Many factors contribute to the conceptualization of health related quality of life. These same factors seem to influence the medical decision-making in a manner that reflects competing principles and interests. The overall trend, however, may appear to be skewed toward weighing “worthiness” of patients for treatment according to their current or expected quality of life. Such position is in contrast to the whole concept of health related quality of life, which was meant to help improve health care access and delivery rather than limit it based on prognosis. This article aims to reiterate the absolute value of life from my understanding of Islamic perspective, and argues against belittling the value of life based on poor health-related quality of life.

In most countries, pathology services have undergone a series of radical reforms, which have impacted on, moulded and manipulated the professions and the diverse set of occupational groups on which they rely. Reorganisation policies have placed considerable emphasis on the need for carefully planned change management and have highlighted the sensitive nature of stakeholder involvement in healthcare delivery of which laboratory medicine is a vital part. Approximately 70% of patient medical management decisions are based on scientific data generated within diagnostic laboratories as part of the healthcare pathway. Within the context of organisations, change presents three major problems, resistance, control, and power. Reform driven changes have led to changes in the work-based tasks and competencies of pathology staff and one strategy that healthcare providers employ to adapt to this dynamic environment is multi-skilling as part of a raft of changes aimed at reducing costs and improving performance, efficiency and competitiveness. This paper identifies the factors, which are crucial in directing the models of change which need to be adopted to deliver the most cost-effective services tailored to meet the needs of patients and the expectations of service users.

The present study has investigated the chemopreventive potential and antilipidperoxidative effect of ethanolic extract of Thespesia populnea (L.)bark on 7,12-dimethylbenz[a] anthracene (DMBA) induced hamster buccal pouch carcinogenesis. Oral squamous cell carcinoma had developed in Syrian golden hamsters by exposing the buccal mucosa to 0.5 % DMBA in liquid paraffin thrice a week for 14 weeks. The tumor incidence, tumor volume and tumor burden that occurred in the hamster buccal pouch were determined. Oral administration of ethanolic extract of T.populnea bark at a dose of 300 mg/kg b.wt to DMBA painted animals on alternate days of DMBA treated for 14 weeks significantly prevented the tumor incidence, tumor volume and tumor burden. Ethanolic extract of T.populnea bark showed potent antilipidperoxidative effect as well as enhanced the antioxidants status in DMBA painted animals. We thus conclude that ethanolic extract of T.populnea bark has potent chemopreventive efficacy and significant antilipidperoxidative effect in DMBA induced oral carcinogenesis. Further studies are needed to isolate and characterize the bioactive chemopreventive component from the bark of T.populnea.

Background: Laparoscopic cholecystectomy (LC) is often performed early for treatment of acute cholecystitis (AC), and has become the treatment of choice for this diagnosis. This has reduced length of stay and is cost effective. It may, however, carry a higher morbidity and an increased rate of conversion to open cholecystectomy. In this article we evaluated the role of early laparoscopic cholecystectomy in surgical treatment of acute cholecystitis at our center. Patients and methods: A retrospective analytical review of 114 cases of acute cholecystitis treated by laparoscopic cholecystectomy is presented. All cases were performed by the authors between 2002 to 2008. All patient records were reviewed and analyzed for age, sex, duration of symptoms, operative findings, conversion rate to open cholecystectomy, length of hospital stay, and any postoperative complications. Results: the mean age of patients was 34.5 years (range 25 to 80). Female to male ratio was 4:1. Operative interventions were performed within the first five days from onset of attack. Operative findings included acute inflammation of the gall bladder with superficial adhesions in 84 (74%) patients. An inflammatory mass with difficult adhesions was found in 20 (18%) patients. Empyema of gall bladder was noted in 10 (9%) cases. Mean length of stay was 2.5 days. Conversion to open cholecystectomy totaled nine (7%) cases. Two cases (1.7%) developed postoperative bile leaks, two (1.7%) cases had postoperative bleeding, 10 (8.7%) cases had postoperative chest infections and two (1.7%) cases had wound infection at the entry port of extracting the gall bladder. There was zero mortality. Conclusion: Early laparoscopic cholecystectomy for acute cholecystitis is feasible and safe and is today's treatment of choice for this event. The primary benefits are shorter hospital stay and quicker recovery.

A 57-year-old female presented with recurrent episodes of right flank pain and fever. No pathogens were detected in urine cultures. Intravenous pyelography and computerized tomography revealed a poor-functioning right kidney with an upper pole cystic tumor. Barium meal showed a communication between the renal pelvis and the duodenum. A right nephrectomy was performed with repair of the fistula. Histological examination revealed chronic pyelonephritis with xanthogranulomatous reaction and cystic renal tumor. The patient remains well at seven year follow-up.

These are the abstracts of a 2.5 days of continuous medical education meeting that was held in Abu Dhabi, UAE to mark the World Diabetes Day 2010. It brought together doctors taking care of children and adults with diabetes and other metabolic and endocrine disorders. The organizers thought it would be particularly relevant to bring pediatric and adult endocrinologists together to exchange experiences because the age gap between pediatric and adult is fairly small. The lectures covered a wide range of issues, such as growth, pituitary tumours, neonatal diabetes, old and new antidiabetic drugs, type 2 diabetes in the adolescence, and calcium disorders. Special emphasis was given to thalasaemia as an important medical problem with medical and endocrine ramifications in this region, management of hypoituitarism in adults, and interdisciplinary issues in endocrinology.