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Colorectal cancer in the young,many questions,few answers

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World Journal of Gastrointestinal Oncology 2016年第6期8卷 481-488页

作者： Kemal I Deen Hiroshi Silva Raeed Deen Pramodh C Chandrasinghe Consultant in Colon and Rectal Surgery The Asiri Surgical Hospital The University of Kelaniya Medical School The University of Sydney Medical School

At a time where the incidence of colorectal cancer,a disease predominantly of developed nations,is showing a decline in those 50 years of age and older,data from the West is showing a rising incidence of this cancer in young *** to this has been the 75% increase in rectal cancer incidence in the last four ***,predictive data based on mathematical modelling indicates a 124 percent rise in the incidence of rectal cancer by the year 2030-a statistic that calls for collective global thought and *** predominance of colorectal cancer(CRC) is likely to be in that part of the large bowel distal to the splenic flexure,which makes flexible sigmoidoscopic examination an ideal screening tool,the cost and benefit of mass screening in young people remain *** countries where the incidence of young CRC is as high as 35% to 50%,the available data do not seem to indicate that the disease in young people is one of high red meat consuming nations *** in our understanding of genetic pathways in the aetiology of CRC,chiefly of the MSI,CIN and CIMP pathway,supports the notion that up to 30% of CRC is genetic,and may reflect a familial trait or environmentally induced ***,a number of other germline and somatic mutations,some of which remain unidentified,may play a role in the genesis of this cancer and stand in the way of a clear understanding of CRC in the ***,a proportion of young persons with CRC die early after curative surgery,presumably from aggressive tumour biology,compared with the majority in whom survival after operation will remain unchanged for five years or *** challenge in the future will be to determine,by genetic fingerprinting or otherwise,those at risk of developing CRC and the determinants of survival in those who develop ***,prevention and early detection,just like for those over 50 years with CRC,will determine the outcome of CRC in young *** present,aside f

关键词： Colon cancer Young age Rectal cancer Colorectal cancer Young patients Survival Early onset

Childhood constipation as an emerging public health problem

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World Journal of Gastroenterology 2016年第30期22卷 6864-6875页

作者： Shaman Rajindrajith Niranga Manjuri Devanarayana Bonaventure Jayasiri Crispus Perera Marc Alexander Benninga Department of Paediatrics Faculty of Medicine University of Kelaniya Department of Physiology Faculty of Medicine University of Kelaniya Consultant Paediatrician Asiri Hospital Department of Paediatric Gastroenterology and Nutrition Emma Children’s Hospital Academic Medical Centre

Functional constipation(FC) is a significant health problem in children and contrary to common belief, has serious ramifications on the lives of children and their families. It is defined by the Rome criteria which encourage the use of multiple clinical features for diagnosis. FC in children has a high prevalence(0.7%-29%) worldwide, both in developed and developing countries. Biopsychosocial risk factors such as psychological stress, poor dietary habits, obesity and child maltreatment are commonly identified predisposing factors for FC. FC poses a significant healthcare burden on the already overstretched health budgets of many countries in terms of out-patient care, in-patient care, expenditure for investigations and prescriptions. Complications are common and range from minor psychological disturbances, to lower health-related quality of life. FC in children also has a significant impact on families. Many paediatric clinical trials have poor methodological quality, and drugs proved to be useful in adults, are not effective in relieving symptoms in children. A significant proportion of inadequately treated children have similar symptoms as adults. These factors show that constipation is an increasing public health problem across the world with a significant medical, social and economic impact. This article highlights the potential public health impact of FC and the possibility of overcoming this problem by concentrating on modifiable risk factors rather than expending resources on high cost investigations and therapeutic modalities.

关键词： Constipation Public health Risk factors Prevention

Sympathetic dysfunction as a cause for hypotension in dengue shock syndrome

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Chinese Medical Journal 2012年第20期125卷 3757-3758页

作者： Jeevagan Vijayabala Malith Attapaththu Priyankara Jayawardena garath Gamini de Silva Godwin Constantine University Medical Unit National Hospital of Sri Lanka Sri Lanka asiri hospital Colombo Sri Lanka

Dengue is an important mosquito-borne disease, caused by one of the four serotypes of dengue *** to the reports from the World Health Organization, every year 50 to 100 million infections occur, including 500 000 dengue hemorrhagic fever cases and 22 000 deaths, mostly among children.1 The main features of severe infection are hypotension, fluid leak and shock. Management of dengue shock syndrome and its pathophysiology are not fully understood. We reported two patients with dengue who developed hypotension without considerable fluid accumulation in the third space and explaining an alternative cause for hypotension in these patients.

关键词： dengue shock syndrome," hypotension sympathetic dysfunction

Tissue plasminogen activator via cross-collateralization for tandem internal carotid and middle cerebral artery occlusion

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World Journal of Clinical Cases 2013年第9期1卷 290-294页

作者： Ketan R Bulsara asiri Ediriwickrema Joshua Pepper Fergus Robertson John Aruny Joseph Schindler Neurosurgical Department Yale and New Haven Hospital Yale University School of Medicine Interventional Radiology Department National Hospital for Neurology and Neurosurgery Interventional Radiology Department Yale and New Haven Hospital

Tandem internal carotid and middle cerebral artery occlusion after carotid dissection predicts poor outcome after systemic thrombolysis. Current treatments include the use of endovascular carotid stenting, which carries with it a high risk of propagating further embolic events and worsening the dissection. New strategies for avoiding the aforementioned side-effects include recanalization using cross-collaterals for delivery of intra-lesional tissue plasminogen activator(t PA). We present two cases that provide further support for this novel approach. Both patients presented with a National Institute of Health Stroke Scale of 20, received intra-arterial t PA via cross-collateralization, and made full recoveries without the need for stenting.

关键词： Tandem internal carotid artery and middle cerebral artery occlusion Intra-arterial tissue plasminogen activator Carotid artery dissection

Spontaneous Monochorionic Triamniotic Triplet Pregnancy: A Case Report

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Open Journal of Obstetrics and Gynecology 2023年第6期13卷 1075-1080页

作者： Al Hussain Al Hazmi Ola Tayeb Afrah Al Mutairi Mufareh asiri Maternity hospital King Saud Medical City Riyadh KSA

Background: Monochorionic triamniotic (MCTA) triplet pregnancy is a rare entity associated with a high risk of complications. In most previously reported cases, the pregnancy was conceived with the use of assisted reproductive technologies, and these cases were associated with complications. Case Presentation: We report a 28-year-old woman with a spontaneously conceived MCTA triplet pregnancy diagnosed at the gestational age of 26 weeks. All fetuses had normal amniotic fluid and umbilical artery Doppler findings were normal. The estimated weight of fetuses was 848 g, 891 g, and 1 kg, respectively. The patient was managed conservatively with a plan to monitor fetal growth every two weeks and a Doppler study twice weekly. On the 8th day of admission, the patient developed labor pains. Per vaginal examination revealed 1 - 2 cm cervical dilatation. Cesarean section was performed, and three girls were delivered with a single placenta (birth weight: 820, 925, and 960 g, respectively). Conclusion: Monochorionic triplet pregnancy is associated with a higher risk of fetal morbidity and mortality. Therefore, awareness of its complications can facilitate better management of such cases.

关键词： Monochorionic Triamniotic Triplet Pregnancy Case Report

Peripheral Central Venous Catheter Induced Supraventricular Tachycardia in a Patient of Acute Lymphoblastic Leukemia

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Case Reports in Clinical Medicine 2016年第3期5卷 67-70页

作者： Rangreze Imran asiri Abdulrahman Al-Hanash Ali Shehla Shafi Khan Department of Internal Medicine KKU Abha KSA Department of Medicine Aseer Central Hospital Abha KSA Department of Family Medicine Armed Force Hospital Khemis Mushayt KSA

Central venous catheters (CVCs) are used in intensive care units (and, increasingly, in other locations) to administer intravenous fluids and blood products, drugs, parenteral nutrition, and to monitor haemodynamic status. The risk of complication during the insertion or exchange of central venous catheters has been well documented. The majority of complications involve mechanical problems, although rarely it may induce arrhythmias as well [1]. Herein we present a case of peripheral central venous catheter induced supraventricular tachycardia in a young patient of acute lymphoblastic leukemia.

关键词： Central Venous Catheter (CVC) Supraventricular Tachycardia Acute Lymphoblastic Lymphoma

Surviving a Catastrophic Upper Gastrointestinal Bleeding Caused by Esophageal-Subclavian Fistula: Case Report

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Open Journal of Gastroenterology 2018年第6期8卷 209-212页

作者： Khalid Y. Nabrawi Mohamed-Elbagir K. Ahmed Abdulrahman Y. asiri Shaima M. Al-Aoun Abdullah M. Alshehri Abdullah H. Alhaizaey Musaad A. Alghamdi Ali S. Alahmari Aseer Central hospital Abha Saudi Arabia King Khalid University Saudi Arabia

Arterio-esophageal fistula (AEF), whether congenital or acquired, is a rare condition which can lead to fatal upper gastrointestinal bleeding. We report here a young man who developed a subclavian-esophageal fistula (SEF) secondary to chicken bone impaction in the upper esophagus. The diagnosis was reached by urgent upper endoscopy and Computed Tomography of the chest which showed pseudo-aneurysmal changes at left subclavian artery with leaked contrast through the fistula towered the esophagus. Urgent endo-vascular angiography confirmed the subclavian arterio-esophageal fistula that was managed uneventfully using covered 6mm Viban stent-graft. The patient survived this serious condition and was discharged home in good condition.

关键词： Gastrointestinal Bleeding Esophageal-Subclavian Fistula

Late onset ilio-psoas abscess due to stump appendicitis： a case report

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The Journal of Biomedical Research 2017年第5期31卷 462-465页

作者： Dafer M. A1 Shehri Abdullah K. asiri Walid M. Abd El Maksoud General Surgery Aseer Central Hospital Abha Saudi Arabia Faculty of Medicine King Khalid University Abha Saudi Arabia. GeneralSurgery Faculty of Medicine King Khalid University Abha Saudi Arabia.

We describe a case of right ilio-psoas abscess caused by stump appendicitis 14 years after open *** appendicitis is a rare complication of appendectomy. Right ilio-psoas abscess was diagnosed in an immunecompetent patient and treated by ultrasound guided percutaneous drainage twice without identifying the cause of the abscess. The patient did not improve until diagnostic laparoscopy was performed revealing a long stump appendicitis to be the origin of infection. It was treated by completion appendectomy. Surgical exploration may be necessary in persistent or recurrent ilio-psoas abscesses. We identified 4 reported cases of post-appendectomy ilio-psoas abscess but without recognizing the cause of the abscess and its relation to appendectomy. This is the first reported case of ilio-psoas abscess that developed as a complication of stump appendicitis.

关键词： stump appendicitis iliopsoas abscess delayed complications appendectomy

Assessment of Breast Cancer Prevention Practices among Women Attending Primary Health Care in Abha City, Aseer Region, Saudi Arabia

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International Journal of Clinical Medicine 2024年第2期15卷 31-54页

作者： Sabah Mohammed asiri Sultan Yahia Alfifii Tagreed Khairan Al-Rashidi Sager Misfer Alqahtani Faiz Abdulrahman Alshafa Fayez Mari Alamri Amal Mohammed asiri Fatima Mohammed Ali Almagadi Thuraya Mohammed asiri Department of Therapeutic Assistance Management General Directorate of Health Affairs Asser Region Abha Saudi Arabia Department of Health Affairs General Directorate of Health Affairs Asser Region Abha Saudi Arabia Department of Kidney King Khaled Hospital Hail Saudi Arabia Department of Nursing Sarat Abida Hospital Aseer Saudi Arabia Department of Radiation Oncology King Faisal Medical City Abha Saudi Arabia Department of Health Affairs KSA MOH Department of Kidney Dialysis Centers General Directorate of Health Affairs Aseer Region Abha Saudi Arabia Department of Operation Ahad Rafidah Hospital General Directorate of Health Affairs in Asseer Region Abha Saudi Arabia South Qunfudah General hospital Jizan Saudi Arabia Armed Forces Southern Region hospital Aseer Saudi Arabia

Cancer is a leading cause of death worldwide, with breast cancer being the most common (2.26 million new cases and 685,000 deaths). In Saudi Arabia, breast cancer ranked the first among females in 2014, accounting for 15.9% of all cancers reported among Saudi nationals and 28.7% of all cancers reported among females of all ages. Early detection of breast cancer could decrease the risks, have a better prognosis, and have better outcomes/more successful treatments. Prevalence of breast cancer reached more than 25% of all diagnosed cancer in the kingdom among women. Aim: This study aims to assess the knowledge and performance of women attending primary care centers about breast self-examination and mammogram screening for prevention and early detection of breast cancer in Abha city primary healthcare centers, Kingdom of Saudi Arabia. Research Method: cross sectional design was conducted by using questionnaire, which was distributed to primary care center nurses. The collected data was statistically analyzed using the Statistical Package for Social Sciences, version 25. Results: The study found that participants had poor awareness and knowledge about breast self-examination, risk factors for breast cancer, and trends and practices in early diagnosis of breast cancer. Conclusion and Recommendations: It recommends increasing awareness campaigns and providing educational programs to improve knowledge and practices.

关键词： Assessment Breast Cancer Prevention Practices Women Attending Health Care Centers Abha City