Incidence and natural course of symptomatic central serous chorioretinopathy in pregnant women in a maternity hospital in Kuwait

To report the incidence, clinical features and natural course of central serous chorioretinopathy [CSR] in pregnant women in Kuwait. Patients were actively recruited from a private maternity hospital. Out of the 17,000 pregnant women who visited the antenatal care clinics [Al-Orf Hospital, Kuwait] over 3 years, 900 had visual complaints. Patients with visual complaints underwent complete ophthalmological assessment. Medical records of patients with CSR were reviewed, and a full clinical ophthalmological assessment was performed including measurement of best corrected visual acuity, intraocular pressure, slit lamp biomicroscopy, dilated indirect ophthalmoscopy and Amsler grid screening, color and red free fundus photography and retinal optical coherence tomography. All patients were evaluated throughout the course of pregnancy and for 6 months after delivery. Four patients had CSR among the 17,000 pregnant women reviewed over 3 years corresponding to an incidence of 0.008% per year. Two patients [50%] had CSR with white subretinal exudates and 2 [50%] had no exudates. There was complete resolution in all patients [100%] within 3 months after delivery. In pregnant women, CSR can present with or without retinal exudates and completely resolves in either case. Further studies with a larger sample size are warranted to investigate the risk factors in pregnant women

Primary carcinoid tumors at atypical sites: report of 3 cases with vague clinical presentations

Carcinold tumors at atypical sites are rare and mostly asymptomatic. In the majority they show normal levels of serotonin and its metabolites in plasma and urine, resulting in a relatively late diagnosis and hence poor prognosis. Relatively large sizes and local recurrences are features of carcinoids at atypical locations and may direct the surgeons' attention to their possible existence. A report of three cases of Carcinoid tumors in the breast, abdominal paravertebral region and the duodenum is given. The symptoms and clinical findings in the three cases were vague and did not raise any suspicion of Carcinoid. Repeated local recurrence in the three cases after excision was the clue for the diagnosis that was confirmed by appropriate diagnostic tools. Carcinoid tumors at atypical sites are either benign or low grade malignant neoplasms with a good long-term prognosis after surgical treatment. Routine resection, which may be aggressive, is the treatment of choice whenever possible, even in recurrent cases. The survival of patients depends basically on the tumor size and the presence of distant metastases. When resection is not feasible, reduction of tumor size may be possible by treatment with Somatostatin analogs

Carcinoembryonic antigen determination in urine differentiates early bilharizal from nonbilharzial urinary bladder carcinoma

Both urinary Bilhariziasis and urothelial neoplasia are associated with increased production of tissue carcinoembryonic antigen [CEA]. Urine and serum CEA were determined in 43 patients with urinary bladder carcinoma including 22 post bilharzial and 21 nonbiharzial cases, in addition to 10 normal control cases. A significant increase was detected in both urine and serum CEA levels with bladder carcinoma compared to control cases. Urinary CEA was significant elevated in 86% of bilharzial, versus 62% in nonhilharzial bladder carcinoma. Only 10.5% of control cases had urinary CEA elevation. The mean urinary CEA in bilharzial cases, was higher than that of nonbilharzial carcinoma, but the difference was not statistically significant. There was a definite relationship between urine CEA and the stage of malignancy; the higher the stage, the higher the level of urine CEA. No relationship could be detected between the stage of malignancy and serum CEA, or between the grade of malignancy and urine or serum CEA levels. In conclusion, urinamy CEA is more useful than serum CEA in the early detection of urothelial carcinoma particularly if provoked by bilharziasis. Its level is also correlated with the tumor stage

Study of carcinoembryonic antigen in bilharzial and non bilharzial carcinoma of the urinary bladder

Urine and serum carcinoembryonic antigen [C.E.A] were determined in 43 patients with bilharzial bladder carcinoma [22 patients] and non- bilharzial bladder carcinoma [21 patients] as well as in 10 normal controls. Significant increase of both urine and serum C.E.A. levels in bladder carcinoma patients compared to control levels was detected. Urinary C.E.A. Was elevated in 86% of bilharzial bladder carcinomal versus 62% in non-bilharzial bladder carcinoma while serum C.E.A. Was raised in 39% of bilharzial bladder carcinoma versus 10.5% in non- bilharzial carcinoma. The mean urinary C.E.A. in bilharzial carcinoma was higher than that of non-bilharzial carcinoma but the difference was not statistically significant. There was a definite relationship between urine C.E.A. And the stage of malignancy, the higher the stage, the higher the level of urine C.E.A. No relationship could be detected between the stage of malignancy and serum C.E.A. or between the grade of malignancy and urine or serum C.E.A levels