Selective or Routine Histology of Cholecystectomy Specimens for Diagnosing Incidental Carcinoma of Gallbladder and Correlation with Careful Intraoperative Macroscopic Examination? A Systematic Review.

BACKGROUND: Selective or Routine histology of cholecystectomy specimens for benign gallbladder disease has always been a matter of debate because of the low prevalence and bad prognosis associated with gall bladder carcinoma. The objective of this study is to ascertain whether selective histology can be preferred over Routine histology without any harm. METHODS: This systematic review is conducted according to PRISMA's checklist; relevant articles were searched in the database until September 1 2020 in PubMed, Scopus, Science Direct, and Web of Science databases, manually, with search queries and without date restrictions. Studies included in this systematic review involved patients who underwent cholecystectomy for benign gallbladder disease and were diagnosed with gallbladder carcinoma incidentally either after selective or routine histology of the gallbladder. RESULTS: A total of 24 routine or selective histology recommending studies were selected for the systematic review after following the inclusion and exclusion criteria. These studies comprised 77,213 numbers of patients and 486 numbers of Malignancies. These studies correlate the number of IGBC diagnosed histologically with the number of IGBC's that were suspected by the surgeons intraoperative by macroscopy. Routine recommending studies show a significant number of IGBC diagnosed histologically as missed by surgeons whereas the selective recommending studies show most of the histologically diagnosed IGBC already suspected by the surgeons intraoperative. When comparing the macroscopic details of the IGBC's between routine and selective studies, we found that there was significant overlap. Most of the findings missed by the surgeons as suspicious in routine studies were suspected by the surgeons involved in selective histology recommending studies. Thereby, favouring selective histology and emphasizing the need for careful intraoperative macroscopy for suspecting IGBC. CONCLUSION: Selective Histological examination of cholecystectomy specimens can be preferred if a careful intraoperative macroscopic examination is done and patient risk factors are taken into consideration.

Awareness and prevalence of coronary artery disease risk factors among Saudi adults in Dawadmi, Riyadh province: A cross-sectional study.

OBJECTIVE: Coronary artery disease (CAD) is one of the leading causes of death and disability worldwide. Amongst the Middle East countries, Saudi Arabia is facing rapid progressive urbanization by the adoption of a westernized lifestyle and food habits, which contribute to the rising burden of CAD. We aim to evaluate the awareness and prevalence of CAD risk factors among Saudi adults. METHODS: This was a cross-sectional study conducted between January and March 2020. Data were collected through an online survey using a self-administered questionnaire. Data assessed on socio-demographic variables, family history of CAD, knowledge of risk factors, symptoms, and complications of CAD. Results data were entered and analyzed using IBM SPSS statistics, version 25. All comparisons were considered significant at P < 0.05. RESULTS: A total of 311 subjects (48.6% men and 51.4% women) included, and most of the participants were between 18 and 25 years. A majority of the participants did not hear about CAD (82%) and unaware of any risk factors (26.4%), symptoms (25.1%), and complications (72.7%) of CAD. The prevalence of a family history of CAD (9.3%), overweight/obesity (58.6%), physical inactivity (79.1%), and smoking (24.1%) observed considerably high among the participants. CONCLUSION: The present study reveals that a significantly low level of awareness and a high prevalence of CAD risk factors found among Saudi adults. Therefore, the awareness program is needed at the public level to increase the knowledge of CAD risk factors so that persons with high risk for future CAD can be prevented.