Ischaemic stroke as the first presentation of occult squamous cell cancer

A 39 years old female presented with sudden onset of left sided weakness and CT scan brain confirmed an ischaemic stroke. Extensive investigations looking for the underlying cause were un-rewarding. She presented few days later with confusion and fever and was found to have multiple new cerebral infarcts, disseminated intravascular coagulation, rectal mass and liver metastases. Biopsy of metastatic liver lesion identified the primary tumour to be of squamous cell origin. Such a rare presentation as ischaemic stroke of a very rare squamous cell carcinoma of rectum has not been reported before

Effect of low lead exposure on gestational age, birth weight and premature rupture of the membrane

To find out the effect of prenatal exposure to low lead from cosmetics on gestational age, premature rupture of the membrane and birth weight. The study was carried out in the mountainous Aseer region, Southwest of Saudi Arabia where the air is thought to be clean and free of lead pollution due to the absence of petroleum smelting and other heavy industries. The region is famous as a holiday resort for tourists from Arabia and the gulf countries. All 176 pregnant women included in the study were of singleton pregnancies of gestational age 27 weeks or more who attended the antenatal outpatient clinic of the main maternity hospital. On the day of delivery 4 milliliters of venous blood from each singleton parturient was placed in a heparinized non-silica containing tube and stored at -20[degree symbol]C prior to analysis. Ninety-four [70.1%] women out of 134 had maternal blood lead concentration < 200 micro g/L and only 40 women had > 200 micro.g/L The mean difference in gestational age was 10.5 days, showing a non significant difference [P=0.152]. Ninety-three women [72.7%] out of a total of 128 who had blood lead concentration <200 micro g/L gave birth to infants weighing an average of 2.87 kg while 35 women who had blood lead level > 200 microg/L gave birth to infants weighing an average of 2.99 kg. The mean difference was 0.12 kg which is non-significant [P=0.261]. Regarding premature rupture of the membrane a total of 127 women with maternal blood lead levels above 200 microg/L showed no significant differences [P=0.64]. The Chi-square test of the relationship between the birth weight [kg] and the levels of blood lead below 150 micro g/L was not significant while the relationship between the birth weight [kg] and the levels of blood lead above 200 micro g/L resulted in very slight differences in the values of infants' birth weight. The detected low lead exposures from cosmetics does not produce statistically significant effects on the three pregnancy outcomes; gestational age, premature rupture of the membrane or birth weight. However, the importance of low lead exposure from the 100% lead sulfide eye cosmetic [kohl] is emphasized

Maternal and umbilical cord blood lead level in Abha maternity hospital, southern Saudi Arbia

To determine maternal and umbilical cord blood lead levels in the main maternity hospital in Southern Saudi Arabia, and to identify the possible source of lead. Whole blood [4 m1] was collected from a total of 172 pregnant ladies and similarly from the cords on the day of delivery. Blood lead concentration of both maternal and umbilical cord was measured using atomic absorption spectrophotometry. Personal interviews of the mothers was conducted to identify the possible sources of lead. The mean concentration of lead in maternal and cord blood were 112.8 +/- 7.84 and 82.38 +/- 5.52 micro.g/L, respectively. There was a direct relationship between maternal and umbilical cord blood lead level [p<0.001]. Our results of personal interviews indicate that lead-containing cosmetic khol is the most likely source of lead in the blood of pregnant females