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   Table of Contents - Current issue
Coverpage
July-September 2022
Volume 1 | Issue 3
Page Nos. 121-187

Online since Friday, July 29, 2022

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ORIGINAL ARTICLES  

Expression of tissue PSA in breast cancer is associated with less aggressive disease and lower chance of tumor relapse p. 121
Ibrahim Yaseen Hachim, Mahmood Yaseen Hachim, Vanessa Michel López-Ozuna, Raji H M Al-Hadithi
DOI:10.4103/abhs.abhs_18_22  
Background: Human kallikrein 3 (hK3), also known as Prostatic specific antigen (PSA), was considered as one of the most useful markers for the detection as well as management of prostate cancer. While PSA was thought to be a prostatic tissue-specific protein, many reports suggest the presence of extraprostatic PSA in different tissues, including the breast. Few reports showed PSA immunoreactivity in breast cancer tissues and suggest a favorable prognostic role of PSA in breast cancer. However, most of those studies were not conclusive or restricted to small scale studies limiting their clinical significance. Methods: We used a bioinformatical approach to investigate the association between tissue PSA expression levels and different clinicopathological parameters in breast cancer using different publicly available databases. Further validation was done using our patient cohort of 40 surgical breast samples obtained from patients attending Al Kadhemyia Teaching Hospital – Iraq. Results: Using a cohort of 593 breast lesion samples extracted from the TCGA database using the ONCOMINE database, our results showed no significant upregulation of PSA mRNA levels in breast cancer samples compared to healthy tissue (P = 0.1). The same trend was also observed in our patient cohort with positive immunoreactivity in 50% (5 samples) of benign lesions compared to 36.66% (11 samples) in breast cancer samples. In addition, investigating the correlation between mRNA PSA expression and different clinicopathological parameters using the Breast Cancer Gene-Expression Miner v4.0 database and ONCOMINE databases, revealed a significant association between PSA expression and tumor grade (P = 0.0001), breast cancer subtype (P < 0.0001), in addition to early-stage disease presented as smaller tumor size and absence of LN involvement. The same trend confirmed with our patient cohort. Moreover, our analysis using KM plotter (4000 breast cancer samples) showed a significant association between higher PSA mRNA levels and favorable patient outcomes presented as prolonged relapse-free survival (RFS) (P < 0.0001). Conclusions: Our results clearly demonstrate the possibility of using tissue mRNA and protein levels of PSA as a marker to identify patients with a favorable outcome and lower risk of tumor recurrence. Our results also highlight the need for more efforts to investigate the biological role of PSA in breast cancer.
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Incidence and seasonal variation of hospital admissions for acute bronchiolitis among children younger than two years in a Northern Emirates hospital p. 131
Balsam Qubais Saeed, Hanan Abdulgader Sharif, Rula Al-Shahrabi, Ahmed Omar Adrees, Zainab Mansour Alkokhardi
DOI:10.4103/abhs.abhs_16_22  
Background: There is limited information about acute bronchiolitis (AB) in the United Arab Emirates. The study aims to describe incidents, hospitalizations, and seasonal variation of AB among children less than 2 years. Methods: The retrospective data were collected for children ≤24 months who were admitted in the University Hospital Sharjah with AB from January 1, 2018 to December 31, 2019. Demographic characteristics, vital signs, management, admission data, cases seasonality, maternity history, and co-infections related to the cases were analyzed. Results: A total of 2496 AB cases were reported. Males and children more than 6 months were more infected than females and infants ≤ 6 month. Most of the cases were from emergency room, discharged within the same day and delivered by normal vaginal delivery. Respiratory syncytial virus (RSV) was the commonest cause of AB. Other etiological agents included influenza viruses, adenoviruses, Streptococcus spp., and Mycoplasma pneumoniae. The seasonal variation peak of AB for the 2 years was found in the Autumn months, with a small peak reported in the beginning of Spring months. The number of AB cases in 2019 was greater than that in 2018. Conclusion: AB is a common reason for hospitalization among males and children more than 6 months during the Autumn season. RSV is the common responsible virus for hospital admissions and morbidity. Our results may guide effort toward healthcare provision and implementation of AB prevention.
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Identifying malignant nodules on chest X-rays: A validation study of radiologist versus artificial intelligence diagnostic accuracy p. 137
Bassam Mahboub, Manoj Tadepalli, Tarun Raj, Rajalakshmi Santhanakrishnan, Mahmood Yaseen Hachim, Usama Bastaki, Rifat Hamoudi, Ehsan Haider, Abdullah Alabousi
DOI:10.4103/abhs.abhs_17_22  
Background: Three and half million anonymous X-rays were gathered from 45 locations worldwide (in-hospital and outpatient settings). qXR was initially trained on this massive dataset. We used an independent dataset of 13,426 chest X-rays from radiologists’ reports. The test data set included 213,459 X-rays chosen at random from a pool of 3.5 million X-rays. The dataset (development) was developed using the remaining X-rays received from the remaining patients. Methods: qXR is a deep learning algorithm-enabled software that is used to study nodules and malignant nodules on X-rays. We observed moderate to a substantial agreement even when observations were made with normal X-rays. Results: qXR presented a high area under the curve (AUC) of 0.99 with a 95% confidence interval calculated with the Clopper–Pearson method. The specificity obtained with qXR was 0.90, and the sensitivity was 1 at the operating threshold. The sensitivity value of qXR in detecting nodules was 0.99, and the specificity ranged from 0.87 to 0.92, with AUC ranging between 0.98 and 0.99. The malignant nodules were detected with a sensitivity ranging from 0.95 to 1.00, specificity between 0.96 and 0.99, and AUC from 0.99 to 1. The sensitivity of radiologists 1 and 2 was between 0.74 and 0.76, with a specificity ranging from 0.98 to 0.99. In detecting the malignant nodules, specificity ranged between 0.98 and 0.99, and sensitivity fell between 0.88 and 0.94. Conclusion: Machine learning model can be used as a passive tool to find incidental cases of lung cancer or as a triaging tool, which accelerate the patient journey through standard care pipeline for lung cancer.
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Nutrition knowledge of caregivers working in health and education centers for children with special healthcare needs p. 144
Leila Cheikh Ismail, Salma Abu Qiyas, Maysm N Mohamad, Tareq Mohammed Ibrahim Osaili, Reyad Rashid Shaker Obaid, Sheima T Saleh, Hanin Kassem, Ayesha S Al Dhaheri, Rameez Al Daour, Radhiya Al Rajaby, Hayder Abbas Hasan, Mona Sharef Hashim
DOI:10.4103/abhs.abhs_26_22  
Background: Children with special healthcare needs are recognized as a high-risk group for malnutrition. Caregivers have a strong influence on the dietary habits of their students, therefore, adequate nutrition knowledge among caregivers and educators has a great potential in improving the health of children. The purpose of this study is to assess the level of nutrition knowledge and demographic influences of knowledge among caregivers working in health and education centers. Methods: a cross-sectional, web-based survey was conducted among educators and caregivers working at Sharjah City for Humanitarian Services to assess their nutritional knowledge using a modified validated general nutrition knowledge questionnaire. Results: 233 participants completed the survey. The basic recommendations about reducing the intake of sugary, salty, and fatty foods and consuming more water and vegetables were best acknowledged. However, an inadequate level of knowledge was identified regarding specified number portion. For instance, more than half of the participants were aware of the need to consume more vegetables and fruits while only 10% knew the minimum number of servings to consume in a day. The overall nutrition knowledge score was adequate at 46.30 (55.1%). Caregivers with nutrition qualifications and who have four children had a significantly higher knowledge score. Older age was associated with better diet-disease relationship knowledge. Conclusions: The level of nutrition knowledge among caregivers and health workers was insufficient. However, periodic nutrition education reinforcement among health caregivers should be considered.
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Soil pH effect on bone degradation: Implications in forensic investigation p. 156
Loveday Ese Oghenemavwe, Clinton David Orupabo, Teke Jemina Horsfall
DOI:10.4103/abhs.abhs_10_22  
Background: Skeletal remains have become the mainstay in forensic investigations. Hence, it is imperative to study bone degradation and some influencers as to guide forensic practices. The purpose of this study was to determine the effect of soil pH on bone degradation. Methods: One-centimeter diameter sections of the mid-shaft of the femur of a male cadaver were buried for the duration of 6 weeks in soils of different pH: 2.98 for the acidic soil, 7.10 for the neutral soil, and 11.58 for the alkaline soil. Histological sections of the exhumed bones were prepared using Frost’s rapid manual method. Four fields of view at 12 o’clock, 3 o’clock, 6 o’clock, and 9 o’clock positions were obtained for each section. Results: Quantitative analysis showed that there was a reduction in the mean Haversian canal area (HCA) and Haversian canal diameter (HCD) in the samples of bone fragments buried in the acidic and alkaline soil when compared with control. The acidic soil sample showed a mean HCA and HCD of 130.58 μm and 12.24 μm as against 136.83 μm and 12.48 μm of the control, whereas the alkaline soil sample showed a mean HCA and HCD of 122.70 μm and 11.70 μm, respectively. Statistical analysis showed a significant difference in the HCA and HCD (P ≤ 0.05). Conclusion: The result of this study suggests that the extreme of soil pH can cause the weathering of bone, which can distort the histomorphometry. The study focused on the extremes of pH and not various scales. This should help guide forensic investigations.
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Knowledge, attitude, and practice toward the novel COVID-19 outbreak: A cross-sectional study in Palestitine p. 162
Hatem A Hejaz, Inad Nawajah, Maaly Wredat, Walaa Melhem
DOI:10.4103/abhs.abhs_16_21  
Background: Coronavirus disease-2019 (COVID-19) outbreak is a global concern and the World Health Organization (WHO) has declared it as a public health emergency of international concern. Objectives: This study aimed to assess knowledge, attitude, and practices (KAP) toward COVID-19 among the general population of Palestine at the time of the COVID-19 pandemic. Materials and Methods: A cross-sectional study was conducted using an online questionnaire; a series of questions regarding the KAP of the population about COVID-19 was asked, and participants’ demographic characteristics and source of information regarding COVID-19 were collected and analyzed using Statistical Package for the Social Sciences (SPSS) software program, version 26.0. Results: Seven hundred twenty-four individuals participated in this study. The average age of the participants was 28 years (standard deviation [SD] = 10.7), the majority were females 558 (77.1%), with a bachelor’s degree 480 (66.3%), and 229 (31.6%) students. Most of them from Hebron governorate 609 (84.1%) and many of them reported that they wear a mask when they leave their house and avoid shaking hands, 494 (68.2%), 424 (58.6%), respectively. The results indicate that Palestinians have a good level of knowledge about COVID-19 with a positive attitude and good compliance with Palestinian government measures. The result showed a significant correlation between female gender, higher age, and higher education with KAP. However, male gender, nonhealth-care-related professions, single, and lower level of education were significantly associated with lower knowledge scores. There was no clear satisfaction with the government’s role in limiting and controlling the spread of COVID-19. Conclusions: Palestinian population showed decent knowledge, appropriate practice, and a positive attitude toward the COVID-19 outbreak.
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CASE REPORT Top

Increased expression of BDNF and inflammatory biomarkers in type 2 diabetes-related claustrophobia: A case report p. 175
Ankita Srivastava, Bashair M Mussa, Salahedeen Abusnana
DOI:10.4103/abhs.abhs_23_22  
Type 2 diabetes mellitus (T2DM) is widely known to cause damage to several organ systems resulting in complications such as neuropathy, nephropathy, and retinopathy. A characteristic feature of T2DM is hyperglycemia, which can adversely affect the brain and cause psychological disorders such as anxiety and depression. Although several studies have reported a strong association between T2DM and psychological disorders, it is surprising that the latter is not well investigated. Therefore, the main objectives of this case report are to (i) emphasize the association between psychological disorders and T2DM and (ii) investigate the expression of brain-derived neurotrophic factor (BDNF) and inflammatory markers in a case of T2DM-related claustrophobia. By investigating the blood and saliva samples of a 40-year-old male suffering from T2DM and claustrophobia, we report a highly significant increase in BDNF expression and inflammatory biomarkers interleukin-6 and monocyte chemoattractant protein-1 along with a concomitant decrease in interleukin-8 and transforming growth factor-beta. Based on these observations, we propose the presence of a correlation between increased BDNF expression, inflammation, and diabetes-related claustrophobia. Outcomes from this report further highlight the significance of considering T2DM-related psychological disorders as an essential diagnostic measure.
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STUDENT ARTICLE Top

Evaluating the impact of sociodemographics and BMI on social anxiety among the students of the University of Sharjah p. 181
Emad Eddin Dalla, Abdulrahman Maziek, Shorouq Hamood, Hayat AlRaeesi, Afaf Mogharbel, Shamma Omran
DOI:10.4103/abhs.abhs_19_22  
Background: The association between social anxiety and specific confounders such as body mass index (BMI) and gender has not been studied in the UAE yet. This study aims to assess the impact of sociodemographics and BMI on social anxiety levels among the university students. Methods: A questionnaire-based cross-sectional study was performed on 578 students using a modified version of the established and validated self-administered “Social Anxiety Questionnaire-Adult 30” (SAQ-A30), which aims to assess social anxiety across five different dimensions. Furthermore, height and weight measurements were obtained using manual scales to calculate the participants’ BMI. Results: About 553 students were eligible for data analysis. Based on analytical tests, the female gender was associated with increased social anxiety (P<0.05). In addition, negative changes of body self-perception were associated with increased social anxiety scores among college students (P<0.0001). However, we found no correlation between social anxiety levels and different BMI groups among the university students. Conclusion: Social anxiety levels increase based on gender and change of body self-perception after entering college in students.
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