Breast Cancer Knowledge, Attitudes and Practices amongst Women in Qatar.

This cross-sectional study examines knowledge, attitudes, and practices surrounding breast cancer awareness and screening among women residents in Qatar. Females, >18 years old, registered with the Primary Health Care Corporation were invited to complete an Arabic or English online survey using a modified version of the Breast Cancer Awareness Module. Of the 9008 participants, 69% report awareness of breast cancer warning signs, but the results did not substantiate these claims. There remains a disconnect between participants' perceived awareness of their ability to detect breast cancer and their actual recognition of individual signs and symptoms. Nearly half (45.4%) report rarely or never checking their breasts for abnormalities (44.6%). Breast self-examination (BSE) and Breast Cancer Screening (BCS) uptake is low and many are unaware of the starting age for invitation to Qatar's BCS program. While only 18% of women report receiving an invitation, 94% attended, indicating that the BCS invitation is a remarkably effective means of improving screening uptake. Policymakers should capitalize on early recognition, which is possible in the youthful population. Broadening awareness campaigns and interventions targeting a broader audience including males, community and religious leaders and healthcare professionals may prove more effective in Arab communities.

Haemoglobin cut-off values for the diagnosis of anaemia in preschool-age children.

BACKGROUND: The World Health Organisation (WHO) suggests haemoglobin that (Hgb) cut-off levels below 2SD from the population mean to initiate anaemia investigations. In the absence of epidemiological data, Hgb less than 11 g/dL is considered abnormal in children up to the age of 59 months (4 years and eleven months). OBJECTIVES: This study reports on the Hgb cut-off levels among children at 1 and 4 years of age. The study compared the prevalence based on the WHO generic cut-off levels and population-specific cut-off-based value defined as below 2SD from the population mean. DESIGN, SETTINGS, AND PARTICIPANTS: A cross-sectional record-based study of healthy children below the age of 59 months attending primary care settings in Qatar. 3 years of Hgb data were collected and analysed using descriptive analyses. We excluded children with any pre-existing disease or who have altered biological parameters indicating a non-healthy child. RESULTS: 39407 Participants were stratified into different sub-groups according to age, gender, and ethnicity. Hgb levels were expressed as the mean ± 2SD for children of one and four years of age. Most children were from Western Asia (45.6%), followed by Northern Africa (23.7%), and Southern Asia (21.7%). Our findings for one-year-old children cut-off levels for anaemia might be as low as 9.9 g/dL and 10.6 g/dL for 4-years old. CONCLUSION: Hgb cut-off values may be set at higher levels for one-year and four-year age groups and many different ethnicities. Higher cut-off points may overestimate the problem as a public health issue. Children may be unnecessarily treated with iron or have needless investigations.

Haematological abnormalities and risk of COVID-19 infection in adult patients attending primary healthcare settings.

Centres for Disease Control and prevention (CDC) reports that there are limited data and information about the impact of underlying medical conditions and the risk of infection. To date, there are no studies that report on the risk of infection among patients with haematological diseases or abnormalities. This cross-sectional study reports on the baseline complete blood count in patients attending publicly funded primary care settings with a diagnosis of suspected COVID-19 infections in the state of Qatar. The study will report on the descriptive characteristics of the population, including gender, age and prior abnormalities to their blood test results. We will compare the results of those with positive and negative PCR test results, where appropriate. Nine hundred sixty-two adult patients attended publicly funded primary health care settings in the state of Qatar between February the 10th and April the 30th 2020 with a diagnosis of suspected COVID-19 infections had prior recorded blood investigations in the last six months and were included in this study. The population was young, mean of age is 38.8±11.6. (Median: 36 [Min: 19 - Max: 85]). Complete blood count of the sample had minimal missing data points. Females were more presented in our samples, Female (n=560, 58.21%) and Male (n=402, 41.79%). Most of our sample had a documented PCR test result, negative (n=831, 86.38%); positive (n=123, 12.79%) and missing (n=8, 0.83%). Low haemoglobin values (n=265, 27.5%) and low red blood cell count (n =170, 17.7%) were the most prevalent complete blood count abnormality in the population. Leukopenia was less common (n=50, 8.2%). Most of the population had normal platelet count (n=895, 93%). Gender was the most influential factor in our sample to increase the odds of having a positive PCR test results; males were more likely to be affected (P<0.001, Chi-square test) (OR 2.56, 95% CI 1.73-3.77). Categories for haematological abnormalities were not associated with increased risk of having a positive PCT test result. In a population attending primary healthcare settings with early presentation of symptoms of COVID-19 infection, the risk of infection among our cohort was not affected by the prior haematological values of those patients. Gender was the most influential parameter in the risk of infection in our population. Analysis of the results using gender-specific categories for different haematological parameters suggested that patients with abnormal haematological values were not at increased risk of having a positive COVID-19 infection.

Preparation and characterization of letrozole-loaded poly(d,l-lactide) nanoparticles for drug delivery in breast cancer therapy.

Letrozole (LTZ), an aromatase inhibitor used for the treatment of hormonally-positive breast cancer in postmenopausal women, has poor water solubility, rapid metabolism, and a range of side effects. In this study, polymer-based nanoparticles (NPs) incorporating the drug have been designed and characterized, aimed to control the release, potentially maximize the therapeutic efficiency, and minimize the side effects of the drug. LTZ was incorporated into poly(d,l-lactide) (PDLLA) NPs by employing the emulsion-solvent evaporation technique using a range of drug concentrations. Loaded drug and drug-polymer interactions were studied using X-ray diffraction and NPs morphology was evaluated using scanning electron microscopy (SEM). Particle size distribution (PSD) and zeta potential of the NPs were analyzed using dynamic light scattering (DLS) and laser Doppler velocimetry (LDV), respectively. Drug content and release profile studies were carried out and determined using ultra performance liquid chromatography (UPLC). The yield of LTZ-PDLLA NPs reached as high as 85%. The NPs were spherical and smooth, regardless of LTZ concentration in the formulation. However, particle size increased from 241.6 ± 1.2 to 348.7 ± 6.1 nm upon increasing LTZ concentration from 0 to 30% w/w, with entrapment efficiencies reaching up to 96.8%. Drug release from the polymeric matrix was best described by Higuchi model with a predominant diffusion-based mechanism. More than 15, 46, and 86% of LTZ was released in a controlled fashion over 30 d from the 10, 20, and 30% LTZ-PDLLA NPs, respectively. Overall, LTZ-PDLLA NPs were designed with appropriate size and surface charge, high drug loading, superior entrapment efficiency, and prolonged release profile.

Preparation and optimization of monodisperse polymeric microparticles using modified vibrating orifice aerosol generator for controlled delivery of letrozole in breast cancer therapy.

Letrozole (LTZ) is effective for the treatment of hormone-receptor-positive breast cancer in postmenopausal women. In this work, and for the first time, using vibrating orifice aerosol generator (VOAG) technology, monodisperse poly-ε-caprolactone (PCL), and poly (D, L-Lactide) (PDLLA) LTZ-loaded microparticles were prepared and found to elicit selective high cytotoxicity against cancerous breast cells with no apparent toxicity on healthy cells in vitro. Plackett-Burman experimental design was utilized to identify the most significant factors affecting particle size distribution to optimize the prepared particles. The generated microparticles were characterized in terms of microscopic morphology, size, zeta potential, drug entrapment efficiency, and release profile over one-month period. Long-term cytotoxicity of the microparticles was also investigated using MCF-7 human breast cancer cell lines in comparison with primary mammary epithelial cells (MEC). The prepared polymeric particles were monodispersed, spherical, and apparently smooth, regardless of the polymer used or the loaded LTZ concentration. Particle size varied from 15.6 to 91.6 µm and from 22.7 to 99.6 µm with size distribution (expressed as span values) ranging from 0.22 to 1.24 and from 0.29 to 1.48 for PCL and PDLLA based microparticles, respectively. Upon optimizing the manufacture parameters, span was reduced to 0.162-0.195. Drug entrapment reached as high as 96.8%, and drug release from PDLLA and PCL followed a biphasic zero-order release using 5 or 30% w/w drug loading in the formulations. Long-term in vitro cytotoxicity studies indicated that microparticles formulations significantly inhibited the growth of MCF-7 cell line over a prolonged period of time but did not have toxic effects on the normal breast epithelial cells.

Delivering Tobacco Cessation Content in the Middle East Through Interprofessional Learning.

Objective. To explore the attitudes of pharmacy, pharmacy technician, medical, and public health students before and after an IPE activity that focused on smoking cessation in the Middle East. Methods. A pre-post intervention research design using the Readiness for Interprofessional Learning Scale (RIPLS) was used for this study. The tool contained 20 items, categorized under the following subscales: teamwork and collaboration, professional identity, and patient-centeredness. Results. A total of 47 out of 50 students from four different health disciplines in Qatar (medicine, pharmacy, pharmacy technician, and public health) who participated in the activity completed a pre- and post-intervention pre-validated questionnaire (94% response rate). Total attitude scores were calculated for all the 20 items along with attitudinal scores of the three domains. Most of the students reported having a positive attitude toward IPE; the number of students having a positive attitude toward IPE increased after the IPE session. The overall median (IQR) score increased from 82 (16) before the session to 84 (15) after the session. Students from different disciplines did not vary in their attitude scores. Conclusion. Health care professional students in Qatar perceived IPE positively, believing that it enhanced their communication skills, collaboration and appreciation of professional roles. This study has implication on developing effective methods to implement IPE in various health professional education curricula.

Perspective of pharmacists in Qatar regarding doping and anti-doping in sports.

BACKGROUND: The aim of this study was to evaluate the current knowledge and perceptions of pharmacists in Qatar with regard to the use of drugs in sport and to explore their views on the introduction of education and training in the area of sports pharmacy. METHODS: A cross-sectional survey was conducted targeting both hospital and community pharmacists in Qatar. A questionnaire consisting of three domains pertaining to participants' knowledge, perceived role of healthcare professionals, and attitudes towards educational needs on the use of drugs in sports was developed and validated. The online survey link and paper-based questionnaires were distributed to the target population. Data analyses were performed using IBM SPSS Statistics. Descriptive and inferential statistics were utilized for the analyses, where P<0.05 indicates statistical significance. RESULTS: A total of 300 pharmacists responded to the survey. Respondents had a limited awareness of doping and anti-doping and achieved an average knowledge score of 53.2% regarding the prohibited status of drugs that may be used by athletes, particularly with respect to over-the-counter medicines and supplements. The majority (81.7%) of the pharmacists expressed an interest in receiving education and training on sports pharmacy. CONCLUSIONS: Specialized training programs are warranted to ensure that pharmacists have the knowledge and skills required to provide athletes with accurate information about anti-doping issues and the safe and effective use of medicines in sport. The development of these programs should be supported by national pharmacy policy makers and designed in collaboration with anti-doping agencies and sports pharmacy experts and educators.

Knowledge and Perceptions of Pharmacy Students in Qatar on Anti-Doping in Sports and on Sports Pharmacy in Undergraduate Curricula.

Objective. To assess pharmacy students' knowledge and perceptions of doping and anti-doping in sports and to explore the curricular needs for undergraduate pharmacy in the field of sports pharmacy. Methods. A cross-sectional, descriptive, web-based survey of pharmacy students was conducted at Qatar University College of Pharmacy from March to May 2014. Data were analyzed using descriptive and inferential statistics. Results. Eighty respondents completed the online survey (80% response rate). Sixty percent were unaware of the World Anti-Doping Agency, and 85% were unaware of the International Pharmaceutical Federation's statement on the pharmacist's role in anti-doping. Students' knowledge score regarding the prohibited status of drugs that may be used by athletes was around 50%. Fourth-year pharmacy students had significantly higher knowledge scores than the other groups of students. Respondents acknowledged the important role of health care professionals, including pharmacists, as advisors on the safe and effective use of drugs in sports. Ninety percent of the students supported the inclusion of sports pharmacy in the curriculum. Conclusion. Pharmacy students indicated a strong desire to play a role in doping prevention and ensure safe and rational use of drugs among athletes. They suggested requiring an education and training strategy for sports pharmacy in undergraduate pharmacy curricula.

Na+/H+ exchanger isoform 1 induced cardiomyocyte hypertrophy involves activation of p90 ribosomal s6 kinase.

Studies using pharmacological and genetic approaches have shown that increased activity/expression of the Na+/H+ exchanger isoform 1 (NHE1) play a critical role in the pathogenesis of cardiac hypertrophy. Despite the importance of NHE1 in cardiac hypertrophy, severe cerebrovascular side effects were associated with the use of NHE1 inhibitors when administered to patients with myocardial infarctions. p90 ribosomal S6 Kinase (RSK), a downstream regulator of the mitogen-activated protein kinase pathway, has also been implicated in cardiac hypertrophy. We hypothesized that RSK plays a role in the NHE1 induced cardiomyocyte hypertrophic response. Infection of H9c2 cardiomyoblasts with the active form of the NHE1 adenovirus induced hypertrophy and was associated with an increase in the phosphorylation of RSK (P<0.05). Parameters of hypertrophy such as cell area, protein content and atrial natriuretic mRNA expression were significantly reduced in H9c2 cardiomyoblasts infected with active NHE1 in the presence of dominant negative RSK (DN-RSK) (P<0.05). These results confirm that NHE1 lies upstream of RSK. Increased phosphorylation and activation of GATA4 at Ser261 was correlated with increased RSK phosphorylation. This increase was reversed upon inhibition of RSK or NHE1. These findings demonstrate for the first time that the NHE1 mediated hypertrophy is accounted for by increased activation and phosphorylation of RSK, which subsequently increased the phosphorylation of GATA4; eventually activating fetal gene transcriptional machinery.