Role of cecal gurgling in diagnosis of acute appendicitis

Objective: to assess the role of Cecal Gurgling [CG] as a clinical sign to diagnose acute Appendicitis

Material and Methods: this study was conducted at the Allied teaching hospitals of FMH College of Medicine and Dentistry Shadman Lahore, between June 2011 and May 2013. Two hundred patients were included in the study between 13 and 50 years of age, presenting with pain right iliac fossa, irrespective of gender. All the patients were grouped according to the Alvarado scoring system into two groups; group I with score more than 7 and group II score less than 7, which was further subdivided onto CG positive and CG negative

Results: mean age of the patients was 18.5years [13-50]. 104 [52%] patients were male and 96 [48%] female. In Group I, 78 [93.97%] were confirmed to have acute appendicitis on histopathology [HP] and 5 [6.02%] were normal. In group II CG positive, 67 [95. 7%] patients were confirmed to have acute appendicitis on HP

Conclusion: we concluded from this study that CG is a good diagnostic sign in patients with borderline diagnosis and can be used in conjunction with Alvarado score to increase its yield. However, large randomized trial is required to strengthen this important clinical sign

Odds of prostate cancer among Pakistani men in relation to their dietary patterns

To determine relationship between dietary pattern of Pakistani men and the odds of prostate cancer. Total of 195 cases of adenocarcinoma of prostate and 390 randomly selected controls were recruited for this retrospective study. Cases and controls were asked about their usual dietary pattern using validated food frequency questionnaire. NutriSurvey software version 2007 was used to compute amount of macro-nutrients and micro-nutrients consumption per week. Odds ratio was used as a measure of strength of association. Unconditional logistic regression was used to compute odds ratios after adjustment of known potential confounding factors and effect modifiers. Mean calories consumed per day for cases was 3720 +/- 878 and for controls was 2918 +/- 487 and this difference was statistically significant [t =11.87 at 255 df ; p<0.001]. Red meat consumption was found to be strongly associated with prostate cancer risk [adjusted OR 2.23 for once a week, OR 10.67 for twice a week, OR 11.82 for thrice a week and OR 14.53 for daily]. On the other hand, consuming chicken for once a week was rather protective [adjusted OR 0.25; 95% CI. 0.14-0.44; p<0.001]. Weekly consumption of seasonal vegetables, fruits were found to play protective role [adjusted OR 0.01; 95% CI.0.005-0.03; p<0.001]. On the other hand, fat consumption demonstrated a strong relationship with prostate cancer risk such that those consuming 80 grams and above fats per day were at higher odds 7.95 [95% CI 4.38-14.43; p<0.001]. Increased risk was also observed with calcium consumption [OR 2.03 [95% CI.1.21- 3.42; p=0.006], however, phosphorous and Iron did not demonstrate any relationship with prostate cancer odds. Pakistan, prostate, dietary pattern, risk, odds, red meat, fruits, vegetables, diary products. Consumption of increased quantities of fats, red meat and dairy products are associated with higher odds of prostate cancer in Pakistani men.

Lifestyle factors associated with the risk of prostate cancer among Pakistani men

Age-adjusted incidence of prostate cancer in Pakistan is 5.3 per 100,000 which is relatively low compared to other Asian countries, but increasing numbers of cases are being reported. Data on risk factors associated with prostate cancer risk among Pakistani men are sparse. The objective of this study was to identify lifestyle factors associated with the risk of prostate cancer in Pakistani men. An unmatched case-control study was conducted in Lahore from February to October 2011. The study enrolled 195 histologically confirmed cases of adenocarcinoma of prostate from Shaukat Khanum Memorial Hospital and Institute of Nuclear Medicine and Oncology Lahore [INMOL] and Lady Reading Hospital, Peshawar, using purposive sampling technique. A total of 390 hospital controls were selected using convenient sampling technique from different teaching hospitals of Lahore after screening with prostate specific antigen levels. A semi-structured interview form was used to collect data through face-to-face interviews. Odds ratio was used as a measure of strength of association and was calculated using unconditional logistic regression. Farmers were found to be at higher odds of prostate cancer [OR=19.76, 95% CI=5.51-70.80, p<0.001]. No significant association was found with marital status, ethnic background, religious affiliation and consanguineous marriages. Level of physical activity was inversely associated with prostate cancer risk [OR=0.05, 95% CI=0.01-0.26, p<0.001]. Positive association was found with increased red meat consumption [OR=11.82, 95% CI=2.88-48.54, p=0.001] and dairy products intake [OR=11.76, 95% CI=4.23-32.67, p<0.001]. Red meat consumption, higher dairy products intake and working as farmers are strongly associated with increased odds of prostate cancer among Pakistani men.

Factors affecting the decision making of australian couples to donate their cryopreserved empbryos for human embryonic stem cell research

The purpose of this review was to describe attitudes of couples in Australia towards donating their surplus frozen embryos for human embryonic stem cell research. A systematic search was conducted including articles published in English, in peer reviewed journals and scientific discourse indexed in MEDLINE / Pub Med database. Embryo donation rate among Australian couples was found to be relatively lower than other countries. Although factors like age of couples, family completion and financial status influenced the decision to donate stored embryos in many countries, willingness to donate embryos among Australian couples based on these factors was less pronounced. Similarly, religious conviction and moral issues played a dominant role in their decision making. On the other hand, a substantial number of Australians would seek help and counseling from their treating physicians at the time of decision to donate embryo for stem cell research. Nevertheless, potential benefits associated with stem cell research should be weighed against potential social, ethical and legal harm to the society

Sociodemographic and lifestyle factors related with the risk of prostate cancer

Carcinoma of prostate is the most frequently diagnosed cancer among men in developed countries. Incidence rate among African-Americans is highest [185.4 per 100,000] in the world followed by Caucasian-Americans [107.8 per 100,000]. Despite high morbidity and mortality, etiology of prostate cancer remains largely unknown. Advancing age, race and family history are the only established risk factors. However, racial and genetic factors alone cannot explain the wide international variation in disease distribution. The objective of this review was to summarize socio-demographic and lifestyle factors in relation to prostate cancer risk. A systematic search was conducted including articles published in peer reviewed journals indexed in MEDLINE/ Pub Med database. Prostate cancer incidence was found to be proportional to increasing urbanization and rise in socioeconomic status. Factors associated with increased prostate cancer risk include raised androgens levels, high saturated fat in diet, reduced physical activity, obesity, smoking and working as farmer. Pattern of prostate cancer incidence and mortality suggests that both genetic and environmental factors contribute towards an excess risk of disease; nevertheless, environmental and life-style factors, especially trend of urbanization and change in socioeconomic status may have accrued the prostate cancer risk in developing countries