Headache and blood pressure in primary health care setting in Kuwait

To identify the types of headache among patients, presenting at a primary health care setting, and to determine the correlation between headache and high blood pressure [BP]. This was a cross-sectional study administered in 2 primary health care centers [Fintas and AbuHalifa] of a regional health district in Kuwait from March 2003 to June 2003. Our study included 290 patients with different types of headache, and requested for BP measurement. The sample included patients, in the age group 15-80 years with an overall mean age of 41 [+13 SD] years. The male to female ratio was 1:2.7 and the majority [85%] of patients were Kuwaitis. Tension headache was the most frequent diagnosis [61.7%] among patients presenting with headache, followed by migraine [11.7%]. The normal systolic BP was <140 mm Hg [52.8%], while 59% had normal diastolic BP, below 90 mm Hg. Increasing age was found to be associated with high BP levels [p<0.001]. Diastolic BP was found significantly higher among males [p<0.01] Tension headache had higher levels of BP while migraine was found to have low levels. None of the sinusitis headache patients had high BP. Positive history of hypertension was found associated with high systolic and diastolic BP in tension and other type of headache [p<0.001]. Headache is a very common symptom among patients presenting at the general practice health care setting, with most cases diagnosed with tension-type headache, and females out numbering males. There was no positive correlation between headache and high BP. Physicians should discourage their patients from considering headache as a measure of their BP status

Bednar tumor

Pigmented dermatofibrosarcoma protuberance DSFP, also known as Bednar tumor or formerly known as pigmented storiform neurofibroma is a rare variant of DSFP. Bednar first described it in 1957. The histology is striking because of the presence of multipolar pigment laden dendritic cells scattered among spindle shaped cells with a storiform pattern, the latter being characteristic of DSFP. The spindle cells are positive for CD34, and Vimentin and negative for S100. The pigment represents melanin. We describe such a tumor because of its rarity and very striking microscopic appearance