Open Access Original Research Article

Reproductive Factors Associated with the Risk of Breast Cancer among Malaysian Women: A Multi-Centre Case-Control Study

Adamu Ahmad Rufa’i, Siew Hwa Yen, Wan Abdul Manan Wan Muda, Venkata Murali Krishna Bhavaraju, Aishah Knight Abd Shatar

Asian Journal of Medicine and Health, Page 1-12
DOI: 10.9734/AJMAH/2017/37027

Aim: This study was conducted to evaluate the association between reproductive factors and the risk of breast cancer among Malaysian women.

Study Design: Case-control study.

Place and Duration of Study: Oncology clinics of 6 selected hospitals from 3 states of Kedah, Kelantan and Penang, between June 2013 and May 2015.

Methodology: We included 334 histologically confirmed breast cancer women and 345 population-based controls matched by age (within 5-year brackets) and ethnicity. Demographic and reproductive data were collected by in-person interviews using a self-administered questionnaire. Multiple logistic regression model was used to estimate multivariate-adjusted odds ratios (OR) and 95% confidence intervals (95% CI) from logistic regression analyses.

Results: The mean age of the cases was 51.95 (± 8.35) years while controls had 52.30 (± 9.14) years. The results showed that menopausal status was associated with the risk of breast cancer with [OR 0.36, 95%CI 0.20-0.62] for pre-menopause, and duration of use of contraceptives [OR 0.49, 95%CI 0.26-0.95] for 1-5 years and OR 0.22, 95% CI 0.10-0.53 for >5 years duration of usage. Also family history was found to be strongly associated with the risk [OR 2.86, 95%CI 1.55-5.26].

Conclusion: This study portrays the need for early screening among Malaysian women with identified risk factors in order to help in the timely detection of breast cancer and appropriate management.

Open Access Original Research Article

Does Pain Adversely Affect the Quality of Life in Hospitalized Cancer Patients?

Dagistan Gozde, Karsli Bilge, Kayacan Nurten, Kol Emine, Akbas Mert

Asian Journal of Medicine and Health, Page 1-10
DOI: 10.9734/AJMAH/2017/32593

Background: Each year, 9 million patients are   diagnosed as a cancer. The pain is the most common cancer-related symptom.  The prevalence of severe pain at diagnosis, during-active treatment and at advanced disease stage range from to 14-100%, to 50-70% and to 60-90% respectively.

Methods: In this study, the factors affecting the quality of life of cancer patients, the effects of these factors and pain on the quality of life of hospitalized cancer patients were investigated. 175 patients in Oncology Department were included. Short Form 36 and Algology Department form.

Results: In our study, the proportion of patients who had pain and who had no pain were 98.9% and 1.1% respectively. When we looked at the Visual Analogue Scale (VAS) score of patients, we saw that pain affects negatively on quality of life scores. When we evaluated the factors like weakness, nausea, vomiting, insomnia, sweating and when we compared the patients who had these symptoms and no symptoms like this; we found that all of these symptoms have negative impact on quality of life.

Conclusions: The development of new surgical techniques, the use of new drugs and therapies in cancer treatment increase survival and decrease mortality in cancer patients. As a progressive disease and duration of life with cancer is prolonged.  So, quality of life and pain  in cancer patients are becoming increasingly important.

Open Access Original Research Article

Metabolic Syndrome and Kidney Damage: Prevalence and Assessment of Risk among Apparently Healthy Resident of Ado Ekiti, South West Nigeria

Ayokunle S. Dada, Daisi D. Ajayi, Emmanuel E. Eyitayo, Julius G. Olaogun, Mojeed O. Rafiu, Olusegun E. Gabriel

Asian Journal of Medicine and Health, Page 1-9
DOI: 10.9734/AJMAH/2017/37606

Background: Individuals with metabolic syndrome are at increased risk of developing chronic kidney disease.

Objective: There is limited information on the relationship between metabolic syndrome and CKD among Nigerian population. Data from few available studies are contradictory.

In this study, we set out to determine the prevalence of CKD and associated metabolic risk factors among selected apparently healthy resident of Ado Ekiti, Nigeria.

Methods: Data for this study were collected during the year 2016 edition of an annual religious outreach program at Ado-Ekiti, Nigeria. A total of 336 adult males and females participated in the study.

Metabolic syndrome was defined according to National Cholesterol Education Program Adult Treatment Panel III. Glomerular filtration rate was estimated using the abbreviated Modification of Diet in Renal Disease formula. CKD was defined as eGFR ≤ 30–59 ml/min/1.73 m2   and /or ≥2+ dipstick proteinuria.

Results: The mean age of the participants was 51.71 ± 10.44 years. The overall prevalence of chronic kidney disease and metabolic syndrome was 7.4% and 24.7% respectively.

In multivariate models, elevated blood pressure OR 3.217 (95% CI 1.144-9.051, P = 0.026) and elevated Triglyceride level OR 3.292 (95% CI 1.245-8.701, P=0.016) were significantly association with an increased odds of chronic kidney disease.

There was a significant difference in the prevalence of CKD among persons with (15.7%) and without (4.7%) metabolic syndrome (P= 0.001). Logistic regression showed that metabolic syndrome is associated with risk of CKD, OR 2.969 CI 1.589-5.545.

Conclusion: This study showed that metabolic syndrome was associated with chronic kidney disease

Open Access Original Research Article

Analysis of Factors Influencing Regulatory Compliance to Contain Man-made Ionizing Radiation from Medical Diagnostic Imaging Equipments in Corporate Hospitals, Tamil Nadu, India

R. Rajan, R. Ganesan

Asian Journal of Medicine and Health, Page 1-17
DOI: 10.9734/AJMAH/2017/37873

Aims: To evaluate the current status of practices being followed to comply with regulatory guidelines by corporate hospitals for containing man-made ionizing radiation while using medical diagnostic imaging equipments. To statistically test and conclude whether Corporate Hospitals located in Metro and Non-metro cities, Revenue and Patient Queue Size influences the compliance.

Study Design: Descriptive Research design has been adopted in this study.

Place and Duration of Study: This study has been conducted in Tamil Nadu, India covering 25 metro and non-metro cities, for the period between June 2015 and May 2016.

Methodology: This research has scoped in 77 corporate hospitals who have expressed willingness to participate in this study out of 214 institutions approached. This study is based on the Regulatory guidelines published by Atomic Energy Regulatory Body, the Regulatory Body in India which controls the distribution and usage of Diagnostic Imaging equipments. This study has designed 7 dependent parameters (Regulatory, Layout Engineering, Technician Competency, Human Safety, Operations Know-How, Radiation Exposure Monitoring and Top Management Commitment). A structured questionnaire with 70 questions on a seven point scale (inclusive of zero) was constructed and administered for data collection. The parametric statistics has been adopted for statistical analysis of data.

Results: The mean of seven dependent variables have been found to be at the higher side of the measurement scale (Regulatory 5.64, Layout Engineering 5.62, Technician Competency 5.59, Human Safety 5.61, Operations Know-How 5.62, Radiation Exposure Monitoring 5.65 and Top Management Commitment 5.67). The corporate hospitals in Metro cities are found to exhibit significantly higher compliance when compared to non-metro, as confirmed by ANOVA results with ‘F” ratio of 16.51, “P” value 0.00157 at a confidence interval of 99.5 percent and alpha value 0.005. Pearson’s correlation coefficient ‘rho’ was found to be 0.057, with a “P” value (0.365) greater than alpha (0.05) at 99.5 percent confidence interval established weak and insignificant relationship between revenue and compliance index. Similarly, the patient queue size did not influence compliance index as revealed by correlation coefficient of 0.104, “P” value 0.312, alpha value 0.05 at 99.5 percent confidence interval.

Conclusion: It was quite evident from this research study that corporate hospitals have established very higher level of regulatory compliance with complete support and involvement of the Top Management. The top 5 key drivers that have led to such a superior level of regulatory compliance have been identified as Appoint full time Radiation Safety Officer, AERB Type approvals & renewals, Usage of TLD badge and testing dosage levels, Monitoring AERB approval policy and Engaging Service providers for equipment Servicing. This research study further recommends similar research work in other states of India and the requirement of a concrete mathematical model for estimation of Radiation Compliance Index.

Open Access Original Research Article

Thyroid Dysfunction and Insulin Resistance

Mohamed Mashahit, Mohamed A. Gomaa, Hala Eltokhi

Asian Journal of Medicine and Health, Page 1-5
DOI: 10.9734/AJMAH/2017/37963

Background: Insulin resistance is a state in which a given concentration of insulin produces biological effect less than expected. The syndrome of insulin resistance involves a broad clinical spectrum, which includes obesity, glucose intolerance, diabetes, and metabolic syndrome. Many of these disorders are associated with various endocrine, metabolic, and genetic conditions. They may also be associated with some immunological diseases and may exhibit distinct phenotypic characteristics.

Aim of the Work: This study aimed to determine the association between altered thyroid hormones and insulin resistance.

Patients and Methods: This study was conducted at Fayoum University Hospital in the period from February to June 2015. It included 90 age and sex-matched non diabetic individuals; they were divided to 3 groups; 30 patients with uncontrolled hypothyroidism, 30 patients with uncontrolled hyperthyroidism according to their thyroid stimulating hormone levels (TSH) and 30 healthy volunteers as a control group. Thyroid stimulating hormone level (TSH) was measured for the control group. For the 3 groups, fasting plasma glucose (FPG) and fasting plasma insulin concentration (FPI) were done. Homeostatic model assessment of insulin resistance was calculated using the formula: HOMA-IR= (FPI× FPG/22.5).

Results: It was found that 50% of hypothyroid patients, 36% of hyperthyroid patients and only 16.5% of the control group had insulin resistance (IR), and the difference was statically significant (p=0.024).

Conclusion: It was found that 50% of hypothyroid and 36% of hyperthyroid had insulin resistance and only 17% of the control group had insulin resistance and this was not correlated to either body weight, BMI, as well as waist circumference.