Background:In India breast cancer is the number one cancer among females with an incidence rate of 25.8 per 100,000 women and mortality of 12.7 per 100,000 women. India continues to have a low 5-year survival rate of breast cancer with only 66.1% as compared to 90% in developed countries. The major reason for low survival is that patients are diagnosed with cancer at high stage. The present study attempts to delineate the time interval between self-detection of breast cancer symptoms and seeking care and to find the main reasons for delay in seeking care. Methods: A cross sectional study was undertaken from October 2016 to March 2017 in a population based cancer registry (PBCR) and hospital based cancer registry (HBCR) located in south of India. Histologically confirmed breast cancer patients (N=181) were interviewed at hospital using a pre-tested semi structured questionnaire. Results: The median time interval between the self-detection of breast cancer symptoms and first contact with general physician was 60 [IQR 30-180] days. The median time to diagnosis from the first contact was 30 [IQR 10 -60] days and the overall median time span from self-detection of symptoms to treatment was 150 [IQR 95-265] days. The major reason given for not seeking medical care in time was lack of awareness in identifying the cancer symptoms both among patients and primary care providers.Conclusion: There was considerable delay from self-detection of symptoms to cancer specific primary treatment of breast cancer. We found lack of awareness among patients as well as in primary care providers to be the major concern for delay. Awareness among the target population and health care professionals would have to be improved for early diagnostics and access to care.

BACKGROUND AND OBJECTIVES: All the four serotypes of dengue virus are found in our country. Case fatality rates in endemic countries like India are 2.5%. During epidemics of dengue, attack rates among susceptible are 40-90%. Early recognition and prompt treatment are vital if disease related morbidity and mortality are to be limited. Clinical features that can be used in the initial assessment of febrile patients are essential tools for clinicians, especially in limited resource settings. Awareness of bradycardia as a clinical finding, could help in the early recognition of dengue and potentially reduce complications and death. METHOD AND RESULTS: The study was conducted in the Department of Medicine, Mysore Medical College & Research Institute, Mysore from the period of July 2010 to December 2010 who met the inclusion and exclusion criteria. A total of 100 patients of Dengue fever were analyzed. The most common age group affected in our study was 20-39 years (53%). The clinical spectrum of cases included 22% cases of Dengue fever (DF), 72% cases of Dengue Hemorrhagic fever (DHF), 6% cases of Dengue Shock Syndrome (DSS). Clinical pulse rate distribution amongst cases showed 27% with bradycardia, 61% with relative bradycardia, and 12% with tachycardia. Electrocardiographic changes in our study showed 37% with sinus bradycardia, 48% with normal sinus rhythm, 1% with first degree heart block, and 14% with sinus tachycardia. CONCLUSION: Bradycardia was a predominant occurrence amongst total of 100 cases of Dengue fever analyzed. 88% of the cases had bradycardia. (61% had relative bradycardia and 27% bradycardia. Majority of the patients on ECG showed sinus bradycardia (37%) and normal sinus rhythm (48%). Hence, awareness of bradycardia as a clinical finding, can help in the early recognition of dengue and potentially reduce complications and death associated with dengue virus infection.

Background: Oral cancer is one of the major health problems in India. Patient delay in seeking medical help usually contributes to late stage at diagnosis, high mortality and low survival. Our study aims to find the time span from first onset of oral cancer symptoms to cancer specific primary treatment.Methods: A cross-sectional study was carried out from October 2015-September 2016 in one of the tertiary care cancer center in Bangalore. Histopathologically confirmed 212 incident oral cancer patients were interviewed using a pre-tested semi structured questionnaire.Results: The median time span between onset of symptoms and seeking medical care was 60 [IQR 30, 104] days, the median time between seeking medical care and diagnosis was 30 [IQR 15, 90] days, and the median time between diagnosis and initiation of treatment was 20 [IQR 12, 33] days.Conclusions: There is considerable delay in seeking cancer specific primary treatment among oral cancer patients. Efforts should be undertaken to increase awareness in the population and all stakeholders regarding symptoms and improve early diagnostics and access to care.