root constriction. Therefore, the goal of this study will be to determine the frequency of severity of disability in patients with severe (i.e., grade III) lumbar neural foraminal stenosis on MRI to ascertain the impact of MRI diagnosis on clinical outcomes. Materials and methods Two hundred fifty patients of either gender with a history of backache referred for MRI were included by purposive sampling. Of these 250 patients, 27 patients had grade II lumbar neural foraminal stenosis, and 21 had grade I neural foraminal stenosis on MRI and were excluded. Thirty-two patients had a spinal infection (e.g., tuberculosis), and 24 patients had a history of trauma. Further, 31 patients were having follow-up scans for previously diagnosed lumbar neural foraminal stenosis. Hence, after excluding these cases, 115 patients were enrolled in this cross-sectional study with grade III lumbar neural foraminal stenosis on MRI. Results The mean age was 51 years (range: 20 to 82 years). Most of the patients (55.6%) were older than 50 years. The most common site of grade III lumbar neural foraminal stenosis was L4-L5 (56.5%). According to the Oswestry disability index, 47 patients (40.9%) had a severe disability, 32 (27.8%) had a moderate disability, 16 (13.9%) were diabled, 14 (12.2%) had a mild disability, and six (5.2%) were bedridden. Conclusions While MRI is the imaging modality of choice in degenerative lumbar spinal stenosis, clinical disabilities can be more extensive than what radiological findings may indicate in approximately 40% of the cases. Therefore, lumbar spinal stenosis should be a neuro-radiological diagnosis, and surgical decisions should be based on clinical scenarios in addition to MRI findings

ARE PULP SENSIBILITY TESTS STILL SENSIBLE?

Background: Electric and thermal tests are the most commonly employed methods for the diagnosis of pulp health status. The objectives of our study are to assess the validity, yield and accuracy of cold and electric pulp tests in determining pulp vitality of teeth requiring endodontic treatment. Methods: A cross sectional study was carried out at the Dental Clinic of Aga Khan University Hospital on 75 patients requiring endodontic treatment. Before commencement of endodontic treatment, a provisional diagnosis of pulp status was made using an electric pulp tester and cold test. The tooth was then labelled as either vital or necrotic. Then an access openings was made and tooth’s actual pulp status (vital/necrotic) was determined by observing bleeding in the pulp chamber. The validity, yield and accuracy were calculated on the basis of these findings. Results: The sensitivity, specificity, positive predictive value and negative predictive value and accuracy of cold test were 84%, 88%, 93%, 73% respectively. The sensitivity & specificity of electric test were 82% and 88% respectively whereas the positive predictive value, negative predictive value and accuracy of electric test were 93% and 71% respectively. The accuracy of cold and electric pulp test were 85% and 84% respectively. Conclusion: Both cold test and EPT have similar sensitivity, specificity and accuracy values. Although vitality tests have a promising future in diagnosis of pulp health status but within limitation of this study we found that sensibility tests have satisfactory validity and accuracy values to be used routinely prior to endodontic and restorative treatments especially when used in conjunction with one each other

Journey from black to pink gums: management of melanin induced physiological gingival hyper pigmentation

Abstract Smile is an expression of happiness, self-confidence, kindness and beauty. Along with teeth and lips, gingiva is also a vital component of smile. Melanin induced gingival hyper pigmentation may appear un-aesthetic especially when it is associated with high smile line, upper anterior labial segment and is uneven in appearance. It affects individuals from all races. Generally, it is believed that melanin induced gingival hyper pigmentation is confined to individuals from dark races. But studies have shown that Iranian, Indian, Italian, Arabian, Greek. German, French, Japanese, Chinese, Jewish, Thai, Malaysian and other ethnic groups also display clinical gingival pigmentation.1 Gingival hyper pigmentation may result in psychological distress especially when the appearance is of utmost importance for the individuals. This article aims to focus on the physiology, clinical appearance and treatment options available for the melanin induced gingival hyper pigmentation along with the reported recurrence in the light of current literature

Assessing Faculty Preference Regarding Online Tools for Assessment in Medical Education: A Cross-Sectional Multi-Center Study

Purpose: E-assessment is a novel practice in developing countries; hence it is essential to determine the online platforms and tools preferred by health sciences education faculty for online assessment. The purpose of this study was to assess the preference of faculty in medical and dental education regarding the online tools for e-assessment of undergraduate students. Methods: This cross-sectional, descriptive study was conducted from June until August 2020 on the faculty of medical and dental undergraduate programs of private and public sector institutes across Karachi, with a sample size of 152. Data was collected through convenience sampling using a validated questionnaire and was analyzed using SPSS version 23. Mean and standard deviation was calculated for numerical data while frequencies and percentages analyzed for categorical data. Results: A total of 125 faculty members participated in the study, having mean age of 37.8±9.99 years, with the majority affiliated with medical program (78%), working in private institutes (58.4%), and teaching basic sciences (64%). Faculty of both basic and clinical sciences preferred Question and Answer (Zoom) for formative assessment (37.6% and 20.8% respectively). Although most faculty were found to not use any online tool for summative assessment, nonetheless, Socrative was preferred for this purpose (23.2% basic sciences, 12.8% clinical sciences). Almost 68% of the faculty faced difficulties in conducting e-assessments and reported that their issues were not resolved effectively (48.2%). Conclusion: Formative assessment was found to be preferably conducted by the Question-and-Answer feature of Zoom. Even though most of the faculty reported not utilizing any online tool for conducting summative assessment, it was found that quiz-based platforms were preferred

Diagnostic accuracy of digital mammography in the detection of breast cancer

Introduction Breast cancer has a high prevalence in the community and places very high demands on resources. Digital mammography provides a good quality image with reduced radiation dose and can detect breast carcinoma in its earlier stages, resulting in good prognosis and improved patient survival. Objective To calculate the diagnostic accuracy of digital mammography in the detection of breast cancer, using histopathology as a gold standard in women aged over 30 years, who are undergoing mammography for screening and diagnostic purposes. Materials and methods This was a cross-sectional analytical study, conducted in the department of radiology, for a total duration of 10 months. A total of 122 patients of age above 30 years, referred for digital mammography for the evaluation of different symptoms related to breast diseases, followed by biopsy/surgery and histopathology, were included in the study. Result Our data confirmed that digital mammography is a highly accurate tool for breast cancer detection having a sensitivity of 97%, a specificity of 64.5%, a positive predictive value of 89%, and a negative predictive value of 90.9%, with a diagnostic accuracy of 89.3%. Conclusion Considering our results, we recommend that digital mammography should replace screen-film mammography as a basic tool to detect breast cancer for both screening and diagnostic purpose

Cellular Services Packages and their Impact on Social Values of Youth

Youth plays a significant role in building of the nation and in the development of a country. Their adoption, aspiration, and objective lead towards change in social value of a culture. Ongoing study investigates the impact of telecom cellular services packages like late night call & unlimited Short Messaging Service (SMS) on the social values of Pakistani youth. In today’s competitive environment cellular companies are mainly targeting youth through their advertisements and would like the youth to get indulge in these activities in order to increase their sales but the point is up to what extent youth showing receptiveness and emotional attachment to these packages. Study was conducted in capital city of Pakistan i.e. Islamabad, mainly considering three famous universities; Iqra University, Bahria University & Foundation University with the sample of 250 respondents; convenient sampling technique is used & results are measured using multiple regression test. Major findings concluded that cellular advertisements of unlimited Short Messaging Service (SMS) and late night call packages have a negative impact on youth but youth is still willing to accept these advertisements as they are negatively attached to the advertisement and use of these packages