Background: Early detection of breast cancer is the most important strategy to prevent deaths from breast cancer as breast cancers that found in early stages is easier to be treated successfully. This study aimed to measure the extent of awareness of Aljouf region residents with importance and methods of breast cancer early detection in females. Methods: A cross-sectional research study of 1,026 participants from different cities in Aljouf province, aged above 18 years and successfully filled the online questionnaire from January to April 2022. Modified Breast Cancer Awareness Measure version 2 was used to assess the awareness of participants regarding early detection of breast cancer. Descriptive statistics and Pearson's chi-square tests were used to analyze the data. Results: Results indicated that majority of participants were Saudi (98.1%), female (86.1%), aged 18-35 (77.6%), and single (62.2%) with university education (63.5%).There was no history of breast cancer in 75.8% of participant's families. The majority of the participants (68.7%) were had some knowledge about breast cancer early detection and its checkups, despite their answers containing little detailed information and a significant disparity in the correct answers. Conclusion: The present study showed that more than two-thirds of the participants had a poor level of awareness about early detection of breast cancer. Knowing about checkup and general knowledge significantly was related to some socio-demographic factors such as age between 18-35 years, high educational level, employment, and marriage.
The management of patients with type 2 diabetes is a complex process that must be individualized and be patient centered. The aim of this study was to assess the metabolic control, the annual incidence and crude prevalence of hypoglycemia, hospitalization, and complications among patients with type 2 diabetes initiating second-line therapy. This study is an observational, longitudinal, prospective study as a part of the multinational DISCOVERing Treatment Reality of Type 2 Diabetes in Real World Settings (DISCOVER) study, that recruited 519 patients with type 2 diabetes who were non-insulin users, aged ≥18 years, and switching to second-line therapy. The cohort was clinically evaluated over three years of follow up. Fear of hypoglycemia was assessed using the Hypoglycemia Fear Survey (HFS II), while the quality of life was assessed using SF36v2 questionnaire. Using second-line therapy improved metabolic control but the annual incidence of microangiopathies were at 61/1000 patient-years, 47/1000 patient-years, and 4/1000 patient-years for neuropathy, retinopathy, and nephropathy, respectively. The incidence of hypoglycemia was 57/1000 patient-years, where 50% were recurrent during the three-years period. The HFS II showed a significant increase in patients’ worries related to hypoglycemia. The incidence of hospitalization was 31/1000 patient-years, out of which 8/1000 patient-years were related to cardiovascular events, mainly myocardial infarction. Moderate metabolic control was associated with lower incidence of macro angiopathy and an increased incidence and fear of hypoglycemia, while it was associated with improved mental component score when assessing the patients’ quality of life. The treating physician’s decision of treatment intensification should be individualized with consideration of befits of good glycemic control versus the risk of hypoglycemia, especially in elderly patients.
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