Physical activity in prevention of cancer and better prognosis

Cancer is a multifactorial disease with genetic and environmental risk factors. Environmental factors may also be termed as modifiable risk factors and these contribute towards 35% of cancer related mortalities as reported by World Health Organization. Obesity is the leading risk factor in this regard, causing not only deaths due to cancer but also to many other diseases. Among different factors causing obesity, a major contributor is lack of physical activity. In this era of modern technology and digitalization, sedentary mode of life has become a part of life and is mostly unavoidable. At the same time, there is a rise in the incidence of cancer. In the olden times, people used to do all manual work, a lot of walk, exercise and had healthy life style. Such healthy life style may have prevented them from various diseases.             Physical activity as a therapy on daily basis, is associated with a reduction in incidence of various carcinomas. It may improve overall wellbeing of healthy people as well as diseases persons from various ailments. As it is a common proverb that, “prevention is better than cure”, physical activity serves as a preventive measure for various diseases and also for fitness of normal healthy people. Although it is a known fact, yet planned population studies are required to provide evidence. Instead of unorganized physical activities, a structured physical activity may help in improvement of condition of cancer patients, prevention of cancer, cancer related deaths as well we quality of life. Healthcare providers should guide the patients in this regard.             There is lack of awareness among physicians and mostly they don’t refer them to physical therapists. There is also lack of information regarding the implementation of the programs and regimens of physical exercises for different diseases and cancers. Physical therapists may guide the patients in terms of frequency, intensity, duration of exercises which may serve as a betterment of their condition.

The Use of Mcv and Mch to Screen for Iron Deficiency in Pregnancy Among Women With Normal Haemoglobin Values

Background: Worldwide the commonest cause of anaemia is inadequate nutritional supply manifest as iron deficiency. Iron deficiency affects 25% of the world’s population and up to 50% in the developing world. Most susceptible are women of child bearing age and infants. In pregnancy most iron deficiency is detected when there is already resultant anaemia by measuring the haemoglobin content. It is important to develop a tool that could pick out women who are iron deficient before anaemia ensues. This study aims to determine the predictive ability of red cell mean corpuscular haemoglobin (MCH) and mean corpuscular volume (MCV) in screening for iron deficiency in pregnancy. Objectives: This study was conducted to determine the diagnostic reliability of MCV and MCH in screening for iron deficiency among pregnant women with normal haemoglobin. The study also determined the prevalence of iron deficiency in the pregnant population without anaemia. Study design: This was a descriptive cross-sectional study. Methods: One hundred and fifty five pregnant women presenting to the antenatal clinic at the Aga Khan University Hospital, Nairobi, before 20 weeks gestational age were enrolled. Blood samples were analysed for haemoglobin, red cell indices and serum ferritin levels. Those whose haemoglobin was above 10.5g/dL underwent correlation of MCH and MCV against serum ferritin. The serum ferritin below 15ng/ml was considered representative of iron deficiency. The cut-off points for MCV and MCH were 80fL and 27pg respectively values below which were considered to represent iron deficiency. Results and analysis: The prevalence of anaemia in the study population was found to be 8%. Of the women whose haemoglobin was normal (above 10.5g/dL) the prevalence of iron deficiency as measured by serum ferritin was 31.5%. MCH had a sensitivity of 77.8% (95% CI 66.3 to 86.6) and a specificity of 68.4% (95% CI 63.1 to 72.4). The MCV had a sensitivity of 46.7% (95% CI 35.8 to 56.8) and a specificity of 84.7% (95% CI 79.7 to 89.2). Both tests were useful as negative predictors when considered in the screening for iron deficiency in pregnancy. Conclusion: The prevalence of iron deficiency is high among pregnant women who have normal haemoglobin values. The red cell indices, MCH and MCV have some value in assuring that iron deficiency is unlikely when they are normal. This might be important in clinical units that practice selective supplementation with haematinics in the obstetric population so as to avoid unnecessary iron therapy which has