Knowledge,Attitudes, and Practices Regarding Cervical Cancer Screening among Omani Women Attending Primary Healthcare Centers in Oman: A Cross-Sectional Survey

Background:This study aimed to assess knowledge, attitudes, and practices regarding cervical cancer, cervical cancer screening, and Papanicolaou (Pap) smear testing among Omani women attending primary healthcare centers in Oman, and to establish a correlation with various sociodemographic characteristics. Methods:A multi-center cross-sectional survey was carried out from August 2019 to January 2020 and included 805 women attending 18 primary healthcare centers. A pre-tested questionnaire was utilized to assess the participants’ sociodemographic characteristics, cervical cancer risk factors, knowledge, attitudes, and practices related to cervical cancer, cervical cancer screening, and Pap smear testing. Results:All 805 women participated in the study (response rate: 100%). Overall, 67.5% and 50.9% had heard of cervical cancer and Pap smear testing, respectively; however, only 13.4% and 10.9% demonstrated high levels of knowledge concerning these topics. Knowledge was significantly associated with educational level, type of educational qualification (i.e. if their degree was related to healthcare), monthly income, and employment status (p ≤ 0.05 each). Only 15.7% of the participants had previously undergone Pap smear testing, although 42.7% were willing to undertake such screening in future. No associations were noted between Pap smear practice or willingness and sociodemographic characteristics, family history of cervical cancer or personal history of cervical cancer or related risk factors. Conclusions:Knowledge regarding cervical cancer and Pap smear testing was suboptimal among a cohort of Omani women attending primary healthcare centers in Oman. This may be a factor behind the increased number of cervical cancer cases in Oman; as such, a well-structured awareness and educational program is needed to address this issue.Key Words: Cervical cancer, papanicolaou test, screening- knowledge, attitudes, practice, Oman     

Combined gemfibrozil (peroxisome proliferator-activated receptor alpha agonist) with reduced steroid dose gives a similar management picture as the full steroid dose in a rat adjuvant-induced arthritis model

Abstract

Objectives: The study aimed to evaluate the efficacy of combined gemfibrozil with prednisolone in the management of adjuvant-induced arthritis (AIA) rat model.

Methods: Seventy two adult male Wistar albino rats were divided equally into 1-control group, three diseased groups: 2- Adjuvant induced arthritis (AIA), 3- high fat diet (HF), and 4- combined AIA-HF, and treated groups: 5- gemfibrozil 30?mg/kg treated AIA group (AIA-G) and the combined AIA-HF treated groups: 6- prednisolone equivalent to human 10?mg (AIA-HF-P10), 7- prednisolone equivalent to human 5?mg (AIA-HF-P5) 8- gemfibrozil (HF-AIA-G) and 9- combined treatment (HF-AIA-G-P5)

Results: HF diet represents a precipitating factor for knee arthritis. Gemfibrozil improved the inflammatory findings in both AIA and AIA-HF groups. Combined administration of gemfibrozil with reduced steroid dose gave a similar therapeutic effect to the full steroid dose. Fortunately, we reported more reduction in the nuclear factor kappa-B (NF-κB) and high mobility group box 1 (HMGB1) in the HF-AIA-G-P5 compared with the HF-AIA-P10 group. The improvement was proved by the histological findings.

Conclusion: Combined reduced prednisolone dose with gemfibrozil potentiates its anti-inflammatory activity. This could be a target in the management of rheumatoid arthritis.     

Synthesis, in vitro anticancer screening and radiosensitizing evaluation of some new 4-[3-(substituted)thioureido]-N-(quinoxalin-2-yl)-benzenesulfonamide derivatives

Sulfonamides and quinoxaline derivatives possess many types of biological activities and have been recently reported to show substantial antitumor activity. This paper reports the synthesis of novel thioureido sulfaquinoxaline derivatives. All the newly synthesized compounds were evaluated for their in vitro anticancer activity against a human liver cell line (HEPG2) and showed higher activity than the reference drug doxorubicin. 4-(3-(4-Ethylbenzoate) thioureido)-N-(quinoxalin-2-yl)benzenesulfonamide (9) (IC?? = 15.6 μmol L?1), N-(pyridin-2-yl)-4-(3-(4-(N-quinoxalin-2-yl-sulfamoyl)phenyl)thioureido)benzenesulfonamide (10) (IC?? = 26.8 μmol L?1) and N-(quinoxalin-2-yl)-4-(3-(4-(N-thiazol-2-ylsulfamoyl)phenyl)thioureido)benzenesulfonamide (11) (IC?? = 24.4 μmol L?1) were the most potent compared to doxorubicin (IC?? = 71.8 μmol L?1). The most potent compounds 9, 10 and 11 were evaluated as radiosensitizing agents by subjecting the compounds to γ-irradiation (8 kGy).     

Synthesis of novel pyrazole and pyrimidine derivatives bearing sulfonamide moiety as antitumor and radiosensitizing agents

Several novel pyrazole 10–16 and pyrimidine 17–19 derivatives bearing Sulfonamide moieties were synthesized in order to study their antitumor activity. The synthesized compounds were characterized by elemental analysis, IR, ¹H-NMR, and mass spectral data, then screened as antitumor agents against human tumor liver and breast cell lines (HEPG2 and MCF7). All the tested compounds were more potent than the reference drug doxorubicin on human liver (HEPG2) cell line, while on human breast cancer (MCF7) cell line, they were less potent than the reference drug. Additionally, some of the synthesized compounds were evaluated for their ability to enhance the cell killing effect of γ-radiation.     

Bone morphogenetic protein-2 will be a novel biochemical marker in urinary tract infections and stone formation

ObjectivesTo investigate the role of bone morphogenetic protein-2 (BMP-2) in patients with urinary tract infection (UTI) and renal stone in relation to Tamm–Horsfall protein (THP) and osteopontin (OPN).Design and methodsELISA kits were used to determine these markers in serum and urinary samples of 20 patients with UTI, 15 with renal stone and 10 controls.ResultsBMP-2 significantly increased in serum of patients who had UTI (P = 0.05) and renal stone (P = 0.01). In the case of UTI, serum BMP-2 at cutoff 44 pg/mL had sensitivity and specificity (92%, 80%), while cystatin C at cutoff 525 ng/mL showed sensitivity and specificity (85%, 91%). THP is a good predictor of renal diseases (P < 0.001) by regression analysis. It is also the most sensitive urinary marker for UTI with sensitivity and specificity (94%, 75%) at cutoff 305 ng/mL.ConclusionCombination of serum BMP-2 and cystatin C are more sensitive and accurate for early diagnosis of renal infection and damage.     

Malathion exposure and insulin resistance among a group of farmers in Al-Sharkia governorate

Objectives

Exposure to certain environmental toxins may be associated with increased risk of developing diabetes mellitus. The aim of the present study was to investigate the relation between chronic exposure to malathion and insulin resistance among farmers.

Design and methods

The study included 98 non diabetic farmers who handle agricultural insecticides during their field work. The range of the exposure period for agricultural pesticides was 15–20 years. All farmers were males with mean age 39 ± 12 years. Another 90 administrative employees at Zagazig University Hospitals, non diabetic males age matched were selected as controls. History taking including family history for diabetes, assessment of blood pressure, height, weight, waist circumference and body mass index was done for all participants. Blood samples were withdrawn for measurement of malathion concentration, fasting blood glucose level and fasting insulin level for calculation of homeostasis model assessment of insulin resistance (HOMA-IR).

Results

24.5% had positive family history for diabetes. It was observed that there was a significant increase in the mean values of malathion blood concentration among studied farmers compared to corresponding controls. There was a positive correlation between malathion blood concentration, waist circumference and insulin resistance. It was also observed that the increase in the mean values of waist circumference and body mass index was accompanied by a significant increase in the mean values of malathion blood concentration.

Conclusion

The current results suggested that chronic exposure of non diabetic farmers to organophosphorus malathion pesticides may induce insulin resistance. This effect tended to strengthen as waist circumference increases.     

Urinary retinoic acid receptor-β2 gene promoter methylation and hyaluronidase activity as noninvasive tests for diagnosis of bladder cancer

ObjectivesWe evaluated the significance of urinary retinoic acid receptor-β2 (RAR-β2) gene promoter methylation and hyaluronidase activity in comparison with voided urine cytology (VUC) in diagnosis of bladder cancer.Design and MethodsThis study included 100 patients diagnosed with bladder cancer, 65 patients with benign urological disorders and 51 healthy volunteers. Urine supernatant was used for determining hyaluronidase activity by zymography while urine sediment was used for cytology and detection of methylated RAR-β2 gene promoter by methylation specific nested PCR.ResultsThe sensitivity and specificity were 53% and 90.5% for VUC, 65% and 89.7% for percent methylation fraction of RAR-β2 gene promoter, and 89% and 90.5% for hyaluronidase activity; combination of the three parameters increased sensitivity to 95%. A significant association was observed between investigated markers and advanced grade tumor.ConclusionsCombined use of RAR-β2 gene promoter methylation, hyaluronidase activity and VUC is promising non-invasive tool for bladder cancer detection.     

The role of cyclins and cyclin dependent kinases in development and progression of hepatitis C virus-genotype 4-associated hepatitis and hepatocellular carcinoma

Altered cell cycle regulatory genes expression contributes to HCV-associated liver disease. We sought to assess the role of cyclins and cyclin dependent kinases (CDKs) in HCV-associated CH and HCC.Aberrant expression of cyclins A, E, D1, CDK2 and CDK4 was assessed by immunohistochemistry and differential PCR in HCV-associated CH and HCC with pericarcinomatous foci (PCF). S phase fraction (SPF) was determined by flow cytometry. Results were correlated with overall survival (OS) in HCC patients.In HCC, cyclins A, E, D1, CDK2 and CDK4 protein overexpression was detected in 52.8%, 52.8%, 69%, 47% and 58% compared to 36.1%, 33%, 56%, 27.8%, 55.6% for CH and 36.1%, 27%, 30.6%, 27%, 50% for PCF. Gene amplification was detected in 38.9%, 33% 66%, 33%, 44% of HCC compared to 27.8%, 25%, 44%, 27.8%, 36% in CH and 25%, 22.2%, 38.9%, 27%, 33% in PCF. A significant difference was reported between HCC, CH, NHT regarding cyclins A, E, D1, CDK2 (p = 0.007, p = 0.002, p = 0.047, p = 0.002) protein expression (ADD) and cyclin D1 amplification (p = 0.009). Cyclins A, E, CDK2 expression was associated with fibrosis in CH (p = 0.004, p = 0.02, p = 0.012). Reduced OS was (ADD) associated with cyclin D1 and cyclin A, grade, stage and metastasis (p = 0.001, p = 0.02, p = 0.018, p = 0.01, p = 0.001).

Conclusions

Increased cyclins A, E, D1, CDK2 and CDK4 expression is important for HCV-associated CH and HCC. Cyclin D1 and cyclin A are prognostic biomarkers associated with reduced OS in HCC. Cyclin D1 aberration could identify high risk groups of CH patients prone to develop HCC.