Primary myelodysplastic syndrome in Jordan: a single-centre experience

Study of the disease patterns and clinical evaluation of myelodysplastic syndrome [MDS]. A retrospective analysis was carried out on 85 patients, with MDS who were followed up over a period of 23 years at Jordan University Hospital, Amman, Jordan. Cases were analyzed according to the French, American and British Classification. Of the 85 patients, 42 [49.4%] were females and 43 [50%] males; mean age was 59 +/- 19 years [range 18-88]. Most subtypes found in patients were refractory anemia [RA] in 27 [31.8%] and RA with excess blasts [RAEB] in 28 [32.9%]. Adverse prognostic indicators were RAEB subtype and requirement for blood transfusion. Our findings showed that MDSs appeared at a younger age and tended to be of the aggressive subtype. Chronic myelomonocytic leukemia subtype seemed to appear dominantly in men

Chronic intussusception in children

Chronic intussusception in three children is reported. Review of the literature is given as well as a discussion of the variation in the course of intussusception. Its symptomatology, modes of presentation, and methods of diagnosis are reviewed. The clinical significance of interserosal adhesions has been evaluated and shown to be of no etiologic importance. These adhesions are the result of chronicity and recurrence ultimately leading to resection rather than reduction of the chronic intussusception. Based on the duration of symptoms, intussusception is classified into three variants: 1. Acute intussusception with its triad of abdominal pain, vomiting, and bloody mucous discharge per rectum. 2. Subacute intussusception in which the symptoms continue from four days to as long as two weeks prior to therapy[13]. Chronic intussusception which continues for more than 14 days prior to therapy[1,2].This classification is totally dependent on the duration of symptoms which should not be the only criterion to determine the ultimate outcome of the individual patient[3] In acute intussusception, the clinical picture is so typical that its diagnosis may frequently be made over the telephone[4]. In contrast, the clinical picture in subacute and chronic intussusception is vague and poorly recognized. This atypical vague clinical picture, together with the chronicity of the symptoms are responsible for delay in the diagnosis in the majority of cases[5]. Interserosal adhesions have been observed by many authors, but their clinical significance has yet to be verified. In this paper, we report three cases in which interserosal adhesions have prevented operative reduction of the intussusception and hence primary resection was the only choice