Association of bone mineral density to dietary intake and predictors of breast cancer in premenopausal and postmenopausal Malaysian women

Daily food intake of women may affect their bone health by altering their bone mineral density (BMD) as the lack of certain nutrients may affect bone integrity whilst, BMD also can be a predictor of breast cancer. To date, many studies have been conducted to discuss on association of BMD and mammographic breast density (MBD) and how both are related to breast cancer risks but no consideration has been made on dietary intake. Therefore, this study was designed to determine the association of dietary intake with BMD and other breast cancer risk factors. A cross-sectional study on 76 pre- and postmenopausal women above 40 years underwent mammogram screening and Dual Energy X-ray Absorptiometry (DEXA) was conducted in Hospital Kuala Lumpur (HKL) for the duration of 1 year. Purposive sampling method was used to choose the respondents. Women who are diagnosed with breast cancer and underwent cancer treatment were excluded from this study. DEXA unit (Hologic Discovery W, Hologic, Inc) were used to measure BMD at the femoral neck and lumbar spine in grams per centimetre squared (g/cm2) and they were classified into normal and abnormal group based on the T-scores. The subjects were asked about their daily dietary pattern for a duration of three days using Diet History Questionnaire (DHQ). The mean of selected characteristics were compared between groups. Additionally, binary logistic regression was used to determine the association between diet intake with BMD and other risk factors of breast cancer. The total number of pre- and postmenopausal women who consented to participate in this study are equal. The mean age was 47.1 years and 54.9 years for premenopausal and postmenopausal women respectively. The results indicate only menopausal age of the women was statistically significant (p < 0.05). A number of 17% premenopausal and 9% of postmenopausal women showed to have family history of breast cancer, however, it was not statistically significant (p = 0.12). There was no significant difference in daily energy intake of food in both groups (p = 0.22). None of the nutrients in daily food intake showed to be statistically significant. Menstrual status showed an association with BMD with p < 0.05 and the remaining risk factors did not show any association. Logistic regression revealed that only menstrual status had correlation with BMD in both groups. This study provided the dietary pattern and the effects on bone health. The association of other risk factors of breast cancer with BMD were also analysed and most of it showed a negative association

Comparison of Colour Doppler Ultrasonography and Indirect Computer Tomography Venography for the Diagnosis of Deep Venous Thrombosis in Patients with Suspected Pulmonary Thromboembolism at a Tertiary Care Centre in Chennai, Tamil Nadu, India

Introduction: Pulmonary Thromboembolism (PTE) and Venous Thromboembolism (VTE) are prevalent conditions with a high mortality rate and need immediate medical attention. The initial and standard imaging techniques are Computed Tomography Pulmonary Angiography (CTPA) for the diagnosis of PTE and Colour Doppler Ultrasonography (CDUS) for Deep Vein Thrombosis (DVT). However, there can be some issues when using these two different approaches, like the requirement for a separate area and more time. With the so-called indirect Computed Tomography Venography (CTV) approach, thrombi in the deep venous system that may cause PTE can be examined right after pulmonary CT Angiography (CTA) without the need for additional contrast agent. Aim: To determine the accuracy of indirect CTV for the diagnosis of deep venous thrombosis in patients with suspected PTE. Materials and Methods: This cross-sectional study was conducted in the Department of Radiology in Government Stanley Medical College, Chennai, Tamil Nadu, India, India from June 2021 to May 2022. A total of 50 patients with a probable diagnosis of PTE and was established with CTA were included. All 50 patients underwent indirect CTV and CDU on the same day. For indirect CTV lower extremities between the iliac crest and the popliteal region were scanned without administration of extra contrast medium. Colour Doppler Ultrasound (CDUS) was considered as Gold standard. To find the efficacy of CTV in determining DVT the Receiver Operating Characteristics curve (ROC) was used. Results: Of the total 50 patients, who were enrolled in the study, 21 (42%) patients were females and 29 (58%) patients were males. The mean age of the study subjects was 43.5±12.1 years. Among these DVT was detected in 25/50 patients (50.0%) by Doppler Sonography, Similarly DVT was detected in 23/50 patients (46%) by CTV. The sensitivity of CTV was 76% and the specificity was 84%, Positive Predictive Value (PPV) of 82.6%, Negative Predictive Values (NPV) of 77.8%. The p-value and kappa value between CTV and CDUS was calculated as 0.0005 and 0.600, respectively. Conclusion: According to the results of the present study, a combined CTA indirect CTV method can determine the DVT with a moderate level of sensitivity and specificity

Pink nodule of the chin: an unusual presentation of metastatic carcinoma

Renal cell carcinoma (RCC) is the most lethal urological tumor, often because it is widely metastasized at the time of diagnosis. There are reports of cutaneous metastases, most commonly to the head and neck, presenting late after RCC is diagnosed. This case presentation explores a 45-year old female patient with a growing skin lesion on her chin, previously treated as an epidermoid cyst before presenting to dermatology clinic. We present a case of cutaneous metastatic clear cell renal cell carcinoma presenting 7 years after initial diagnosis