PURPOSE Patients with breast cancer in Pakistan commonly present with advanced disease. The objectives of this study were to evaluate the frequency and length of delays in seeking medical consultation and to assess the factors associated with them. METHODS Four hundred ninety-nine patients with newly diagnosed breast cancer were enrolled and interviewed over the period from February 2015 to August 2017. Information on sociodemographic factors, delay to medical consultation, stage of breast cancer at presentation, and tumor characteristics of the breast cancer were collected through face-to-face interviews and medical file review. RESULTS The mean (standard deviation) age of patients with breast cancer was 48.0 (12.3) years. The mean (standard deviation) patient delay was 15.7 (25.9) months, with 55.2% of women detecting a breast lump but not seeking a medical consultation because of a lack of awareness about the significance of the lump. A total of 9.4% of the women decided to seek treatment initially using complementary and alternative medicine and traditional treatment; 9.4% of the women presented to a health care provider with a breast lump but no action was taken, and they were wrongly reassured about the lump without mammography or biopsy. For 26% of the women, the delay in presentation was caused by anxiety, fears and misconceptions regarding diagnosis and treatment, and other social factors including possible adverse effects on their relationship with their husband. Multivariable analysis showed a strong association of lower socioeconomic status (odds ratio [OR], 8.11 [95% CI, 2.46 to 26.69]) and late stage of breast cancer (OR, 4.83 [95% CI, 1.74 to 13.39]) with a patient delay of ≥ 3 months. CONCLUSION Patient delay is a serious problem in Pakistan. There is an urgent need for intensive and comprehensive breast cancer education that addresses the myths and misconceptions related to breast cancer.
Background The prevalence of vitamin D inadequacy and breast cancer are both high among women living in Karachi, Pakistan. Methods A matched case control study was conducted in two hospitals of Karachi, Pakistan to evaluate the association of vitamin D (serum 25-hydroxyvitamin D) concentrations, vitamin D supplementation and sun exposure with breast cancer among Pakistani women. A total of 411 newly diagnosed histologically confirmed primary breast cancer cases were enrolled and 784 controls, free of breast and any other cancers, were matched by age (year of birth ± 5 years), residence in the same geographic area and study site. Information was collected on sociodemographic history, history of vitamin D supplementation, past medical and obstetrical history, family history of breast cancer, sun exposure history, histopathology reports and anthropometric measurement and venous blood was collected to measure serum 25-hydroxyvitamin D (25(OH)D) concentration. Results Compared to patients with sufficient serum vitamin D (>30 ng/ml), women with serum vitamin D deficiency (<20ng/ml), had a higher risk of breast cancer (OR = 1.65, 95%CI: 1.10, 2.50). Women with history of vitamin D supplementation one year prior to enrollment, had significant protective effect against breast cancer (OR = 0.32, 95% CI: 0.24, 0.43). Conclusions and recommendation Serum vitamin D deficiency was associated with increased risk of breast cancer, while vitamin D supplementation was associated with decreased risk of breast cancer.
The present antiepileptic drugs pose several problems in the management of seizures owing to their meager neuroprotective potential, adverse effects on bone, detrimental effects on cognitive function, chronic toxicity, drug interactions, side effects including aggression, agitation, and irritability and sometimes exacerbation of seizures. We followed up progressive preclinical investigation in mice against pilocarpine (PILO)-induced status epilepticus (SE) and temporal lobe epilepsy (TLE). To determine the response of raloxifene (RF) (4 and 8 mg/kg), fluoxetine (FT) (14 and 22 mg/kg), bromocriptine (BC) (6 and 10 mg/kg), and their low-dose combinations, oral treatment was scheduled for 28 days followed by PILO (300 mg/kg, i.p). The response was stalked for intensive behavioral monitoring of convulsions, hippocampal neuropeptide Y (NPY), and oxidative stress discernment along with histomorphological studies. The resultant data confirmed the therapeutic potential of triple drug combination of raloxifene (4 mg/kg) with fluoxetine (14 mg/kg) and bromocriptine (6 mg/kg) compared to monotherapy with raloxifene (4 mg/kg), and bromocriptine (6 mg/kg) as otherwise monotherapy with fluoxetine (14 mg/kg) was ineffective to suppress convulsions; an effect better than sodium valproate (300 mg/kg), a standard AED, was validated. Most profoundly, PILO-induced compensatory increases in hippocampal NPY levels (20.01%), which was escalated (100%) with the triple drug combination. The same pattern of results was superseded for oxidative stress indices and neuronal damage. The results for the first time demonstrate the propitious role of triple drug combination in the management of SE and TLE. Therapeutically, this enhancing profile of drugs fosters a safer and more effective drug-combination regimen. Graphical abstract ᅟ.
Breast cancer is a commonly diagnosed neoplastic ailment in females particularly near menopause. This ailment signifies a substantial health problem as it has influenced a large number of women. Several risk factors are associated with breast cancer that cannot be altered, but certain can be modified. The existence of risk factors of breast carcinoma does not mean that cancer is unavoidable; numerous females having risk factors not ever developed the disease. The risk factors aid in identifying the females who may get help at maximum from screening or other precautionary measures. It is noteworthy that breast carcinoma can also ensue in females with no recognizable risk factors. The augmented occurrence of breast cancer worldwide revealed by several epidemiological investigations indicates the need of aiming multidirectional investigations so as to ascertain risk factors linked with the incidence of this disease.
An 8-week feeding trial was conducted to study the effects of dietary protein levels on the growth, feed utilization and haemato-biochemical parameters of mirror carp, Cyprinus carpio specularis (1.50 ± 0.02 g; 4.5 ± 0.05 cm). Six casein-gelatin based isocaloric (367 kcal 100 g -1 , gross energy) diets containing graded levels of dietary protein (25%-50% CP) were formulated. 20 fish were randomly stocked in triplicate groups in 75L circular trough fitted with continuous flow-through system and fed experimental diets at 4% BW/day at 0800 and 1700h. Maximum live weight gain (258%), best feed conversion ratio (FCR) (1.63) and protein efficiency ratio (PER) (1.53) were obtained in fish fed diet containing 40% dietary protein. However, quadratic regression analysis live weight gain, FCR, PER and body protein deposition (BPD) data indicated requirements for dietary protein at 43.5%, 41.6%, 34.7% and 37.3% of dry diet, respectively. Significantly higher whole body protein, low moisture and intermediate body fat contents were recorded at 40% protein containing diet (P<0.05). While minimum ash content was recorded at 25% protein level. The highest HIS value (3.39%) was observed at the lowest protein level. Significant differences were also observed in Hb, HCT and RBC values of different groups fed with varying levels of dietary protein (P<0.05). Whereas, no significant differences were observed in their WBC count except at 25% protein level, where higher WBC count was recorded (P>0.05). Based on the above results, it is recommended that 41.5% protein level would be useful for optimum growth and efficient feed utilization of this fish species.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.