This study was to evaluate the prevalence of iron deficiency anemia and the associated factors of anemia during pregnancy in the lower north of Thailand. A prospective study was conducted in pregnant women who attended the antenatal care clinic at Naresuan University hospital, Phitsanulok, from May 2008 - May 2010. All subjects were from the lower northern region of Thailand. A complete blood count and serum ferritin was performed in every case. Anemia during pregnancy was defined according to World Health Organization criterion as the hemoglobin less than 11 g/dL. Iron deficiency anemia was the anemia with a serum ferritin of less than 15 mg/L. Four hundred and one pregnant women were recruited for the study. Teenage pregnancy was 27%. The gestational age at the first visit ranged from 5 to 38 weeks and the iron supplement was found in 30% of cases. Anemia was found in 70 cases (17.5%). Twenty-four cases (6.0% of 401) had iron deficiency anemia but 61 cases were at the stage of iron deficient erythropoiesis without anemia. Associated factor for iron deficiency anemia was gestational age. This study confirmed a high prevalence of anemia and iron deficiency anemia. High proportion of pregnancies with iron deficient erythropoiesis was warranted.

Aged ; Dental Health Services ; standards ; Health Services for the Aged ; standards ; Humans ; Nursing Homes ; Oral Health ; Singapore

Objective: The study examines the effectiveness of a CBT treatment programme over and above that of Treatment As Usual (TAU), with children who were referred to an outpatient child psychiatric clinic for disruptive behaviour disorders in Singapore. Methods: One hundred and three children aged 8 to 12 (mean±SD=10.22±1.31) who participated in the study were assigned to either the CBT+TAU (n= 51) or TAU group (n=52). Children in both the CBT+TAU and TAU groups received a standard and typical service offered to children at the outpatient child psychiatric clinic. In addition, children in the CBT+TAU group attended the CBT treatment programme that consisted of nine 1.5 hour weekly sessions. Results: Findings from ANCOVA indicated that children in the CBT+TAU treatment group showed significantly lower levels of aggression and significantly lower levels of parental stress at posttreatment and at 3-month follow-up in comparison to the TAU group. Conclusions: Findings from the present study provided some evidence of the effects of CBT in reducing aggressive behaviour and parental stress among children with disruptive behaviour disorders. Interpretation of the findings, recommendations for future research, and implications of the present study were presented.

INTRODUCTION: The occurrence of malignant tumors associated with leprosy has been observed, with lymphoma being the most commonly associated non-epithelial malignant tumor and may be due to the depressed immunologic surveillance. The converse where leprosy manifests in a lymphoma patient undergoing chemotherapy has also been mentioned in a few articles. CASE SUMMARY: A 49-year-old female was diagnosed to have peripheral T-cell lymphoma after an initial presentation of enlarged lymph nodes, generalized asymptomatic papules and plaques on the trunk, and pancytopenia. Two weeks after initiation of chemotherapy with cyclophosphamide, doxorubicin, vincristine, prednisolone (CHOP), her skin lesions progressed to become violaceous to slightly hyperpigmented. Further query revealed a year-long history of hypoesthesia of the lower extremities. Histopathologic examination revealed nodular histiolymphocytic infltrates surrounding blood vessels, adnexal structures, and nerves, consistent with lepromatous leprosy. Fite-Faraco stain was positive. Due to lymphoma-related pancytopenia, the patient was given monthly rifampicin, ofoxacin and minocycline (ROM) chemotherapy, alternatively. Erythema nodosum leprosum reaction developed for which clofazimine was given, resulting in improvement. CONCLUSION Leprosy is a great mimicker and dermatologists need to be adept at diagnosing skin conditions in immunocompromised patients, especially since disease course and manifestation may be modifed in this subset of patients. Leprosy must be considered when granulomatous lesions arise in lymphoma patients before ascribing them to the underlying disease. Management may also be challenging due to the comorbidities, which may limit treatment options. Careful history, clinical clues, histopathologic correlation, and prudent therapeutic approach are important tools in addressing these cases.

Carcinoma ; diagnostic imaging ; secondary ; Humans ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; pathology ; Pancreatic Neoplasms ; diagnostic imaging ; secondary ; Ultrasonography