Cytogenetic and cytokine profile in elderly patients with cytopenia.

In the elderly with cytopenia, the diagnosis of myelodysplastic syndrome (MDS) may be missed. Cytokine levels contribute to the pathology of MDS. Hence, the objectives were to evaluate cytogenetic profile as a prognostic indicator in risk stratification and cytokine levels as a screening tool in patients with cytopenia for diagnosis. Over 2 years (2016-2018), 150 elderly patients were screened. MDS diagnosis was confirmed by morphology. Interleukin-2 (IL-2) and IL-6 levels were assessed in 50 patients, and karyotyping was performed in 20 confirmed cases of MDS. Age-matched healthy controls were used for comparison of cytokine levels. Among 150 patients, 88.6% had anemia, including nutritional anemia (51.2%). MDS diagnosis was confirmed in 35 patients. In 15 patients, unexplained cytopenia (UC) was present. Karyotyping in 20 MDS patients was normal in 15 (75%) patients and revealed a complex karyotype in four (20%) patients and double chromosomal abnormality in one (5%) patient. The Revised International Prognostic Scoring System (IPSS-R) scored 91% in the low-risk group and 9% (n = 3) in the high-risk group; the latter three developed acute myeloid leukemia (AML) and two of them had a 7q deletion. Among the 15 cases of UC, one patient died from refractory anemia. No significant difference in levels of IL-2 and IL-6 were found between MDS and UC patients when compared with healthy controls, as well as between different risk groups and karyotypes. A significant difference in IL-2 levels was found in MDS patients with disease progression and with stable disease. On the basis of the findings, it is suggested that IL-2 levels will help in predicting disease progression.

Breast Cancer Risk factor awareness and utilization of screening program: A cross-sectional study among women in the Northern Emirates.

BACKGROUND: Breast cancer is the principal cause of cancer deaths among women worldwide. Among Emirati females, breast cancer ranked first accounting for 23.1% of the total cancers. Around 58% of the cases occurred were reported from northern emirates. United Arab Emirates is having higher percentage of expat female population than Emirati women. There is lack of data regarding the knowledge and attitude about breast cancer in this mixed population. AIM: The aim of this study was to determine the knowledge and attitude of women towards breast cancer, risk factors and the screening program in women above the age of 19 years residing in northern emirates of the UAE. MATERIALS AND METHODS: This is a multi-center based study conducted in selected northern emirates of the UAE. This study employed cross-sectional design involving women above the age of 19 years. The study was conducted among 400 women who attended three hospitals in Ajman, Sharjah and Fujairah. Pretested, content validated questionnaire was used for data collection. Descriptive and inferential analysis was performed. RESULTS: About 85.2% of participants had heard about breast cancer. Among all, 47.9% felt breast cancer is more frequent than other cancers. While inquiring about symptomatology, most of the respondents had incorrect knowledge (79.8% for painless breast lump, 78.6% change in breast size, 76.3% nipple discharge). Subjects were queried for breast cancer screening (BSE) and were observed to have poor knowledge. Regarding practice of those with correct knowledge on BSE 34.2% of the participants had correct practice. CONCLUSION: The result shows that while substantial number still remains ignorant of breast cancer issues, a good number of those who have knowledge were yet to translate knowledge and attitudes into practice.

Acute Traumatic Ulnar Nerve Subluxation: A Case Report and Pathomechanism.

INTRODUCTION: Acute traumatic subluxation of the ulnar nerve at the cubital tunnel is rare or under-reported. CASE REPORT: A 31 year old Asian man presented with severe, radiating pain from the elbow to forearm, following a fall on his outstretched hand. He had swelling and severe tenderness at the posteromedial aspect of the elbow. Pain aggravated with elbow flexion beyond 80 degrees. There was no neurological deficit. Dynamic ultrasound demonstrated subluxation of ulnar nerve with elbow flexion. Broad arm sling immobilization was given for three weeks. At final follow up, he was asymptomatic with full range of pain free motion at the elbow. CONCLUSION: Our case report summarizes the presentation, management and pathomechanism of a rare clinical entity.

HIV-related knowledge, attitudes, perceived benefits, and risks of HIV testing among pregnant women in rural Southern India.

The rising prevalence of HIV among pregnant women in rural India is of great concern. Prenatal voluntary counseling and HIV testing (VCT) is critical to prevent mother-to-child transmission of HIV (PMTCT). We surveyed 202 pregnant women attending a rural antenatal clinic in Southern India to investigate HIV-related knowledge, attitudes toward infant feeding practices, and perceived benefits and risks of HIV testing. Of the total of 202 women surveyed, 189 women (94%) had heard of HIV/AIDS and 60% of them had relatively good knowledge regarding risk factors for HIV transmission. However, 48% did not know that there are "means to prevent mother-to-child HIV transmission." If women were not to breastfeed her baby, negative attitudes expected from the partner would include 84% thinking that that the mother is harming the baby, 78% thinking she is not a good mother, 74% thinking she has HIV, and 66% thinking she has been unfaithful. Ninety-seven percent of women did not perceive themselves at risk for HIV and only 57% had been tested for HIV. Although, 85% of women expressed their willingness to be tested, most were concerned about confidentiality and disclosing HIV serostatus because of fear of negative reactions from their husbands, parents, and community. Many social and cultural barriers confront pregnant women when they decide to opt for HIV testing. If VCT and PMTCT interventions are to be successful, urgent attention must be focused on education, development of innovative culturally appropriate interventions that empower women to make decisions about HIV testing, involvement of men, and addressing stigma and discriminatory attitudes toward people living with HIV/AIDS.