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The predicted risk factors of heavy lifting, prolonged sedentary activity, chronic cough, varicose veins, pregnancy, constipation, and family history of haemorrhoids were significantly more frequent among cases compared with controls (p < 005, x or Fisher's exact tests), with the latter risk factor having the most significance (p = 00005). Among cases, anal pain, prolapse and rectal bleeding were the most frequent presenting symptoms. Of medical concern was the delay in consultation, exceeding two months in 77 per cent of cases. Among this group, 45 per cent expressed delay of around one year or more, the maximum being 11 years. Illiteracy (no formal education) was the only significant factor associated with long delay (p = 0003).

A pilot study of the use of clinical guidelines to determine appropriateness of patient placement on intensive and high dependency care units