European Journal of Molecular & Clinical Medicine

Background: Breast cancer is a major health concern in India, with an estimated 266,000 new cases and 74,000 deaths annually. The prevalence of risk factors for breast cancer in India is of great concern, as it is one of the most common types of cancer among women in the country. The present study aimed to assess several established risk factors for breast cancer, including age, family history, and lifestyle factors such as diet and physical activity. In India, the average age at diagnosis for breast cancer is typically 10-15 years younger than in Western countries, which may be due to differences in reproductive and hormonal factors. Material and Methods: Present study was prospective and retrospective, conducted in patients with malignancy, lesions diagnosed on the basis of histopathological examination (TNM staging system) were considered as cases. Results: In the present study, The mean age of the study subjects was 51.20±10.8 years. The majority of the participant was of >50 years of age (n=213, 42.6%) followed by 41-50 years (n=195, 39%) and <40 years (n=92, 18.4%). The mean weight of the patients was 63.34±8.12 kg. Most of the subjects had 57-68 kg of weight (n=138, 39.6%) followed by 23.4% (n=117), 15.6% (n=78,) 10.8% (n=54), and 10.6% (n=53) of the subjects belonged to 49-58 kg, 69-78 kg, >78kg and 38-48 kg weight category respectively. The mean age at menarche in patients was found to be 12.47±1.42 years. In 52.4% (n=262) of the patients, the age at menarche was 10-12 years. Whereas, in 46% (n=230), 0.8% (n=4), and 0.8% (n=4) of patients it was 13-14 years, <10 years, and >14 years respectively. The mean age of the patients at first childbirth was 22.35±4.89 years. Most of the patients had their first child at 20-24 years of age (49.4%, n=247) followed by 34.8% (n=174), 11.6% (n=58), and 4.2% (n=21) of patients it was at <20 years, 25-29 years, ≥30 years of age respectively. The mean number of pregnancies in study subjects was 2.67±4.18. The majority of patients had 1-2 pregnancies (49.6%, n=248) followed by 35.6% (n=178), 9.4% (n=47), and 5.4% (n=27) of the patients had 3-4, 0, and >4 pregnancies. In 79.4% (n=397) of patients, the duration of breastfeeding was >6 months whereas in 20.6% (n=103) patients the duration of breastfeeding was 4-6 months. Among the study subjects, 3.4% (n=17) of the patients had a family history of breast cancer whereas, it was absent in the majority of the subjects (96.6%, n=483). A history of oral contraceptive use was noted in only 4.4% (n=22) of patients, only 0.6% of the patients had a history of hormone replacement therapy. The majority of study subjects were housewives (60.4%, n=302) whereas, the occupation of 12.6% (n=63), 2.6% (n=13), 0.4% (n=2), 3.8% (n=19), and 20.2% (n=101) of patients were service, retired, student, self-employed, and other respectively. 51% (n=255) of the subject had premenopausal status whereas, 49% (n=245) of the subjects were with postmenopausal status. Modifiable risk factors were observed in 10% (n=50) of the patients including obesity, smoking, and use of other drugs in 5% (n=25), 1% (n=5), and 4% (n=20) of patients respectively. Conclusion: The common modifiable risk factors commonly attributed to breast cancer were not correlating and trends were observed to vary in this rural setup.

Background:Breast cancer is a major health concern in India, with an estimated 266,000 new cases and 74,000 deaths annually. The prevalence of risk factors for breast cancer in India is of great concern, as it is one of the most common types of cancer among women in the country. The present study aimed to assess several established risk factors for breast cancer, including age, family history, and lifestyle factors such as diet and physical activity. In India, the average age at diagnosis for breast cancer is typically 10-15 years younger than in Western countries, which may be due to differences in reproductive and hormonal factors.Material and Methods: Present study was prospective and retrospective, conducted in patients with malignancy, lesions diagnosed on the basis of histopathological examination (TNM staging system) were considered as cases. Results: In the present study, The mean age of the study subjects was 51.20±10.8 years. The majority of the participant was of >50 years of age (n=213, 42.6%) followed by 41-50 years (n=195, 39%) and <40 years (n=92, 18.4%). The mean weight of the patients was 63.34±8.12 kg. Most of the subjects had 57-68 kg of weight (n=138, 39.6%) followed by 23.4% (n=117), 15.6% (n=78,) 10.8% (n=54), and 10.6% (n=53) of the subjects belonged to 49-58 kg, 69-78 kg, >78kg and 38-48 kg weight category respectively. The mean age at menarche in patients was found to be 12.47±1.42 years. In 52.4% (n=262) of the patients, the age at menarche was 10-12 years. Whereas, in 46% (n=230), 0.8% (n=4), and 0.8% (n=4) of patients it was 13-14 years, <10 years, and >14 years respectively. The mean age of the patients at first childbirth was 22.35±4.89 years. Most of the patients had their first child at 20-24 years of age (49.4%, n=247) followed by 34.8% (n=174), 11.6% (n=58), and 4.2% (n=21) of patients it was at <20 years, 25-29 years, ≥30 years of age respectively. The mean number of pregnancies in study subjects was 2.67±4.18. The majority of patients had 1-2 pregnancies (49.6%, n=248) followed by 35.6% (n=178), 9.4% (n=47), and 5.4% (n=27) of the patients had 3-4, 0, and >4 pregnancies. In 79.4% (n=397) of patients, the duration of breastfeeding was >6 months whereas in 20.6% (n=103) patients the duration of breastfeeding was 4-6 months. Among the study subjects, 3.4% (n=17) of the patients had a family history of breast cancer whereas, it was absent in the majority of the subjects (96.6%, n=483). A history of oral contraceptive use was noted in only 4.4% (n=22) of patients, only 0.6% of the patients had a history of hormone replacement therapy. The majority of study subjects were housewives (60.4%, n=302) whereas, the occupation of 12.6% (n=63), 2.6% (n=13), 0.4% (n=2), 3.8% (n=19), and 20.2% (n=101) of patients were service, retired, student, self-employed, and other respectively. 51% (n=255) of the subject had premenopausal status whereas, 49% (n=245) of the subjects were with postmenopausal status. Modifiable risk factors were observed in 10% (n=50) of the patients including obesity, smoking, and use of other drugs in 5% (n=25), 1% (n=5), and 4% (n=20) of patients respectively. Conclusion: The common modifiable risk factors commonly attributed to breast cancer were not correlating and trends were observed to vary in this rural setup.

Background: Pneumonia continues to be one of the leading causes of mortality among children under five years of age despite effective vaccines and nutritional and environmental interventions. This study designed to study the risk factors and outcome of IMNCI classified severe and very severe pneumonia in under five children.
Methods: Children between 2-60 months, fulfilling inclusion criteria were enrolled as cases. Baseline clinical assessment and physical examinations findings recorded. Lab and radiological investigations done. Reassessment done at 48 hrs for the cases of treatment failure.
Results: There were 75 out of 119 with incomplete immunization, 73 out of 83 with lack of exclusive breast feeding, 104 out of 185 with poor and 125 out of 136 malnourished develops very severe pneumonia. There was significant association between incomplete immunization, lack of exclusive breast feeding, lower socioeconomic status and malnutrition for risk of severe pneumonia (p=0.00). Consolidation (241) over X ray chest PA view was most common finding followed by interstitial infiltration (49) and pleural fluid/air (10).The most common complication observed was empyema followed by meningitis and septicemia and 12 out 136 having very severe pneumonia died, while 124 were successfully discharged and there was significant association between very severe pneumonia with outcome as death (p=0.0056) and 41 out 136 having very severe pneumonia were having treatment failure, while 95 were successfully treated for illness.
Conclusion: Early identification of these risk factors and anticipation of treatment failure may have therapeutic implication for starting more intensive therapy, thereby preventing complications and reducing childhood mortality and morbidity due to pneumonia.

Aim: To assess the Knowledge and Awareness regarding Breastfeeding and COVID-19 vaccination among Pregnant and Lactating Mothers attending OPD in a Service Hospital during COVID-19 Pandemic.
Material and Methods: Hospital based cross sectional study. Sample size of 380 Pregnant and Lactating Mothers attending OPD antenatally or postnatally were included in the study. Ethics committee approval was taken. A peer reviewed predesigned questionnaire was used to obtain information after taking consent. Demographic data and Knowledge of Mothers regarding Breastfeeding and COVID-19 Vaccination data was collected and analyzed.
Results: Our Study revealed knowledge and awareness regarding Breastfeeding and COVID-19 Vaccination in Pregnant and Lactating Mothers during COVID-19 Pandemic in a Service Hospital to be 53% and 57% respectively. Our Study also found a significant correlation between Age and Education of Mothers and their Knowledge regarding Breastfeeding in Pregnant and Lactating Mothers during COVID-19 Pandemic. A significant Correlation was found between Education of Mothers and their Knowledge regarding COVID-19 Vaccine in Pregnant and Lactating Mothers during COVID-19 Pandemic.
Conclusion: This study emphasizes the need to focus on promotion of breast feeding and COVID-19 Vaccination in Pregnant and Lactating during COVID-19 Pandemic. These simple steps may contribute in lowering Neonatal and Infant Mortality rates. Breastfeeding must continue after Maternal COVID-19 vaccination

In this review, I describe the effect of breastfeeding in premenopausal breast cancer in Jordan. For the time being, breast cancer is considered to be the most frequent type of cancer among women in the world. Many studies explore the effect of breastfeeding to prevent of  breast cancer, although studies have suggested that breastfeeding reduces the risk of breast cancer. In 2020, 2.3 million women diagnosed with breast cancer and 685 000 deaths in breast cancer in the world. In the end of 2020, there were 7.8 million women alive who were diagnosed with breast cancer in the past 5 years, making it the world’s most prevalent cancer (WHO, 2021). mothers should be encouraged to breastfeed their babies because the clinical evidence has shown that there is a lower risk of breast cancer in women who breastfed their babies.

Objective: Knowledge of pseudo constipation behaviour in exclusively breastfed infant’s 0-6-month age
is sparse. This benign temporary condition creates anxiety among parents and health care providers so as
infants are put to diagnostic tests and treatments not required. Mothers self-introduce early add on feeds
as of anxiety which may hinder the optimal infant feeding. The study aimed to:
1. To determine prevalence of pseudo constipation or infrequent stools in 0-6 months healthy
breastfeeding infants.
2. To draw correlation of pseudo constipation and its impact on exclusive breastfeeding.
Methods: 100 mothers fitting into inclusion criteria were put to a set of questionnaire. Babies born with
normal birth weight, passed meconium within 48 hours and predominantly breastfed, having satisfactory
weight gain and no illness history in past 6 months were included. Babies with functional constipation,
infant dyschezia, history suggesting of organic causes of constipation, failure to thrive, congenital
anomalies or associated illness were excluded.
Results: The prevalence of pseudo constipation in 0-6months predominantly breastfed infants was 42%.
All these infants had mean peak time duration of defecation ≥2days and mean duration the symptom
lasted in weeks was 5.43 weeks (SD-4.52, median-5). All infants had reduction in frequency of stools in
second month of life (median-45 days). Among the infants who had pseudo constipation behaviour
64.3% of mothers had started early complimentary feeds <6month age. The comparison between the
cases and control group showed to be highly significant with χ 2 =21.23, df =1, p <0.001.
Conclusion: Prevalence of pseudo obstruction behavior in exclusive breastfed infants is as high as 42%.
Nearly 64.3% of mothers intervened this by adding complimentary feeds early <6-month age. We would
like stress that knowledge of this temporary condition requiring no interventions would be a great benefit
for pediatricians, pediatric surgeons, nurses and parents.

Introduction and background: World Health Organization (WHO) recommends exclusive breast feeding for at least 6 months and thereafter until the child is 2 years of age. The success of introduction and sustenance of any health initiative depends upon the knowledge and attitudes towards those health practices. This study was undertaken to assess the baseline knowledge, attitudes and anticipated practices of MBBS students and help in framing policies towards inclusion of breast-feeding training in regular curriculum.
Methodology: A cross sectional survey was carried on at a private medical college on 137 medicos comprising of Final year MBBS and Interns. Using Google Forms, a survey questionnaire was prepared, comprising of 37 items assessing the knowledge, attitude and anticipatory practices towards breastfeeding and infant nutrition.
Results: The mean overall score of Final MBBS participants was 64.5% and that of Interns were 71.2% (P value = 0.002). In all 3 domains the Interns scored higher than Final MBBS participants and the differences were statistically significant. There were positive correlations between knowledge and attitude (r= 0.36, P value < 0.001), knowledge and practices (r= 0.53, P value < 0.001) and attitude and practices (r = 0.44, P value < 0.001).
Conclusion: This study highlights the knowledge, attitude and practice level of students among Final MBBS and Interns at our institute. The overall knowledge level was average. As tomorrows practitioners and policy makers it is mandatory to shape this group of young doctors in order to ensure that future of our nation that is current generation of childrenare in safe hands.