Round cell vaginal malignant melanoma. A rare entity

Malignant melanoma is predominantly a skin disease but in rare instances it may occur at other sites. A vaginal melanoma is a rare clinical entity and the round cell type is an uncommon variant. Although the present case was clinically diagnosed as a urethral caruncle, on histopathological examination and immunostaining it was diagnosed as a round cell pigmented malignant melanoma. The patient refused radical surgery and was given a full course radiotherapy treatment but died a year later. Malignant vaginal melanoma carries a very poor prognosis even when lesion is localised at the time of presentation. The five-year survival rate ranges from 10-20% with the prognosis being influenced by tumour size. A tumour size >/= 3cm has a poor prognosis. Age, mitotic count, stage, and location of the lesion do not influence survival rates

Prevalence of helicobacter pylori infection among patients with dyspepsia in South-Western Saudi Arabia

Helicobacter pylori [H. pylori] infection is a major cause of various upper gastrointestinal [UGI] disorders. The aim of this study was to determine the prevalence of H. pylori among patients with dyspepsia. A prospective study was carried out in the Gastroenterology Division, King Fahd Central Hospital, Gizan, Kingdom of Saudi Arabia from January 1995 to December 1998. Four hundred and eighty-eight patients with dyspepsia were consecutively examined using the UGI endoscopy during a 4-year period. Data analyzed included demographic details, clinical indications for the examination, endoscopic findings and results of the histopathologic assessment for H. pylori. Overall, H. pylori were detected in 268 [54.9%] of the gastric biopsies from 488 patients [322 males and 166 females, aged 13-90 years]. Helicobacter pylori infection was present in 140 [60.1%] of 253 patients with chronic gastritis diagnosed by endoscopy and in 49 [62.8%] of 78 patients with duodenal ulcers [DU]. The rate in DU patients was significantly higher than the rate [43.6%] in patients with normal endoscopic findings [odds ratio [OR]=2.18, 95% confidence interval [CI] 1.02-4.70; p=0.04]. Of 455 biopsies with histologic gastritis, 268 [OR=58.9%, 95% CI 54.2-63.4] were positive for H. pylori and all specimens [n=33] with no histological evidence of gastritis were negative. The well-described association of H. pylori with DU and non-ulcer dyspepsia was confirmed by our study. However, the rate of H. pylori in our patients was at the lower end of the range [50-80%], which was previously reported among largely urban populations in Saudi Arabia suggests differences in the prevalence of H. pylori-infections between urbanized and rural populations. Helicobacter pylori negative peptic ulcer disease remains an important entity that may be associated with the use of non-steroidal anti inflammatory drugs and in our environment, the habitual chewing of qat leaves [catha edulis]