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.

Duodenal perforation simple closure or definitive surgery in emergency laparotomy

Perforated peptic ulcer, an emergency, continues to afflict large number of population. Males are affected more than females. There is close association with Helicobacter pylori and NSAID's ingestion. Duration of perforation > 12 hours, systolic blood pressure less than 100 mm Hg and co morbid conditions are the risk factors. Controversy exists regarding simple closure or definitive surgery in emergency setting. This prospective study was conducted at CMH, Rawalpindi from July 2000 to Dec 2001. 46 males, alternatively allocated to two groups received either simple closure with omental patch or truncal vagotomy with drainage procedure. Risk factors were stratified into scoring system. Patients were followed up and results graded as modified Visick's classification. There was no mortality with risk score 1 or 2 in both groups. 66.6% mortality in group - I and 100% mortality in group - II with risk score 3 was noted. Excellent / good results were obtained in 52.3% of cases undergoing simple closure versus 85% undergoing definitive surgery

Maternal risk factors in early onset septicemia

This study was done to find out the association between the maternal risk factors like premature onset of labor [POL], prolonged rupture of membranes [PROM], and chorioamnionitis [CA] and subsequent development of early onset sepsis in the newborn. Of 129 patients studied 58 [44.96] developed sepsis. Premature onset of labor, prolonged rupture of membranes, and chorioamnionitis Present in 41[31.89%], 91[70.5%], 71[55.0%] respectively and sepsis developed in 30[73%], 42[46.5%], 1[51.47%] respectively. Two risk factors namely POL, ROM was present in 21 and 17[80.95%] babies developed sepsis. POL and CA was present in 13 and 12[92.30%] had sepsis. PROM and CA was present in 50 and 35[70%] had sepsis. Three risk factors POL, PROM, CA were present in 10 and 9[90%] developed sepsis. This indicates that presence of multiple maternal risk factors make a child more susceptible to have early onset neonatal sepsis

Perforated appendicitis versus non-perforated appendicitis

Of 156 patients with acute appendicitis, seen during 24 months, 21 had perforated. Age over 30 years especially in males, duration of symptoms over 48 hours, pulse rate on admission exceeding 1007 minute, generalised abdominal tenderness, leucocyte count in excess of 10,000 mm3 and a neutrophilia in excess of 70 percent, characterized patients with appendicular perforation. The rate of complications was five times greater and the mean hospital stay nearly twice as much in the perforated group