Knowledge, Attitude and Practice about Breast Cancer among Saudi Women: A Cross-sectional Study in Riyadh

Background: Worldwide, breast cancer is the most common cancer in women. Breast cancer screening has been found effective in early diagnosis and decreasing mortality rates. Aim of the study: To assess Saudi Women’s knowledge, attitudes and practices towards breast cancer screening in Riyadh, Saudi Arabia, and investigate factors that influence these practices. Methods: This is a cross-sectional community-based survey; a self-administered questionnaire was used to collect data from a convenience sample of females with a wide spectrum of socio-demographic profiles. A scoring scheme was used to score women’s responses. Logistic regression analyses were conducted to identify factors associated with screening practices viz. breast self-examination (BSE), mammography and attitudes. Results: The study included 407 females, mean (± S.D) age of 28 years (± 8.5); 45% were married and 40.2% had a university degree. Only 30% of females practiced BSE and 25% had ever performed mammography. Stepwise logistic regression analysis revealed that inappropriate attitude is independently predictable by inadequate knowledge (p<0.0001). Factors independently associated with BSE practice in the stepwise logistic regression analysis were being married (p<0.05), appropriate attitude (p<0.05), adequate knowledge (p<0.05) and performing a mammography test (p<0.0001). Factors independently associated with performing mammography were age greater than 40 years (p<0.05), higher knowledge score (p<0.0001) and practicing BSE (p<0.0001). Conclusion: These study findings indicate significant inadequate knowledge, inappropriate attitude towards breast cancer as well as suboptimal screening practices among Saudi women. Therefore, preventive educational campaigns employing innovative strategies to increase population awareness, particularly targeting future generations through schools and university curricula, should be urgently implemented to reverse the course of the upward growing incidence of breast cancer disease in the Kingdom of Saudi Arabia.

Tumor Necrosis Factor-alpha (-308 G/A) is a Predictor for Development of Gestational Diabetes Mellitus in Saudi Pregnant Women

Inflammation may play a role in the pathogenesis of gestational diabetes mellitus (GDM) and also, it is one of the mostpopular pregnancy complications. The goal of the research was to study the association exists among common many formsin the stimulate area (-308G/A) of the TNF-alpha gene and increased danger for become better of GDM in Saudi pregnantwomen population.GDM and healthy subjects were genotyped with PCR- RFLP technique. No association was noticedamong the TNF-α -308 G/A in different and sensitivity to GDM disease in our Saudi cohort. There was a secondarycombination among TNF-α –308 G/A polymorphism in GDM (vs. normal control) (p = 0.605), which its triviality may becaused to survivor agent. The frequency of the -308 A allele (5) and genotype classification was in Hardy-Weinbergequilibrium (GG, n=54; GA, n=41; AA, n=5).The G-308A various, detected by PCR amplification and Nco-1 digestion,determines the lowest of a restriction site finding in a single band of 107 bp (the (A) allele). The (A) allele frequencies of the-308 (G/A) TNFα polymorphism were 26% in the GDM group and 29% in the depend subjects, with no significant differenceamong the two groups may be due to considerable variance in allele frequencies of the polymorphism by BMI quartiles (≥25kg/m2, for each quartile n=86) with -308G allele transporters had contains a higher BMI than A allele transporters(P=0.000**). Furthermore, considerable was found positively correlated with BMI, age, and children number.CONCLUSION: It could concluded that theTNF-α-308 G>A genotype frequency comparison among patients and controlwas not statistically significant in the Saudi women and also, the SNP in situation -308 (G/A) for the human. TNF- gene is adependent danger agent or a predictor for GDM.

Screening for Glucokinase (GCK) Gene Mutation in Gestational Diabetes Women in Western Region of Saudi Arabia.

Aim: The study involved screening of three exons of glucokinase gene (7, 8 and 9) to detect mutations at posi­tions 682A>G, p.T228A, 895G>C, p.G299R and 1148C>A, p.S383X, respectively in Saudi pregnant women with or without gestational diabetes. Study Design: Retrospective study. Place and Duration of Study: The Obstetrics and Gynecology clinic of King Abdul-Aziz Hospital in South Jeddah between May and October 2013. Methodology: A sample of 100 Saudi pregnant women classified as healthy (control, N = 50 (pregnant women without diabetes)) or with gestational diabetes (N = 50) was analyzed for mutations in the GCK gene. Blood samples were taken and DNA was extracted from whole blood. The target part of GCK gene was amplified by the polymerase chain reaction (PCR). The specific amplified regions were digested by restriction enzymes: BstUI for exon 7, HhaI for exon 8 and BfaI for exon 9, and electrophoresed on agarose gel. Mutations were screened by restriction fragment length polymorphism. Results: Fasting glucose levels were statistically higher in gestational diabetes women than controls (P-value = 0.00). The difference in Glucose Challenge Test (GCT) values between two groups shows significante p-value = 0.00. However, We observed that there was no significant correlation between any of the GCK mutations and gestational diabetes in Saudi population. Conclusion: The glucokinase gene mutations do not affect glucose metabolism in pregnant Saudi women.

Association of obesity with vitamin D deficiency and the clinical implications.

Background: Obesity is a complex disorder which leads to health problems like diabetes, hypertension and hyper cholesterolemia. It has been reported that obesity is associated with vitamin D insufficiency due to decreased bio-availability. The aim of the present study is to investigate whether vitamin D deficiency can be a causative factor for obesity in Saudi women above 40 years. Methods: 100 Saudi female patients above 40 years who came to the outpatient department of Arar central hospital were selected for the study. Patients who were on immunosuppressive drugs, with hormonal disorders and with impaired renal function were excluded from the study. The data was collected using a questionnaire which included the socio demographic details, height, weight and medical history and the serum vitamin D levels were assessed. Results: 69% of the Saudi women were obese (BMI >30). 84% (n=58) of the obese women had vitamin D deficiency (<50 nmols/l) while 69.6% of the overweight women had vitamin D deficiency. 43.5% (n = 30) of obese women had diabetes, 44.9% (n=31) of obese women had hypertension. The association between obesity and vitamin D deficiency was not significant. Conclusions: No significant association was found between obesity and vitamin D deficiency indicating that vitamin D deficiency has no significant role in causing obesity in Saudi women above 40 years.

Prevalence of osteoporosis and factors associated with osteoporosis in women above 40 years in the Northern Part of Saudi Arabia.

Background: Women have lower bone density than men and they lose bone mass more quickly as they advance in age, which leads to osteoporosis. The Saudi Diabetes and Endocrine Association in the Eastern Province revealed that 30 to 50% of Saudi women above 40 years of age develop osteoporosis. Factors related to the development of osteoporosis include poor diet, low calcium intake, vitamin D deficiency, sedentary lifestyle and smoking. Previous studies have shown that there is a high prevalence of vitamin D deficiency in Saudi women. Methods: The present study was done in 100 Saudi women above 40 years of age who were outpatients in Arar Central Hospital during a period of four months. After taking an informed consent, data was collected relating to the risk factors, vitamin D levels were assessed and the patients underwent a Dual Energy X-ray Absorptiometry (DEXA) scan. Results: The results showed that 82% of Saudi women patients had vitamin D deficiency. Only 21% of women were exposed to sunlight. 58% of the women had low BMD (18% with osteoporosis and 40% with osteopenia). Only 5% of patients took Vitamin D and Calcium rich diet and 7% were in the habit of doing exercise. There was a significant association between bone mass density and exercise when Fisher's exact test was used (P value < 0.05) Conclusion: Prevalence of osteopenia is higher than osteoporosis in the Saudi women above 40 years in the Northern part of Saudi Arabia. The major cause of low BMD is lack of exercise even though there is a high prevalence of Vitamin D deficiency.