Cervical cancer prevention in Bahrain: Review

Cervical cancer is estimated as the second most common cause of death worldwide from cancer in women. Approximately 650 women die from this cancer every day; half-million are diagnosed each year. Until recently, the few available reports on the prevalence of cancer from the Arabian Gulf Council States [GCC] were suggestive that the incidence of uterine cancer in general was less common compared with those reported from western country. Cancer registries in the GCC States in the last five years indicate that uterine cancer has moved to the third on the list of leading causes of cancer in the region. Among a population of 1,025, 000 in the kingdom of Bahrain, it is estimated that 10-15 new cases of cervical cancer are diagnosed each year [2001-2007], and approximately 4-6 deaths from this disease per annum. There is an evidence of a gradual increase in the incidence of cervical cancer compared with the figures two decades ago. The ratio of endometrial compared with cervical cancer was 1:2 but the two incidences are presently reversed. Cytology screening for uterine cancer was started in Bahrain in 1971, which soon was integrated in postnatal and in gynecological clinics. Recently successful program of public health screening was introduced against breast cancer in Bahrain; it is imperative that a similar program of national screening against uterine and cervical cancer combined with a national campaign for immunization of adolescent girls against human papilloma virus be integrated in the program and thus reducing the mortality from these two leading causes of cancer death among women. In this article a review of definitions, prevalence and history of cervical cytology service in Bahrain will be presented. Contemporary concepts of cervical cytology, new standard of care and current practice guidelines in screening and prevention will be reviewed. Finally, a discussion on the ways and means of improving the existing cytology and prevention programs in Bahrain will be discussed

Chronic non puerperal inversion of uterus

Inversion of the uterus is a rare clinical problem. It occurs either as an obstetric emergency or as a gynecological complication where it is a diagnostic challenge. A rare case of non- puerperal inversion, caused by fundal leiomyoma, was encountered in a-59- year old woman resulting in severe vaginal bleeding. It was thought initially to be a large pedunculated fibroid polyp, but it was discovered to be associated with inversion during surgery. She was treated with total hysterectomy using an abdominal and vaginal approach

Alloimmune cytopenia part I hemolytic disease of the fetus and the newborn [HDFN]

One of the most dramatic advances of modern medicine has been the discovery and development of diagnostic methods, treatment and prophylaxis of hemolytic disease of the fetus and the newbom [HDFN]. In a few decades, the field has progressed from a complete lack of understanding of the condition to a detailed grasp and understanding of the molecular and immunological bases of the disease. These advances have in turn culminated in the development of prophylaxis and the near total elimination of its morbidity. In this review, we shall briefly cover the history and progress of developments of this condition and presents the new concepts in the classification and nomenclature of alloimmune cytopenia of pregnancy. We will also provide a short account on advances in the pathophysiology, treatment and prevention of this condition. A review of developments in management will be discussed together with highlights of health care issues of women with alloimmune cytopenia

Alloimmune cytopenia: part II ; alloimmune thrombocytopenia, and neutropenia alloimmune thrombocytopenia

Feto-maternal alloinmmune thrombocytopenia and neutropenia occurs when the mother produces antibodies against a platelet or a neutrophil alloantigen that the fetus has inherited from the father. As a result, there is destruction of the fetal platelets or the neutrophil according to the condition and result in a reduction in their numbers. Reduction in the platelets can cause intrauterine fetal bleeding or bleeding after birth. In severe cases, this bleeding may lead to long lasting disabilities. In the case of neonatal neutropenia the reduction of the neutrophils will increase the susceptibility to serious infectious. Current advances in management attempts at the prevention of thrombocytopenia and neutropenia in the fetus. This includes administration of intravenous immunoglobulin corticosteroids, or intrauterine transfusion of antigen-compatible platelets or neutrophils to the fetus. The management is costly and requires specialized labs and skilled perinatal and neonatal care