Issue: IeJSME 2009 3(2)
Dilemma of Pregnant Ladies with Breast Cancer
Authors: Zainur Rashid Z, S Sulaiha S A, Lew K G, Nurhana S.
ABSTRACT
Gestational breast cancer (GBC) or pregnancy-associated breast cancer was defined as breast cancer diagnosed during pregnancy and within 1 year of delivery. Breast cancer is the second commonest cancer after cervical seen in pregnancy and lactation. Nevertheless, the incidence is low and accounts for approximately 1 in 3000 of pregnancies. A delay in diagnosis is common and 70% to 89% of patients with operable primary lesions already have positive axillary lymph nodes. Breast cancer identified during pregnancy can be extremely distressing for the mother despite it has similar course of disease and prognosis seen in non-pregnant women of the same age and stage of disease. Diagnostic and treatment options should be carefully decided to prevent further harm to the mother or any potential risk to the developing fetus.
Keywords: Breast cancer; Pregnancy; Diagnosis; Management.
Citation: IeJSME 2009: 3 (2): 3-7
Cement Vertebroplasty In The Elderly With Osteoporotic Vertebral Fractures. A Preliminary Study On The Change In Activity Of Daily Living After Treatment
Author: Collin Looi Seng-Kim
ABSTRACT
Background: To assess the effect of cement vertebroplasty on the activity of daily living of elderly patients who have sustained a vertebral osteoporotic fracture.
Patients and Methods: Seven patients with clinically significant and radiologically proven osteoporotic vertebral compression fractures suitable to be treated with percutaneous cement vertebroplasty were recruited. Evaluation was based on pre- and postprocedure activity by clinical documentation (including interview) and by a self-developed questionnaire (including quality of life).
Results: Following the procedure, 54% of patients resumed their activities of daily living with minimal pain while 46% of patients were able to do so without any pain (p<0.05). Up to 85% of patients did not require any form of medication (p<0.05) and 77% of patients were found to have no pain. In addition to that, almost 62% of patients were able to ambulate normally.
Conclusion: Percutaneous cement vertebroplasty appears to significantly improve the activities of daily living of elderly patients who have sustained vertebral osteoporotic fractures. It is also found to be a safe procedure which contributes to reduced usage of medication, immediate pain reduction and improvement in functional status of the patient.
Keywords: Percutaneous cement vertebroplasty, quality of life, daily activity.
Citation: IeJSME 2009: 3 (2): 8-13
Prevalence Of Exclusive Breast Feeding And Its Correlates In An Urban Slum In Western India
Authors: Patil Sapna S, Hasamnis Ameya A, Pathare Rooma S, Parmar Aarti, Rashid A K, Narayan K A.
ABSTRACT
Background: The World Health Organization recommends the practice of exclusive breastfeeding of infants for the first 6 months after birth. The objective of present study was to estimate the prevalence and the factors influencing exclusive breastfeeding. The perceptions of mothers about breastfeeding in an urban slum area of Western India were also enquired.
Methods: This cross sectional study was conducted over six months amongst 200 mothers of children in the age group of 6 – 12 months attending the growth and development clinic in one of the urban health centres. Data was collected using a pre-tested, structured questionnaire on breastfeeding practices. Factors related to exclusive breastfeeding were analysed using bivariate and multivariate analysis.
Results: Prevalence of exclusive breastfeeding reported by the participants was 61.5%. Having a male child, maternal age < 30 years, level of education of mother, parity, receiving infant feeding advice, initiation of breastfeeding within one hour of birth and administration of colostrum to the baby were associated with exclusive breastfeeding (p<0.001). Multivariate logistic regression analysis revealed that male sex (adjusted odd ratios: 20.03), primiparity (0.19), home delivery (0.32), receiving infant feeding advice (5.90), initiation of breastfeeding within one hour of birth (0.26) and giving colostrum to the baby (2.56) were independently associated with exclusive breastfeeding. Prelacteal feeds were given by almost 35% of mothers.
Conclusion: Prevalence of exclusive breastfeeding was higher than the national figures. However, practices like discarding the colostrum, giving prelacteal feeds, early/late weaning and use of formula feeds are still widely prevalent and need to be addressed.
Keywords: Breastfeeding, Exclusive breastfeeding, Prelacteal feeds, India, Urban.
Citation: IeJSME 2009: 3 (2): 14-18
Traditional Male Circumcision In A Rural Community In Kedah, Malaysia
Authors: Rashid A K, Teh Swee-Ping, Narayan K A.
ABSTRACT
Background: Circumcision though not mentioned in the Quran is believed to be a compulsory practice among the Muslims. In Malaysia, although there are several methods of circumcision available and traditional circumcision is still popular.
Methods: A cross-sectional survey was carried out in a small fishing village of Kedah to study the methods of circumcision available to the villagers. This was followed with an in-depth interview conducted with ‘Tok Mudim’, a practitioner of traditional method of circumcision.
Results: Forty three of the eligible 71 subjects participated in the study giving the response rate as 60.5%. The most common age for circumcision was 9 years old. Despite private clinics being the most common place of circumcisions, there was an increasing number of boys going to the ‘Tok Mudim’ for circumcision. A Mass Circumcision Ceremony is traditionally practiced. The ‘Tok Mudim’ described the procedure in detail and was of the opinion that the reason traditional method is still popular was because of the fear of injections and impotency among the parents. Most common complication faced by the ‘Tok Mudim’ was bleeding and infection.
Discussion and Conclusion: Till the community shifts entirely to using modern medicine, there is a need to integrate traditional practitioners into the system. Training the ‘Tok Mudim’ to use modern instruments and aseptic techniques should be considered.
Keywords: Male circumcision, rural, Malaysia.
Citation: IeJSME 2009: 3 (2): 19-23
Gingival Fibromatosis with Chronic Periodontitis – A Rare Case Report
Authors: Sanadi Rizwan M
ABSTRACT
Gingival fibromatosis is frequently an isolated condition of little consequence apart from a cosmetic problem and occasional associations with uncommon syndromes. This case report of a 38 year old female patient describes the gingival enlargement associated with chronic periodontitis. The enlargement extended beyond the middle thirds of the clinical crowns of the teeth. It was associated with generalized mobility, pocket formation and bone loss. The patient also complained of bleeding gums and difficulty in speech and mastication. This is the first case report of gingival fibromatosis associated with chronic periodontitis.
Keywords: Bleeding gums, chronic periodontitis, gingival enlargement, gingival fibromatosis, mobility, pocket formation.
Citation: IeJSME 2009: 3 (2): 24-27
Role of Ampicillin-Sulbactam: A District Hospital’s Experience in Treating Diabetic Foot Ulcers
Authors: Ng C S, Vadivelu M, Chan K Y.
ABSTRACT
Ampicillin-sulbactam combination is the most frequently prescribed antibiotic in diabetic foot ulcers. We conducted a retrospective study to evaluate the antibiotic sensitivity of bacteria isolated to this antibiotic. In 33 patients with diabetic foot ulcer (September 2008-March 2009), 67% were culture positive in which Citrobacter spp accounted for 36% of these isolates. The rest isolated included Pseudomonas aeruginosa (22%), Proteus spp (18%), Acinetobacter spp (9%), Klebsiella pneumoniae (5%), Escherichia coli (5%) and Staphylococcus aureus (5%). These isolates were more likely to be ampicillin-resistant (n=18) than were ampicillin-sensitive isolates (n=4). Ampicillin resistance has raised our concern about current practice of prescribing ampicillin/ sulbactam as monotherapy for majority of our patients with such ulcers.
Keywords: Diabetic foot ulcers, Ampicillin-sulbactam, District hospital.
Citation: IeJSME 2009: 3 (2): 28-30
