Awareness and Knowledge of Colorectal Cancer Screening Among Medical Students at the University of Aleppo: A Cross-Sectional Study

Background  Colorectal cancer (CRC) is the third leading cause of malignancy in Syria. The aim of our study was to assess the awareness and knowledge of CRC and its screening methods among medical students at the University of Aleppo.

Methods  A cross-sectional study of medical students at the University of Aleppo was conducted using a self-administered 12-element questionnaire. The questionnaire consisted of demographics, awareness of CRC, knowledge of CRC and its screening methods. Awareness of CRC included three questions asking students if they ever heard of CRC and its screening methods. Knowledge of CRC was evaluated through three sets of questions about CRC risk factors, signs and symptoms, and preventative methods. The students were selected randomly during academic lectures. A χ² or Fisher's exact tests for categorical variables were used for statistical analysis, as appropriate. A two-sided p  < 0.05 was considered statistically significant. We stratified students based on pre-clinical versus clinical years and average academic score.

Results  A total of 824 students completed the questionnaire. The majority of students were aware of CRC (98.9%) and CRC screening methods (79.8%). Students had poor knowledge of CRC risk factors (16.5% for non-modifiable factors and 11.7% for modifiable factors), signs and symptoms (52.6%), and protective factors (9.9%). Only 31.7% of students were able to identify the appropriate age to initiate screening for average-risk individuals. Clinical students had better awareness and knowledge of CRC and its screening methods. Clinical students with higher academic score showed better awareness and knowledge in some elements.

Conclusion  Our study reported high awareness and poor knowledge rates of CRC and its screening methods among medical students at the University of Aleppo. Although clinical students had higher awareness and knowledge of CRC compared to pre-clinical students, the impact of academic score revealed variable results.

Gastrogastric herniation: An unusual complication following greater curve plication for the treatment of morbid obesity: Case report

Bariatric surgery is the most effective treatment for obese patients. Laparoscopic greater curvature plication (LGCP) is a good, effective and feasible surgical option for the treatment of obese patients. But it has some complications that should be considered such as gastric remnant distention, stomal stenosis and marginal ulcers.

Here, we reported an extremely rare complication “gastro-gastric herniation”. This condition was diagnosed through upper gastrointestinal contrast imaging and treated through laparoscopy. The hernia was invaginated and firm continuous sutures were placed. We followed the patient for one year and the results were great.

Thus, we can add gastro-gastric hernia to the medical literature as a rare complication of laparoscopic greater curvature gastric plication, and It is considered a serious condition that requires immediate treatment and follow-up.

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Obesity is considered as an important risk factor for many serious diseases.

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Bariatric surgery is the most effective treatment for obese patients.

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Laparoscopic greater curvature plication (LGCP) is an effective and feasible surgical option.

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Gastrogastric herniation is a rare complication of greater curve plication.

Left sided Richter type obturator hernia causing intestinal obstruction: A case report

Introduction

Although relatively rare, an obturator hernia is a significant cause of intestinal obstruction. It usually occurs in emaciated elderly females. Computed tomography is the imaging modality of choice to diagnose obturator hernias.

Case report

In this report we present a case of an elderly female who presented to the emergency department with features suggesting bowel obstruction. The patient was admitted to the hospital and was initially managed conservatively. Two days later the patient underwent an exploratory laparotomy and was diagnosed with a left sided Richter type obturator hernia. The hernia was successfully reduced and the necrotic bowel was resected with end to end anastomosis.

Discussion

An obturator hernia is a rare type of abdominal hernias which often occurs in very thin old females. Patients with obturator hernias usually present with symptoms of acute or intermittent small bowel obstruction. Mild symptoms without abdominal pain may be due to incomplete obstruction or Richter type hernia. Computed tomography is considered the gold standard diagnostic modality for obturator hernias. An early surgical intervention is the treatment of choice.

Conclusion

The clinical diagnosis of an obturator hernia is often difficult due to its nonspecific symptoms and infrequent signs. Yet early diagnosis is mandatory because its delay contributes to bowel necrosis and to the poor prognosis in these patients. Surgery remains the only effective management of this condition.

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Obturator hernias are a rare cause of intestinal obstruction.

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An obturator hernia usually occurs in very thin elderly females.

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Obturator hernias present with symptoms of intestinal obstruction.

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Computed tomography is the imaging modality of choice to diagnose obturator hernias.

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The only management of this condition is surgery through either laparotomy or laparoscopy.

Acute single appendicitis in a female with a duplicated appendix

Appendiceal duplication is a rare congenital anomaly with an estimated incidence ranging from 0.004 to 0.009%. Preoperative diagnosis of a duplicated appendix is often difficult and is usually done intraoperatively. Histopathological examination of the surgical specimen is mandatory to confirm the presence of two appendices. In this case we report a female patient with acute inflammation in one of her two appendices. Surgeons should always bear in mind this rare anomaly to avoid serious ethical and legal consequences.