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Al Farwānīyah, Kuwait

Azim H.A.,Italian National Cancer Institute | Azim H.A.,Jules Bordet Institute | Bellettini G.,ASL Citta di Milan | Liptrott S.J.,Italian National Cancer Institute | And 7 more authors.
Breast | Year: 2010

Little is known regarding the safety and feasibility of breastfeeding in women with a history of breast cancer. We have performed a survey among breast cancer patients who completed their pregnancy following breast cancer management to examine their lactation behaviours and its effect on breast cancer outcome. Out of 32 women identified, 20 were reachable and accepted to take the questionnaire. Ten women initiated breastfeeding, 4 stopped within one month and 6 had long-term success with a median period of 11 months (7-17 months). The latter were all previously subjected to breast conserving surgery and received qualified lactation counselling at delivery. The main reasons for not initiating breastfeeding were " uncertainty regarding maternal safety" and " a priori unfeasibility" expressed either by the obstetrician or by the oncologist. At a median follow-up of 48 months following delivery, all 20 women were alive with two relapses; one in each group (i.e., lactating and non-lactating). This analysis adds to the limited available evidence on the feasibility and safety of breastfeeding in breast cancer survivors. Proper fertility and survivorship counselling is crucial and requires more attention in breast cancer clinics. © 2010.


El-Hodhod M.A.,Ain Shams University | Hamdy A.M.,Ain Shams University | Abbas A.A.,Ain Shams University | Moftah S.G.,Ain Shams University | Ramadan A.A.M.,Pediatrician
BMC Gastroenterology | Year: 2012

Background: Diminished bone mineral density (BMD) is of significant concern in pediatric inflammatory bowel disease (IBD). Exact etiology is debatable. The recognition of fibroblast growth factor 23 (FGF23), a phosphaturic hormone related to tumor necrosis factor alpha (TNF-α) makes it plausible to hypothesize its possible relation to this pathology.Methods: In this follow up case control study, BMD as well as serum levels of FGF23, calcium, phosphorus, alkaline phosphatase, creatinine, parathyroid hormone, 25 hydroxy vitamin D 3 and 1, 25 dihydroxy vitamin D 3 were measured in 47 children with IBD during flare and reassessed in the next remission.Results: Low BMD was frequent during IBD flare (87.2%) with significant improvement after remission (44.7%). During disease flare, only 21.3% of patients had vitamin D deficiency, which was severe in 12.8%. During remission, all patients had normal vitamin D except for two patients with Crohn's disease (CD) who remained vitamin D deficient. Mean value of serum FGF23 was significantly higher among patients with IBD during flare compared to controls. It showed significant improvement during remission but not to the control values. 1, 25 dihydroxy vitamin D 3, FGF23, serum calcium and urinary phosphorus were significant determinants of BMD in IBD patients.Conclusions: We can conclude that diminished BMD in childhood IBD is a common multifactorial problem. Elevated FGF23 would be a novel addition to the list of factors affecting bone mineral density in this context. Further molecular studies are warranted to display the exact interplay of these factors. © 2012 El-Hodhod et al.; licensee BioMed Central Ltd.


Kalra V.,Pediatric Neurology | Mishra D.,Maulana Azad Medical College | Agrawal K.,Pediatrician
Journal of Communicable Diseases | Year: 2012

Neurocysticercosis (NC) spreads due to complex socio-cultural and economic conditions prevailing in our country. The up-scaling of the infection among pediatric age group in recent times is related to faulty food preparation and personal hygiene practices, which are amenable to simple preventable measures in daily life. Students are prime targets for educational intervention to change sanitary habits due to their impressionable minds. Further, changing the knowledge, attitudes and practices (KAP) of teachers regarding the disease leads to a multiplier effect as they pass on the message to many generations of students. Our previous studies demonstrated significant lacunae in knowledge about the disease epidemiology and prevention among school students and teachers. A pilot health-education intervention program was undertaken in 24 randomly selected municipal primary schools in Delhi, to increase awareness of students and schoolteachers regarding NC. The content of the program was devised based on the analysis of previous KAP studies done in a similar population. The activities consisted of a slide show, a lecture in vernacular language, demonstration of illustrations, charts and samples of infested pork, and question-answer sessions with the audience. Conducting skits involving role-play by trained child artists was used as a unique mode of passing health education messages. Posters and pamphlets in the local language were prepared and distributed in the school. A total of 200 teachers, 4786 students, 846 parents, 79 sanitary staff, 65 school-health nurses and 23 school-health physicians attended the activities. Feedback was collected 3 months after the activity from each school (21 physicians and 70 schoolteachers). All respondents considered the program to be successful in increasing their own and students' awareness about NC and its prevention. There was significant improvement in teachers' knowledge about the impact of changing sanitary habits in prevention of the disease, and the appropriate practices to be adopted. This study demonstrated the feasibility and efficacy of conducting health education intervention in primary schools for changing sanitary practices for prevention of NC.


Fallah R.,University of Yazd | Habibian S.,Pediatrician | Noori-Shadkam M.,University of Yazd
Iranian Journal of Child Neurology | Year: 2016

Objective Reduction of pain of invasive procedures in neonates can prevent pain side effects. The purpose of present study was to evaluate the efficacy and safety of a single low dose of intravenous fentanyl in reducing of lumbar puncture (LP) pain in neonates. Materials & Methods In this randomized clinical trial, registered with code number of 2014022616761N150, admitted neonates to Shahid Sadoughi Hospital, Yazd, Iran from August-April 2012 (45 cases) were randomly assigned into two groups to receive 2 μg/kg of intravenous fentanyl or 0.2 milliliter of normal saline, two min before LP. Primary outcome was success rate in reducing of pain during needle insertion to skin (pain score of less than three). Secondary outcomes were clinical side effects and serious adverse events. Results Forty-five neonates including 23 girls and 22 boys were evaluated. Pain reduction was obtained in 39.1% (9 of 23 neonates) of fentanyl group and in 4.5% (one of 22 neonates) of control group. Means of pulse rate (136.41± 9.16 vs. 148.9± 8.99) and pain score during needle insertion (3.41±1.31 vs. 5.8±1.12) were lower in fentanyl group. No severe adverse effects were seen in both groups. Side effects such as vomiting [9% (N=2) in control and 4.3% (N=1) in fentanyle group] and mild transient decrease in oxygen saturation in 8.7% (N=2) of fentanyle group were seen. Safety in two groups was not statistically different. Conclusion Intravenous fentanyl might be considered as a safe and effective analgesic drug in LP in neonates. © 2016 Iranian Child Neurology Society. All Rights Reserved.


Desai S.,Public Health Agency of Canada | Diener T.,Population and Public Health Services | Tan B.J.-K.,Infectious Diseases | Lowry N.J.,University of Saskatchewan | And 3 more authors.
Canadian Journal of Infectious Diseases and Medical Microbiology | Year: 2014

The present article reports a case involving an immunocompetent, previously well child who, despite two previous doses of inactivated poliovirus vaccine, developed severe flaccid paralysis consistent with polio after receiving oral polio vaccine. Copyright © Pulsus Group Inc.

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