Background & Objective: Office hysteroscopy (OH) is an efficient alternative for diagnosis and management of intrauterine pathology. The main goal of this study is to determine the usefulness and tolerability of OH in the patient population of a tertiary teaching hospital in the Kingdom of Bahrain. Methods: The total population consists of 101 patients who were prospectively included in the study from 2018 to 2020. The main indication for OH were abnormal uterine bleeding followed by post-menopausal bleeding. Results: The procedure was tolerable without analgesia in 93% of cases, analgesia was required in 3.96% of cases, and minor complications consisted of abdominal pain and dizziness (0.99%), as well as uterine bleeding (0.99 %). Given a success rate of 90% using a 1.8mm diameter hysteroscope, it can be concluded that OH with Etonox (N2O2) as an analgesic is a safe and feasible procedure for patients of varying ages and parities. Conclusion: OH is particularly useful in the workup of abnormal uterine bleeding, post-menopausal bleeding, assisted IUCD removal, endometrial biopsy, and the removal of small polyps.
{"title":"Office Hysteroscopy: King Hamad University Hospital Experience","authors":"H. Malas, S. Hsu, Yasmin Mohammed","doi":"10.26715/jbms.35_1_1","DOIUrl":"https://doi.org/10.26715/jbms.35_1_1","url":null,"abstract":"Background & Objective: Office hysteroscopy (OH) is an efficient alternative for diagnosis and management of intrauterine pathology. The main goal of this study is to determine the usefulness and tolerability of OH in the patient population of a tertiary teaching hospital in the Kingdom of Bahrain. Methods: The total population consists of 101 patients who were prospectively included in the study from 2018 to 2020. The main indication for OH were abnormal uterine bleeding followed by post-menopausal bleeding. Results: The procedure was tolerable without analgesia in 93% of cases, analgesia was required in 3.96% of cases, and minor complications consisted of abdominal pain and dizziness (0.99%), as well as uterine bleeding (0.99 %). Given a success rate of 90% using a 1.8mm diameter hysteroscope, it can be concluded that OH with Etonox (N2O2) as an analgesic is a safe and feasible procedure for patients of varying ages and parities. Conclusion: OH is particularly useful in the workup of abnormal uterine bleeding, post-menopausal bleeding, assisted IUCD removal, endometrial biopsy, and the removal of small polyps.","PeriodicalId":85027,"journal":{"name":"Journal of the Bahrain Medical Society = Majallat Jam'iyat al-Atibba' al-Bahrayniyah","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69075247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alagille syndrome (AS) commonly presents with cholestasis, much like other liver diseases, making the diagnosis challenging. We report a case of a patient with AS mimicking biliary atresia (BA) with a poor outcome. The infant, a product of a non-consanguineous marriage, presented with jaundice, clay stools, peripheral pulmonary stenosis, atrial septal defect, and butterfly vertebrae. Cholescintigraphy showed an absence of radiotracer excretion. Surgical exploration revealed the presence of a hypoplastic hepatic duct but a normal gallbladder, cystic, and common bile ducts. Intraoperative cholangiogram favored BA, and a Kasai procedure was performed. The liver biopsy demonstrated focal areas of ductular proliferation and periportal ballooning degeneration without bile duct paucity. The patient exhibited worsening cardiac and liver conditions, growth failure, and developmental delay. She died suddenly at home at the age of 34 months. The cholangiographic and histological abnormalities found in our patient were suggestive of BA. At the same time, she displayed four out of five diagnostic criteria for AS. Based on our experience with this case, we suggest expeditious genetic testing should be considered for any case of neonatal cholestasis with diagnostic uncertainty. This may help avoid unwarranted surgical interventions, potentially associated with worse outcomes.
{"title":"Alagille Syndrome: Challenging Diagnosis and Prognostic Factors, A Case Report","authors":"Marwa Sameer1","doi":"10.26715/jbms.35_3_6","DOIUrl":"https://doi.org/10.26715/jbms.35_3_6","url":null,"abstract":"Alagille syndrome (AS) commonly presents with cholestasis, much like other liver diseases, making the diagnosis challenging. We report a case of a patient with AS mimicking biliary atresia (BA) with a poor outcome. The infant, a product of a non-consanguineous marriage, presented with jaundice, clay stools, peripheral pulmonary stenosis, atrial septal defect, and butterfly vertebrae. Cholescintigraphy showed an absence of radiotracer excretion. Surgical exploration revealed the presence of a hypoplastic hepatic duct but a normal gallbladder, cystic, and common bile ducts. Intraoperative cholangiogram favored BA, and a Kasai procedure was performed. The liver biopsy demonstrated focal areas of ductular proliferation and periportal ballooning degeneration without bile duct paucity. The patient exhibited worsening cardiac and liver conditions, growth failure, and developmental delay. She died suddenly at home at the age of 34 months. The cholangiographic and histological abnormalities found in our patient were suggestive of BA. At the same time, she displayed four out of five diagnostic criteria for AS. Based on our experience with this case, we suggest expeditious genetic testing should be considered for any case of neonatal cholestasis with diagnostic uncertainty. This may help avoid unwarranted surgical interventions, potentially associated with worse outcomes.","PeriodicalId":85027,"journal":{"name":"Journal of the Bahrain Medical Society = Majallat Jam'iyat al-Atibba' al-Bahrayniyah","volume":"68 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136207293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background & Objectives: Caudal epidural and dorsal nerve penile blockade are commonly used for analgesia during and after hypospadias repair in children. Comparative studies to recommend the most effective block are in dearth. This study aims to compare penile block versus caudal block with bupivacaine for hypospadias repair in children in terms of post-operative effectiveness, pain management, and complications. Methodology: The study was conducted on 60 male children, aged 1-9 years, undergoing hypospadias surgery under general anesthesia. The subjects were randomly divided into two groups: (A: caudal block, n=30, and B: penile block, n=30). A postoperative pain assessment was conducted using FLACC scale until 24 hours post-surgery. Results: The patients from the A and B groups were comparable in age, weight, and ASA classification. All patients in the 2 groups did not feel pain post-operatively throughout the first 6 hours. One patient (3.4%) from each of the A and B groups started to feel pain 6 hours, and 9 hours, respectively after surgery. Eight patients (26.7%) in group A and 6 patients (20%) in group B felt pain throughout 6 to 24 hours after surgery. Four patients from group A and 1 patient from group B developed nausea and vomiting during the first 24 hours post-surgery. Conclusion: The penile blockade proved to be more effective in lowering postoperative pain scores, with fewer side effects, thereby decreasing the need for rescue analgesia.
{"title":"Comparing Postoperative Analgesia of Caudal and Penile Blockade using Bupivacaine in Children Undergoing Hypospadias Repair","authors":"Mohamed Magdeldin M. Ahmed, Ahmed Murad Bella","doi":"10.26715/jbms.35_2_3","DOIUrl":"https://doi.org/10.26715/jbms.35_2_3","url":null,"abstract":"Background & Objectives: Caudal epidural and dorsal nerve penile blockade are commonly used for analgesia during and after hypospadias repair in children. Comparative studies to recommend the most effective block are in dearth. This study aims to compare penile block versus caudal block with bupivacaine for hypospadias repair in children in terms of post-operative effectiveness, pain management, and complications. Methodology: The study was conducted on 60 male children, aged 1-9 years, undergoing hypospadias surgery under general anesthesia. The subjects were randomly divided into two groups: (A: caudal block, n=30, and B: penile block, n=30). A postoperative pain assessment was conducted using FLACC scale until 24 hours post-surgery. Results: The patients from the A and B groups were comparable in age, weight, and ASA classification. All patients in the 2 groups did not feel pain post-operatively throughout the first 6 hours. One patient (3.4%) from each of the A and B groups started to feel pain 6 hours, and 9 hours, respectively after surgery. Eight patients (26.7%) in group A and 6 patients (20%) in group B felt pain throughout 6 to 24 hours after surgery. Four patients from group A and 1 patient from group B developed nausea and vomiting during the first 24 hours post-surgery. Conclusion: The penile blockade proved to be more effective in lowering postoperative pain scores, with fewer side effects, thereby decreasing the need for rescue analgesia.","PeriodicalId":85027,"journal":{"name":"Journal of the Bahrain Medical Society = Majallat Jam'iyat al-Atibba' al-Bahrayniyah","volume":"73 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69075116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A situation analysis among which a cross-sectional survey of dental practitioners working in primary healthcare centers found that while 127 (94.8%) out of 134 respondents consider fissure sealants effective yet, most of them have misconceptions regarding which teeth to consider carious and which to seal as only 15 (11.2%) recognized that initial carious and non-cavitated carious lesions are the same and only around half sealed either. Fissure sealants are provided for free in primary healthcare centers, but they seem underutilized as only 35 (37.6%) dentists use them very often. To address these issues and others raised by dentists and dental hygienists on the indications and the use of fissure sealants; evidence-based clinical recommendations are provided keeping in mind the high level of caries among children and adolescents in Bahrain and the services provided in primary healthcare centers. Further studies will be needed to evaluate different reasons affecting dental practitioners' knowledge and use of fissure sealants as a method of preventing and controlling caries.
{"title":"Clinical Recommendations to Improve Utilization of Fissure Sealants in Primary Healthcare Centers in Bahrain","authors":"Eman Flaihan Alrowaili","doi":"10.26715/jbms.35_2_4","DOIUrl":"https://doi.org/10.26715/jbms.35_2_4","url":null,"abstract":"A situation analysis among which a cross-sectional survey of dental practitioners working in primary healthcare centers found that while 127 (94.8%) out of 134 respondents consider fissure sealants effective yet, most of them have misconceptions regarding which teeth to consider carious and which to seal as only 15 (11.2%) recognized that initial carious and non-cavitated carious lesions are the same and only around half sealed either. Fissure sealants are provided for free in primary healthcare centers, but they seem underutilized as only 35 (37.6%) dentists use them very often. To address these issues and others raised by dentists and dental hygienists on the indications and the use of fissure sealants; evidence-based clinical recommendations are provided keeping in mind the high level of caries among children and adolescents in Bahrain and the services provided in primary healthcare centers. Further studies will be needed to evaluate different reasons affecting dental practitioners' knowledge and use of fissure sealants as a method of preventing and controlling caries.","PeriodicalId":85027,"journal":{"name":"Journal of the Bahrain Medical Society = Majallat Jam'iyat al-Atibba' al-Bahrayniyah","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69075130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. M. Saleh, Sara S. Ahmed, Ghufran A. Al Sebea, Dalal A. Al Othman, Najla Y. Al Ansari, Behnaz E. Tadayyon, A. Al-Sayyad
Objective: Family planning (FP) has become a fundamental part of healthcare and it can be achieved effectively by safe methods. This study was conducted to determine the gender difference in the knowledge, attitudes, and practices towards FP among married adults attending primary healthcare centers (PHCs) in Bahrain. Methods: This cross-sectional study was conducted at five PHCs from the four governorates in Bahrain over two weeks period in May 2021. A self-administered questionnaire was used to evaluate the knowledge, practice, and attitude of married adults towards FP. Results: The study included 1221 participants (705 females and 516 males). Our study showed that 83.6% of the population had heard of Family Planning Methods (FPM) in general. However, female participants heard more about FPM than males. The FPM practice revealed that 71.9% of the participants are using at least one method. The most common methods are withdrawal (42.4%), and male condoms (29.9%). However, 42.5% of participants still have fears about using FPM. The majority of these fears were related to side effects (57.7%). Conclusions: The study revealed that the level of knowledge, attitude and FP utilization in both sexes was lower compared to other studies. In order to improve the public’s practice of FP, more investment should be made in health promotion programs. Keywords: Knowledge, Attitudes, Practices, Family Planning, Gender Difference, Bahrain.
{"title":"Gender Difference in Knowledge, Attitudes and Practices towards Family Planning among Married Adults Attending Primary Health Care Centers in The Kingdom of Bahrain: Cross Sectional Study","authors":"S. M. Saleh, Sara S. Ahmed, Ghufran A. Al Sebea, Dalal A. Al Othman, Najla Y. Al Ansari, Behnaz E. Tadayyon, A. Al-Sayyad","doi":"10.26715/jbms.35_1_2","DOIUrl":"https://doi.org/10.26715/jbms.35_1_2","url":null,"abstract":"Objective: Family planning (FP) has become a fundamental part of healthcare and it can be achieved effectively by safe methods. This study was conducted to determine the gender difference in the knowledge, attitudes, and practices towards FP among married adults attending primary healthcare centers (PHCs) in Bahrain. Methods: This cross-sectional study was conducted at five PHCs from the four governorates in Bahrain over two weeks period in May 2021. A self-administered questionnaire was used to evaluate the knowledge, practice, and attitude of married adults towards FP. Results: The study included 1221 participants (705 females and 516 males). Our study showed that 83.6% of the population had heard of Family Planning Methods (FPM) in general. However, female participants heard more about FPM than males. The FPM practice revealed that 71.9% of the participants are using at least one method. The most common methods are withdrawal (42.4%), and male condoms (29.9%). However, 42.5% of participants still have fears about using FPM. The majority of these fears were related to side effects (57.7%). Conclusions: The study revealed that the level of knowledge, attitude and FP utilization in both sexes was lower compared to other studies. In order to improve the public’s practice of FP, more investment should be made in health promotion programs. Keywords: Knowledge, Attitudes, Practices, Family Planning, Gender Difference, Bahrain.","PeriodicalId":85027,"journal":{"name":"Journal of the Bahrain Medical Society = Majallat Jam'iyat al-Atibba' al-Bahrayniyah","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69075303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Pulmonary atresia is a congenital heart defect that results from failure in the formation of the pulmonary valve that leads to right ventricular outflow obstruction, preventing the right heart ejection of blood to the lungs. It is also associated with a high incidence of chromosomal anomalies. Methods: A retrospective styesyesudy of all infants diagnosed with pulmonary in Bahrain was undertaken. Pulmonary atresia was classified into pulmonary atresia with intact ventricular septum, pulmonary atresia in Tetralogy of Fallot, and pulmonary atresia in complex cyanotic heart defects. Short-term outcomes, survival, and associated genetics were analyzed. Results: 84 patients were diagnosed. 57 (67.9%) were males and 27 (32.1%) were females (p = 0.204). The median age at diagnosis was 25 days. Patients diagnosed with pulmonary atresia and complex cyanotic heart defects had the highest early survival rate. The early survival rate of patients diagnosed with pulmonary atresia with intact ventricular septum was lowest (p = 0.0179). Twenty-two patients (26.19%) had chromosomal anomalies. The DiGeorge syndrome was found in 18 patients, and 2 with Down Syndrome and other dysmorphisms in 2. 19 (86.36%) with chromosomal anomalies had pulmonary atresia and Tetralogy of Fallot, and 3(13.64%) with pulmonary atresia and complex cyanotic heart defects (p = 0.027). Conclusions: Pulmonary atresia is a rare but serious congenital heart defect. The lowest short-term survival is in those with intact intraventricular septum. There is a high incidence of chromosomal deletion of 22q11 leading to DiGeorge syndrome in those with Tetralogy of Fallot with pulmonary atresia. Early catheterization and surgical techniques are effective palliation for short-term survival.
{"title":"Pulmonary Valve Atresia in the Kingdom of Bahrain: Early Outcomes and Genetic Associations","authors":"Feras A. Majeed Buhusayen","doi":"10.26715/jbms.35_3_1","DOIUrl":"https://doi.org/10.26715/jbms.35_3_1","url":null,"abstract":"Background: Pulmonary atresia is a congenital heart defect that results from failure in the formation of the pulmonary valve that leads to right ventricular outflow obstruction, preventing the right heart ejection of blood to the lungs. It is also associated with a high incidence of chromosomal anomalies. Methods: A retrospective styesyesudy of all infants diagnosed with pulmonary in Bahrain was undertaken. Pulmonary atresia was classified into pulmonary atresia with intact ventricular septum, pulmonary atresia in Tetralogy of Fallot, and pulmonary atresia in complex cyanotic heart defects. Short-term outcomes, survival, and associated genetics were analyzed. Results: 84 patients were diagnosed. 57 (67.9%) were males and 27 (32.1%) were females (p = 0.204). The median age at diagnosis was 25 days. Patients diagnosed with pulmonary atresia and complex cyanotic heart defects had the highest early survival rate. The early survival rate of patients diagnosed with pulmonary atresia with intact ventricular septum was lowest (p = 0.0179). Twenty-two patients (26.19%) had chromosomal anomalies. The DiGeorge syndrome was found in 18 patients, and 2 with Down Syndrome and other dysmorphisms in 2. 19 (86.36%) with chromosomal anomalies had pulmonary atresia and Tetralogy of Fallot, and 3(13.64%) with pulmonary atresia and complex cyanotic heart defects (p = 0.027). Conclusions: Pulmonary atresia is a rare but serious congenital heart defect. The lowest short-term survival is in those with intact intraventricular septum. There is a high incidence of chromosomal deletion of 22q11 leading to DiGeorge syndrome in those with Tetralogy of Fallot with pulmonary atresia. Early catheterization and surgical techniques are effective palliation for short-term survival.","PeriodicalId":85027,"journal":{"name":"Journal of the Bahrain Medical Society = Majallat Jam'iyat al-Atibba' al-Bahrayniyah","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136207560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
E. Haji, Fatema Jamsheer, G. Jassim, Ashwaq Sabt, Amani Abdulla AlSabagh, Lama Mahmood Nasar, Khadija Ebrahim Hassan, Ebtisam Nuhaily
Background: The Global school-based student health survey (GSHS) was developed to help countries measure and assess students' health behaviors and protective factors. This report discusses results from the first GSHS carried out in Bahrain during 2015-2016 by the Ministry of Education in collaboration with World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC). Methods: The GSHS includes students aged 13-17 years and employed a two-stage sample design involving a school and class level. 64 public and private schools were sampled out of 162 schools, and 320 classes of students in grades 7-11 were selected. Students completed a questionnaire addressing mental health, protective factors, sexual behaviors, violence, and unintentional injury. Results: 7,143 (89%) of the 8,068 sampled students completed the questionnaire. Of the students who responded, 3,685 (51.1%) were males, and 5,843 (84.5%) were between the ages of 13 to 17 years old. 27.2% of students were physically attacked, 41.4% were in a physical fight, and 28.6% were bullied one or more times during the past 12 months. 38.1% of the students never or rarely wore a seatbelt when in a car, and 30.7% never or rarely wore a helmet when riding a bicycle. 16.2% of students felt lonely most of the time or always, and 15.2% seriously considered attempting suicide during the past 12 months. Conclusion: The study reported rates of violence, physical fights, bullying, and unsafe practices among school-Age children. Raising awareness regarding mental health and emotional well-being, assessment and support among school children is vital. Keywords: Bahrain, Mental health, School, School health, WHO
{"title":"Global School-Based Student Health Survey 2016-Bahrain: Mental health","authors":"E. Haji, Fatema Jamsheer, G. Jassim, Ashwaq Sabt, Amani Abdulla AlSabagh, Lama Mahmood Nasar, Khadija Ebrahim Hassan, Ebtisam Nuhaily","doi":"10.26715/jbms.35_1_4","DOIUrl":"https://doi.org/10.26715/jbms.35_1_4","url":null,"abstract":"Background: The Global school-based student health survey (GSHS) was developed to help countries measure and assess students' health behaviors and protective factors. This report discusses results from the first GSHS carried out in Bahrain during 2015-2016 by the Ministry of Education in collaboration with World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC). Methods: The GSHS includes students aged 13-17 years and employed a two-stage sample design involving a school and class level. 64 public and private schools were sampled out of 162 schools, and 320 classes of students in grades 7-11 were selected. Students completed a questionnaire addressing mental health, protective factors, sexual behaviors, violence, and unintentional injury. Results: 7,143 (89%) of the 8,068 sampled students completed the questionnaire. Of the students who responded, 3,685 (51.1%) were males, and 5,843 (84.5%) were between the ages of 13 to 17 years old. 27.2% of students were physically attacked, 41.4% were in a physical fight, and 28.6% were bullied one or more times during the past 12 months. 38.1% of the students never or rarely wore a seatbelt when in a car, and 30.7% never or rarely wore a helmet when riding a bicycle. 16.2% of students felt lonely most of the time or always, and 15.2% seriously considered attempting suicide during the past 12 months. Conclusion: The study reported rates of violence, physical fights, bullying, and unsafe practices among school-Age children. Raising awareness regarding mental health and emotional well-being, assessment and support among school children is vital. Keywords: Bahrain, Mental health, School, School health, WHO","PeriodicalId":85027,"journal":{"name":"Journal of the Bahrain Medical Society = Majallat Jam'iyat al-Atibba' al-Bahrayniyah","volume":"91 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69075368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Myasthenia gravis (MG) is an autoimmune disease involving the postsynaptic receptors in the neuromuscular junction, characterized by weakness of the muscles. Ocular myasthenia gravis is a subtype of disease where weakness of oculomotor muscles usually occurs with the presence of ptosis. MG is considered a rare disease in pediatric age groups. Acetylcholinesterase inhibitors and immune-modifying medications are usually the mainstays of medication. We report here, a case of a 2-year-old that presented with ptosis and was diagnosed as ocular myasthenia gravis. Our case report describes the clinical presentation, diagnostic tests, and treatments followed.
{"title":"An Ocular Myasthenia Gravis: A Case Report","authors":"Dana I. Ajlan, R. Al-Ghatam","doi":"10.26715/jbms.35_1_8","DOIUrl":"https://doi.org/10.26715/jbms.35_1_8","url":null,"abstract":"Myasthenia gravis (MG) is an autoimmune disease involving the postsynaptic receptors in the neuromuscular junction, characterized by weakness of the muscles. Ocular myasthenia gravis is a subtype of disease where weakness of oculomotor muscles usually occurs with the presence of ptosis. MG is considered a rare disease in pediatric age groups. Acetylcholinesterase inhibitors and immune-modifying medications are usually the mainstays of medication. We report here, a case of a 2-year-old that presented with ptosis and was diagnosed as ocular myasthenia gravis. Our case report describes the clinical presentation, diagnostic tests, and treatments followed.","PeriodicalId":85027,"journal":{"name":"Journal of the Bahrain Medical Society = Majallat Jam'iyat al-Atibba' al-Bahrayniyah","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69074997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fatema K. Bindayna, Noora A. AlHammadi, Noora K. Bindayna, Qoot A. Alboainain, Mustafa M. EzzlArab, Behnaz E. Tadayyon
Background: Pregnancy is associated with immunological and physiological changes in many organ systems. Influenza in pregnancy has been associated with higher rates of morbidity and mortality. The Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) advocate antenatal influenza vaccination. Objective: This study aims to assess Primary Healthcare Physicians’ (PHPs) knowledge, practice, and attitude regarding influenza vaccination of pregnant women in Bahrain. Also, to identify the perceived facilitators and barriers to influenza vaccination for pregnant women among PHPs. Methodology: A cross-sectional study was conducted in all Primary Health Centers (PHCs) in Bahrain belonging to the Ministry of Health (MOH), which included 25 PHCs and 3 health clinics spread across five health regions. One hundred and nighty -two physicians responded to a survey about their awareness, practice, and attitude about influenza immunization in pregnancy. Conclusion: In general, physicians agree that influenza vaccination is necessary and safe for all pregnant women, not only those having high-risk pregnancies. Furthermore, good counseling can help overcome many fears or barriers.
{"title":"Primary Healthcare Physicians’ Knowledge, Practice, and Attitude Towards Influenza Vaccination of Pregnant Women in Bahrain","authors":"Fatema K. Bindayna, Noora A. AlHammadi, Noora K. Bindayna, Qoot A. Alboainain, Mustafa M. EzzlArab, Behnaz E. Tadayyon","doi":"10.26715/jbms.35_2_2","DOIUrl":"https://doi.org/10.26715/jbms.35_2_2","url":null,"abstract":"Background: Pregnancy is associated with immunological and physiological changes in many organ systems. Influenza in pregnancy has been associated with higher rates of morbidity and mortality. The Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) advocate antenatal influenza vaccination. Objective: This study aims to assess Primary Healthcare Physicians’ (PHPs) knowledge, practice, and attitude regarding influenza vaccination of pregnant women in Bahrain. Also, to identify the perceived facilitators and barriers to influenza vaccination for pregnant women among PHPs. Methodology: A cross-sectional study was conducted in all Primary Health Centers (PHCs) in Bahrain belonging to the Ministry of Health (MOH), which included 25 PHCs and 3 health clinics spread across five health regions. One hundred and nighty -two physicians responded to a survey about their awareness, practice, and attitude about influenza immunization in pregnancy. Conclusion: In general, physicians agree that influenza vaccination is necessary and safe for all pregnant women, not only those having high-risk pregnancies. Furthermore, good counseling can help overcome many fears or barriers.","PeriodicalId":85027,"journal":{"name":"Journal of the Bahrain Medical Society = Majallat Jam'iyat al-Atibba' al-Bahrayniyah","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69075071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Obstructive uropathy, secondary to mass obstructing effects such as hematometrocolpos and consequent acute urinary retention (AUR); is a proven but rare condition in females. Imperforated hymen, which is found in 0.05-0.1% of females, obstructs blood flow at the onset of mensuration with a resultant hematometrocolpos presenting most commonly with abdominal pain and urinary symptoms in the background of primary amenorrhea, which is similar to the presentation of the 11 years old female in the case report. She had abdominal pain and dysuria, which AUR followed for 16 hours. The patient was at Tunner stage 3, and the examination revealed a palpable tender pelvic mass up to the umbilicus level with a bulging introitus and an imperforated hymen. Ultrasonography confirmed hematometrocolpos and an associated bilateral grade 2 hydronephrosis. Therefore, hymenotomy and excision of hymenal edges were done. Although diagnosis can be directed by physical examination, it can be significantly delayed or missed due to generally low incidence rate and insufficient physical examination due to cultural and religious reasons. This case report directs toward the importance of high clinical suspicion of hematometrocolpos as a cause of AUR in adolescent females and the necessity of a complete detailed physical examination, although it is rare.
{"title":"Obstructive Uropathy as a Complication of Hematometrocolpos in an Adolescent Female: A Case Report","authors":"","doi":"10.26715/jbms.35_1_10","DOIUrl":"https://doi.org/10.26715/jbms.35_1_10","url":null,"abstract":"Obstructive uropathy, secondary to mass obstructing effects such as hematometrocolpos and consequent acute urinary retention (AUR); is a proven but rare condition in females. Imperforated hymen, which is found in 0.05-0.1% of females, obstructs blood flow at the onset of mensuration with a resultant hematometrocolpos presenting most commonly with abdominal pain and urinary symptoms in the background of primary amenorrhea, which is similar to the presentation of the 11 years old female in the case report. She had abdominal pain and dysuria, which AUR followed for 16 hours. The patient was at Tunner stage 3, and the examination revealed a palpable tender pelvic mass up to the umbilicus level with a bulging introitus and an imperforated hymen. Ultrasonography confirmed hematometrocolpos and an associated bilateral grade 2 hydronephrosis. Therefore, hymenotomy and excision of hymenal edges were done. Although diagnosis can be directed by physical examination, it can be significantly delayed or missed due to generally low incidence rate and insufficient physical examination due to cultural and religious reasons. This case report directs toward the importance of high clinical suspicion of hematometrocolpos as a cause of AUR in adolescent females and the necessity of a complete detailed physical examination, although it is rare.","PeriodicalId":85027,"journal":{"name":"Journal of the Bahrain Medical Society = Majallat Jam'iyat al-Atibba' al-Bahrayniyah","volume":"118 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69075262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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