Background: Syrian refugee women not only suffered the refuging journey but also faced the burden of being the heads of their households in a new community. We aimed to investigate the mental health status, traumatic history, social support, and post-traumatic growth (PTG) of Syrian refugee women. Methods: A cross-sectional study was conducted using a structured interviewer-administered survey between August and November 2019. Syrian refugee women who head their households and live outside camps were eligible. The survey included items investigating socio-demographic characteristics and conflict-related physical trauma history. The Refugee Health Screener-15 (RHS-15) scale was used to screen for emotional distress symptoms of depression, anxiety, and post-traumatic stress disorder (PTSD), with a score range of 0−4 and higher scores indicating emotional distress. The Multidimensional Scale of Perceived Social Support (MSPSS) was utilized to assess the perceived support from family, friends, and significant others (score range 1−7), with scores of 3−5 and 5.1−7.0 representing moderate and high support, respectively. The PTG Inventory (PTGI) scale investigated the positive transformation following trauma; the score range was 0−5, and the cutoff point of ≥3 defined moderate-to-high growth levels. Results: Out of 140 invited refugee women, 95 were included, with a response rate of 67.9%. Their mean (SD) age was 41.30 (11.75) years, 50.5% were widowed, and 17.9% reported their husbands as missing persons. High levels of conflict-related traumatic exposure were found, including threats of personal death (94.7%), physical injury (92.6%), or both (92.6%); and a history of family member death (92.6%), missing (71.6%), or injury (53.7%). The mean (SD) RHS-15 score was above average (2.08 (0.46)), and most women (90.5%) were at high risk for depression, anxiety, and PTSD symptoms. The mean (SD) MSPSS score was 5.08 (0.71), representing moderate social support, with friends' support being the highest (5.23 (0.85)). The mean (SD) PTGI score was 2.44 (0.48), indicating low growth, with only 12.6% of women experiencing moderate-to-high growth levels. Spiritual change and personal strength had the highest sub-scores, with moderate-to-high growth levels experienced by 97.9% and 84.2%, respectively. Most women were more optimistic and religious, had feelings of self-reliance and better difficulties adapting, and were stronger than they thought. Statistically significant correlations of MSPSS and its subscales with RHS-15 and PTGI were detected. Conclusion: Significant but unspoken mental health problems were highly prevalent among Syrian refugee women and an imminent need for psychological support to overcome traumatic exposure. The role of social support seems to be prominent and needs further investigation.
Background The COVID-19 pandemic had many implications on healthcare services, including cellular pathology. The pandemic-related lockdown was applied in Jordan from March to May 2020. King Abdullah University Hospital (KAUH) was chosen to provide care for COVID-19 patients during that period. Since there was no experience in dealing with COVID-19 patients, the hospital maintained some essential services but canceled elective surgeries and procedures. The rationale was to prioritize care for COVID-19 patients and to provide better adherence to infection control policies and protect non-infected patients and healthcare workers. The purpose of the present study is to investigate the impact of COVID-19 pandemic restrictions on cellular pathology practice patterns at KAUH. Methods This is a retrospective observational study conducted at KAUH. All cellular pathology reports during the 2020 national lockdown were retrieved. The total numbers of specimens including types and procedures were recorded. Data were compared with the corresponding data in 2019 when there was no pandemic and when hospital and laboratory services were run in full capacity. Results 2020 lockdown period showed a 57.9% reduction in the total number of specimens received at the cellular pathology laboratory as compared to the corresponding period of 2019 (1400 versus 3322). Emergency procedures have represented 99.1% of the service during the lockdown with a remarkable diversity shift. Conclusion There was a significant drop in the number of specimens dealt with at KAUH cellular pathology laboratory during the COVID-19 pandemic-related national lockdown. We learned from this pandemic how to adapt to such circumstances by adjusting our way of working to reach the best level of staff safety while maintaining highly productive work. Implementing digital pathology platforms, working from home strategies and alternative training methodologies have emerged as an essential need.
Background. Neurokinin 1 receptor (NK1R) is a promising biomarker and therapeutic target in breast cancer. This study was aimed at investigating the expression level of NK1R in breast cancer tissues and its relationship with proliferation index as measured by Ki-67, clinicopathological characteristics of patients, and overall survival rate. Methods. Immunohistochemical expression of NK1R and Ki-67 was measured in 164 paraffin-embedded breast cancer tissues of four molecular subtypes (42 HER2-enriched, 40 luminal A, 42 luminal B, and 40 triple negative). NK1R was scored semiquantitatively, while Ki-67 was obtained by the percentage of total number of tumor cells with nuclear staining. The optimal cutoff values for NK1R and Ki-67 were assessed by Cutoff Finder. Pearson’s Chi-square ( χ 2 ) and Fisher’s exact tests were used to compare the staining scores between groups. The Kaplan-Meier method with log-rank test was used for survival analysis. ANOVA and Student’s t -test were used to compare group means. Results. A total of 164 patients were included in the study which represented females with invasive ductal carcinoma. NK1R was expressed at high levels in about 34% of investigated cases. The mean Ki-67 level was about 27% and 41.5% of sample had high Ki-67 ( expression level > 22 % ). NK1R expression levels were associated with higher tumor grade ( p = 0.021 ) and high Ki-67 ( p = 0.012 ). NK1R expression negatively impacted overall survival in grade II tumors ( p = 0.027 ). Conclusion. NK1R contributes to cellular proliferation and is associated with negative prognosis in breast cancer. These findings suggest the potential role of NK1R as a therapeutic target in breast cancer.
Despite that, other studies reported that around one-fifth of the cases will have no response to RT. Other workers reported that the contribution of neoadjuvant RT to pathological complete response in terms of survival was of limited or minimal benefit [8]. In view of the above changes, the real challenge in rectal cancer treatment is to identify patients who would fully benefit from the new treatment protocols which involve RT. The aim of this article is to present the different histological systems used to classify the response rate of the patients and to discuss the different types of biomarkers used to predict of the response of patients to RT/ chemoradiotherapy (CRT). RT Mechanism of Action Oxidative stress damage is extensive in cells exposed to ionising radiation. This damage mainly targets nuclear DNA through inhib-The management of rectal cancer is a major undertaking. There are currently multiple treatment modalities with variable degrees of complications. Radiotherapy (RT) is one of the more frequently used modalities either on its own or more frequently with chemotherapy mostly before the definitive surgery. The outcome of RT is unpredictable. RT has its serious side effects and there are no guarantees of its usefulness in all patients. This article outlines the effect of RT on the tumor, reviews the various staging systems of responses to RT and present recent evidence of which case is less responsive to such treatments to avoid unnecessary complications.
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