Background Breast cancer is the most common form of cancer in women and second most common cancer after lung cancer. The prognosis of breast cancer depends on early detection and intervention which in turn relies upon awareness. Health workers in all communities are responsible for educating the population at risk. This study evaluates the knowledge regarding breast cancer, personal judgment of confidence, perceived barriers to help seeking and breast self-examination practices among Pakistani female medical students and studies the impact of clinical training on the studied variables. Methods Descriptive cross-sectional study design using self-administered validated questionnaires (BCAM-Breast Cancer Awareness Measure designed by Cancer Research UK) was employed. Female medical students enrolled in clinical and pre-clinical classes of King Edward Medical University, Lahore were targeted and questioned regarding symptoms, risk factors and their practices regarding breast cancer. Possible barriers to seeking help were also studied. Result The mean number of symptoms correctly identified was 6.7 ± 3.2 (5.5 ± 3.2 for pre-clinical and 7.8 ± 2.9 for clinical students) and for risk factors it was 4.3 ± 2.1 (3.7 ± 2.1 for pre-clinical and 4.7 ± 2.2 for clinical students). The difference in the level of perception of two groups was found to be significant ( p < 0.001 for symptoms and p < 0.001 for risk factors). 38.7% of the subjects responded that they check their breasts rarely, 33.1% were fairly confident while 8.6% were very confident about detecting a change in their breast, 50.0% never noticed a change in their breast, and 77.4% will contact a doctor within a week or less of finding a change in their breast. Confidence about detecting a change significantly improved ( p < 0.001) after the start of clinical training. Conclusion This study suggests that clinical training may have improved knowledge of female medical students regarding breast cancer; yet the knowledge related to the symptoms and risk factors of breast cancer and frequency of breast self-examination of female medical students is less than anticipated.
The genetic variants of HLAs (human leukocyte antigens) play a crucial role in the virus–host interaction and pathology of COVID-19. The genetic variants of HLAs not only influence T cell immune responses but also B cell immune responses by presenting a variety of peptide fragments of invading pathogens. Peptide cocktail vaccines produced by using various conserved HLA-A2 epitopes provoke substantial specific CD8+ T cell responses in experimental animals. The HLA profiles vary among individuals and trigger different T cell-mediated immune responses in COVID-19 infections. Those with HLA-C*01 and HLA-B*44 are highly susceptible to the disease. However, HLA-A*02:01, HLA-DR*03:01, and HLA-Cw*15:02 alleles show resistance to SARS infection. Understanding the genetic association of HLA with COVID-19 susceptibility and severity is important because it can help in studying the transmission of COVID-19 and its physiopathogenesis. The HLA-C*01 and B*44 allele pathways can be studied to gain insight into disease transmission and physiopathogenesis. Therefore, integrating HLA testing is suggested in the ongoing pandemic, which will help in the rapid identification of highly susceptible populations worldwide and possibly acclimate vaccine development. Therefore, understanding the correlation between HLA and SARS-CoV-2 is critical in opening new insights into COVID-19 therapeutics, based on previous studies conducted.
Heart failure is associated with clinically measurable markers such as B-type Natriuretic Peptide (BNP) and D-dimer levels. We did a brief literature review to assess the diagnostic accuracy of these biomarkers and their correlation. The significance of BNP and D-dimer as individual biomarkers is more reliable compared to their correlation as suggested by multiple research studies found in relevant databases.
Wunderlich syndrome is a rare fatal condition characterized by spontaneous atraumatic renal hemorrhage that confined to peri-renal and sub capsular space. It may present as an acute or insidious onset. Female has more predilection for the syndrome compared to males. Diagnosis is usually incidental. A constellation of symptoms known as Lenk's triad described by the German physician Carl Reinhold August Wunderlich in diagnosing the condition that are acute flank pain, flank mass and hypovolemic shock. Etiologies related to the syndrome can be broadly classified into neoplastic and non-neoplastic. Commonest benign neoplastic cause of Wunderlich syndrome is renal angiomyolipoma while malignant causes such as Renal Cell Carcinoma (RCC) and liposarcoma. Non neoplastic causes such as vasculitis, aneurysm, arteriovenous malformation and cystic rupture. Wunderlich syndrome has a high mortality rate associated with the rupture of the hematoma. Early accurate diagnosis is crucial in patient's intervention and management. Multimodality treatment is available in Wunderlich syndrome such as highly specific embolization, surgeries as well as conservative. Treatments are tailored according to the hematoma size, availability specialty services and patient's hemodynamic status.
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