Impact of Physiological Symptoms and Complications of Colorectal Cancer on the Quality of Life of Patients at King Abdulaziz University Hospital.

Colorectal cancer (CRC) is common worldwide. The high prevalence of the disease raises concerns about how CRC influences the health-related quality of life (QoL). To explore the impact of physiological symptoms and complications of CRC on patients' QoL, we conducted a cross-sectional survey using the FACT-C self-report instrument. The chi-square test was used to compare qualitative data. We found that pain was reported by most of the patients (n = 31; 77.5 %). Furthermore, male patients were more likely to complain of pain "mostly" as compared with females (P = .032). We found no significant differences between genders regarding general health-related questions. A greater proportion of male patients often complained of abdominal cramps (P = .542), weight loss (P = .086), and diarrhea (P = .408). More than half of the patients (n = 26; 65 %) reported having a good appetite; a greater proportion of males reported having a good appetite "mostly" (P = .014). Social and psychological qualities of life were not significantly different between male and female patients. Male and female patients did not differ in their report of disease acceptance (P = .420) and ability to enjoy life (P = .744). No difference was also found between genders regarding contentment with QoL (P = .793) or ability to sleep well (P = .695). Furthermore, there were no differences between genders regarding job fulfillment (P = .272). Our results add to the growing body of knowledge about the effect of CRC on QoL. Importantly, the differences in self-reported pain and appetite between male and female patients in our study suggest the importance of gender-based treatments in improving patients' QoL.

Development and cognitive functions in Saudi pre-school children with feeding problems without underlying medical disorders.

AIM: This study was conducted to assess development and cognitive functions in relation to growth in Saudi pre-school children with feeding problems (FPs) without underlying medical disorders. METHODS: Three hundred fifteen pre-school children with FPs (221 with normal growth (FP-N), 62 with failure to thrive (FTT) (FP-FTT), 32 with overweight (FP-OW)) and 100 healthy children (Ref group) underwent in-depth assessment by anthropometric measurements, dietetic history, Behavioral Pediatrics Feeding Assessment Scale, Denver Developmental Screening test (DDST) and Stanford Binet fifth edition intelligence scales (SB-5). RESULTS: The main FPs detected in Saudi children were picky eating in 85.5% of FP-N group, infantile anorexia and poor eating in more than 90% of FP-FTT group and overeating in 53% of FP-OW group. FPs were not due to evident psychosocial factors but were mostly related to unhealthy feeding behaviours. FP-N children were still having normal growth parameters, but they had significantly lower growth parameters than healthy children. Failed screening with DDST was only more significantly recorded in FP-FTT children than in Ref children (P = 0.04). The overall IQ value by SB-5 was significantly lower in FP-FTT group compared with FP-N group (P = 0.01), in FP-FTT group compared with Ref group (P < 0.001) as well as in FP-OW group compared with Ref group (P < 0.001). CONCLUSIONS: Persistent FPs resulted in significant negative impact not only on growth status but also on developmental milestones and cognitive functions of pre-school children. Healthy feeding habits are mandatory to prevent serious consequences of FPs on growth and development of Saudi pre-school children.

Association of CTLA-4 (+49A/G) gene polymorphism with type 1 diabetes mellitus in Egyptian children.

OBJECTIVE: To investigate the distribution of cytotoxic T lymphocyte-associated antigen-4 (CTLA-4) (+49 A/G) gene variants and the association of these variants with the clinical and laboratory findings in Egyptian children with Type-1 Diabetes (T1D). METHODS: A case control study was done for 104 Egyptian children with T1D and 78 age and sex matched healthy control. CTLA-4 (+49 A/G) gene polymorphism typing was done by PCR amplification followed by restriction fragment length polymorphism (RFLP) method. RESULTS: CTLA-4 G allele and GG homozygous genotype were significantly increased in T1D patients than in control group (P = 0.047, P = 0.048 respectively). There is no statistical difference between patient with optimal diabetic control (HbA1c < 8.5) and poor control (HbA1c ≥ 8.5) as regarding the CTLA-4 gene variant. The CTLA-4 GG genotype was statistically associated with younger age of patients (P = 0.027) and younger age of presentation (P = 0.036). Insignificant association was found between CTLA-4 alleles / genotypes and diabetic complications. CONCLUSION: The CTLA-4 +49 GG homozygous genotype is associated with T1D in Egyptian children especially with younger age of onset and in younger patients, and not associated with grades of diabetic control or diabetic complication.

Vitamin D receptor gene polymorphism as possible risk factor in rheumatoid arthritis and rheumatoid related osteoporosis.

OBJECTIVE: To study the role of VDR polymorphisms as risk factor for RA and osteoporosis, and whether osteoporosis complicating RA is due to RA or VDR polymorphisms. METHODS: VDR gene polymorphisms ApaI, TaqI, BsmI and FokI were typed by RFLP for 128 RA patients, 30 postmenopausal osteoporotic females and 150 healthy controls. RESULTS: Significant differences were found between patients and healthy controls in the frequency of BsmI and TaqI (Pc<0.05) but no significant associations were found for FokI and ApaI polymorphisms except for aa genotype (Pc<0.001). Titers of RF were higher with aa and bb genotypes. Anti-CCP and CRP levels were higher with aa genotype and more bone loss was associated with Bb genotype. Ff genotype frequency was higher in RA patients with osteoporosis than those without osteoporosis. CONCLUSIONS: The ApaI, BsmI and TaqI polymorphisms may be a susceptibility risk factors for RA and the Ff genotype may be responsible for development of osteoporosis in RA Egyptian patients. However, the present study needs to be replicated in a large number of patients from allover the Egypt and also in multi-ethnic populations.

Growth hormone/insulin-like growth factor-1 axis: a possible non-nutritional factor for growth retardation in children with cerebral palsy.

OBJECTIVE: To assess growth hormone (GH)/insulin like growth factor-1 (IGF-1) axis as a possible non-nutritional factor for growth retardation in children with cerebral palsy (CP). METHODS: A case-control study was conducted at a tertiary university hospital. Thirty children with CP (seven children with normal growth [CP-N] and 23 with retarded growth [CP-R]), 30 children with protein energy malnutrition (PEM), and 30 healthy children (REF group) underwent an assessment of growth parameters, serum IGF-1, basal GH, and peak GH after stimulation with insulin. RESULTS: PEM patients had higher basal GH levels than CP-N, CP-R and REF groups (p = 0.026, p < 0.001, and p < 0.001 respectively). After insulin stimulation, CP-N, CP-R, and PEM patients had lower GH levels compared to the REF group (p = 0.04, p = 0.007, and p = 0.036 respectively). IGF-1 levels were lower in CP-R group compared to CP-N and REF groups (p = 0.037 and p < 0.001 respectively), and in PEM group compared to CP-N and REF groups (p < 0.001 and p < 0.001 respectively). CONCLUSIONS: CP-R patients failed to demonstrate the same high basal GH response as PEM patients, and responded inadequately to the insulin stimulation test, but they had IGF-1 levels comparable to those of PEM patients. On the other hand, CP-N patients behaved as controls regarding their basal GH and IGF-1 levels, but failed to respond adequately to the insulin stimulation test. The PEM group presented high basal GH and low IGF-1 levels. These findings suggest that non-nutritional factors contribute to growth retardation in CP children.

Prevalence and desire for body contouring surgery in postbariatric patients in saudi arabia.

BACKGROUND: Morbid obesity has become a common problem worldwide and as a result the demand for bariatric surgery has increased as well. Most patients develop skin redundancy and sagging at many body parts after major weight loss procedures which increased the demand for body contouring procedures. AIMS: The study was to address the prevalence and patient's desire for body contouring procedures. MATERIALS AND METHODS: A cross-sectional study targeting the postbariatric patients from April 2011 to October 2011 was conducted at our hospital. Questionnaire was administered in order to measure frequency and patients desire to undergo body contouring surgery after massive weight loss. RESULTS: The total number of patients was 128 patients. The mean age of our patients was 37-year old (range 18-56 year). The percentage of the desire for body contouring surgery after bariatric surgery was 78.1%. There was very pronounced desire to body contouring surgery after those who underwent gastric bypass surgery with P-value 0.001. Only 18 patients (14%) have underwent body contouring surgery, with a total of 29 procedures, in which abdominoplasty considered the most commonly procedure performed (57%). CONCLUSION: With the increasing number of weight loss surgery, there is higher number of patients that desire a body contouring surgery, which create huge disparity between demand and accessibility.

Eixo hormônio de crescimento/fator de crescimento semelhante à insulina-1: um possível fator não nutricional para o retardo de crescimento em crianças com paralisia cerebral / Growth hormone/insulin-like growth factor-1 axis: a possible non-nutritional factor for growth retardation in children with cerebral palsy

OBJETIVO: Avaliar o eixo hormônio de crescimento (GH)/fator de crescimento semelhante à insulina 1 (IGF-1) como possível fator não nutricional para o retardo de crescimento em crianças com paralisia cerebral (PC). MÉTODOS: Um estudo caso-controle foi realizado em um hospital universitário terciário. Trinta crianças com PC [sete crianças com crescimento normal (PC-N) e 23 com retardo de crescimento (PC-R)], 30 crianças com desnutrição proteico-energética (DPE), e 30 crianças sadias (grupo REF) tiveram avaliados seus parâmetros de crescimento, IGF-1 sérico, GH basal, e pico de GH após estímulo com insulina. RESULTADOS: Os pacientes com DPE apresentaram níveis basais mais elevados de GH do que os grupos PC-N, PC-R e REF (p = 0,026, p < 0,001 e p = 0,001, respectivamente). Após estímulo com insulina, os grupos PC-N, PC-R e DPE apresentaram níveis menores de GH se comparados ao grupo REF (p = 0,04, p = 0,007, p = 0,036, respectivamente). O nível de IGF-1 foi menor no grupo PC-R se comparado aos grupos PC-N e REF (p = 0,037 e p < 0,001, respectivamente), e no grupo DPE se comparado aos grupos PC-N e REF (p < 0,001 e p < 0,001, respectivamente). CONCLUSÕES: Os pacientes com PC-R não demonstraram a mesma resposta basal elevada do GH apresentada pelos pacientes com DPE, e responderam de forma inadequada ao estímulo com insulina, mas apresentaram níveis de IGF-1 comparáveis aos dos pacientes com DPE. Por outro lado, os pacientes com PC-N tiveram comportamento semelhante ao dos controles com relação aos níveis basais de GH e IGF-1, mas não responderam adequadamente ao estímulo com insulina. O grupo DPE apresentou GH basal elevado e IGF-1 baixo. Esses achados sugerem que fatores não nutricionais contribuem para o retardo de crescimento em crianças com PC.

OBJECTIVE: To assess growth hormone (GH)/insulin like growth factor-1 (IGF-1) axis as a possible non-nutritional factor for growth retardation in children with cerebral palsy (CP). METHODS: A case-control study was conducted at a tertiary university hospital. Thirty children with CP (seven children with normal growth [CP-N] and 23 with retarded growth [CP-R]), 30 children with protein energy malnutrition (PEM), and 30 healthy children (REF group) underwent an assessment of growth parameters, serum IGF-1, basal GH, and peak GH after stimulation with insulin. RESULTS: PEM patients had higher basal GH levels than CP-N, CP-R and REF groups (p = 0.026, p < 0.001, and p < 0.001 respectively). After insulin stimulation, CP-N, CP-R, and PEM patients had lower GH levels compared to the REF group (p = 0.04, p = 0.007, and p = 0.036 respectively). IGF-1 levels were lower in CP-R group compared to CP-N and REF groups (p = 0.037 and p < 0.001 respectively), and in PEM group compared to CP-N and REF groups (p < 0.001 and p < 0.001 respectively). CONCLUSIONS: CP-R patients failed to demonstrate the same high basal GH response as PEM patients, and responded inadequately to the insulin stimulation test, but they had IGF-1 levels comparable to those of PEM patients. On the other hand, CP-N patients behaved as controls regarding their basal GH and IGF-1 levels, but failed to respond adequately to the insulin stimulation test. The PEM group presented high basal GH and low IGF-1 levels. These findings suggest that non-nutritional factors contribute to growth retardation in CP children.