Is There a Relationship Between Waking Up from Sleep and the Onset of Testicular Torsion?

Testicular torsion is a serious urologic emergency that can present with unusual or atypical history and examination. Classical pain from testicular torsion is of sudden onset, significantly severe, and is accompanied by nausea and vomiting. However, in some patients, the initial scrotal pain appears to considerably subside within the next few hours. In others, testicular torsion tends to occur while sleeping, and many patients recount a history of being woken up from sleep by intense pain. Furthermore, some patients in this subset can resume normal activities and even sleep through the night with little or no discomfort, without a perceived need for pain medications. Other patients initially experience mild pain, which worsens over time. Consequently, these patients are less likely to be evaluated immediately. In view of these atypical cases, the question remains unanswered regarding sleep as a predisposing factor for testicular torsion. This narrative review focuses on exploring the association between sleep and testicular torsion.

Knowledge, Attitude, and Practice of Colorectal Cancer Screening Among Primary Healthcare Physicians in Riyadh Second Health Cluster.

BACKGROUND: Colorectal cancer is the third common cancer, and the second common cause of cancer death in the world. According to the 2014 Cancer Incidence Report of the Kingdom of Saudi Arabia, colorectal cancer account for 11.5% from all cancers reported among Saudi nationals. By the year 2030, the incidence of colorectal cancer could increase fourfold among both genders. AIM: The study aimed to conduct to understand the knowledge, attitude, and practice of primary healthcare physicians regarding colorectal cancer screening in Riyadh Second Health Cluster in the city of Riyadh, Saudi Arabia. MATERIALS AND METHODS: A cross-sectional study design, probability proportional to size sampling at the cluster zones level and convenient sampling for the physicians, were used among physicians working in the primary healthcare centers in the city of Riyadh between October 2022 and November 2022. RESULT: Of the 213 respondents, the mean age of the physician was 35, the majority were males (59%), Saudi Arabian nationality (60%), Resident Physicians (54%) and ≤ five years' work experience (45%). Sixty-four percent of the study participants believe that the majority of asymptomatic average-risk patients have to start the screening at the age of 45 years old. Ninety-seven percent believe that colorectal cancer screening for asymptomatic average-risk patients aged 45 years and older is effective. Ninety-two percent of the physicians perform colorectal cancer screening for asymptomatic average-risk patients aged 45 years. The mean knowledge score is 4.65 (SD=2.33) with a range of 0 to 10. The mean attitude score is 4.19 (SD=1.28) with a range of 0 to 6. CONCLUSION: The study found that the physicians had higher attitude and practice towards colorectal cancer screening and adequate knowledge towards colorectal cancer screening. The knowledge and attitude scores are associated with practicing colorectal cancer screening.