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 fo... more 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.
The Southeast Asian journal of tropical medicine and public health, 2016
Research in the field of factors associated with depression among adolescents is lacking in Malay... more Research in the field of factors associated with depression among adolescents is lacking in Malaysia. The aims of the present study were to assess the current prevalence of depression and its related factors among secondary school students in Pasir Gudang, South Malaysia. In this cross sectional study, 2,927 secondary school students (13-17 years old) from urban areas were screened for symptoms of mental disorder as well as demographic and risk behaviors using a validated Depression, Anxiety and Stress Scale (DASS) 12 questionnaire. The majority of the respondents (53.8%) were Malay, of which 53.1% were female. Symptoms of mild depression were found in 33.2% of the respondents, while the prevalence of the symptoms of moderate, severe, and extremely severe depression was 21.5%, 18.1%, and 3.0%, respectively. Logistic regression suggested that participants who were Chinese or had a lower average grade were three times more likely to have depression, while those who came from a single-...
Menopause is the condition when regular menstrual periods cease and may be accompanied by psychol... more 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 dys... more 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.
Asian Pacific journal of cancer prevention : APJCP, 2015
Electrical impedance tomography (EIT) is a new non-invasive, mobile screening method which does n... more 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.
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 fo... more 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.
The Southeast Asian journal of tropical medicine and public health, 2016
Research in the field of factors associated with depression among adolescents is lacking in Malay... more Research in the field of factors associated with depression among adolescents is lacking in Malaysia. The aims of the present study were to assess the current prevalence of depression and its related factors among secondary school students in Pasir Gudang, South Malaysia. In this cross sectional study, 2,927 secondary school students (13-17 years old) from urban areas were screened for symptoms of mental disorder as well as demographic and risk behaviors using a validated Depression, Anxiety and Stress Scale (DASS) 12 questionnaire. The majority of the respondents (53.8%) were Malay, of which 53.1% were female. Symptoms of mild depression were found in 33.2% of the respondents, while the prevalence of the symptoms of moderate, severe, and extremely severe depression was 21.5%, 18.1%, and 3.0%, respectively. Logistic regression suggested that participants who were Chinese or had a lower average grade were three times more likely to have depression, while those who came from a single-...
Menopause is the condition when regular menstrual periods cease and may be accompanied by psychol... more 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 dys... more 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.
Asian Pacific journal of cancer prevention : APJCP, 2015
Electrical impedance tomography (EIT) is a new non-invasive, mobile screening method which does n... more 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.
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