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Haider Ali Malakzai,1 Ahmed Maseh Haidary,1 Saleema Gulzar,2 Mujtaba Haidari,1 Abdul Sami Ibrahimkhil,3 Ramin Saadaat,1 Ahmadullah Hakimi,1 Sayed Murtaza Sadat Hofiani,4 Soma Rahmani,5 Jamshid Abdul-Ghafar1 1Department of Pathology and Clinical Laboratory, French Medical Institute for Mothers and Children (FMIC), Kabul, Afghanistan; 2School of Nursing and Midwifery, Aga Khan University (AKU), Karachi, Pakistan; 3Central Public Health Laboratories (CPHL), Kabul, Afghanistan; 4Department of Academics and Research, Postgraduate Medical Education (PGME), French Medical Institute for Mothers and Children (FMIC), Kabul, Afghanistan; 5World Health Organization (WHO), United Nations Office for the Coordination of Humanitarian and Economic Assistance Programmes Relating to Afghanistan (UNOCA) Compound, Kabul, AfghanistanCorrespondence: Jamshid Abdul-Ghafar, Tel +93 792827287, Email jamshid.jalal@fmic.org.afPurpose: Cancer is one of the leading causes of mortality and morbidity, and therefore, tremendous research work is continuously being done around the world with consideration of etiopathogenesis as well as identification of therapeutic targets. Decades of continuous war in Afghanistan has left the medical infrastructure of the country in a miserable situation. There is a serious deficiency in research work in the fields of pathology and oncology at the moment with minimal data available to elaborate about the demographic characteristics of various malignant disorders in the country, which would be indispensable to pave the way for further research and development.Patients and Methods: A descriptive cross-sectional study was conducted to describe the prevalence, distribution, and important histopathological features of malignant tumors reported at tertiary level in Afghanistan.Results: Out of 2328 consecutive cases of solid malignant tumors included in our study, 93.8% were primary and 6.2% were metastatic. Breast was the most common site of origin for primary malignancy (29.5%) in females; however, in males, esophagus was the leading site for primary malignant tumors (16.3%). Invasive ductal carcinoma was the most common histologic type of malignancy in females (87.9%). However, in both genders, squamous cell carcinoma of esophagus and skin, osteosarcoma of bone and soft tissue, and glioblastoma of central nervous system were the most common histologic types of malignancies diagnosed. Small intestine was a frequently involved site affected by extranodal non-Hodgkin lymphomas. Overall, the majority of the cancers were diagnosed in stage-II.Conclusion: Findings in our study were somewhat similar to data presented elsewhere in the world, with some significant differences that could be related to the local factors. Our study revealed that most of the malignant tumors were diagnosed in later stages of the disease, attributable to scarcity of specialized oncology institutions and public awareness.Keywords: cancer, prevalence, lymphoma, sarcoma, Afghanistan

In this research work, surface-modified nano zerovalent copper (nZVC) was prepared using a simple borohydride reduction method. The spectroscopic and crystallographic results revealed the successful synthesis of surface-modified nano zerovalent copper (nZVC) using solvents such as ethanol (ETOH), ethylene glycol (EG) and tween80 (T80). The as-synthesized material was fully characterized for morphological surface and crystal structural properties. The results indicated that EG provides an excellent synthesis environment to nZVC compared to ETOH and T80 in terms of good dispersion, high surface area and excellent catalytic properties. The catalytic efficiency of nZVC/EG was investigated alone and with peroxymonosulphate (PMS) in the absence of light. The degradation results demonstrated that the involvement of PMS synergistically boosted the catalytic efficiency of synthesized nZVC/EG material. Furthermore, the degradation products (DPs) of CBZ were determined by GC−MS and subsequently, the degradation pathways were proposed. The ecotoxicity analysis of the DPs was also explored. The proposed (nZVC/EG/PMS) system is economical and efficient and thus could be applied for the degradation of CBZ from an aquatic system after altering the degradation pathways in such a way that results in harmless products.

Objective This study aimed to explore bereaved parents’ and healthcare providers experiences of care after stillbirth. Study design Qualitative in-depth interviews with 55 women, men, female elders, healthcare providers and key informants in Kabul province, Afghanistan between October and November 2017. Results Inadequate and insensitive communication and practices by healthcare providers, including avoiding or delaying disclosing the stillbirth were recurring concerns. There was a disconnect between parents’ desires and healthcare provider’s perceptions. The absence of shared decision-making on seeing and holding the baby and memory-making, manifested as profound regret. Health providers’ reported hospitals were not equipped to separate women who had a stillbirth and acknowledged that psychological support would be beneficial. However, the absence of trained personnel and resource constraints prevented provision of such support. Conclusion Findings can inform future provision of perinatal bereavement care. Given resource constraints, communication training can be considered with longer term goals to develop context-appropriate bereavement care guidelines.

Kisspeptin has an important role in the stimulation of hypothalamic-pituitary-gonadal axis in term of pubertal development, release of reproductive and metabolic hormones and ultimately affecting the fertility. The aim of the present study was to evaluate the serum kisspeptin level and its correlation with semen quality and selected hormones in buffalo bulls during the summer and spring seasons. Semen and blood samples from eight Nili-Ravi buffalo bulls (age: 9.21 ± 1.02 years) were collected. Semen was analysed using computer-assisted semen analysis. Serum concentrations of kisspeptin, gonadotropin releasing hormone (GnRH), follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone, cortisol, triiodothyronine (T3), thyroxin (T4) and insulin like growth factor (IGF-1) were estimated using enzyme-linked immunosorbent assay kits. Kisspeptin was neither affected by seasons and nor correlated with semen parameters and hormones. Higher levels of GnRH, LH, cortisol, IGF-1, total motility (TM), average path velocity (VAP), straight-line velocity (VSL), curvilinear velocity (VCL) and linearity (LIN) were recorded in summer compared to spring. Correlations of GnRH versusIGF-1 and LH, LH versus IGF-1 and cortisol, FSH versus T4 and testosterone, testosterone versus T3 and T4 and T3 versus T4 were observed. The GnRH and IGF-1 were positively associated with TM, VAP, VSL, VCL and LIN. The LH was correlated with VSL, straightness and LIN. In conclusion, GnRH, LH, and IGF-1 correlations with semen parameters can be used to indicate semen quality. The buffalo bulls are well-adapted and can give quality semen in the summer season.

Background The underlying pathways leading to stillbirth in low- and middle-income countries are not well understood. Context-specific understanding of how and why stillbirths occur is needed to prioritise interventions and identify barriers to their effective implementation and uptake. Aim To explore the contribution of contextual, individual, household-level and health system factors to stillbirth in Afghanistan. Methods Using a qualitative approach, we conducted semi-structured in-depth interviews with women and men that experienced stillbirth, female elders, community health workers, healthcare providers, and government officials in Kabul province, Afghanistan between October-November 2017. We used thematic analysis to identify contributing factors and developed a conceptual map describing possible pathways to stillbirth. Findings We found that low utilisation and access to healthcare was a key contributing factor, as were unmanaged conditions in pregnancy that increased women’s risk of complications and stillbirth. Sociocultural factors related to the treatment of women and perceptions about medical interventions deprived women of interventions that could potentially prevent stillbirth. The quality of care from public and private providers during pregnancy and childbirth was a recurring concern exacerbated by health system constraints that led to unnecessary delays; while environmental factors linked to the ongoing conflict were also perceived to contribute to stillbirth. These pathways were underscored by social, cultural, economic factors and individual perceptions that contributed to the three-delays. Discussion Efforts are needed at the community-level to facilitate care-seeking and raise awareness of stillbirth risk factors and the facility-level to strengthen antenatal and childbirth care quality, ensure culturally appropriate and respectful care, and reduce treatment delays.