51 research outputs found
Association between AgNORs and Immunohistochemical Expression of ER, PR, HER2/neu, and p53 in Breast Carcinoma
Settings. Despite the limited diagnostic utility of AgNORs (argyrophilic nucleolar organiser region-associated proteins) for individual breast lesions, AgNOR analysis bears a significant potential for characterizing cell proliferative activity of breast lesions. Methodology. The present study investigated the relationship between mean AgNORs count and immunohistochemical expression of ER, PR, HER2/neu, and p53 in breast carcinoma in serial paraffin sections from 137 breast carcinomas. Twenty control cases of benign breast lesions were included. Results. Mean AgNOR counts correlated significantly inversely with hormone estrogen receptors (ER), Progesterone receptors (PR), and p53 immunohistochemical expression, denoting P values of 0.05, 0.01, and 0.001, respectively. No significant correlation was found between mean AgNOR counts and HER2/neu, P = 0.9. Mean AgNOR count was significantly higher in grade II tumor cells. We conclude that mean AgNOR counts correlate with ER, PR, and P53 tumor markers in breast carcinomas. Conclusion. We recommend the use of mean AgNOR count for accurate reporting of breast carcinomas, as well as prediction of ER, PR, and P53 in routine paraffin sections
Prevalence of Hypertension in Hail Region, KSA: in a Comprehensive Survey
Hypertension is a global pandemic; thus, the purpose of this study was to estimate the current prevalence of hypertension in Hail Region, KSA. The study used a cross-sectional survey of Saudi civilian, included 5000 individuals selected from 30 primary health care centers (PHCs) in Hail Region. The results shows that the overall prevalence of hypertension in Hail was 30.2%. The prevalence of male was 30.8% and female was 29.6% (P <0.0001). The risk of hypertension increases with the increase of age, as well as, with increasing of body mass index (BMI) and this was found to be statistically significant p < 0.0001. The results designate that Hypertension is a chief health problem in Hail Region that necessitate urgent intervention control measures. Improved community-based awareness and prevention efforts are strongly needed to address the modifiable factors
Molecular detection of Mycobacterium tuberculosis and its relationship to histopathological diagnosis in paraffin-embedded lymph node tissues
Background: Tuberculous lymphadenitis (TBL) is one of the most common forms of extra pulmonary tuberculosis (EPTB) worldwide, with difficulty in its diagnosis. And since in the Sudan, the routinely used method for diagnosis is conventional histopathology, the aim of this study was to confirm the histopathological diagnosis by polymerase chain reaction (PCR).Methods: In this study 718 lymph node (LN) biopsies were retrieved, of which 161 were diagnosed as TBL (histopathological evidences). PCR technique was performed for all 161 positive samples to detect the IS6110 sequence of M. tuberculosis as well as to obtain the sensitivity and specificity of morphological diagnosis.Results: Out of 161 specimens 135 (84%) were found to be positive with PCR, the remaining 26 (16%) were negative.Conclusions: Although PCR indicated high sensitivity it can’t be a substitute for conventional histopathology in the diagnosis of tuberculous lymphadenitis in tissue
Global economic burden of unmet surgical need for appendicitis
Background: There is a substantial gap in provision of adequate surgical care in many low-and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods: Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results: Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US 73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was 75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion: For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially
Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy
Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe
Global variation in anastomosis and end colostomy formation following left-sided colorectal resection
Background
End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection.
Methods
This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model.
Results
In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001).
Conclusion
Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone
STUDIU PRIVIND GRADUL DE CONSTIENTIZARE SI ATITUDINEA FATA DE EXPUNEREA LA SUBSTANTE CHIMICE CANCERIGENE OBISNUITE IN NORDUL STATULUI SUDAN
The objective of this study was to assess the burden of exposure, knowledge and attitude toward some common chemical carcinogens in Northern State of Sudan. Methodology: In this is a community-based, cross-sectional study, data was collected as a part of cancer awareness campaign that covered an area inhibited with 40,000 individuals. Results: Of the 187 (96.4%), who responded to the question, whether they have a continuous contact with insecticides, 118/187 (63.1%) answered yes. Also 62/191 (30%) have declared that they use to eat fresh vegetable in the farm without washing. Of the 191 respondents regarding tobacco and alcohol habits, 59 (31%), 76 (40%) and 28 (15%), of tobacco smokers, toombak dippers and alcoholic beverage users respectively, have used or currently using these products. Conclusion: The data at hand point to the urgent need for educational programs and preventive measures against the exposure to carcinogenic chemicals. Key words: Tobacco use, Alcohol consumption, Insecticides exposure, Plasticizers exposure, Radiation exposure, Sudan, Cancer awareness.Obiective: Obiectivul acestui studiu a fost de a evalua povara expunerii, cunostintele si atitudinea fata de substante chimice carcinogene uzuale in nordul statului Sudan. Metodologie: In acest studiu populational, transversal, datele au fost colectate in cadrul campaniei de constientizare a cancerului, care a acoperit o zona cu 40.000 de persoane. Rezultate: Din cele 187 (96,4%) de persoane care au raspuns intrebarilor, si care au contact permanent cu insecticidele, 118 din 187 de persoane (63,1%) au raspuns cu “da”. De asemenea, 62 din 191 (30%) au declarat ca obisnuiesc sa consume legume proaspete, din gradina/gospodarie, fara a le spala. Din cele 191 de persoane care au raspuns cu referire la obiceiurile legate de fumat si consumul de alcool, 59 (31%), 76 (40%) si 28 (15%) dintre fumatori, utilizatori de toombak si respectiv consumatorii de alcool, au folosit sau folosesc, in prezent, aceste produse. Concluzii: Datele disponibile sugereaza nevoia urgenta de programe educationale si masuri preventive impotriva expunerii la substante chimice cancerigene. Cuvinte cheie: consumul de tigari, consumul de alcool, expunerea la insecticide, expunerea la plastifianti, expunerea la radiatii, Sudan, constientizarea cancerului
Impact of Implementing Grading Fine Needle Aspiration Cytology in Diagnosis of Breast Cancer amongst Sudanese Women
Objectives: This study estimated the merit of employment of Grading Fine Needle Aspiration Cytology (GFNAC) in the assessment of breast lumps, compared to conventional Conventional Fine Needle Aspiration Cytology (CFNAC).Methods: Seventy-five women with breast lumps were referred to the surgical unit at Khartoum Teaching Hospital. Fine Needle Aspiration (FNA) materials were obtained for cytology and biopsies from the same patients for histopathology. Cytological materials were assessed using two diagnostic systems (GFNAC and CFNAC) without prior knowledge of the histopathologic diagnosis.Results: Of the 75 patients studied, 40 (53.3�20were diagnosed as having breast cancer by Histopathology and the remaining 35 (46.7�20were diagnosed with benign lesions. Of the 40 positive cases, 35 (87.5�20and 28 (70�20were found positive by CFNAC and GFNAC respectively. Of the 35 negative cases, 33 (94.3�20and 35(100�20were found negative by CFAC and GFAC correspondingly.Conclusion: The obtained Specificity of 94.3�0and 100�0in addition to sensitivity of 87.5�2070�0were credited for CFNAC and GFNAC systems respectively. Therefore, it is recommended to merge GFNAC as a supplementary to CFNAC for the diagnosis of breast cancer
EVALUAREA GRADULUI DE CONSTIENTIZARE FATA DE UNELE SUBSTANTE CANCERIGENE IN REGIUNEA HAIL, ARABIA SAUDITA
OBJECTIVE: The objective of this study was to assess the knowledge toward the use of some common chemical among Hail region population. METHODOLOGY: This is a cross-sectional survey in which data was collected from an area inhibited with 120,000 individuals. Of the 600 asked to participate, only 475/600(79.2%) subjects have completed the standard form. RESULTS: Of the 475 (79.2%), who responded to the question, whether they are currently smokers or alcohol consumers, 167/475(35.2%) or 46/475(9.7%) respectively, answered yes. Also 68/475 (14.2%) are used to eat fresh vegetable without washing. Regarding exposure to insecticides and other chemicals, 116/475(24.4%) and 245/475 (51.6%), were found with continuous exposure, in this order.CONCLUSION: The present study strongly hit the urgent need for cancer awareness programs and prevention strategies to reduce the exposure to carcinogenic chemicals. Keywords: carcinogenic chemicals, Smokers, alcoholic consumers, cancer awareness, Hail.OBIECTIV: Obiectivul acestui studiu a fost de a evalua cunostintele despre utilizarea unor produse chimice uzuale in populatia regiunii Hail. METODOLOGIE: Aceasta este o ancheta transversala in care datele au fost colectate dintr- o zona locuita de 120.000 de persoane. Din cei 600 care au cerut sa participe, numai 475/600 (79,2%) subiecti au completat formularul standard.REZULTATE: Din 475 (79,2%), care au raspuns la intrebarea, daca ei sunt in prezent fumatori sau consumatori de alcool, 167/475 (35,2%) si respectiv, 46/475 (9,7%), a raspuns da. De asemenea, 68/475 (14,2%), obisnuiesc sa manance legume proaspete fara a le spala. In ceea ce priveste expunerea la insecticide si alte substante chimice, 116/475 (24,4%) si 245/475 (51,6%), au fost gasiti cu expunere continua, in aceasta ordineCONCLUZIE: Studiul de fata a evidentiat puternic nevoia urgenta de programe de constientizare privitoare la cancer si la strategiile preventive pentru a reduce expunerea la substante chimice cancerigene Cuvinte cheie: substante chimice cancerigene, fumatori, consumatori de alcool, constientizare cancer, Hai
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