Histopathological Profile of Different Breast Lesions: A Single-Center Observational Study.

OBJECTIVE: To describe the histopathological pattern of different breast lesions among tissue specimens sent to our laboratory. METHOD: A record-based study using a retrospective review of 255 histologically diagnosed breast biopsy reports in the histopathology department of authors from December 2016 to November 2021 was conducted. The specimens were collected from core biopsy, lumpectomy, and mastectomy. All data obtained were analyzed using the Statistical Package for the Social Sciences (SPSS) version 28 (IBM SPSS Statistics, Armonk, NY). Then, the findings were presented using text, tables, and charts. RESULT: A total of 255 breast lesions were analyzed in this study. Most of the cases were benign (58.8%), followed by inflammatory lesions (21.6%), and malignant (19.6%). Fibroadenoma was the most prevalent benign lesion (36.7%), and most of the patients (70.9%) were in the age group of 20-39 years old. The most common inflammatory lesion was granulomatous mastitis (56.4%), and most of the cases were diagnosed in the age group of 30-39 years old. Invasive ductal carcinoma (IDC) was the most encountered histological type of carcinoma (62%). Of the malignant cases, 52% were diagnosed before the age of 50 years. Among these 50 cases, grade 2 was the most prevalent one (46%). CONCLUSION: Benign breast lesions are more common than malignant breast lesions, and fibroadenoma is the most common benign subtype. Granulomatous mastitis is the most prevalent inflammatory breast lesion. About two-thirds of malignant cases are non-Arab. Invasive ductal carcinoma with no special type (NST) is the most common malignant subtype.

Outcomes of Neurorehabilitation Among Patients With Prolonged Disorders of Consciousness.

BACKGROUND:  The impact of neurorehabilitation on patients with prolonged disorders of consciousness (PDOC) is not well known. We assessed the range of motion (ROM), muscle girth and power, level of consciousness, development of musculoskeletal deformity, and superficial sensation. METHODS:  A retrospective observational record-based study was done, which included the data of patients diagnosed with PDOC admitted at Thumbay Physical Therapy & Rehabilitation Hospital, Ajman, UAE, between 2020 and 2022. Data on the "range of motion", "muscle girth and power", "level of consciousness", "development of musculoskeletal deformity", and "superficial sensation" were collected and analyzed. The SPSS software version 27 (IBM Corp., Armonk, NY, USA) was used for analysis. The chi-square test was used to assess association, and the t-test was used to test the mean difference. RESULTS:  We assessed the data of 21 patients with PDOC. The superficial sensation was found to have increased significantly (p<0.025). There was a decrease in the proportion of patients with musculoskeletal deformities during the follow-up period. The ROM, muscle girth, and muscle power were also preserved without significant deterioration. However, the level of consciousness measured by the Glasgow coma scale (GCS) showed no improvement. CONCLUSIONS: Our research showed that neurorehabilitation significantly improves superficial sensation and prevents the development of musculoskeletal deformities. However, the mean level of consciousness remained the same. There was also no decrease in ROM. Both muscle girth and power were preserved over two years.

The effect of access to electronic resources during examination on medical and dental students scores in summative assessment: quasi experimental study.

BACKGROUND: Access to electronic (E) resources has become an indispensable requirement in medical education and practice. OBJECTIVE: Our objective was to assess the effect of E-resources access during examination on end-course-exam scores of medical and dental students. METHODS: A quasi-experimental study which included two cohorts of medical (n = 106 & 85) and three cohorts of dental students (n = 66, 64 and 69) who took end-course- exams. Each exam was composed of two- parts (Part I and II), that encompassed equal number of questions and duration. Access to E-resources was allowed in part-II only. Items Difficulty Index (DI), Discrimination Index, (DisI), Point Biserial, (PBS) and cognitive level were determined. RESULTS: The study included 390 students. The proportion of items at various levels of DI, DisI, and PBS and the average values for item DI, DisI in both parts of each exam were comparable. The average scores in part-II were significantly higher than part-I (P < 0.001, < 0.001 and 0.04) and lower-order cognitive-level items scores were higher in three exams (P < 0.0001, 0.0001, 0.0001). Higher- order cognitive level items scores were comparable between part I and II in all courses. The significant factor for change in marks were questions cognitive level and type of the course. CONCLUSION: Access to E-resources during examination does not make a significant difference in scores of higher-order cognitive level items. Question cognitive level and course type were the significant factors for the change in exam scores when accessing E-resources. Time-restricted E-resources accessed tests that examine higher cognitive level item had no significant academic integrity drawback.

Predictors of Nicotine Dependence Among Adult Male Midwakh and Cigarette Smokers.

Objectives: Midwakh is a popular form of smoking in the Middle East. This study aimed to assess the predictors of nicotine dependence among cigarette or midwakh smokers in the United Arab Emirates (UAE). Methods: This cross-sectional study was conducted from September to December 2015 in Ajman, UAE. A convenience sampling strategy was implemented to recruit adult male smokers aged ≥18 years who exclusively smoked either cigarettes or midwakh. A validated self-administered questionnaire was used to collect data from the participants, with nicotine dependence assessed using the Modified Fagerström Test for Nicotine Dependence. In addition, the levels of salivary cotinine and exhaled breath carbon monoxide (CO) were measured. Results: Of the 88 adult male smokers included in the study, 40 (45.5%) were cigarette smokers and 48 (54.5%) smoked midwakh. The majority of participants were 26-35 years of age (48.9%), followed by 18-25 years (30.7%) and >35 years (20.5%). Midwakh use was associated with more than a three-fold increase in the risk of moderate-to-high nicotine dependence compared to cigarette smoking. Moreover, for each unit increase in CO level, there was a 10% increase in the risk of nicotine dependency. There was also a significant association between nicotine dependence level and depth of inhalation (P = 0.023). Conclusion: Type of smoking and CO level were found to be significant predictors of nicotine dependence among adult male smokers. In particular, greater dependency was observed among midwakh smokers than cigarette smokers.

Salivary cotinine concentration and carbon monoxide levels in young adults smoking midwakh in comparison with cigarette smokers.

OBJECTIVES: To estimate and compare the salivary cotinine levels using a semiquantitative method, called NicAlert, between three groups: non-smokers, daily smokers of cigarettes and daily smokers of midwakh, and to compare the carbon monoxide (CO) levels among these groups. MATERIALS AND METHODS: A total of 159 adult male volunteers aged 20 and above were included, with 54 current cigarette smokers, 52 current midwakh smokers and 53 non-smokers. Estimate of breath carbon monoxide and salivary cotinine were collected, as well as sociodemographic characteristics and details of smoking habits and second-hand smoke exposure among participants. Institutional review board approval was obtained and data were analysed using SPSS V.21 with the Kruskal-Wallis test used to obtain differences in the distribution. RESULTS: There was no significant difference in the median breath CO and salivary cotinine levels between cigarette and midwakh smokers. Levels of breath CO were significantly higher in cigarette and midwakh smokers as compared with non-smokers (19.5, 17.5 and 6.0, respectively, p<0.05); the same relationship was observed for cotinine levels among cigarette and midwakh smokers as compared with non-smokers (4.0, 3.0 and 0.0, respectively, p≤0.05). Additionally, the values of both salivary cotinine and breath CO increased with the frequency of tobacco use. CONCLUSION: These are the first data that we are aware of that demonstrate that in terms of at least two key biomarkers of tobacco use, there are comparable levels of exposure between cigarettes and midwakh users, demonstrating a need for intensified attention to the use of midwakh.

Predictors of Colorectal Cancer Knowledge among Adults in the United Arab Emirates

Objective: To assess knowledge regarding colorectal cancer (CRC) and to identify its predictors in the UAE. Materials and Methods: A cross sectional study was conducted among subjects ≥ 50 years-old, using a validated self-administered questionnaire. Awareness of CRC risk factors, warning signs/symptoms (S/S), and screening methods was evaluated with a level of knowledge score for various areas. Low (poor) knowledge was defined as a score below the corresponding average value. The Chi-square test and logistic regression were used in the statistical analysis. Results: The percentage of respondents who had poor knowledge score concerning risk factors, warning S/S and screening were 81.7%, 84.7% and 94.1% respectively. Male and lower education level subjects had significantly higher probability of low knowledge related to risk factors and warning S/S. Also respondents without a family history of CRC or personal history of polyps had a significantly higher probability of low knowledge concerning warning S/S compared to those who had a positive history. Significantly higher probability of low knowledge concerning screening methods was noted among non-Arabs and subjects with a lower education level. Conclusion: Most of the respondents had poor knowledge. Gender, education level, family and personal history and ethnicity were found to be significant predictors of CRC knowledge.

Contraceptive Utilisation Among Mothers of Reproductive Age in Ajman, United Arab Emirates.

OBJECTIVES: This study aimed to determine contraceptive utilisation among mothers aged 18-49 years old in Ajman, United Arab Emirates (UAE). METHODS: This cross-sectional study was carried out from May to November 2013. A total of 400 participants were recruited from two primary healthcare centres and one private hospital in Ajman. An interviewer-administered validated questionnaire was used for data collection. RESULTS: The frequency of previous and current contraceptive use was 68.0% and 61.8%, respectively. Expatriates more frequently used contraceptives in comparison to Emiratis (77.3% versus 54.3%, respectively). Contraceptive use increased significantly with age (75.5% among >35-year-olds versus 57.3% among ≤25-year-olds; P <0.050) and education level (83.3% among postgraduates versus 60.0% among those with primary education; P <0.050). In addition, contraceptive use was significantly higher among those living in a nuclear family system (P <0.050). A univariate analysis indicated significant associations between contraceptive use and age, nationality, education level, type of family system, employment sector, parity, knowledge of birth control measures and source of birth control information (P <0.050 each). However, no significant associations were found via multivariate analysis. CONCLUSION: Healthcare practitioners can play a pivotal role in providing contraceptive advice which could lead to an improvement in contraceptive utilisation. Efforts are recommended to raise awareness regarding newer forms of contraceptives among mothers of reproductive age in the UAE.

Spousal Concordance of Diabetes Mellitus among Women in Ajman, United Arab Emirates.

OBJECTIVES: Spousal concordance is defined as similar behaviours and associated health statuses between spouses. This study aimed to identify the concordance of diabetes mellitus (DM) and related variables among genetically unrelated couples in Ajman, United Arab Emirates (UAE). METHODS: This cross-sectional study included 270 married women attending either the Mushairef Health Center or the Gulf Medical College Hospital in Ajman between May and November 2012. A validated questionnaire was designed to determine sociodemographic characteristics and a history or family history of DM, hypertension, coronary artery disease or dyslipidaemia among the women and their husbands. The weight, height, body mass index, waist circumference, fasting blood sugar and glycated haemoglobin (HbA1c) levels of all women were measured. RESULTS: Of the women, 39.3% of those with diabetic husbands and 39.9% of those with non-diabetic husbands were diabetic themselves (P >0.050). The prevalence of DM spousal concordance was 17.8%. A history of hypertension, coronary artery disease and dyslipidaemia was significantly more frequent among women whose husbands had a history of the same conditions (P = 0.001, 0.040 and 0.002, respectively). Spousal concordance of abnormal glycaemia among non-diabetic women with diabetic husbands was significant (P = 0.001). Having a diabetic husband (P = 0.006) and being obese (P = 0.009) were the only significant predictors of hyperglycaemia among non-diabetic women after controlling for confounding factors. CONCLUSION: There was significant concordance of abnormal glycaemia among non-diabetic women with diabetic husbands. The spouses of diabetic patients may therefore be a target population for regular hyperglycaemia and DM screening.

Incidence of Type 2 Diabetes Mellitus among Emirati Residents in Ajman, United Arab Emirates.

BACKGROUND: Diabetes mellitus (DM), particularly type-2 is a major public health concern worldwide. Not much information is available with regard to the incidence of DM in United Arab Emirates (UAE). This study aimed at determining the incidence rate of diabetes mellitus among Emirati population in Ajman, UAE. This is a retrospective cohort study. METHODS: This study was conducted in all primary health care centers and Shaikh Khalifa and GMC Hospitals, Ajman, UAE where the Emirati population primarily go for diagnosis and treatment. The incident cases of diabetes mellitus were collected during the period 2010 January to December. RESULTS: A total of 158 cases newly detected in 2010, 54 were among non-Emiratis and one was type-1 diabetes. Eliminating these, the remaining 101 were included in the analysis. The age of the patients ranged from 23 years to 78 years; 35 (34.7%) males and 66 (65.3%) were females. The overall incidence observed was 4.8/1,000 person-years (PY) with a female predominance of 6.3/1,000 PY against incidence among males of 3.3/1,000 PY. With regard to age specific incidence rate among males, it increases with age till 60 years and then showed a decreasing trend. Among females also the same trend was observed but not as similar to males. CONCLUSION: The highest incidence rate was observed in the 55-59 age group among males, 23.4/1,000 PY and females, 32.4/1,000 PY. Among males the incidence rate was much less compared to females in-the age groups older than 59 years.

Assessment of Breast Cancer Awareness among Female University Students in Ajman, United Arab Emirates.

OBJECTIVES: The aim of this study was to assess female university students' knowledge of breast cancer and its preventative measures and to identify their main misconceptions regarding breast cancer. METHODS: This cross-sectional study was conducted between April 2011 and June 2012 and included female students from three large universities in Ajman, United Arab Emirates (UAE). A stratified random sampling procedure was used. Data were collected through a validated, pilot-tested, self-administered questionnaire. The questionnaire included 35 questions testing knowledge of risk factors, warning signs and methods for the early detection of breast cancer. Participants' opinions regarding breast cancer misconceptions were also sought. RESULTS: The participants (n = 392) were most frequently between 18 and 22 years old (63.5%), non-Emirati (90.1%) and never married (89%). A family history of breast cancer was reported by 36 (9.2%) of the students. The percentage of participants who had low/below average knowledge scores regarding risk factors, warning signs and methods for early detection of breast cancer was 40.6%, 45.9% and 86.5%, respectively. Significantly higher knowledge scores on risk factors were noticed among participants with a family history of breast cancer (P = 0.03). The misconception most frequently identified was that "treatment for breast cancer affects a woman's femininity" (62.5%). CONCLUSION: A profound lack of knowledge about breast cancer was noted among female university students in the three UAE universities studied. The most prominent gaps in knowledge identified were those concerning breast cancer screening methods.

Breast self examination practice and breast cancer risk perception among female university students in Ajman.

Breast cancer is the top cancer in women worldwide and its incidence is increasing, particularly in developing countries. In the United Arab Emirates (UAE), many cases are first diagnosed in later stages and at younger age compared to those seen in developed countries. Early detection in order to improve breast cancer outcome and survival remains the cornerstone of breast cancer control. Performance of breast self examination is one of the important steps for identifying breast disease at an early stage, by the woman herself. No information has hitherto been available about the frequency of this practice among female university students in UAE or about their breast cancer risk perception and therefore the present study was conducted in Ajman. It was found that 22.7% of the participants practiced BSE but only 3% of them practiced BSE monthly. Marital status but not age as significantly associated with age likelihood. The most frequent reported barriers for BSE were lack of knowledge, considering oneself not at risk and the absence of doctor advice. These factors need to be taken into account in intervention efforts.

Acute effects of dokha smoking on the cardiovascular and respiratory systems among UAE male university students.

BACKGROUND: In the United Arab Emirates (UAE) tobacco use is rampant. A less reported, yet widely used form of smoking native to UAE is midwakh or dhokha. The aim of the study is to assess the acute effects of smoking dokha (Arabian pipe) on the cardiovascular and respiratory systems among male university students in the UAE. METHOD: A quasi-experimental study was conducted among 97 male volunteers aged more than 17 years. Blood pressure, heart rate and respiratory rate of each participant, were measured before and immediately after smoking. A self administered questionnaire was used to collect personal details and data about smoking pattern. RESULTS: Mean increases in systolic blood pressures (12±1 mmHg), heart rates (20±2 bpm) and respiratory rates (4±1 breaths/min) were observed (p<0.001). A mean decrease in diastolic blood pressures (1±1 mmHg) was observed (p=0.483). CONCLUSION: Smoking dokha has a significant acute effect on systolic blood pressure, heart rate and respiratory rate. Anti smoking campaigns must address the ill effects of this form of smoking. Results from the study warrant further research into this method of smoking which is becoming more popular.

Smokers and marriage: attitude of youth in the United Arab Emirates.

INTRODUCTION: In order to control the tobacco scourge, an array of measures is required. Among them is focusing on adolescent relationships as it has been shown that being in a close relationship with a smoker or a non smoker will in the long run be a major factor in deciding whether the individual adopts smoking for initial non-smokers or ceases the habit for initial smokers. OBJECTIVES: To assess the attitude of youth towards other smokers and towards marrying a smoker. MATERIALS AND METHODS: A cross-sectional study was carried out among 415 students from five universities in the United Arab Emirates (UAE). Self-administered structured questionnaires were used for data collection. The Chi square test was used to detect significant differences between frequencies. RESULTS: Of the 415 participants who provided their gender information, 99 (24%) were males and 314 (76%) were females. Of all the participants, 83.5% were not willing to marry smokers, while 16.5% were willing. Of those whose parents smoked (106) 68% did not like it when their parents smoked, 13.6% had no opinion, 17.5% did not mind, while the other 1% had other thoughts. Of those whose close friends smoked, 43.4% did not like it, 16.2% did not have any opinion, 36.9% did not mind while 3.5% had other thoughts. CONCLUSION: Most participants, both males and females are not willing to marry smokers and prefer to have non-smokers as spouses. Also, smokers are seen as less attractive by both genders in contrast to what appears as popular beliefs amongst youngsters and what is depicted in tobacco advertisements. Tobacco control activities can be undertaken in the community and colleges by incorporating students as facilitators.

Knowledge regarding risk factors of hypertension among entry year students of a medical university.

CONTEXT: Hypertension in youth is increasing, but there is a dearth of data about the knowledge of risk factors in this age group. AIMS: To assess the knowledge of risk factors of hypertension among university students and associate it with the blood pressure, physical activity, family history of cardiovascular disease (CVD), and sociodemographic variables. MATERIALS AND METHODS: A cross-sectional survey among students enrolled in the first year, in the four academic programs, with the use of a validated, self-administered questionnaire on physical activity in the past 30 days and knowledge of risk factors of hypertension. A score of 6 on 11 was considered as good knowledge for modifiable risk factors. Blood pressure was also measured. The data was analyzed using PASW-17, Chi square test, and binary logistic regression analysis was done. RESULTS: Of the 110 participants, 69.2% were < 20 years of age, 76.4% were females, and 40% were Arabs. Stress, high cholesterol, obesity, and smoking were identified as risk factors by 75.5, 73.6, 77.6, and 71.8%, respectively; 69.1% considered high salt intake and 62.7% considered high calorie diet as risk factors. Energy drink was considered as a risk factor by 64.5%, coffee consumption 35.5%, physical inactivity 47%, and oral contraceptives 13.6%. Half the group did not consider a family history of CVD as a risk factor, 60% did not consider older age as a risk factor, and 88% did not think male gender was a risk factor. Knowledge of modifiable risk factors was better than that of non-modifiable risk factors. Although nationality, course of study, raised blood pressure, and history of diabetes showed significant association with good knowledge, their net effect was not significant by the Adjusted Odd's Ratio. CONCLUSIONS: The study identified some gaps in knowledge regarding both modifiable and non-modifiable risk factors of hypertension among students. A larger study would enable health promotion activities tailored to the needs of this age group.

Serum zinc levels in diabetic patients and effect of zinc supplementation on glycemic control of type 2 diabetics.

OBJECTIVE: The present study is an attempt to assess serum zinc level in a sample of diabetic patients (both type 1 and type 2 diabetics) in comparison with those of apparently healthy controls, and to ascertain the relationship between the levels of serum zinc with some epidemiological variables. Furthermore, a trial of zinc supplementation for 3 months conducted to assess the effect of zinc supplementation on glycemic control of the studied type 2 diabetic patients, and the factors that affect the response to this supplementation. METHODS: Collection of data was carried out during the period between November 2002 to February 2003 at the Diabetic Center of Merjan Teaching Hospital in Babil Governorate, Iraq. In the first part of the study (a case-control study), the diabetic group included 133 diabetic patients (type 1 and 2) who were chosen from patients attending the Diabetic Center during the period of the study. The control group included 133 apparently healthy subjects who were selected from the workers of the same hospital. Selection of cases and controls was carried out by using systematic random sampling procedure. In the second part of the study (single blind were intervention study), type 2 diabetic patients (101 patients) divided into 2 groups; the first group included 50 patients supplemented with oral zinc sulfate (30 mg of elemental zinc/cap/day) for 3 months and second group included 51 patients given placebo and designed as control group. RESULTS: The first part of the study shows that the mean value for serum zinc level was significantly lower in diabetic patients than healthy controls (64.2 +/- 12.6 microg/dl for type 1 diabetics, and 68.9 +/- 11.9 microg/dl for type 2 diabetics versus 83.4 +/- 12.5 microg/dl for healthy controls). Using simple linear regression, significant positive correlation was found between serum zinc level and years of education and significant negative correlation was found between serum zinc level and baseline HbA1c% value, in the diabetic group. While significant positive correlation found between serum zinc level and estimated zinc intake in the control group. Using multiple regression analysis, serum zinc level showed significant positive correlation with gender (being a male compared with female), and estimated zinc intake and significant negative correlation with diabetes state (diabetic compared with non-diabetic), residence (urban compared with rural residents), and plant protein intake. The second part of the study shows that the mean value for HbA1c% concentration of the supplemented group decreased significantly at the end of the 3 months of follow up, while no significant changes were found in the mean value for HbA1c% of the control group. The present study showed that the change in HbA1c% after supplementation had significant negative correlation with baseline HbA1c% value. CONCLUSION: Diabetic patients have significantly lower mean serum zinc levels compared with healthy controls. Zinc supplementation for type-2 diabetics has beneficial effects in elevating their serum zinc level, and in improving their glycemic control that is shown by decreasing their HbA1c% concentration.