Knowledge, attitude, and practice of breast self-examination among female undergraduate medical students in Poonch Medical College, Azad Kashmir.

A cross-sectional observational study was conducted to assess the knowledge, attitude, and practice (KAP) of breast self-examination (BSE) among female undergraduate medical students in Poonch Medical College, Azad Kashmir. Out of 306 respondents, 250 completed the 16-item questionnaire (response rate of 81.7%). The correlations between knowledge, attitude, and practice were observed. Out of the total 250 respondents, 180 (72.0%) had ever heard of BSE, and 62 (24.8%) had performed BSE. The most important source of information regarding BSE was 'internet', which delivered knowledge to 64 (25.6%) students. The majority 200 (80%) thought that publicity and campaigns can motivate students to perform BSE. There was mild uphill correlation between knowledge and attitude, and knowledge and practice (p<0.001). The study identified poor KAP of BSE among the students, although most of the students gave high importance to BSE practice. Nationwide BSE campaigns can be undertaken to increase the practice as most of the respondents were positive about mass campaign.

Prevalence and significance of potential drug-drug interactions among cancer patients receiving chemotherapy.

BACKGROUND: Cancer patients often receive multiple drugs to maximize their therapeutic benefit, treat co-morbidities and counter the adverse effects of chemotherapy. Concomitant administration of multiple drugs increases the risk of drug interactions leading to compromised therapeutic efficacy or safety of therapy. The purpose of this study was to identify the prevalence, levels and predictors of potential drug-drug interactions (pDDIs) among cancer patients. METHODS: Six hundred and 78 patients receiving chemotherapy from two tertiary care hospitals were included in this cross-sectional study. Patient medication profiles were screened for pDDIs using the Micromedex® database. Logistic regression analysis was performed to identify the predictors of pDDIs. RESULTS: The overall prevalence of pDDIs was 78%, majority of patients had 1-2 pDDIs (39.2%). A total of 1843 pDDIs were detected. Major-pDDIs were most frequent (67.3%) whereas, a significant association of pDDIs was found between > 7 all prescribed drugs (p < 0.001) and ≥ 3 anti-cancer drugs (p < 0.001). Potential adverse outcomes of these interactions include reduced therapeutic effectiveness, QT interval prolongation, tendon rupture, bone marrow suppression and neurotoxicity. CONCLUSIONS: Major finding of this study is the high prevalence of pDDIs signifying the need of strict patient monitoring for pDDIs among cancer patients. Patients at higher risk to pDDIs include those prescribed with > 7 any types of drugs or ≥ 3 anticancer drugs. Moreover, list of most frequently identified major and moderate interactions will aid health care professional in timely identification and prevention of pDDIs.

Hemophagocytic Lymphohistiocytosis Complicating Dengue and Plasmodium vivax Coinfection.

Hemophagocytic lymphohistiocytosis (HLH) is a rare disorder. Dysfunction of cytotoxic T and natural killer (NK) cells causes uncontrolled activity of lymphocytes and histiocytes which leads to HLH. Infections, malignancies, and autoimmune disorders are associated with development of HLH. Dengue and Plasmodium vivax are rare causes of HLH. We report the first ever case of a young man who developed fatal HLH that complicated Dengue Hemorrhagic Fever (DHF) and Plasmodium vivax infection.