Cancer statistics in Yemen: incidence and mortality, in 2020.

BACKGROUND: The current cancer epidemiological profile in Yemen suffers from a lack of locally representative data and resources, posing a challenge in determining the real incidence, prevalence, survival and mortality rates, particularly data extracted from national hospitals. This study aims to provide a comprehensive overview of the cancer burden and trends in Yemen for 2020, including incidence and mortality rates. METHODS: The current study provides cancer statistics and their trends in Yemen, including incidence and mortality, in 2020 by using descriptive statistics. The data was obtained using the Global Cancer Observatory (GCO) 2020 online database. RESULTS: According to the (GCP) database in 2020, the crude incidence rate (CIR) of all cancers in Yemen was 55.2 per 100.000. The age-standardized rate (ASR) was 97.0 per 100.000, and the cumulative risk (0-74) was 22.0 per 100.000. The age-standardized rate (ASR) was 76.5 per 100.000, and the cumulative risk (0-74) was 19.6 per 100.000. Furthermore, the crude mortality rate (CIR) of all cancers was 40.6 per 100.000. Breast cancer was most prevalent in Yemen across all age groups and genders (31.1%), followed by colorectal cancer (7.7%) and leukemia (5.7%). Breast cancer also ranked as the primary cause of mortality at an estimated percentage of 13.5%, followed by colorectal cancer (8.8%) and stomach cancer (7.1%). CONCLUSION: Cancer has become a significant life-threatening illness in Yemen with an increase in the disease burden of breast cancer in women. Furthermore, leukemia in children and colorectal cancer in both sexes have experienced a more significant burden as well. Therefore, it is imperative for initiatives for cancer control and prevention to be prioritised at national and regional levels.

Association of combined -344T/C and K173R polymorphisms in aldosterone synthase gene with type 2 diabetes mellitus in the Moroccan population.

Background: Aldosterone synthase (CYP11B2) is crucial for aldosterone production, and variations in its gene may influence type 2 diabetes mellitus (T2DM) development. This study explores the link between two single nucleotide polymorphisms (SNPs) in the CYP11B2 gene - -344T/C and K173R and T2DM in the Moroccan population . Methods: The research involved 86 individuals with T2DM and 75 control subjects. Genotyping for the -344T/C and K173R SNPs was performed using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis . Result: Results indicated significant differences in the genotype and allelic distribution of the CYP11B2 K173R polymorphism between T2DM patients and control subjects, with P-values of 0.02 and 0.04, respectively. The -344T/C polymorphism showed no significant genomic level differences, but its allelic variations were statistically significant (P=0.01), indicating a notable association between the C allele and T2DM. Furthermore, the K173R polymorphism was found to significantly increase T2DM risk, with a 2.34-fold higher risk in individuals carrying the KR genotype. The study also examined the combined effect of these SNPs. The dominant model analysis (TT vs. TC+CC and KK vs. KR+RR) showed significant differences between T2DM patients and controls for both SNPs. Additionally, a haplotype-based analysis revealed that the C-R haplotype was associated with an increased risk of T2DM. Conclusion: Our study suggests a significant association between the CYP11B2-K173R polymorphism and T2DM in the Moroccan population. Conversely, while the CYP11B2 -344T/C polymorphism exhibits a significant difference in allelic distribution, no significant difference is observed at the genomic level.

Perceptions and experiences of women with a history of gestational diabetes mellitus: A qualitative evidence synthesis.

Gestational Diabetes Mellitus (GDM) is strongly associated with the future risk of type 2 diabetes mellitus (T2DM). Women with GDM have a 10 times higher risk than women without GDM over a 10-year follow-up period. The objective of this review is to synthesise the existing evidence regarding women's views and experiences of the emotional and practical impact of GDM and its implications for diabetes prevention. Findings will be used to inform the design of interventions to prevent or delay T2DM. A systematic review of qualitative studies was conducted searching PubMed, MEDLINE, Science Direct, Scopus, and PsycINFO, from 2010 to 2021. Studies were eligible if they addressed how women's experiences and perceptions of GDM influenced women's adherence to postpartum follow-up and lifestyle interventions. The Social-Ecological Model guided the data analysis including five levels of influence specific to health behaviour: intrapersonal factors, interpersonal factors, health system organisational factors, public policy and environmental factors, and community factors. We included 31 articles after screening 22 943 citations and 51 full texts. We found that women's role as mother and caregiver is competing with one's own health priority resulting in poor postpartum screening and poor management of eating and physical activity behaviours. A supportive environment including partners, family, peers and health professionals is essential for lifestyle changes. Other environmental factors such as limited financial means or lack of health education were also barriers to adopting a healthy lifestyle. Many factors hinder T2DM postpartum screening and healthy lifestyle behaviours after GDM, yet the postpartum period is an opportunity to improve access to diabetes prevention, care and education. Women's experiences and needs should be considered when designing strategies and interventions to promote healthier lifestyles in this population.

The Double Burden of Obesity and Underweight in Yemeni Adults.

INTRODUCTION:  Yemen has a unique low-income population with several sociopolitical challenges and the association between weight disorders and sociodemographic and lifestyle factors is not clearly understood. AIM:  The aim of this study is to estimate the prevalence of obesity, overweight and underweight among Yemeni adults, and to identify their associated factors. METHODS: A cross-sectional study was conducted from 11 January to 25 March 2020, including 561 subjects of Yemen's adult population aged 18 and above, from four Yemeni governorates, who answered a questionnaire including demographic, socio-economic, and physical activity items after getting their signed consent. Height and weight were measured, and body mass index (BMI) was computed. The association between obesity or overweight (BMI ≥ 25.0kg/m2) or underweight (BMI < 18.5 kg/m2) and the other variables was analyzed using multinomial logistic regression. RESULTS: A total of 561 subjects aged ≥ 18 years have participated in this survey. The overall prevalence of obesity and overweight was 10.3%, 95% CI [7.7%; 12.8%] and 20.3%, 95% CI [17%; 23.5%] respectively, while the one for underweight was 21.2%, 95% CI [17.8%; 24.5%]. The risk of overweight-obesity increased with age (OR=1.02, 95% CI (1.01-1.03)), living in urban areas (OR= 1.680, 95% CI (1.105-2.552)) and average-high socioeconomic status (SES) (OR= 1.729, 95% CI (1.156-2.587)) while the risk of underweight decreased with the age (OR= 0.981, 95% CI (0.964-0.998)). CONCLUSION: These findings provide a special case of high prevalence of obesity, overweight, and underweight in Yemen. Therefore, implementing awareness and prevention programs is highly recommended there.

Prevalence of metabolic syndrome and its components based on a harmonious definition among adults in Morocco.

PURPOSE: Metabolic syndrome is a cluster of risk factors for diabetes and cardiovascular diseases that includes central obesity, hypertension, glucose intolerance, high triglyceride, and low high-density lipoprotein cholesterol. Its prevalence is rapidly increasing worldwide. This study aimed to estimate the prevalence of metabolic syndrome and associated risk factors in a representative sample of Morocco adults using the 2009 joint interim statement definition. PATIENTS AND METHODS: We analyzed data of 820 patients aged 19 years and older. For metabolic syndrome diagnosis, we used the criteria of the recently published joint interim statement (2009). RESULTS: The prevalence of metabolic syndrome is 35.73% among all adults, 18.56% among men, and 40.12% among women. Prevalence increased with age, peaking among those aged 50-59 years. The most common abnormality highlights abdominal obesity (49.15%). Also, half of patients have one or two risk factors for developing this syndrome. CONCLUSION: The prevalence of metabolic syndrome and associated risk factors is high among adults in Morocco, especially in women. The most prevalent component of metabolic syndrome in our population was abdominal obesity.

Blood lead, cadmium and mercury among children from urban, industrial and rural areas of Fez Boulemane Region (Morocco): relevant factors and early renal effects.

OBJECTIVES: To describe blood lead (Pb-B), cadmium (Cd-B) and mercury (Hg-B) levels in children living in urban, industrial and rural areas in Fez city (north of Morocco) and to identify the determinants and some renal effects of exposure. MATERIAL AND METHODS: The study was conducted from June 2007 to January 2008 in 209 school children (113 girls, 96 boys), aged 6-12 years, from urban, industrial and rural areas in Fez city. Interview and questionnaires data were obtained. Blood and urinary samples were analyzed. RESULTS: The mean of blood lead levels (Pb-B) in our population was 55.53 µg/l (range: 7.5-231.1 µg/l). Children from the urban area had higher blood lead levels (BLLs) mean (82.36 µg/l) than children from industrial and rural areas (48.23 and 35.99 µg/l, respectively); with no significant difference between boys and girls. BLLs were associated with traffic intensity, passive smoking and infancy in the urban area. The mean of blood cadmium levels (BCLs) was 0.22 µg/l (range: 0.06-0.68 µg/l), with no difference between various areas. Rural boys had higher BCLs mean than rural girls, but no gender influence was noticed in the other areas. BCLs were associated with the number of cigarettes smoked at children's homes. The blood mercury levels (BMLs) mean was 0.49 µg/l (range: 0.01-5.31 µg/l). The BMLs mean was higher in urban and industrial areas than in the rural area with no gender-related difference. BMLs were associated with amalgam fillings and infancy in the urban area. About 8% of the children had BLLs ≥ 100 µg/l particularly in the urban area, microalbuminuria and a decrease in height were noticed in girls from the inner city of Fez and that can be related to high BLLs (89.45 µg/l). CONCLUSIONS: There is a need to control and regulate potential sources of contamination by these trace elements in children; particularly for lead.

Screening of CYP1B1 and MYOC in Moroccan families with primary congenital glaucoma: three novel mutations in CYP1B1.

PURPOSE: To investigate the contribution of cytochrome P4501B1 (CYP1B1) and myocillin (MYOC) mutations to primary congenital glaucoma (PCG) in Moroccan families. METHODS: This study included 90 unrelated families with PCG and 100 normal control individuals. Two previously reported CYP1B1 mutations (g.4339delG and p.G61E) were first screened by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). The coding exons of CYP1B1 were sequenced in g.4339delG- and p.G61E-negative or heterozygous probands. Then the coding exons of MYOC were sequenced in patients who had no mutation in CYP1B1 or carried heterozygous CYP1B1 mutation. RESULTS: Twelve CYP1B1 mutations were identified in 43 PCG pedigrees. Three of them were novel (p.R163C, p.C470Y, and g.4330-4331delTG) and associated with moderate to severe phenotypes. Two novel intronic polymorphisms in CYP1B1 were identified in addition to those previously described. The g.4339delG was the most frequent mutation detected in 31 families (34.44%), followed by the p.G61E in seven families (7.77%). The remaining mutations (p.R163C, p.E173K, g.4330-4331delTG, p.E229K, p.R390S, p.R368H, p.R469W, p.C470Y, and g.7901-7913del13bp) were infrequent. One family with the p.R390S mutation showed both PCG and primary open angle glaucoma (POAG) phenotypes. One proband was heterozygous for p.T193K mutation in MYOC. This mutation has been initially associated with POAG, but never with PCG. CONCLUSIONS: Our results support that mutations in CYP1B1 are a major cause for PCG in the Moroccan population with a predominance of the g.4339delG mutation. Furthermore, these results demonstrate the diversity of CYP1B1 mutations, while suggesting a modest role of MYOC in Moroccan PCG.

[C634R mutation of the protooncongene RET and molecular diagnosis in multiple endocrine neoplasia type 2 in a large Moroccan family]. / Mutation C634R du proto-oncogène RET et diagnostic moléculaire dans une grande famille marocaine de néoplasie endocrinienne multiple de type 2A.

Multiple endocrine neoplasia (MEN) 2A is an inherited disease characterized by the development of medullary thyroid carcinoma (MTC), pheochromocytoma and/or hyperparathyroïdism. It has been shown to be associated with germline mutations in the RET proto-oncogene. Direct DNA testing, therefore allows the identification of subjects with asymptomatic MEN 2A who can be offered prophylactic thyroidectomy and biochemical screening as preventive measures. DNA analysis of RET exon 8, 10, 13, 14, 15 and 16 was performed by direct sequencing of PCR product on automated sequencer and or PCR-digestion. In this report, we describe a MEN2A family witch initially seemed a sporadic case of MTC. We first characterized the C634R RET mutation in the index and then we identified 3 carriers who developed the disease and 3 young carriers who were apparently asymptomatic. A genetic counselling and the management of the carriers were proposed. This study confirmed that genetic testing ; in order to detect gene carriers is technically possible in Morocco. This will contribute to the definition of a national policy of this cancer control.

Unusual phenotypic features in a patient with a novel splice mutation in the GHRHR gene.

Isolated growth hormone deficiency (IGHD) may be of genetic origin. One of the few genes involved in that condition encodes the growth hormone releasing hormone receptor (GHRHR) that, through its ligand (GHRH), plays a pivotal role in the GH synthesis and secretion by the pituitary. Our objective is to describe the phenotype of two siblings born to a consanguineous union presenting with short stature (IGHD) and Magnetic Resonance Imaging (MRI) abnormalities, and to identify the molecular basis of this condition. Our main outcome measures were clinical and endocrinological investigations, MRI of the pituitary region, study of the GHRHR gene sequence and transcripts. In both patients, the severe growth retardation (-5SD) was combined with anterior pituitary hypoplasia. In addition to these classical phenotypic features for IGHD, one of the patients had a Chiari I malformation, an arachnoid cyst, and a dysmorphic anterior pituitary. A homozygous sequence variation in the consensus donor splice site of intron 1 (IVS1 + 2T > G) of the GHRHR gene was identified in both patients. Using in vitro transcription assay, we showed that this mutation results in abnormal splicing of GHRHR transcripts. In this report, which broadens the phenotype associated with GHRHR defects, we discuss the possible role of the GHRHR in the proper development of extrapituitary structures, through a mechanism that could be direct or secondary to severe GH deficiency.

Evidence of clinical and genetic heterogeneity in autosomal dominant congenital cerulean cataracts.

Autosomal dominant cerulean cataracts (ADCC) have previously been mapped to two loci: one on chromosome 17q24 and the other on chromosome 22q11.2-q12.2, which includes the beta-B2 crystallin (CRYBB2) candidate gene. Using polymorphic markers in these regions (D17S802, D17S836, D17S1806 and CRYBB2, D22S258) for linkage analysis, we excluded these loci in a large Moroccan family presenting with an unusual form of ADCC with early onset of lens opacities and rapid evolution. This finding confirms the clinical and genetic heterogeneity of autosomal dominant congenital cerulean cataracts.