Saudi Med J
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To determine the rate of pediatric orthopedic clinic visits attributable to normal musculoskeletal (MSK) variations in children less than 12 years of age; to characterize the etiology and to characterize the etiology and management plan in this group in an attempt to identify areas that could be improved in pediatric orthopedic clinical practice. ⋯ Normal variations represent the most common complaint in pediatric orthopedic private practice. Inappropriate referrals, useless follow-up visits, and excessive investigations were a common practice, overloading the health care system. None of the previous efforts made any notable improvement.
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To examine the androgen receptor (AR) status in colorectal cancer (CRC) patients by the immunohistochemical method and to correlate the findings with all available clinicopathological parameters of prognostic significance. ⋯ There is a complete lack of AR expression in normal colonic mucosa; however, AR was expressed in 16 cases (40%) of colorectal adenoma. In CRC, AR expression was high in 118 cases (36.4%). There were no significant correlations between AR expression and gender, age, tumor histologic type, and tumor location. However, AR expression revealed a significant correlation with tumor size (p=0.026), tumor differentiation (p=0.047), American Joint Committee on Cancer (AJCC) staging (p=0.043), lymph node positivity (p=0.018), lymphovascular invasion (p=0.018), and distant metastasis (p=0.049). In univariate Kaplan-Meier survival analysis, there was a significant (p=0.002) difference in overall survival between AR positive and negative tumors in favor of the latter. In multivariate (COX) models, high AR expression (p=0.002), AJCC (p less than 0.001), and lymphovascular invasion (p less than 0.001) were the only significant independent prognostic indicators of overall survival in CRC.Conlusion: Our study showed that the patients with higher AR expression had a significantly poorer survival rate, AR expression had the potential to be a prognostic marker of CRC.
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Case Reports
Surgical repair of bilateral congenital diaphragmatic hernia associated with hepatopulmonary fusion.
Bilateral congenital diaphragmatic hernia (CDH) is a rare congenital anomaly with high neonatal mortality. The condition is rarely associated with hepatopulmonary fusion (HPF). We reported the surgical repair of bilateral CDH in a male infant aged 6 weeks. ⋯ The medial portion was left intact to avoid injury of the anomalous pulmonary venous drainage. After 2 weeks, the patients had a surgical repair of the cardiac defects, and the postoperative course was complicated by bleeding and prolonged ventilation. No hernia recurrence was observed after 9 months.
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To evaluate the attitudes of pregnant women towards different forms of labor pain relief, preferred methods of pain relief, and the effects of social media on their awareness and knowledge. ⋯ A total of 62.7% were aware of labor pain. However, 58.7% of the total sample group was unaware of labor pain relief, and 79.8% of the total sample group was unaware of the different forms of labor pain relief available. Educational level was significantly associated with awareness and knowledge of labor pain relief (p=0.001). The majority of pregnant women obtained information from friends (57.5%); and only 16.1% of women received information from their health care providers.Conlclusion: Most of the pregnant women recruited into this study had insuficient awareness of labor pain and methods of pain relief. They acquired their information from their friends and families rather than from their health care providers.