Exploring the Barriers Toward Colorectal Cancer Screening: A Literature Review

Background: Colorectal cancer is the third most common cancer and the second leading cause of death worldwide. Bowel cancer screening helps prevent colon cancer by early detection of polyps, leading to efficient treatment and reduced mortality. Within Qatar, primary health facilities promote bowel screening by using the faecal occult blood test. However, the popularity and use of this test is still low. Aim: The aim of this literature review is to explore barriers related to colorectal cancer bowel screening using the faecal occult blood test in primary health care settings to facilitate colorectal cancer screening in Qatar. Method: Cronin’s five step framework for literature reviews was utilized for this paper. This review included nine articles that were peer-reviewed and published between 2009 and 2019. The nine articles were appraised by using the Mixed Methods Appraisal Tool. This tool has separate criteria to assess the quality of the qualitative, quantitative, and mixed-method studies. Result: Three main barriers to bowel cancer screening included knowledge deficit, personal beliefs and organizational barriers. Conclusion: The main barriers are related to the patients’ lack of knowledge and personal beliefs. Overcoming these barriers is essential to raising awareness about this issue among all nurses, physicians, and patients. It is necessary to involve stakeholders in order to mitigate barriers. Developing educational activities for healthcare professionals will provide information that they can share with patients to encourage screening and decrease the fear of the test. Developing a pamphlet to increase patient awareness will also encourage screening and work toward decreasing fear. Key words: faecal occult blood test, faecal immunochemical test, barriers

AVASCULAR NECROSIS MAY NOT HAVE AN ATHEROSCLEROTIC BACKGROUND IN SICKLE CELL DISEASES

Background: We tried to understand whether or not there is a significant association between avascular necrosis (AVN) and atherosclerosis in sickle cell diseases (SCD). Methods: All patients with the SCD were included. Results: The study included 434 patients (212 females) with similar mean ages in male and female genders (30.8 versus 30.3 years, respectively, p>0.05). Smoking (23.8% versus 6.1%, p<0.001) and alcohol (4.9% versus 0.4%, p<0.001) were higher in male gender, significantly. Transfused units of red blood cells (RBC) in their lives (48.1 versus 28.5, p=0.000) were also higher in male gender, significantly. Similarly, disseminated teeth losses (<20 teeth present) (5.4% versus 1.4%, p<0.001), chronic obstructive pulmonary disease (COPD) (25.2% versus 7.0%, p<0.001), ileus (7.2% versus 1.4%, p<0.001), cirrhosis (8.1% versus 1.8%, p<0.001), leg ulcers (19.8% versus 7.0%, p<0.001), digital clubbing (14.8% versus 6.6%, p<0.001), coronary heart disease (CHD) (18.0% versus 13.2%, p<0.05), chronic renal disease (CRD) (9.9% versus 6.1%, p<0.05), and stroke (12.1% versus 7.5%, p<0.05) were all higher in male gender but not AVN (24.3% versus 25.4%, p>0.05), significantly. Conclusion: SCD are severe inflammatory processes on vascular endothelium, particularly at the capillary level since the capillary system is the main distributor of hardened RBC into the tissues. Although the higher smoking and alcohol-like strong atherosclerotic risk factors and disseminated teeth losses, COPD, ileus, cirrhosis, leg ulcers, digital clubbing, CHD, CRD, and stroke-like obvious atherosclerotic consequences in male gender, AVN was not higher in them, significantly. In another definition, AVN may not have an atherosclerotic background in the SCD. Key words: Sickle cell diseases, chronic endothelial damage, atherosclerosis, avascular necrosis, male gender, smoking, alcohol

August 2021 - Volume 15, Issue 3 AUTOSPLENECTOMY MAY NOT HAVE AN ATHEROSCLEROTIC BACKGROUND IN SICKLE CELL DISEASES

Background: We tried to understand whether or not there is a significant relationship between autosplenectomy and atherosclerosis in sickle cell diseases (SCD). Methods: All patients with the SCD were included. Results: The study included 434 patients (222 males and 212 females) with similar mean ages in male and female genders (30.8 versus 30.3 years, respectively, p>0.05). Smoking (23.8% versus 6.1%, p<0.001) and alcohol (4.9% versus 0.4%, p<0.001) were higher in males, significantly. Transfused units of red blood cells (RBC) in their lives (48.1 versus 28.5, p=0.000) were also higher in males, significantly. Similarly, disseminated teeth losses (<20 teeth present) (5.4% versus 1.4%, p<0.001), chronic obstructive pulmonary disease (COPD) (25.2% versus 7.0%, p<0.001), ileus (7.2% versus 1.4%, p<0.001), cirrhosis (8.1% versus 1.8%, p<0.001), leg ulcers (19.8% versus 7.0%, p<0.001), digital clubbing (14.8% versus 6.6%, p<0.001), coronary heart disease (CHD) (18.0% versus 13.2%, p<0.05), chronic renal disease (CRD) (9.9% versus 6.1%, p<0.05), and stroke (12.1% versus 7.5%, p<0.05) were all higher in males but not autosplenectomy (50.4% versus 53.3%, p>0.05) in the SCD. Conclusion: SCD are severe inflammatory processes on vascular endothelium, particularly at the capillary level since the capillary system is the main distributor of hardened RBC into the tissues. Although the higher smoking and alcohol-like strong atherosclerotic risk factors and disseminated teeth losses, COPD, ileus, cirrhosis, leg ulcers, digital clubbing, CHD, CRD, and stroke-like obvious atherosclerotic consequences in male gender, autosplenectomy was not higher in them, significantly. In another definition, autosplenectomy may not have an atherosclerotic background in the SCD. Key words: Sickle cell diseases, chronic endothelial damage, atherosclerosis, autosplenectomy, male gender, smoking, alcohol

Atherosclerotic Background of Cirrhosis in Sickle Cell Patients

Background: We tried to understand the presence of any atherosclerotic background of cirrhosis in patients with sickle cell diseases (SCDs). Methods: The study was performed in the Hematology Service of the Mustafa Kemal University on SCDs patients between March 2007 and June 2012. Results: The study included 256 patients with SCDs (127 females). Their mean age was 29.3 years. Cirrhosis was detected in 5.8% (15) of the SCDs patients without any gender difference (6.2% of females versus 5.4% of males, p>0.05). There were 15 (5.8%) patients with chronic obstructive pulmonary disease with a highly significant male predominance (3.1% versus 8.5%, p<0.001). Digital clubbing and pulmonary hypertension were also higher in males, but the differences were nonsignificant in between (4.7% versus 6.2% and 11.0% versus 12.4%, respectively). Similarly, the leg ulcers were significantly higher in males, too (5.5% versus 16.2%, p<0.001). The significant male predominance was also observed in stroke and smoking (3.1% versus 6.2%, p<0.05 and 3.9% versus 11.6%, p<0.001, respectively). There were 14 (5.4%) mortal patients during the five-year follow-up period (6.2% of females and 4.6% of males, p>0.05), and the mean ages were 31.0 and 26.8 years, respectively (p>0.05). Conclusion: Probably cirrhosis is a systemic inflammatory process prominently affecting the hepatic vasculature, and an eventual accelerated atheroscerotic process is the main underlying cause of characteristics of the disease. SCDs are accelerated systemic atherosclerotic processes, too, and the higher prevalence of cirrhosis in SCDs patients may indicate the underlying atherosclerotic background of cirrhosis. Key words: Atherosclerosis, metabolic syndrome, cirrhosis, sickle cell diseases

KNOWLEDGE AND INFANT FEEDING PRACTICES’ INFLUENCE ON ARAB IMMIGRANT MOTHERS’ INITIATION AND EXCLUSIVE BREASTFEEDING

Breastfeeding is known to provide health benefits for newborns and breastfeeding mothers. The World Health Organization and Health Canada recommend exclusive breastfeeding for the first six months of an infant’s life. However, the rates of exclusive breastfeeding practices among Arab immigrant mothers are lower when compared with rates for non-immigrant Canadian mothers and mothers in the immigrants’ countries of origin. Critical ethnography was used to explore the contextual factors that influence the initiation and exclusive breastfeeding practices by Arab immigrant mothers in Canada. Critical ethnography, using individual in-depth interviews was employed to explore the breastfeeding practices among immigrant Arab mothers in Alberta, and factors influencing the mothers’ decision or ability to breastfeed exclusively. Exploratory and open-ended questions were used. Face-to-face interviews were conducted with ten women for 1 and 1 and ½ hours . Participant selection criteria included Arab mothers who were within six months postpartum, aged 18–49 years, and who have resided in Canada for less than five years. An analysis of the qualitative narrative data indicated that knowledge and traditional infant feedingpractices primarily influenced Arab immigrant mothers’ initiation and exclusive breastfeeding practices. The findings from this study have the potential to facilitate supportive culturally safe and sensitive interventions that are tailored to address Arab mothers’ breastfeeding concerns and needs, so that exclusive breastfeeding might be promoted within this population in Canada. Further, the research will provide information needed for addressing some key challenges relating to culture, religion, and the healthcare system. Key words: Arab immigrant mothers, exclusive breastfeeding,

BLOOD GLUCOSE CONTROL AND SURGICAL SITE INFECTIONS IN CANCER PATIENTS: A LITERATURE REVIEW

Background: Surgical site infections (SSI) are the most common acquired infection during hospitalization and a major cause of morbidity, mortality, increased health care costs and delays in treatments for cancer patients. Objective: The objective of this literature review was to gain a better understanding of the relationship between uncontrolled blood glucose and the odds of developing a SSI among cancer patients. Interventions / Methods: A database search (which engaged PubMed, Medline, Cumulative Index to Nursing and Allied Health Literature and The Cochrane Database of Systematic Reviews) was completed using the key words: ‘surgical site infection’ or ‘surgical wound infection’ OR ‘SSI’ AND cancer or neoplasms OR oncology OR tumor OR malignancy AND diabetes OR hyperglycemia AND risk factors. Twenty-seven studies met the inclusion criteria to be included in this review. Results: The odds ratio for history of diabetes or hyperglycemia and SSI following cancer surgery varied across studies. This is likely explained in part by the fact that some types of surgery are more invasive than others, are more lengthy, and involve areas of the body that are more prone to infection. The study with the highest rate of SSI (62.1%) was among patients with oral cancer and the study with the lowest rate of SSI (3.1%) was among patients with spinal cancer. Conclusion: The literature review results suggested an association between SSI and patients with a history of diabetes mellitus or hyperglycemia. Key Words: Diabetes, cancer, literature review, surgical site infections, surgery, glucose

The Nocturnal Kissing of an Annoying Mosquito; Unusual Insect Bite Reaction, a Case Report and a Literature Review

Insects represent more than half of all known living organisms in the world. Both human beings and insects share a common biodiversity and the influence of insects on human life is enormous. They share an intimate relationship in which human beings are both benefitted and harmed. Insects inflict harm by stinging, biting or transmitting diseases. Rarely, humans are harmed by inadvertently coming in contact with the toxin of an insect. Insect dermatitis is characterized by tingling and burning within 10 minutes of contact, and sometimes the incurred dermatitis is a self-healing condition. Such cases usually happen while asleep when there is a lag time between the crush of the insect and waking up in the morning. A case while sleeping, heard the insect fly around her bare chest, in summer time, and on waving it away instinctively while sleeping, and the insect had been crushed on her bare upper chest skin, incurring a subsequent skin reaction without the typical red bite mark followed by an evolving burning ulcerative skin lesion, that took a while to subside and heal completely. Key words: insect bite, crash, skin reaction.

Worse Prognosis of Sickle Cell Diseases in Males even in the Absence of Smoking and Alcohol

Background: We tried to understand the prognosis of sickle cell diseases (SCD) in both genders. Methods: All cases with the SCD in the absence of smoking and alcohol were included. Results: The study included 368 patients (168 males and 200 females). Mean age (29.4 versus 30.2 years), associated thalassemia minors (72.0% versus 69.0%), and body mass index (BMI) (21.7 versus 21.6 kg/m2) were similar in males and females, respectively (p>0.05 for all). Whereas total bilirubin value of the plasma (5.2 versus 4.0 mg/dL, p=0.011), transfused units of red blood cells (RBC) in their lives (46.8 versus 29.2, p=0.002), disseminated teeth losses (4.7% versus 1.0%, p<0.001), chronic obstructive pulmonary disease (COPD) (20.8% versus 6.0%, p<0.001), ileus (5.3% versus 2.0%, p<0.01), cirrhosis (5.9% versus 1.5%, p<0.001), leg ulcers (16.0% versus 7.5%, p<0.001), digital clubbing (13.0% versus 5.5%, p<0.001), and chronic renal disease (CRD) (10.7% versus 6.5%, p<0.05) were all higher in males, significantly. Conclusion: SCD are severe inflammatory processes on vascular endothelium, particularly at the capillary level since the capillary system is the main distributor of the hardened RBC into tissues. Although the similar mean age, associated thalassemia minors, and BMI and absence of smoking and alcohol, the higher total bilirubin value of the plasma, transfused units of RBC in their lives, disseminated teeth losses, COPD, ileus, cirrhosis, leg ulcers, digital clubbing, and CRD in males may be explained by the dominant role of male sex in life according to the physical power that may accelerate systemic atherosclerotic process all over the body. Key words: Sickle cell diseases, male sex, chronic endothelial damage, atherosclerosis, metabolic syndrome, early aging, premature death