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Hepatic Vascular Variants in Hereditary Haemorrhagic Telangiectasia: Imaging findings. 遗传性出血性毛细血管扩张的肝血管变异
Q3 Medicine Pub Date : 2023-11-01 Epub Date: 2023-11-30 DOI: 10.18295/squmj.1.2023.011
Alamelu Alagappan, Biswajit Sahoo, Jain H Prakash, Manas K Panigrahi, Taraprasad Tripathy

Hereditary haemorrhagic telangiectasia (HHT) is an autosomal dominant disorder characterised by vascular dysplasia. Hepatic vascular malformations (VMs) range from small telangiectases to significant vascular shunting. Here we report two cases of HHT. Case 1 had diffuse ectasia of the hepatic artery along its intrahepatic and extrahepatic course with a hepatic arterial aneurysm. Case 2 presented with ileal and hepatic telangiectases. Knowledge of these vascular variants is indispensable for clinicians and radiologists in aiding diagnosis and surgical and interventional management.

遗传性出血性毛细血管扩张症(HHT)是一种常染色体显性遗传病,以血管发育不良为特征。肝血管畸形(vm)的范围从小的毛细血管扩张到明显的血管分流。我们在此报告两例HHT病例。病例1为肝动脉沿肝内及肝外扩散扩张伴肝动脉瘤。病例2表现为回肠和肝毛细血管扩张。这些血管变异的知识是必不可少的临床医生和放射科医生在辅助诊断和手术和介入管理。关键词:血管畸形,HHT,动静脉畸形,回肠毛细血管扩张。
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引用次数: 0
Is Forced Coughing Effective in Reducing Pain During Cervical Biopsy?: A systematic review and meta-analysis. 宫颈活检时强迫咳嗽是否有效减轻疼痛?
Q3 Medicine Pub Date : 2023-11-01 Epub Date: 2023-11-30 DOI: 10.18295/squmj.5.2023.026
Yassamine Ouerdane, Aya Abd Elmegeed, Mohammed Tarek, Imane Bakhtaoui, Ahmed K Awad, Nihal Al Riyami, Ahmed Saad

This review aimed to compare the potential analgesic effect of forced coughing (FC) with that of local anaesthetics (LA) or placebo during cervical biopsy. A total of 5 electronic databases-Scopus, PubMed, Web of Science, Cochrane Library and Google Scholar-were systematically searched from inception till March 2021. Data were extracted from 6 randomised controlled trials and analysed. During cervical biopsy, the overall effect favoured LA over FC (mean difference [MD] = 1.06, 95% confidence interval [CI]: 0.58 to 1.54; P <0.0001). Compared to no pain management, pooled data were comparable between the two groups (MD = -1.2, 95% CI: -3.35 to 0.94; P = 0.27). Procedure duration was significantly longer in the LA group than in the FC group (MD = -1.94, 95% CI: -2.47 to -1.41; P <0.00001). FC and LA are both useful pain-lowering modalities during cervical biopsy, depending on the setting and their availability.

我们的目的是比较宫颈活检时强迫咳嗽(FC)技术与局部麻醉(LA)或安慰剂的潜在镇痛效果。从成立到2021年3月,我们系统地检索了5个电子数据库;Scopus, PubMed, Web of Science, Cochrane Library, b谷歌Scholar。从6个随机对照试验中提取数据,并使用Review Manager软件进行分析。在宫颈活检中,LA组总体效果优于FC组(MD =1.06;95% CI [0.58 ~ 1.54];P < 0.0001)。另一方面,与无疼痛管理相比,两组间的汇总数据具有可比性(MD = -1.2;95% CI [-3.35 ~ 0.94];P = 0.27)。LA组手术时间明显长于FC组(MD = -1.94;95% CI [-2.47 ~ - 1.41];P < 0.00001)。根据设置和可用性,FC和LA在宫颈活检期间似乎是有用的镇痛方式。建议进一步研究。关键词:宫颈活检;阴道镜;强迫咳嗽;疼痛。
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引用次数: 0
Incidence of Optic Neuritis among Omani Patients with Multiple Sclerosis at the Sultan Qaboos University Hospital, Muscat, Oman. 阿曼马斯喀特苏丹卡布斯大学医院多发性硬化症患者视神经炎的发生率
Q3 Medicine Pub Date : 2023-11-01 Epub Date: 2023-11-30 DOI: 10.18295/squmj.5.2023.029
Fatma Alkharusi, Buthaina Sabt, Abdullah S Al-Mujaini

Objectives: Multiple sclerosis (MS) is a chronic, multifaceted, heterogeneous autoimmune disease, with optic neuritis (ON) being a common early manifestation among those with MS. This study aimed to estimate the incidence of ON among Omani patients with MS.

Methods: This retrospective cross-sectional study included all Omani patients diagnosed with MS at the Sultan Qaboos University Hospital, Muscat, Oman, between January 1991 and December 2019. The data were collected from the neurology registry and electronic medical records and analysed descriptively using univariant and multivariant statistical techniques.

Results: Out of the 185 patients diagnosed with MS during the study period, 170 were included in the analysis. The male-to-female ratio was 1:2 and the mean age was 28 years. The incidence of ON in the population was 28.8%, with 83.7% of ON patients presenting with relapse-remitting MS (RRMS). Overall, 28.6% of patients presented with O N as an initial manifestation of MS, whereas 42.8% developed ON at a later stage. Most patients (49.4%) were from higher-latitude regions of Oman such as Muscat and Al Batinah.

Conclusions: The incidence of both MS and ON increased over the study period. While the overall incidence was low in comparison with Western data, it was similar to the rates reported elsewhere in the Arabian Peninsula. Overall, ON was the most common manifestation of MS in the cohort, with younger female patients more frequently presenting with both MS and ON. A significant association was found between the RRMS subtype and ON presentation.

目的:多发性硬化症(MS)是一种慢性、多面性、异质性自身免疫性疾病,视神经炎(ON)是常见的早期表现。方法:这项回顾性横断面研究包括1991年1月至2019年12月在阿曼马斯喀特苏丹卡布斯大学医院诊断为多发性硬化症的所有阿曼患者。数据收集自神经病学登记处和电子病历。使用单变量和多变量统计技术对数据进行描述性分析。结果:在研究期间诊断为MS的185例患者中,有170例被纳入分析。男女比例为1:3,平均年龄28岁。ON在人群中的发病率为28.8%,其中83.7%的ON患者表现为复发-缓解型MS (RRMS)。总体而言,28.6%的患者在MS的初始表现为ON,而42.8%的患者在后期发展为ON。大多数患者(49.4%)来自阿曼高纬度地区,如马斯喀特和Al Batinah。结论:在研究期间,多发性硬化症和ON的发病率均有所增加。虽然与西方数据相比,总体发病率较低,但与阿拉伯半岛其他地方报告的发病率相似。总体而言,ON是该队列中MS最常见的表现,年轻女性患者更常同时出现MS和ON。RRMS亚型与ON表现有显著相关性。关键词:脱髓鞘疾病;视神经炎;多发性硬化;多发性硬化,复发缓解;发病率;流行病学;阿曼。
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引用次数: 0
The Burden of Human Parechoviruses Among Children in Oman: A retrospective study. 人类细小病毒对阿曼儿童的负担
Q3 Medicine Pub Date : 2023-11-01 Epub Date: 2023-11-30 DOI: 10.18295/squmj.5.2023.033
Aws Al-Farsi, Zaid Alhinai, Fatma Ba Alawi, Khuloud Al Maamari, Laila S Al Yazidi

Objectives: This study aimed to evaluate the burden, clinical and laboratory features and outcomes of human parechoviruses (HPeVs) infection among children in Oman.

Methods: This retrospective study included children (aged <18 years) with molecularly proven HPeV infection who were managed at Sultan Qaboos University Hospital, Muscat, Oman, between January 2017 and December 2019. Data were obtained from the patients' medical records and analysed to describe their demographics, clinical and laboratory features, management and outcomes.

Results: HPeV was detected in 61 patients, 44 (72%) of whom were males. The median age of these patients was nine months (interquartile range [IQR]: 6-15 months). HPeV was detected throughout the year without any significant peaks. Majority of the patients (n = 51, 84%) had co-infection with other viruses. Forty-eight (79%) children with HPeV infection required hospitalisation, and their median length of hospital stay was five days (IQR: 3-8 days). Ex-prematurity (n = 10, 16%) was the commonest comorbidity among this group. Fever (n = 41, 67%) and cough (n = 41, 67%) were the commonest presenting symptoms among the children. Two-thirds of the HPeV-infected children in this cohort were managed for lower respiratory tract infection; none was managed for meningitis. Gastroenteritis was not common in this cohort; only eight children had diarrhoea. All children made a full recovery.

Conclusion: HPeVs infection does not show a clear seasonality in Oman. Most of the children were aged <2 years and had a viral co-infection. The outcomes of HPeV infection were favourable, with no mortalities, but a thorough follow-up for neurological outcomes was lacking.

目的:研究苏丹卡布斯大学医院(SQUH)管理的儿童中人类细小病毒(HPeVs)感染的负担、临床和实验室特征以及结果。方法:这是一项对2017年1月至2019年12月期间在SQUH治疗的分子证实HPeV感染的儿童(<18岁)的回顾性研究。从患者的医疗记录中收集数据并进行分析,以描述人口统计学、临床和实验室特征、管理和结果。结果:61例患者检出HPeV,其中44例(72%)为男性。这些患者的中位年龄为9个月(IQR,6-15个月)。全年都检测到HPeV,没有任何显著的峰值。我们的大多数患者(51%;84%)与其他病毒共同感染。48名(79%)感染HPeV的儿童需要住院治疗,他们的中位住院时间为5天(IQR,3-8天)。早产(10;16%)是该组中最常见的合并症。发烧(41;67%)和咳嗽(41;67%)是这些儿童最常见的症状。该队列中三分之二的HPeV感染儿童接受了下呼吸道感染治疗,没有接受脑膜炎治疗。胃肠炎在我们的研究中并不常见,只有8名儿童腹泻。所有的孩子都完全康复了。结论:HPeVs在阿曼没有明显的季节性。大多数儿童年龄在2岁以下,有病毒共同感染。HPeVs的结果是有利的,没有死亡,但缺乏对神经系统结果的彻底随访。关键词:儿童;细小病毒;传染结果阿曼。
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引用次数: 0
Erythematous Plaque in the Left Axillary Region: A diagnostic challenge where dermoscopy can help. 左腋窝红斑斑块
Q3 Medicine Pub Date : 2023-11-01 Epub Date: 2023-11-30 DOI: 10.18295/squmj.5.2023.034
Maria Dolores Pegalajar-García, Jose Mellado, Ricardo Ruiz-Villaverde, Francisco J Navarro-Triviño
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引用次数: 0
Re: Guillain-Barré Syndrome Associated with SARS-CoV-2 in Two Paediatric Patients. 关于两名儿童患者的格林-巴利综合征与 SARS-CoV-2 有关。
Q3 Medicine Pub Date : 2023-11-01 Epub Date: 2023-11-30 DOI: 10.18295/squmj.11.2023.067
Sounira Mehri, Sinda Zarrouk, Josef Finsterer
NONE
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引用次数: 0
Erdheim-Chester Disease Presenting as Bilateral Facial Masses 厄德海姆-切斯特病表现为双侧面部肿块
Q3 Medicine Pub Date : 2023-10-19 DOI: 10.18295/squmj.10.2023.065
Asim Qureshi, Abdulaziz Bakathir, Fizza Qureshi, Amanullah Beg, Asem Shalaby
Erdheim-Chester disease (ECD) is a rare form of non-Langerhans cell histiocytosis with unknown etiology. It is recently recognized to be neoplastic with genetic mutations affecting the mitogen-activating protein kinase (MAPK) pathway. We here present a case of a 49-year-old female who initially presented in 2012 with bilateral facial masses to a tertiary care center. These were removed but later recurred over a period of ten years. She then presented with xanthelasmas, bone lesions, secondary infertility due to hypothalamic hypogonadism, diabetes insipidus, and Hashimoto’s hypothyroidism. The facial masses were biopsied, and they showed classic morphological features in the form of diffuse infiltration by foamy histiocytes, with scattered Touton type of giant cells, patchy lymphocytic infiltrates, and dense fibrosis. The presented ECD case is particularly interesting due to the recurrent bilateral facial masses. To the best of our knowledge, this is the first documented case in Oman. The patient is stable and is being followed up in the clinic. Keywords: Erdheim-Chester disease, Langerhans cell histiocytosis.
埃尔德海姆-切斯特病(ECD)是一种罕见的病因不明的非朗格汉斯细胞组织细胞增多症。最近被认为是一种影响丝裂原激活蛋白激酶(MAPK)途径的基因突变的肿瘤。我们在这里提出一个49岁的女性病例,她最初于2012年在三级保健中心提出双侧面部肿块。这些都被切除了,但后来在十年的时间里又复发了。她随后出现黄斑瘤、骨病变、下丘脑性腺功能减退、尿崩症和桥本氏甲状腺功能减退所致的继发性不孕。面部肿物活检显示典型形态学特征,泡沫组织细胞弥漫性浸润,散在的图顿巨细胞,斑片状淋巴细胞浸润,致密纤维化。由于复发的双侧面部肿块,本例的ECD病例特别有趣。据我们所知,这是阿曼第一例有记录的病例。患者情况稳定,正在诊所接受随访。关键词:Erdheim-Chester病;朗格汉斯细胞组织细胞增多症;
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引用次数: 0
Effectiveness of EMLA Cream in the Management of Arterio-Venous Fistula Needle Insertion Pain in Haemodialysis Patients EMLA乳膏治疗血液透析患者动静脉瘘针插入痛的疗效观察
Q3 Medicine Pub Date : 2023-10-19 DOI: 10.18295/squmj.10.2023.058
Hamid Al Shahri, Issa Al Salmi, Waleed Al Rajhi, Hamidreza Shemshaki
This systematic review is conducted to assess the effectiveness of EMLA-cream in the management of Arterio-Venous Fistula-AVF needle insertion pain in adult haemodialysis-HD patients compared with other alternative interventions. The main search was conducted in November 2020 and was updated on 5th December 2020. In the search strategy, keywords and synonyms were used, and multiple databases were searched with no date limitation to ensure a comprehensive search that would allocate all studies relevant to the review, and to minimize location bias. The following databases were explored: Joanna Briggs Institute (JBI), the International Prospective Register of Systematic Reviews (PROSPERO), Cochrane Library, and the Campbell Collaboration Library of Systematic Reviews. The keywords “EMLA cream”, “Arterio-Venous Fistula needle pain” and “hemodialysis patients” or “haemodialysis patient” were used for a scoping search in Google Scholar, whereas in the databases were ((“EMLA”) OR (“eutectic mixture of local anesthetic*) AND Arteriovenous*) OR “fistula needle* fistula cannula* and (“h#emodialysis patient OR * dialysis patient)). A total of 209 studies were found in this search and were filtered. Initially, any duplicated studies were removed, leaving 89 studies that were relevant to the inclusion and exclusion criteria. Two studies were included from the hand search. There were no studies identified in the grey literature or backward and forward chaining search. Following this initial filtration, the titles and abstracts of the remaining studies were reviewed and 76 were excluded. The full text of 15 studies was read in full and nine were excluded for the following reasons: three studies were focused on mixed participants, six studies used other interventions and one study was a duplicate paper with the same author and different title. Five studies were taken forward for critical appraisal. EMLA-cream is an effective management strategy in reducing AVF needle insertion pain among adult HD-patients. However, despite the positive effect of EMLA cream in reducing HD needle insertion pain, with fewer side effects, the findings should be considered with caution, as there are some limitations, and further research is required. Keywords: EMLA; Pain; Dialysis; Arterio-Venous Fistula
本系统综述旨在评估EMLA-cream治疗成人血液透析hd患者动静脉瘘- avf针插入痛的有效性,并与其他替代干预措施进行比较。主要搜索于2020年11月进行,并于2020年12月5日更新。在搜索策略中,使用关键词和同义词,并在没有日期限制的情况下搜索多个数据库,以确保全面的搜索,分配所有与综述相关的研究,并最大限度地减少位置偏差。以下数据库被探索:乔安娜布里格斯研究所(JBI),国际前瞻性系统评论登记册(PROSPERO),科克伦图书馆和坎贝尔系统评论合作图书馆。在Google Scholar中使用关键词“EMLA乳膏”、“动静脉瘘针痛”和“血液透析患者”或“血液透析患者”进行范围搜索,而在数据库中则是(“EMLA”)或(“局部麻醉剂共溶混合物*)和动静脉*)或“瘘针*瘘管*”和(“h#emodialysis患者或*透析患者))。在这次搜索中,总共发现了209项研究,并进行了筛选。最初,所有重复的研究都被删除,留下89项与纳入和排除标准相关的研究。从手检索中纳入了两项研究。在灰色文献或前后链检索中没有发现任何研究。在初步筛选之后,对剩余研究的标题和摘要进行了审查,并排除了76项研究。15项研究的全文被完整阅读,9项研究被排除,原因如下:3项研究集中在混合参与者身上,6项研究使用了其他干预措施,1项研究是同一作者不同标题的重复论文。提出了五项研究进行批判性评价。EMLA-cream是减少成人hd患者AVF针插入疼痛的有效管理策略。然而,尽管EMLA乳膏在减轻HD针扎痛方面具有积极作用,副作用较少,但研究结果仍应谨慎考虑,因为存在一定的局限性,需要进一步研究。 关键词:EMLA;疼痛;透析;动静脉瘘
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引用次数: 0
A Scoping Review of the Biological, Socioeconomic, and Environmental Determinants of Overweight and Obesity among Middle Eastern and Northern African Nationalities 中东和北非民族中超重和肥胖的生物学、社会经济和环境决定因素的范围综述
Q3 Medicine Pub Date : 2023-10-19 DOI: 10.18295/squmj.10.2023.059
Glenn FD Valdez, Muna Ajzoon, Noor Al Zuwameri
Globally, and particularly in the Middle East and North Africa (MENA) region, obesity and overweight have become serious public health concerns. The objective of this scoping review is to identify and summarize the available data on the determinants of overweight and obesity among MENA nationalities. An extensive search was conducted of electronic databases, including Google Scholar, PUBMED, and PROQUEST, for articles published from 2007 until 2022. Ten articles of the 333 that were found in the original search after filtering met the requirements for inclusion. Data extraction and quality assessment were applied to each of the selected studies. A thorough synthesis of the factors influencing overweight and obesity in MENA nationalities is provided by this scoping review. The results show the intricate interplay of anthropometric, behavioral, sociodemographic, and environmental factors that cause overweight and obesity in this population. Keywords: Overweight; Obesity; Body Mass Index; Oman.
在全球,特别是在中东和北非地区,肥胖和超重已成为严重的公共卫生问题。这项范围审查的目的是确定和总结有关中东和北非国家中超重和肥胖决定因素的现有数据。广泛检索电子数据库,包括Google Scholar、PUBMED和PROQUEST,检索2007年至2022年发表的文章。在原始搜索333篇文章中,经过过滤,有10篇文章符合纳入条件。数据提取和质量评估应用于每一个选定的研究。本综述全面综合了影响中东和北非国家超重和肥胖的因素。研究结果表明,人体测量学、行为、社会人口学和环境因素之间错综复杂的相互作用导致了这一人群的超重和肥胖。关键词:超重;肥胖;身体质量指数;阿曼。
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引用次数: 0
Case Series of Midazolam-Induced Seizures-Like Activity in Five Neonates 咪达唑仑致5例新生儿癫痫样活动的病例系列分析
Q3 Medicine Pub Date : 2023-10-19 DOI: 10.18295/squmj.10.2023.063
Heba Shaker, Fatema Al-Amrani, Hilal Al Mandhari
An intravenous administration of midazolam may result in seizure-like activity or movement. This report describes five neonates who developed seizure-like movements after intravenous midazolam injection. The patients presented between 2019 and 2022. The abnormal movements occurred shortly after intravenous bolus administration of midazolam. None of our patients experienced seizure-like movements after receiving midazolam infusions. The seizure-like movements were aborted either spontaneously or by antiseizure medications. Also, we did not observe any seizure recurrence in any of the infants during the later stages of their treatment. Since this adverse effect might be related to the speed of the bolus administration, intravenous midazolam must be given as a slow bolus over 2-3 minutes followed by a slow flush of normal saline. To prevent midazolam's potential adverse effect on newborns, neonatal caregivers must be aware of it. Keywords: Midazolam; Injection, intravenous, Seizures; Infant, Newborn; Hypnotics and Sedatives.
静脉注射咪达唑仑可导致类似癫痫发作的活动或运动。本报告描述了5例静脉注射咪达唑仑后出现癫痫样运动的新生儿。这些患者出现在2019年至2022年之间。在静脉注射咪达唑仑后不久出现异常运动。我们的病人在接受咪达唑仑输注后没有出现癫痫样的运动。这些类似癫痫发作的动作要么是自发的,要么是通过抗癫痫药物终止的。同时,我们没有观察到任何癫痫复发的婴儿在后期的治疗。由于这种不良反应可能与给药速度有关,因此静脉注射咪达唑仑必须缓慢给药2-3分钟,然后缓慢冲洗生理盐水。为了防止咪达唑仑对新生儿的潜在不良影响,新生儿护理人员必须意识到这一点。 关键词:咪达唑仑;注射、静脉注射、癫痫发作;婴儿,新生;催眠药和镇静剂。
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引用次数: 0
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Sultan Qaboos University Medical Journal
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