Molecular subtypes among patients with breast cancer

Objective: To evaluate the estrogen receptor [ER], progesterone receptor [PR] and HER-2 receptor expression in breast cancer patients

Design: A Retrospective Study

Setting: Oncology Department, King Hamad University Hospital, Bahrain

Method: All women with a confirmed diagnosis of breast cancer via biopsy from 2010 to 2016 were reviewed. The following were documented: age, type, and stage of cancer

Result: Eighty-nine patients were included in the study. A total of one hundred and two patients were diagnosed with breast cancer based on biopsy results; thirteen patients were excluded due to the unknown stage and/or grade. The mean age was 53.9 years. The majority of cases were infiltrating ductal carcinoma [IDC], 82 [92%]. The most common molecular subtype detected in the study was Luminal B [ER+, PR+, HER2+], 29 [32.6%] of the study population. Nine [10%] had an unknown grade, and 8 [8.9%] had unknown stage were excluded from the analysis

Conclusion: Many patients were lost to follow-up. More effort is needed to reduce the proportion of unknown stages and grades of breast cancer cases. Further research is advised to evaluate the prognosis of breast cancer patients in Bahrain due to the high incidence in the Gulf Cooperation Council [GCC]

Pregnancy outcome of sickle cell disease women

Objective: To evaluate the maternal and fetal outcome in pregnant women with sickle cell disease [SCD] compared with healthy women

Setting: Department of Gynecology and Obstetrics, Salmaniya Medical Complex, Bahrain

Design: Retrospective Case-Control Study

Method: Patients with SCD who delivered from 1 January 2011 to 31 December 2012 were reviewed. The matched controls had neither SCD nor sickle cell trait

Result: Patients with sickle cell disease required significantly more admissions during their pregnancy, 135 [78.4%] compared to the control, 74 [37.4%]. One hundred thirteen [65.6%] SCD patients were admitted with vaso-occlusive crises and 18 [10.4%] with hemolytic crises. SCD patients had a significant decrease in parity, gestational age and birth weight compared with the control group. SCD patients had a significant rise in the incidence of urinary tract infection, but there was no difference between both groups in the incidence of hypertensive disorders, mode of delivery and perinatal outcome. Four [2.3%] patients with SCD died; two [1.2%] patients died due to pulmonary embolism, one [0.6%] due to acute chest syndrome and one due sepsis and disseminated intravascular coagulopathy

Conclusion: Sickle cell disease is hazardous both to the mother and the fetus and is associated with high maternal morbidity and mortality

Laparoscopic splenectomy in children with sickle cell disease

Background: Many children with Sickle Cell Disease [SCD] might experience severe sickle cell crises due to splenic complications. These include hypersplenism, acute splenic sequestration, splenic abscess and massive splenic infarction. Splenectomy is indicated to decrease the rate of recurrence of complications and the associated morbidity and mortality. The laparoscopic approach has proved to be associated with a better outcome. Many laparoscopic techniques were implemented for the removal of the spleen, especially when it is enlarged and fragile

Objective: To evaluate laparoscopic assisted splenectomy technique and outcome in 51 children with SCD

Design: A Retrospective Review

Setting: Department of Pediatric Surgery, Salmaniya Medical Complex, Bahrain

Method: Fifty-one children who had laparoscopic assisted splenectomy with a small inguinal incision from January 2002 to December 2014 were reviewed

Result: Fifty-one children had laparoscopic assisted splenectomy for either hypersplenism 42 [82.4%] or acute splenic sequestration 9 [17.6%]; 32 [63%] males and 19 [37%] females. The age range was 6 to 14 years, a mean age of 9.8. Only one [1.9%] case required conversion to open procedure due to excessive bleeding. Only 7 [13.7%] were admitted in the ICU following the procedure. The mean length of hospital stay was four days; the measured decrease in the HBS was 38%, preoperative fever was seen in 16 [31%], and there was no mortality

Conclusion: Laparoscopic splenectomy with a left inguinal incision is a safe and effective approach in children with SCD