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Epidemiological Study on Breast Cancer Associated Risk Factors and Screening Practices among Women in the Holy City of Varanasi, Uttar Pradesh, India

  • Paul, Shatabdi;Solanki, Prem Prakash;Shahi, Uday Pratap;Srikrishna, Saripella
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.18
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    • pp.8163-8171
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    • 2016
  • Background: Breast cancer is the second most cause of death (1.38 million, 10.9% of all cancer) worldwide after lung cancer. In present study, we assess the knowledge, level of awareness of risk factors and screening practices especially breast self examination (BSE) among women, considering the non-feasibility of diagnostic tools such as mammography for breast screening techniques of breast cancer in the holy city Varanasi, Uttar Pradesh, India. Materials and Methods: A cross-sectional population based survey was conducted. The investigation tool adopted was self administrated questionnaire format. Data were analysed using SPSS 20 version and Chi square test to determine significant association between various education groups with awareness and knowledge, analysis of variance was applied in order to establish significance. Results: The attitude of participants in this study, among 560 women 500 (89%) responded (age group 18-65 years), 53.8% were married. The knowledge about BSE was very low (16%) and out of them 15.6% were practised BSE only once in life time. study shown that prominent age at which women achieve their parity was 20 yrs, among 500 participants 224 women have achieved their parity from age 18 to 30 yrs. Very well known awareness about risk factors of breast cancer were alcohol (64.6%), smoking (64%) and least known awareness risk factors were early menarche (17.2%) and use of red meat (23%). The recovery factors of breast cancer cases were doctors support (95%) and family support (94.5%) as most familiar responses of the holy city Varanasi. Conclusions: The study revealed that the awareness about risk factors and practised of BSE among women in Varanasi is extremely low in comparison with other cities and countries as well (Delhi, Mumbai, Himachal Pradesh, Turkey and Nigeria). However, doctors and health workers may promote the early diagnosis of breast cancer.

Effect of antidiarrhoeal formulation on acute experimental diarrhoea in rats

  • Khan, M. Aleem;Khan, Naeem A.;Qasmi, Iqbal A.;Ahmad, Ghufran;Zafar, Shadab
    • Advances in Traditional Medicine
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    • v.5 no.2
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    • pp.150-155
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    • 2005
  • Aqueous extract of antidiarrhoeal formulation (ADF) containing Holarrhena antidysentrica, Aegle marmelos and Punica granatum was investigated for antidiarrhoeal activity against charcoal-induced gut transit, serotonin-induced diarrhoea and $PGE_2-induced$ small intestine enteropooling in rats. The control, standard and test groups of experimental animals were administered with normal saline (p.o.), diphenoxylate hydrochloride (5 mg/kg, p.o.) and ADF (250 mg and 500 mg/kg, p.o.) respectively except the control group of $PGE_2-induced$ small intestine enteropooling which received only 5% ethanol in normal saline (i.p.). Charcoal (10 ml/kg, p.o.) and serotonin $(600\;{\mu}g/kg,\;i.p.)$ were administered after 30 min, while $PGE_2\;(100\;{\mu}g/kg,\;p.o.)$ was administered immediately afterwards. The distance traveled by charcoal in small intestine was measured after 15 and 30 min of charcoal administration, diarrhoea was observed every 30 min for six hour after serotonin administration and the volume of intestinal fluid was measured after 30 min of $PGE_2$ administration. Oral administration of ADF significantly inhibited the frequency of defaecation and decreased the propulsion of charcoal meal through the gastrointestinal tract, reduced the wetness of faecal dropping in serotonin-induced diarrhoea and also reduced the $PGE_2-induced$small intestine enteropooling. ADF may have potential to reduce the diarrhoea in rats.

Tobacco Use and Quit Behaviour Assessment in the Global Adult Tobacco Survey (GATS): Invalid Responses and Implications

  • Jena, Pratap Kumar;Kishore, Jugal;Pati, Sanghamitra;Sarkar, Bidyut Kanti;Das, Sagarika
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.11
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    • pp.6563-6568
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    • 2013
  • Background: Tobacco use and quit attempts are two key indicators of the Global Adult Tobacco Survey (GATS) that assess quit attempts among current as well as former tobacco users. The relevant data have inherent policy implications for tobacco cessation programme evaluation. This study aimed to review the concepts of quit attempt assessment and quantifying invalid responses considering GATS-India data. Materials and Methods: GATS assessment of tobacco use and quit attempts were examined in the current literature. Two categories of invalid responses were identified by stratified analysis of the duration of last quit attempt among current users and duration of abstinence among former users. Category A included absolute invalid responses when time-frame of assessment of current tobacco use and less than former tobacco use were violated. Category B included responses that violated the unit of measurement of time. Results: Current daily use, current less than daily use and former use in GATS were imprecisely defined with overlapping of time-frame of assessment. Overall responses of 3,102 current smokers, 4,036 current smokeless users, 1,904 former smokers and 1,343 former smokeless users were analyzed to quantify invalid responses. Analysis indicated overall 21.2% (category A: 7.32%; category B: 17.7%) and 22.7% (category A: 8.05%; category B: 18.1%) invalid responses among current smokers and smokeless users respectively regarding their duration of last quit attempt. Similarly overall 6.62% (category A: 4.7%; category B: 2.3%) and 10.6% (category A: 8.6%; category B: 3.5%) invalid responses were identified among former smokers and smokeless users respectively regarding their duration of abstinence. Conclusions: High invalid responses for a single assessment are due to the imprecise definition of current use, former use and quit attempt; and failure to utilize opportunity of direct data entry interface use during the survey to validate responses instantly. Redefining tobacco use and quit attempts considering an appropriate timeframe would reduce invalid responses.

Assessment of indoor air micro-flora in selected schools

  • Katiyar, Vinita
    • Advances in environmental research
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    • v.2 no.1
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    • pp.61-80
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    • 2013
  • Quantification of viable forms of microbial community (bacteria and fungi) using culture-dependent methods was done in order to characterize the indoor air quality (IAQ). Role of those factors, which may influence the concentration of viable counts of bacteria and fungi, like ventilation, occupancy, outdoor concentration and environmental parameters (temperature and relative humidity) were also determined. Volumetric-infiltration sampling technique was employed to collect air samples both inside and outside the schools. As regard of measurements of airborne viable culturable microflora of schools during one academic year, the level of TVMCs in school buildings was ranged between 803-5368 cfu/$m^3$. Viable counts of bacteria (VBCs) were constituted 63.7% of the mean total viable microbial counts where as viable counts of fungi (VFCs) formed 36.3% of the total. Mean a total viable microbial count (TVMCs) in three schools was 2491 cfu/$m^3$. Outdoor level of TVMCs was varied from 736-5855 cfu/$m^3$. Maximum and minimum VBCs were 3678-286 cfu/m3 respectively. Culturable fungal counts were ranged from 268-2089 cfu/$m^3$ in three schools. Significant positive correlation (p < 0.01) was indicated that indoor concentration of viable community reliant upon outdoor concentration. Temperature seemed to have a large effect (p < 0.05, p < 0.01) on the concentration of viable culturable microbial community rather than relative humidity. Consistent with the analysis and findings, the concentration of viable cultural counts of bacteria and fungi found indoors, were of several orders of magnitude, depending upon the potential of local, spatial and temporal factors, IO ratio appeared as a crucial indicator to identify the source of microbial contaminants.

Multiple Stakeholder Perspectives on Cancer Stigma in North India

  • Gupta, Adyya;Dhillon, Preet K;Govil, Jyotsna;Bumb, Dipika;Dey, Subhojit;Krishnan, Suneeta
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.14
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    • pp.6141-6147
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    • 2015
  • Background: Cancer is a leading cause of death worldwide. A large proportion of cancer deaths are preventable through early detection but there are a range of social, emotional, cultural and financial dimensions that hinder the effectiveness of cancer prevention and treatment efforts. Cancer stigma is one such barrier and is increasingly recognized as an important factor influencing health awareness and promotion, and hence, disease prevention and control. The impact and extent of stigma on the cancer early detection and care continuum is poorly understood in India. Objectives: To evaluate cancer awareness and stigma from multiple stakeholder perspectives in North India, including men and women from the general population, health care professionals and educators, and cancer survivors. Materials and Methods: A qualitative study was conducted with in-depth interviews (IDIs) and focus group discussions (FGDs) among 39 individuals over a period of 3 months in 2014. Three groups of participants were chosen purposively - 1) men and women who attended cancer screening camps held by the Indian Cancer Society, Delhi; 2) health care providers and 3) cancer survivors. Results: Most participants were unaware of what cancers are in general, their causes and ways of prevention. Attitudes of families towards cancer patients were observed to be positive and caring. Nevertheless, stigma and its impact emerged as a cross cutting theme across all groups. Cost of treatment, lack of awarenes and beliefs in alternate medicines were identified as some of the major barriers to seeking care. Conclusions: This study suggests a need for spreading awareness, knowledge about cancers and assessing associated impact among the people. Also Future research is recommended to help eradicate stigma from the society and reduce cancer-related stigma in the Indian context.

What is the Most Suitable Time Period to Assess the Time Trends in Cancer Incidence Rates to Make Valid Predictions - an Empirical Approach

  • Ramnath, Takiar;Shah, Varsha Premchandbhai;Krishnan, Sathish Kumar
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.8
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    • pp.3097-3100
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    • 2015
  • Projections of cancer cases are particularly useful in developing countries to plan and prioritize both diagnostic and treatment facilities. In the prediction of cancer cases for the future period say after 5 years or after 10 years, it is imperative to use the knowledge of past time trends in incidence rates as well as in population at risk. In most of the recently published studies the duration for which the time trend was assessed was more than 10 years while in few studies the duration was between 5-7 years. This raises the question as to what is the optimum time period which should be used for assessment of time trends and projections. Thus, the present paper explores the suitability of different time periods to predict the future rates so that the valid projections of cancer burden can be done for India. The cancer incidence data of selected cancer sites of Bangalore, Bhopal, Chennai, Delhi and Mumbai PBCR for the period of 1991-2009 was utilized. The three time periods were selected namely 1991-2005; 1996-2005, 1999-2005 to assess the time trends and projections. For the five selected sites, each for males and females and for each registry, the time trend was assessed and the linear regression equation was obtained to give prediction for the years 2006, 2007, 2008 and 2009. These predictions were compared with actual incidence data. The time period giving the least error in prediction was adjudged as the best. The result of the current analysis suggested that for projections of cancer cases, the 10 years duration data are most appropriate as compared to 7 year or 15 year incidence data.

Type-Specific Incidence and Persistence of HPV Infection among Young Women: A Prospective Study in North India

  • Datta, Palika;Bhatla, Neerja;Pandey, R.M.;Dar, Lalit;Patro, A. Rajkumar;Vasisht, Shachi;Kriplani, Alka;Singh, Neeta
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.3
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    • pp.1019-1024
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    • 2012
  • Background: Infections with human papillomavirus (HPV) are highly prevalent among sexually active young women in India. However, not much is known about the incidence of type-specific human papillomavirus (HPV) infections and their patterns of persistence, especially in the Indian context. Objective: The objective of this study was to evaluate the rate of acquisition and persistence of HPV types in young women. Methods: Women residing in an urban slum in Delhi (n=1300) were followed for 24 months at 6 monthly intervals. Exfoliated cervical cells collected at each visit were tested for the presence of HPV DNA. Genotyping was performed using the reverse line blot assay. Results: The incidence rate for any HPV type was calculated to be 5 per 1000 women-months. Among high risk HPV types, HPV16 had the highest incidence rate followed by HPV59, HPV52 and HPV18, i.e., 3.0, 0.58, 0.41 and 0.35 women per 1000 women-months respectively. The persistence rate was higher for high-risk than low-risk HPV types. Among low-risk types, HPV42, HPV62, HPV84 and HPV89 were found to persist. Whereas almost all high risk types showed persistence, the highest rate was found in women with HPV types 16, 45, 67, 31, 51 and 59. The persistence rate for HPV16 infection was 45 per 1000 women-months. Conclusion: Incident HPV infections and high risk HPV type-specific persistence were found to be high in our study population of young married women. Understanding the patterns of HPV infection may help plan appropriate strategies for prevention programs including vaccination and screening.

Mutational Analysis of Prohibitin - A Highly Conserved Gene in Indian Female Breast Cancer Cases

  • Najm, Mohammad Zeeshan;Akhtar, Md. Salman;Ahmad, Istaq;Sadaf, Sadaf;Mallick, Mohd Nasar;Kausar, Mohd Adnan;Chattopadhyay, Shilpi;Ahad, Amjid;Zaidi, Shuaib;Husain, Syed Akhtar;Siddiqui, Waseem Ahmad
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.10
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    • pp.5113-5117
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    • 2012
  • Prohibitin (PHB) is a chaperone protein which is highly conserved evolutionarily. It shows significant homology with the Drosophila cc gene which is considered important for development and differentiation of Drosophila melanogaster. Investigations have revealed an involvement of PHB in cellular proliferation and development, apoptosis, signal transduction, mitochondrial function and regulation of the estrogen and androgen receptors. Therefore, we conducted the present study to analyze mutations in the highly conserved region in Indian female breast cancer patients. Conventional PCR-SSCP and Automated DNA sequencing were performed with a total of 105 breast cancer samples along with adjacent normal tissue. Of the total, 14.2% (15/105) demonstrated a mutation status of prohibitin observed in our study population. We identified a novel missense mutation (Thr>Ser), a novel deletion of T nucleotide in an intron adjacent to intron-exon boundary and a previously determined missense mutation (Val>Ala). A statistically significant correlation was obtained which suggested that prohibitin may be associated with tumor development and/or progression of at least some proportion of breast cancers.

Global Adult Tobacco Survey (GATS): A Case for Change in Definition, Analysis and Interpretation of "Cigarettes" and "Cigarettes Per Day" in Completed and Future Surveys

  • Jena, Pratap Kumar;Kishore, Jugal;Sarkar, Bidyut K.
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.5
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    • pp.3299-3304
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    • 2013
  • Background: The Global Adult Tobacco Survey has 15 key indicators, cigarettes smoked per day (CPD) among daily smokers being one of them. The first wave of GATS in 14 countries indicated that mean CPD use is higher in women than men in India only, which is contrary to the current understanding of tobacco use globally. This study was undertaken to understand the unusual findings for mean CPD use in the GATS-India survey. Materials and Methods: Items B06a and B06b of the GATS India survey questionnaire that collected information on daily consumption of manufactured and rolled cigarettes were analyzed using SPSS software. Exclusive users were identified from these items after excluding the concurrent users of other tobacco products. Cigarette type, exclusive use and gender stratified analyses were made. Consumption of different types of cigarettes among the mixed users of manufactured and rolled cigarettes were correlated. Results: Higher mean number of CPD use among male daily-smokers was observed than their female counterparts in product specific analysis. Mean CPD as per GATS cigarette definition was higher in males than females for exclusive users but a reverse trend was observed in case of non-exclusive users. Use of manufactured cigarettes increased with increase in use of rolled cigarette among the mixed users and around half of these users reported equal CPD frequency for the both types of cigarettes. Conclusions: The anomaly in mean CPD estimate in GATS-India data was due to inclusion of two heterogeneous products to define cigarettes, variation in cigarette product specific user proportions contributing to the average and non-exclusive concurrent use of other tobacco products. The consumption pattern of cigarettes among the mixed users highlights bias in CPD reporting. Definition, analysis and interpretation of 'cigarettes per day' in the GATS India survey need to be improved by redefining cigarettes and making product specific analyses.

Hospital-based Study of Endometrial Cancer Survival in Mumbai, India

  • Balasubramaniam, Ganesh;Sushama, S.;Rasika, B.;Mahantshetty, U.
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.2
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    • pp.977-980
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    • 2013
  • Background: Endometrial cancer is common in western women, and the rates are very high; however in India, the rates are as low as 4.3 per 100,000 (Delhi). Objective: To estimate the survival of endometrial cancer patients based on age, education, family history, tobacco habit, number of pregnancies, clinical extent of disease and treatment received. Materials and Methods: The present retrospective study was carried out at the Tata Memorial Hospital (TMH), Mumbai, India, between 1999-2002. 310 cases treated in TMH were considered as eligible entrants for the study. Five-year survival rates were estimated using actuarial and loss-adjusted (LAR) methods. Results: The proportions of patients dying above 50 years of age, non-residents and illiterates was higher than their counterparts. 54.8% of patients had some form of treatment before attending TMH. There were only 4.2% tobacco-chewers and only 6.1% had a family history of cancer. There were 25.8% who had 3-5 pregnancies (not living children) and 38.1% did not remember the pregnancy history. The 5-year overall survival rate was 92%. The five-year rates indicated better prognosis for those aged less than 50 years (97%), non-tobacco-chewers (94%), with no family history of cancer (93%), with localized disease (93%) and those treated with surgery either alone or as a combination treatment (95%). Conclusions: The present study showed that endometrial cancer patients with localized disease at diagnosis have a good outcome in India. A detailed study will help in understanding the prognostic indicators for survival especially with the newer treatment technologies now available.