Patients' Experiences of a Sarcoma Diagnosis: A Process Mapping Exercise of Diagnostic Pathways

Patients with sarcoma often report prolonged time to diagnosis, which is attributed to the rarity of sarcoma and the low awareness of pre-diagnostic signs and symptoms.

AIMS

To describe patients' experiences of pre-diagnostic signs/symptoms and pathways to diagnosis, including where help was sought, and the processes involved.

METHODS

Mixed methods involving quantitative, qualitative and inductive thematic analyses using novel process mapping of patient journey data, as reported by the patients. We examined the time from symptom onset to first professional presentation (patient interval, PI), first consultation to diagnostic biopsy, first consultation to diagnosis (diagnostic interval) and first presentation to diagnosis (total interval).

RESULTS

A total of 87 interviews were conducted over 5 months in 2017. Of these, 78 (40 males/38 females) were included. The sarcoma subtypes were bone (n = 21), soft tissue (n = 41), head and neck (n = 9) and gastro-intestinal (GIST; n = 7). Age at diagnosis was 13-24 (n = 7), 25-39 (n = 23), 40-64 (n = 34) and 65+ (n = 14) years. The median PI was 13 days (1-4971) and similar between sarcoma subtypes, with the exception of GIST (mPI = 2 days, (1-60). The longest mPI (31 days, range 4-762) was for those aged 13-24 years. The median diagnostic interval was 87.5 (range 0-5474 days). A total of 21 patients were misdiagnosed prior to diagnosis and symptoms were commonly attributed to lifestyle factors.

CONCLUSIONS

Prolonged times to diagnosis were experienced by the majority of patients in our sample. Further research into the evolution of pre-diagnostic sarcoma symptoms is required to inform awareness interventions.

Camel (Camelus dromedarius) raw milk’s hypotensive roles within chemical induced hypertension model in rats

Dromedary camels (Camelus dromedarius) inhabit not only arid areas but are among common domestic animals that are normally kept for numerous uses. It’s raw milk (CM) is believed to have exceptional nutraceutical value in addition to it’s other uses similar to camel itself. This study aimed to evaluate hypotensive efficacy of raw CM within context of chemical induced hypertension model in albino rats. Rats received the chemical; L-NAME (50 mg/kg body weight/day, p.o.) and amlodipine (10 mg/kg/day, p.o.) as negative and positive controls for 4 weeks. Rats of treatment group received concurrently L-NAME (50 mg/kg body weight /day, p.o.) and raw milk of camel at (100, 300, and 500 mg/kg body weight/day p.o.) respectively for 4 weeks. Result showed significant decrease (p <  0.001) in treatment relative to negative control in all measured parameters viz systolic, diastolic and mean arterial blood pressures in accordance to the used dosages. Also elevated levels of liver/kidney biomarkers in negative control became reduced compared to normal and positive controls courtesy of CM treatment. In conclusion, obtained data revealed CM to be effective in controlling hypertension. The bioactive constituents present in CM appeared likely to be responsible for the observed effect of antioxidant action and ACE inhibition. Evidence is thus provided from research findings that raw CM can afford efficient hypotensive effect.

Mn(II), Co(II), Ni(II), and Cu(II) complexes of amino acid derived Schiff base ligand: Synthesis, characterization and in-vitro antibacterial investigations

Four complexes of Mn(II), Co(II), Ni(II) and Cu(II) with Schiff base ligand (H3L) derived from 2-amino-3-methylbutanoic acid and acetylacetonate were synthesized. All complexes were characterized by elemental analysis, Fourier-transform infrared spectroscopy and electronic spectroscopy. The results confirmed the coordination of the ligand to metals in tridentate fashion via the hydroxyl oxygen, the azomethine nitrogen and the enolic acetylacetonate oxygen. Antimicrobial activities were established for all complexes, free ligand and ciprofloxacin for comparison. Both the ligand and its metal complexes were active against Gram-positive and negative bacterial strains. The Cu(II) complex, showed highest antibacterial activity among the complexes screened. Other complexes displayed considerable antibacterial activity. Octahedral geometry was proposed for the metal(II) complexes with the Schiff base.                     KEY WORDS: Schiff base, Amino acid, Metal Complexes, Antibacterial agents   Bull. Chem. Soc. Ethiop. 2021, 35(1), 97-106. DOI: https://dx.doi.org/10.4314/bcse.v35i1.8

Influence of Anacardium occidentale leaf supplementation in broiler chicken diet on performance, caecal microbiota, blood chemistry, immune status, carcass, and meat quality

1. This study investigated the growth performance, caecal microbiota, blood chemistry, splenic cytokines, serum immunoglobulins, carcase, meat quality and oxidative status of broiler chickens fed diets supplemented with Anacardium occidentale leaf powder (AOLP) in comparison with antibiotic and synthetic antioxidant.2. Three hundred and twenty, one-day old Arbor Acre broiler chicks were randomly allotted into four treatment groups consisting of eight pen replicates with 10 birds per pen. The treatment groups were T0, basal diet only; T1, basal diet + 0.4 g/kg oxytetracycline + 0.12 g/kg butylated hydroxyanisole (BHA); T2, basal diet + 2 g/kg AOLP and T3, basal diet + 4 g/kg AOLP. The birds were fed for 42 d when performance was assessed, and then euthanised.3. During 0-42 d, feed conversion ratio was higher (P = 0.033) in T0 birds compared with birds fed other diets. Diet did not affect carcase traits, organ weights, serum biochemical indices, and meat composition, pH, cook loss or meat colour. Supplemented birds had higher erythrocyte (P = 0.042) and haemoglobin (P = 0.025), and lower leukocytes (P = 0.012) compared with the T0 birds.4. Diet T3 upregulated (P = 0.020) splenic interleukin-10 compared with other diets. The T0 birds had higher (P < 0.05) interleukin-6 and serum IgG and IgM compared with the supplemented birds. Caecal E. coli and Salmonella spp. counts were higher (P < 0.05) in T0 birds than in the supplemented groups. Lactobacillus spp. counts were higher (P = 0.001) in T3 birds than in those fed other diets. Breast and thigh meat from the T0 birds had higher (P < 0.05) TBARS value, and carbonyl content compared to the supplemented birds. The T0 breast meat had higher drip loss (P = 0.001) than meat from the supplemented birds.5. The results suggested that AOLP exhibited antimicrobial and antioxidant properties that were comparable to the responses to oxytetracycline and BHA (T1) in broiler diets. Nonetheless, the efficacy of AOLP needs to be verified under disease challenge or compromised health condition.