The impact of smoking on the complications of acute appendicitis

Introduction: The pathophysiology of appendicitis likely stems from obstruction of the appendiceal orifice leading to an increase in intraluminal and intramural pressure, resulting in small vessel occlusion and lymphatic stasis. Organ supplied by an end artery, such as the appendix, are more prone to the deleterious effects of arterial occlusion. The continuous cigarette smoking might be associated with a greater risk for developing atherosclerosis. Objectives: The aim is to evaluate the effect of cigarette smoking on the incidence of complications of acute appendicitis. Methods: Patients suffered from symptoms and signs suggesting acute appendicitis were examined and investigated. a multiple items collecting data questionnaire including smoking status and exclusion of confounders were constructed. The complicated and non-complicated appendicitis were compared concerning their smoking status. Results: Seventy-two Patients were included in this study; the mean age of studied patients was 24.13 ± 9.1 years. The age of 57% of patients were below the mean age and considered as younger age group, while the remaining 43% of patients were equal or above the mean age which considered as older age group. Thirty-three percentage of patients had ≥ 36 hours prehospital delay and considered as delay group, while the remaining 67% of patients had < 36 hours prehospital delay which considered no delay group, males constitute 54% of studied patients. smokers constitute 29% while the remaining 71% of studied patients were nonsmokers, 61.9% of the smokers developed complications of appendicitis. Conclusion: Perforated acute appendicitis is higher among current tobacco smokers. (AU)

The value of terminal lleum intubation during colonoscopy

Abstract It is uncertain whether terminal ileum intubation should be performed routinely during colonoscopy, as there is uncertainty regarding its diagnostic value. The aim of the present study is to assess the diagnostic yield of terminal ileum intubation during colonoscopy according to indications for colonoscopy. This is a cross-sectional study in which the results of 294 total colonoscopy procedures were reviewed; ileal intubation was performed in 269 (91.49%) patients. The indications for colonoscopy, the results of ileoscopy, and the histopathological results of ileal biopsies were evaluated. A total of 54 (20%) out of 269 patients who had successful intubation into the terminal ileumshowed macroscopic abnormalities on the terminal ileum. Biopsies were positive in 4 out of 54 (7.4%); all were of Crohn disease. Two were erosions (9.5%.) and 2 were ulcers (18.8%). The two erosions were presented as abdominal pain, abdominal pain and alternating bowel motion. Those with ulcers were presented with diarrhea and perianal disease. Conclusions Considering the low diagnostic yield of ileal intubation during colonoscopy, the decision to performileoscopy or not during colonoscopy needs to bemade on a case-by-case basis. However, routine ileal intubation, brief attempts should be considered despite low diagnostic yield. (AU)

Effects of Obesity on the pulmonary function test

Aim: To evaluate the effects of increasing BMI on the Respiratory function. Introduction: There is a worldwide increasing prevalence of overweihgt and obesity. Researchers have found that obesity affects the respiratory function leading to different respiratory medical illnesses, including asthma and obstructive deep apnea. The effect of obesity on the pulmonary functiion is assisted using different anthropometric measurements, like BMI, waist circumference, skin fold, etc. So the aim of this study is to evaluate the effect of increasing BMI on different respiratory function test measures. Methods: 23 adult males with BMI of 25 and above were included in the study and compared with 18 normal weight adult males with BMI of (18-24.99) regarding different measures of PFT like: FVC, FEV1, PEFR and FEF. Results: no significant difference was found between the two groupsñ. Conclusions: there were no effects of increasing BMI on the respiratory functions

A clinical study of newly-diagnosed colorectal cancer over 2 years in a gastroenterology center in Iraq / Estudo clínico de câncer colorretal recém-diagnosticado por 2 anos em um centro de gastroenterologia no Iraque

ABSTRACT Background and study aims: Colorectal cancer (CRC) is the most common gastrointestinal cancer and the third most commonly diagnosed malignancy affecting about one million individuals each year. The etiology for most cases of CRC appears to be related to environmental factors. This study to describe the main characteristics of this malignancy regarding age, gender, and anatomical sub site distribution, as well as the main presenting symptoms in Iraqi patients. Patients and methods: Patients with newly-diagnosed CRC by colonoscopy findings and confirmed by histopathological examination of endoscopic colonic biopsies were studied. Results: Sixty three cases with a newly-diagnosed CRC were included in this study. There were 31 (49.2%) males and 32 (50.8%) females. CRC peaked in the 60-69 years old age group (p < 0.05), more than 60% were between 40 and 69 years old. Fresh bleeding per rectum was the most common symptom occurred in 48 (76.2%) patients; while the least common was weight loss (19%). The mean duration of symptoms before referral was 7.3 ± 12.6 months. The tumor sites of the CRC were the rectum and sigmoid region seen in 77.8% (p < 0.05), the rectum alone reported in 37 patients (58.7%); followed by sigmoid colon in 12 (19%) patients, cecum in 7 (11.1%) patients and the ascending colon seen in 2 (3.2%) patients. Conclusions: In this study CRC occurs in relatively younger age groups in comparison to studies in the developed countries with rectal cancer predominates of all colorectal cancers.

RESUMO Contexto e objetivos do estudo: O câncer colorretal é a neoplasia gastrointestinal mais comum e o terceiro tumor maligno mais comumente diagnosticado, afetando cerca de um milhão de pessoas anualmente. A etiologia da maioria dos casos de câncer colorretal parece estar relacionada a fatores ambientais. Este estudo descreve as principais características dessa neoplasia quanto à idade, gênero e distribuição anatômica do subsite, bem como os principais sintomas observados em pacientes iraquianos. Pacientes e métodos: O estudo avaliou pacientes com câncer colorretal recém-diagnosticado por achados de colonoscopia e confirmados por exame histopatológico de biópsias endoscópicas do cólon. Resultados: O estudo incluiu 63 casos de pacientes com câncer colorretal recém-diagnosticado; 31 (49,2%) homens e 32 (50,8%) mulheres. O câncer colorretal atingiu o pico na faixa etária de 60 a 69 anos (p < 0,05); mais de 60% dos pacientes tinham entre 40 e 69 anos de idade. O sangramento retal fresco foi o sintoma mais comum em 48 (76,2%) pacientes; o sintoma menos comum foi a perda de peso (19%). A duração média dos sintomas antes do encaminhamento para especialista foi de 7,3 ± 12,6 meses. Os principais sítios tumorais do câncer colorretal foram a região do reto e sigmoide em 77,8% dos pacientes (p < 0,05) e o reto isolado em 37 pacientes (58,7%); seguido por cólon sigmoide em 12 pacientes (19%), ceco em sete (11,1%) e cólon ascendente em dois pacientes (3,2%). Conclusões: No presente estudo, o câncer colorretal foi observado em grupos etários relativamente mais jovens do que em estudos conduzidos em países desenvolvidos; a neoplasia retal foi o tipo de câncer colorretal mais comumente observado.