Hepatocellular carcinoma in Qatar

The main aim of this study was to report and discuss epidemiological, etiological, type of treatment and data on survival of the patients with each mode of treatment using available data for patients with hepatocellular carcinoma [HCC] who have been diagnosed at Hamad Medical Corporation during the period March 2004-December 2010 inclusive. Retrospective analysis of 150 patient's data had been done, including demographic, epidemiological, etiological disease status assessment with child Pugh criteria, modes of treatment and treatment related outcome. Patient's various characteristics such as demographic, epidemiological, and other clinical characteristics were summarized using an appropriate descriptive statistics. Univariate Kaplan-Meier survival curve analysis was performed to estimate overall and group wise survival at different time points. Furthermore, the log-rank test was applied to determine any statistical difference in survival among various subgroups. In addition, the multivariate Cox regression method was used to assess the significant effects of various prognostic factors on outcome survival time. The mean age of the studied HCC patients was 58.8 years [31-87years] with a male: female ratio of 3:1 [76% Male 24% Female]. There were 48 [32%] Qatari and 102 [62%] non- Qatari patients. The underlying etiology HCV was the most common [45%] similar to Western European countries, HBV in [27%], alcoholic liver disease only in 6 [4%], Child-Pugh assessment was A in [33%], B in [37%] and C in [30%], nearly half of the patients [53%] were in advanced stage and had palliative treatment, the other half had chemoembolization in [17%], systemic therapy sorafenib in [13%], surgery [liver resection or transplantation] in [12%] and local ablation in [5%]. HCC is more common in males [ratio M: F 3:1]. HCV is the most common underlying cause, similar to the pattern in western European countries. The survivals in our patient were comparable to other studies reported in the literature. Patients who had chemoembolization had the longest median survival [Median = 27 months, 95% CI [20.27- 33.72]. Majority of cases [53%] were diagnosed at advanced stage. To improve the outcome of treatment of HCC patients, the number of early and very early stage diagnosis should be increased by improving the implementation and effectiveness of the strategic screening program

Immuno-compromised patient with bilateral pulmonary infiltrates [docetaxel induced hypersensitivity interstitial pneumonitis]

A middle-aged lady admitted with metastatic breast cancer developed acute respiratory problems with bilateral pulmonary infiltrates after five days of cytotoxic administration, as an acute adverse drug reaction to the docetaxel that resolved completely after high dosage of dexamethasone

Tuberculosis presenting as immune thrombocytopenia: a case report and review of the literature

Various hematological abnormalities commonly occur in active tuberculosis [TB] but thrombocytopenia is exceedingly rare and immune thrombocytopenic purpura [ITP] is reported in only a few cases. A 28-year-old male presented with thrombocytopenia-induced epistaxis and generalized purpura that did not respond to intravenous immunoglobulin but did resolve after antituberculous treatment. The characteristics of this rarely documented association are reviewed