Psychological Adaptive Mechanism Maturity, Age, and Depression Symptoms in Advanced-Stage Cancer Patients

Background: Previously, we reported that the maturity of Psychological Adaptive Mechanism (PAM; alternatively, ego defense mechanism) endorsement, but not depression symptom severity, predicted 5-year survival rates in adult cancer patients and that study controlled for age as a significant variable. In this investigation, we hypothesized that greater PAM maturity would correlate significantly with age and with fewer depression symptoms in a larger sample.Methods: In this cross-section study, adult cancer outpatients (N=293) completed the Defense Style Questionnaire (DSQ), the Beck Depression Inventory (BDI), and provided additional clinical data. Spearman’s correlation and multiple regression modeling provided statistical tests of the study hypotheses.Results: Contrary to our hypothesis, DSQ PAM maturity endorsement did not correlate significantly with increasing age. Greater PAM maturity ratio on the DSQ (p<0.0001) and current antidepressant use (p<0.05), however, both provided inverse associations with total BDI symptom frequency (p<0.01). Age was inversely associated with BDI mood (p<0.0001) and somatic scores (p<0.04). Items that worsened BDI symptom frequency included self-reported mood-altering anti-cancer medications and any psychiatric history. Cancer stage, time since diagnosis, and chemotherapy treatment did not correlate with DSQ or BDI scores. Multiple regression analysis found that the correlated items accounted for 17.2% of the variance in mood symptoms and 4.9% in somatic symptoms. Specifically, adaptive maturity and age associated with fewer depression symptoms, while cancer medications affecting mood, and a previous psychiatric history each predicted higher frequency of depression scores.Conclusion: The results suggest that PAM maturity likely predicts fewer depression symptoms while younger age associates with more depression symptoms in this clinical sample. Centrally, acting cancer medications, such as glucocorticoids, and any history of psychiatric disorder correlated with increased depression symptom frequencies. In this cross-section study, antidepressant medications indicated higher frequencies of depressive symptoms, likely reflecting their use in persons previously diagnosed with depression. Further research should target factors that improve PAM maturity as a potential treatment target, especially in younger age groups.

The Number and Determinants of Nutrient foramina among dry human femur bones from the East African population: A Cross-section study

Background: Nutrient foramina form important landmarks on the femur and other bones as the portal of entry for nutrient arteries. Nutrient arteries are important sources of blood supply for growing bones; and their variations may be due to congenital or acquired causes. These variations are important in anatomical comparisons, orthopaedic surgical practice and forensic medicine. Aims: This study aimed at establishing the number and determinants of the nutrient foramina among dry human femur bones from the East African population. Materials and methods: This was a cross-section study of 333 dry femur bones from the East African population, at the Galloway osteological collection of Makerere University college of health sciences. The number of nutrient foramina on the shaft of each femur, the corresponding demographic, clinical and morphometric characteristics were documented. Data were entered in an Excel sheet and exported to STATA 14 for analysis. Univariate, bivariate and multivariable analyses were performed to obtain the summary statistics and the measures of association. At all levels of analysis, a p-value of less than 0.05 was considered statistically significant. Results: Of the 333 femurs, 291 (87.4%) were from males; and 137(50.15%) were right femurs. The age ranged from 20 to 75 years with a mean age of 35 (SD± 12) years. Nutrient foramina ranged from one to four; mean of 1.4 (SD±0.5) and median of 1 (IQR: 1 to 2). Of the 333 femurs, 199 (59.8%) had one foramen, 129 (38.7%) had two foramina, four femurs had three foramina and one femur had four foramina. There was a statistically significant association between the number of nutrient foramina and the femur’s: mid-shaft circumference (p=0.014; 95%CI: 0.003 to 0.028), nationality (p=0.016; 95%CI: -0.284 to -0.030) and sex (p=0.012; 96%CI: -0.405 to -0.050). Conclusion: Nutrient foramina among femurs from the East African population range from one to four per femur, with predominantly one foramen. The key determinants of the number of foramina are: mean mid-shaft circumference, nationality and sex. These findings are significant in anatomical comparisons; forensic and orthopaedic practices. KEY WORDS: Nutrient foramina, dry human femur, East African population, morphometric characteristics.

Hormonal Replacement Therapy in Surgically Induced Menopause: A Prospective Cross Section Study from a Tertiary Care Institution from A Sub-himalayan State

Background: Early surgical menopause increases risk of cardiovascular disease, osteoporosis, fracture, cognitive impairment and sexual dysfunction than women with late menopause. Estrogen therapy (ET) remains the most effective therapy for vasomotor symptoms related to surgically induced menopause. Meterials and Methods: It was a prospective cross-section study. Result: Amongst 255 symptomatic women, 163 (63.92%) women had severe vasomotor symptoms and 54 (33.12% of 163 women) of them had very incapacitating symptoms with marked reduction in their quality of life. 59 (23.13%) women had moderate symptoms with mild disturbances in their sleep while 33 (12.94%) women had only mild symptoms. Conclusion: It is agreed that women who undergo bilateral oophorectomy before the onset of natural menopause should be considered for estrogen therapy for the management of vasomotor symptoms until the average age of natural menopause.

Association of Blood Lead Level and Breast Cancer Risk in US Women: A Cross-Sectional Study(NHANES 2003-2014)

Background: Environmental chemical exposures may play a important role in breast cancer etiology.Higher levels of exposure to environmental chemicals, such as heavy metals, may be associated with a high risk of patients with breast cancer, but the evidence is limited and inconsistent. Thus, In the current study, we used National Health and Nutrition Examination Survey (NHANES) data to to assess the influence of blood lead on risk of patients with breast cancer.Methods:This cross-section study was conducted by extracting data from NHANES database(2003-2014). Logistic regression was applied to explore the association between the blood lead and the incidence of breast cancer. Cox proportional hazards regression models were used to estimate the odds ratio (OR) and 95% confifidence interval (CI) of association between blood lead and the risk of breast cancer adjusted for confounder factors.Results: A total of 10153 participants were included. Elevated blood levels of lead was associated with higher risks of breast cancer ( OR 1.16; 95% CI, 1.09–1.22)in the unadjusted analysis.But after adjustment for established risk factors, we did not observe significant association between blood levels and breast cancer risk ( OR 1.00; 95% CI, 0.95–1.15).Conclusion: We found no significant association between elevated blood lead levels and high risk of breast cancer in our cross-section study.

Assessing Knowledge and Practices of the Community towards Corona Virus Disease 2019 in Mbale Municipality, Uganda: Across Section Study

Background: The Corona virus disease, first identified in Wuhan city, Hubei province of China, is a respiratory illness caused by Novel Corona Virus also known as Severe Acute Respiratory Syndrome Corona Virus 2 (SARS Cov.2). The disease is characterised by; dry cough and shortness of breath with difficulty in breathing and at least 2 of the following; fever, chills, muscle pain, headache, sore throat and loss of test and smell. Uganda in general and Mbale in particular has people of diverse culture, religion and ethnic background as well as diverse socio economic activities with various practices. This multi-cultural environment creates differences in perception of information and practices. Most cultures encourage socialisation through social functions like attending weddings, funerals, work places and gatherings and Muslims who have to go for congregation prayers in the mosques 5 times a day among others. This puts such communities at risk of spreading the disease very fast and slow in adapting to control measures Aim: In this study, we aimed at assessing knowledge and practices of the community towards COVID 19 in Mbale municipality. Methods and Materials: A cross section study was used; Data was obtained using a Questionnaires to a sample of 355 respondents and an observation tool was also used to observe behaviour patterns and practices of 776 participants towards the control measures of COVID-19. Results: There was a total of 355 respondents with 208 /355 (58.59%) male and 147/355 (41.4%) female. 149/355(42%) possessed good knowledge, 131/355(36.9%) had moderate knowledge and 75/355(21%) had a little knowledge on COVID-19. Participants who were single and aged between 21-30 years were found to be more knowledgeable than other groups (P value=.001 and P value=.003 respectively).The source of COVID 19 information was mainly from television and radios 124/248 (50%) and social media 34/248 (21.8%) and the least source of information being 14/248(5.6%) and 9/248(3.6%) from health workers and Religious leaders respectively. 496/776 (64%) of the respondents observed, washed their hands and only124/776 (16%) of the respondents wore face masks. 98/776 (12.6%) were seen shaking hands and 15/776(2%) were seen hugging. Conclusion: Use of appropriate and well-designed Health education materials on radios, televisions and social media platforms like Facebook and twitter among others can be effective means of communication since they can reach the highest number of people. Ministry of Health should design ways for systematically integrating both political and religious leaders in Health Education Campaigns. Government should provide facemasks and enforce their use. A study to assess the ability of both political and religious leaders in health promotion campaigns should be carried out.