Publications by authors named "Saira Khan"

79 Publications

Epidemiology and prognostic factors of pediatric brain tumor survival in the US: Evidence from four decades of population data.

Cancer Epidemiol 2021 May 1;72:101942. Epub 2021 May 1.

Program of Epidemiology, College of Health Sciences, University of Delaware, 100 Discovery Blvd, Newark, DE, 19713, United States.

Brain tumors, a group of heterogeneous diseases, are the second most common cancer and the leading cause of cancer-related deaths in children. Insight into the prognosis of pediatric brain tumor survival has led to improved outcomes and could be further advanced through precision in prognosis. We analyzed the United States SEER population-based dataset of 15,723 pediatric brain tumor patients diagnosed and followed between 1975 and 2016 using a stratified Cox proportional hazards model. Mortality risk declined with increased age at diagnosis, the adjusted hazard ratio (aHR) (95 % confidence interval) was 0.60 (0.55, 0.67) and 0.47 (0.42, 0.52) for ages at diagnosis 1-10 years and 10-19 years, respectively, when compared with infants. Non-Hispanic Caucasian patients showed a lower risk of mortality than non-Hispanic African Americans (1.21 (1.11, 1.32)) and Hispanics (1.21 (1.11, 1.32)). Primary tumor sites, grades, and histology showed substantial heterogeneity in mortality risk. Brainstem (2.62 (2.41, 2.85)) and Cerebrum (1.63 (1.46, 1.81)) had an elevated risk of mortality than lobes. Similarly, Grade II (1.32 (1.07, 1.62)), Grade III (3.39 (2.74, 4.19)), and Grade IV (2.18 (1.80, 2.64)) showed an inflated risk of mortality than Grade I. Compared to low-grade glioma, high-grade glioma (7.92 (7.09, 8.85)), Primitive neuroectodermal tumors (4.72 (4.15, 5.37)), Medulloblastoma (3.11 (2.79, 3.47)), and Ependymal-tumors (2.20 (1.95, 2.48)) had increased risk of mortality. County-level poverty and geographic region showed substantial variation in survival. This large population-based comprehensive study confirmed identified prognostic factors of pediatric brain tumor survival and provided estimates as epidemiologic evidence with greater generalization.
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http://dx.doi.org/10.1016/j.canep.2021.101942DOI Listing
May 2021

Effect of M. chamomilla L. tea on chlorpromazine induced catalepsy: A neuroprotective study.

Pak J Pharm Sci 2020 Sep;33(5):1945-1953

Department of Pathology, Dow University of Health Sciences, Karachi, Pakistan.

We determined anti-Parkinson's activity of M. chamomilla L. tea in chlorpromazine (CPZ) developed investigational animal model. In this research, effects of M. chamomilla L. tea 2.14ml/ kg P.O were studied on cataleptic behavior and its effect on brain histopathological changes and immunohistochemistry (IHC) in rats. The experimental design was developed by administering CPZ (3mg/kg, I/P) for twenty-one days to produce Parkinson's disease-like symptoms to 4 animal groups. We observed that chlorpromazine significantly produced motor dysfunctions (catalepsy) in a time period of twenty-one days. The M. chamomilla L. significantly (P<0.005) minimized/shorten/taper down catalepsy in rats just like standard group (Levodopa/carbidopa treated group). The maximum reduction was observed from both treated and standard groups on the 21st day. M. chamomilla L. treated rats mid brain sections showed presence of proliferative blood vessels, increase cellularity with reactive glial cells as compared to CPZ group. Furthermore, immunostaining CD68 & CD21 of M. chamomilla L. treated rats mid brain region showed few CD68 cells & no polymorphs neutrophils after CD21 staining. Thus, this research work disclosed the neuroprotective effect of M. chamomilla L. tea against Parkinson's disease-like symptoms or anti-Parkinson's activity induced by CPZ.
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September 2020

Body size throughout the life-course and incident benign prostatic hyperplasia-related outcomes and nocturia.

BMC Urol 2021 Mar 27;21(1):47. Epub 2021 Mar 27.

Division of Public Health Sciences, Department of Surgery, Washington University in St. Louis School of Medicine, 660 S. Euclid Ave., Campus Box 8100, St. Louis, MO, 63110, USA.

Background: Existing evidence suggests that there is an association between body size and prevalent Benign Prostatic Hyperplasia (BPH)-related outcomes and nocturia. However, there is limited evidence on the association between body size throughout the life-course and incident BPH-related outcomes.

Methods: Our study population consisted of men without histories of prostate cancer, BPH-related outcomes, or nocturia in the intervention arm of the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO) (n = 4710). Associations for body size in early- (age 20), mid- (age 50) and late-life (age ≥ 55, mean age 60.7 years) and weight change with incident BPH-related outcomes (including self-reported nocturia and physician diagnosis of BPH, digital rectal examination-estimated prostate volume ≥ 30 cc, and prostate-specific antigen [PSA] concentration > 1.4 ng/mL) were examined using Poisson regression with robust variance estimation.

Results: Men who were obese in late-life were 25% more likely to report nocturia (Relative Risk (RR): 1.25, 95% Confidence Interval (CI): 1.11-1.40; p-trend < 0.0001) and men who were either overweight or obese in late-life were more likely to report a prostate volume ≥ 30 cc (RR: 1.13, 95% CI 1.07-1.21; RR: 1.10, 95% CI 1.02-1.19; p-trend = 0.017) as compared to normal weight men. Obesity at ages 20 and 50 was similarly associated with both nocturia and prostate volume ≥ 30 cc. Considering trajectories of body size, men who were normal weight at age 20 and became overweight or obese by later-life had increased risks of nocturia (RR: 1.09, 95% CI 0.98-1.22; RR: 1.28, 95% CI 1.10-1.47) and a prostate volume ≥ 30 cc (RR: 1.12, 95% CI 1.05-1.20). Too few men were obese early in life to examine the independent effect of early-life body size. Later-life body size modified the association between physical activity and nocturia.

Conclusions: We found that later-life body size, independent of early-life body size, was associated with adverse BPH outcomes, suggesting that interventions to reduce body size even late in life can potentially reduce the burden of BPH-related outcomes and nocturia.
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http://dx.doi.org/10.1186/s12894-021-00816-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8005244PMC
March 2021

Impact of non-renewable and renewable energy consumption on economic growth: evidence from income and regional groups of countries.

Environ Sci Pollut Res Int 2021 Mar 19. Epub 2021 Mar 19.

Department of Biotechnology, COMSATS University Islamabad, Abbottabad Campus, Abbottabad, Pakistan.

The motivation behind this study is to investigate the impact of non-renewable and renewable energy consumption on economic growth for a panel of 99 world countries with energy inclusive production function and then finding the empirical evidences for income and regional classification of world economies. To accomplish this purpose, the study has employed panel estimation techniques of dynamic and fully modified ordinary least square and fixed effects model after confirming Hausman test over the period of 1995-2017. For overall sample, the impact of non-renewable and renewable energy consumption on economic growth is found to be significantly positive while this relationship of energy-growth varies at income and regional classification. To incorporate the omitted variable biasness, capital and labor were included in the model. Thus, it is evident from the results that in the presence of non-renewable and renewable energy consumption, capital and labor have significant positive impact on economic growth. It is concluded that although energy consumption has a vital importance in boosting growth and development of the economies but heavily focusing on non-renewable energy cause environmental problems therefore, it is suggested to promote renewable energy sector for efficient and environment friendly use of energy.
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http://dx.doi.org/10.1007/s11356-021-13448-xDOI Listing
March 2021

Review: Herbs, Immunity and nCOVID-19: Old performers in new Pandemic.

Pak J Pharm Sci 2020 Jul;33(4):1747-1753

Department of Pharmacology, Faculty of Pharmacy and Pharmaceutical Sciences, University of Karachi, Karachi, Pakistan.

The novel coronavirus (nCOVID-19) has spread to endless nations and turn out to be a pandemic around the globe. Because of the developing number of affirmed cases and open public hazard owing to its high risk of infection rate, it has expected a lot of consideration from world health organizations and national health regulatory and monitoring agencies. The world is in surge to explore or discover novel treatment options and vaccine that can lead to cure. There is no proven effective treatment for nCOVID-19 however along with available antiviral therapy Chinese researchers recommended herbal treatments as effective and alternative treatments options to treat this pandemic. Herbal products are wealthy in dynamic phytochemicals, such as the terpenoids, various collection of flavonoids, sulfides, lignans constiuents, coumarins concentrates, saponins moities, polyphenolics composite, numerous alkaloids, polyines, furyl mixtures, proteins and related compounds, thiophenes and peptides groups. In this review we discussed pathogeneis, immunity and current herbal treatment strategies of nCOVID-19 to cure this world wide pandemic.
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July 2020

Why Do Epidemiologic Studies Find an Inverse Association Between Intraprostatic Inflammation and Prostate Cancer: A Possible Role for Colliding Bias?

Cancer Epidemiol Biomarkers Prev 2021 Feb;30(2):255-259

Division of Public Health Sciences, Department of Surgery, Alvin J. Siteman Cancer Center, and Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri.

Inflammation is an emerging risk factor for prostate cancer based largely on evidence from animal models and histopathologic observations. However, findings from patho-epidemiologic studies of intraprostatic inflammation and prostate cancer have been less supportive, with inverse associations observed in many studies of intraprostatic inflammation and prostate cancer diagnosis. Here, we propose collider stratification bias as a potential methodologic explanation for these inverse findings and provide strategies for conducting future etiologic studies of intraprostatic inflammation and prostate cancer.
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http://dx.doi.org/10.1158/1055-9965.EPI-20-1009DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8040828PMC
February 2021

Breast Cancer Mortality Hot Spots Among Black Women With de Novo Metastatic Breast Cancer.

JNCI Cancer Spectr 2021 Feb 1;5(1):pkaa086. Epub 2020 Oct 1.

Division of Epidemiology, Department of Population Health Sciences, Augusta University, Augusta, GA, USA.

Background: Black women living in southern states have the highest breast cancer mortality rate in the United States. The prognosis of de novo metastatic breast cancer is poor. Given these mortality rates, we are the first to link nationally representative data on breast cancer mortality hot spots (counties with high breast cancer mortality rates) with cancer mortality data in the United States and investigate the association of geographic breast cancer mortality hot spots with de novo metastatic breast cancer mortality among Black women.

Methods: We identified 7292 Black women diagnosed with de novo metastatic breast cancer in Surveillance, Epidemiology, and End Results (SEER). The county-level characteristics were obtained from 2014 County Health Rankings and linked to SEER. We used Cox proportional hazards models to calculate adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for mortality between hot spot and non-hot spot counties.

Results: Among 7292 patients, 393 (5.4%) resided in breast cancer mortality hot spots. Women residing in hot spots had similar risks of breast cancer-specific mortality (aHR = 0.99, 95% CI = 0.85 to 1.15) and all-cause mortality (aHR = 0.97, 95% CI = 0.84 to 1.11) as women in non-hot spots after adjusting for individual and tumor-level factors and treatments. Additional adjustment for county-level characteristics did not impact mortality.

Conclusion: Living in a breast cancer mortality hot spot was not associated with de novo metastatic breast cancer mortality among Black women. Future research should begin to examine variation in both individual and population-level determinants, as well as in molecular and genetic determinants that underlie the aggressive nature of de novo metastatic breast cancer.
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http://dx.doi.org/10.1093/jncics/pkaa086DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7791608PMC
February 2021

Strategies for Success: Landing Your First Academic Position and Navigating the Early Years-A Report from the American Society of Preventive Oncology's Early Career Investigator Special Interest Group.

Cancer Epidemiol Biomarkers Prev 2021 Jan;30(1):233-236

Department of Population Health Sciences, Albany College of Pharmacy and Health Sciences, Albany, New York.

As part of the 2019 American Society of Preventative Oncology (ASPO) annual meeting, the Early Career Investigator Special Interest Group organized a session entitled "Strategies for Success: Landing Your First Academic Position and Navigating the Early Years."* This session was designed to provide senior doctoral students and postdoctoral fellows with strategies for preparing successful faculty job applications. Furthermore, strategies and best practices to help guide early career faculty through the initial years of their academic positions were also discussed. This report summarizes the main themes of the session, including advice and recommendations from the panelists.
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http://dx.doi.org/10.1158/1055-9965.EPI-20-0750DOI Listing
January 2021

Modeling pastoralist movement in response to environmental variables and conflict in Somaliland: Combining agent-based modeling and geospatial data.

PLoS One 2020 30;15(12):e0244185. Epub 2020 Dec 30.

Harvard Humanitarian Initiative, Harvard University, Cambridge, Massachusetts, United States of America.

Pastoralism is widely practiced in arid lands and is the primary means of livelihood for approximately 268 million people across Africa. Environmental, interpersonal, and transactional variables such as vegetation and water availability, conflict, ethnic tensions, and private/public land delineation influence the movements of these populations. The challenges of climate change and conflict are widely felt by nomadic pastoralists in Somalia, where resources are scarce, natural disasters are increasingly common, and protracted conflict has plagued communities for decades. Bereft of real-time data, researchers and programmatic personnel often turn to post hoc analysis to understand the interaction between climate, conflict, and migration, and design programs to address the needs of nomadic pastoralists. By designing an Agent-Based Model to simulate the movement of nomadic pastoralists based on typologically-diverse, historical data of environmental, interpersonal, and transactional variables in Somaliland and Puntland between 2008 and 2018, this study explores how pastoralists respond to changing environments. Through subsequent application of spatial analysis such as choropleth maps, kernel density mapping, and standard deviational ellipses, we characterize the resultant pastoralist population distribution in response to these variables. Outcomes demonstrate a large scale spatio-temporal trend of pastoralists migrating to the southeast of the study area with high density areas in the south of Nugaal, the northwest of Sool, and along the Ethiopian border. While minimal inter-seasonal variability is seen, multiple analyses support the consolidation of pastoralists to specifically favorable regions. Exploration of the large-scale population, climate, and conflict trends allows for cogent narratives and associative hypotheses regarding the pastoralist migration during the study period. While this model produces compelling associations between pastoralist movements and terrestrial and conflict variables, it relies heavily on assumptions and incomplete data that are not necessarily representative of realities on the ground. Given the paucity of data regarding pastoralist decision-making and migration, validation remains challenging.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0244185PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7773237PMC
March 2021

Comparison of the antidepressant like activity of homeopathic remedies (Argentum nitricum, Staphysagria and Ignatia amara) and their effect on the behavior of rodents.

Pak J Pharm Sci 2020 May;33(3):937-945

Institute of Pharmaceutical Sciences, Jinnah Sindh Medical University, Karachi, Pakistan.

The majority of the world population suffers from mental and behavioral disorder. It is the need of the time to find an alternate of presently available medicines in order to decrease the medical expense. Homeopathic remedies are available and prescribed by homeopaths for treatment of anxiety and depression. Unfortunately, no data are available that proves its potential to relieve mental illness. The current study is designed to assess neuro behavioral and antidepressant like effects of homeopathic remedies Staphysagria, Argentum nitricum and Ignatia amara in comparison with standard drug (escitalopram). Different neuro behavioral activities were analyzed. The animals were administered the doses of all homeopathic remedied (60 µl to the rats) and escitalopram (0.042 mg to rats) through the oral route. The activities were observed on day 30th and day 60th. Our result suggests that the swimming time in Staphysagria treated group were significantly improved (p<0.001) after day 60th and significance rise was observed (p<0.01) in Ignatia amara treated animals, whereas significant decline (p<0.05) in struggling time was observed in Argentum nitricum administered animals after the 60th day as compared to 30th day. The central square crossings were improved highly significantly (p<0.001) after the 30th day dosing, by all three remedies and peripheral squares crossing were found highly significantly increased (p<0.001) after chronic dosing in Staphysagria and Ignatia amara treated groups. It is concluded from the results that all three homeopathic remedies produce comparable effects like standard drug while among all three remedies Staphysagria possess a potent antidepressant activity. To the best of our knowledge the current study reports first time the anti-depressant potential of homeopathic remedies in rodents.
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May 2020

Spatiotemporal Trends in Discarded Needle Reports in San Francisco Over a 10-year Period, 2010-2019.

Int J Drug Policy 2021 Jan 1;87:103018. Epub 2020 Nov 1.

Division of General Internal Medicine and Mongan Institute, Massachusetts General Hospital, 55 Fruit St, Boston, Massachusetts, 02114 USA; Department of Medicine, Harvard Medical School, 25 Shattuck St, Boston, Massachusetts, 02115 USA. Electronic address:

Background: To describe the geographic and spatiotemporal distribution of needle reports in San Francisco, and examine spatial relationships between needle reports and needle disposal boxes, needle disposal kiosks, and homeless shelters.

Methods: We conducted multiple geospatial analyses of a crowdsourced database of non-emergency service requests. We describe changes in discarded needle and bulky item reports across San Francisco between 2010 and 2019, and compared changes in the reporting patterns of these items, while 200-meter Euclidean buffers captured needle reports in close proximity to needle deposit boxes, needle deposit kiosks, and homeless shelters in 2019.

Results: 34,912 needle reports were included. Yearly needle reports increased by 3827.1%, with a markedly different geospatial distribution from bulky item reports. 45.6% of needle reports originated in the five downtown neighborhoods with the highest needle report density, and 33.8% were identified within 200 meters of boxes, kiosks, or homeless shelters.

Conclusions: Reports of discarded needles in San Francisco increased dramatically over the last decade, and more than one third of 2019 reports were adjacent to harm reduction and homeless shelter locations. Needle reports provide an opportunity to understand changes in public injection drug use and target harm reduction services.
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http://dx.doi.org/10.1016/j.drugpo.2020.103018DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7940553PMC
January 2021

First Report of Aedes albopictus (Diptera: Culicidae) in District Mirpur, Azad Jammu and Kashmir, Pakistan.

J Med Entomol 2021 03;58(2):943-946

Field Epidemiology and Disease Surveillance Division, National Institute of Health, Islamabad, Pakistan.

Our article documents the presence of Aedes albopictus (Skuse) from urban and rural locations in the lower Himalaya Mountains, northern Pakistan. Larvae were collected from graveyards, junkyards, plant nurseries, parks, and houses. Used tires, bird drinking pots, and water storage containers were the most common containers used by this mosquito. In the absence of Aedes aegypti (L.) (Diptera: Culicidae), Ae. albopictus appears to be the primary vector of recent dengue virus outbreaks.
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http://dx.doi.org/10.1093/jme/tjaa202DOI Listing
March 2021

A Comparative Analysis of Online Medical Record Utilization and Perception by Cancer Survivorship.

Med Care 2020 12;58(12):1075-1081

Department of Population Health Sciences, Division of Epidemiology, Augusta University, Augusta, GA.

Background: Cancer survivors face many challenges including coordinating care across multiple providers and maintaining medical records from multiple institutions. Access and utilization of online medical records could help cancer survivors manage this complexity. Here, we examined how cancer survivors differ from those without a history of cancer with regards to utilization and perception of medical records.

Methods: We conducted a cross-sectional study of 3491 respondents, from the Health Information National Trends survey 5, cycle 2. The association of medical record utilization and perceptions with cancer survivorship was assessed using survey-weighted logistic regression.

Results: Cancer survivors (n=593) were more likely to report that a provider maintains a computerized medical record [adjusted odds ratio (AOR)=2.05; 95% confidence (CI), 1.24-3.41] and were more likely to report confidence in medical record safeguards (AOR=1.44; 95% CI, 1.03-2.03). However, cancer survivors were no more likely to access online medical records than those without a history of cancer (AOR=1.13; 95% CI, 0.69-1.86). Cancer survivors were no more likely to report privacy concerns as a reason for not accessing online medical records, however, survivors were more likely to report a preference for speaking directly with a provider as a reason for not accessing online medical records (AOR=2.24; 95% CI, 0.99-5.05).

Conclusions: Although cancer survivors are more likely to trust medical record safe guards and do not express increased concerns about online medical record privacy, a preference to speak directly with provider is a barrier of use.
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http://dx.doi.org/10.1097/MLR.0000000000001413DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7665999PMC
December 2020

Contamination of heavy metals in poultry eggs: a study presenting relation between heavy metals in feed intake and eggs.

Arch Environ Occup Health 2020 Aug 3:1-13. Epub 2020 Aug 3.

Office of Research Innovation and Commercialization (ORIC), Lahore Garrison University, Lahore, Pakistan.

This study aims to quantify heavy metals (Ni, Pb, Zn, Mn, Cr, Cu and Se) in eggs obtained from poultry farms and backyard raised hens by comparing the concentration of metals in their feed intake. Overall, 90 samples of egg and 12 samples of poultry feed (6 each with food and water) were collected from 3 different poultry farms and backyards located in peri-urban areas of Lahore. A di-acid digestion method was adopted for digestion, after which digested samples were analyzed under atomic absorption spectrophotometer. Results showed that the concentration of Pb, Cr and Se in egg white (Pb = 0.6578, Cr = 0.18 and Se = 0.2161), egg yolk (Pb = 0.7011, Cr = 0.2617 and Se = 0.2656), feed (Pb = 2.585, Cr = 1.3039 and Se = 0.9411) and water (Pb = 0.5483, Cr = 0.1006 and Se = 0.3461) were above permissible limits in both poultry farms (study group 1) and backyards (study group 2). The concentration of metals such as Pb, Mn, Cr, Cu and Se in poultry farms eggs were higher than backyard hen eggs, which may be due to the intake of contaminated feed. So, the current study concluded that the higher concentration of metals in eggs has a positive correlation with the intake of feed contaminated with heavy metals.
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http://dx.doi.org/10.1080/19338244.2020.1799182DOI Listing
August 2020

Association of systemic lupus erythematosus disease activity index score with clinical and laboratory parameters in pediatric onset systemic lupus erythematosus.

Pak J Med Sci 2020 Mar-Apr;36(3):467-472

Muhammad Kamil Hussain Raja, MBBS. Division of Rheumatology, Fatima Memorial Hospital, Lahore, Pakistan.

Objective: To determine the association of systemic lupus erythematosus disease activity index (SLEDAI) score in pediatric onset SLE (p-SLE) with clinical and laboratory parameters.

Methods: This cross sectional observational study was conducted at Division of Rheumatology, Fatima Memorial Hospital, Lahore from November 2018 to January 2019. Total 23 patients diagnosed with p-SLE having onset of symptoms at ≤ 18 years of age, irrespective of their current age at presentation, of either gender, fulfilling criteria of 2012 Systemic Lupus International Collaborating Clinics (SLICC) criteria were enrolled. Patients' clinical symptoms and laboratory parameters were reviewed, SLEDAI scores were calculated. Collected Data were entered in proforma and analyzed on SPSS version 23.

Results: There were 91.3% females. Mean age at diagnosis was 11years ± 4years. At presentation patients had hematological involvement 69.6% followed by mucocutaneous symptoms 65.2% and renal involvement 21.6%. ANA by IFA was positive in all, while anti-ds-DNA was positive in 78.3% patients. SLEDAI score was ≥6 in 87% patients, average SLEDAI score was higher in patients with renal involvement (0.06). Elevated ESR (r=0.48, =0.02), Anti-dsDNA (r=0.44, 0.05) and low complement levels (0.03) were significantly positively correlated, while hemoglobin (r= -0.43, 0.04) was negatively correlated with the SLEDAI score.

Conclusion: In this study, patients with Lupus Nephritis had high SLEDAI scores. Elevated Anti-dsDNA titer, ESR, low complement levels and hemoglobin were significantly associated with high SLEDAI scores. We recommend that SLEDAI score should be calculated in p-SLE patients for stringent disease monitoring and treatment.
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http://dx.doi.org/10.12669/pjms.36.3.1480DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7150399PMC
April 2020

A comparative neurobehavioral study of sesame oil and fish oil on experimental animals.

Pak J Pharm Sci 2020 Mar;33(2):511-521

Saidu Medical College, Swat, Khyber Pakhtunkhwa, Pakistan.

Natural oils are enriched with polyunsaturated fatty acids (PUFAs) which are important for our health. Recent experimental data explained that PUFAs might have a beneficial effect on various brain functions such as anxiety, dementia, epileptic seizures, depression or bipolar and other neurobehavioral diseases. The objective of the current research work was to evaluate the effect of sesame oil, fish oil and mixture of both oils (1:1) on neurobehavioral changes and cognition. For this purpose shark fish oil and sesame oil were extracted out and there poly unsaturated and saturated fatty acids were analyzed by using GCFID that exposed the presence of different PUFs in shark fish oil, sesame oil and mixture of both oils. Neurobehavioral changes were seen after 5ml/kg/day sesame oil, 5ml/kg/day shark fish oil and 1:1 combination of both oil 5ml/kg/day administration on open field, cage crossing, light and dark, stationary rod, forced swimming induced depression test and water maze test. Our GCFID results showed sesame and fish oil enriched with higher amount of PUFs and showed significant anxiolytic and antidepressant like effect after 30 days of treatment (P<0.05) however combination of these both oils exhibited greater efficacy (P<0.01) in reducing anxiety and depression as imipramine standard drug. Results showed that combination of both oils (sesame oil and fish oil) could be a better option to treat neurobehavioral problems as compared to alone.
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March 2020

Physical health composite and risk of cancer mortality in the REasons for Geographic and Racial Differences in Stroke Study.

Prev Med 2020 03 16;132:105989. Epub 2020 Jan 16.

Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, USA.

It is unclear how resting myocardial workload, as indexed by baseline measures of rate-pressure product (RPP) and physical activity (PA), is associated with the overall risk of cancer mortality. We performed prospective analyses among 28,810 men and women from the REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort. We used a novel physical health (PH) composite index and categorized participants into one of four groups based on combinations from self-reported PA and RPP: 1) No PA and High RPP; 2) No PA and Low RPP; 3) Yes PA and High RPP; and 4) Yes PA and Low RPP. We examined the association between baseline PH composite and cancer mortality adjusted for potential confounders using Cox regression. A total of 1191 cancer deaths were observed over the 10-year observation period, with the majority being lung (26.87%) and gastrointestinal (21.49%) cancers. Even after controlling for sociodemographics, health behaviors, baseline comorbidity score, and medications, participants with No PA and High RPP had 71% greater risk of cancer mortality when compared to participants with PA and Low RPP (adjusted HR: 1.71, 95% CI: 1.42-2.06). These associations persisted after examining BMI, smoking, income, and gender as effect modifiers and all-cause mortality as a competing risk. Poorer physical health composite, including the novel RPP metric, was associated with a nearly 2-fold long-term risk of cancer mortality. The physical health composite has important public health implications as it provides a measure of risk beyond traditional measure of obesity and physical activity.
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http://dx.doi.org/10.1016/j.ypmed.2020.105989DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7048236PMC
March 2020

Adaptive family functioning and borderline personality disorder: Mediating role of impulsivity.

J Pak Med Assoc 2020 Jan;70(1):86-89

National Institute of Psychology, Quaid-I-Azam University Islamabad, Pakistan.

Objective: To explore the relationship among adaptive family functioning, iImpulsivity and borderline personality disorder, and to test the mediating role of impulsivity between the other two elements.

Methods: The cross-sectional correlational study was conducted at the National Institute of Psychology, Quaid-i-Azam University, Islamabad, Pakistan, from August 17, 2015, to June 10, 2017, and comprised patients seeking psychiatric consultation. The Diagnostic and Statistical Manual of Mental Disorders-4th Edition criteria was used to assess personality disorders. Correlation and mediation analysis was carried out on those diagnosed with borderline personality disorder. Data was analysed using SPSS 21.

Results: Of the 408 patients assessed, 183(45%) had borderline personality disorder. Of them, 118(64.4%) were males and 65(35.5%) were females. Both impulsivity and borderline personality disorder were negatively related to adaptive family functioning (p<0.01). Significant positive relationship was found between impulsivity and border line personality disorder(p< 0.01) .

Conclusions: The mediating role of impulsivity between adaptive family functioning and borderline personality disorder was established.
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http://dx.doi.org/10.5455/JPMA.6250DOI Listing
January 2020

A rheumatology curriculum in Pakistan for empowering family physicians and fighting disability.

Clin Rheumatol 2020 Mar 17;39(3):681-687. Epub 2019 Dec 17.

Lupus Clinical Research, National Institute of Arthritis, and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, MD, USA.

Introduction: Pakistan has a population of over 200 million with only 75 trained rheumatologists. To address the needs of rheumatology care, it is of paramount importance to train the primary care physician as a first line of defense.

Methods: The project "Empowering Family Physicians; fighting disability" was the recipient of a 2018 ILAR grant. This project began with development of an evidence-based curriculum using ACR Rheum2learn modules along with guidelines from international societies. A blended learning approach was chosen with nine online learning modules sandwiched between two face-to-face sessions. Participants' assessment entailed quizzes, clinical scenarios, and portfolio development all completed online, while face-to-face sessions relied upon power-point presentations and an objective structured clinical examination. Course impact was assessed with pre-course and post-course questionnaires. Overall perception of the training was evaluated through candidate feedback.

Results: Participants were enrolled from across the country totaling 48 health care providers (44 family physicians and 4 allied health professionals). The adherence to face-to-face sessions was 82.5% and 63.6% for the online component. The mean score for post-course assessment (mean = 2.369, SD = 0.3425) was significantly higher than for the pre-course assessment (mean = 1.792, SD = 0.4838) with statistically significant difference of, t (12) = - 7.756, p < 0.0001 (confidence interval: - 0.7390 to - 0.4149). The perception of the strategy was positive with 80% strongly satisfied with the workshops and presentations.

Conclusion: Empowering family physicians by training them in rheumatology care can be an effective tool to fight unmet needs in access to musculoskeletal health care. We plan to offer a shortened version of the course at regular intervals.Key Points• Pakistan has a huge shortage of rheumatology care with only 75 rheumatologists caring for a population of over 200 million.• To improve access to rheumatology care,the "Empowering Family Physicians; Fighting disability" course was launched in 2018 with the help of anILAR grant.• A blended learning approach comprising of 9 online modules sandwiched between two face-to-face sessions was chosen.• A statistically significant difference between pre- and post-courseself-assessment of participantssuggests that the courseis an effective tool for teaching Family Physicians.
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http://dx.doi.org/10.1007/s10067-019-04797-7DOI Listing
March 2020

Rural-urban differences e-cigarette ever use, the perception of harm, and e-cigarette information seeking behaviors among U.S. adults in a nationally representative study.

Prev Med 2020 01 21;130:105898. Epub 2019 Nov 21.

Washington University in St. Louis School of Medicine, Division of Public Health Sciences, Department of Surgery, 660 S. Euclid Ave., Campus Box 8100, St. Louis, MO 63110, USA. Electronic address:

Adults living in rural areas, compared to their urban counterparts, are at an increased risk of using tobacco-related products and mortality due to tobacco-related diseases. The harms and benefits of e-cigarette use are mixed, and similarly obscure messaging about these harms and benefits have a critical influence on e-cigarette uptake and perceptions. However, little is known about rural-urban differences in the prevalence of adult e-cigarette daily usage. Using the Health Information National Trends Survey-Food and Drug Administration (HINTS-FDA) cycles 1 and 2, we conducted weighted logistic regressions to assess rural-urban differences in the prevalence of adult e-cigarette daily usage, perceived harm, and e-cigarette information seeking behaviors. This analysis included adults aged 18 years and older in the United States (N = 4229). Both rural and urban respondents reported a similar history of e-cigarette use. Rural respondents were significantly more likely than urban respondents to trust religious organizations and leaders and tobacco companies for information about e-cigarettes. Rural and urban respondents were equally as likely to believe e-cigarettes are addictive, perceive e-cigarette use as harmful, and believe e-cigarettes are more harmful than tobacco cigarettes. Respondents were equally as likely to look for information on e-cigarettes, the health effects of e-cigarettes, and cessation; and, to seek e-cigarette information from healthcare professionals, family and friends, and health organizations and groups. Given our findings, it will be pertinent to continue to research the potential harms of e-cigarette use and develop accurate health communication messages to avoid rural-urban disparities observed for cigarette smoking-related outcomes.
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http://dx.doi.org/10.1016/j.ypmed.2019.105898DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6945810PMC
January 2020

Investigation of anti-inflammatory and analgesic activities of camel milk in animal models.

Pak J Pharm Sci 2019 Jul;32(4(Supplementary)):1879-1883

Department of Pharmacology, Faculty of Pharmacy and Pharmaceutical Sciences, University of Karachi, Pakistan.

Opioids and non-opioids have long been used as analgesic, anti-inflammatory and antipyretic. Long-term use of these drugs may lead to severe toxicities. Therefore natural remedies are now being explored to avoid risk of adverse effects associated with the use of these conventional medicines. Bioactive components from milk of different species have been identified as nutraceuticals, but no experimental or clinical study is conducted so far to explore the analgesic and anti-inflammatory potential of camel milk. In this study we evaluated camel milk for its possible analgesic and antiinflammatory activity. The anti-inflammatory effects of camel milk was studied in rats using paw edema method (induced by acetic acid) while tail-flick method was used to evaluate its analgesic effect in mice. Significantly increased tail-flick latency was shown after camel milk (33ml/kg) treatment when compared with acetylsalicylic acid at all time intervals. Anti-inflammatory activity of camel milk was significant (p<0.001) at 4th hour of treatment as shown by maximum percentage inhibition in edema volume (46.84%) in comparison to control. Results of our present study suggested possible use of camel milk as adjuvant therapy in treating various chronic pain and inflammatory ailments. Camel milk could further be investigated in future for recognition of biochemical constituents responsible for its antiinflammatory and pain relieving activities.
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July 2019

The Fennel, Foeniculum vulgare incorporated diet shows anxiolytic potential: A pre-clinical study.

Pak J Pharm Sci 2019 Jul;32(4(Supplementary)):1813-1819

Department of Pharmacology, Faculty of Pharmacy and Pharmaceutical Sciences, University of Karachi, Karachi, Pakistan.

This novel study was conducted with objective to evaluate the anxiolytic potential of whole-crushed seeds of Foeniculum vulgare (FV) which were incorporated in diet. Albino mice were divided in three groups: Control-group, Study-group 2% FV and Study-group 4% FV, each having 10 mice. Special dietary pellets containing whole-crushed Foeniculum vulgare seeds were prepared in 2% and 4% ratio, respectively and were fed to respective Study groups whereas Control-group was given regular rodent diet for 2 months. Animal behaviour was assessed using Home Cage Activity test, Head Dip test, Light and Dark Box test and Open Field test at intervals of 15 days for a period of 2 months. The results of this study showed, decrease in Cage Crossing activity, more number of Head Dips, increased time spent in Light box and increase in number of transitions between Light and Dark Box, increased number of Central Squares Crossed and increased time spent in Central Squares of Open Field arena for both study groups in comparison with control group. Foeniculum vulgare whole-crushed seeds diet of 2% and 4% was found to have anxiolytic effect.
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July 2019

Smoking history, intensity, and duration and risk of prostate cancer recurrence among men with prostate cancer who received definitive treatment.

Ann Epidemiol 2019 10 6;38:4-10. Epub 2019 Sep 6.

Division of Public Health Sciences, Department of Surgery, Washington University in St. Louis School of Medicine, St. Louis, MO.

Purpose: To examine the association of smoking history and multiple measures of smoking intensity and duration with risk of biochemical recurrence in men treated for prostate cancer.

Methods: We conducted a prospective cohort study of 1641 men (773 ever-smokers) treated with radical prostatectomy or radiation between 2003 and 2010. The association between ever-smoking and risk of biochemical recurrence was examined using Cox Proportional Hazards models with adjustment for confounders. Among ever-smokers, we further assessed the association between multiple measures of smoking duration and intensity and risk of biochemical recurrence.

Results: In the full cohort, we observed no association between ever-smoking and risk of biochemical recurrence. However, among ever-smokers, a smoking duration of greater than or equal to 10 years was significantly associated with biochemical recurrence (hazard ratio: 2.32, 95% confidence interval: 1.01, 5.33). Our results also suggested that greater than or equal to 10 pack-years of smoking may be associated with an increased risk of biochemical recurrence (hazard ratio: 1.75, 95% confidence interval: 0.97, 3.15). No association was observed between packs smoked per day or years since smoking cessation (among former smokers) and risk of biochemical recurrence.

Conclusion: Smoking duration is a significant predicator of biochemical recurrence among men with prostate cancer who are current or former smokers.
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http://dx.doi.org/10.1016/j.annepidem.2019.08.011DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6914316PMC
October 2019

Do breast quadrants explain racial disparities in breast cancer outcomes?

Cancer Causes Control 2019 Nov 27;30(11):1171-1182. Epub 2019 Aug 27.

Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, 660 South Euclid Ave, Campus Box 8100, St. Louis, MO, 63110, USA.

Purpose: Tumors of the inner quadrants of the breast are associated with poorer survival than those of the upper-outer quadrant. It is unknown whether racial differences in breast cancer outcomes are modified by breast quadrant, in addition to comparisons among Asian subgroups.

Methods: Using the Surveillance, Epidemiology, and End Results database, we analyzed data among women diagnosed with non-metastatic invasive breast cancer between 1990 and 2014. We performed Cox proportional hazards regression models to assess the associations of race with breast cancer-specific survival and overall survival, stratified by breast quadrants. The models were adjusted for age, year of the diagnosis, tumor size, grade, histological type, tumor laterality, lymph node, estrogen receptor, progesterone receptor, and treatments.

Results: Among 454,154 patients (73.0% White, 10.0% Black, 7.8% Asian/PI, and 9.2% Hispanic), 54.3% had tumors diagnosed in the upper-outer quadrant of the breast. Asian/PI women were more likely than White to have tumors diagnosed in the nipple/central portion of the breast and were less likely to have diagnosed in the upper-outer quadrant (P < 0.001), despite a similar distribution of breast quadrant between Black, Hispanic, and White women. Compared with White women, the multivariable-adjusted hazard ratios of breast cancer-specific mortality were 1.41 (95% CI 1.37-1.44) in Black women, 0.82 (95% CI 0.79-0.85) in Asian women, and 1.05 (95% CI 1.02-1.09) in Hispanic women. Among Asian subgroups, Japanese American women had a lower risk of breast cancer-specific mortality (HR = 0.68, 95% CI 0.62-0.74) compared with White women. Overall survival was similar to breast cancer-specific survival in each race group. The race-associated risks did not vary significantly by breast quadrants for breast cancer-specific mortality and all-cause mortality.

Conclusions: Differences in breast cancer survival by race could not be attributed to tumor locations. Understanding the cultural, biological, and lifestyle factors that vary between White, African American, and ethnic subgroups of Asian American women may help explain these survival differences.
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http://dx.doi.org/10.1007/s10552-019-01222-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6924513PMC
November 2019

A Systematic Review and Meta-analysis of Associations between Clinical Prostatitis and Prostate Cancer: New Estimates Accounting for Detection Bias.

Cancer Epidemiol Biomarkers Prev 2019 10 23;28(10):1594-1603. Epub 2019 Jul 23.

Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri.

Background: Previous meta-analyses have estimated summary positive associations between clinical prostatitis and prostate cancer. However, none have accounted for detection bias, the possibility for increased prostate cancer screening and detection in men with clinical prostatitis, in their pooled estimates.

Methods: We searched for studies that investigated the relation between clinical prostatitis and prostate cancer through November 2018. Random effects meta-analysis was used to calculate summary odds ratios (OR) among all studies and in strata defined by methods used to reduce detection bias. Although an increased odds of prostate cancer was seen among men with a history of clinical prostatitis in all 38 eligible studies combined [OR, 2.05; 95% confidence interval (CI), 1.64-2.57], this estimate attenuated to null among studies that performed the most rigorous analyses to limit detection bias (OR, 1.16; 95% CI, 0.77-1.74).

Conclusions: Our findings indicate that previously reported positive associations between clinical prostatitis and prostate cancer are likely due to detection bias.

Impact: Studies using rigorous detection bias methods are warranted to replicate these findings, as well as to examine the possible relation between prostate inflammation and prostate cancer directly, rather than indirectly through the diagnosis of "prostatitis," which includes a large proportion of men without evidence of prostate inflammation.
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http://dx.doi.org/10.1158/1055-9965.EPI-19-0387DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6774844PMC
October 2019

Evaluation of pharmacological and toxic effects of ethanolic extract of radish pods in albino rabbits: A biochemical and histopathological study.

Pak J Pharm Sci 2019 May;32(3 (Supplementary)):1275-1279

Department of Pharmacology, Faculty of Pharmacy and Pharmaceutical Sciences, University of Karachi, Karachi, Pakistan.

Radish pods are known as vegetable eaten as a part of diet. Though the pharmacologic potential of radish has been well known but there are fewer reports regarding pharmacological and toxic effects of radish pods. On account of this reason, the current study was aimed to evaluate the pharmacological and toxic effects of ethanol extract of Raphanus caudatus (radish pods) in rabbits after 60 days of administration. The plant extract was administered in 250, 500 and 1000mg/kg doses and effect was observed on hepatic, renal, cardiac and lipid profile. The extract was found to be hepatoprotective, nephroprotective and cardioprotective. Also it showed hypocholestrolemic potential at 1000 mg/kg. However at higher doses the extract presented chronic gastritis. Conversely, no indication of histological alterations was seen in other vital organs such as liver, kidneys, heart. Thus there is critical requirement to identify toxic constituent/s inducing gastritis so that safety profile of the plant can be established for effective therapeutic use.
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May 2019

Bioactivity-guided isolation of rosmarinic acid as the principle bioactive compound from the butanol extract of Isodon rugosus against the pea aphid, Acyrthosiphon pisum.

PLoS One 2019 24;14(6):e0215048. Epub 2019 Jun 24.

Department of Biotechnology, COMSATS University Islamabad, Abbottabad Campus, Abbottabad, Pakistan.

Aphids are agricultural pest insects that transmit viruses and cause feeding damage on a global scale. Current pest control practices involving the excessive use of synthetic insecticides over many years have resulted in aphid resistance to a number of pesticides. In nature, plants produce secondary metabolites during their interaction with insects and these metabolites can act as toxicants, antifeedants, anti-oviposition agents and deterrents towards the insects. In a previous study, we demonstrated that the butanol fraction from a crude methanolic extract of an important plant species, Isodon rugosus showed strong insecticidal activity against the pea aphid, Acyrthosiphon pisum. To further explore this finding, the current study aimed to exploit a bioactivity-guided strategy to isolate and identify the active compound in the butanol fraction of I. rugosus. As such, reversed-phase flash chromatography, acidic extraction and different spectroscopic techniques were used to isolate and identify the new compound, rosmarinic acid, as the bioactive compound in I. rugosus. Insecticidal potential of rosmarinic acid against A. pisum was evaluated using standard protocols and the data obtained was analyzed using qualitative and quantitative statistical approaches. Considering that a very low concentration of this compound (LC90 = 5.4 ppm) causes significant mortality in A. pisum within 24 h, rosmarinic acid could be exploited as a potent insecticide against this important pest insect. Furthermore, I. rugosus is already used for medicinal purposes and rosmarinic acid is known to reduce genotoxic effects induced by chemicals, hence it is expected to be safer compared to the current conventional pesticides. While this study highlights the potential of I. rugosus as a possible biopesticide source against A. pisum, it also provides the basis for further exploration and development of formulations for effective field application.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0215048PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6590782PMC
January 2020

The association of marital status and mortality among men with early-stage prostate cancer treated with radical prostatectomy: insight into post-prostatectomy survival strategies.

Cancer Causes Control 2019 Aug 18;30(8):871-876. Epub 2019 Jun 18.

Division of Public Health Sciences, Department of Surgery, Washington University in St. Louis School of Medicine, 660 S. Euclid Avenue, Campus Box 8100, St. Louis, MO, 63110, USA.

Purpose: The purpose of this study was to determine the association of marital status, a marker of social support, with all-cause and prostate cancer-specific mortality in a cohort of men with early-stage prostate cancer treated with radical prostatectomy.

Methods: We conducted a retrospective cohort study of 3,579 men treated for localized (stage 1-2) prostate cancer with radical prostatectomy at a single institution between 1994 and 2004. Marital status (not married vs. married) and marital history (never married, divorced, widowed vs. married) at the time of prostatectomy were examined in relation to (1) all-cause mortality and (2) prostate cancer-specific mortality using Cox proportional hazards regression.

Results: Not being married (vs. married) at the time of radical prostatectomy was associated with an increased risk of all-cause mortality [Hazard Ratio (HR) 1.42; 95% Confidence Interval (CI) 1.10, 1.85]. Similarly, in analyses of marital history, never-married men were at highest risk of all-cause mortality (HR 1.77, 95% CI 1.19, 2.63). Unmarried status (vs. married) was also associated with an increased risk of prostate cancer-specific mortality (HR 1.97; 95% CI 1.01, 3.83).

Conclusions: Unmarried men with prostate cancer were at greater risk for death after radical prostatectomy. Among married men with prostate cancer, marriage likely serves as a multi-faceted proxy for many protective factors including social support. Future studies should explore the mechanisms underlying these findings to inform the development of novel prostate cancer survival interventions for unmarried men and those with low social support.
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http://dx.doi.org/10.1007/s10552-019-01194-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6739072PMC
August 2019

Disparities in Health Information-Seeking Behaviors and Fatalistic Views of Cancer by Sexual Orientation Identity: A Nationally Representative Study of Adults in the United States.

LGBT Health 2019 May/Jun;6(4):192-201. Epub 2019 May 20.

Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri.

A lack of national data makes it difficult to estimate, but LGB adults appear to have a higher risk of cancer. Although limited research exists to explain the disparity, we aimed to explore potential differences in access to and utilization of health information and in cancer-related beliefs and behaviors. We used data from the Health Information National Trends Survey 5, Cycle 1 conducted from January 25 through May 5, 2017. Using survey-weighted logistic regression, we explored potential differences in health information-seeking behavior, trusted sources of health care information, engagement with the health care system, awareness of cancer risk factors, cancer fatalism, cancer-related health behaviors, and historical cancer screening between 117 LGB and 2857 heterosexual respondents. LGB respondents were more likely to report looking for information about health or medical topics than heterosexual respondents (adjusted odds ratio [aOR]: 3.12; confidence interval [95% CI]: 1.07-9.06), but less likely to seek health information first from a doctor (aOR: 0.17; 95% CI: 0.06-0.50) after adjusting for age, race, and sex. LGB persons were less likely to report that they trust receiving health or medical information from friends and family and more likely to be worried about getting cancer (aOR: 2.30; 95% CI: 1.04-5.05). Our findings indicate a growing need for the production of tailored cancer prevention and control materials for members of sexual minority groups. More work is needed to understand barriers that LGB populations face in accessing this health information and building informative social support networks.
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http://dx.doi.org/10.1089/lgbt.2018.0112DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6551968PMC
July 2020