Background: Communication in healthcare settings is vital for patient safety and quality of care, affecting outcomes including anxiety levels, satisfaction, and medication adherence. Aim: This study explored patients' and family members' perceptions of the family meeting process in inpatient palliative care. Methods: An exploratory qualitative study was conducted using semi-structured individual interviews with family members of seriously ill patients recruited purposively from a nonprofit community hospital. Interviews were conducted in person between July 2010 and March 2011. Data were analyzed using thematic analysis following phenomenological approach. Results: Twenty-four respondents provided 118 significant statements. Four main themes emerged: (1) the distinctiveness of family meetings, (2) the blind transition and family readiness, (3) the impact on decision-making process, and (4) setting expectations and clarifying care goals. Conclusion: Family members reported that discussions with the inpatient palliative care team resulted in improved communication and knowledge, which contributed to enhanced decision-making ability.
OBJECTIVE:Refrigeration of food has been shown to mitigate environmental and dietary risk factors important in the pathogenesis of gastric cancer. Globally, the incidence of gastric cancer has decreased. This study aims to determine the relationship between refrigerator ownership and gastric cancer. METHODS:Gastric cancer data were obtained from the Global Burden of Disease study, and refrigerator ownership data were sourced from GlobalDataLab. Countries were excluded from the analysis if they lacked refrigerator ownership data for more than 10 years or had over 80% ownership at the start of data collection. The relationship between the two variables was assessed using Spearman's rank correlation coefficient. RESULT:Countries were screened using the inclusion criteria, and 85 countries from five continents were included in the study. Seventy-three countries demonstrated a negative correlation between refrigerator ownership and gastric cancer among their male populations, and 55 countries showed comparable results among their female populations. Thirteen countries exhibited a positive correlation between the two variables. CONCLUSION:Increasing refrigerator ownership appears to be associated with decreasing gastric cancer rates. Further research is needed to identify the specific risk factors involved in gastric cancer pathogenesis in the 13 countries where this association was not observed.
INTRODUCTION:Brown adipose tissue (BAT) activity seen on 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) has been increasingly recognized as a potential biomarker in various cancers, including lymphomas. The aim of this study was to investigate the correlation between posttreatment survival outcomes and BAT activity depicted in baseline FDG PET/CT scans in lymphoma patients. MATERIAL AND METHOD:This retrospective study was conducted at the PET/CT Section of the Department of Radiology, Aga Khan University Hospital, Karachi, Pakistan (2019-2025). The study was granted exemption by the Ethical Review Committee (2024-10630-31016). Patients with lymphoma (Hodgkin's and non-Hodgkin's; HL; NHL) whose baseline FDG PET/CT revealed BAT activation were selected. FDG PET/CT scan was acquired using a standardized protocol adopted from the European Association of Nuclear Medicine Guidelines (2015). These patients were followed for a mean of 03 years (range 15-36 months) for survival outcome (progression-free survival; PFS). RESULTS:During the study period, 259 patients with lymphomas (96 HL and 163 HL) who had baseline FDG PET/CT were selected. The cohort included 75% males (n = 194) and 25% females (n = 65), with a median age of 58 years (range: 03-80). BAT activation was identified in 27% of patients (n = 69). A significant association was observed between BAT activation and higher 3-year PFS, with activated BAT patients achieving a survival rate of 78% compared to 58% in those without activation (p < 0.05). CONCLUSION:Lymphoma patients with activated BAT depicted in their baseline FDG PET/CTs showed longer progression-free survival than those without. This study also emphasizes the need for further evaluation of BAT's role in metabolism, tumor microenvironment, and long-term prognosis in patients with lymphomas.
OBJECTIVE:To evaluate the anticancer mechanisms of Chamuangone against cholangiocarcinoma (CCA) cells. METHODS:Chamuangone was tested for cytotoxicity against KKU-100 and KKU-452 cells for 24 and 48 h. Apoptosis, cell proliferation, mitochondrial membrane potential, and intracellular reactive oxygen species (ROS) levels were assessed using Annexin V, Ki-67, JC-1 assays, and DCFH-DA fluorescence probe, respectively. Oncology proteins expression was measured. RESULTS:Chamuangone inhibited CCA cell growth in a dose- and time- dependent manner, with IC50 values in KKU- 100 cells of 1.175 and 0.331 μg/mL at 24 and 48 hours, respectively; in KKU- 452 cells, the IC50 values were 1.208 and 0.428 μg/mL. Consequently, Chamuangone at 1.5 and 3.0 μg/mL effectively induced both early and late apoptosis in a statistically significant manner, which correlated with a marked reduction in cell proliferation, as evidenced by the decrease in Ki-67 positive populations to 49.04% and 17.02%, respectively. Chamuangone at concentrations of 0.75, 1.5, and 3.0 μg/mL significantly induced mitochondrial dysfunction by reducing the Red/Green fluorescence ratio across all time points (3-24 h), indicating a loss of mitochondrial membrane potential that triggers apoptosis. The induction of intracellular oxidative stress was indicated by a significant increase in the high-dose group of Chamuangone. Moreover, it also suppressed the expression of key ROS- and oxidative stress-associated oncogenic proteins, including Carbonic Anhydrase IX, Enolase2, CXCL8/IL-8, Galectin-3, EGFR/ErbB1, Progranulin, FGF basic, Dkk-1, p27/kip1, Mesothelin, Survivin, leading to redox imbalance and apoptosis in KKU-100 cells. CONCLUSION:Chamuangone inhibits CCA cell proliferation by inducing apoptosis through mechanisms involving the suppression of the Ki67, loss of mitochondrial membrane potential, intracellular ROS accumulation, and downregulation of oncogenic-related proteins involved in proliferation, survival, angiogenesis, and oxidative stress. Thus, Chamuangone has significant potential as a lead compound for the development of novel CCA therapeutics.
BACKGROUND:Fluoropyrimidine-based chemotherapy is a fundamental treatment for colorectal cancer (CRC), yet its therapeutic efficacy is often limited by significant inter-individual variability. Enzymes involved in 5-fluorouracil (5-FU) metabolism thymidylate synthase (TS), dihydropyrimidine dehydrogenase (DPD), and methylenetetrahydrofolate reductase (MTHFR) are critical determinants of drug response. This study aimed to evaluate the molecular correlation between TS, DPD, and MTHFR mRNA expression in paired tumor tissue and peripheral blood samples, while simultaneously developing and validating a non-invasive predictive nomogram to forecast therapeutic response to neoadjuvant CAPEOX (capecitabine-oxaliplatin) chemotherapy in advanced CRC. METHODS:A prospective cohort study was conducted on 36 patients with stage III-IV CRC receiving CAPEOX. mRNA expression of TS, DPD, and MTHFR was quantified using qRT-PCR from paired tumor and peripheral blood samples. Chemotherapy response was evaluated using RECIST 1.1 criteria. Statistical analyses included Spearman correlation, the Mann-Whitney U test, and multivariate logistic regression. A nomogram was constructed based on significant predictors. RESULTS:DPD and MTHFR expression levels were significantly lower in responders than in non-responders (p < 0.001), while TS expression showed no significant difference. Gene expression in tissue and blood was strongly correlated (r = 0.820 for TS, r = 0.658 for DPD, and r = 0.623 for MTHFR; all p < 0.001). Multivariate analysis identified blood-based DPD and MTHFR expression as independent predictors of response. The predictive nomogram demonstrated excellent discrimination (AUC = 0.932). CONCLUSION:Lower DPD and MTHFR expression predicts a favorable response to neoadjuvant CAPEOX in advanced CRC. These biomarkers offer a promising, non-invasive approach to personalizing treatment strategies potentially enhancing therapeutic efficacy while minimizing unnecessary toxicity.
BACKGROUND:Accurate staging is paramount in optimizing outcomes for patients with operable adenocarcinoma of the stomach and gastroesophageal junction (GEJ). Cross-sectional imaging frequently underestimates the true extent of disease, particularly occult peritoneal metastases. Adding Staging laparoscopy (SL) enhances diagnostic precision, but its universal application remains debated. Identifying clinicopathological predictors of upstaging may enable the selective yet mandatory use of SL in high-risk subgroups. METHODS:In this single-centre retrospective study, we analysed 182 patients with clinically operable adenocarcinoma of the stomach and GEJ who underwent SL as part of their staging work-up between June 2018 and December 2024. Clinical, radiological, and pathological variables were assessed to determine their association with upstaging. The primary endpoint was the detection of unsuspected metastatic disease or positive peritoneal cytology on SL. The secondary endpoint was to identify independent predictors of upstaging using multivariate logistic regression. RESULTS:Of 182 patients evaluated, 37 patients (20.3%) were upstaged on SL, precluding curative-intent surgery. The most common route of upstaging was detection of peritoneal metastases 33(18.1%) and the rest of the patient had isolated positive cytology 4 (2.2%). High-risk features significantly associated with upstaging included minimal ascites (OR 5.87, p<0.001), signet ring cell histology (OR 4.15, p=0.007), linitis plastica morphology (OR 3.42, p=0.002), and tumor thickness ≥15 mm (OR 2.21, p=0.034). Notably, radiologically node-negative patients with none of the high-risk features had a low probability of upstaging. A risk-stratified algorithm based on these parameters improved the diagnostic yield of SL and reduced non-therapeutic laparotomies. CONCLUSION:Universal incorporation of staging laparoscopy into treatment algorithms for operable gastric and GEJ adenocarcinoma is challenging in many settings due to resource and economic constraints. While established guidelines endorse SL in selected scenarios, our findings suggest that, in addition to these proven indications, the consideration of SL in patients with linitis plastica morphology, tumour thickness >15 mm, signet ring cell carcinoma histology, and even mild ascites can further refine the staging accuracy. Targeting these high-risk subgroups enables a more personalised treatment approach, maximises the detection of occult metastases, and, importantly, reduces the incidence of non-therapeutic laparotomies.
OBJECTIVES:This study aims to investigate rural women's knowledge and attitudes towards cervical cancer, their willingness to participate in cervical cancer screening, and the perceived obstacles to screening. METHODOLOGY:A community-based cross-sectional study was conducted in Madurai district, Tamil Nadu, India, from February to July 2024, involving 350 women aged 25 to 65 years. Utilizing multistage random sampling, the study employed face-to-face interviews with a semi-structured questionnaire focused on knowledge and attitudes towards cervical cancer, as well as barriers to screening services. Data were analyzed using R programming (version 4.4.3). RESULTS:Participants had a mean age of 33.83 ± 7.56 years, with 29.1% being illiterate. Only 15.7% had undergone cervical cancer screening. Approximately 68.3% and 66.8% expressed willingness to undergo cervical cancer screening if it were free or recommended by a doctor, respectively. Major barriers to screening included fear of falling sick after screening (65.1%), lack of awareness (64.3%), and the belief that screening is unnecessary at their age (64%). Women aged 35-44 years (3.21 ± 0.49, p = 0.05, β = -0.542), those who were non-working (3.14 ± 0.50, p = 0.02, β = -0.739), illiterate (3.21 ± 0.57, p = 0.04, β = -1.093), of lower socioeconomic class (3.09 ± 0.52, p = 0.05, β = -0.883), and those who had never undergone cervical cancer screening (3.07 ± 0.52, p = 0.02, β = -0.677) had significantly lower mean knowledge scores. CONCLUSION:The research highlights significant gaps in awareness and screening among rural women in Madurai, despite a positive attitude towards screening. Low participation rates stem from educational and socioeconomic barriers. The study's regional focus may limit broader applicability, and social desirability bias may be a concern due to the use of interviewer-administered questionnaires. Enhancing the Makkalai Thedi Maruthuvam program in Tamil Nadu with targeted education and community involvement could boost awareness and screening rates.
OBJECTIVES:Engineered nanomaterials could potentially interact with biomolecules and intracellular processes, as many biological activities take place at the nanoscale level. Conventional anticancer therapies have several limitations, which warrant the introduction of alternative cancer cell killing agents. METHODS:In the present study, we have synthesized ZnO nanoparticles using orange peel extract and encapsulated them inside polyethylene glycol (PEG), a biocompatible polymer (PEG-ZnO-OP). Different characterization techniques were performed to ensure the proper synthesis of the nanoparticles. The biocompatibility was assessed by the MTT assay using normal fibroblast cells, 3T3L1, hemolysis assay, and zebrafish embryo studies. Finally, the anticancer activity in vitro was estimated by the MTT assay in the lung cancer cell line. RESULTS:The hydrodynamic diameter and zeta potential were 43 nm and -20 mV, respectively, showing an ultrasmall size and moderate stability in an aqueous environment. The XRD data suggested a good crystalline structure; SEM and EDX showed size distribution between 81 nm and 143 nm, and the presence of Zn and O, along with other trace elements, was probably contributed by the orange peel extract. The PEG-ZnO-OP nanoparticles were highly biocompatible up to a dose of 50 μg/mL, as assessed both in vitro and in vivo. Further, the anticancer activity showed a high cell killing effect with an IC50 value of 43.88 μg/ml. CONCLUSION:This study demonstrated that our synthesized PEG-ZnO-OP nanoparticles were safe to administer and could cause significant cancer cell killing. Future studies involving the anticancer effect in other cell lines and animal models need further exploration.
BACKGROUND:Timely diagnosis and treatment are critical for improving cancer survival; however, significant delays persist across the cancer care continuum, particularly in resource-constrained settings like India. This study aimed to analyze the extent and patterns of delays among patients with breast, cervical, and head and neck cancers in northwestern India. METHODS:This exploratory cross-sectional study included all histopathologically confirmed cases of the three cancer types who initiated radiotherapy at the Radiotherapy Department of Government Medical College, Amritsar, during December 1, 2023, to November 30, 2024. Data on sociodemographic profiles, clinical details, and treatment timelines were collected through interviews and medical records. Delays were categorized as appraisal, help-seeking, diagnostic, pre-treatment, system, and total delays. Analysis was conducted at the descriptive, bivariate, and multivariable levels. Median delays and interquartile ranges were calculated for each cancer type. Differences in delay intervals between cancer groups were assessed using the Kruskal-Wallis H test, and differences between two-category variables were assessed using the Mann-Whitney U test. Associations between categorical variables and the presence of prolonged total delay (≥120 days) were examined using the chi-square test or Fisher's exact test, as appropriate. Correlation between total delay and number of medical contacts was evaluated using Spearman's rank correlation coefficient. Finally, multivariable binary logistic regression was performed to identify independent predictors of prolonged total delay, and adjusted odds ratios with 95% confidence intervals were reported. A p-value of <0.05 was considered statistically significant. RESULTS:Among the 119 patients included in the study (45 breast, 28 cervical, and 46 head and neck cancers), breast cancer patients experienced the longest total delay (median: 282 days), followed by cervical (median: 199 days) and head and neck cancers (median: 190 days). System delay was the primary contributor across all three cancer types, driven largely by diagnostic delays. Appraisal delay was longest for breast cancer (median 155.5 days), help-seeking delay was longest for head and neck cancer (median 65 days), and pre-treatment delay was also longest for breast cancer (median 51.5 days). Variations in delays were observed across sociodemographic factors, but none reached statistical significance. CONCLUSION:This study highlights the need for a targeted, cancer-specific approach to address delays, with a focus on strengthening diagnostic services and improving system efficiency within the healthcare infrastructure. Implementing multi-pronged strategies for early detection, timely care, and prevention is crucial in reducing the cancer burden in this high-risk region.
PURPOSE:This study aims to identify key molecular targets and pathways of newly designed metal-dithiocarbamate peptide complexes in breast cancer using a network pharmacology approach, addressing the limited understanding of their systems-level mechanisms of action. METHODS:Fifteen essential metal dithiocarbamate complexes were evaluated using ADMET profiling and network pharmacology analysis. Potential protein targets were predicted using the SwissTargetPrediction and SuperPred databases, followed by protein-protein interaction (PPI) analysis via STRING and topological analysis using Cytoscape. RESULTS:A total of 502 potential targets were identified, of which 21 hub proteins were extracted through network clustering. Topological analysis revealed CDK1, CCNA2, CCNB1, and CCNB2 as key hub genes with the highest degree (≥20), betweenness, and closeness centrality values. KEGG enrichment analysis indicated that these targets were primarily involved in cell cycle regulation, cellular senescence, and p53 signaling pathway. CONCLUSION:This study provides a system-level perspective on the potential anticancer mechanisms of metal-dithiocarbamate complexes in breast cancer. Although the findings are predictive and computational, they highlight promising molecular targets that warrant further experimental validation.
BACKGROUND:Uterine leiomyomas are the most common benign tumors in women of reproductive age, often causing significant symptoms such as abnormal bleeding, pain, and infertility. Melatonin, a hormone with anti-proliferative and oncostatic properties, has been studied; however, its effects on uterine leiomyomas remain unclear. OBJECTIVE:This study aimed to evaluate the immunohistochemical expression of melatonin receptors MT1 and MT2 in uterine leiomyomas compared to normal myometrium, and to correlate their expression with clinical and histopathological features. METHODS:A case-control study was conducted on ninety cases retrieved (60 leiomyoma cases, thirty normal myometrium controls). Immunohistochemical staining was performed to assess the expression of MT1 and MT2 receptors. Clinical data were collected, and statistical analyses were conducted to evaluate associations between receptor expression and demographic, clinical, and histological features. RESULTS:MT1 and MT2 were significantly overexpressed in leiomyomas compared to controls (MT1: 70% vs. 30%, p < 0.0001; MT2: 60% vs. 16.7%, p < 0.0001). A strong positive correlation was observed between MT1 and MT2 expression (r = 0.6, p < 0.0001). MT1 score varied significantly with age (p = 0.03), tumor location (p = 0.04), and presenting symptoms (p = 0.03), while MT2 expression was positively associated with the number of lesions (p = 0.033). CONCLUSION:Melatonin receptors MT1 and MT2 are significantly upregulated in uterine leiomyomas, suggesting a potential role in their pathogenesis. These findings support further investigation into melatonin-based therapies as adjunctive treatments for leiomyomas.
OBJECTIVES:To evaluate the diagnostic yield of staging imaging in detecting distant metastases among women with early-stage breast cancer in Oman, assess alignment with international guidelines, and identify key patient factors that could guide selective imaging use. METHODS:A retrospective cohort study was conducted at Sultan Qaboos University Hospital, Muscat, Oman, including women diagnosed with stage 0-II breast cancer between January 2014 and December 2019. Patient demographics, tumor characteristics, imaging modalities, and outcomes were reviewed. Staging imaging included computed tomography (CT) with bone scintigraphy and/or positron emission tomography (PET-CT). The primary outcome was the prevalence of confirmed metastatic disease (M1). Fisher's exact test was used to assess associations between clinicopathological factors and metastatic yield. The Number Needed to Image (NNI) was calculated to estimate the efficiency of imaging. RESULTS:Among 207 patients, 187 (90.3%) underwent staging imaging. Suspicious findings were detected in 10 patients (5.3% of those imaged), but only six cases (3.2% of those imaged; 2.9% of the total cohort) were confirmed as true metastases. All confirmed metastases were identified using CT with bone scans, while PET-CT did not detect any additional cases. Lymph node status was the strongest predictor of metastases (p = 0.011). Node-positive patients had a 19.0% metastasis rate compared with 1.1% among node-negative patients. The NNI was 5 for node-positive versus 93 for node- negative patients, demonstrating the limited value of routine imaging in low-risk groups. CONCLUSION:The overall yield of routine staging imaging in early-stage breast cancer is low, with the greatest benefit observed in node-positive patients. Adopting risk-based, guideline- aligned imaging strategies could reduce unnecessary investigations, patient anxiety, and healthcare costs while ensuring optimal use of resources.
BACKGROUND/AIM:Hypoxia poses a significant challenge to cancer therapy. The impact of hypoxia on butyrate, a gut metabolite that has anti-colorectal-cancer properties, is unclear. Thus, the aim of this study was to determine the activity of sodium butyrate (NaB) under hypoxic conditions. Furthermore, this study was the first to investigate the potential of carbonic anhydrase IX (CA IX), a hypoxia-regulated gene, as a target for NaB. MATERIALS AND METHODS:The Caco-2 and HT-29 colorectal cancer cell lines were exposed to 0, 5, 10, 15, and 20 mM NaB under hypoxic and normoxic conditions for 24 and 48 hours. We assessed cell viability and clonogenicity rates using an MTT assay and a colony-forming assay, respectively. RT-PCR was used to measure the effect of NaB on CA IX expression level. RESULTS:After 24 hours of treatment with NaB, the percentage of viable HT-29 cells decreased under normoxic conditions, while it remained unchanged under hypoxic conditions. After 48 hours, the percentage of viable HT-29 cells decreased under both oxygen conditions. The viability of normoxic and hypoxic Caco-2 cells was only reduced after 48 hours of NaB application. Interestingly, NaB significantly reduced the number of HT-29 and Caco-2 colonies in normoxic and hypoxic conditions. NaB significantly decreased CA IX mRNA expression level in HT-29 hypoxic cells after 48 hours (p <0.0001), but not after 24 hours. CONCLUSION:At the beginning, hypoxia caused an alteration in the anti-colorectal-cancer activity of NaB, which then returned to normal. Our data revealed the novel finding that NaB downregulates CA IX, suggesting a potential therapeutic strategy for colorectal cancer that targets tumor metabolism and pH regulation.
PURPOSE:This study aimed to map and synthesize available screening instruments for detecting psychosocial problems in cancer patients. METHODS:A scoping review was conducted following Arksey and O'Malley's framework. Literature searches were performed in PubMed, Scopus, and ScienceDirect using predefined keywords, focusing on English-language, full-text, and quantitative studies. Data extraction included study characteristics (title, author, year, objectives, design, sample) and key findings on the validation and application of screening tools. A thematic analysis was performed by two independent reviewers, with discrepancies resolved through discussion, to compare psychometric properties, clinical feasibility, and the scope of detection across instruments. RESULTS:Of 18,225 records identified 11 studies met the inclusion criteria. Fourteen screening instruments were identified, including the DT, HADS, PHQ-2, PHQ-9, GAD-7, ESAS, PROMIS Depression Short Form, MAX-PC, DADDS, STAI-S, PHQ-ADS, MADRS-S, e-VAS, and DART. The analysis generated three major themes: (1) psychometric strength (validity and reliability), (2) clinical feasibility (time efficiency, ease of use, applicability across cancer populations), and (3) scope of detection (range of psychosocial problems identified, such as depression, anxiety, general distress, and death anxiety). CONCLUSION:Several rapid screening instruments demonstrate strong psychometric properties and clinical applicability for detecting psychosocial problems in cancer patients. Future research should focus on integrating the most effective tools into oncology practice and on developing a rapid, comprehensive instrument tailored to clinical needs, thereby enhancing early detection and psychosocial care.
PURPOSE:This study aims to explore the lived experiences of families caring for breast cancer patients undergoing chemotherapy, focusing on the multidimensional impacts and coping mechanisms in the Indonesian cultural context. METHOD:Using Van Manen's hermeneutic phenomenological approach, this qualitative study involved 20 family members of breast cancer patients undergoing chemotherapy at a government hospital in Semarang, Indonesia. Data were collected through in-depth, semi-structured interviews, supported by field notes and demographic questionnaires. Thematic analysis was conducted using NVivo software and Colaizzi's method to extract key themes and subthemes. RESULTS:Four major themes emerged: (1) information on the impact of chemotherapy, which included physical, psychological, and socioeconomic changes experienced by patients and observed by families; (2) unpreparedness to face side effects, revealing families' confusion and emotional responses due to a lack of knowledge; (3) The need for adequate information and support, highlighting the demand for clear communication and psychological guidance from healthcare providers; and (4) Hope and the meaning of being a caregiver, in which families found renewed strength, spiritual growth, and purpose throughout the caregiving journey. These findings highlight the complex emotional and social dynamics that families encounter during the cancer treatment process. CONCLUSIONS:Chemotherapy has a profound impact not only on patients but also on their families. A lack of preparedness and insufficient support intensify emotional and practical burdens. Therefore, a culturally sensitive, family-centered nursing intervention is crucial to enhance family resilience, ensure effective caregiving, and improve overall quality of life during cancer treatment in developing countries. Such culturally sensitive, family-centered nursing support is essential to strengthen caregiver resilience, reduce burden, and improve the quality of life for both patients and families during chemotherapy.
BACKGROUND:Brain tumors are among the most complex and life-threatening malignancies, with limited understanding of their genetic etiology. Poly (ADP-ribose) polymerase 1 (PARP1) plays a critical role in DNA repair. The single nucleotide polymorphism (SNP) rs1136410 (A>G) in PARP1, which results in a Val762Ala substitution, has been suggested to alter PARP1 enzymatic activity and potentially influence tumor development. However, its association with brain tumors remains underexplored particularly in the population of Khyber Pakhtunkhwa (KP), Pakistan. METHODS:In this study, we enrolled 200 patients with brain tumors, along with an additional 200 individuals as controls. DNA was extracted using the phenol-chloroform method, followed by genotyping through the Amplification Refractory Mutation System-Polymerase Chain Reaction (ARMS-PCR). Statistical analysis was conducted using GraphPad Prism. RESULTS:The genotypic distribution of rs1136410 in brain tumor patients and healthy individuals indicates that this SNP is significantly associated with brain tumors (Chi-square = 13.24, df = 2, p = 0.0013). The AA genotype was associated with a 77% increased risk of overall brain tumors (OR = 1.77, p = 0.0065), an 88% increased risk of glioma (OR = 1.88, p = 0.0159), and a 2.9-fold increased risk of meningioma (OR = 2.91, p = 0.0073). In contrast, the GG genotype was associated with a 63% decreased risk of overall brain tumors (OR = 0.37, p = 0.0011), an 84% decreased risk of glioma (OR = 0.26, p = 0.0019), and an 80% decreased risk of meningioma (OR = 0.21, p = 0.0217). Similarly, the A allele was associated with an increased risk of brain tumors (OR = 1.88, p = 0.0065), whereas the G allele was associated with a decreased risk (OR = 0.53, p = 0.0001). CONCLUSION:In conclusion, this study demonstrates that rs1136410 is significantly associated with brain tumor risk particularly with the glioma and meningioma subtypes underscoring the role of PARP1 in brain tumor genetics and its potential as a therapeutic target.
BACKGROUND:Oral squamous cell carcinoma (OSCC) is the sixth most prevalent cancer globally and constitutes a major public health burden in Bangladesh, with approximately 7.5% of all cancer-related deaths. Although tobacco and betel-quid use are recognized risk factors, dietary patterns may also contribute to OSCC development. OBJECTIVE:This study investigated the association of lifestyle and dietary factors with OSCC in Bangladeshi patients and explored the potential involvement of TERT promoter mutations and human papillomavirus (HPV) infection. METHODS:A hospital-based, case-control study was conducted involving 47 histopathologically confirmed OSCC patients and 100 age- and sex-matched healthy controls without cancer or chronic illness. Sociodemographic, lifestyle, and dietary data were collected through a structured questionnaire. Tumor DNA was analyzed for TERT promoter mutations and HPV DNA using PCR and Sanger sequencing. Statistical analyses were performed using multivariable logistic regression to identify significant associations. RESULTS:Excessive betel-quid chewing was strongly associated with OSCC (p < 0.01). Among 39 sequenced OSCC samples, 25 single-nucleotide polymorphisms (SNPs) at position -245 (A>G) and one hotspot mutation at position -124 (G>A) of the TERT promoter were identified substantially lower than frequencies reported in other populations. No HPV DNA was detected in any sample. Certain dietary patterns such as low fruit and vegetable intake and high consumption of betel quid were linked to increased OSCC risk. CONCLUSION:Our findings suggest that, in Bangladeshi patients, specific dietary and lifestyle factors, rather than HPV infection or TERT promoter mutations, contribute significantly to OSCC development. Targeted public health strategies emphasizing nutritional awareness and cessation of betel-quid use are recommended.
OBJECTIVE:The effect of previous biliary reconstruction (BR) or endoscopic sphincterotomy (EST) on post-hepatectomy bile leakage and abscess formation remains controversial. This study aimed to investigate the incidence, clinical findings, and risk factors of postoperative abscesses in the liver resection plane in patients with such histories. METHODS:This multicenter retrospective study included 5,742 patients who underwent liver resection between 2011 and 2020 (38 with a history of BR, 44 with EST, and 5,660 with no history of biliary treatment). The incidence, clinical characteristics, and risk factors for abscess formation, as well as factors associated with prolonged healing duration (≥45 days), were analyzed. RESULTS:Abscess formation was significantly more frequent in the BR (47.4%) and EST (25.0%) groups than in the non-BR/non-EST group (3.5%). Bile leakage was identified as an independent risk factor for abscess formation. Bile leakage and mixed infection both significantly more frequent in the BR group than in the non-BR/non-EST group were independent risk factors for prolonged healing duration. CONCLUSION:Patients with a history of BR or EST are at a higher risk of postoperative abscess formation in the liver resection plane. Bile leakage plays a critical role in both abscess development and prolonged healing.
BACKGROUND:Hepatocellular carcinoma (HCC) is the most common primary liver malignancy and a major cause of cancer-related mortality worldwide. Chronic hepatitis C virus (HCV) infection remains the predominant etiological factor in Egypt. The limited sensitivity and specificity of alpha-fetoprotein (AFP) continue to hinder early HCC detection. This study aimed to assess the diagnostic significance of circulating microRNA-155 (miRNA-155) expression in HCV-related HCC and to develop a novel, noninvasive diagnostic model combining miRNA-155 with routine biomarkers. Methods: A total of 42 HCV-positive HCC patients, 83 patients with liver cirrhosis (LC), and 20 healthy controls were enrolled. Clinical, hematologic, and biochemical parameters were analyzed. Circulating miRNA-155 levels were quantified by quantitative real-time PCR and normalized to U6 RNA. Receiver operating characteristic (ROC) curve analysis and multivariate discriminant analyses were used to develop a composite diagnostic model integrating AFP, albumin, platelet count, INR, AST/ALT ratio, and miRNA-155, designated the HCC-miR Score. RESULTS:Liver function tests and hematologic indices showed progressive deterioration from controls to LC and HCC groups. miRNA-155 expression was significantly elevated in HCC (6.71 ° 3.38) compared with LC (5.44 ° 2.31) and controls (1.27 ° 0.68) (p < 0.0001). The HCC-miR Score demonstrated superior diagnostic accuracy (AUC = 0.753) to AFP alone (AUC = 0.713), achieving 100% sensitivity and 68% specificity at a cutoff value of 0.32. The model effectively discriminated early-stage, small-sized, and well-differentiated tumors from cirrhotic cases, outperforming AFP across all subgroups. CONCLUSION:Circulating miRNA-155 is markedly upregulated in HCV-related HCC and correlates strongly with disease progression. The novel HCC-miR Score represents a simple, sensitive, and noninvasive model for the early diagnosis of HCC in high-risk HCV patients.
