RESUMO
In most Arab countries, including Algeria, Lebanon, Libya, Morocco, Oman, Tunisia, Sudan and the United Arab Emirates [UAE], cervical cancer is the second most common malignancy seen in women. The objective of this study was to ascertain whether or not cervical cancer screening [CCS] is important in the detection of precancer and early cervical cancers, and if so, to understand how it can most effectively be implemented in the UAE. Before introducing any CCS programme, it is important to determine [1] the knowledge, attitude and practice [KAP] of physicians involved in the screening programme, [2] the actual prevalence of the precancer and cancer of the cervix, and [3] the choice of treatment modalities available. These factors will determine the likely effectiveness of screening. As in other Arab countries, women in the UAE have little awareness of Papanicolaou's stain test [also known as the Pap smear], and so many have never undergone this test. This is critical, as many patients present with advanced-stage disease in countries where awareness is low. Our observations indicate that there are significant gaps in the KAP of primary health care physicians with regard to CCS. Additionally, standards in colposcopy and cytology services are severely lacking, despite good treatment modalities. Based on this study, it is imperative that physicians receive training and that quality control measures be implemented prior to the introduction of CCS, to ensure that the programme can succeed in the UAE. In this way, the experience of the UAE should serve as a learning model for other countries in the Arab world, where CCS and prevention programmes have yet to be initiated
RESUMO
The aetiology and pathophysiology of asthma remain complex. The role of systemic cytokines, especially Transforming Growth Factor B1 [TGF beta-1] and its response to inhaled steroids has not been explored before. Therefore, we studied plasma TGF-beta 1 levels in stable asthmatics on inhaled steroids. Asthmatics and age and sex matched controls were recruited prospectively from an outpatient department of a university hospital from January 2001 to February 2002. Information on asthma and its management including the status of inhaled steroid usage were collected by a questionnaire and subsequent review of medical records. Plasma TGF-beta 1 and serum IgE levels were estimated using established methods in our laboratory. The median age of the 40 patients was 26.5 [22.25 - 33.25] years. 18 patients were on regular inhaled steroids. Plasma TGF-beta 1 levels varied significantly between patients on regular inhaled steroids, not on steroids and controls [p=0.003]. The median TGF-beta 1 in asthmatics on inhaled steroids [1.4ng/ml, 1.16 - 1.92] was significantly lower compared to those not on it of asthma was not significantly different in atopic and non-atopic groups. Low plasma TGF beta-1 in asthmatics on regular inhaled steroids may reflect a better control of airway inflammation