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Background: Populations of African ancestry are underrepresented in global oncology clinical trials resulting in paucity of data on safety and efficacy of cancer medicines in vulnerable Black populations. The ARETTA clinical trial was initiated by the Nigerian Breast Cancer Study Team in partnership with the University of Chicago Comprehensive Cancer Center to build local capacity for biomarker informed clinical trials and translational breast cancer research. ARETTA is a pragmatic single-arm, phase II clinical trial to optimize therapy and determine the safety and efficacy of neoadjuvant taxotere and trastuzumab in women with HER2-positive breast cancer. The study sought to 1) determine the pathological complete response (pCR) rate of patients with early stage breast cancer to neoadjuvant docetaxel and subcutaneous trastusumab 2) develop the capacity of investigators in Nigeria to improve quality of care through participation in oncology clinical trials using upgraded facilities and trained personnel and 3) determine accrual rate and retention of participants. Methods: Inclusion criteria include treatment naïve women aged 18 years to 70 years with HER-2 positive breast cancer stages II-IIIC (AJCC). Eligible participants receive four cycles of docetaxel 75mg/m2 and trastuzumab every 3 weeks. Those with incomplete clinical response by breast ultrasound volume measurements receive 3 additional cycles of chemotherapy; cyclophosphamide 600mg/m2, epirubicin 90mg/m2 and 5-fluorouracil 600mg/m2 every 3 weeks before re-evaluation for surgery. All participants receive a fixed dose of sub-cutaneous Herceptin (600mg) every 3 weeks (total of 18 doses). The primary endpoint is pCR rate. Secondary objectives are to evaluate invasive disease-free survival (iDFS), the pattern of response and mechanisms of resistance to treatment based on genomic markers, the pharmacokinetics of Herceptin SC, quality of life, and adverse event rates, including cardiac toxicity. Planned enrollment is 47 evaluable patients, which will provide 90% power to test the null hypothesis that the pCR rate is 20% versus a 40% alternative (one-sided alpha=0.05). More protocol details can be found at ClinicalTRial.gov NCT03879577 and JCO Glob Oncol2020 doi: 10.1200/GO.20.00043 Progress: The study has met its primary endpoint and will be closed to accrual by the time of the meeting. Results will be submitting as Late Breaking before the meeting Citation Format: Atara Ntekim, Adenike Adeniji-Sofoluwe, Abiola Ibraheem, Anthonia Sowunmi, Ayorinde Folasire, Thomas Olajide, Olalekan Olasehinde, Akinwunmi Komolafe, AbdulRazzak Lawal, Foluso Omodele, Ayodele Sanni, Mustapha Ajani, Olayinka Kotila, Sharifat Folorunsho, Tonyin Aniagwu, Adewumi Alabi, Abiodun Popoola, Chioma Asuzu, Adetola Daramola, Chinedum Babalola, Theodore Karrison, Fatimah Abdulkareem, Olufunmilayo I. Olopade. Assessing Response to neoadjuvant Taxotere and TrAstuzumab in Nigerian women with HER2-positive breast cancer (ARETTA) [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr OT2-21-01.

Neurogenic bowel dysfunction (NBD) is fecal incontinence or constipation which is prevalent in kids with both congenital and acquired neurological disorders. NBD results from loss of normal sensory or motor control and may include both the upper and the lower gastrointestinal (GI) tract Constipation and fecal incontinence are frequent symptoms of neurogenic bowel dysfunction (NBD), which makes it a challenging condition to treat. Also, they have a major impact on quality of life and dignity. Bowel dysfunction is less studied compared to neurogenic bladder, generally prevelant in spina bifida, but practically as prevalent in other neurological conditions. Generally, the objective of neurogenic bowel management is to achieve complete emptying of the rectum on a systematic basis. This may be accomplished through with a multidimensional approach containing of conservative, medical and even surgical approaches. A modified Delphi procedure was used to construct a statement document. This paper discusses the various causes of paediatric NBD. Our aim is to enhance clinical management, numerous therapeutic techniques are given. Due to both the improved survival rate and better diagnosis, there are more children and teenagers with NBD. The number of children and adolescents with NBD is growing as a result of better diagnosis and a greater survival rat NBD can cause either faecal incontinence or constipation, or both, with a fair amount of predictability. However, each patient will experience NBD in a different way depending on a variety of underlying conditions and coexisting conditions. Due to the status of the affected child and caregivers, management of NBD should be individualized using a combined multidisciplinary therapy.

Inadequate pathology personnel and high cost of running a Pathology facility are factors affecting access to timely and quality pathology services in resource-constrained settings. Telepathology is a novel technology that allows Pathologists to remotely assess collected samples. Though the initial cost of setting up a telepathology facility is high, its overall benefits far outweigh the cost. Its usefulness as a quality assurance measure, as a permanent image data storage system, in reducing costs associated with repeated slide preparations, reducing turn-around time of pathology reports, in collaborative research and in teaching has been well documented. This paper highlights the experiences, gains and challenges encountered in the deployment of telepathology in two resource-constrained settings in Nigeria. Overcoming the challenges associated with setting up a telepathology service in sub-Saharan Africa is important as it has the potential to improve overall health outcomes in a medically underserved region while ensuring technology and knowledge transfer are achieved.

Background: There is no doubt; smoking harms nearly every organ of the body. Tobacco consumption is a major risk factor for morbidity and mortality. The main objective of this study was to estimate the current status of; prevalence, age at beginning, causes, and factors affecting smoking among the general population of Saudi Arabia. Methodology: We conducted a survey on 1089 individuals aged 15 years or older (55.2% were males) which was performed between May and July 2018. Data were collected through a self-administered online distributed questionnaire. The questionnaire included questions on socio-demographic characteristics, tobacco consumption, period of smoking (in years), age at the beginning of smoking, causes of smoking, personal opinion on smoking, trial to stop smoking, previous experience of stopping smoking and frequency of smoking per day and if the participant has any chronic disease, which affected by smoking. Results: Overall prevalence of current smoking was 45.4% and males were more likely to smoke than females as 78.3%% were males (p=0.001). Mean age of smoking initiation was 16.4 years (±11.8 years) with 20.8% of ever smokers starting at the age of (11-15) years. Daily shisha smoking was reported by 5.1% of the population. Among even smokers, 71.1% of individuals reportedly attempted to quit smoking. Of those, 28.5 % were successful by the time of the study. The reported causes of smoking were for entertainment in 32.8%, to relieve stress in 20.0%, for experience in 18.8% and for stimulating family members and relatives in 18.6%. Smoking is a bad habit and harmful was reported as a personal opinion of 80.0% of the participants. Conclusions: The prevalence of tobacco consumption in Saudi Arabia is considerably high as nearly half (45.4%) are smokers, but there is a good percentage of trial for quitting. So we recommend implementation of aggressive health education of the public to encourage smoking initiation and encourage quitting. We also recommend decision makers to consider increasing taxation on tobacco products.

PURPOSE Apoptosis resistance to anticancer treatments can occur due to over-expression of Bcl-2 anti-apoptotic proteins. Studies have shown the use of Allium sativum (garlic) as a herbal supplement among cancer patients. In this study, the inhibitory activity of phytochemicals from Allium sativum against Bcl-2 anti-apoptotic protein was demonstrated using a computational technique. METHODS Identified phytoconstituents from A. sativum were docked in receptor grid generated active sites of Bcl-2 (PDB-ID: 4AQ3) protein using the Glide-Ligand docking tool of Schrödinger Maestro 12.5. Receptor-ligand complex pharmacophore models were generated using the PHASE module, and the binding free energy of the complex was calculated using the MM-GBSA Prime panel. Potential lead compounds were screened for drug likeness using the Lipinski rule of five (RO5) and Veber rule. Absorption, distribution, metabolism, excretion, and toxicity (ADME/T) predictions of the leads were carried out using the PROTOX-II tool. Induced fit docking simulation was performed on the top ranked hit compound. RESULTS Extra precision docking results showed that myricetin, kaempferol, and apigenin (flavonoid); α and β-phellandrene (cyclic monoterpene); 3-vinyl-4H-1,2-dithiin, 3-vinyl-1,2-dithiin and 2-vinyl-4H-1,3-dithiine (organosulphur) were ranked highest, with docking scores range from -6.00 to -3.78 kcal/mol compared with -3.62 kcal/mol demonstrated by co-crystallized ligand. Apigenin (CID: 5280443), 3-vinyl-1,2-dithiin (CID: 10219489), and 3-vinyl-4H-1,2-dithiin (CID: 150636) were identified as the top three lead compounds with free binding energies of -33.83, -30.36, and -29.70 kcal/mol respectively. The identified lead compounds from A. sativum were in accordance with RO5 and Veber rule with good oral bio-availability and ADME/T profile. Similar to the co-crystallized ligand, apigenin interacted with important active site amino acid residues like Try 67, Asp 70, Leu 96, Arg 105, Ala 108 among others. CONCLUSION Some bioactive phytochemicals from A. sativum can be explored for development toward inhibition of antiapoptotic protein Bcl-2 in apoptosis resistance to anticancer treatments.