Rhinoscleroma: a clinicopathological study from the Gulf region.

INTRODUCTION: Rhinoscleroma is a chronic progressive inflammatory disease of the upper respiratory tract. We report a clinicopathological series from the Gulf region. METHODS: The clinical and pathological features of patients diagnosed with rhinoscleroma at three main hospitals in Saudi Arabia and Bahrain over a 20-year period are presented. Archived glass slides and paraffin blocks from these patients were retrieved from the pathology files for review. Special stains were performed whenever indicated. Biopsy material and clinical data from 25 patients formed the basis of this study. RESULTS: Most of the patients were young females with a median age of 24 years. The nose was involved in all cases with frequent extension to other parts of the upper respiratory tract. The provisional clinical diagnoses included syphilis, midline granuloma and malignancy. The histological differential diagnoses included leprosy, malakoplakia and metastatic renal cell carcinoma. CONCLUSION: Rhinoscleroma is rare in Saudi Arabia and Bahrain. Awareness of possible clinical presentations and early diagnosis will significantly reduce the morbidity caused by this disease.

Oesophageal cancer in Bahrain.

ABSTRACT Data from all 148 cases of oesophageal cancer in Bahrain during 1952-99 were analysed according to patient sex and age and site and histological pattern of tumour, and compared with other Gulf countries. In Bahrain, oesophageal cancer accounted for 2.6% of malignant neoplasms. The female:male ratio was 1.8:1, and the majority of patients were > or =51 years and < or =70 years of age. The lower and upper third of the oesophagus were the most and least frequently involved sites, respectively. Squamous carcinoma (males) and adenocarcinoma (females) were the main histological types. There is varying consistency between these data and those of other Gulf countries having similar anthropological and demographic profiles. A prospective study may help to better understand the aetiology of the disease and inform preventive policies.

Oesophageal cancer in Bahrain

Data from all 148 cases of oesophageal cancer in Bahrain during 1952-99 were analysed according to patient sex and age and site and histological pattern of tumour, and compared with other Gulf countries. In Bahrain, oesophageal cancer accounted for 2.6% of malignant neoplasms. The female:male ratio was 1.8:1, and the majority of patients were >/=51 years and </=70 years of age. The lower and upper third of the oesophagus were the most and least frequently involved sites, respectively. Squamous carcinoma [males] and adenocarcinoma [females] were the main histological types. There is varying consistency between these data and those of other Gulf countries having similar anthropological and demographic profiles. A prospective study may help to better underst and the aetiology of the disease and inform preventive policies

Primary dissecting hepatic artery aneurysm in pregnancy.

A 32-year-old 32 weeks pregnant primigravida presented with acute abdomen and died 13 h later. She was normotensive during her antenatal period and on admission. At postmortem, a primary dissecting aneurysm of the main hepatic artery extending into its intrahepatic right branch was found. The cause of the dissection was presumably pregnancy-related.

Hemoglobinopathies and glucose-6-phosphate dehydrogenase deficiency in hospital births in Bahrain.

In view of the high prevalence of clinical cases of sickle cell anemia, hemoglobin-H-disease and glucose-6-phosphate dehydrogenase deficiency in the archipelago of the State of Bahrain, a cord blood screening study was undertaken over a 15 month period (October 1984 to December 1985) to determine the gene frequency of these diseases. All the state hospitals participated in this study and a total of 10,327 cord blood samples obtained from babies born to Bahraini parents were analyzed. These presented over 80% of all neonates born in the country during the study period. The phenotypes detected included: AF, AF-Barts, SFA and SFA-Barts. Homozygous sickle cell disease was detected in 2.1%, and in 11.2%, the sickle cell trait was present. The incidence of alpha-thalassemia gene based on elevated Bart's hemoglobin was 24.3% in these neonates. The incidence of G6PD-deficiency was as high as 20.9%. Availability of these statistics has enabled the authorities in the Ministry of Health in collaboration with the National Hereditary Anemia Society to plan a comprehensive health care program for patients with hereditary diseases and their families.

Secondary chordoma of the mandible.

The first case of primary sacrococcygeal chordoma metastasising to the mandible and presenting with obstructed labour is described. The pathological features of this tumour, its clinical presentation and management are discussed.

The function of the gallbladder as a lesser biliary circulation.

The function of the gallbladder is questioned in a hypothesis postulating that all bile which enters this reservoir is totally absorbed to the liver and none of it flows back to the cystic duct and duodenum. Cholecystokinesis is believed to increase and maintain a gradient of intravesical pressure which increases the filtration pressure necessary for the absorption of bile to the liver. The absorption is through the tributaries of the cystic veins, the ducts of Luschka and Rokitansky-Aschoff sinuses. Although the hypothesis lacks experimental support, it is based on a number of anatomical, histological, physiological, radiological and surgical observations.

Rhinosporidiosis in Bahrain, Arabian Gulf.

Rhinosporidiosis occurred in Bahrain only in Indian expatriate workers who had the disease in India before coming to Bahrain. The pathological and clinical aspects of the disease as well as its possible health hazard in Bahrain are discussed.

The short term effects of a supra-lethal dose of irradiation and changes in the environmental temperature on the growth of tail bones of the mouse.

The growth and histological features of the tail vertebrae of young mice (31 day old) were observed for 48 h after transference from a cold (8 degrees) to a hot (33 degrees) environment. Some mice received a massive (5000 rad) dose of X-ray to the tail. Less than 2 h after housing the animals in the heat there was a period of very rapid growth lasting 12 h after which time growth slowed but was still much greater than the animals in the cold. Animals whose tails were irradiated (and also put in the heat) showed the same rapid growth for 12 h but after this growth ceased. Evidence is provided which shows that the initial rapid growth in the heat is due to an abnormal increase in the linear dimensions of the hypertrophic cells of the growth plate. This is most marked in the hot-irradiated animals.

The effects of changes in the environmental temperature on the growth of tail bones in the mouse.

The tails of baby mice grow rapidly and independently of environmental temperature because they are kept warm by their mothers. After weaning, at approximately 3 weeks of age, tail growth is strictly related to environmental temperatures. During the first 2 weeks after weaning growth rates of 1.2-1.4 mm/day/tail were seen at 33 degrees and a maximum of 2.43 mm/day/tail was observed in one group kept at 36 degrees. Animals kept at 8 degrees or 4 degrees showed tail growth rates of 0.4 mm/day or less. However, the tails of animals transferred from either hot to cold or cold to hot during their first 2 weeks after weaning immediately grew at the same rate as those of animals kept in these conditions continuously, thus indicating that heat was acting directly on bone growth. The tails of animals kept continuously in the hot environment at 33 degrees completed their growth early so that their growth rate fell below that of controls after about 3 weeks of treatment (when they were 6-7 weeks old) and below that of "cold" animals after about 4 weeks (7-8 weeks old). The tails of the "control" and "cold" animals grew slowly for a very long time, 150-195 days. Even so, because of the very rapid early growth of tails in the hot environment, their final length was always greater than either the "control" or "cold" tails.

The effects of changes in the environmental temperature on the growth of bone in the mouse. Radiological and morphological study.

Groups of 25-day-old mice were kept at 33 degrees, 21 degrees and 8 degrees for up to 195 days. Measurements and observations on length, width, gross and microscopic structure using radiological and histological techniques were made on central and peripheral bones. Tail bones of animals kept at 33 degrees grew longer and faster than those in the cold but also closed their epiphyses earlier. The diaphyses of "hot" vertebrae were cylindrical but "cold" and "control" vertebrae were of narrower diameter in their mid-diaphyses compared to their distal ends producing a "waisted" appearance. The "cold" vertebrae in addition showed thickened cortical bone and more woven bone in the marrow cavity. These changes were interpreted as indicating a disproportionate sensitivity of external apposition of cortical bone to cold. The internal remodelling of bone as the vertebrae grew was only affected by the coldest conditions and accounted for the thickened cortex and denser woven bone in the marrow cavity.