Latiffah Latiff

L e t t e r t o t h e E d i t o r Dear Sir, Cervical clear cell adenocarcinoma (CCAC) accounts for 3%–10% of adenocarcinoma of the uterine cervix cases (1,2) and is often associated with diethylstilbestrol (DES) exposure in utero. (3) CCAC of the uterine cervix is uncommon in adolescents and only a few such cases have been reported. (1,4) We herein report an extremely rare case of a patient with cervical CCAC without DES exposure. A ten-year-old girl presented with a history of intermittent bloodstained discharge of one year. She was only referred to a gynaecologist after a failure to respond to hormone therapy within one year. Physical examination revealed a palpable pelvic mass that was about the size of a gravid uterus of 14 weeks, with visible tissue protruding through the introitus. Magnetic resonance imaging showed a huge mass arising from the cervix of a rudimentary uterus and pushing the pelvic organs toward the abdomen (Fig. 1). There was no evidence of organomegaly or enlarged lymph nodes. The upper and lower urinary tracts appeared normal. Biopsy confirmed the diagnosis of Stage IB2 CCAC of the uterine cervix (Fig. 2). The patient underwent radical abdominal hysterectomy and bilateral pelvic lymph node dissection, followed by six cycles of carboplatin and paclitaxel. Subsequently, pelvic examination under anaesthesia, vault cytology and computed tomography of the abdomen and pelvis were performed. Unfortunately, the patient developed recurrence in her lungs and brain. She and her family declined further treatment and the patient succumbed three months later. Previous literature showed that the first peak of CCAC occurs in women aged 17–37 years, while the second peak occurs in women aged 44–88 years. The former group comprised mostly DES-exposed women and the latter those without a history of DES exposure. (3,4) Significant features for the prognosis of CCAC of the uterine cervix are related to the stage at diagnosis, tumour size, grade of nuclear atypia, pelvic lymph node status and lymphatic invasion. (3,5) The key modality of treatment for early-stage cervical carcinoma is radical abdominal hysterectomy with pelvic lymphadenectomy, which results in permanent infertility in the patient. When CCAC of the uterine cervix occurs in adolescents and women of reproductive age, other surgical options should be considered if the patient desires to maintain her fertility after treatment. We suggest that an awareness of rare, forgotten cancers (e.g. CCAC of the uterine cervix in adolescents) and the need for prompt referral to a tertiary gynaecological oncology centre should be raised among general practitioners, gynaecologists and surgeons. Additionally, CCAC of the uterine cervix in adolescents should be considered as a possible differential diagnosis of bloodstained vaginal discharge without a history of sexual abuse or DES exposure. In the interim, specialists and physicians should remain cautious and attempt to act early, assertively and properly to diagnose and treat CCAC of the uterine cervix in adolescents so as to improve the survival rate of patients.

Menopause is the condition when regular menstrual periods cease and may be accompanied by psychological and physical symptoms. The purpose of current study was to determine Nigella sativa effects on reproductive system in experimental menopause animal models. A series of experiments was conducted to investigate the effects of different dosages of N. sativa (first experiment), various extracts of N. sativa (second experiment) and some of its ingredients (third experiment) on selected menopausal parameters of ovariectomized (OVX) rats. Forty different OVX rats were equally divided into 5 groups and administered with one of the following treatments for 21 days: conjugated equine estrogen (positive control), distilled water or olive oil (negative control), treatment groups (N. sativa300, 600 and 1200 mg/kg in the first experiment), (300mg/kg methanol, hexane and SFE extracts of N. sativa in the second experiment) and (linoleic acid 50 mg/kg, gamma linolenic acid 10mg/kg, and thymoquinon...

ABSTRACT This study aimed to determine the association between anthropometric measurement and dyslipidemia and their association with hypertension among older people. A cross sectional study was done among the residents in two old folks homes (Rumah Seri Kenangan Cheras and Little Sisters of the Poor) in urban Malaysia using a pre-tested guided questionnaire. Measurements taken were the blood pressure level, height and weight measurement and lipid profile. There were 92 respondents participated in the study. The prevalence of hypertension was 51.1%. The study found significant association between anthropometric measurement and hypertension although there was no difference in waist hip ratio measurement among hypertensive and normotensive individuals. Level of total cholesterol, LDL-C and triglycerides were significantly higher among hypertensive individuals compared to normotensive individuals. The prevalence rate of hypertension among residents in this study is higher compared to the national prevalence rate among the older adults. Appropriate invention programmes should be reinforced to reduce the complications of hypertension especially among institutionalized elderly.

Electrical impedance tomography (EIT) is a new non-invasive, mobile screening method which does not use ionizing radiation to the human breast. It is based on the theory that cancer cells display altered local dielectric properties, thus demonstrating measurably higher conductivity values. This article reviews the utilisation of EIT in breast cancer detection. It could be used as an adjunct to mammography and ultrasonography for breast cancer screening.

Cardiovascular disease (CVD) is the main cause of morbidity and premature mortality in end stage renal failure patients (ESRD) receiving dialysis. The aim of our study was to evaluate the impact of various risk factors in this group of high CVD risk patients in local population. We carried out a cross-sectional retrospective study in a single hospital. A total of 136 ESRF patients, consisted of 43 haemodialysis (HD) and 93 continuous ambulatory peritoneal dialysis (CAPD) patients, were recruited and followed up for 36 months duration. Midweek clinical and laboratory data were collected. The occurrence of existing and new CVD events was recorded. Multiple Logistic Regression showed pre-existing cardiovascular event (odds ratio, 4.124; 95% confidence interval [CI], 0.990 to 17.187), elevated total cholesterol level (odds ratio, 0.550; 95% CI, 0.315 to 0.963), elevated serum phosphate level (odds ratio, 5.862; 95% CI, 1.041 to 33.024) and elevated random blood glucose level (odds ratio, 1.193; 95% CI, 1.012 to 1.406) were significantly associated with occurrence of CVD events. History of cardiovascular event before the initiation of dialysis, elevated level of serum phosphate and random blood glucose levels are the risk factors of CVD whereas paradoxically a high total cholesterol level has CVD protective effect towards the ESRF patients.

Missing main meals and an unhealthy snacking pattern can lead to poor diet quality and consequently to the presence of chronic diseases among which mental disorder is no exception. Since there is little research on diet, skipping meals and psychological status in Asian countries, this study tries to determine eating behaviour and predicting symptoms of stress and depression of adolescents in Pasir Gudang, Malaysia. A cross-sectional study was conducted among Form 1 secondary school-going adolescents (n 1565, response rate: 90%) in southern Malaysia from April to May 2013. A self-administered structured and validated questionnaire (socio-demographic, eating behaviour questionnaire, and depression, anxiety and stress scales (DASS-21)) was used for data collection. Among respondents, 803 (51.3%) were female, 1125 were Malay (71.9%) with a mean age of 13.7 (SD=0.8) years. Logistic regression analysis indicated that students who were underweight (OR=3.07, 95% CI 1.21, 7.76), obese (OR=2.64, 95% CI 1.01, 6.87), used to eat out of home (OR=1.37, 95% CI 1.28, 2.13), eat dinner (>4 days/week) (OR=1.59, 95% CI 1.04, 2.43) were more likely to have depression or stress symptoms. Moreover, participants with 4-7 days/week eating breakfast (OR=0.88, 95% CI 0.21, 0.89) were less likely to be at mild/moderate stress. Findings underscore the effect of unhealthy eating practices among adolescents on mental health. Targeted education should be implemented to improve psychological well-being.

Many adolescents suffer from common mental disorders such as stress, which affects health through the psychosocial process, eating behavior, food choices and physical activity. During adolescence, dietary patterns are formed and can affect the occurrence of diseases in later life. This is a review of the results in the pertinent literature, from 1989 until November 2013, concerning stress and the contributing factors that lead to obesity among adolescents. The aim of this review is to identify obesity among stressed adolescents as well as the contributing factors. A descriptive design was used for both quantitative and qualitative studies while, in addition, psychological theories were used for the qualitative studies. The articles were screened to ensure their quality and included in this review accordingly. Ten articles were included in the review comprising cross-sectional, cohort, review and meta-analysis. Interviews and questionnaires were used for data collection. The literatu...

Breast cancer is the most common cancer and the second principal cause of cancer deaths among women worldwide, including Malaysia. This study focused on media choice and attempted to determine the communication channels mostly used and preferred by women in seeking information and knowledge about breast cancer. A cross sectional study was carried out to examine the breast cancer prevention information seeking behavior among 450 students at one private university in Malaysia. The mean age of respondents was 25±4.3 years. Common interpersonal information sources were doctors, friends, and nurses and common channel information sources were television, brochure, and internet. Overall, 89.9% used cell phones, 46.1% had an interest in receiving cell phone breast cancer prevention messages, 73.9% used text messaging, and 36.7% had an interest in receiving text breast cancer prevention messages. Bivariate analysis revealed significant differences among age, eduation, nationality and use of ...

ABSTRACT The aim of this study was to determine the prevalence of hypertension and its associated risk factors among University Putra Malaysia (UPM) retirees in Klang Valley, Malaysia. This study was conducted among UPM retirees aged 50 years and above. Seventy-three respondents (males n = 62, females n = 11) were selected randomly and interviewed using a pre-designed questionnaire to collect information on the above variables. Blood pressure and anthropometric parameters measurement were done using standardized technique. Prevalence of hypertension was 32.88% in males and 36.36% in females, with the highest proportion among those aged 70 years and above (75%). Isolated systolic hypertension was detected in 50% hypertensive subjects. The mean systolic blood pressure was 133.73±16.35 mmHg with a significant difference observed in age group and various ethnics (p<0.05). The mean diastolic blood pressure was 81.99±9.46 mmHg. Among hypertensive subjects, 70.83% were aware of their hypertension and 82.35% (14) were currently under treatment. Among ever diagnosed hypertensive, 73.33% were currently under treatment and a mere 40.91% achieved blood pressure control. Factors found to be significantly associated with hypertension were literacy (χ2 = 16.51, df = 2, p<0.05) and previous job (χ2 = 8.82, df = 1, p<0.05). The prevalence of hypertension in this study was high. It is highly recommend that proper screening of blood pressure should be emphasized among the retirees to increase their awareness on the importance of blood pressure control and to improve lifestyle modification of hypertension.

180 HealthMED-Volume 5/Number 1/2011 Journal of Society for development in new net environment in B&H Abstract Hypertension and its comorbid conditions may affect patients' quality of life. This study is to de-termine the relationship between comorbid condi-tions and health-related ...

Breast cancer is the most frequent cancer and the second reason of cancer deaths among woman worldwide, including Malaysia. The objective of this paper is to assess the practice of breast self-examination (BSE) and identify the barriers of BSE practice among undergraduate female students in Malaysia. A cross-sectional study conducted among 810 female undergraduate students in Klang Valley, Malaysia between April-Jun 2012. Data was collected via self-administered questionnaire which was developed and pre-tested for this study. The majority of respondents were Malay 709 (95.6 %) and single 719 (96.9 %) with a mean age of 21.7 (1.1). Only hundred eleven (15 %) of the participants had a family history of breast cancer. 70.5 % of the respondents do not practice breast self-examination, 70.5 % do not know how to do it, 64.7 and 61.5 % reported no symptoms of breast cancer and worries to detect breast cancer, respectively. Univariate analysis showed that age, marital status and personal history of breast disease were statistically associated with the practice of breast self-examination. In this study, a high percentage of respondents were aware of breast cancer but do not perform breast self-examination. Knowledge, socio-cultural and environmental factors were identified as barriers; so it is recommended that knowledge among the public about breast cancer and promotion of public breast health awareness campaigns through the media should be carried out.

In Malaysia, breast cancer is the first cancer among females regardness of race. The purpose of this study was to identify the knowledge and BSE practice among undergraduate female students at four public universities in Klang Valley, Malaysia. This cross-sectional study was conducted among 820 undergraduate female students using a self-administered questionnaire covering socio-demographic data, knowledge of breast cancer and BSE practice. The mean age of the respondents was 21.7±1.2 years. The majority of them were single (96.8%), Malay (91.9%) and 16.5% of respondents had a family history of breast cancer. This study showed low level of knowledge on breast cancer and breast self-examination among participants. Only 19.6% participants were performing BSE regularly. Knowledge of breast self-examination was significantly associated with BSE practice (p=0.00). Also, there were significant associations between performing BSE with age, marital status and being trained by a doctor for do...

The choice of surgical incision in the abdomen is determined by access for surgery. It has been suggested that utilizing a transverse or oblique rather than a midline incision may influence other parameters such as duration of surgery, recovery and complication rates. However, there is a little study as to whether a particular incision confers any advantage. The aim of the study was to determine whether a dorso-latera l incision or a transverse incision confers any advantage to the rats. Ninety five 16 weeks age female Sprague- Dawley rats were divided into two groups. Ovariectomy was preceded either by a single dorso-lateral incision (in the first group, n=45) or a single transverse lateral incision (in the second group, n=50). Animals in group A (vertical incision, n= 45) had a mean weight of 259.11±20.31 and those in group B (transverse incision, n=50) weighted 254.20±20.31 g, There was significant differences in the duration of surgery in the two groups (p

Despite continuous argument about the efficacy of breast self-examination; it still could be a life-saving technique through inspiring and empowering women to take better control over their body/breast and health. This study investigated Malaysian female university students' knowledge about breast cancer risk factors, signs, and symptoms and assessed breast self-examination frequency among students. A cross-sectional survey was conducted in 2013 in nine public and private universities in the Klang Valley and Selangor. 842 female students were respondents for the self-administered survey technique. Simple descriptive and inferential statistics were employed for data analysis. The uptake of breast self-examination (BSE) was less than 50% among the students. Most of students had insufficient knowledge on several breast cancer risk factors. Actions and efforts should be done to increase knowledge of breast cancer through the development of ethnically and traditionally sensitive educational training on BSE and breast cancer literacy.

Breast cancer is the most frequently occurring cancer in women and the most common cause of cancer death worldwide. A cross-sectional study was carried out among 792 female undergraduate students in public universities in Klang Valley, Malaysia, from January to April 2011. Data were collected using a validated questionnaire developed for this study. The mean age of respondents was 21.7±1.2 years. Most of them were single (96.8%), Malay (91.9%) and 150 (19.6%) claimed they had practiced BSE. There was a significant differences between performers and non-performers correlated to age, marital status, check breast by doctor, and being trained about BSE. Performers had lower mean scores for perceived barriers and susceptibility and higher mean score for confidence. Stepwise logistic regression analysis yielded four significant predictor variables. Overall our findings indicate that the practice of BSE while perceived as being important is not frequently practiced among female in Malaysia...

The aim of this open label crossover study was to investigate the effects of Nigella sativa on reproductive health and metabolic profile of perimenopausal women in Rawang, Malaysia. Sixty nine perimenopausal women aged 45 to 65 were allocated into the experimental group treated orally with 1600mg/day of encapsulated pure powdered N. sativa compared to control groups treated with placebo for 12 weeks. At the end of study, participants underwent washout period for fourteen days before being crossed over and continued for another cycle of treatment. Participants were abstained from taking any other drugs, herbal preparations or food supplements throughout the study. Body weight, height, waist circumference, blood pressure, biochemical parameters and hormonal levels were measured at baseline and at the end of experiment for both cycles. Face to face interview was carried out at baseline and every week to check for compliance, minimize dropouts and to record reproductive health and quali...

In Iran, breast cancer is the most prevalent cancer in women and a major public health problem. A cross sectional study was carried out to determine knowledge on breast cancer and breast self- examination (BSE) practices of 384 females living in the city of Hamadan, Iran. A purposive sampling method was adopted and data were collected via face-to-face interviews based on a validated questionnaire developed for this study. Among respondents 268 (69.8%) were married and 144 (37.5%) of the respondents reported having a family history of breast cancer. One hundred respondents (26.0%) claimed they practiced BSE. Level of breast cancer knowledge was significantly associated with BSE practice (p=0.000). There was no association with demographic details (p<0.05). The findings showed that Iranian women's knowledge regarding breast cancer and the practice of BSE is inadequate. Targeted education should be implemented to improve early detection of breast cancer.

University students are a target group for blood donor programs. To develop a blood donation culture among university students, it is important to identify factors used to predict their intent to donate blood. This study attempted to develop a valid and reliable measurement tool to be employed in assessing variables in a blood donation behavior model based on the Theory of Planned Behavior (TPB), a commonly used theoretical foundation for social psychology studies. We employed an elicitation study, in which we determined the commonly held behavioral and normative beliefs about blood donation. We used the results of the elicitation study and a standard format for creating questionnaire items for all constructs of the TPB model to prepare the first draft of the measurement tool. After piloting the questionnaire, we prepared the final draft of the questionnaire to be used in our main study. Examination of internal consistency using Chronbach's alpha coefficient and item-total stati...