Curable Disease Research Articles

Age-specific incidence, treatment, and survival trends in esophageal cancer: a Dutch population-based cohort study

Background Data on the age-specific incidence of esophageal cancer are lacking. Our aim was to investigate the age-stratified incidence, treatment, and survival trends of esophageal cancer in the Netherlands, with a focus on adults <50 years. Material and methods Patients diagnosed with esophageal cancer were included from the nationwide Netherlands Cancer Registry (1989–2018). Follow-up data were available until 31 December 2018. Annual percentage changes of incidence were analyzed according to age group (<50, 50–74, and ≥75 years) and histology type: adenocarcinoma (EAC) and squamous cell carcinoma (ESCC). Treatment trends and relative survival rates (RSR) were estimated by age and stage grouping. Results A total 59,584 patients were included. In adults <50 years, EAC incidence tripled (mean increase per year: males 1.5%, females 3%), while the incidence of ESCC decreased (mean decrease per year: males −5.3%, females −4.3%). Patients <50 years more often presented with advanced disease stages compared to older patients and were more likely to receive multimodality treatments. Most patients <50 years with potentially curable disease were treated with neoadjuvant chemoradiotherapy followed by surgery compared to patients 50–74 and ≥75 years (74% vs. 55% vs. 15%, respectively; p < .001), and received more frequent systemic therapy once staged with palliative disease (72% vs. 54% vs. 19%, respectively; p < .001). The largest RSR improvement was seen in patients <50 years with early-stage (five years: +47%), potentially curable (five years: +22%), and palliative disease (one year: +11%). Over time, a trend of increasing survival difference was seen between patients <50 and ≥75 years with potentially curable (five-year difference: 17% to 27%) and palliative disease (one-year difference: 11% to 20%). Conclusion The incidence of EAC is increasing in adults <50 years in the Netherlands. Differences in the use of multimodality treatments with curative or life-prolonging intent in different age categories may account for increasing survival gaps.

Therapeutic and Protective Potential of Mesenchymal Stem Cells, Pharmaceutical Agents and Current Vaccines Against COVID-19.

It has been almost 18 months since the first outbreak of COVID-19 disease was reported in Wuhan, China. This unexpected devastating phenomenon, raised a great deal of concerns and anxiety among people around the world and imposed a huge economic burden on the nations' health care systems. Accordingly, clinical scientists, pharmacologists and physicians worldwide felt an urgent demand for a safe, effective therapeutic agent, treatment strategy or vaccine in order to prevent or cure the recently-emerged disease. Initially, due to the lack of specific pharmacological agents and approved vaccines to combat the COVID-19, the disease control in the confirmed cases was limited to supportive care. Accordingly, repositioning or repurposing current drugs and examining their possible therapeutic efficacy received a great deal of attention. Despite revealing promising results in some clinical trials, the overall results are conflicting. For this reason, there is an urgent need to seek and investigate other potential therapeutics. Mesenchymal stem cells (MSC), representing immunomodulatory and regenerative capacity to treat both curable and intractable diseases, have been investigated in COVID-19 clinical trials carried out in different parts of the world. Nevertheless, up to now, none of the MSC-based approaches has been approved in controlling COVID-19 infection. Thanks to the fact that the final solution for defeating the pandemic is developing a safe, effective vaccine, enormous efforts and clinical research have been carried out. In this review, we will concisely discuss the safety and efficacy of the most relevant pharmacological agents, MSC-based approaches and candidate vaccines for treating and preventing COVID-19 infection.

Racial disparities in operative management of localized, non-functional pancreatic neuroendocrine tumors in surgically fit patients.

Guidelines recommend resection of non-functional neuroendocrine tumors of the pancreas (NF-pNETs) that are ≥2cm in size. We compared utilization of surgery based on race. We identified non-Hispanic White and Black patients with localized NF-pNETs ≥2cm and Charlson-Deyo score 0-1 in the NCDB (2004-2016). We compared utilization of surgery by race, adjusting for clinicodemographic variables. Overall survival was compared based on management. A total of 3459 patients were included (White=3005; Black=454). Black patients were younger (58vs63 years) and more often treated at academic facilities (65.3%vs60.3%). Overall, Black and White patients underwent surgery at similar rates (77.3%vs79.6%). When stratified by primary site, Black patients with body/tail tumors were less likely to undergo surgery (78.5%vs84.7%). On multivariable analysis, Black race was associated with a lower likelihood of surgery overall (OR 0.74,p=0.034) and in patients with body/tail tumors (OR 0.56,p=0.001). Non-operative management was associated with a higher risk of death (HR 3.19,p<0.001). In a national cohort of patients with NF-pNETs meeting criteria for resection, Black race is associated with lower frequency of surgery. Operative intervention is associated with prolonged survival. Persistent racial disparities in management of a surgically curable disease should be targeted for improvement.

Why are people still dying of drug-susceptible TB in Paris in the 21st century?

BACKGROUND: Although the burden of TB is lower in France than in low-income countries, patients continue to die from TB in Paris. Our goal was to describe TB-related deaths and to identify associated risk factors.METHODS: We conducted a retrospective cohort study in two hospitals in Paris between 2013 and 2018. All patients with drug-susceptible TB were included and followed until end of treatment. The primary outcome was death. We performed univariate and multivariate analysis using Cox proportional hazard model.RESULTS: Of the 523 patients included, 362 were men (median age 37 years), of whom 24 patients died (4.5%). The final survival model concluded that age (HR 1.1 for each additional year), not living in one´s own accommodation (HR 5.9), being born in France (HR 8.0), being alcoholic (HR 4.2), having a history of cancer (HR 7.1) or meningeal or miliary TB (HR 8.2) were associated with a higher risk of death.CONCLUSION: The rate of TB-associated death is unacceptably high for a curable disease. To note, patients born in France were much more at risk of death than immigrants. We believe raising awareness among healthcare professionals is a potentially easy and efficient lever for improving care.

Outcomes of tuberculosis treatment in a tertiary health facility in north-central Nigeria

Background: Tuberculosis (TB) remains a major public health concern despite being a curable and preventable disease. The treatment of TB using a cocktail of drugs over a period of six months under the directly observed treatment short-course strategy has led to a reduction in cases but is plagued by some challenges that leads to unsuccessful or poor outcomes, which can ultimately result in spread of infections, development of drug resistance and increase in morbidity and mortality. The objectives of this study are to determine outcomes of TB treatment in Dalhatu Araf Specialist Hospital, Lafia, Nasarawa State, Nigeria and the factors that may be associated with the outcomes.&#x0D; Methodology: This was a retrospective study using the medical records of patients who were registered for TB treatment over a five-year period between 2016 to 2020. Data from TB registers including demographic and relevant clinical information, and treatment outcomes, were extracted into a structured data extraction format, and analysed with SPSS version 21.0 software package. Univariate and bivariate analyses were conducted, and Chi square test was used to determine association between TB outcomes and independent variables at 95% confidence interval and p&lt;0.05 was considered as the significant value.&#x0D; Results: Records of 1,313 patients were studied, 744 (56.7%) were males while 569 (43.3%) were females. The age range of the patients was ≤ 1 year - 96 years, with a mean age of 30±16.7 years. Most were pulmonary TB cases (88.8%, n=1,166), newly diagnosed (95.5%, n=1254), and human immunodeficiency virus (HIV) negative at the time of TB diagnosis (63.7%, n=837). Eight hundred and seven (61.5%) patients had successful treatment, and 34% (n=446) had unsuccessful outcomes made of ‘loss to follow-up’ 25.8% (n=339), deaths 7.8% (n=102) and treatment failure 0.4% (n=5), while 2.3% (n=30) were transferred out and 2.3% (n=30) removed from TB register. Treatment success rate was significantly higher in patients with pulmonary TB (p=0.0024), residents in Lafia LGA (p=0.0005), those treated in 2016 (p=0.0006) and bacteriologically confirmed cases (p&lt;0.0001), while death rate was significantly lower among patients who were HIV-negative at the time of TB diagnosis (p&lt;0.0001).&#x0D; Conclusion: TB treatment success rate in this study fell short of the WHO average rate. High rates of ‘loss to follow-up’ and deaths in this study is a wake-up call to all stakeholders in the facility and the State to put in place measures to reduce poor outcomes of TB treatment.

Inspiratory laryngeal stridor as the main feature of progressive encephalomyelitis with rigidity and myoclonus: a case report and literature review

BackgroundProgressive encephalomyelitis with rigidity and myoclonus (PERM) is an acute, potentially life-threatening, yet curable neuro-immunological disease characterized by spasms, muscular rigidity, and brainstem and autonomic dysfunction. The clinical features of glycine receptor (GlyR) antibody-positive PERM may be overlooked, particularly with some unusual symptoms.Case presentationA 52-year-old man was admitted to the hospital for evaluation of tension headache for 20 days and mild dysarthria. These symptoms were followed by panic, profuse sweating, severe dysarthria, dizziness, unsteady gait, and paroxysmal muscle spasms. Brain magnetic resonance imaging and cerebrospinal fluid analysis were normal. The patient’s condition steadily deteriorated. He repeatedly presented with rigidity, panic attacks, severe anxiety, paroxysmal inspiratory laryngeal stridor, cyanosis of the lips, and intractable epilepsy. Electromyography showed multiple myoclonic seizures, a single generalized tonic-clonic seizure, and a single generalized tonic seizure. Screening for autoimmune encephalitis antibodies revealed anti-GlyR antibodies in his cerebrospinal fluid. Immunomodulatory pulse therapy with steroids and immunoglobulin resulted in expeditious improvement of the symptoms within 2 weeks, and a follow-up at 5 weeks showed consistent clinical improvement.ConclusionOur case highlights that inspiratory laryngeal stridor is an important symptom of PERM. Our observation widens the spectrum of the clinical presentation of anti-GlyR antibody-positive PERM, where early identification is a key to improving prognosis.

Этапное лечение расстройств аутистического спектра, ассоциированных с генетическим дефицитом фолатного цикла

В статье рассмотрено этапное лечение детей с расстройствами аутистического спектра, ассоциированными с генетическим дефицитом фолатного цикла, в свете новых открытий в патогенезе заболевания. Предложено разделить рекомендуемые терапевтические вмешательства на 3 последовательных этапа: противомикробное/противовирусное лечение, иммунотерапия при помощи в/в иммуноглобулина, нейрореабилитация с использованием инновационных медикаментозных средств и междисциплинарной немедикаментозной помощи. Особая форма аутистических расстройств, связанных с генетическим дефицитом фолатного цикла, в отличие от других генетических форм аутизма, является потенциально курабельной болезнью, и этапная стратификация терапевтических подходов позволяет добиться больших успехов в преодолении инвалидизирующих психических нарушений, которые ранее представлялись неизлечимыми.

Clinical Significance of Erythrocyte Sedimentation Rate in Tuberculosis

Background: Tuberculosis is a chronic infectious disease caused by Mycobacterium tuberculosis and still it is a common disease in developing countries. A variety of hematological parameters are studied in tuberculous patients such as decreased Hb(anemia), increased WBC count, increased ESR, and thrombocytopenia. Nowadays TB is a curable and preventable disease. The present study was undertaken to study the ESR values in TB patients and compare their values with ZiehlNelson staining. Method: The present study was carried out on 328 patients who had sputum smear-positive for AFB. based on the recommendation of the RNTCP grading system of AFB in Sputum ZiehlNelson staining, the cases of PTB group were further categorized into four subgroups AFB– 3+, AFB – 2+, AFB –1+ and scanty. The ESR was performed by a rapidly modified Westergren method on EDTA whole blood sample. Results: out of the 324 cases of tuberculosis collected from our hospital, male 252, female 72 from 14-80 years of age. ESR was elevated in patients with an increased grading of sputum positive (3+). The distribution of the mean value of, ESR in different grades of ZN staining of sputum in AFB positive patients was scanty(35.5), 1+(27.5), 2+(30.2),3+(42.4). respectively. Conclusion: Our study concluded that active TB is associated mostly with very high ESR values (≥ 100 mm/h) and with markedly raised values in all the grades of sputum AFB positive patients.

Salvage surgery following immuno-chemo-radiotherapy for advanced non-small cell lung cancer

BackgroundSalvage surgery following definitive radiotherapy or systemic treatment has become a feasible treatment option in selected patients with advanced initially unresectable non-small cell lung cancer. Recent clinical trials of neoadjuvant treatment have showed that surgery following immuno-chemotherapy is safely performed. Here, we present the first case of salvage surgery following immuno-chemotherapy with concurrent definitive radiotherapy for advanced lung large cell carcinoma.Case presentationA 44-year male was admitted to our hospital for salvage surgery. Ten months prior to this administration, he had been diagnosed with unresectable large cell carcinoma with malignant pericardial effusion (clinical stage IVA/T3N2M1A; no driver-gene alteration) originating from the right upper lobe (RUL). Due to rapid intrabronchial tumor growth causing severe dyspnea, emergency bronchial stenting in the right main bronchus using an expandable metallic stent had been performed. Thereafter, he had received immuno-chemotherapy with concurrent definitive radiotherapy. Despite dramatic radiographic response, he had suffered from persistent and refractory Pseudomonas aeruginosa lung infection associated with bronchial stent placement. As pericardial effusion had disappeared and no distant metastasis had developed, he was diagnosed with a potentially curable disease and was referred to our hospital. An extended sleeve resection was successfully performed, and pathological sections revealed that pathologic complete response was achieved with immuno-chemo-radiotherapy. The patient received no subsequent treatment, and is alive without tumor recurrence at 8 months after surgery.ConclusionsSalvage surgery following immuno-chemotherapy with concurrent definitive radiotherapy for advanced non-small cell lung cancer may be feasible in selected patients, and may be considered as a treatment option to control local disease.

The Promise of Metastasis-Directed Therapy for Oligometastatic Prostate Cancer: Going Beneath the Surface with Molecular Imaging.

Historically, metastatic disease was thought to represent an all-or-nothing incurable state, distinct from curable localized disease and necessitating treatment with systemic therapy alone. The role for life-prolonging local therapy was known to be futile. This dogma was challenged in the 1990s with

Reduction of the Vertebral Bone Mineral Density in Patients with Hodgkin Lymphoma Correlates with Their Age and the Treatment Regimen They Received.

Simple SummaryHodgkin lymphoma (HL) is considered a largely curable disease (~80%). The young patient age at diagnosis and their long life expectancy make quality-of-life issues, including osteopenia, exceedingly important. This study aimed to assess treatment-related bone mineral density (BMD) changes that are overlooked in this young population. BMD was measured using PET/CT scans. Among 213 patients (median age 29 years), post-treatment BMD reduction of >15% was significantly more common in those aged ≥30 years and was also associated with a cumulative dose of steroids used. At 6 months post-therapy, BMD recovery was observed in ABVD (adriamycin/bleomycin/vinblastine/dacarbazine) treated patients, while individuals receiving EB (bleomycin/etoposide/adriamycin/cyclophosphamide/oncovin/procarbazine/prednisone) regimens demonstrated persistent BMD loss and higher rates of osteopenia. Our findings suggest that steroid use should be minimized and highly gonadotoxic drugs like procarbazine should be substituted with less toxic ones, due to their deleterious effect on BMD. Adequate vitamin D levels should be maintained.Nowadays, Hodgkin lymphoma (HL) has become highly curable. The young age at diagnosis and long life expectancy emphasize the importance of preventing long-term treatment side effects, including bone mineral density (BMD) loss, in these patients. We aimed to evaluate the effects of first-line therapeutic modalities on BMD dynamics in HL patients, intending to identify individuals at risk for osteopenia. Demographics, HL risk factors, treatment, including cumulative steroid doses, and BMD of 213 newly-diagnosed HL patients (median age 29 years), treated at Rambam between 2008–2016, were analyzed. The main chemotherapy regimens applied were: ABVD (adriamycin, bleomycin, vinblastine, dacarbazine) and escalated BEACOPP (EB; bleomycin, etoposide, adriamycin, cyclophosphamide, oncovin, procarbazine, prednisone). BMD was measured using PET/CT scans. BMD loss >15% was revealed in 48% of patients at therapy completion, with osteopenia prevalence of 4% and 14% at baseline and post-therapy, respectively. Cumulative hydrocortisone equivalent doses >3400 mg/m2 correlated with significant BMD reduction. Multivariate analysis at 6 months post-therapy identified age ≥30 years and EB-regimens as significant risk factors for BMD decrease >15%. Therapy-related BMD loss is common in HL patients. Its persistence is associated with age ≥30 years and EB treatment. Reduction of cumulative steroid doses and switch to non-gonadotoxic drugs should be considered.

Reappraising the Role of Allogeneic Hematopoietic Stem Cell Transplantation in Relapsed and Refractory Hodgkin's Lymphoma: Recent Advances and Outcomes.

Hodgkin’s lymphoma is a rare yet highly curable disease in the majority of patients treated with modern chemotherapy regimens. For patients who fail to respond to or relapse after initial systemic therapies, treatment with high-dose chemotherapy and autologous hematopoietic stem cell transplantation can provide a cure for many with chemotherapy-responsive lymphoma. Patients who relapse after autologous transplant or those with chemorefractory disease have poor prognosis and represent a high unmet need. Allogeneic hematopoietic stem cell transplantation provides a proven curative therapy for these patients and should be considered, especially in young and medically fit patients. The use of newer agents in this disease such as brentuximab vedotin and immune checkpoint inhibitors can help bring more patients to transplantation and should be considered as well.

Blinatumomab as a Bridge Therapy for Hematopoietic Stem Cell Transplantation in Pediatric Refractory/Relapsed Acute Lymphoblastic Leukemia.

Simple SummaryImmunotherapies are modern treatment modalities, giving hope for improvements of frozen cure rates in many childhood malignancies. More intensive cytotoxic chemotherapy cycles didn’t improve cure rates, only increase number of adverse events. Blinatumomab, a bispecific CD3/CD19 antibody construct, has been successfully used in relapsed/refractory r/r B-cell precursor ALL (BCP-ALL) as a bridge to hematopoietic stem cell transplantation (HSCT). We retrospectively assessed the efficacy and toxicity of blinatumomab in 13 children with r/r BCP-ALL. The response rate in our cohort of patients was 85%, with subsequent feasible HSCT in 11 out of 13 children. Although our study had some limitations with regard to its retrospective design and limited patient population, it clearly showed blinatumomab as not only a feasible but also an effective therapeutic option in pretreated children with r/r BCP-ALL, with a tolerable toxicity profile, paving the way for an HSCT procedure. To date, this is the first retrospective study from Poland on efficacy and toxicity of blinatumomab therapy in children with r/r ALL.Despite the progress that has been made in recent decades in the treatment of pediatric acute leukemias, e.g., converting acute lymphoblastic leukemia (ALL) from a fatal to a highly curable disease, 15–20% of children still relapse. Blinatumomab, a bispecific CD3/CD19 antibody construct, has been successfully used in relapsed/refractory r/r B-cell precursor ALL (BCP-ALL) as a bridge to hematopoietic stem cell transplantation (HSCT). We retrospectively assessed the efficacy and toxicity of blinatumomab in 13 children with r/r BCP-ALL. Between 2017 and 2021, thirteen children, aged 1–18 years, with r/r BCP-ALL were treated with blinatumomab. Two patients were administered blinatumomab for refractory relapse without complete remission (CR), one due to primary refractory disease, and ten patients were in CR with minimal residual disease (MRD) ≥ 10−3. The response rate in our cohort of patients was 85%, with subsequent feasible HSCT in 11 out of 13 children. Ten children reached MRD negativity after the first blinatumomab administration. The three-year OS for the study patients was 85% (Mantel–Cox, p < 0.001) and median follow-up was 24.5 (range: 1–47). All responders proceeded to HSCT and are alive in CR, and MRD negative. Although our study had some limitations with regard to its retrospective design and limited patient population, it clearly showed blinatumomab as not only a feasible but also an effective therapeutic option in pretreated children with r/r BCP-ALL, with a tolerable toxicity profile, paving the way for an HSCT procedure.

Late-Stage Presentation of Testicular Cancer Patients Attended a Specialized Hospital: Findings of a Crosssectional Study

Background: Testicular Cancer (TC) is of interest and importance because its incidence has been increasing in most countries over the past four decades. The purpose of this study is to determine the frequency of patients with common histopathology, most common stage during presentation, biochemical and radiological findings, common levels of tumour markers. Methods: This cross-sectional study was carried out in the Department of Medical Oncology of National Institute of Cancer Research and Hospital (NICRH), Mohakhali, Dhaka, Bangladesh from July 2015 to June 2016. A total number of 52 patients were taken as study participants who are admitted as newly diagnosed at the NICRH. Data collection: tumour markers, USG of whole abdomen and chest X-ray were performed to all the patients for determination of the staging of the tumour. Results: The present study found the majority of the patients were found in stage III disease. Patients with Cryptorchidism needed to be educated regarding its early management to reduce the incidence of testicular tumour among them. It was observed that young people could be adequately knowledgeable and optimal awareness could be developed regarding early symptoms of the disease, then they may be found in earlier stage of their disease, which is curable with modern management method. Targeting to alter the cancer patients’ presentation by rising consciousness about TC, prognosis can be largely improved in future. Conclusion: This study was conducted to find out the features which were unknown in perspective of Bangladesh, so that burden of TC can be reduced, and prognosis can be further improved of this potentially curable disease. JOPSOM 2021; 40(1): 26-33

Role of minimally invasive surgery in the treatment of gallbladder metastatic melanoma. A review of the literature and a case report

BackgroundPrimary and secondary gallbladder melanomas are rare, and only 58 cases have been reported in scientific literature to date. This paper aimed to explore the role of minimally invasive surgery in the management of gallbladder metastatic melanomas.CaseHerein, we present the case of a 68‐year‐old man with metastatic gallbladder melanoma who was treated with laparoscopic cholecystectomy. Our case management was then compared with that of other cases reported in the literature.ConclusionCurrently, metastatic melanomas can be considered as a potentially curable disease. Palliation of symptoms and fast recovery following minimally invasive procedures could be beneficial for these patients. Particularly, laparoscopic procedures appear to prolong the survival of gallbladder melanoma patients.

21-ЛЕТНЯЯ ДИНАМИКА ВКЛАДА СМЕРТНОСТИ ОТ ИЗЛЕЧИМЫХ ЗАБОЛЕВАНИЙ В СНИЖЕНИЕ ОЖИДАЕМОЙ ПРОДОЛЖИТЕЛЬНОСТИ ЖИЗНИ НАСЕЛЕНИЯ КРАСНОЯРСКОГО КРАЯ

Significance. One of the strategic priorities of the Russian domestic policy is to increase life expectancy to 78 and 80 years in 2024 and 2030, respectively. High mortality from curable diseases that contributes to the decrease in life expectancy in the Krasnoyarsk Territory can be associated with low access to timely medical care. The current policy in the economic and social spheres should contribute to reducing mortality from curable diseases, which ultimately should result in the increased life expectancy. The purpose of the study is to analyze dynamics in contribution of mortality from curable diseases to the decrease in life expectancy in the Krasnoyarsk Territory to evaluate the current situation and identify prospects for increasing life expectancy. Material and methods. Contribution to the decrease in life expectancy was calculated according to the method of assessing eliminated reserves. To assess dynamics in the analyzed indicators, the total and average annual growth and loss rates, expressed as a percentage, were calculated. Results. The study has assessed contribution of mortality from curable diseases to the decrease in life expectancy calculated during the study. The assessed contribution makes it possible to evaluate possible reserves of the Krasnoyarsk Territory healthcare system cat can be mobilized using modern and effective medical interventions, including secondary prevention and treatment, to decrease mortality in the light of the target values of life expectancy established at the federal level. A special focus in the Krasnoyarsk Territory should be placed on mortality from diseases of the circulatory system, neoplasms and diseases of the digestive system associated with curable causes. Conclusion. Improving quality of treatment and secondary prevention of such curable diseases will make it possible to improve life quality and decrease premature deaths resulting in the increased life expectancy in the Krasnoyarsk Territory.

Is there a window of opportunity for the therapeutic use of vitamin D in multiple sclerosis?

Multiple sclerosis is an autoimmune treatable but not curable disease. There are a multiplicity of medications for multiple sclerosis therapy, including a class entitled disease-modifying drugs that are mainly indicated to reduce the number and severity of disease relapses. Not all patients respond well to these therapies, and minor to severe adverse effects have been reported. Vitamin D, called sunshine vitamin, is being studied as a possible light at the end of the tunnel. In this review, we recapitulated the similar immunopathogenesis of multiple sclerosis and experimental autoimmune encephalomyelitis, the immunomodulatory and neuroprotective potential of vitamin D and the state-of-art concerning its supplementation to multiple sclerosis patients. Finally, based on our and other groups’ experimental findings, we analyzed the need to consider the relevance of the route and the different time-point administration aspects for a more rational indication of this vitamin to multiple sclerosis patients.

Awareness of diabetes mellitus and its risk factors among the Saudi non-diabetic population in Jazan Region, Saudi Arabia

Background: Diabetes is a chronic metabolic condition characterized by a lack of insulin-producing cells, impaired insulin activity, or a combination of the two. Today, Saudi Arabia has one of the highest rates of diabetes, with 23.7% of the population suffering from the disease. Many people with diabetes do not realize they have the disease until one of its life-threatening complications occurs. Objectives: This study aimed to estimate the prevalence of knowledge and awareness about diabetes mellitus (DM) among the non-diabetic population and its association with sociodemographic variables in the Jazan Region of Saudi Arabia. Methods: A community-based cross-sectional study was conducted on non-diabetic community members from January 2022 to April 2022 in the Jazan Region. Participants were selected through a random sampling method and completed self-administered questionnaires that included demographic variables. Microsoft Excel was used for data entry, and Statistical Package for the Social Sciences version 23 was used for data processing and analysis. Result: A total of 475 subjects participated in this study. Moreover, 86.7% (412) of the study participants defined diabetes as the presence of high blood sugar levels in the body, but nearly half (44.6%) thought that DM was a curable disease. Regarding the complications of DM, 81.3% mentioned that DM could lead to amputations, followed by causing eye problems or even blindness (79.8%). Conclusion: The population in the Jazan Region has enough general knowledge of diabetes regarding symptoms, complications, and so on; however, most of the population has the misconception that diabetes can be cured. Therefore, our study suggests that more efforts should be made to increase knowledge of diabetes, especially among the less educated elderly population.

H3N2 INFLUENZA LUNG INFECTION AND ACUTE ENCEPHALOPATHY- CAN OSELTAMIVIR BE A COMMON SOLUTION?

Background: Influenza infection subtypes have emerged as a serious, fatal but curable disease in many parts of the world for more than a decade. Though classically it involves respiratory tract, there also can be extrapulmonary involvement of multiple organ system in Influenza that can lead to death. Case Report: We report a 79 year old male was diagnosed with H3N2 lung infection and treated with 5 days course of Oseltamivir. He later developed CNS complications. The possible causes of encephalopathy were ruled out after thorough evaluation. Appropriate antibiotics and antiviral drugs were started but patient’s condition did not improve. Studies suggest various central nervous system complications including encephalopathy that can occur secondary to Influenza virus infection. Influenza virus has been detected in CSF PCR but the sensitivity is very low. A second course of Oseltamivir was started based on clinical judgement after which the patient’s condition gradually improved. Oseltamivir was continued for 14 days. Conclusion: It is at times difficult to detect the causative organism in cases of CNS infection that can delay treatment. In such cases empirical treatment with antibiotics and acyclovir or with antitubercular drugs is the usual treatment regime that is applied in most small hospital setups after which the patient may or may not improve. Any history of prior or recent attack of Influenza respiratory infection should not be missed by the clinicians and, if found so, CNS complications secondary to Influenza infections should be kept in mind. In such cases it is imperative to add Oseltamivir to the treatment. Inclusion of extended course of Oseltamivir can save lives in resource limited setups.

Multi-Model Detection of Lung Cancer Using Unsupervised Diffusion Classification Algorithm

Lung cancer is a curable disease if detected early, and its mortality rate decreases with forwarding treatment measures. At first, an easy and accurate way to detect is by using image processing techniques on the cancer-affected images captured from the patients. This paper proposes a novel lung cancer detection method. Firstly, an adaptive median filter algorithm (AMF) is applied to preprocess those images for improving the quality of the affected area. Then, a supervised image edge detection algorithm (SIED) is presented to segment those images. Then, feature extraction is employed to extract the mean, standard deviation, energy, contrast, etc., of the cancer-affected area. Finally, an unsupervised diffusion classification (UDC) algorithm is explored to narrow down the affected areas. The proposed lung cancer detection method is implemented on two datasets obtained from standard hospital real-time values. The experiment results achieved superior performance in the detection of lung cancer, which demonstrates that our new model can contribute to the early detection of lung cancer.