Kidney cancer in the Middle East and North Africa region: a 30-year analysis (1990-2019).

Kidney cancer, a type of urogenital cancer, imposes a high burden on patients. Despite this, no recent research has evaluated the burden of this type of cancer in the Middle East and North Africa (MENA) region. This study explored the burden of kidney cancer from 1990 to 2019 according to age, sex and socio-demographic index (SDI). The Global Burden of Disease (GBD) 2019 data was utilized to estimate the incidence, death, and disability-adjusted life-years (DALYs) caused by kidney cancer. These estimates were reported as counts and as age-standardised rates with 95% uncertainty intervals (UIs). The estimated age-standardised incidence, mortality, and DALY rates of kidney cancer in 2019 were 3.2 (2.8-3.6), 1.4 (1.2-1.6), and 37.2 (32.0-42.6) per 100,000, respectively. Over the period from 1990 to 2019, these rates have increased by 98.0%, 48.9%, and 37.7%, respectively. In 2019, the United Arab Emirates, Qatar, and Lebanon had the largest age-standardised incidence, mortality, and DALY rates. The smallest age-standardised incidence rates were seen in Yemen, Afghanistan, and the Syrian Arab Republic. Additionally, the smallest age-standardised mortality and DALY rates were observed in the Syrian Arab Republic, Yemen, and Morocco. The highest incidence rates were found among individuals aged 75-79 in both males and females. In 2019, the MENA/Global DALY ratio exceeded one for females aged 5-19 age and males aged 5-14, compared to 1990age groups in males. The burden of kidney cancer consistently rose with increasing SDI levels from 1990 to 2019. The increasing burden of kidney cancer highlights the urgent need for interventions aimed at improving early diagnosis and treatment in the region.

Compatibility of the radical prostatectomy specimen findings with digital rectal examination.

PURPOSE: The purpose of this research is to evaluate the compatibility of the pathological grading of prostate carcinoma in transrectal biopsy sample (TRUS), Gleason scores 3 + 3 = 6, and a palpable nodule in digital rectal examination (DRE) with radical prostatectomy samples in patients with prostate cancer. METHODS: Sixty-one patients with prostate cancer were included. Transrectal biopsy of the prostate and Gleason score were recorded in the histopathological report of the radical prostatectomy sample independently for each patient. RESULTS: The mean ± standard deviation of PSA level in patients was 8.52 ± 2.23. The average prostate volume was 46.0 ± 12.17 ml. The average density of PSA was 20.06 ± 7.74 ml. The results revealed that 36% of the people after surgery had similar pathology compared to the score before surgery (Gleason score 3 + 3 = 6) while 64% had non-homogeneous reporting (Gleason score 3 + 4 = 7 and other results). The study showed that low prostate volume before surgery was associated with a higher Gleason score after surgery. Although there was no significant relationship between PSA level above 10 before surgery and higher Gleason scores after surgery, there was a statistically significant relationship between PSA density above 15% and higher Gleason scores after surgery (P < 0.001). PSA density was a strong predictor for postoperative Gleason score (P = 0.004). CONCLUSION: The high level of PSA density before surgery increased the risk of higher Gleason scores after surgery by 95.99%. Over 64% of the individuals had inconsistency in tumor upgrading, and the palpable firm nodule in the DRE should not be ignored.

The burden of testicular cancer from 1990 to 2019 in the Middle East and North Africa region.

Background: The incidence rate of testicular cancer has risen in many countries during recent decades. This study aimed to outline the impact of testicular cancer on the Middle East and North Africa (MENA) region from 1990 to 2019, examining its burden by age group and according to the socio-demographic index (SDI). Methods: Data on the incidence, death, and disability-adjusted life-years (DALYs) due to testicular cancer were retrieved from the Global Burden of Disease study 2019. The counts and age-standardized rates (per 100,000) were reported, and all rates were accompanied by 95% uncertainty intervals (UIs). Results: In MENA, the age-standardized incidence rate of testicular cancer was 1.4 per 100,000 in 2019, showing a 244.0% increase since 1990. Similarly, the annual death rate, at 0.1, experienced a 2.6% rise during the same period. In 2019, testicular cancer accounted for 31.1 thousand DALYs, marking an age-standardized rate of 5.0, which was 2.8% higher than in 1990. The 1-4 age group exhibited the largest incidence rate in 2019. In addition, in both 1990 and 2019 the MENA/Global DALY ratio was higher than one in the 1-14 year age groups. During the period 1990 to 2019, the age-standardized DALY rate of testicular cancer steadily rose with higher SDI values, except for a decrease observed at an SDI of 0.8. Conclusion: Over the last thirty years, there has been a notable rise in the burden of testicular cancer in the MENA region.

Effectiveness of intravenous lidocaine versus intravenous morphine for patients with renal colic in the emergency department.

BACKGROUND: Despite the fact that numerous medications have been introduced to treat renal colic, none has been proven to relieve the pain rapidly and thoroughly. In this study, we aimed at comparing the effects of intravenous lidocaine versus intravenous morphine in patients suffering from renal colic. METHODS: In a prospective randomized double-blind clinical trial performed in the emergency department of Imam Reza educational hospital of Tabriz, Iran, we studied 240 patients, 18-65 years old, who were referred due to renal colic. Patients were divided into two groups. In group I (120 people) single-dose intravenous lidocaine (1.5 mg/kg) was administered and in group II (120 people) single-dose intravenous morphine (0.1 mg/kg) was administered slowly. Visual Analogue Pain Scale (VAS) was recorded while admission, 5, 10, 15 and 30 minutes after injection. Statistical data and results were studied using descriptive statistics as percentage and Mean ± SD. To compare the response to treatment, Mann-Whitney U-test was used in two groups. Consequently, the data were analyzed using the SPSS16 software. RESULTS: Pain score measured in two groups five minutes after the injection of lidocaine and morphine were 65 % and 53 % respectively (95% CI 0.60 - 0.69, CI 0.48 - 0.57, p = 0.0002).108 (90 %) patients (95 % CI 0.84 - 0.95) from group I and 84 (70%) patients (95 % CI 0.62 - 0.78) from group II responded appropriately at the end of the complete treatment. The difference was statistically significant (p = 0.0001). CONCLUSIONS: Changing the smooth muscle tone and reducing the transmission of afferent sensory pathways, lidocaine causes a significant reduction in pain. TRIAL REGISTRATION: Clinical Trials IRCT138901042496N3.

Parenteral lidocaine for treatment of intractable renal colic: a case series.

INTRODUCTION: We report a case series of successful treatment of intractable renal colic using parenteral lidocaine. CASE PRESENTATION: Because of inconsistent responses to standard treatment with opioids and non-steroidal anti-inflammatory drugs in patients with renal colic pain, we decided to begin a trial of a single intravenous dose of lidocaine (approximately 1.5 mg/kg) slowly in eight patients with intractable renal colic who were referred to our emergency medicine department. The patients were six men and two women with a mean age at diagnosis of 34.62 years (age range, 28 to 42 years). The patients were of Iranian ethnic origin. The patients' degree of pain, based on Visual Analog Scale score upon entering our emergency medicine department, was recorded 10, 20, and 30 minutes after lidocaine injection. The patients' degree of pain decreased from a mean Visual Analog Scale score (±SD) of 8.87 ± 0.99 (95% confidence interval (95% CI) 8.04 to 9.70) to a mean Visual Analog Scale score (±SD) of 1 ± 2.82 (95% CI -1.36 to 3.36) before and 30 minutes after lidocaine treatment, respectively. Two of eight patients experienced transient mild dizziness, and three of eight patients experienced minimal slurring of speech. No patient experienced serious adverse events. CONCLUSION: Parenteral lidocaine treatment can reduce pain dramatically or subtly.

Effect of body mass index on severity and prevalence of varicocele.

Varicocele is classified as grade I-III regarding its severity. This study was aimed to determine the correlation between height and weight with varicocele grade in 18-30 years age group. We enrolled 400 persons aged 18-30 years referred to the specialist's clinics of Tabriz Medical Sciences University or Medical Commission Since Sep. 2004 to Mar. 2005. First we divided the volunteers in two groups including Varicocele Group and Non-varicocele Group, then varicocele patients were classified to three grades considering the severity of the disease: severe (Grade III), moderate (Grade II) and mild (Grade I). Finally, the correlation between height, weight and Body Mass Index (BMI) was evaluated. There was a significant relation between height and grades of left-side varicocele; in other words the severity of disease was increased with height (p = 0.004). Also, height increased the prevalence ofvaricocele (p = 0.011). On the other hand, low weight and BMI increased the prevalence of varicocele (p = 0.000, p = 0.004) but did not affect the severity of disease (p = 0.364, p = 0.172). In conclusion, the height of patients directly affected the prevalence and severity of left-side varicocele which probably is related to length of left internal spermatic veins in these patients and increased hydrostatic pressure in taller patients. Also, the weight and BMI is effective on the prevalence of varicocele. It seems that slim and tall persons will benefit from evaluation while puberty.