Hematopoietic stem cell transplantation in the eastern mediterranean region [EMRO] 2008-2009: report on behalf of the eastern mediterranean bone marrow transplantation [EMBMT] group

The Eastern Mediterranean Bone Marrow Transplantation [EMBMT] Group has accumulated over 25 years of data and experience in hematopoietic stem cell transplantation [HSCT], most particularly in he-moglobinopathies, severe aplastic anemia [SAA], and inherited metabolic and immune disorders, in addition to hematologic malignancies peculiar to the region and where recent updates in trends in activities are warranted. To study trends in HSCT activities in the World Health Organization-Eastern Mediterranean [EM] region surveyed by EMBMT between 2008 and 2009. STUDY DESIGN: Retrospective analysis of the survey data, mainly of the cumulative number of transplants, types of transplants [autologous vs. allogeneic], types of conditioning as myeloablative [MAC] vs. reduced intensity conditioning [RIC] and trends in leukemias, hemo-globinopathies, SAA, inherited bone marrow failure syndromes amongst others. Fourteen teams from ten Eastern Mediterranean Region Organization [EMRO] countries reported their data [100% return rate] to the EMBMT for the years 2008-2009 with a total of 2608 first HSCT [1286 in 2008; 1322 in 2009]. Allogeneic HSCT represented the majority [63%] in both years. The main indications for allogeneic HSCT were acute leukemias [732; 44%], bone marrow failure syndromes [331, 20%], hemoglobinopathies [255; 15%] and immune deficiencies [90; 5%]. There was a progressive increase in the proportions of chronic myeloid leukemia [CML] cases transplanted beyond the first chronic phase [3; 7% of all CML cases in 2008 vs 13; 29% in 2009]. The main indications for autologous transplants were plasma cell disorders [345; 36%] Hodgkin disease [256; 27%], non-Hodgkin lymphoma [207; 22%] and solid tumors [83; 9%]. RIC continued to show a progressive increase over the years [7% in 2007, 11% in 2008 and 13% in 2009], yet remained relatively low compared to contemporary practices in Europe published by EBMT. The vast majority [95%] of allo-HSCT sources were from sibling donors with a continued dominance of peripheral blood [PB] [1076; 63%], while cord blood transplant [CBT] increased to 83 [5% of allo-HSCT], matched unrelated donor [MUD] remained underutilized [1; 0%] and there were no haploidentical transplants reported. Large centers with >50 HSCT/year showed a plateau of the total number of allo-HSCT over the last 5 years that may be related to capacity issues and needs further study. There is an overall increased rate of HSCT in the EMRO region with a significant increase in utilization of CBT and allogeneic PB-HSCT as a valuable source. However, further research on outcome data and development of regional donor banks [CB and MUD] may help facilitate future planning to satisfy the regional needs and increase collaboration within the group and globally

Coronary events in Bahrain: descriptive study

In Bahrain, cardiovascular death accounts for about 19.5% annually. Prevalence of Ischemic Heart Diseases [IHD] was 174.4 per 100,000 populations. Coronary events found to be the fourth leading cause of discharge from Salmaniya Medical Complex [SMC] in 2005. To evaluate the pattern and profile of patients with coronary events. Salmaniya Medical Complex, Kingdom of Bahrain. Retrospective Cross-sectional Study. Two hundred twenty-six patients were selected by a systematic random sampling technique from patients admitted with coronary events in SMC from 1 January 2004 to 31 December 2004. Data were reviewed and documented from the medical record. One hundred thirty-eight [61.1%] suffered from unstable angina, 66 [29.2%] had myocardial infarction and 22 other coronary events. Pre-existing cardiovascular diseases [previous IHD, atherosclerotic diseases, other heart diseases and stroke] suffered by almost half of the patients. Hypertension was reported in 97 [42.9%] patients, while diabetes was reported in 82 [36.3%] patients. More than two-third of cases diagnosed with coronary events had unstable angina and nearly one-third of cases had myocardial infarction. The majority of patients had preexisting morbidities, which include diabetes mellitus, hypertension and chronic cardiac conditions

Tobacco training and educating primary care professionals in Bahrain

Tobacco use has been well identified as the primary preventable cause of premature deaths and disability, yet results from previous surveys shows that educational curriculum of health professionals don't address this topic adequately. To assess primary care professionals knowledge, perception and attitude related to selected tobacco use and effect items. Responses to self administered questionnaire by primary care professionals. Hundred fifty primary care professionals participated in the study, 24.7% of them are current smokers and 10% ex-smokers. Inadequacy in tobacco education curriculum was noted. In particular for nature of tobacco use addiction and management of tobacco dependence. Only 12% of local graduate and 16% of overseas graduate professionals had received formal training on smoking cessation interventions

Cancer prevention: role of primary care professionals

Review the current inputs of primary care professionals in Bahrain in the area of cancer prevention, Three key tasks performed at primary care level were reviewed [female cancer screening, tobacco control, Hepatitis B immunization]. The review is based on data collected from various health statistics, annual reports and national and regional surveys. Cancer is an important cause of morbidity and mortality in Bahrain. Evidence reported that a large proportion of cancer is preventable in nature, and suggest that primary care professionals have a critical role to play in cancer prevention and control. Although the coverage of cervical and breast screening was low [30% and 40%, respectively], yet, the current screening program covers women of lower risk. There is an urgent need to involve primary care professionals in tobacco control and tobacco cessation activities in particular. Follow up for Hepatitis B cases and contacts are identified as a priority area and need further improvement. Guidelines for screening and management of Hepatitis B cases at Primary care level need to be established Primary care professionals can increase their inputs in cancer prevention. Public education about cancer risk factors is priority activity. They require to be involved more in tobacco cessation programs. New measures for female cancer screening are required to improve the role of primary care professionals