Scoping review of healthcare professionals' views on intimate partner violence in the Middle East and North Africa.

OBJECTIVES: This scoping review aims to survey healthcare providers (HCPs) in the Middle East and North Africa (MENA) about their knowledge, attitudes and barriers to working with women who have experienced intimate partner violence (IPV). This review aims to map the breadth of available peer-reviewed literature that may inform future educational training programmes. DESIGN: Scoping review. DATA SOURCES: The scoping review included studies up to December 2023 from PUBMED, Medline, COCHRANE, Cumulative Index of Nursing and Allied Health Literature, PsycINFO and Arabic medical journals. ELIGIBILITY CRITERIA: Selected articles were restricted to those carried out in the MENA region, available in full text and with no date restrictions. DATA EXTRACTION AND SYNTHESIS: Data were extracted from all studies to include research location, year of publication, type of journal, methodology, design, participants, knowledge, attitudes and barriers. By charting the information into a table, the data were analysed using frequency, counts and descriptive content analysis. RESULTS: Of the 1060 articles reviewed, 29 eligible studies were included in this scoping review. 27% of the articles reported HCPs' lack of knowledge about IPV protocols. The dominant attitude reported was a preference to treat the presenting health complaint and avoid discussing IPV. Finally, 30% of articles reported HCPs' lack of training as the main barrier. CONCLUSION: Our paper concluded that there is a lack of research in understanding the knowledge, attitudes and barriers surrounding HCPs in the MENA region and IPV. This scoping review highlights the need for further research, informed interventions and training for HCPs in the region.

Significance of ca15-3 in carcinoma of the breast with Visceral metastases.

Background: The most common malignancy and second most common cause of death is breast cancer among women. About 2.09 million fatalities from breast cancer happened in 2018. The objective was to evaluate the elevated CA15-3 in breast cancer patients with visceral metastases presenting at the tertiary care hospital of Karachi. Methods: It was a cross-sectional study conducted at the Department of Oncology of Jinnah Postgraduate Medical Center from 15th December 2018 to 15th November 2019. Female patients aged 26-80 years diagnosed with visceral metastatic (defined as metastasis to lung, liver, brain and adrenal glands) breast cancer were included in the study. The diagnosis of breast cancer was confirmed on histopathology whereas the metastatic sites were evaluated using physical examination and imaging. The serum CA15-3 concentration was assessed using assay kits. The serum CA15-3 level of 0-32 U/ml was taken as normal range for all the patients whereas CA15-3 level greater than 32 U/L was considered as elevated CA15-3. SPSS version 23 was used to enter and analyze data. Results: A total of 139 females were included in the study. The mean age & BMI of the patients were reported as 46.5 years & 26.69 kg/m2. In the majority of the patients' metastases were detected in the liver (n=54), 92 in the lungs+ parenchymal disease, 20 in adrenal glands, 12 in pleural effusion and 10 in the brain. Out of 139 patients with visceral metastases, 52(37.4%) had normal CA15-3 level whereas 87 (62.6%) had elevated serum CA15-3 levels (>32 U/L). Conclusion: The serum CA15-3 tumour marker is elevated significantly in visceral metastases and can be used as a prognostic marker in metastatic breast cancer patients.

Effect Of Tamoxifen On Plasma Lipid Profile In Patients Of Breast Cancer.

BACKGROUND: To evaluate the effect of Tamoxifen on plasma lipid profile in breast cancer patients presenting at tertiary care hospitals. METHODS: It was a longitudinal study conducted at the Department of Oncology of Jinnah Postgraduate Medical Center from December 2018 to November 2019. Eighty-eight females aged 26-66 years diagnosed with breast cancer were included in the study using a non-probability consecutive sampling technique. Detailed gynaecological and clinical investigations and detailed history were taken. The blood samples of all the patients were collected and the plasma lipid profile was measured before initiation of Tamoxifen treatment and three- and six-months post-treatment at the clinical laboratory. The plasma lipid profile includes the measurement of Total cholesterol (mg/dl), Triglyceride(mg/dl), High-density Lipoprotein (mg/dl) & Low-density Lipoprotein (mg/dl). SPSS version 23 was used to analyse data. RESULTS: After treatment, there was a significant reduction in serum cholesterol & Low-density Lipoprotein level by 20.54 mg/dl & 16.46 mg/dl at 3 months (p<0.05), moreover there was a significant increase in Triglyceride by 22.14 at 3 months (p<0.05). No significant difference was observed in High density lipoprotein level at 3 months after using Tamoxifen. At 6 months there was a significant reduction in serum cholesterol and low-density lipoprotein by 32.29mg/dl and 24.11 mg/dl at 6 months (p<0.05), moreover there was a significant increase in Triglyceride level by 42.19 mg/dl at 6 months (p<0.05). No significant difference was observed in High-density lipoprotein level at 6 months after using Tamoxifen. CONCLUSIONS: Total cholesterol and Low-density Lipoprotein levels showed significant reduction over the period of six months from the baseline with the use of Tamoxifen. Hence Tamoxifen should be considered to have an added advantage on lipid metabolism and therefore, can reduce the risk of cardiovascular events.