Anticipated time to seek medical advice for possible lung cancer symptoms and barriers to timely presentation in Palestine: a national cross-sectional study.

BACKGROUND: Lung cancer (LC) has poor survival outcomes mainly due to diagnosis at late stages. This study explored the anticipated time to seek medical advice for possible LC symptoms and barriers to early presentation in Palestine. METHODS: This cross-sectional study recruited adult participants from hospitals, primary healthcare centers, and public spaces of 11 governorates using convenience sampling. A modified, translated-into-Arabic version of the validated LC awareness measure was used to assess LC symptom awareness, the time needed to seek medical advice and barriers to early presentation. RESULTS: A total of 4762 participants were included. The proportion that would immediately seek medical advice for possible LC symptoms varied according to the symptoms' nature. For respiratory symptoms, this ranged from 15.0% for 'painful cough' to 37.0% for 'coughing up blood'. For non-respiratory symptoms, this ranged from '4.2% for 'unexplained loss of appetite' to 13.8% for 'changes in the shape of fingers or nails'. Participants with good LC symptom awareness were more likely to seek medical advice within a week of recognizing most LC symptoms. About 13.0% would delay their visit to see a doctor after recognizing an LC symptom. The most reported barriers were emotional with 'disliking the visit to healthcare facilities' (59.8%) as the leading barrier. CONCLUSION: LC respiratory symptoms were more likely to prompt early seeking of medical advice. Good LC symptom awareness was associated with a higher likelihood of help-seeking within a week. Educational interventions are needed to promote LC awareness and address the perceived barriers to early presentation in low-resource settings, such as Palestine.

Awareness of Palestinians about lung cancer symptoms: a national cross-sectional study.

BACKGROUND: The majority of lung cancer (LC) cases are diagnosed at an advanced stage. Poor awareness of LC symptoms is a contributor to late diagnosis. This study aimed to assess the awareness of LC symptoms among Palestinians, and to examine the factors associated with displaying good awareness. METHODS: Participants were recruited from hospitals, primary healthcare centers and public spaces using convenience sampling. A translated-into-Arabic version of the validated LC awareness measure was used to assess recognition of 14 LC symptoms. One point was given for each recognized symptom. The total score was calculated and categorized based on the number of symptoms recognized: poor (0-4), fair (5-9), and good (10-14). Multivariable logistic regression was used to examine the association between participant characteristics and having good awareness. The multivariable analysis adjusted for age-group, gender, education, monthly income, occupation, residence, marital status, any chronic disease, knowing someone with cancer, smoking history, and site of data collection. RESULTS: Of 5174 potential participants approached, 4817 completed the questionnaire (response rate = 93.1%) and 4762 were included in the final analysis. Of these, 2742 (56.9%) were from the West Bank and Jerusalem (WBJ) and 2020 (43.1%) were from the Gaza Strip. Participants from the WBJ were older, had higher monthly income but lower education, and suffered from more chronic diseases. The most recognized respiratory LC symptom was 'worsening in an existing cough'(n = 3884, 81.6%) while the least recognized was 'a cough that does not go away for two or three weeks'(n = 2951, 62.0%). The most recognized non-respiratory LC symptom was 'persistent tiredness or lack of energy'(n = 3205, 67.3%) while the least recognized was 'persistent shoulder pain'(n = 1170, 24.6%). A total of 2466 participants (51.8%) displayed good awareness of LC symptoms. Participants from both the Gaza Strip and the WBJ had similar likelihoods to have good awareness levels. Factors associated with a higher likelihood to display good awareness included female gender, having post-secondary education, being employed, knowing someone with cancer, and visiting hospitals and primary healthcare centers. CONCLUSION: About half of the study participants displayed a good level of awareness of LC symptoms. Further improvement in public awareness of LC symptoms by educational interventions might reduce LC mortality by promoting early diagnosis.

Association between children's resilience and practising oral habits: a cross-sectional study.

Introduction While resilience is the quality of being buffered against stressors, practising oral habits is suggested to be a maladaptive behaviour towards stressors. The relation between resilience and practising oral habits in children remains vague.Aims This study aims to investigate the association between practising oral habits and resilience in children aged 5-7 years.Materials and methods An electronic Google form questionnaire was distributed through social media among five schools' children's parents, utilising the Child and Youth Resilience Measure-Revised Person Most Knowledgeable version (PMK-CYRM-R) scale as a resilience assessment tool, and the third domain of interview part of the Nordic Orofacial Test-Screen (NOT-S) as a habit assessment tool. The questionnaire received 227 eligible responses which were divided into habit-free group (123; 54.19%) and habit-practising group (104; 45.81%). The third domain of the interview part of the NOT-S included sucking habit, bruxism and nail-biting habits. The mean PMK-CYRM-R scores were calculated for each group and statistical analysis was done using SPSS Statistics package.Results Total PMK-CYRM-R score was 46.05 ± 3.63 in the habit-free group and 44.10 ± 3.59 in the habit-practising group (p = 0.0001). Bruxism, nail-biting and sucking habit subgroups showed statistically significant lower personal resilience levels than the habit-free group.Conclusion The results of the current study suggest that children with low resilience levels may be more likely to practise oral habits.

Myths and Misconceptions Around Lung Cancer Causation in Palestine: Is It Time to Intervene?

PURPOSE: Having an accurate knowledge of what truly increases the likelihood of developing lung cancer (LC) may help people make better decisions about lifestyle changes that could potentially lower their risk. This study assessed current beliefs in LC causation myths among Palestinians and explored factors associated with displaying good recognition of such myths. METHODS: A national cross-sectional study was conducted from July 2019 to March 2020. A modified version of the Cancer Awareness Measure-Mythical Causes Scale was used for data collection. The awareness level of LC causation myths was determined based on the number of myths recognized to be incorrect: poor (0-4), fair (5-9), and good (10-13). RESULTS: A total of 4,817 participants completed the questionnaire of 5,174 approached (response rate = 93.1%). In total, 4,762 participants were included in the final analysis. Myths unrelated to food were more commonly recognized than food-related myths. The food-related myth most frequently recognized was eating burnt food (n = 1,427; 30.0%) followed by drinking from plastic bottles (n = 1,389; 29.2%). The food-related myth least commonly recognized was eating food containing additives (n = 737; 15.5%). The most frequently recognized myth unrelated to food was having a physical trauma (n = 2,903; 61%), whereas the least was using cleaning products (n = 1,140; 23.9%). Only 287 participants (6%) displayed good awareness. Having a chronic disease and knowing someone with cancer were associated with a decrease in the likelihood of displaying good awareness. Conversely, participants who were smoking cigarettes/shisha and those recruited from hospitals had an associated increase in the likelihood of displaying good awareness. CONCLUSION: This study found very poor awareness of LC causation myths, with only 6% recognizing ≥10 myths. Initiatives addressing LC mythical causes are needed.

Current situation and future directions of lung cancer risk factor awareness in Palestine: a cross-sectional study.

OBJECTIVES: To evaluate lung cancer (LC) risk factor awareness among Palestinians and identify factors associated with good awareness. DESIGN: Cross-sectional study. SETTINGS: Participants were recruited using convenience sampling from hospitals, primary healthcare centres (PHCs) and public spaces located at 11 governorates in Palestine. PARTICIPANTS: Of 5174 approached, 4817 participants completed the questionnaire (response rate=93.1%). A total of 4762 questionnaires were included: 2742 from the West Bank and Jerusalem (WBJ) and 2020 from the Gaza Strip. Exclusion criteria were working or studying in a health-related field, having a nationality other than Palestinian and visiting oncology departments or clinics at the time of data collection. TOOL: A modified version of the validated LC Awareness Measure was used for data collection. PRIMARY AND SECONDARY OUTCOMES: The primary outcome was LC risk factor awareness level as determined by the number of factors recognised: poor (0-3), fair (4-7) and good (8-10). Secondary outcomes include the recognition of each LC risk factor. RESULTS: Smoking-related risk factors were more often recognised than other LC risk factors. The most recognised risk factors were 'smoking cigarettes' (n=4466, 93.8%) and 'smoking shisha (waterpipes)' (n=4337, 91.1%). The least recognised risk factors were 'having a close relative with LC' (n=2084, 43.8%) and 'having had treatment for any cancer in the past' (n=2368, 49.7%).A total of 2381 participants (50.0%) displayed good awareness of LC risk factors. Participants from the WBJ and the Gaza Strip had similar likelihood to display good awareness (50.6% vs 49.1%). Being≥45 years, having higher education and monthly income, knowing someone with cancer and visiting hospitals and PHCs seemed to have a positive impact on displaying good awareness. CONCLUSION: Half of study participants displayed good awareness of LC risk factors. Educational interventions are warranted to further improve public awareness of LC risk factors, especially those unrelated to smoking.

Nigella sativa oil as a pulp medicament for pulpotomized teeth: a histopathological evaluation.

PURPOSE: Concerns about the safety of formocresol (FC) as a pulpotomy agent in Pediatric Dentistry have lead to the search of new capping medicaments. Indigenous plant medicines such as Nigella Sativa (NS) have been the focus of many researches. Therefore the purpose of this study was to investigate histo-pathologically the pulp response to NS oil and FC in dogs. METHOD: Forty teeth in 4 male dogs of undefined breed aging 12-14 months were used in this study. Coronal access cavities were performed on the upper and lower premolars so that both medicaments were tested in the same animal in alternate sides of the mouth. Four weeks after treatment the animals were sacrificed, paraffin sections were prepared for histological, histochemical and immuno-histochemical staining. RESULTS: Specimens in the NS group showed mild to moderate vasodilatation. Few specimens showed scattered inflammatory cell infiltration and the odontoblastic layer was continuous. While the FC group showed moderate to severe vasodilatation with high inflammatory cell infiltrate and degenerative changes. CONCLUSIONS: NS possesses an anti-inflammatory effect and the pulp maintains its vitality after its application, which could qualify its use as a pulp medicament for pulpotomized teeth in clinical practice.

Assessment of schoolteachers' knowledge about management of traumatic dental injuries in Al-Madinah city, Saudi Arabia.

OBJECTIVE: This study aimed to assess the knowledge of primary and intermediate schoolteachers about the management of TDIs in Al-Madinah city, Saudi Arabia. MATERIALS AND METHODS: A previously validated, self-administered, anonymous, close-ended structured questionnaire was administered to schoolteachers in 13 different schools. It included two parts: basic demographic information (part one) and questions regarding the management of dental traumatic injuries (part two). RESULTS: A total of 178 schoolteachers voluntarily completely filled in the questionnaire. Nearly 28.1% of the teachers acquired a first-aid training program and 6.2% only learned about dental injury management in first-aid training. Concerning the knowledge about the management of dental traumatic injuries, 55.1% of teachers realized the appropriate time for treatment of dental traumatic injuries. A few percentage of teachers selected correct answers for the suitable storage medium. The most commonly selected storage media were found to be cold milk, physiological saline, and patient's saliva at 14.6%, 6.7%, and 2.2%, respectively. CONCLUSION: The knowledge among primary and intermediate schoolteachers in the management of dental traumatic injuries is unsatisfactory.

Erosive and cariogenic potential of various pediatric liquid medicaments on primary tooth enamel: A SEM study.

BACKGROUND: Oral pediatric liquid medications (PLMs) are commonly used in children who suffer from chronic diseases. The physicochemical parameters of PLMs can have a deleterious effect on tooth structure. OBJECTIVES: The purpose of the present study was to investigate the erosive and cariogenic effect of widespread PLMs on the surface roughness and structure of primary tooth enamel. MATERIAL AND METHODS: The erosive potential of 8 common PLMs used in Egypt was assessed by measuring their inherent pH, using a digital pH electrode meter. The total sugar content was measured according to the Fehling method. The erosive effect of each liquid medicine on the enamel surface of primary teeth was assessed using scanning electron microscopy (SEM) and energy dispersive X-ray (EDX) microanalysis for calcium (Ca) and phosphorus (P) content. RESULTS: Most PLMs revealed an acidic nature, with pH values ranging between 3.47 and 6.92. About 93.8% of analgesics had pH values ≤5.5, critical for enamel demineralization, whereas most antitussives and 1 antibiotic (Augmentin®) had pH values ≥6.2. Sucrose was present in all the samples studied. The SEM analysis revealed observable differences in the tooth enamel in the experimental groups, with different degrees of surface roughness and erosion. CONCLUSIONS: The current results suggest that the pH, sugar content and Ca dissolution ability of PLMs can significantly influence erosion in primary tooth enamel.

Growth and Product Formation of Clostridium ljungdahlii in Presence of Cyanide.

Cyanide is a minor constituent of crude syngas whose content depends on the feedstock and gasification procedure. It is a known poison to metal catalysts and inhibits iron-containing enzymes like carbon monoxide dehydrogenase of acetogenic organisms. Therefore, it is considered a component that has to be removed from the gas stream prior to use in chemical synthesis or syngas fermentation. We show that the growth rate and maximum biomass concentration of Clostridium ljungdahlii are unaffected by cyanide at concentrations of up to 1.0 mM with fructose as a carbon source and up to 0.1 mM with syngas as a carbon source. After the culture is adapted to cyanide it shows no growth inhibition. While the difference in growth is an increasing lag-phase with increasing cyanide concentrations, the product spectrum shifts from 97% acetic acid and 3% ethanol at 0 mM cyanide to 20% acetic acid and 80% ethanol at 1.0 mM cyanide for cultures growing on (fructose) and 80% acetic acid and 20% ethanol at 0.1 mM cyanide (syngas).

Glucosyltransferase B, immunoglobulin a, and caries experience among a group of Egyptian preschool children.

PURPOSE: Glucosyltransferase B enzyme (GtfB) plays an essential role in the pathogenesis of dental caries. It catalyzes the synthesis of water-insoluble glucan from sucrose, which is essential for accumulation of Streptococcus mutans in the dental biofilm. On the other hand, salivary immunoglobulin A (sIgA) plays a protective role in the same process. Therefore, the purpose of this study was to attempt to correlate glucosyltransferase B enzyme and immunoglobulin A levels in whole saliva with caries experience in preschool children. METHODS: Forty-five 3- to 6-year-old were examined clinically, and their caries experiences were recorded as decayed, missing, and filled teeth (dmft) scores. Unstimulated whole saliva was collected and analyzed for GtfB and IgA using enzyme-linked immunosorbent assay. RESULTS: Mixed-model analysis revealed that both GtfB and IgA are covariants regarding the effect on dmft scores (P =.008). GtfB levels displayed a simultaneous increase in caries experience (dmft) and number of carious lesions (d), while IgA levels were high in caries-free children and significantly lower values were obtained in the high caries group. CONCLUSION: Salivary IgA was negatively correlated with caries experience and inversely proportional with GtfB levels in the saliva of preschool children.