Background In low-income countries breast cancer awareness (BCA) is essential to reduce the proportion of advanced stage presentations of breast cancer. There is a lack of studies using multivariable techniques to explore factors related to BCA in low-income countries. The objective of this study was to identify to what extent women in Fiji and Kashmir, India have BCA and practice breast self-examination (BSE) as well as factors associated with BCA and BSE. Methods A survey of women aged ≥18 years was conducted in Fiji and Kashmir, India to assess BCA and rates of BSE. Comparison between Fiji and Kashmir was done using student’s t-test for continuous data and chi-square for binary data. Factors associated with BCA and BSE were analysed using a multivariable logistic regression for Fiji and Kashmir separately. Results Data were collected from 399 and 1982 women in Kashmir and Fiji, respectively. Of 1968 women in Fiji 57% were deemed to have an acceptable BCA compared to only 7.3% of 395 women in Kashmir. Having some education was associated with having BCA with an odds ratio of 4.7 (1.7–13) in Fiji and 10 (1.7–59) in Kashmir. Of 1976 women in Fiji 40% had tertiary education while 40% of 392 women in Kashmir had no education at all. The marital status was similar in both samples (n = 1973 and 395) with 68–69% being married and 21–26% being single. The lack of female doctors or nurses with whom to discuss issues, was perceived as a problem in both countries. Conclusions The key finding is an association between having any level of education and BCA. This correlation was much stronger than for a family history of breast cancer and BCA. Hence, general education to illiterate women may reduce the proportion of women in low-income countries presenting with advanced-stage breast cancer.
Background: Necrotizing fasciitis (NF) is a potentially life threatening disease. Delayed recognition and surgical intervention is directly linked to increased mortality. Laboratory risk indicator for necrotizing fasciitis (LRINEC) score, a laboratory oriented tool has potential to prevent morbidity and mortality but there exhibits a controversy regarding its utility which needs re-evaluation to prove it’s utility.Methods: A tertiary care hospital based observational study aims to evaluate diagnostic and prognostic value of LRINEC score. Patient above 18 years clinically diagnosed as SSTI and confirmed as NF histopathologically without co-morbidities were enrolled as subjects. Clinical evaluation and laboratory oriented LRINEC score were the study factors. Outcome factors were morbidity and mortality and histopathological confirmation of NF. Patients were analyzed as cellulitis and NF with identification of factors associated with NF; Univariate analysis with Kaplan-Meier survival analysis and ROC plotting was done.Results: Total 166 patients were enrolled with mean age of 47.14±15.76 years and 2:1 is the male : female ratio and. A total of 117 patients were diagnosed as Cellulitis and 49 patients were NF. Clinically Discharge, fever and cuticular necrosis was statistically associated with NF (p<0.01). Mortality in NF was 22.4% and no mortality in Cellulitis. Mean LRINEC score in cellulitis and NF was 1.95±0.972 and 7.57±1.51 (p<0.01). Survival analysis graph and ROC showed LRINEC score of 6 as diagnostic and score ≥9 as poor prognostic indicator.Conclusions: LRINEC score is a useful diagnostic and prognostic tool in patients of NF.
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