Background and objectives: The number of obese children worldwide is rising very rapidly in the past 4 decades so that childhood obesity is now considered as one of the serious public health challenges. The objective of this study is to provide an overview of the literature focused on the burden of childhood obesity and the ways to overcome it. Materials and methods: Peer-reviewed studies published between 1991 and 2018 were considered for the review. Studies meeting eligibility criteria were published in English, targeted children aged 3–18 years. Seventy-six studies were considered for inclusion. Eighteen studies were excluded due to poor methodological quality. Sixty-four studies were included in the review. Data were extracted independently. Results: This review identified the evidence-based intervention of childhood obesity prevention. The results indicate six key issues of emphasis in the literature: population-based preventive approach as the best option; preschool and primary school population as the major target group; behavioral changes are crucial; development of the structures to support policies and interventions at the level of government to prevent childhood obesity; population-wide policies and interventions and community-based interventions to combat childhood obesity prevention. Multisectoral collaboration and strong community participations are essential in building evidence-based well-constructed programs, policies and strategies for the prevention of childhood obesity. Conclusion: Childhood obesity is associated with significant reduction in quality of life as well as related to bullying and social isolation. World Health Organization (WHO) recommended a population-based approach for childhood obesity prevention. The key components include structures to support policies and interventions, population-wide policies and initiatives and community-based interventions. Population-based preventive approach is one of the cost-effective ways and very much crucial to control the rising tide of childhood obesity.
Muhammad N Baqui,
Background and objectives: Breast carcinoma of female is a leading cause of morbidity and mortality. Till date, a lot of studies have been carried out to find the accurate prognostic parameters of breast carcinoma to facilitate its treatment. In Asian population frequency of reactivity of some of these parameters like estrogen receptors (ER), progesterone receptors (PR), human epidermal growth factor receptor 2 (HER-2) and E-cadherin receptor differs from the western population. As no more data are available on Bangladeshi population, this study was designed to find out the status of these receptors for this specific ethnic group. Materials and methods: Total 86 histopathologically confirmed samples of breast carcinoma were included in this study. Histologically, they were divided into lobular and nonlobular category. Immunostain was done for ER, PR, HER-2 and E-cadherin receptor study. Statistical analysis was done to find out the association of these receptors with histological classification and grade. Results: The mean age of the patients was 45.6 ± 10.7 years. Among histological subtype, total 9 (10.5%) found to be of lobular category and 77 (89.5%) were nonlobular type. Out of 86 patients, almost two third (61.6%) of patients were ER positive and 54.7% were PR positive. On the other hand 24 (27.9%) patients showed HER-2 overexpression and 79.1% patient showed E-cadherin positivity. About 64 (83.1%) nonlobular carcinoma was positive for E-cadherin. Only E-cadherin receptor showed significant association with histological classification. Conclusion: It has been found that Bangladeshi population has lower rate of ER positivity when compared with the Western population and there is significant association between the histological type of breast carcinoma and E-cadherin receptor positivity.
Kailash C Kharkwal,
Theoann L Daniel,
Tee C Hing,
Naqiuddin BM Fazali
Biopsy, Cervical cancer, Colposcopy, Pap smear screening, Sensitivity, Specificity
DOI: 10.5005/jp-journals-10082-02204 |
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Kharkwal KC, Lo K, Tahmina A, Daniel TL, Teelashinee N, Hing TC, Fazali NB. A Study on Effectiveness of Pap Smear in Mass Screening of Premalignant Lesions of Cervix. 2019; 2 (2):65-68.
Background and objectives: A study on the accuracy of Pap smear was conducted in Pantai Hospital, Sungai Petani, Malaysia involving 125 patients from the Department of Obstetrics and Gynaecology. Cervical cancer is a significant health issue for women; being the second most common cancer among women in Malaysia hence early detection of precancerous lesions can prevent progression to cervical carcinoma. The objective of this study was to measure the sensitivity, specificity, positive predictive value, negative predictive value, percentage of false-negative, percentage of false-positive and yield of Pap smear by comparing Pap smear results with colposcopy guided cervical biopsy. Materials and methods: The study was conducted among 125 patients who have undergone both Pap smear and colposcopy-guided cervical biopsy using a cross-sectional study with a purposive sampling method. The data obtained were analyzed statistically. Results: 125 patients participated in this study, giving Pap smear a sensitivity of 38%, specificity of 64%, positive predictive value of 80.85%, negative predictive value of 20.51%, false-positive for intraepithelial lesion or malignancy of 38%, false-negative for intraepithelial lesion or malignancy 62%. Of the total 125 patients studied, 62.4% were indicated to have a cervical biopsy due to clinical suspicion and among them biopsy report was positive for intraepithelial lesion or malignancy in 79.5%. Conclusion: The sensitivity and specificity of Pap smear as a screening tool for precancerous cervical lesions is low. It is therefore inadequate to be used alone as a screening tool. The study also shows that having a high index of clinical suspicion even when the Pap smear results were normal was important in order not to miss a precancerous cervical lesion as early detection can prevent progression to cervical cancer. Hence, a more experienced doctor with a high index of clinical suspicion is vital.
K Raman Sethuraman,
DOI: 10.5005/jp-journals-10082-02205 |
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Sethuraman KR, Santhadevy A, Saravanakumar R. Strategic Method to Identify Students Needing Additional Curricular Support: Empirical Evidence across Courses in Health Professions Education in a Private Health Sciences University. 2019; 2 (2):69-72.
Background and objectives: To validate the generalization of the first periodic assessment as a tool for identification of the students needing additional curricular support (SNACS) across the health sciences courses. Materials and methods: The performance of the students in the first periodic assessment and summative assessment were compared retrospectively for two batches in medical college and nursing college of a private health sciences university. The students were divided into three groups based on their ranks in the first periodic assessment as high, middle and lower third rank. The odds of failure of the students in the lower third formative ranking was compared to that of the students in the middle and top-third ranking. Results: Analysis of the retrospective data of the medical and nursing college revealed that majority of the students failed in the summative assessment belonged to the lower third formative ranking. The odds of failure of the students in lower-third ranking was consistently more than that of the students in the middle and top third ranking. Conclusion: Based on the results of the study across the courses in health profession, the performance of the students in the first periodic assessment is a valid method to identify the SNACS at the earliest.
Background and objectives: In the developing countries, the problem of human immunodeficiency virus (HIV) infection is serious. The burden of this disease in the developing countries cannot be estimated only from the disease morbidity and mortality. Children orphaned by human immunodeficiency virus/acquired immunodeficiency virus (AIDS) are one of the most fearful but yet unnoticed problem in our Indian community. This study aims to assess the health profile of HIV positive orphans in relation to physical health of HIV orphans. The objectives of the study were to assess the physical health profile of HIV positive orphans with respect to nutritional status and presence of opportunistic infections in HIV positive orphans of selected orphanages. Materials and methods: Design of the study was cross-sectional. The study was carried out from September 2013 to March 2015. With convenient sampling, two orphanages exclusively for HIV positive orphans were selected. The total number of orphans from both the orphanages was 84. The universal sampling method was used and all the HIV positive orphans were included in the study. Physical health of the HIV positive orphans was assessed by medical examination conducted by the investigator, anthropometry, and additional information procured from medical records of the orphans. Presence of any opportunistic infection was assessed by opportunistic infection checklist. Results and conclusion: In the present study, it was observed that 22 orphan children (26%) were underweight. It was observed that the total number of orphan children having opportunistic infection was 21 (25%) and the most common opportunistic infection was pulmonary tuberculosis (TB) (8, 38%).
Outcome-based education and competency-based education are two entities in medical or dental education where much is spoken about in the last few years. Very few institutions have taken this seriously and moved ahead to improve the standards of educations with respect to relevance and multidimensional training of the undergraduates and postgraduates. In the Indian scenario in the field of dentistry, we can observe the lack of impetus from the faculty to take up this and enhance the learning quality amongst the trainees. In this paper, the importance of such time-tested training strategy is stressed upon with the experiences of the author along with evidence from literature.
Koyalmannam R Sethuraman,
Paracetamol is one of the most widely used drug available over the counter (OTC) which is persistently and heavily promoted by the catchy advertisements all around us. Surprisingly, it is one of the most common drugs for suicide as well. Shockingly, paracetamol causes hepatotoxicity even at therapeutic doses, which has led some national formularies to recommend dose reductions. This article aims to highlight the aspects which are not in the limelight of this widely available OTC medication. In addition to creating awareness, we also suggest implementation of laws to reduce the risks of deliberate and accidental overdose.
Tirou A Tirougnanassambandamourty
The major invasive tumor types of carcinoma breast include infiltrating ductal, invasive lobular, ductal/lobular, mucinous (colloid), tubular, medullary and papillary carcinomas. Of these, infiltrating ductal carcinoma (IDC) is, by far, the most common subtype accounting for 70–80% of all invasive lesions. Combination of more than one pathological form is a very rare phenomenon. Here, we present such mixed mucinous and infiltrating ductal type in a male breast carcinoma.