Acquired pure megakaryocytic aplasia successfully treated with cyclosporine

Acquired pure megakaryocytic aplasia is a rare hematological disorder characterized by thrombocytopenia with absent or markedly reduced megakaryocytes in the bone marrow. We report a case of a 25-year-old male diagnosed as acquired pure megakaryocytic aplasia. Treatment with prednisone and intravenous immunoglobulin failed, but he was successfully treated with cyclosporine, with complete remission after 90 days and normal platelet count maintained thereafter

The role of vitamin D deficiency and osteoporosis in breast cancer

Aim Epidemiological studies suggest an association between vitamin D and calcium intake and breast cancer. The aim of this study was to determine the association of breast cancer with vitamin D deficiency and osteoporosis according to menopausal status and to examine vitamin D and bone mineral density (BMD) levels in breast cancer patients. Methods This was an observational cohort hospital-based study. It included 635 patients with breast cancer. Socio-demographic information, type of consanguinity, menopause status, medical history, lifestyle habits, dietary intake, BMD measurements and vitamin D levels were collected. Descriptive and univariate analyses were performed. Results Of the studied patients, 36.1% were Qataris, 63.9% non-Qatari Arabs, 40% premenopausal women, 20.9% university graduates and 37.2% housewives. Overall, 31.8% of breast cancer women were affected with osteopenia/osteoporosis. Vitamin D deficiency (10.7% vs. 7.9%) and severe vitamin D insufficiency (39.2% vs. 32.5%) were higher in postmenopausal women than premenopausal women (P < 0.001). Low physical activity (< 30 min/day) was observed among vitamin D deficient (46.8%) and osteoporotic (45%) women. Dietary intake of vitamin D was significantly lower in vitamin D deficient women; these included dairy products (33.1%), milk (38.6%), seafood (39.6%), (P < 0.001) and for osteoporotic women, dairy products (46%), calcium (21.3%), milk (36.1%), yoghurt (37.6%), cheese (37.6%) and sea food (34.7%) (P < 0.001). Conclusion The present study findings revealed a high prevalence of vitamin D deficiency and osteoporosis in breast cancer patients. Also, the dietary intake of vitamin D and calcium was significantly lower in breast cancer women

An assessment of reliability and validity of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 among breast cancer patients in Qatar

Introduction: Breast cancer has been the most common cancer type that affects women worldwide and subsequent treatment is oftenassociated with considerable psychological and quality of life (QoL). Aim: This study aimed to assess psychometric properties of theArabic version of the European Organization for Research and Treatment of Cancer (EORTC) general QoL questionnaire (QLQ‑C30)for breast cancer patients in Qatar. Materials and Methods: This is a cross‑sectional hospital‑based study conducted on 678 breastcancer patients using Arabic version of the EORTC QLQ‑C30 tool. Results: The mean age of women was 47.7 ± 10.2 years and33.4% of women had consanguineous parents. Six subscales out of the nine met the standards of reliability with coefficientsranging from 0.55 to 0.89. The mean score of all functioning scales was high >55. Advanced breast cancer stages of III–IV hadhigher symptomatic scores significantly than those in early stages for the physical function, cognitive, fatigue, insomnia, appetiteloss, constipation, and financial difficulties. Correlation coefficients between each item ranged from –0.113 to 0.960, and item21 (tense) and item 23 (irritable) had strongest negative correlations with their corresponding emotional functioning subscale,whereas items 29 (physical condition) and 30 (overall QoL) had the strongest positive correlation with Global Health/QoL subscale.Item 6 (limited work) showed a higher correlation with fatigue (r = 0.749). Likewise, item 19 (pain interfered with daily activities)of the pain subscale had higher correlations with physical functioning, role functioning, and fatigue subscales. Conclusion: QatariArabic version of the EORTC QLQ‑C30 showed acceptable psychometric properties, which is a reliable and valid instrument, thatcan be used by oncologists

Assessing Breast Cancer Risk Estimates Based on the Gail Model and Its Predictors in Qatari Women

Background: The Gail model is the most widely used breast cancer risk assessment tool. An accurate assessment of individual’s breast cancer risk is very important for prevention of the disease and for the health care providers to make decision on taking chemoprevention for high-risk women in clinical practice in Qatar. Aim: To assess the breast cancer risk among Arab women population in Qatar using the Gail model and provide a global comparison of risk assessment. Subjects and Methods: In this cross-sectional study of 1488 women (aged 35 years and older), we used the Gail Risk Assessment Tool to assess the risk of developing breast cancer. Sociodemographic features such as age, lifestyle habits, body mass index, breast-feeding duration, consanguinity among parents, and family history of breast cancer were considered as possible risks. Results: The mean age of the study population was 47.8 ± 10.8 years. Qatari women and Arab women constituted 64.7% and 35.3% of the study population, respectively. The mean 5-year and lifetime breast cancer risks were 1.12 ± 0.52 and 10.57 ± 3.1, respectively. Consanguineous marriage among parents was seen in 30.6% of participants. We found a relationship between the 5-year and lifetime risks of breast cancer and variables such as age, age at menarche, gravidity, parity, body mass index, family history of cancer, menopause age, occupation, and level of education. The linear regression analysis identified the predictors for breast cancer in women such as age, age at menarche, age of first birth, family history and age of menopausal were considered the strong predictors and significant contributing risk factors for breast cancer after adjusting for ethnicity, parity and other variables. Conclusion: The current study is the first to evaluate the performance of the Gail model for Arab women population in the Gulf Cooperation Council. Gail model is an appropriate breast cancer risk assessment tool for female population in Qatar

Does consanguinity lead to decreased incidence of breast cancer?

Background In the Middle East region, consanguinity remains to be a central feature where it has shown an increasing trend Breast cancer is an extremely complex disease, characterized by a progressive multistep process caused by interactions of both environmental and genetic factors AIM The aim of this study was to examine the possible effect of consanguinity on the risk of breast cancer in a population with a high rate of consanguinity and find the associated risk-modifying factors Subjects and methods The study included 167 Qatari and other Arab expatriates women with breast cancer and 341 age and ethnicity matched control women A questionnaire that included the socio-demographic information, type of consanguinity, medical history, life style habits, dietary intake and tumor grade was designed to collect, the information of cases and controls A total number of 214 breast cancer patients were approached and 167 cases completed the questionnaires with a response rate of 78% Of the 417 healthy women who agreed to participate in this study. 341 responded to the questionnaire (81 8%) Results The study revealed that the rate of parental consanguinity was lower in breast cancer patients (24%) than in controls (32 3%) (p = 0 062) Female controls were slightly younger (46 5 +/- 11 9) than breast cancer patients (48 4 +/- 10.7) Breast cancer incidence was significantly higher in Qatari women (34 1%) compared to other Arab women (65 9%) (p = 0 034) A significant difference was noted only in occupation of the studied women between cases and controls (p < 0 001) Overweight (46 7%) and obesity (32 9%) were significantly higher in female breast cancer patients compared to controls (p = 0 028) Overall, the mean coefficient of consanguinity was lower in breast cancer patients (0 014) than in controls (0 018) (p = 0 0125) Family history of breast cancer was significantly more often in breast cancer patients (14 4%) than in controls (6 2%) (p = 0 002) However, the family history of breast cancer was more often positive in cases of non-consanguineous parents (15 7%) than cases of consanguineous parents (10 0%) Conclusion The present study revealed the lack of association between of breast cancer and the parental consanguinity in Arab women residing in Qatar The family history of breast cancer and the body mass index (BMI) are highly associated with breast cancer (C) 2010 Elsevier Ltd. All rights reserve

Do We Need to Maximise the Breast Cancer Screening Awareness?: Experience with an Endogamous Society with High Fertility

Background: In the State of Qatar, breast cancer has become the most common form of cancer among women. The aim of this study was to explore knowledge, attitude and practice about breast cancer and to identify potential barriers to screening procedures among women. Methods: This multistage sampling cross sectional survey in primary health care centers and the outpatient department of the Women's Hospital in the State of Qatar targeted a representative sample of 1,200 Qatari women aged between 30 to 55 years of age during the period from December 2008 to April 2009. A total 1,002 subjects (83.5%) consented to participation. Face to face interviews were conducted with a designed questionnaire covering knowledge about breast cancer, attitudes and practices of breast cancer screening. Socio-demographic variables were included. Results: The majority of Qatari women demonstrated an adequate knowledge about breast cancer, with a significant relation to education status. Almost three quarters were aware that breast cancer is the most common cancer in women. A good proportion knew that nipple retraction (81.2%) and discharge of blood (74.6%) are warning signs. Of the studied Qatari women, 24.9% identified breast self examination, 23.3% clinical breast examination (CBE) and 22.5% mammography as methods for detection of breast cancer. The frequently reported barriers among the Qatari women were asking any doctor/nurse how to perform breast self examination (57.3%), embarrassment about CBE (53.3%) and fear of mammography results (54.9%). Univariate and multivariate logistic regression analysis showed that family history, level of education, living in an urban area and having medical check-ups when healthy were significant predictors for CBE and mammography. Conclusion: The study findings revealed that although Qatari women had adequate general knowledge about breast cancer, the screening rates for BSE, CBE and mammography were low, these being performed most frequently by young Qatari women with a higher level of education

Two Ocular Infections during Conventional Chemotherapy in a Patient with Acute Lymphoblastic Leukemia: A Case Report

Viral retinitis due to cytomegalovirus (CMV) infection is rare in patients with acute leukemia who did not receive hematopoietic stem cell transplantation. We report a case of CMV retinitis that developed in a 49-year-old patient with acute lymphoblastic leukemia. The patient was treated with salvage chemotherapy using a hyper-CVAD regimen and did not receive hematopoietic stem cell transplantation. The incidence of CMV retinitis in this subgroup of patients is not described in literature. He had a very complicated course during chemotherapy but was successfully treated, with preservation of visual acuity, and to date he is in complete remission. Interestingly, prior to CMV retinitis, the patient had been diagnosed with and treated for candida retinitis. This case shows the importance of eye examination and care in patients diagnosed with hematological malignancies