Rhus coriaria induces senescence and autophagic cell death in breast cancer cells through a mechanism involving p38 and ERK1/2 activation

Here, we investigated the anticancer effect of Rhus coriaria on three breast cancer cell lines. We demonstrated that Rhus coriaria ethanolic extract (RCE) inhibits the proliferation of these cell lines in a time- and concentration-dependent manner. RCE induced senescence and cell cycle arrest at G1 phase. These changes were concomitant with upregulation of p21, downregulation of cyclin D1, p27, PCNA, c-myc, phospho-RB and expression of senescence-associated β-galactosidase activity. No proliferative recovery was detected after RCE removal. Annexin V staining and PARP cleavage analysis revealed a minimal induction of apoptosis in MDA-MB-231 cells. Electron microscopy revealed the presence of autophagic vacuoles in RCE-treated cells. Interestingly, blocking autophagy by 3-methyladenine (3-MA) or chloroquine (CQ) reduced RCE-induced cell death and senescence. RCE was also found to activate p38 and ERK1/2 signaling pathways which coincided with induction of autophagy. Furthermore, we found that while both autophagy inhibitors abolished p38 phosphorylation, only CQ led to significant decrease in pERK1/2. Finally, RCE induced DNA damage and reduced mutant p53, two events that preceded autophagy. Our findings provide strong evidence that R. coriaria possesses strong anti-breast cancer activity through induction of senescence and autophagic cell death, making it a promising alternative or adjunct therapeutic candidate against breast cancer.UAEU Program for Advanced Research (Grant 31S111-UPAR) and by the Zayed Center for Health Sciences (ZCHS) research grant (grant 31R021) and College of Science Individual Research Grant (grant 31S123) to Rabah Iratni

Maternal Mortality Ratio and Universal Access to Reproductive Health Care in the State of Qatar between 1990 and 2012: A PEARL Study Analysis

Study Aim: The Millennium Development Goal (MDG)- 5 mandates a three quarters reduction in Maternal Mortality Ratio (MMR) and provision of universal access to reproductive health by 2015. Our study aims to analyze Qatar’s performance in achieving MDG 5 between 1990 and 2012.Study Design: A National Prospective cohort-studyData Source: Qatar Perinatal Registry (Q-Peri-Reg) for 2011 and 2012 dataMethods: National data on total deliveries, total births (live and stillbirths) and maternal mortality (during pregnancy to day 42 post-delivery) was collected from all public and private maternity units in Qatar (1st January 2011- December, 31st 2012) and compared with historical maternal mortality data (1990-2010) ascertained from the database of maternity and neonatal units of Women’s Hospital, annual reports of Hamad Medical Corporation and international reports. For inter country comparison, country data was extracted from World Health Statistics 2011(WHO).Results: The country wide live births were 20583 during 2011 and 22,225 during 2012 with two maternal deaths duringeach year giving an MMR of 9.85/100,000 and 8.99/100,000 live births respectively which was more than three quarters decline from an MMR of 49/100,000 in 1990. During 2011, 74.22% deliveries were normal vaginal (n 15076) and 25.78% (n 5238) by Caesarean section. 99.45 % of deliveries were attended by a trained birth attendant in a maternity facility while 0.55 % (n = 114) took place out of hospital. 100% of mothers had made at least one antenatal visit and 100% of live births were examined by a pediatrician and entered in national birth register. Qatar’s 2011 and 2012 MMR is significantly lower than the current global MMR of 260/100,000 and Eastern Mediterranean Region MMR of 320/100,000.Conclusion: Qatar has achieved its target MDG 5 well before 2015. Qatar’s 2011 and 2012 MMR is comparable to most high income countries. Qatar’s reproductive health system, with its universal access for all, provides a unique model to study the correlates and associations of maternal survival which can form the basis of global health systems improvement strategies

Causal explanations of miscarriage amongst Qataris

Background Despite its commonality, there is a paucity of literature on miscarriage in non-Western societies. In particular, there is little understanding of how people ascribe cause to miscarriage. This research sought to gain an in-depth understanding of notions of miscarriage causality and risk amongst Qataris. Methods The study adopted an exploratory descriptive qualitative approach and collected data during 18 months of ethnographic research in Qatar, including semi-structured interviews. The sample includes 60 primary participants (20 pregnant women and 40 women who had recently miscarried), and 55 secondary participants including family members, health care providers, religious scholars and traditional healers. Informed consent was obtained from all participants. Primary participants were interviewed in Arabic. The interviews were audio recorded, transcribed and translated into English. Data was analysed using an inductive thematic approach, which involved identification and application of multiple codes to different text segments. Data were encoded manually and examined for recurrences across the data set. Similar quotations were grouped into subcategories and further categorized into main themes. Results A number of key themes emerged, revealing Qatari women attributed miscarriages to a number of factors including: supernatural forces, such as God’s will and evil eye; lifestyle, such as physical activities and consuming particular substances; medical conditions, such as diabetes; and emotional state, such as stress, and emotional upset. Resting, avoiding stress and upset, maintaining healthy diet, and spiritual healing (ruqyah) are seen as a means to avoid miscarriage. Conclusion Practices and beliefs around miscarriage are embedded in social, cultural, religious and medical frameworks. Understanding the socio-cultural context and understandings of explanatory theories can enhance health care providers’ understandings, resulting in improved communication and care