systematic translation of biomarkers research into clinical practice

Background: The rapid gains in science and technology during the last century resulted in an epidemiological shift from infectious diseases to non-communicable diseases like cancer, diabetes mellitus, and cardiovascular diseases. However, despite the large funding put into the understanding of etiology of cancer, identification of novel diagnostic markers, and advancing cancer treatment, the translation of research findings into clinical practice leaves much to be desired for

Methods and Results: The translation of cancer biomarkers into clinical practice is a great challenge that needs to be promptly addressed for better cancer outcomes. This review discusses the characteristics of clinically useful cancer biomarkers, and how biomarkers identified by research can be used for the improved cancer management and patient outcomes. We also explored the underlying reasons for the less than an optimal translation of biomarkers research into clinical practice, how basic medical sciences can undertake more clinically relevant research, and provide suggestions on how to improve the clinical translation of research findings from such studies. The reason delaying the clinical translation of biomarkers are: lack of systematic analyses on existing cancer biomarkers; inadequate sample size; lack of an optimal scoring system and threshold; limited use of panels of biomarkers; technical differences between laboratories; and the need for well-designed validation studies [biomarker clinical trials]

Conclusion: Clinical translation of biomarkers could potentially be facilitated through a systematic approach taking into account the reasons highlighted in the current study

Effectiveness of dengue fever prevention campaigns; a study of knowledge and practices in urban/semi-urban communities of Lahore

Dengue fever badly hits Pakistan in 2011. A large number of people died due to dengue fever. To control the alarming situation, other than treatment, work had been started at all levels. Department of Social Welfare and Bait-ul-Maal, Punjab was involved by the City District Government to work for the awareness among public for the preventive measures and practices to reduce the spread of the epidemic. Anti-dengue awareness campaigns were organized at the community level with the help of non-government organizations. A survey was conducted with the following objectives to evaluate the effectiveness of anti-dengue awareness activities: [1] Public knowledge of Dengue fever. [2] Anti-mosquito Preventive Practices. A cross sectional household survey. Out of ten towns of Lahore city, Samanabad Town was selected. Januarys to March 2014. A structured interview schedule of three sections was designed. Interviews were conducted from urban/semi-urban communities. By using multistage random sampling, Out of ten towns of Lahore city, Samanabad Town was selected. Samanabad Town is consisted of 24 union councils with a population of 17 million. Three union councils: 86, 104 and 112 were randomly selected. 400 household were randomly selected from these union councils for interview to ensure representativeness of the sample. Males/Females aged 15-65 and above lived in the households of Samanabad Town were the respondents. One respondent was selected from each household. In this cross-sectional study, by using Taro Yamni Formula, 400 interviews were successfully conducted with a response rate of 100%. Other than demographics, 17-items questionnaire measured knowledge and practices about awareness and dengue prevention. Descriptive statistics and Pearson Correlation coefficient was used for the analysis of the data. Data was analyzed by using SPSS 20. Maturity of the community members' 76 - 92% was aware and had knowledge of preventive measures. 66 - 83% practicing regularly in the households. Data analysis indicated a positive and significant association between knowledge about dengue prevention and practices about dengue eradication [r = 0.000, p < .005]. Consistent awareness campaigns for dengue fever prevention and control enhances public knowledge and motivates individuals to adopt preventive practices in day to day routine life. To foster and maintain public interest, attractive beneficial public friendly practical economical practices need to be publicized to motivate young ones in communities. Orientation training programs of community paid health workers will be helpful to improve skills to assert effective dengue fever preventive measures and control activities to reduce the breeding sites of mosquitoes

Dietary patterns; precursor of health behaviors during chronic illness

In order to promote healthful trends, insight is needed in the behavioral determinants of nutrition behaviors. Most research on behavioral determinants has been linked with individuals' physical health and socio-economic factors. However, health behavior is influenced by individual physical health and abilities. Multiple dynamics of chronic illnesses within human body influenced the dietary patterns. For disease prognosis, doctors advised patients to observe preventive measures. The researchers tried to identify the changes in the dietary patterns protective effects of food consumption such as mutton, chicken, beef, snacks and sweets on chronic illnesses that reduce the risk factors and contribute in the patients' health behaviors. The empirical data was collected from three Dialysis Units: Mayo Hospital, Jinnah Hospital, Lahore General Hospital and all admitted patients of Punjab Institute of Cardiology, Lahore. These four hospitals have good turn-over of the patients should in this exploratory study, purposive sampling method was used. For the collection of quantitative data, a hospital-based survey was conducted by using a structured interview schedule. 275 patients [131-cardiac and 144-renal failure] including 184 males [67%] and 91 females [33%] between age of 20 to 110 years were interviewed. Age mean +/- standard deviation was 44 years; S.D = 15.338. Descriptive statistics [frequencies, percentages] and multiple response tables were deployed to find out the research goals across heart and kidney diseases. Results indicates that before illness, majority 238 [86.5%] of the patients took three meals. After illness, 34% patients changed the food consumption. In two meals, 96.7% patients used vegetables, 86.2% used pulses along with chapatti, and 98.5% used tap water to drink. In other drinks, 87.6% used tea, 50.5% used milk, and 52% used to drink lassi. A high proportion [65%] of patients for first treatment consults with GP's. 10.6% changed their food consumption on the advice of hakeem/homeopathic and 10.6% changed on the advices of others. 78% were unable to perform their daily activities and need help; 89% patients changed food choices; and 86% patients follow doctors' advices. Change in diet is a contributing factor towards health and well-being during illness. It reduces risk factors and a good indicator of patients' health behaviors to cope with the disease

Heart and kidney patients; correlational patterns of social support with coping strategies and subjective well-being

The prevalence of chronic diseases is exceptionally high [37.9%] among the adult population of Pakistan. Social support could play a significant role in shaping the coping strategies and determining the subjective wellbeing of chronically ill patients. This research documents the correlation patterns of social support with coping strategies and subjective well-being among Heart and Kidney Patients. The primary data was collected from four major hospitals in Lahore by using purposive sampling method. For the collection of quantitative data, a hospital-based, cross-sectional survey was conducted with 275 admitted patients [131-heart and 144-kidney]184 male and 91 female [20 to 110 years of age] by using a structured interview schedule. Pearson Product-moment Correlation and Multiple Regression Analysis were performed on the data set. Strongest correlation was found between emotional and informational social support [r=.853]. Instrumental social support also indicates strong relationship with the emotional social support [r=.838]. There was a moderate positive correlation [r=.339] between behavioral coping, emotional social support and informational social support [r=.424]. Data show a negative relationship between physical coping and subjective well-being [r=.381]. Results of the study suggest that emotional [beta=.230] and informational [beta=.217] social support affect the patients' ability to actively engage in behavioral and physical coping for the subjective well-being; however, physical coping indicated negative effects [beta =-.225] on the subjective feelings of well-being. A strong correlations among four types of social support exists and behavioral coping has the strongest impact on the subjective well-being [beta=.629]

Coping strategies during chronic illness: a comparative study of cardiac and renal failure patients

Pakistan is a developing country where the majority of the population belongs to the lower socioeconomic class. Chronic diseases such as cardiovascular and kidney diseases are increasing day by day in Pakistan. Individuals suffering from chronic illnesses are at a greater risk of problems as compared to the un-sick. Their vulnerable situation and the stress of the event creates a lot of changes, changing the meaning of individual lives altogether. To understand the dynamics of chronic illnesses, it is important to find out what coping strategies were used by the cardiac and renal failure patients? The researchers tried to find out whether cardiac and renal failure patients differ in their coping strategies. Quantitative cross sectional study. August 2014. The data was collected from the Dialysis Units of Mayo Hospital, Jinnah Hospital, Lahore General Hospital and all admitted patients of Punjab Institute of Cardiology, Lahore. These four hospitals have good turn-over of the patients. Purposive sampling method was used in this study. For the collection of quantitative data, a hospital-based survey was conducted by using a structured interview schedule. 275 patients [131-cardiac and 144-renal failure] including 184 males and 91 females between age of 20 to 110 years were interviewed. Mean age was 44 years [S.D = 15.338]. T-Test for independent groups and Pearson's correlation tests were carried out to compare cardiac and renal failure patients coping strategies along with descriptive statistics. Results indicate that renal failure patients used more physical coping [M = 11.23], t [df = 273] = -1.235, p<.01 that cardiac patients [M = 10.83], t[df = 273] = -1.242, p<.01. Cardiac patients used more psychological [M = 28.69], t[df = 273] = 1.511,p<.01and behavioral coping [M = 17.37], t[df = 273] = 3.977,p<.01 than renal failure patients psychological[M = 27.97], t[df = 273] = -1.517,p<.01 and behavioral coping[M = 15.43], t[df = 273] = 3.980,p<.01. F = 11.800.1.882, and 0.623 which are greater [i.e., p<.05]. Pearson's Product-moment correlation coefficient show strong correlation exists between behavioral and psychological coping [r = .428]. Study found significant differences between the cardiac and renal failure patients coping strategies. Renal failure patients used physical coping strategies more whereas cardiac patients used more psychological and behavioral coping strategies