Epistaxis: the commonest otolaryngological emergency in Arar, Northern Saudi Arabia

Background: Epistaxis is a common clinical condition that ranges from a minor nuisance to a life threatening emergency. It may be a chronic problem or symptom of generalized disorder

Objective: to determine the etiology, risk factors and the outcome of the conservative and surgical management of epistaxis in the studied population

Methods: This is a cross-sectional, community-based survey being directed to the Saudi adult population living in Arar city during the period of October and November 2017. The study instrument is a self-administered, pre-designed questionnaire

Results: The study included 175 epistaxis cases, 39.4% females and 60.6% males, 45.1% were 20-29 years . Hypertension was found in 4.0%, 20% were smokers and 7.4% were ex-smokers. Epistaxis was idiopathic in 56.6% of cases, local injury in 16%, nasal allergy in 8.6%, nasal infection in 7.4%, mucosal irritation in 2.9%, high blood pressure in 2.9%, foreign bodies in 2.2%, nasal tumors in 1.7% and blood dyscrasias in 1.1%. Most [85.1%] of the cases were treated at home and 14.9% in the emergency department of hospitals. Cauterization of bleeding point, employed for only 1.7% of the cases and surgical treatment in only 1.1%

Conclusion: epistaxis was more common in males than females, most cases are idiopathic, local injury and nasal allergy are also considered causes. The majority of epistaxis were not life threatening and can be treated conservatively. Most of the cases were treated at home mainly by pressure on the nose and considerable percentage treated in the emergency department of the hospitals mainly by nasal backing

Burnout y factores de riesgo psicosocial en el personal de un hospital de larga estancia / Staff burnout and psychosocial risk factors in a long-stay hospital in Spain / Burnout e fatores de risco psicossocial em funcionários de um hospital de longa permanência

Resumen: Nuestro objetivo fue evaluar la relación entre los riesgos psicosociales y el burnout en un hospital español de media-larga estancia. Se realizó un estudio transversal en 2017, aplicando la versión española del MBI-HSS y el cuestionario F-Psico 3.1 del Instituto Nacional de Seguridad e Higiene en el Trabajo. Variables predictoras: características sociodemográficas, moduladoras y factores de riesgo psicosocial. Variables resultado: prevalencia de burnout y afectación de sus subescalas. La asociación entre variables se cuantificó con odds ratio. El cansancio emocional se asoció positivamente a los riesgos psicosociales vinculados a carga de trabajo, demandas psicológicas, participación/supervisión, desempeño de rol, relaciones/apoyo social y al consumo de ansiolíticos; fueron factores protectores los hijos, sentirse valorado por pacientes y compañeros, satisfacción laboral, optimismo y apoyo social. Las asociaciones halladas para la despersonalización fueron similares, pero más débiles. La baja realización personal se asoció positivamente a los riesgos psicosociales vinculados al tiempo trabajado, autonomía, variedad/contenido del trabajo, desempeño de rol y apoyo social; fue la subescala que mostró mayor número de variables sociodemográficas/moduladoras protectoras: estado civil, tener hijos, trabajar de noche, sentirse valorado por pacientes y familiares, ilusión por el trabajo, apoyo social, autoeficacia y optimismo. Según nuestros resultados, existe asociación entre los riesgos psicosociales y el burnout. Los individuos con mayor satisfacción laboral, autoeficacia y optimismo, afrontan mejor el estrés y son menos vulnerables a los riesgos psicosociales y al burnout

Abstract: The aim of this study was to assess the relationship between psychosocial risks and burnout syndrome in a long-stay hospital in Spain. A cross-sectional study was conducted in 2017, applying the Spanish version of the MBI-HSS and the F-Psico 3.1 questionnaire of Spain's National Institute of Work Safety and Health. The predictive variables were sociodemographic characteristics, modulators, and psychosocial risk factors. The outcome variables were prevalence of burnout and the effects on his subscales. Associations between variables were measured by odds ratio. Burnout was directly associated with psychosocial risks related to workload, psychological demands, participation/supervision, role performance and social support, and consumption of anxiolytics. Meanwhile, protective factors were having children, feeling valued by patients and coworkers, satisfaction at work, optimism, and social support. The associations found on depersonalization were similar but weaker. Low personal fulfillment was directly associated with the psychosocial risks related to length of workweek, limited autonomy and variety/content of work, and role performance and social support. Low personal fulfillment was the subscale with the most modulating and protective sociodemographic variables included marital status, children, night shift, feeling valued by patients and family members, social support, self-efficacy, and optimism. According to our results, there is an association between psychosocial risks and burnout syndrome. Individuals with greater work satisfaction, self-efficacy, and optimism cope better with stress and are less vulnerable to psychosocial risks and burnout.

Resumo: Nosso objetivo foi avaliar a relação entre os riscos psicossociais e a síndrome de burnout em um hospital espanhol de meia-longa permanência. Foi realizado um estudo transversal em 2017, aplicando a versão espanhola do MBI-HSS e o questionário F-Psico 3.1 do Instituto Nacional de Segurança e Higiene no Trabalho. Variáveis preditoras: características sociodemográficas, moduladoras e fatores de risco psicossocial. Variáveis de resultado: prevalência de burnout e afetação das subfaixas. A associação entre variáveis foi quantificada com odds ratio. A fatiga emocional foi associada positivamente aos riscos psicossociais vinculados a uma carga de trabalho, demandas psicológicas, participação/supervisão, desempenho de funções, relações/apoio social e consumo de ansiolíticos; por outro lado, foram fatores protetores: os filhos, se sentir valorados por pacientes e companheiros de trabalho, satisfação laboral, otimismo e apoio social. As associações encontradas para a despersonalização foram similares, entretanto mais débeis. A baixa realização pessoal foi associada positivamente aos riscos psicossociais vinculados ao tempo trabalhado, autonomia, variedade/conteúdo do trabalho, desempenho de funções e apoio social; foi a subfaixa que mostrou maior número de variáveis sociodemográficas/moduladoras protetoras: estado civil, ter filhos, trabalhar de noite, sentir-se valorizado por pacientes e membros da família, ilusão pelo trabalho, apoio social, auto-eficácia e otimismo. Segundo nossos resultados, existe uma associação entre os riscos psicossociais e a síndrome de burnout. Os indivíduos com maior satisfação laboral, auto-eficácia e otimismo afrontam melhor o stress e são menos vulneráveis aos riscos psicossociais e ao burnout.

Burnout in the staff of a chronic care hospital / Burnout en el personal de un hospital de crónicos

ABSTRACT OBJECTIVE To estimate the prevalence of Burnout in a medium or long-stay hospital, to monitor its evolution and to highlight the importance of cut-off points used to avoid distortions in the interpretation of the results. METHODS Two cross-sectional studies (2013-2016) were carried out, applying the Spanish version of the Maslach Burnout Inventory to the staff of a chronic care hospital (n = 323). Result variables were: Burnout prevalence and a high degree of affectation of the subscales and predictor variables: sociodemographic characteristics and factors that trigger and modulate the syndrome. The association between variables was quantified using odds ratio. RESULTS The participation rate went from 31.5% to 39.3%. The professionals presented a mean level of Burnout in both moments, observing a lower degree of affectation of the depersonalization subscales and personal accomplishment in the 2016 cut-off. The average score of the subscales in 2016 was 21.5 for emotional fatigue, 4.7 for depersonalization and 41.7 for personal fulfillment, compared to the values of emotional fatigue = 21.6, depersonalization = 6.9 and personal fulfillment = 36.3 obtained in 2013. The emotional fatigue score was slightly higher than the mean value of the national studies (19.9), while the rest of the values were similar to the mean values of the studies considered. The prevalence of Burnout and the interpretation of the results varied significantly according to the cut-off points considered. In both studies, sociodemographic variables showed little significance, while social support and interpersonal relationships were associated with the degree of burnout among professionals. CONCLUSIONS Our prevalence of Burnout was similar to that of other studies consulted, although the emotional component is more marked in our environment. The interpretation of the results varied significantly according to the cut-off points applied, due to the cross-cultural differences.

RESUMEN OBJETIVO Estimar la prevalencia de Burnout en un hospital de media-larga estancia, monitorizar su evolución y evidenciar la importancia de los puntos de corte utilizados para evitar sesgos en la interpretación de los resultados. MÉTODOS Se realizaron dos estudios transversales (2013-2016), aplicando la versión española del cuestionario Maslach Burnout Inventory al personal de un hospital de crónicos (n = 323). Fueron variables resultado: prevalencia de Burnout y alto grado de afectación de las subescalas y variables predictoras: características sociodemográficas y factores desencadenantes y moduladores del síndrome. La asociación entre variables se cuantificó mediante odds ratio. RESULTADOS El índice de participación pasó del 31,5% al 39,3%. Los profesionales presentaron un nivel medio de Burnout en ambos momentos, observándose menor grado de afectación de las subescalas de despersonalización y realización personal en el corte realizado en 2016. La puntuación media de las subescalas en 2016 fue 21,5 para el cansancio emocional, 4,7 para la despersonalización y 41,7 para la realización personal, frente a los valores de cansancio emocional = 21,6, despersonalización = 6,9 y realización personal = 36,3 obtenidos en 2013. La puntuación de la escala de cansancio emocional fue ligeramente superior al valor promedio de los estudios nacionales (19,9), mientras que el resto de valores fueron similares a los valores promedio de los estudios considerados. La prevalencia de Burnout y la interpretación de los resultados variaron significativamente en función de los puntos de corte considerados. En ambos estudios, las variables sociodemográficas mostraron escasa significación, mientras que el apoyo social y las relaciones interpersonales se asociaron al grado de Burnout de los profesionales. CONCLUSIONES Nuestra prevalencia de Burnout fue similar a la de otros estudios consultados, aunque el componente emocional es más marcado en nuestro medio. La interpretación de los resultados varió significativamente en función de los puntos de corte aplicados, debido a las diferencias transculturales.

Additive benefits of environmental enrichment and voluntary exercise on cognition and motor coordination in diabetic mice

Objective: To evaluate the effects of voluntary daily exercise and environmental enrichment on spatial memory and learning as well as motor coordination and learning, in diabetic mice

Setting: College of Medicine and Medical Sciences, Arabian Gulf University, Bahrain

Design: An Experimental Animal Study

Method: BALB/C mice [20 g to 25 g] received 55 mg/kg streptozotocin IP daily for five days. Diabetic mice were randomly assigned to one of the following groups for 12 weeks' duration: [1] social isolation; [2] an environmental enrichment; [3] environmental enrichment and voluntary daily exercise. The fourth group consisted of normal controls. At the end of 12 weeks, the mice were assessed by the Morris Water Maze and the Rotarod for cognitive and motor performance respectively

Result: All diabetic mice showed hyperglycemia. In water maze testing, exercise and environmental enrichment groups showed better learning as evidenced by reductions in time [escape latency] and distance swum to reach a submerged platform compared to diabetic isolated mice. In diabetic mice, exercise itself did not have a significant additional benefit on learning and memory compared to environmental enrichment alone. In rotarod test, motor learning was impaired with isolation but enhanced with environmental enrichment and exercise

Conclusion: Environmental enrichment and exercise confer significant benefits on cognition and motor performance in diabetic mice

Assessment of thyroid hormone levels and thyroid disorders: a case study from Gujranwala, Pakistan

This case study is conducted to investigate the thyroid hormone levels and relevant disorders including evaluation of dietary conditions in the rural area of Gujranwala and its surrounding districts. Thyroid disorders are clinically prevalent and their manifestation differs considerably with geographical variations. A randomized study of 177 subjects was carried out, with a questionnaire about their dietary habits/life style and acquisition of blood samples for thyroid hormone level assessment using radioimmunoassay technique. This study was permitted by the local ethics committee and an informed consent was obtained from the patients. Study of normally distributed population with p value less than 0.005 and mean age 32.67+/-13 years demonstrated that 37% female and 43% males were hyperthyroid with elevated levels of FT3and FT4. Amongst the diagnosed cases of hyperthyroidism 47% females and 33% of males were using Iodized salt with 50ug/ppm increased concentration of KI0s in their diet without any prescription. Furthermore, 60% of diagnosed hypothyroid cases were having no iodine supplementation in their diet. Thyroid function problems are more common in females [N=137] than males [N=40] but the severity of this disease was found to be more pronounced in males as the TSH level [33.13+/-22.73] was twice that as compared to females [17.63+/-18.15]. Despite a high prevalence of recognized thyroid disease in the population a considerable number of inhabitants have undiagnosed thyroid dysfunction. These findings necessities wider scale studies for the mapping of thyroid behavior and the contributing factors for this region with a population of more than 20 million

Terrorist attacks in the largest metropolitan city of Pakistan: Profile of soft tissue and skeletal injuries from a single trauma center / 世界急诊医学杂志（英文）

BACKGROUND: Pakistan has been hugely struck with massive bomb explosions (car and suicide bombs) resulting in multiple casualties in the past few years. The aim of this study is to present the patterns of skeletal and soft tissue injuries and to review the outcome of the victims who presented to our hospital. METHODS: This is a retrospective chart review from January 2008 to December 2012. The medical record numbers of patients were obtained from the hospital Health Information and Management Sciences (HIMS) as per the ICD-9 coding. RESULTS: During the study period, more than 100 suicide and implanted bomb blast attacks took place in the public proceedings, government offices, residential areas and other places of the city. Altogether 262 patients were enrolled in the study. The mean age of the patients was 31±14 years. The shrapnel inflicted wounds were present on to the upper limb in 24 patients and the lower limb in 50. CONCLUSION: Long bone fractures were the most common skeletal injuries. The fractures were complicated by penetrating fragments and nails which result in post operative infections and prolonged hospital stay.

Impact of rituximab and IPI on survival in diffuse large B cell lymphoma patients treated at a tertiary level cancer centre in Pakistan: a single-centre experience

To determine the impact of Rituximab and international prognostic index score on survival in diffuse large B-cell lymphoma patients. The retrospective study was conducted at Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, from January to May 2013 and comprised record of patients with diffuse large B-cell lymphoma who were treated from 2007 to 2010. Baseline international prognostic index score, stage at presentation were noted and the records were divided into two groups A and B on the basis of the type of chemotherapy. SPSS 19 was used for statistical analysis. Of the 93 patients in the study whose records were reviewed, 54[58%] were men. Overall median age was 43 years [range: 18-76]. Stages at presentation were stage-I 14 [15.1%], stage-II 41 [44.1%], stage-III 20 [21.5%] and stage-IV 18 [19.4%]. International prognostic index risk categorisation was low risk 59[63.4%], low intermediate risk 23[24.7%], high intermediate risk 10[10.8%] and high risk 1[1.1%]. There were 31[33%] patients in Group A and 62[67%] in Group B. Median follow-up was 3.9 years [range: 1.2-6.1]. Overall survival at 4 years was 66.4%; for Group A 65.3% and for Group B 66.7% [p<0.4]. On the basis of risk categories, overall survival was statistically significant [p<0.001] between the groups. International prognostic index risk categorisation had statistically significant impact on survival. However, there was no evidence of a significant survival benefit between types of chemotherapy. Further controlled trials are needed in this regard

Secondary malignant melanoma in primary mediastinal germ cell tumour

Secondary transformation in Germ Cell Tumours [GCT] is an extremely rare event. We report here a case of malignant melanoma arising in primary mediastinal GCT. A young male presented with new onset dyspnoea and a mediastinal mass. As serum alpha fetoprotein was raised, a diagnosis of primary mediastinal GCT was made. He achieved remission with standard chemotherapy and resection of the mass. After a year, he relapsed with widespread disease which on work-up revealed malignant melanoma. As examination for cutaneous melanoma was unremarkable, a diagnosis of mediastinal GCT with secondary transformation to melanoma was made. Exact origin of melanoma in GCTs is unknown, but these may occur from transformation of dermal elements or de-differentiation of germ cells to melanomas. Before making such a diagnosis, search for primary cutaneous melanoma is mandatory. No clear guidelines exist in literature for the treatment of secondary melanomas, so current management guidelines for cutaneous melanoma may be followed

Primary anal mucinous adenocarcinoma: a case series

Primary mucinous adenocarcinoma is a rare malignancy of the anus [3% of anal cancers], the pathogenesis of which is better understood by immunohistochemistry. We reviewed cases of primary mucinous adenocarcinoma of the anus from 2000 to 2009 in the Hepatogastroenterology Department of the University Hospital Centre of Marrakech. Three cases were identified who were males with the mean age of 68 years, and presented with a chronic anal fistula. Two cases had anal pain. Clinical examination revealed multiple fistulae in two cases with a secretion simulating 'cooked grains of tapioca'. Diagnosis was confirmed by histopathology and immunohistochemical profile [CK7 positive/CK20 negative]. Imaging revealed a retro-rectal collection with thickening of the anal wall without metastasis [two cases]. One patient underwent abdominoperinal resection without recurrence

New face of female sex work in Pakistan: need for innovative interventions

The prime objective of this paper is to contextualize the socio-economic and environmental factors contributing to and resulting from behaviours and practices of FSWs for transmission of STI/HIV infections. Information on these independent predictors is the key to design health systems related interventions for minimizing risks and vulnerabilities of FSWs. In the bio-behavioural survey, 545 FSWs were recruited for the quantitative component and 13 in-depth interviews were completed for qualitative arm. Data was collected on socio-economic characteristics, sexual interactions, marital relationship, violence and harassment and reproductive and sexual health. Most FSWs are illiterate [n=345, 64%], married]n=490, 91%],having children [n=462, 98%] living with their families [n=478, 91%] sell sex part-time during the day at kothie khana's1, small hotels in the locality. The mean age at first intercourse was reported to be 16 years, yet a significant proportion had had sexual contact before the age of 15 [39%] with someone other than their husband [37%]; the experience was perceived [unwanted] [40%] or even [forced] [5%]. The high contraception rate [64%] especially condom use [54%] reported in the quantitative arm of the study was not validated during in-depth interviews due to client preferences. Abortion is used as a frequent method [58%] of contraception, assisted by locally available midwives or dais[2]. A sizeabie proportion reported experiencing STI symptoms [n=317, 63%] for which informal healthcare providers were accessed. Most common perpetuators were husbands [66%] for physical violence and police [43%] for sexual abuse. Female sex trade in Pakistan is mainly part-time by married women who sell sex due to lack of education, skilled training and formal employment resulting from gender disparities. Standardized reproductive and sexual healthcare interventions, involving informal healthcare sector would improve reproductive health indicators, yet socio-economic and gender disparities demand long-term multi-sectoral structural strategies

Tuberculous appendicitis

Gastrointestinal tuberculosis is quite rare, representing only 3% of all extrapulmonary cases. Involvement of the appendix is rare, only occurring in about 1% of cases. It is usually secondary to tuberculosis elsewhere in the abdomen. A prompt diagnosis depends on a high index of suspicion as clinical signs may be nonspecific and microbiological confirmation is difficult. Histopathologic examination is often the only way to reach a diagnosis and to establish specific antibiotic therapy. In these cases, due to the absence of specific symptoms and signs, the diagnosis is delayed until after surgery

Calcified liver hydatid cyst compressing the gall bladder

A 48-year-old male patient was admitted to suffering from hydatid disease located in the gall bladder. Although Morocco remains an endemic area for echinococcosis, this presentation of the disease was rare. The pericyst was tightly attached to the liver. Complete pericystectomy with cholecystectomy was done. Histopathology confirmed the presence of a calcified hydatid cyst of the gall bladder. Perioperative adjuvant medical therapy with albendazole was administered. After a 2-year follow-up, no recurrence occurred

Cancer registration in Basrah 2005: preliminary results.

Cancer is a disease which shows significant variation with time and across geographical entities. In Basrah, Iraq, despite the widespread impression that cancer is increasing, researchers are not yet able to draw clear boundaries as to the extent of cancer and its determinants. In this paper, we make a start in that direction; the aim was to measure as accurately as possible the incidence of cancer (all types) in Basrah, to assess age specific incidence rates and to map the cases across different areas of the governorate. For this purpose we compiled data on every accessible case of cancer. The cancer registry in Basrah was used as the prime source of data on newly diagnosed cancer cases, supported by three other sources: the Cancer Registration Section at the Department of Pathology and Forensic Medicine, College of Medicine, University of Basrah; the Oncology Centre at Al-Sadr Teaching Hospital; and the Oncology Ward in Basrah Maternity and Child Hospital. Other minor sources were also utilized. Information on cases from these sources was subjected to meticulous verification regarding repetition, place of residence and other potential errors. The overall incidence rate was 74.3/100,000 population with a higher rate for females (80.5/100,000) than for males (68.1/100,000). The results indicate clear increase in registered cancer cases with increasing age. The lowest incidence rate was among females aged 5-14 years (10.5/100,000) and the highest was among males aged 65 years and above (660.2/100,000). The results show no major variation in the annual incidence rates of cancer in different areas of Basrah governorate. This finding may suggest a common exposure to cancer risk factors. To reach sound conclusions about extent and determinants of cancer in Basrah, immense multi-spectrum efforts are now needed.

Blood lead level among children in Basrah

A cross sectional study to assess Blood Lead Levels [BLLs] among children in Basrah was carried out during July 2005. The study included children 1-6 years old attending three selected primary health care centres located at different socioeconomic areas in Basrah [representing both rural and urban communities]. Two of the health centres are located in the city centre, one in a relatively high socioeconomic area [Al-Razi health centre] and the second in low socioeconomic area [Al-Seef health centre]. The third health centre included in the study is located in Abul-Khasib district. The questionnaire method was used in collecting information regarding socioeconomic factors that may be related to environmental exposure to lead, and a blood sample was taken from each child to measure the blood lead level. The BLLs among children in this study ranged between 1 and 65 microg/dL [mean +/- SD, 11.59 +/- 9.1 microg/dL]. Overall, 40.4% of children had elevated blood lead levels >/= 10 mg/dL]. The mean BLL was significantly higher for children who live in rural or in urban low socioeconomic area than that for children living in urban high socioeconomic area. Age above 2 years was significantly associated with elevated BLLs

Work-related allergic disorders among flour mill workers

A cross-sectional comparative study was carried out to study the prevalence of occupational allergic disorders among flour mill workers. In this study the flour mill workers from three major flour mill industries in Basrah [study group] were compared to non exposed group from diary products and pepsi cola industries [comparative group]. The results showed that the prevalence of work-related allergic conditions as reported by workers and diagnosed by one of the investigators was significantly higher among the study group than that in the comparison group

Cancer mortality in Basrah

This study aimed at determining the burden of cancer as a cause of death in Basrah over three selected years; namely 1989, 1997 and 2005. All death registries in Basrah city, Districts and sub districts were used as sources of information for data compiling. Every death recorded in the three years was checked for cause of death and all cases for which any type of cancer written as the cause of death were identified. Data related to age, sex, place of residence, type of cancer, place where death was certified and year of death were obtained. In addition, the numbers of total deaths due to all causes in each year were also recorded. The results indicate a total of 297 deaths in 1989, 499 deaths in 1997 and 649 deaths in 2005 could be attributed to cancer. Regarding sex distribution of deaths, slightly more deaths occurred in males [53.8%] than in females [46.2%] with significant rise of cancer in females in 2005. Cancer as a cause of death represents about 5% of all deaths with some degree of increase in 1997 and 2005 as compared to 1989, but no major change in the cancer specific death rates among different years. Geographically, the distribution shows significant but not substantial variation with years. The mean age of dead persons was similar in the three years. The leading cancer deaths were those of lung, urinary bladder, blood, breast, lymphomas and CNS. The overall risk of death is not much different in different years except for a slight increase in 1997 and 2005 in comparison to 1989. Most cancers show stable or slightly fluctuating level of risk of death with time. Slight rise in the risk of death may be noticed in cancers of CNS, blood [leukemia], Bones, lymphomas and Colon-rectum. The researchers suggest that the stable level of mortality could reflect some improvement in treatment based on early diagnosis of many cancers. A study covering at least ten years is highly recommended to establish more sound time trend in cancer mortality

Haematological changes among divers

Diving as a job, exposes individuals to a variety of environmental stresses not often encountered in other types of activities. These stresses lead to changes in many organ systems in the body of divers including haemopoietic system. No previous study was carried out in Iraq to examine the changes in haematological parameters among divers and the association between the diving environmental factors and these changes. This is a cross-sectional comparative study with a practical component. Eighty divers and 160 non-divers from the Iraqi Navy Force were included. Twenty-five divers were exposed to 2.5 ATA [Absolute Atmosphere] pressure for 15 minutes in a hyper baric chamber. All the studied haematological parameters, which were evaluated, including WBC count, RBC count, Hb concentration, PCV, MCV, MCH, MCHC, platelet count, MPV, and ESR were found to be different in divers as compared to non-divers. The MCV, PCV, MCH, platelet count, were significantly lower in divers. While Hb, and MCHC values were lower in divers but without a statistical significant difference, In addition, the mean RBC count, MPV, and ESR were significantly higher in divers. While WBC count was not significantly higher in divers. The study confirmed the previous findings of other studies, which indicate that diving has an effect on the haemopoietic system. The need to introduce haematological investigations as part of the pre employment check-up of divers, as -well as periodic investigations of divers are recommended

Partial hydatidiform mole

A case of partial hydatidiform mole is presented, occurring in a young primiparous woman after natural conception. She presented with incomplete miscarriage. Histological diagnosis of partial mole was made. Failure of beta HCG to fall resulted in the start of chemotherapy. WHO scoring placed her in low risk group. In spite of the low risk, she required third line chemotherapy for complete eradication of disease