Molecular detection of Leishmania species in human and animals from cutaneous leishmaniasis endemic areas of Waziristan, Khyber Pakhtunkhwa, Pakistan

Objectives:To detect Leishmania species in human patients, animal reservoirs and Phlebotomus sandflies in Waziristan, Pakistan.Methods:Tissue smears and aspirates from 448 cutaneous leishmaniasis (CL) suspected patients were analyzed. To sort out role of the reservoir hosts, skin scrapings, spleen and liver samples from 104 rodents were collected. Furthermore, buffy coat samples were obtained from 60 domestic animals. Sandflies were also trapped. All human, animals and sandfly samples were tested by microscopy, kinetoplastic PCR and internal transcribed spacer 1 (ITS1) PCR followed by restriction fragment length polymorphism for detection of Leishmania species.Results:An overall prevalence of 3.83% and 5.21% through microscopy and ITS1 PCR respectively was found. However, the statistically non-significant correlation was found between area, gender, and number of lesions. The presence of rodents, sandflies, domestic animals and internally displaced people increased the risk of CL. Using ITS1-PCR-RFLP, Leishmania tropica (L. tropica) was confirmed in 106 samples while 25 of the isolates were diagnosed as Leishmania major (L. major). Similarly, 3/104 rodents were positive for L. major and 14 pools of DNA samples containing Phlebotomus sergenti sandflies were positive for L. tropica. None of samples from domestic animals were positive for leishmaniasis.Conclusions:In the present study, L. tropica and L. major are found to be the main causative agents of CL in study area. Movement of internally displaced people from CL endemic areas presents a risk for nearby CL free areas. To the best of our knowledge, we report for the first time L. major infection in rodents (Rattus rattus) and L. tropica in Phlebotomus sergenti sandflies trapped in Waziristan, Pakistan.

Unani concept of jaundice and its management

Jaundice is a disease, which is characterized by yellow staining of the skin and sclera by abnormally high blood levels of the bile pigment bilirubin. The yellowing extends to other tissues and body fluids. Bilirubin, a tetrapyrrole pigment, is a brokendown product of heme [ferroprotoporphyrin IX]. About 70 to 80% of the 250 to 300 mg of bilirubin produced each day is derived from the breakdown of hemoglobin in senescent red blood cells. The remainder comes from prematurely destroyed erythroid cells in bone marrow and from the turnover of hemoproteins such as myoglobin and crytochromes found in tissues throughout the body

The philosophy of Unani system of medicine is based on the humoral theory. The theory was central theme to the teachings of Hippocrates and Galen and it became the dominant theory in Europe for many centuries. As per the Unani system of medicine, the cause of jaundice is the accumulation of yellow or black humours in the cutaneous tissue and its nearby tissues. Based upon the nature of discoloration jaundice is classified into two types: Yellow Jaundice and Black Jaundice

In the allopathic system there lack of effective drugs for jaundice. Some hepatoprotective drugs are available but many side effects are associated with them due to their chemical composition. In Unani system of medicine, this disease can be cured with completely natural and noninvasive methods

Present study was conducted in MIJ Tibbia Unani Medical College, Mumbai in the year 2007. Nine patients suffering from sciatica due to lumbar spine osteoarthritis were selected. Their clinical examinations were conducted to diagnose the sciatica. The X-ray of the lumbar spine was also taken to confirm the diagnosis of osteoarthritis of lumbar spines. Massage with Roghan-e-Surkh on the lower back and affected lower limb for 8-10 minutes daily for 14 days caused a significant reduction in the symptoms and signs of sciatica after the completion of study

Theft of Unani formulations for the treatment of various diseases is not new but it is a matter of concern since last couple of decades. However, information regarding Unani Medicine exists in Arabic, Urdu, Persian and other regional languages. The examiners of different national/ international patent offices are unable to understand this information as prior art, before granting patents due to language barrier

Some of the examples of case studies of misappropriation of Pistacia lentiscus Linn is discussed in which the indication of Pistacia lentiscus Linn i.e. anti-inflammatory [mentioned in Unani classical texts] has been claimed for wrong patent

Miraculous effects of honey

Honey is an ancient remedy for the treatment of infected wounds, which has recently been 'rediscovered' by the medical profession, particularly where conventional modern therapeutic agents are failing. There are now many published reports describing the effectiveness of honey in rapidly clearing infection from wounds, with no adverse effects to show the healing process. There is also some evidence to suggest that honey may actively promote healing. In laboratory studies, it has been shown to have an antimicrobial action against a broad spectrum of bacteria and fungi. However, further research is needed to optimize the effective use of this agent in clinical practice

Coincidence of trisomy 18 and Robertsonian [13; 14]

This case report presents a coincidence of trisomy 18 and balanced Robertsonian translocation [13;14]. Aneuploidy was suspected based on anomalies detected in ultrasound scan and confirmed with karyotype. In a 31 years-old healthy woman with a history of one miscarriage, second trimester ultrasound scan reported IUGR [<3rd percentile] with normal amniotic fluid, bilateral choroid plexus cysts, suspicious agenesis of corpus callosum and clenched hands. Amniocentesis was performed and karyotype was 46xx,der[13;14] [q10;q10],+18. Maternal karyotype was 45xx,der[13;14][q10;q10]. Pregnancy was continued due to legal limitation for termination after 20 weeks gestation. Delivery was done at 36 weeks gestation. A female newborn was borned and a physical feature was hypotonia, small mouth, prominent occiput, low-set and posteriorly rotated ears, clenched hands with overlapping fingers and rocker bottom feet. Ultrasound scan and echocardiography detected agenesis of corpus callosum and VSD, ASD, PDA and cardiomegaly. These features are typical of trisomy 18. Balanced Robertsonian translocation usually has no phenotypic expression. Genetic counseling and prenatal diagnosis for future pregnancy was recommended

Increased nuchal translucency and pregnancy outcome

To study the outcome of cases with nuchal translucency [NT] >/= 95th centile in the first trimester of pregnancy. This cross sectional study was performed at Iranian Fetal Medicine Foundation [FMF] between January 2009 and December 2011. Totally, 186 cases with NT >/= 95th centile who attended for the first trimester screening were studied. All cases with increased NT including those with normal karyotype were followed up with anomaly scan at 18-22 weeks and fetal echocardiography at 22-24 weeks. Pregnancy outcome was extracted from delivery records and pediatrics notes and telephone interviews. Of screened cases, 186 fetuses had an NT >/= 95th centile, of them 19.8% were abnormal karyotype, including 29 cases of trisomy 21, three of trisomy 18, two of trisomy 13, three of Turner syndrome. 77.8% did not show any abnormalities on follow-up examinations. 4.6% of cases were found to have malformation antenatally and 4% cases postnatally. 11.4% women elected termination of pregnancy without further follow up. There were 4.6% fetal loss and 1.3% hydrops fetalis. In this unselected population, the study showed one out of four fetuses with enlarged NT had an adverse pregnancy outcome [miscarriage, fetal loss, and fetal abnormalities], however the chance of having a normal child after exclusion of chromosomal abnormalities and adverse pregnancy outcome was 95%

Assessing the Nutritional Status of Children with Leukemia from Hospitals in Kuala Lumpur

A cross-sectional study was carried out to evaluate the nutritional status of 51 subjects with leukemia aged 4 to 12 years from the Haematology & Oncology Paediatric Ward, Universiti Kebangsaan Malaysia Medical Centre (PPUKM) and the Paediatric Institute of Kuala Lumpur. Nutritional status was assessed using anthropometric measurements, biochemical and haematological parameters. Subjects comprised 32 (62.7%) males and 19 (27.3%) females. Most of the subjects (41.2%) were in the age group of 4 to 6 years. More than half of the children were Malays (70.6%) followed by Indians (15.7%) and Chinese (13.7%). The subjects were diagnosed as acute lymphoblastic leukemia (ALL) (84.3%) followed by acute myelogenous leukemia (AML) (13.7%) and chronic myelogenous leukemia (CML) (2.0%) respectively. Most of the children were in remission status (54.9%). Underweight (<-2 SD for weight-for-age) was observed in 37.3% of the children while 17.6% of them were stunted (<-2 SD for height-for-age), and sign(s) of malnutrition (<-2 SD) for mid upper arm circumference (MUAC)-for-age was observed in 15.7% of the subjects. Approximately 20.0% of the subjects were in the severe malnutrition category with respect to low serum albumin levels (<3.5g/dl). All subjects had hemoglobin levels of less than the normal range. While the results indicated no significant differences in the nutritional status of subjects with leukemia at different stages of treatment, it was observed that the prevalence of malnutrition was higher in children with newly diagnosed leukemia. Thus, the nutritional status of children with leukemia should be monitored closely as there is a likelihood of deterioration owing to the disease.

use of complementary and alternative therapies in Western Saudi Arabia

To examine the use of complementary and alternative therapies [CAT] in our region, particularly for children with chronic conditions, and explore contributing factors to their use. A prospective random sample of mothers visiting the out patient department of King Abdulaziz University Hospital in Jeddah, Saudi Arabia were identified from the 1st of June, 2006 to the 31st of May, 2008. A survey using a structured 50-item questionnaire was used to examine their demographics, child's medical problem, and the use of CAT. Seventy-nine mothers were interviewed, and their child's condition was acute in 47%, chronic, or recurrent in 53%, and treatable in 84%. Neurological complaints were reported in 25%. Thirty-three [42%] families used CAT in their child, mostly [57%] before seeking medical help. Religious and spiritual healing was used in 82%, oral, or topical preparations or herbs in 30%, and physical interventions in 21%. Factors associated with using CAT included child's age < 1 year [p = 0.008], less than high school education of the fathers [p = 0.01], chronic medical condition [p = 0.00008] or neurological disorder [p = 0009], and positive family history of using CAT [p < 0.0001]. Many parents refer to CAT typically before seeking medical help. Pediatricians should counsel and caution parents regarding the lack of studies demonstrating efficacy and safety of CAT in young children

[Effect of waste activated sludge pretreatment with ozone on the performance of aerobic digestion process]

A conventional treatment to stabilize the excess activated sludge is the aerobic digestion process but due to long aeration time, it requires large equipments as well as high investment cost. Because of high oxidation potential of ozone, sludge ozonation enhances stabilization rate and reduces sludge treatment equipment size and cost. Therefore, in this study, the combination of pretreatment with ozone and aerobic digestion processes were investigated. The experimental set-up consisted of an ozone generator and ozonation reactor with the total volume of 2 L. Removal percentages of TSS, VS, total and soluble COD, HPC, fecal coliform and settable solids were measured in integrated process compared to the single ones. The results of this research indicated that the aerobic digestion of waste activated sludge during 10 days could reduce 38% of volatile solids and thus obtaining the EPA standard. Also, the results of combined ozonation and aerobic digestion revealed that the pre-ozonation at 0.25 g O3/g TS or 0.5 g O3/g TS with 6 or 3 days aeration, respectively, could achieve 38% reduction in VS and hence the requirement set by EPA. Therefore, integration of pre-ozonation with aerobic digestion can significantly reduce the digestion time to attain the standards. The sludge pre-ozonation with low dose of ozone due to solids disintegration can enhance the efficiency of aerobic digestion in waste activated sludge stabilization, and consequently decrease size of equipments, air requirement, investment and probably operation cost

Study of the effeciency of volcanic rock bed filters in enhanced ammonia and fecal coliform removal from khoy wastewater treatment plant

Ammonia and fecal coliform removal from wastewater is of high necessity because of its inappropriate impact on environment where wastewater accumulates. Aerated lagoons as well as polishing ponds would not be able to decrease ammonia and fecal coliforms in an efficient way. Different procedures are usually applied for the removal of ammonia and fecal coliform in wastewater treatment plants. In this study, effluent of polishing pond in wastewater treatment plant of Khoy in North-West Azerbaijan with three different loading flow rates [0.3, 0.6, 0.9 m[3]/m[3].d] was entered into the rock filter with volcanic rock bed, rock diameter size of which was 50 mm. To determine the efficiency of rock filter in any loading flow rates, 10 samples of influent and effluent were taken. The results showed that mean of effluent ammonia level changed from 16.8 to 4.8 mg/1 and effluent fecal coliform from 1.9xl0[4] MPN/l00ml to SJxl0[3] MPN/lOOml. Rock filter efficiency for Ammonia and fecal coliform removal of pond effluent were 71.4% and 70% respectively. Ammonia and fecal coliform decreased in all loading flow rates but in the first rate changes were more remarkable than the two other rates. As loading flow rate increased, removal efficiency decreased. This is probably due to low hydraulic retention time that resulted in decreasing nitrification. Thus it is concluded that rock filter here presented has better efficiency than what were used in similar studies

prospective randomized controlled trial of two regimens of vaginal misoprostol in second trimester termination of pregnancy

The search continues for a safe effective and cheap method for mid-trimester termination of pregnancy. Misoprostol is a strong contender in this respect. The dose schedule is still not fixed. The objective of this study was to compare the efficacy and adverse effects of two dose regimens of vaginal misoprostol for second trimester termination. Prospective randomized double blind controlled trial was undertaken in 162 women at 14-24 weeks gestation in a teaching hospital. Subjects were randomized to receive either regime A: 400 microg of intra vaginal misoprostol every 6h, or regime B: 200 microg of intravaginal misoprostol every 6h. The main outcome measure was the success rate at 24h, total dose required, induction-abortion interval and adverse effects. Data was analyzed by student's t-test, Mann-whitney U-test, the chi-squared test or Fisher's exact test. There was a significant difference in the success rate at 24 and 48hr [regime A: 74% and 97.5%; regime B: 61.7% and 88.9% P=0.016 and 0.029 respectively] and in the mean induction abortion interval [14 Vs 20h, P=0.01] Mean Misoprostol requirement was significantly higher for regime A [731 microg +/- 362 microg vs. 531microg +/- 357 microgm, P=0.001]. Use of 400 microg vaginal misoprostol is superior to 200 microg vaginal misoprostol for second trimester abortion

[ effect of mgso4 to lidocaien in Spinal Anesthesia for cesarean patients]

Background: spinal Anesthesia has numerous indications in lower abdomen surgery, but duration of analgesia and anesthesia is one of the limitations of this method. Lidocaine-the most common drug in Spinal anesthesia causes a short term anesthesia and analgesia which is lower than one hour. Today different kinds of drugs are for enhancing onset increasing intensity and analgesia duration in spinal anesthesia such as magnesium sulfate which it blocks NMDA receptors

Materials and Methods: in the randomized double blind clinical trial study, 80 patients candidate for first cesarean surgery in Shariati Hospital were divided into two groups. In control group 2ml Lidocaine 5% + 0.5ml sterile water was injected and in the study group 2ml Lidocaine 5% + 0.5ml magnesium sulfate 10% without preservative was injected. The patients were immediately tilted to head up position

Results: level of sensory block was evaluated by pin-prick test in midclavicular line. Analgesia duration was considered from the time of injection until the patient's request for analgesic or complaining of pain. Anesthesia level was T6 in most patients. Analgesic duration in case group was between 160.8+49.1 min, in control group was 113.3+7.3 min. That is statistically significant [p=0.001]

Conclusions: when Mgso4 is added to lidocaine in spinal anesthesia, the duration of analgesia is increased significantly [P<0.05]. This increase of duration of analgesia was not accompanied by increase of side effects. Based on the results of our study, complications such as nausea, vomiting, dyspnea during the surgery and in the recovery room, hypotension during surgery were not statistically different between two groups [p>0.05]

effect of subcutaneous injection of l% lidocaine in the lumbosacral region on labor pain

Labor pain is considered as one of the most important causes of stress for the parturient. The aim of this study was to compare the effects of subcutaneous injection of 1% lidocaine with normal saline in the lumbosacral region on labor pain reduction and their complications. Seventy para 2, term ASA I parturient were enrolled in a randomized clinical trial and randomly allocated to lidocaine group [injection of 0.5 ml 1% lidocaine or control group [injection of 0.5 ml normal saline]. Drugs were injected subcutaneously at 4 points in lumbosacral region [Michaelis' rhomboid] by an insulin syringe. Labor pain was assessed by visual analogue scale 15, 40 and 60 minutes after injections. There were no significant differences among age, systolic and diastolic blood pressures and fetal or maternal age between groups. The pain intensities in lidocaine group were significantly lower 15, 40 and 60 minutes after injections compared with normal saline group. There was no significant difference between normal saline pain intensity after injection compared with before injection but in lidocaine group all the post-injection pain intensities were significantly lower compared to pre-injection. There -were no cases of hemodynamic instability or fetal complications. Subcutaneous injection of 1% lidocaine in the Michaelis rhomboid region is accompanied by minimal hemodynamic changes or complications and significant reduction in labor pain

histiocytose a cellules de Langerhans pulmonaire de l' adulte

Pulmonary Langerhans cell histiocytosis belongs to the spectrum of the Langerhans' cell histiocytosis. The common point is tissue infiltration by Langerhans' cell granuloma. But the pulmonary type occurs predominantly in young adults and is associated with tobacco. The most frequently encountered symptoms are cough and dyspnea. Twenty-five to 35% of the cases are incidental findings. 20% of cases present with extra-thoracic lesions including skin, bone and hypothalamo-pituitary axis. On scanning images the lung parenchyma is infiltrated at the beginning by stellar nodules of less than 10 mm, which evolve either gradually to form cysts or towards remission, spontaneous or induced by the treatment. With pulmonary function testing, the two types of anomalies [obstruction and restriction] are observed. The reduction in diffusing capacity observed in 60 to 90% of the cases reflects the pulmonary vascular involvement. Detec-tion of more than 5% of CD-la cells in bronchiolo-alveolar lavage fluid and transbronchial biopsies are not sensitive. Treatment is controversial and includes primarily smoking cessation and corticosteroid therapy at the early nodular stage

Frequency of benign and preinvasive breast diseases

The importance of benign proliferative and non-invasive breast lesions as a risk factor preceding the development of invasive mammary carcinoma is well established in the literature. The objective of this study is to estimate the magnitude of benign proliferative diseases as well as mammary intra-epithelial neoplasia in the Western region of the Kingdom of Saudi Arabia [KSA], in order to encourage nationwide breast cancer screening programs for early detection of the high risk proliferative and pre-invasive breast lesions. We reviewed histopathology records [reports and slides of selected cases] of 2129 breast cases including mastectomies and breast biopsies from January 1985 to December 2002 in King Abdul-Aziz University Hospital and King Khalid National Guard Hospital, Jeddah, KSA. All the cases and diagnosis are listed and reclassified using systematized nomenclature of medicine [SNOMED] coding system and then regrouped based on the associated risk factors of developing breast carcinoma. Two thousand one hundred and twenty-nine reports were reviewed and 2343 diagnosis were identified as some cases had more than one diagnosis. The total of benign diagnosis were 1504 after exclusion of malignant diagnosis [558], normal breast tissue, gynecomastia, and non-mammary tissue [281]. All diagnosis [1504] were reclassified based on anatomical prognostic indicators into non-proliferative [1283/1504], proliferative [140/1504], atypical hyperplasia [AH] [8/1504], and carcinoma in situ [CIS] [73/1504]. We compare our findings with the literature and we found that the percentage of benign non-proliferative diagnosis was 85.3% that is higher than the literature 69.7%. Proliferative diseases were 9.3% and atypical hyperplasia was 0.5%, which was lower than the literature 26.2% and 3.6%. On the other hand, CIS diagnosis was 4.9%, which is much higher than the reported literature 1.7%. The study findings could be explained on the basis of higher prevalence of benign breast lesions in our population, or it is related to the number of cases studied, or to the diagnostic criteria followed initially. These findings should encourage us to refine our diagnostic criteria of proliferative diseases, AH and CIS [mammary intraepithelial neoplasia [MIN]]. In addition, we strongly encourage a breast cancer screening program, nationwide

Profile of pop smear cytology in the Western region of Saudi Arabia

Cervical carcinoma is an important womens health problem in the Western countries. There are only few published data on this disease in the Kingdom of Saudi Arabia [KSA]. The aim of this study is to evaluate the abnormal cytological entities detected by cervical Pap smear in Western region of KSA and to discuss the importance of Pap smears screening programs. Retrospective review of all the cervical smears present at the King Abdul-Aziz University Hospital, Jeddah, KSA from 1984 to 2000. The reports of 22089 smears were retrieved from the file of the pathology department. There were 368 [1.66%] abnormal Pap smears out of 22089 smears. Out of these 368 abnormal Pap smears there were 62 [16.8%, mean age 37 year] cervical intraepithelial neoplasia grade 1, 45 [12.2%, mean age 38.5] cervical intraepithelial neoplasia grade 2, 27 [7.3%, mean age 40.5] cervical intraepithelial neoplasia grade 3, 22 [6%, mean age 38.5] positive for malignant cells, 36 [9.8%, mean age 40.5] atypical endocervical cells, 88 [23.9%, mean age 39] atypical squamous cells, 9 [2.4%, mean age 40.5] squamous metaplasia with atypia, 26 [7.1%, mean age 45] squamous cell carcinoma, 6 [1.6%, mean age 36.5] reparative atypia, 2 [5.4% mean age 35] herpes virus changes, 19 [5.1%, mean age 37.5] human papilloma virus changes, 5 [1.4%, mean age 55] adenocarcinoma of endometrium, and 7 [1.9%, men age 43.5] adenocarcinoma of endocervix. Cervical intraepithelial neoplasia and invasive cervical carcinoma are less common in KSA compared to the Western countries, however, cervical screening programs are necessary nationwide to estimate the actual magnitude of cervical carcinoma and its precursor lesions

Histopathological and Immunohistochemical Characteristics of Primary Renal Primitive neuroectodermal Tumor

We report a 32-year-old male who presented with huge [17x10.5x5 cm] right kidney with metastasis in the liver and retroperitoneal lymph nodes. Histological, detailed immunohistochemical studies and electron microscopic examinations were performed. Microscopy revealed small to intermediate sized cells with hyperchromatic nuclei, scanty cytoplasm, abundant mitosis with no pseudorossete formation. Immunohistochemical study revealed positive staining of the tumor cells for S100, neurofilaments, neuron specific enolase, vimentin and myoglobin. Primitive neuroectodermal tumors are rare malignant round cell tumors of the kidney. A correct diagnosis can be made on light microscopic features, and by immunohistochemically positive staining for more than one neural marker. This neoplasm should be differentiated from other renal neoplasms composed of small round cells

Analysis of false positive and false negative cytological diagnosis of breast lesions

To study the reasons for interpretive errors in false negative and false positive diagnosis of breast carcinoma on fine needle aspiration cytology material. We reviewed only those cases in which cytohistological discrepancies were found, where the cytologic material was abnormal and to some extent misinterpreted or both. There was only one false negative case [false negative fraction 0.32%] proved histologically as ductal carcinoma and four false positive cases [false positive fraction 1.2%]; 2 fibroadenoma; 1 fibrocystic disease; and 1 stromal fibrosis. Smears of the two false positive fibroadenoma cases showed very high cellularity, overcrowded clusters and frequent stripped nuclei. The fibrocystic case showed tight clusters of apocrine cells and sheets of loosely aggregated macrophages that were over interpreted. Smears of the false negative ductal carcinoma was hypocellular overall, and the cells showed minimal nuclear pleomorphism. Overcrowded clusters and hypercellular smears should be carefully assessed for uniformity of cells and detailed nuclear and cytomorphological features. If the full-blown malignant cytomorphological changes are not visible, a diagnosis of suspicious or inconclusive should be made and frozen section recommended before surgery. Hypocellularity and relatively nuclear monomorphism are the reasons for failure to diagnose malignant breast lesions. Careful attention should be paid to extreme nuclear monomorphism and absence of naked bipolar cells. A cytologically atypical or suspicious diagnosis together with positive radiological and clinical findings should suggest a diagnosis of malignancy

Morphological profile of testicular biopsies associated with infertility

Based on testicular biopsies examined at King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia, the goal of this retrospective study is identification and systemization of the histopathological patterns of testicular biopsies received especially for investigating male infertility and further more to compare the findings of our study with similar studies in the literature. Our study group consisted of 164 testicular biopsies, which were examined in the Department of Histopathology at King Abdulaziz University Hospital in Jeddah, over a period of 10 years. The data was retrieved and analyzed and the available histopathological results were grouped into 8 different morphological categories. The findings of the biopsies associated with infertility were complied as follows: 45 [27%] showed normal spermatogenesis of which 15% showed active spermatogenesis associated with duct obstruction, 41 [25%] with hypospermatogenesis, 39 [24%] showed end stage tubular sclerosis with interstitial fibrosis, 27 [16.5%] with germ cell aplasia [with or without focal spermatogenesis], 11 [7%] biopsies showed maturation arrest and only on biopsy were associated with karyotpic abnormalities. A higher percentage of hypospermatogenesis and end stage tubular sclerosis with interstitial fibrosis was noticed in this study when compared with the other studies reported from Saudi Arabia. A high percentage [27%] of the biopsies show normal spermatogenesis with or without duct obstruction

Pattern of breast diseases in a teaching hospital in Jeddah, Saudi Arabia

The aim of this case series study is to evaluate the outline and pattern of male and female breast diseases in Saudi Arabia. Also to compare 8 studies of literature discussing the profile of malignant and benign female breast diseases in the Kingdom. We hope that this study will assist us to appreciate the prototype breast diseases in our region. Our study consisted of 1084 consecutive male and female breast lesions. Data on these specimens, received in the time frame of 15 years between January 1984 and March 2000, was retrieved from the records of the laboratory. The outline of breast lesions were tabulated and classified into inflammatory, benign and malignant lesions. In female breasts, benign lesions comprised 57% of all lesions [mean age 28.5], most commonly reported being fibroadenoma 47%, fibrocystic disease 22% and fibroadenosis 14%. Malignant lesions comprised 32.5% of all lesions [mean age 48.49], most commonly reported being ductal carcinoma 88% and lobular carcinoma 4.5%. Inflammatory lesions comprised 11% of all lesions [mean age 35.0], most commonly reported lesion being chronic mastitis 31% and ductectasia 19%. Male benign lesions comprised 55 cases [87%]. Eight cases [13%] of malignant lesions, 6 ductal carcinomas and 2 metastatic adenocarcinomas, were also identified. The rates for female breast lesions varied in different studies but benign fibroadenoma constituted the most common breast lesion and secondly ductal carcinoma. The mean age for malignant lesion in 7 different studies came to be 44.05. In the male breast, carcinomas constituted 3% of all breast carcinomas. Gynecomastia being the most common male breast lesion constituting 54%