Thyrotropin hormone level as predictor for papillary thyroid carcinoma in patients with thyroid nodule

To assess thyrotropin hormone level as predictor of papillary thyroid carcinoma. A Retrospective Study. Salmaniya Medical Complex, Bahrain. Biochemical results of thyroid function, FNAB and histological reports of 319 patients [277 females and 42 males] were retrospectively evaluated. Thirty-seven [11.6%] patients had papillary thyroid carcinoma [PTC] and 282 [88.4%] patients had benign multinodular goiter [BMNG]. Twenty-eight [10.1%] had PTC in females on final histopathology diagnosis and 9 [21.4%] in males, both genders had thyroid nodule, [P<0.05]. The mean TSH level was 5.85 mlU/L [ +/- 20.6]. The mean TSH level was significantly higher in patient with PTC than those having benign thyroid disease [BTD] [P<0.0001]. Subgroups analysis revealed no statistically significant difference among patients harboring PTC and those diagnosed as BTD. High incidence of PTC is associated with TSH above the clinical reference range. It is recommended that patients with TSH in the upper reference range should be subjected to FNAB for possible carcinoma

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

Lymph node involvement in plasmacytoma

A case of plasmacytoma of the spine with multiple sites of involvement at presentation is reported. The sites involved were T4, T5, T9 levels and the jugular foramen. The patient had no evidence of bone marrow involvement or paraprotein either in the serum or urine. Resections of the tumour from T4 and T5 levels was performed, followed by radiation therapy. The patient developed a recurrence seven and half years after the initial presentation. The recurrence occurred at the right clavicle and in the soft tissue around it. This was followed by multiple recurrences at the same site with involvement of the supraclavicular lymphnodes inspite of aggressive chemotherapy, radiation therapy and autologous stem cell transplant. Fine Needle Aspiration cytology and histology showed a typical plasma cell neoplasm with characterstic nuclear features, immunohistochemistry was compatible with a plasmacytoma

Histiocytic cytophagic panniculitis [a case report]

A fatal case of cytophagic panniculitis is reported in a 9 year old Omani girl. The patient died of generalised haemorrhage and liver failure. The pathogenesis of the condition is discussed