Risk Factors, Clinical Manifestations and Treatment Outcomes of Colon Cancer Patients in National Guard Hospital in Jeddah, Saudi Arabia.

Introduction Colon cancer is the third most common cancer worldwide and its incidence is increasing day by day. Provision of early management to cancer patients can lead to a good prognosis. Hence, we evaluated the risk factors, clinical manifestations and treatment outcomes for colon cancer patients in National Guard Health Affairs (NGHA), Jeddah, Saudi Arabia from January 2010 to December 2020 by comparing those results according to their age groups. Methods A retrospective cohort study was performed on 251 colon cancer patients who underwent a surgical procedure. The patients were divided into the following age groups: ≤ 50 (young), 51-60 and > 60 (old) years old. The demographic variables such as age and gender were collected. The results were classified into risk factors, clinical features and treatment outcomes. The comparison between different age groups was made using Chi-square or Fisher's exact test. The data was stored in Excel 2016 (Microsoft Corporation, Redmond, USA) and analyzed using SPSS (IBM Corp, Armonk, USA). Results The results revealed that most patients were males and the median age for diagnosis was 58 years old. There were 15.1% of patients with a positive family history. Moreover, the most common anatomical position was the left side of the colon in all age groups. Most patients had moderately differentiated colon cancer in the histopathological diagnosis. Laparotomy was the most common procedure done to patients in all age groups. There was no difference between all age groups and the aggressiveness of colon cancer. Young patients (≤ 50 years) had a higher percentage to have 5-year recurrence rate (42 % vs 19% vs 25%, p-value < 0.05) in comparison to patients between 51-60 years and old patients (> 60 years) respectively. However, there was no association between all age groups and 5-year mortality rate (22% vs 9% vs 19%, p-value = 0.171). Conclusion In comparison to old patients (> 60 years), young patients (≤ 50 years) have a more rate of recurrent colon cancer. In relation to all age groups, there were no differences in terms of the aggressive presentation or 5-year mortality rates. In addition, it appears that there were some differences between our study results and worldwide results. This may be because of occupational, cultural and/or genetic variations. Further studies with a higher number of patients and multicenter data collection are highly recommended.

Pathophysiology of diabetes: An overview.

Diabetes mellitus is a chronic heterogeneous metabolic disorder with complex pathogenesis. It is characterized by elevated blood glucose levels or hyperglycemia, which results from abnormalities in either insulin secretion or insulin action or both. Hyperglycemia manifests in various forms with a varied presentation and results in carbohydrate, fat, and protein metabolic dysfunctions. Long-term hyperglycemia often leads to various microvascular and macrovascular diabetic complications, which are mainly responsible for diabetes-associated morbidity and mortality. Hyperglycemia serves as the primary biomarker for the diagnosis of diabetes as well. In this review, we would be focusing on the classification of diabetes and its pathophysiology including that of its various types.

A Comparison of Biomarkers in the Assessment of Glycemic Control in Diabetes: Reviewing the Evidence.

BACKGROUND: Diabetes Mellitus (DM) is a chronic life-long progressive multisystem heterogeneous metabolic disorder with complex pathogenesis. INTRODUCTION: Hyperglycemia is not only one of the classical signs of DM, but it also serves as the pivotal prerequisite for the diagnosis of the disease. However, with the advancement in the field of analytical biochemistry, a number of alternative and specific biomarkers have been discovered which can be used for better diagnosis of the DM. In this review, we have discussed various aspects of DM and different biomarkers used in assessing glycemia. METHODOLOGY: A thorough literature survey was conducted to identify various studies that reported the use of conventional and non-conventional markers for the assessment of glycemia in DM patients. CONCLUSION: The accurate detection and hence diagnosis of DM has become easy and more specific with the use of various biomarkers.

Interleukin-10 -592C/A, but not -1082A/G promoter single nucleotide polymorphism, is associated with a decreased risk of colorectal cancer in an ethnic Kashmiri population: a case-control study.

Chronic inflammation influences the development of various cancers including colorectal cancer (CRC). Interleukin-10 (IL-10), an anti-inflammatory cytokine, plays a vital role in several homeostatic physiological processes occurring in the human gastrointestinal tract including intestinal inflammation and is a key regulator of several gastrointestinal tract pathophysiological processes such as inflammatory bowel diseases that are associated with an increased predisposition to CRC. Several studies have reported the association of various polymorphisms in the human IL-10 gene including IL-10 -592C/A and IL-10 -1082A/G single nucleotide polymorphisms (SNPs) with various cancers including CRC, but these SNPs are yet to be studied in a Kashmiri population with respect to CRC risk. The aim of this study was to analyze the association of IL-10 -592C/A and IL-10 -1082A/G promoter SNPs with CRC risk in an ethnic Kashmiri population through a case-control design. The genotype frequencies of IL-10 -592C/A and IL-10 -1082A/G promoter SNPs were compared between 142 CRC patients and 184 individually matched healthy controls using the PCR and restriction fragment length polymorphism method. The association between the IL-10 -592C/A and IL-10 -1082A/G SNPs and CRC risk was examined through conditional logistic regression models adjusted for multiple possible confounding (third) variables. The possible effect measure modification of the association between the relevant SNP genotypes and CRC risk by various CRC risk factors including age, sex, and smoking status was also evaluated. Further, the associations between these SNPs and various clinicopathological parameters, demographic variables, and environmental factors in the case group patients with respect to CRC risk were also analyzed. The overall association between the IL-10 -592C/A SNP and the modulation of CRC risk was found to be significant (P=0.001). The variant genotype (AA) was significantly associated with a decreased risk of CRC (odds ratio: 0.25; 95% confidence interval: 0.11-0.61; P=0.002). Further, the less common IL-10 -592A allele was associated with a decreased risk of CRC (odds ratio: 0.64; 95% confidence interval: 0.46-0.88; P=0.0092). The overall association between the IL-10 -1082A/G SNP and the modulation of CRC risk was not found to be significant (P=0.141). This study has shown that there is a significant association between the IL-10 -592C/A promoter SNP and a decreased risk of CRC in an ethnic Kashmiri population, but the association between IL-10 -1082A/G SNP and the risk of CRC in the population under study is not significant. However, to substantiate our findings, this study needs to be replicated with a larger sample size and with other ethnically defined populations with comparable CRC incidence.