Fasting and Cancer: Practice and Patients’ Quality of Life during Ramadan

Introduction: Ramadan is the ninth lunar month of the Muslim calendar, and fasting during Ramadan is one of the five pillars of Islam. Muslim cancer patients and health professionals are faced with a dilemma between the necessity of fasting and its possible adverse effects during Ramadan on the health status of cancer patients. We believe that addressing the issue of fasting in cancer patients is of global interest. Objectives: Prevalence of fasting in cancer patients during Ramadan;Predictive factors of Ramadan fasting in cancer patients;The effect of fasting during Ramadan on the quality of life of cancer patients. Materials and Methods: A structured questionnaire was used to interview adult cancer patients who received chemotherapy IV—or oral treatment at the medical oncology department at the Hassan II University Hospital in Fez during the month of Ramadan 1443 Hijri (April to May 2022). The quality of cancer patients’ lives during their fasting practice in Ramadan was evaluated via the QLQ-C30 questionnaires. Results: 48% of patients did not fast during Ramadan, 22% and 30% were partial and complete fasters respectively. Patients, with OMS 0 to 1, who receive outpatient treatment, non-metastatic patients and patients on oral treatment were more frequent in the completely fasted group. All these factors showed statistically significant values (p < 0.05). 44% of patients sought advice from the treating oncologist if they could fast, while only 15% of patients during Ramadan asked an imam if they could be excused from fasting. A comparison of the QLQ-C30 data showed a significant improvement in emotional functioning with fasting, however, patients had clinically more but not significantly fatigue after fasting. Conclusion: Female gender, good WHO, non-metastatic disease, and oral or outpatient treatment were more likely to be fasting. This study argues that fasting did not influence the quality of life, and appears to significantly improve emotional functioning in cancer patients during Ramadan.

SARS-COV-2 Rapid Antigen Test in Comparison with RT-PCR for Laboratory Diagnosis of COVID-19 in a Southwest State of Nigeria

Objectives: Rapid and accurate identification of persons infected with SARS-CoV-2 which causes COVID-19 is key to managing the pandemic. The urgent need to scale up access to COVID-19 testing in Nigeria has led to the government’s introduction of the use of COVID-19 Ag rapid diagnostic test (RDT) across various settings in the country. However, field performance evaluation of the rapid SARS-CoV-2 antigen detection test is required to be conducted periodically and compared with the gold standard real-time reverse transcription-polymerase chain reaction (RT-PCR) test for diagnosis of COVID-19 cases. Design: A prospective COVID-19 screening and un-blinded verification of the performance of the STANDARD Q COVID-19 Ag test kit. Setting: The rapid SARS-CoV-2 antigen detection test, StandardTM Q COVID-19 Ag kit was compared with the RT-PCR test for detection of SARS-CoV-2 in nasopharyngeal samples for COVID-19 screening from persons and personnel attending a national youth camp orientation exercise during the second wave of the COVID-19 outbreak (January to March 2021) in Ondo state, southwest Nigeria. Participants: Three hundred fifty-one persons and personnel were screened for COVID-19 infection. Results: Of 351 respondents screened, 68 (19.4%) were positive, and 264 (75.2%) were negative for both COVID-19 Ag RDT and RT-PCR assay. The rapid SARS-CoV-2 antigen detection test’s sensitivity and specificity were 78.16% (95% CI = 68.02% - 86.31%) and 100.0% (95% CI = 98.61% - 100.0%), respectively and the diagnostic accuracy was 94.59% (95% CI: 92 - 97). Respondents that were symptomatic had a higher test sensitivity of 78.6% (49.2 - 95.3) compared to those without symptoms 78.1% (66.9 - 86.9) (p Conclusions: Our study shows evidence that StandardTM Q COVID-19 Ag kit can be an appropriate rapid antigen test that could be used to screen for positive COVID-19 tests to guide decision-making for clinical management of persons infected with COVID-19, especially for closed settings and other clinical care settings.

Determinants of internet addiction among medical students in Casablanca: a cross-sectional study

Objective:This study aimed to estimate the prevalence and determinants of Internet addiction among medical students at the Faculty of Medicine and Pharmacy of Casablanca,Morocco.Methods:This was a cross-sectional study conducted among students at the Faculty of Medicine and Pharmacy in Casablanca between October and March 2020.An online questionnaire was administered to students to collect data and internet addiction was assessed by the Young questionnaire.A score threshold≥50 was adopted to define addiction.Univariate and multivariate logistic regression analyses were used to identify factors associated with internet addiction.Results:Out of a total of 4093 FMPC students enrolled in the 2020-2021 academic year,506 agreed to participate in this study,including 303 females and 203 males.The mean addiction score assessed on the Young scale was(49.08±16.11).The prevalence of Internet addiction was 44.5%(225/506,95% CI:40% to 49%).Multiple regression analysis showed that being older than 20 years(OR=0.17,95% CI:0.40 to 0.64),being female(OR=1.70,95% CI:1.04 to 2.78),being in the dissertation year(6th year)(OR=5.17,95% CI:2.23 to 11.44),having a history of psychiatric consultation(OR=2.64,95% CI:1.34 to 5.21),having divorced parents(OR=2.64,95% CI:1.05 to 5.87),use of sleeping medication(OR=2.9,95% CI:1.05 to 3.70),sleep disorders(OR=2.06,95% CI:1.25 to 3.79),sleep deprivation(OR=2.26,95% CI:1.39 to 3.65),excessive daytime sleepiness(OR=5.39,95% CI:2.19 to 13.24),anxiety disorders(OR=1.47,95% CI:1.18 to 2.30),duration of internet connection(>4 h)(OR=11.43,95% CI:4.85 to 27.66),and having frequent conflicts with parents(OR=2.37,95% CI:1.49 to 3.79)and friends(OR=0.26,95% CI:0.11 to 0.65)were independently associated with internet addiction.Conclusion:The prevalence of Internet addiction among medical students in Casablanca remains high.Targeted action on the determinants would be of great value in prevention.

Factors Associated with Non-Adherence to Treatment in Sickle Cell Patients Monitored at the National Reference Center for Sickle Cell Disease in Niger

Introduction: Sickle cell disease is a real public health problem in the world and particularly in Niger where the prevalence of the S gene is estimated at 25% and that of the homozygous forms at between 1% and 2%. Treatment combines quarterly follow-up of patients and management of complications. The objective of this study was to identify the potential explanatory factors of non-adherence to treatment in sickle cell patients followed at the national reference center for sickle cell disease in Niger. Methods: This is a cross-sectional study of sickle cell cases followed at the CNRD in Niger. The population consisted of all sickle cell patients followed in this center in 2021. The data collection techniques were individual interviews and documentary reviews. Non-adherence was assessed with the Girerd test. Descriptive statistical tests and simple and multiple logistic regression models were performed. Results: A total of 368 patients were enrolled. The median age is 7 years (4;10) and the sex ratio is 1.04. Ninety-eight (98) or 26.6% were compliant and 270 (73.4%) were non-compliant. In multivariate analysis, the factors independently and negatively associated with non-adherence to treatment were schooling (adjusted OR [95% CI], p-value), 0.17 [0.10 - 0.30];p Conclusion: The factors influencing treatment compliance identified in this study are all modifiable. To prevent the complications of sickle cell disease, we must fight against ignorance, make care services accessible and make care free.

TIF3转基因CHO和COS7细胞株的构建与鉴定

[目的 ]TIF3(MouseTranslationInitiationFacfor 3)是从镉转化BALB/c 3T3细胞中克隆出来的新基因 ,其在基因文库 (Gen Bank)的新添编号为AF2 710 72。为了对该基因的生物学功能进行研究 ,构建了TIF3转基因CHO和COS7细胞株并作了鉴定。[方法 ]采用磷酸钙介导转染技术和G418细胞筛选法 ,以pcD NA3 1/V5 His TOPO为表达载体 ,构建TIF3转基因CHO和COS7细胞株 ;应用WesternBlot技术对转基因表达产物进行分析与鉴定。实验设计分无转染组 (空白对照 )、载体转染组 (载体对照 )和目的基因转染组 (载体 +TIF3cDNA )。 [结果 ]结果显示 ,无论在CHO细胞还是COS7细胞 ,经转染和G418筛选后 ,无转染组的细胞 10 0 %死亡 ,而载体转染组和TIF3cDNA转染组的细胞形成较多的细胞集落。提示克隆化基因的细胞转染及G418筛选效果良好。经WesternBlot分析与鉴定 ,在 7株转染和经G418反复筛选的CHO细胞株中 ,有 3株具有高效稳定表达约 36kDa的TIF3编码蛋白质 ;在 4株转染和经G418反复筛选的COS7细胞株中有 2株也具有高效稳定的TIF3编码蛋白质表达 ,而无转染组和载体对照组的CHO和COS7细胞均缺乏此蛋白质表达。 [结论 ]本研究成功地构建了 3株TIF3转基因CHO细胞株和 2株TIF3转基因COS7细胞株。这两类TIF3转基因哺乳动物细胞稳定?

镉相关翻译启动因子TIF3致Ras癌基因蛋白的异常表达

目的研究镉相关翻译启动因子TIF3对多种细胞肿瘤相关基因表达的影响,探索镉的分子致癌机制。方法应用TIF3基因真核细胞稳定表达系统和Westernblot检测技术,用各种单克隆抗体检测细胞肿瘤相关基因蛋白的表达情况。结果相对于载体转染中国仓鼠卵巢(CHO)对照细胞,在4株具有高效稳定表达TIF3编码蛋白质的CHO细胞系中均有pan-ras癌基因蛋白异常表达,其编码蛋白(21kDa)含量均明显高于对照组;其余肿瘤相关基因蛋白如c-myc,c-jun,MDM2,ODC,p16,p53,CyclinD1的表达蛋白在TIF3转基因细胞与对照细胞之间未见明显差别。结论镉相关翻译启动因子TIF3是一种镉应答原癌基因,TIF3的超额表达可导致Ras癌基因蛋白异常表达,这可能是镉应答原癌基因TIF3的分子致癌机制。

硅转化BALB/c-3T3细胞基因组DNA异常甲基化的研究

目的 对硅转化细胞基因组DNA异常甲基化进行研究 ,探讨硅的表遗传致癌机制。方法 从结晶型硅 (Si)转化BALB/c 3T3细胞中提取基因组DNA ,经Mse1(甲基化非敏感性酶 )单独消化或Mse1和BstU1(甲基化敏感性酶 )联合消化 ,消化产物用甲基化敏感性内切酶指纹法 (MSRF)进行分析 ,差异显示出异常甲基化基因片段 ,进一步将异常甲基化DNA片段亚克隆和序列测定 ,再与基因文库中的基因进行类比分析。结果 发现硅转化细胞存在 6条异常甲基化DNA(其中 1条为高甲基化 ,5条有低甲基化现象 ) ,序列测定显示这些异常甲基化基因片段似乎来源于一些RNA转录和蛋白质翻译等基因家族。结论 DNA异常甲基化会导致基因表达激活或抑制 ,因此硅转化细胞基因组某些功能基因DNA异常甲基化导致的异常表达 。

Intention of healthcare workers to accept COVID-19 vaccination and related factors:A systematic review and meta-analysis

Considering medical and economic burden of coronavirus disease 2019(COVID-19), a high COVID-19 vaccination coverage among healthcare workers(HCWs) is an urgent need. The aim of this systematic review and meta-analysis was to evaluate the intention of HCWs to accept COVID-19 vaccination and to identify related factors. We searched Pub Med, MEDLINE, Scopus, Web of Science, Pro Quest, CINAHL and med Rxiv until July 14, 2021. The heterogeneity between results was very high;thus, we applied a random effects model to estimate pooled effects. We performed subgroup and meta-regression analysis to identify possible resources of heterogeneity. Twenty four studies, including 50 940 HCWs, met the inclusion criteria. The overall proportion of HCWs that intend to accept COVID-19 vaccination was 63.5%(95% confidence interval: 56.5%-70.2%) with a wide range among studies from 27.7% to 90.1%. The following factors were associated with increased HCWs’ willingness to get vaccinated against COVID-19: male gender, older age, white HCWs, physician profession, higher education level, comorbidity among HCWs, vaccination against flu during previous season, stronger vaccine confidence, positive attitude towards a COVID-19 vaccine, fear about COVID-19, individual perceived risk about COVID-19, and contact with suspected or confirmed COVID-19 patients. The reluctance of HCWs to vaccinate against COVID-19 could diminish the trust of individuals and trigger a ripple effect in the general public. Since vaccination is a complex behavior, understanding the way that HCWs take the decision to accept or refuse COVID-19 vaccination will give us the opportunity to develop the appropriate interventions to increase COVID-19 vaccination uptake.

Walking-friendly built environments and objectively measured physical function in older adults

Background:Few studies have examined the associations between urban design attributes and older adults’physical function.Especially,it is not well known how built-environment attributes may influence physical function in Asian cities.The aim of this study was to examine associations between objectively measured environmental attributes of walkability and objectively assessed physical function in a sample of Japanese older adults.Methods:Cross-sectional data collected in 2013 from 314 older residents(aged 65-84 years)living in Japan were used.Physical function was estimated from objectively measured upper-and lower-body function,mobility,and balance by a trained research team member.A comprehensive list of built-environment attributes,including population density,availability of destinations,intersection density,and distance to the nearest public transport station,were objectively calculated.Walk Score as a composite measure of neighborhood walkability was also obtained.Results:Among men,higher population density,availability of destinations,and intersection density were significantly associated with better physical function performance(1-legged stance with eyes open).Higher Walk Score was also marginally associated with better physical function performance(1-legged stance with eyes open).None of the environmental attributes were associated with physical function in elderly women.Conclusion:Our findings indicate that environmental attributes of walkability are associated with the physical function of elderly men in the context of Asia.Walking-friendly neighborhoods can not only promote older adults’active behaviors but can also support their physical function.

Differences in transportation and leisure physical activity by neighborhood design controlling for residential choice

Background:Cross-sectional studies provide useful insight about the associations between the built environment and physical activity(PA),particularly when reasons for neighborhood choice are considered.Our study analyzed the relationship between levels of weekly transportation and leisure PA among 3 neighborhood designs,statistically adjusting for sociodemographic characteristics and reasons for neighborhood choice.Methods:A stratified random sample of adults(age>20 years)living in Calgary(Canada)neighborhoods with different neighborhood designs(grid,warped-grid,and curvilinear)and socioeconomic status completed a self-administered questionnaire capturing PA,sociodemographic characteristics,and reasons for neighborhood choice(response rate=10.1%;n=1023).Generalized linear models estimated associations between neighborhood design and transportation and leisure PA outcomes(participation(any vs.none)and volume(metabolic equivalent:h/week)),adjusting for neighborhood socioeconomic status,sociodemographic characteristics(gender,age,ethnicity,education,household income,marital status,children,vehicle access,dog ownership,and injury),and reasons for neighborhood choice(e.g.,proximity and quality of recreational and utilitarian destinations,proximity to work,highway access,aesthetics,and sense of community).Results:Overall,854 participants had resided in their neighborhood for at least 12 months and provided complete data.Compared with those living in curvilinear neighborhoods,grid neighborhood participants had greater odds(p<0.05)of participating in any transportation walking(odds ratio(OR)=2.17),transportation and leisure cycling(OR=2.39 and OR=1.70),active transportation(OR=2.16),and high-intensity leisure PA(≥6 metabolic equivalent;OR=1.74),respectively.There were no neighborhood differences in the volume of any transportation or leisure PA undertaken.Adjustment for neighborhood selection had minimal impact on the statistical or practical importance of model estimates.Conclusion:Neighborhood design is associated with PA patterns in adults,independent of reasons for neighborhood choice and sociodemogranhic factors.

Outcome of Epidemiological Investigation of COVID-19 Outbreak in a South West State of Nigeria, March to August 2020

Background: On 3rd April 2020, an outbreak of Coronavirus disease-2019 (COVID-19) was confirmed in Ondo State, Southwest Nigeria. Field investigations were conducted by the State Ministry of Health (MoH) to identify and confirm additional cases. This paper provides the outcome of the epidemiological investigation of the outbreak to further guide outbreak response activities. Methods: Field epidemiology methods coordinated by the State Public Health Emergency Operations Center (PHEOC) were used in the outbreak investigation. Suspected cases were reported through the routine Integrated Disease Surveillance and Response (IDSR) network in the State. Also, active case search/finding to communities and health facilities using the operational case definitions was conducted. Furthermore, the state COVID-19 emergency call center was established with toll-free phone number provided to members of the public to call-in to report suspected persons with symptoms consistent with the COVID-19 operational case definition (signal). All cases reported were investigated with nasopharyngeal sample collected and confirmatory testing for COVID-19 done by real-time polymerase chain reaction (RT-PCR) in a national reference laboratory. Information of each case investigated was documented using the COVID-19 case investigation form and COVID-19 line-list which captured socio-demographic characteristics, history of exposure to COVID-19, presenting symptoms, travel history and sample collection details. Data were extracted from the case investigation form and line list and analyzed using SPSS version 20, with a p-value set at < 0.05. Results: A total of 4353 suspected cases were reported and investigated, of which 1316 cases were confirmed between March 19, 2020 and August 9, 2020. The mean age of the confirmed cases was 37.8 ± 14.8 years. The highest proportion of COVID-19 cases and deaths occurred in the age group 20 - 39 years (50.6%) and ≥60 years (13.5%), respectively. More males (52.4%) were affected than females (45.8%). There were 404 (30.7%) healthcare workers infection. About a quarter (325;24.7%) of the cases was symptomatic and presented with key symptoms such as cough (98/325;30.2%) and fever (74/325;22.8%) during the investigation. A case fatality rate (CFR) of 2.2% was recorded in 7 of the 17 Local Government Areas (LGAs) where confirmed cases were reported in the State. Most of the confirmed cases, 1169 (88.8%) reside in urban LGAs of the State. The epidemic curve shows a propagated pattern of transmission with the outbreak reaching its peak on July 2, 2020. Significantly, higher proportion of death was recorded in the age group ≥ 60 years (14;13.5%) and among males (26;3.6%) (p < 0.001). Conclusions: Our investigation found high transmission of COVID-19 infection among urban residents (LGAs) and health care workers with high mortality among males in older age group in the State. Hence, we recommend intensified risk communication and use of community structures to ensure compliance with public health COVID-19 preventive protocols including enforcing infection prevention and control compliance, particularly among high-risk groups.

Identification of new genetic risk factors for prostate cancer

There is evidence that a substantial part of genetic predisposition to prostate cancer （PCa） may be due to lower penetrance genes which are found by genome-wide association studies. We have recently conducted such a study and seven new regions of the genome linked to PCa risk have been identified. Three of these loci contain candidate susceptibility genes： MSMB, LMTK2 and KLK2/3. The MSMB and KLK2/3 genes may be useful for PCa screening, and the LMTK2 gene might provide a potential therapeutic target. Together with results from other groups, there are now 23 germline genetic variants which have been reported. These results have the potential to be developed into a genetic test. However, we consider that marketing of tests to the public is premature, as PCa risk can not be evaluated fully at this stage and the appropriate screening protocols need to be developed. Follow-up validation studies, as well as studies to explore the psychological implications of genetic profile testing, will be vital prior to roll out into healthcare.

Impact of hepatitis C virus core mutations on the response to interferon-based treatment in chronic hepatitis C

AIM To determine whether hepatitis C virus(HCV) core substitutions play a role in the response to interferon-based treatment in Caucasian patients. METHODS One hundred eight HCV chronically infected patients initiating treatment with pegylated IFN plus ribavirin for 48 wk were tested for baseline substitutions at codons 70 and 91 of the viral core protein(Big Dye Terminator vers.3.1, Applied Biosystems,) and for genetic polymorphisms in host IL28 B gene rs12979860(Custom TaqM an 5' allelic discrimination assay; Applied Biosystems).RESULTS Of the patients, all were infected with HCV genotype 1b, 44.4% had low baseline HCV viral load, and 37.9% had mild/moderate fibrosis. Only 38.9% achieved therapeutic success, defined as sustained virological response(SVR). Eighty-eight percent of the patients presented at least one substitution at core position 70(R70Q/H) or/and position 91(L91M). The favorable IL28 B CC polymorphism was detected in only 17.6% of the patients. In the univariate analysis, young age(P < 0.001), urban residence(P = 0.004), IL28 B CC genotype(P < 0.001), absence of core mutations(P = 0.005), achievement of rapid virologic response(P < 0.001) and early virological response(P < 0.001) were significantly correlated with SVR. A multivariate analysis revealed three independent predictors of therapeutic success: young age(P < 0.001), absence of core substitutions(P = 0.04) and IL28 B CC genotype(P < 0.001); the model correctly classified 75.9% of SVR cases with a positive predictive value of 80.7%. CONCLUSION HCV core mutations can help distinguish between patients who can still benefit from the affordable IFNbased therapy from those who must be treated with DAAs to prevent the evolution towards end-stage liver disease.

Comparison of Essential Oil Composition,Phenolic Compound and Biological Activities of Salvia microphylla and Teucrium polium(Lamiaceae)

Salvia microphylla and Teucrium polium are medicinal and aromatic plants with ethnobotanical uses.The present study was conducted to investigate the chemical composition of Salvia microphylla and Teucrium polium essential oils,the secondary metabolites,and the biological activities of their infusion and methanolic(MeOH)extracts.Essential oils were extracted by hydrodistillation from shoots Salvia microphylla and Teucrium polium.Phenolic content,antioxidant and antimicrobial activities were determined.Gas chromatography-mass spectrometry(GCMS)results showed the presence of significant qualitative and quantitative variations for the composition of the both essential oils(EO).Salvia microphylla EO were most complex and present 70 compounds with the major components wereβ-caryophyllene(13.32%),1,8 cineole(11.25%),Cis p-Menthane-3-one(10.74%),andβ-Selinenol(9.71%).Where in the Teucrium polium EO,45 compounds were identified with the important components areβ-cadinene(10%),β-citronellol(8.5%),Carvacrol(7.63%),and Eugenol(7.15%).Obtained results showed that both plant are very rich in secondary metabolites.Extracts isolated from Salvia microphylla presented the highest contents in the phenolic compound than extracted from Teucrium polium.The antioxidant activity data demonstrated that all extracts showed strong antioxidant and radical scavenging activities.Essential oil and methanol extracts presented a potential for antimicrobial activities against all tested microorganisms.The obtained results highlight the potential use of Salvia microphylla and Teucrium polium as possible natural antioxidant substances and sources of bioactive molecules.

Risk Factors of Gastric Cancer in Wuwei City- an Endemic Region of Gastric Cancer

OBJECTIVE Studies have shown that risk factors of gastric cancer include living habits, eating moldy pickled food, dystrophy, lack of nutrients, and genetics, etc. This study explores the prevalence of these factors in Wuwei, a city in northwest China with a high incidence of gastric cancer. METHODS Family histories of the residents in Wuwei City were investigated with a case-control method. Segregation ratio and heredity degree of gastric cancer were calculated using the Li-ManteI-Cart and Falconer＇s regression methods. Chronic gastritis patients were followed-up by home visits, gastroscopy, and pathology. Carcinogenic fungi and volatilile N-nitroso compounds were noted in the residents＇ meals. Helicobactor pylori （Hp） was assessed in their gastric mucosa and the total content of serum vitamin C in 293 healthy adults was determined. RESULTS In Wuwei City, the segregation ratio of gastric cancer was 0.077. The heredity degree of first-degree relatives was 22.91%. The incidence rate of cancer per year in people in an atrophic gastritis group was 1.09%. Eight kinds of nitrosamines and 14 kinds of carcinogenic fungi were detected in the residents＇ food. Total average vitamin C in the serum of the 293 healthy adults in the summer was 5.74±2.79 mg/L. The positive rate of Hp in gastric mucosa of the residents was 67%. CONCLUSION The major extrinsic factors include infection of Hp, atrophic gastritis （especially atrophic hyperplasia）, and genetic susceptibility.

Prognostic Factors Influencing the Survival of Patients with Metastatic Non-Small Cell Lung Cancer in the Moroccan Population: Retrospective Study of 405 Cases

Introduction: Non-small cell lung cancer is the most common lung cancer. Despite the therapeutic advances, its prognosis is very reserved. Aim: Determine the different prognostic factors of patients with metastatic non-small cell lung cancer and their correlation with patient survival. Methods: A retrospective study was conducted at the medical oncology department of Hassan II University Hospital in Fez, collecting 405 patients during a period of 10 years, from January 2008 to January 2018. The statistical analysis of the results was done by the software SPSS version 23, the survival was calculated by the Kaplan-Meier method. The Cox method was used to study prognostic factors. Results: The average age of our patients was 59 years, with a sex ratio M/F of 6.1. In multivariate analysis, we found a significant correlation between the deterioration of survival and an age greater than 75 years (p = 0.023), a general degraded state (p < 0.001), presence of a biological inflammatory syndrome (p < 0.001), anemia (p < 0.001) and hypoalbuminemia (p < 0.001). In addition, no significant association was found in patients with toxic habits or multiple metastatic sites. Conclusion: The prognostic factors of metastatic NSCLC in our patients were PS, age, anemia, hypoalbuminemia and inflammatory syndrome. We propose to validate all the factors identified by retrospective studies by prospective studies in order to guarantee the best chances of survival for patients.

Prevalence and Factors Associated with Overweight and Obesity among Adolescents in Schools in Benin in 2016

Introduction Overweight and obesity are considered to be global public health concerns. The objective was to estimate the prevalence of overweight and obesity and the associated factors. Methods This was a cross-sectional study conducted in 2016 and involving 3968 adolescents of 10 to 19 years from 40 secondary schools in Benin. Participants were selected using a 2-level random sampling technique. Data were collected through a self-administered questionnaire and were analyzed using Epi Info and Stata softwares. Associated factors were investigated by a logistic regression. Results Mean age was 16.54 ± 0.04 years and sex ratio was 1.16. The prevalence of overweight was 8.1% and that of obesity was 1.6%. Associated risk factors were female gender, sedentary lifestyle, consumption of sugary and carbonated beverages. Consumption of fruits and vegetables, regular physical activity, age over than 15 years were protective factors. Conclusion Overweight and obesity among school adolescents are increasing in Benin. The establishment of a school nutrition program and the promotion of regular physical activity should contribute to reducing their prevalence.

Blood Pressure Patterns and Factors Associated with Relative Hypertension among Steady State Sickle Cell Disease Patients in Kinshasa, Democratic Republic of the Congo: A Cross-Sectional Study

Background: Although systemic hypertension is rarely seen in steady state sickle cell disease (SCD), relative hypertension has been reported to be associated with an increased risk of cardiovascular and renal complications. Objective: To determine the prevalence of BP patterns and assess factors associated with relative hypertension insickle cell anemia (SCA) adult patients. Methods: Clinical data and office BP were obtained from 103 consecutive steady-state SCA adult patients (mean age 26 ± 7.9 years, 66% females, 22.3% on hydroxyurea) attending four healthcare centers providing SCD-specific care in Kinshasa. Seated BP was measured using an automated electronic device. Three consecutive blood pressure measurements were taken with 2 minutes interval between readings and the average of the 2 last readings was considered for the analyses. Normal BP, relative hypertension and systemic hypertension were defined as BP 120/70 mmHg, 120 - 139/70 - 89 mmHg and ≥140/90 mmHg, respectively. Results: Normal BP, relative hypertension and systemic hypertension were observed in 56 (54%), 43(42%) and 4 (4%) of SCA patients, respectively. In multivariate analysis, factors associated with relative hypertension were leg ulcer (aOR 2.05;95%CI 1.77 - 5.18;p = 0.016), central obesity (aOR 3.32;95%CI 1.28 - 6.24;p = 0.001), smoking (aOR 5.02;95%CI 1.51 - 9.50;p = 0.017), and microalbumiuria (aOR 3.44;95%CI 1.44 - 5.76;p = 0.035). Conclusion: Relative hypertension was a common finding in the present case series and associated with traditional cardiovascular risk factor as well as factors specific to SCD highlighting the need for measures to prevent its progression towards systemic hypertension and associated cardiovascular and renal disease.

Factors Associated with Delay in Presentation of Symptomatic Cancers among HIV Infected Persons in Plateau State, Nigeria

There is increased incidence of cancer worldwide but much of the burden of morbidity and mortality will occur in the developing world because of cancer associated infectious diseases of which HIV infection carries a large proportion. Site-based studies show that proportion of late stage cancer presentation range between 60% - 92% in the last 10 years. There is paucity of information on reasons for the late presentation. This study is aimed to find out the factors associated with delay in presentation of symptomatic cancers among HIV infected persons in Plateau State, Nigeria. A mixed method study consists of quantitative and qualitative component. Participants were sampled from HIV infected persons diagnosed with cancer and referred to the Oncology unit. Variables on Patient and health service factors associated with late presentation of cancers were collected. Quantitative data was analyzed using Epi info version 3.5.3 and Microsoft Excel while thematic analysis was done for qualitative data. There were 503 respondents and the mean age was 48.7 ± 13.5 years. Male sex OR 2.5, (P = 0.002);Farming occupation OR 1.7, (P = 0.0005) and Primary education OR 2.0, (P = 0.0005) were associated with delay. Majority of respondents 349(69%) presented more than six months after onset of symptom. Common symptoms were pain 462(45.70%), swelling 237(23.44%) and skin discoloration 210(20.77). Their Initial reaction was mainly the use of alternative remedies 234(46.5) CI 42.1 - 51.0. Up to 274(54.47%) of participants obtained diagnosis 3 months after presenting to a health facility. Laboratory related issues 199(39.56%) and long booking time 163(32.40%) were the most common reasons for delay. Delay was found to be both patient and services related. The study also suggests that cancer symptom awareness is poor among the participants. There is no tangible cancer prevention program in the HIV/AIDs treatment program. A more in-depth knowledge of cancer is required for both the sufferer and the care giver.

Quality of life and symptom distress after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy

BACKGROUND Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy(CRS/HIPEC)for peritoneal surface malignancy can effectively control the disease,however it is also associated with adverse effects which may affect quality of life(QoL).AIM To investigate early perioperative QoL after CRS/HIPEC,which has not been discussed in Taiwan.METHODS This single institution,observational cohort study enrolled patients who received CRS/HIPEC.We assessed QoL using the Taiwan residents version of the MD Anderson Symptom Inventory(MDASI-T)and European Organization Research and Treatment of Cancer Core Quality of Life Questionnaire(EORTC QLQ-C30).Participants completed the questionnaires before CRS/HIPEC(S1),at the first outpatient follow-up(S2),and 3 mo after CRS/HIPEC(S3).RESULTS Fifty-eight patients were analyzed.There was no significant perioperative difference in global health status.Significant changes in physical and role functioning scores decreased at S2,and fatigue and pain scores increased at S2 but returned to baseline at S3.Multiple regression analysis showed that age and performance status were significantly correlated with QoL.In the MDASI-T questionnaire,distress/feeling upset and lack of appetite had the highest scores at S1,compared to fatigue and distress/feeling upset at S2,and fatigue and lack of appetite at S3.The leading interference items were working at S1 and S2 and activity at S3.MDASI-T scores were significantly negatively correlated with the EORTC QLQ-C30 results.CONCLUSION QoL and symptom severity improved or returned to baseline in most categories within 3 mo after CRS/HIPEC.Our findings can help with preoperative consultation and perioperative care.