No abstract

This study was conducted to assess knowledge, perception, and attitudes regarding cancer and treatment among healthy relatives of cancer patients who attended an outpatient cancer clinic with their relatives who suffer from cancers. The participants recruited in this cross-sectional, interview-based study were 846 (557 female and 289 male subjects) healthy relatives of cancer patients from the outpatient cancer clinic at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. Most of the participants answered that they believed the causes of cancer were genetic (44.90 %), followed by environmental factors (30.10 %), diet (26.90 %), other causes (26.90 %), envy (26.90 %), and black magic (17.60 %). Most of the healthy participants believed that doctors should tell patients the full truth about the diagnosis (83.57 %). More than half of the healthy population stated that cancer patients should accept all types of treatment (chemotherapy and/or radiotherapy and/or surgery), with more male subjects having this position than females (P = 0.014). Most of the participants believed that cancer cannot be caught from another person who suffered from cancer (67.50 %). Most of the participants believed that cancer education was sufficient (66.70 %), with a significant difference between male and female respondents (P = 0.004). With regard to why cancer patients hide their disease, most of the participants in the age group <25 years believed that the causes were fear of loss of health insurance (56.20 %), followed by job loss (34.40 %), and then social stigma (9.40 %); in the age group between 25 and 45 years, the causes were fear of loss of health insurance (76.50 %), followed by social stigma (14.70 %), and then job loss (8.80 %); while in the age group >45 years, the reasons were job loss (47.10 %), followed by health insurance loss (41.20 %), and then social stigma (11.80 %), with a significant difference between groups (P = 0.034). This study demonstrated that still a large number of healthy participants had deficient perceptions and poor attitudes about important issues concerning cancers such as different mode of treatments, alternative treatment, biological causes, and prognosis, particularly among male respondents. Prevention education strategies should be considered, including targeted approaches that aim to reduce disparities in cancer perception among the general population.

Medical educators are in a continuous quest to close the gap between the needs of medical practice and the rising expectations of the communities in their countries. During the past two decades, competency-based medical education has been evolving as an appealing strategy to close this gap. In 2017, the Egyptian medical education authorities mandated all medical schools to change their curricula to comply with revised national academic reference standards, which changed from outcome-based to competency-based. In parallel, they also changed the timeline of all medical programs for six years of studentship and one-year internship to five years and two years, respectively. This substantial reform involved the assessment of the existing situation, an awareness campaign for the proposed changes and an extensive national faculty development program. Monitoring the implementation of this substantial reform was performed through surveys, field visits and meetings with students, teaching staff and program directors. In addition to the expected challenges, the COVID-19-associated restrictions presented a significant further challenge during the implementation of this reform. This article presents the rationale for and steps of this reform, the challenges faced and how they were addressed.

The current study aimed to investigate the diagnostic value of glycated albumin (GA), glycated hemoglobin (HbA1c), and a number of routine biomarkers as noninvasive indicators of liver fibrosis in patients with chronic hepatitis C (CHC). One hundred patients with CHC were subjected to full medical history and examination, in addition to ultrasound‐guided liver biopsy and histopathological examination for assessment of liver fibrosis stage. GA and HbA1c values, GA/HbA1c ratio, liver function tests, complete blood count, and alpha fetoprotein (AFP) were determined. A novel noninvasive index, dubbed Fibrosis Prediction Score (FPS), was selected for predicting significant liver fibrosis based on total bilirubin, glycated albumin, platelet count, age, and AFP. A validation study for FPS was applied on archival data which include 66 diabetics' patients. The FPS had area under the curve (AUC) of 0.92 for classification of patients with significant fibrosis with 81% sensitivity and 95% specificity. The AUCs of FPS in predicting advanced fibrosis and cirrhosis were 0.86 and 0.82, respectively. Comparison of AST‐to‐platelet ratio index (APRI) and FIB‐4 with FPS indicated increased sensitivity and specificity of FPS over APRI and FIB4 in both significant and advanced fibrosis. FPS has a good sensitivity and specificity for prediction of significant and advanced liver fibrosis in patients with CHC.