Using platelet-to-lymphocyte ratio as a diagnostic marker in malignant ovarian tumors

Background: Ovarian malignancy, is the fifth global fatal disease for women, and the most common cause of death in Gynecological cancer. Objective was to evaluate any diagnostic role of Platelet-to-lymphocyte ratio in epithelial ovarian tumors.Methods: A prospective analysis, over 1 year; (October 2016 to October 2017). Setting: University hospital’s Gynaecological oncology centre. Subjects & Methodology: A total of 36 patients with epithelial ovarian tumors, not under any adjuvant therapy and negative for any other malignancy, or any blood diseases causing blood count changes. All subjects underwent preoperative assessment of CA125 and Platelet-to-lymphocyte ratio (PLR), followed by a staging laparotomy and the appropriate management according to the standard protocols. Postoperative histopathological confirmation of the disease type, stage and grade was done for all cases.Results: (77.8%) of the patients had early stage disease while (22.2%) had advanced stage. Neither mean platelet, lymphocytic counts, nor PLR express any significant difference between early and late stage disease. CA 125 levels, however changed significantly in advanced stages. PLR showed a statistically significant difference between the three stages of the disease (P=0.007).   There was a positive correlation between PLR and CA125 (r=0.184 and P=0.283).Conclusions: PLR rise significantly with tumor stages and correlates significantly with CA125. No significant change in PLR values with tumor type or grade. PLR might be a potential diagnostic / prognostic marker of ovarian epithelial cancer

Using platelet-to-lymphocyte ratio as a diagnostic marker in malignant ovarian tumors

Background: Ovarian malignancy, is the fifth global fatal disease for women, and the most common cause of death in Gynecological cancer. Objective was to evaluate any diagnostic role of Platelet-to-lymphocyte ratio in epithelial ovarian tumors.Methods: A prospective analysis, over 1 year; (October 2016 to October 2017). Setting: University hospital’s Gynaecological oncology centre. Subjects & Methodology: A total of 36 patients with epithelial ovarian tumors, not under any adjuvant therapy and negative for any other malignancy, or any blood diseases causing blood count changes. All subjects underwent preoperative assessment of CA125 and Platelet-to-lymphocyte ratio (PLR), followed by a staging laparotomy and the appropriate management according to the standard protocols. Postoperative histopathological confirmation of the disease type, stage and grade was done for all cases.Results: (77.8%) of the patients had early stage disease while (22.2%) had advanced stage. Neither mean platelet, lymphocytic counts, nor PLR express any significant difference between early and late stage disease. CA 125 levels, however changed significantly in advanced stages. PLR showed a statistically significant difference between the three stages of the disease (P=0.007).   There was a positive correlation between PLR and CA125 (r=0.184 and P=0.283).Conclusions: PLR rise significantly with tumor stages and correlates significantly with CA125. No significant change in PLR values with tumor type or grade. PLR might be a potential diagnostic / prognostic marker of ovarian epithelial cancer

Assessment of exclusive and dual cigarette and hookah smoking among a sample of pregnant women in Egypt

Background Limited data exists regarding tobacco use during pregnancy, particularly in Middle Eastern countries. We examined tobacco use patterns and beliefs regarding secondhand smoke exposure (SHS) before and during pregnancy among Egyptian women. Methods Pregnant women were recruited during their last trimester from maternity hospitals in Cairo, Egypt from June, 2015 to May, 2016. Two hundred women were interviewed about their tobacco use before and during pregnancy, as well as their attitudes and beliefs regarding tobacco use and SHS. Results Participants had a mean age of 27 ( + 4.6) years. Before pregnancy, 30% of the women reported using tobacco. Among tobacco users, 60% were dual users of cigarettes and hookah, 35% were exclusive cigarette smokers, and 5% were exclusive hookah smokers. Prevalence of daily cigarette smoking decreased during pregnancy (-62.9%, p< .0001), but daily hookah use did not change (-7.4%, p=0.215). Most dual users (75%) transitioned to exclusive hookah smoking during pregnancy. Only 13% of smokers quit all products, whereas 28% continued their same smoking behaviors. Social acceptability of hookah and cigarette smoking was high among tobacco users and did not differ by product. The majority of women agreed that tobacco use is harmful during pregnancy (92%) and SHS is harmful to a newborn (94%), and this did not differ by smoking status. However, only 68% agreed that a pregnant woman's SHS was harmful to herself and her unborn child. Conclusions Among this sample of pregnant women, dual use of hookah and cigarettes was common before pregnancy. The transition from dual to exclusive hookah smoking during pregnancy suggests that hookah may be perceived as less harmful than cigarettes and could serve as a substitute for conventional cigarettes. Future work is needed to understand and address hookah smoking during pregnancy and misperceptions about the harmful effects of SHS among women of child-bearing age in Cairo, Egypt

Exclusive and Dual Cigarette and Hookah Smoking Is Associated with Adverse Perinatal Outcomes among Pregnant Women in Cairo, Egypt

This study assessed the prevalence of prenatal smoking, factors associated with prenatal smoking, and its association with birth outcomes in a sample of pregnant women in Egypt. Pregnant women were recruited during their last trimester from antenatal clinics in Cairo from June 2015 to May 2016. Participants completed an interviewer-administered survey that assessed tobacco use and attitudes, and exhaled carbon monoxide (CO) was measured. Gestational age at delivery and offspring birth weight were collected via a postnatal phone interview. Two hundred pregnant women ages 16&ndash;37 years participated. More than a quarter (29.0%) of women reported smoking (cigarettes, hookah, or both) during their current pregnancy, and hookah was more popular than cigarettes. Most women who smoked prior to their current pregnancy either maintained their current smoking habits (46.6%) or switched from dual to hookah-only smoking (46.6%). Current smokers during pregnancy had a higher mean (&plusmn;SD) exhaled CO level (2.97 &plusmn; 1.45 vs. 0.25 &plusmn; 0.60 ppm, p &lt; 0.001) and had babies with a lower mean birth weight (2583 &plusmn; 300 vs. 2991 &plusmn; 478 g, p &lt; 0.001) than non-smokers. Smokers during pregnancy had greater odds of premature birth and/or low birth weight babies compared to non-smokers. Dual cigarette-hookah smokers had the highest risk. Additional focused programs are required to prevent women of childbearing age from initiating tobacco use and empower women to stop tobacco use during the preconception and gestational periods

Prevalence and factors associated with second hand smoke exposure among a sample of pregnant women in Cairo, Egypt

Abstract Purpose This study estimated the prevalence of and factors associated with secondhand smoke (SHS) exposure, and assessed attitudes and knowledge about SHS among pregnant women in Cairo, Egypt. Methods Pregnant women in the third trimester were recruited to participate in a survey assessing tobacco smoking and SHS exposure during their current pregnancy. Participants were recruited from three antenatal clinics in Cairo, Egypt, from June 2015 to May 2016. We examined differences in sociodemographic characteristics and SHS exposure, attitudes, and knowledge by smoking/SHS status. We used multivariable ordinary least squares regression to examine the association between husbands’ smoking and pregnant women’s mean daily hours of SHS exposure, adjusting for women’s smoking status, age group, education, and urban (vs. suburban/rural) residence. Results Of two hundred pregnant women aged 16–37 years, about two-thirds (69%) had a husband who smoked tobacco. During their current pregnancy, most women reported being non-smokers (71%), and 38% of non-smokers reported being SHS-exposed. Non-smokers exposed to SHS tended to live in more rural areas and have husbands who smoked in the home. In adjusted analyses, having a husband who smoked was significantly associated with a greater mean number of hours of SHS exposure per day exposed, and this difference was driven by husbands who smoked in the home (p < 0.001). Women in the SHS-exposed group were less likely than other groups to agree that SHS exposure was harmful to their own or their future child’s health; however, all groups agreed that SHS was harmful to newborn health. Conclusion Among our sample of pregnant women in Cairo, Egypt, there was a high rate of SHS exposure as well as misconceptions about the safety of SHS exposure to a developing fetus. Our findings suggest a need for targeted education and gender-sensitive messaging about SHS exposure, along with improved enforcement of existing tobacco control policies

The impact of music therapy on anxiety and pregnancy rate among infertile women undergoing assisted reproductive technologies: a systematic review and meta-analysis

Objective: We aimed to perform a systematic review and meta-analysis to evaluate the effect of music therapy on anxiety and pregnancy rates among infertile women undergoing to perform assisted reproductive technologies (ART). Methods: Cochrane Library, PubMed, ISI web of science, and Scopus were searched from inception to May 2021. We included randomized controlled trials (RCTs) that compared music therapy (intervention group) to no music intervention (control group). Our primary outcomes were anxiety score using the State-Trait Anxiety Inventory (STAI) tool and pain score utilizing the Visual Analog Scale (VAS). Our secondary outcomes were the overall satisfaction score and clinical pregnancy rate. We extracted the available data from included studies and pooled them in a meta-analysis model using RevMan software. The overall quality of evidence was assessed through GRADEpro GDT software. Results: Seven RCTs with a total number of 793 patients were included in our study. Music therapy significantly reduced the anxiety score compared to control group (MD= −3.09, 95% CI [−5.57, −0.61], p = 0.01). Moreover, pain score was significantly improved after music treatment (MD= −2.93, 95% CI [−3.86, −2.00], p > 0.001). A significant improvement in the overall satisfaction score was found among music therapy group (MD= 1.51, 95% CI [0.40, 2.61], p = 0.008). Although more women in music therapy group experienced an increase in the clinical pregnancy rate in comparison with control group, the result was not statistically significant (RR= 1.08, 95% CI [0.94, 1.26], p = 0.28). The GRADEpro GDT tool showed a moderate quality of evidence for the evaluated outcomes. Conclusions: There is evidence of moderate quality that music therapy improves anxiety, pain, and satisfaction scores among infertile women undergoing ART. Moreover, it increases the clinical pregnancy rate but without statistical significance. More trials with a larger sample size are needed to investigate the influence of music therapy on the clinical outcomes of ART

Twelve-month observational study of children with cancer in 41 countries during the COVID-19 pandemic

Childhood cancer is a leading cause of death. It is unclear whether the COVID-19 pandemic has impacted childhood cancer mortality. In this study, we aimed to establish all-cause mortality rates for childhood cancers during the COVID-19 pandemic and determine the factors associated with mortality

Global economic burden of unmet surgical need for appendicitis

Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially

Global economic burden of unmet surgical need for appendicitis

Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially