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A Statistical Study of the Risk Factors for Urinary Bladder Cancer in Pakistan

Thesis Info

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Author

Muhammad Riaz Ahmad

Program

PhD

Institute

Government College University

City

Lahore

Province

Punjab

Country

Pakistan

Thesis Completing Year

2011

Thesis Completion Status

Completed

Subject

Statistics

Language

English

Link

http://prr.hec.gov.pk/jspui/handle/123456789/364

Added

2021-02-17 19:49:13

Modified

2024-03-24 20:25:49

ARI ID

1676724426645

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This study investigated the effect of different risk factors in the occurrence of urinary bladder cancer in Pakistan on the basis of a case control study using both descriptive and analytical approaches. A sample of 900 subjects including 300 cases and 600 controls was selected from different areas of Pakistan including headquarter of all four provinces and federal area (Islamabad) through a questionnaire. The requisite information was obtained from all the patients/ controls by the researcher using the direct interview method. From the headquarters of Khyber PukhtoonKhwa, Sindh, Baluchistan and federal area (Islamabad), 150 subjects (including cases and controls) were taken from wards of two selected public hospitals but from the headquarter of the Punjab (Lahore), 300 subjects (including cases and controls) were taken from the wards of four selected public hospitals. Controls are taken by matching the gender, area of residence and age above 40 years. About 22 factors with sub categories were included in the study. For bivariate analysis, the chi-square, phi/v statistics and Kandall’s tau-b are used. For the purpose of multivariate analysis, the binary logistic regression was run by using the SPSS (version-16) to observe the significant risk factors and prediction of the model. In the descriptive analysis, it was observed that risk of bladder cancer increases with an increase in the number of cigarettes smoked per day, years of smoking and risk decreases when the stop smoking period increases. Further more, similar results were observed in the bivariate analysis. In the overall analysis, the six factors including hair dye, chemical exposure, family history, cigarette smoking, fried items and fats items are found to be positively significant with the odds ratios and 95 % confidence intervals of odds ratios (2.96; 1.396-6.279), (2.59; 1.460-4.607), (3.13; 1.325-7.394), (10.6; 7.007-15.941), (2.11; 1.364-3.269) and (2.08; 1.309-3.305), respectively. While the three factors including lifestyle, fluid consumption and use of fruits are found to be negatively significant with odds ratios and 95% confidence intervals for the odds ratios (0.102; 0.056-0.187), (0.268; 0.183-0.392) and (0.292; 0.193-0.440), respectively indicating that these three factors are protective factors against urinary bladder cancer. In area wise study, eight factors age, social status, lifestyle, family history, cigarette smoking, tea, fluid consumptions and fruits in Punjab, three factors cigarette smoking, source of drinking water and fried items in Islamabad, six factors chemical exposure, lifestyle, cigarette smoking, fluid consumption, fried items and fruit in Khyber Pukhtoon Khwa, three factors cigarette smoking, fluid consumption and fruits in Baluchistan and two factors cigarette smoking and fluid consumption in Sindh are found to be significant. In eight factors of Punjab, age, family history, cigarette smoking and tea are found to be positively significant while the other four factors social status, lifestyle, fluid consumptions and fruits are negatively associated with the bladder cancer. In three factors of Islamabad, two factors cigarette smoking and fried items are observed to be positively significant while the source of drinking water (government provided water) is observed to be protective as compared to the tap water. In six factors of Khyber Pukhtoon Khwa, chemical exposure, cigarette smoking and fried items are directly associated with the risk of bladder cancer while the other three factors lifestyle, fluid consumption and fruit are the protective factors for the disease. In three factors of Baluchistan, cigarette smoking is found to be positively significant while the fluid consumption and fruits are inversely associated with risk of bladder cancer. In two factors of Sindh, cigarette smoking is directly associated with disease while the other fluid consumption is found to be negatively significant. Cigarette smoking is the major risk factor and found to be significant in each area of Pakistan. Fluid consumption is also major protective factor and found to be significant in all areas except Islamabad. In studying the occupational risk factors, four categories of the occupations including cooks, drivers, metal workers and textile workers are found to be significant with the odds ratios and the 95% confidence intervals (14.132; 4.068 - 49.088), (7.949; 3.321- 19.025), (7.571; 3.147 - 18.214) and (2.168; 1.136 - 4.138), respectively. While the farmers, painters and leather workers are observed to be insignificant in Pakistan. According to this study, the cooks are at higher risk of bladder cancer as compared to all other occupations. Key Terms: Bladder cancer, Risk Factors, Logistic Regression, Odds ratio, Controls, Significance, Retrospective
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باتیں ’’خواب، خوشبو،آئینے‘‘ کی

باتیں ’’خواب، خوشبو،آئینے‘‘ کی

سماج میں خیالات و جذبات کے اظہار کیلئے بہت سے ذرائع موجود ہیں مگر کئی ذرائع ایسے ہیں جن میں ابلاغ زیادہ موثر نہیں ہے۔جیسا کہ سنگ تراشی اور تصویر کشی ہیں۔کیونکہ ان دونوں ذرائع میں فنکار اور دیکھنے والے کے نقطہ نظر میں بہت زیادہ اختلاف رائے کی گنجائش ہوتی ہے۔ہر کوئی فنکار کی سوچ تک رسائی نہیں رکھتااس لیے سماج میں ان ذرائع کو کم ہی استعمال میں لایا جاتا ہے۔البتہ شاعری ایسا موثر ذریعہ ہے جس میں شاعر اپنا نقطہ نظر بہت کم الفاظ اور وقت میں دوسروں تک پہنچا سکتا ہے اس لیے ہمیں سماج میں چہار سو شاعری کا راج نظر آتا ہے۔اسی ذریعہ سے محترمہ عظمت فردوس اسوہ نے اپنے خیالات کا اظہار کیا ہے اور اپنے خیالات کو ’’خواب خوشبو آئینے‘‘ کا نام دے کر ادب کو امیر بنانے کی کوشش کی ہے۔

اس مجموعہ کلام میں ایک نعت ،مدح مرشد،مدح غالب و جالب،ایک نظم ’’ماں‘‘ قطعات،فردیات اور غزلیات پڑھنے والے کی دلچسپی کا باعث ہیں۔محترمہ اسوہ نے اپنے کلام میں جن موضوعات پر قلم چلائی ہے۔اسکا مختصر جائزہ کچھ اس طرح سے ہے۔

شاعرہ نے شاعری کی روایت سے انحراف کرتے ہوئے اس مجموعہ کلام کو اپنے مرشد کی مدح بیان کرکے شروع کیا ہے۔مگر انہوں نیمدحیہ اشعار پر کوئی موضوع نہیں لکھا۔لکھتی ہیں کہ میرے مرشد نے مجھے سیدھے رستے سے روشناس کیا اور آج میں جو کچھ بھی ہوں اپنے مرشد کی نظر کرم کی بدولت ہوں۔

مجھ کو مرشد نے حق شناس کیا

سیدھے رستے سے روشناس کیا

ان کی نظر کرم ہے بس اسوہؔ

مجھ سی بندی کو اتنا خاص کیا(ص11)

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