Knowledge and attitude of the population toward cancer prostate Riyadh, Saudi Arabia

The aim of the following study is to assess the knowledge and attitude of men, in our region, regarding cancer prostate and its screening practices. The field work was conducted in Riyadh City, during the period February through July 2011. It was a population - based cross-sectional study comprising 400 men over 40 years. In addition to socio-demographic data, history of the present and past medical illness, history of prostatic diseases and examination, family history of cancer prostate; participants were inquired about their knowledge and attitude toward prostate cancer [PC] and screening behavior using through two different Likert scales. Only 10% of the respondents had practiced a regular PC examination checkup. Their knowledge about PC was poor and their attitude toward examination and screening was fair, where the mean of total correct knowledge score was 10.25 +/- 2.5 [51.25%], while the mean of total attitude score was 18.3 +/- 4.08 [65.3%]. The respondents identified the physicians as the main sources of this information [62.4%], though they were not the main motives for a regular checkup. Knowledge represented the only significant predictor for participants' attitude. Beliefs and attitudes have a great impact, at every stage of the cancer continuum, this attitudes depends mainly on level of knowledge and quantity of information provided to patients and their families. Such attitudes should rely on a solid background of proper information and motivation from physicians to enhance and empower attitudes toward PC screening behavior

Assessment of lower urinary tract symptoms in Saudi men using the international prostate symptoms score

Benign prostatic hyperplasia-related lower urinary tract symptoms [LUTS] are common among older men, the incidence and prevalence are increasing rapidly, and they are associated with diminished health-related quality-of-life [QOL]. The aim was to describe the prevalence of LUTS in Saudi population and its relation to some other parameters. Saudi men over the age of 40 were invited to participate in the study; in Riyadh city from August 2012 through March 2013. All participants were assessed for the serum level of prostate-specific antigen [PSA] and digital rectal examination. Participants were given a linguistically validated Arabic version of the International Prostate Symptom Score [IPSS]. Demographic and other medical comorbidities were assessed. Based on the IPSS, a subdivision of men into three symptoms classes has been proposed, resulting in groups with mild [1265, 58.3%], moderate [505, 27.3%], and severe symptoms [81, 4.4%] and the prevalence of moderate to severe was 31.7%. There was a weak, but significant correlation between the total IPSS and age, total prostate volume, and PSA. Severity of symptoms is increasing with increased age. Multiple regression analysis reported that prostate volume and all individual items of IPSS except straining were significant predictors of QOL and patient satisfaction, where frequency and incomplete emptying had the heaviest impact on patient's QOL. LUTS were common among men in Saudi population over 40, the prevalence increases with age and most of them were unpleased because of their urinary symptoms, poor QOL was mainly determined by individual symptoms; mainly frequency and incomplete emptying

Priapism associated with pregabalin

Priapism is a well-known cause of erectile dysfunction. There are a wide variety of causes, including hemoglobinopathy, neurological diseases, and drugs. We present a case report of an Asian man who presented with priapism that was continuous for 3 days after taking three doses of pregabalin for chronic back pain. Cavernous aspiration, phenylephrine injection, and a winter shunt all failed to achieve detumescence. The patient then presented to our institution on the 5[th] day of his initial presentation, and an El-Ghorab shunt was performed, after which detumescence and pain relief were achieved. We suggest that pregabalin might induce tumescence through acting on the alpha2 delta1 subunit of voltage-gated calcium channels in the penile smooth muscle or by presynaptic inhibition of noradrenaline release. Further studies are warranted regarding the action of pregabalin and its effect on penile physiology

Prospective randomized trial of 100u vs 200u botox in the treatment of idiopathic overactive bladder

To evaluate the clinical outcomes of two different doses of BTX-A in patients with refractory idiopathic overactive bladder. Thirty nine patients with refractory idiopathic overactive bladder from 1/1/2008 till 30/3/2009 were evaluated in a tertiary care hospital. Patients were evaluated using urodynamic studies, voiding diary, UDI-6 and IIQ-7 questionnaires prior to being prospectively randomized [alternate randomization] to the BTX-A applications and three months after treatment. Voiding diary and residual volume were followed two weeks later. All patients received intradetrusorial injections of BTX-A [Botox, Allergan, Irvine, CA] of 100u or 200u under cystoscopic control on an outpatient basis. The primary endpoint was assessed for the improvement of urodynamic parameters and adverse events at three months after the initial treatment. Secondary end points included urinary frequency, urgency and UUI episodes as assessed by voiding diary and QoL. Eleven patients were enrolled to each arm of the study. There were no significant differences in demographic characteristics between the two groups. Urodynamic assessment at the end of the third month showed significant improvement in urodynamic variables in both groups. There was no statistically significant difference in urodynamic parameters and in the voiding diary between the two groups. QOL was significantly improved in both groups with no statistically significant difference between the different doses. Only three patients developed acute urinary retention. BTX-A at 100u and 200u appears to improve symptoms, urodynamic parameters and QoL with no statistical significance between the two groups

Association of physicians' knowledge and behavior with prostate cancer counseling and screening in Saudi Arabia

To investigate the knowledge, attitudes and practices of primary care physicians towards prostate cancer counseling and screening. This cross sectional study was conducted in May 2009 to October 2009 through a survey questionnaire, which was distributed to all licensed primary care physicians in Riyadh, Saudi Arabia. The study took place in the Princess Al-Johara Al-Ibrahim Center for Cancer Research, King Saud University, Saudi Arabia. Data was obtained from 204 primary care physicians using self-reports of prostate cancer screening practices, knowledge, attitudes towards prostate cancer screening, and continuous medical education preferences. Respondents' characteristics were also collected. Approximately 54.7% of the respondents were practicing counseling and referring prostate cancer patients. The mean correct knowledge score was 54.3%, their attitude was not strong; the only statement that approximately 70% of physicians agreed upon was about the value of screening, however, the reliability and evidence to support digital rectal examination and prostatic specific antigen were in question. Our primary care physicians had self-confidence in suspecting and referring high-risk patients for screening, but not for management and treatment. Knowledge and attitude were found to be the most significant predictors that determine physicians' self practice. Physicians' practice towards a screening procedures or early detection of diseases should rely on a good background of information, which in turn enhances their self-efficacy and develops a good and positive attitude towards their practice skills

Determinants of primary care physicians' practice of prostate cancer counseling and screening

The objective was to examine practices of primary care physicians and their determinants towards prostate cancer screening. Data was obtained from 204 primary care physicians using self-reports of prostate cancer screening practices, knowledge, and attitudes towards prostate cancer screening. Nearly half of the respondent [54.7%] were practicing counseling and referring prostate cancer patients. The mean correct knowledge score was 54.3%, the physicians attitude was not strong; the only statement that nearly seventy percent of physicians agreed upon was about the value of screening, however, the reliability and evidence to support DRE and PSA were in question. Knowledge and attitude were found to be the most significant predictors that determine physicians' self practice. Background information and attitudes are important determinants of physicians' practice behavior towards prostate cancer counseling and referral in our study