Oman Medical Journal最新文献

{"title":"Thrombotic Thrombocytopenic Purpura in Oman: Disease Burden and Outcomes.","authors":"Samata Al Dowaiki, Khalid Al Hashmi, Sulayma Al-Lamki, Muhana Al Muselhi, Murtadha Al-Khabori","doi":"10.5001/omj.2024.115","DOIUrl":"https://doi.org/10.5001/omj.2024.115","url":null,"abstract":"<p><strong>Objectives: </strong>Thrombotic thrombocytopenic purpura (TTP) is a rare, life-threatening autoimmune disorder; limited information about this disease is available from the Middle East. This study aimed to provide a background data on TTP epidemiology in Oman, including its clinical characteristics, disease course, and outcomes.</p><p><strong>Methods: </strong>The study used a longitudinal retrospective observational design, drawing on the electronic patient records of two major hospitals in Muscat from January 2006 to December 2019. Patients who met the diagnostic criteria for TTP were included in the analysis.</p><p><strong>Results: </strong>Over 13 years, 54 patients were diagnosed with TTP, seven (13.0%) of whom experienced a relapse. The incidence of TTP in Oman was 1.8 cases per million population per year, mainly affecting women aged 30-50 years. ADAMTS-13 testing in 23 (42.6%) cases revealed enzyme deficiency in six patients and acquired autoantibodies in 10 patients. Treatments included steroids (94.4%), therapeutic plasma exchange (77.8%), rituximab (42.6%), and cyclosporin (18.5%). Among the TTP-induced morbidities, 46.3% of the participants developed deranged kidney function, 24.0% required hemodialysis. Neurological morbidities included seizures (25.4%), confusion (24.1%), stroke (18.5%), and coma (3.7%). Residual neurological deficits occurred in two (20.0%) of 10 patients with stroke. All patients with seizures recovered. The case fatality rate during the study period was seven (13.0%), with 30-day and 90-day mortality rates of 9.3% and 13.0%, respectively.</p><p><strong>Conclusions: </strong>Though TTP was found to be rare in Oman, the affected patients were at risk of developing serious renal and neurological complications. The unusually low prevalence suggests TTP may be underdiagnosed in Oman.</p>","PeriodicalId":19667,"journal":{"name":"Oman Medical Journal","volume":"39 6","pages":"e694"},"PeriodicalIF":0.0,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12004064/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144010826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unilateral Tubal Twin Ectopic Pregnancy: A Rare Case Report and Literature Review.","authors":"Gehan Mohammed Atef, Maryam A Al-Attas, Hjazia S Alnaqla, Ibtesam F Alshammari","doi":"10.5001/omj.2024.36","DOIUrl":"10.5001/omj.2024.36","url":null,"abstract":"<p><p>Ectopic pregnancy is a common and potentially fatal gynecologic emergency that endangers the mother's life if left untreated and undetected. We present a rare case of a spontaneously conceived unilateral tubal twin ectopic pregnancy. The diagnosis was made using transvaginal ultrasound, and the case was referred to the early pregnancy unit.</p>","PeriodicalId":19667,"journal":{"name":"Oman Medical Journal","volume":"1 1","pages":"e700"},"PeriodicalIF":0.0,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11993908/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70685070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unusual Cause of Lung Nodules in an Adolescent.","authors":"Yusriya Al Rawahi, Majid Al Jabri, Sameer Raniga, Maiya Al Bahri, Adawiya Al Jamei, Dafalla Rahmatallah","doi":"10.5001/omj.2024.97","DOIUrl":"https://doi.org/10.5001/omj.2024.97","url":null,"abstract":"","PeriodicalId":19667,"journal":{"name":"Oman Medical Journal","volume":"39 6","pages":"e704"},"PeriodicalIF":0.0,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11995390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144033515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sleep Quality and its Daytime Effects Among University Students in the UAE.","authors":"Mahmood Dhahir Al-Mendalawi","doi":"10.5001/omj.2024.121","DOIUrl":"https://doi.org/10.5001/omj.2024.121","url":null,"abstract":"","PeriodicalId":19667,"journal":{"name":"Oman Medical Journal","volume":"39 6","pages":"e706"},"PeriodicalIF":0.0,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11980031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Series of Q Fever Infection: A 15-year Experience at Sultan Qaboos University Hospital, Oman.","authors":"Kowthar S Hassan, Batool Al Lawati, Turkiya Al-Siyabi","doi":"10.5001/omj.2024.110","DOIUrl":"https://doi.org/10.5001/omj.2024.110","url":null,"abstract":"<p><strong>Objectives: </strong>Q fever is a worldwide zoonosis, yet its prevalence may be underestimated due to the challenges in diagnosis. We present a series of cases where patients were treated for Q fever infection based primarily on their clinical features and available laboratory tests, highlighting the difficulties in establishing the diagnosis.</p><p><strong>Methods: </strong>This 15-year case series was observed from January 2009 to November 2023 at Sultan Qaboos University Hospital, Oman. Relevant patient information was obtained from the electronic hospital records under the ethical approval MREC # 3139.</p><p><strong>Results: </strong>We treated 17 patients from a total of 1481 patients tested. The median age was 38 years, with a male-to-female ratio of 1.4:1. Fever was the most common symptom, and six patients experienced weight loss. Hepatobiliary, respiratory, neurological, and musculoskeletal symptoms occurred in 10, six, five, and four patients, respectively. Three patients developed rashes during their illness. Two patients had definite infective endocarditis, one had probable infective endocarditis, and two patients had pericardial effusion.</p><p><strong>Conclusions: </strong>Q fever should be considered in the differential diagnosis of a wide range of clinical presentations. However, it can be clinically challenging, and serological test interpretation can be difficult in areas of endemicity and with limited diagnostic tests. A combination of compatible clinical illnesses and appropriate diagnostic tests is necessary for accurate diagnosis.</p>","PeriodicalId":19667,"journal":{"name":"Oman Medical Journal","volume":"39 6","pages":"e691"},"PeriodicalIF":0.0,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12010304/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Allergic Rhinitis and its Impact on Quality of Life Among Pediatric Patients in Tabuk, Saudi Arabia.","authors":"Sawsan Mohammed S Alblewi, Lama Mousa Alenazi, Rawan Saud Alshahrani, Rahaf Thamer Alharbi, Nouf Abduallah Alotaibi, Hadeel Mousa D Albalawi, Dalal Luai S Albalawi, Atiaf Abdullah Alfaidi, Danah Ali H Abu Sabir","doi":"10.5001/omj.2024.118","DOIUrl":"https://doi.org/10.5001/omj.2024.118","url":null,"abstract":"<p><strong>Objectives: </strong>Allergic rhinitis (AR) is a common condition among schoolchildren in various regions of Saudi Arabia, manifesting primarily through nasal symptoms. It significantly affects sleep, mood, and academic performance due to exposure to allergens. AR places a considerable burden on the quality of life (QoL), often leading to moderate to high levels of stress. We aimed to assess the prevalence and impact of AR on the QoL among children.</p><p><strong>Methods: </strong>This cross-sectional observational study was conducted from September 2023 to April 2024 in Tabuk, Saudi Arabia. Data was collected from a self-administered questionnaire adapted from previous studies.</p><p><strong>Results: </strong>The study included 235 pediatric patients. The prevalence of diagnosed AR among the participants was 64.3% (n = 151). Symptoms duration varied, with seasonal allergies affecting 63.4% (n = 149) and perennial allergies affecting 41.7% (n = 98) of the children. Notably, sleep quality was significantly compromised in 79.1% (n = 186) of cases, and emotional well-being was impacted in 78.3% (n = 184). AR was significantly correlated with impaired daily activities, school performance, and social interactions (<i>p</i> < 0.001). It also had a profound impact on sleep quality (<i>p</i> < 0.001), emotional well-being (<i>p</i> < 0.001), and physical activity (<i>p</i> < 0.001), indicating a broad and severe effect on QoL. Management strategies demonstrated significant associations, with education or counseling (<i>p =</i>0.009) and psychological support (<i>p =</i>0.043), showing the strongest correlation with the prevalence and management of AR.</p><p><strong>Conclusions: </strong>This study demonstrated that AR has a significant and multifaceted impact on pediatric patients in Tabuk, Saudi Arabia, affecting daily activities, sleep, emotional well-being, and physical activities. While educational initiatives and psychological support showed promise in managing the condition, further efforts are required to address environmental factors and enhance comprehensive management strategies.</p>","PeriodicalId":19667,"journal":{"name":"Oman Medical Journal","volume":"39 6","pages":"e696"},"PeriodicalIF":0.0,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11983380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rare Combination of Phenotypes of Karyomegalic Interstitial Nephritis and Autosomal Recessive Polycystic Kidney Disease in an Omani Child.","authors":"Intisar Al Alawi, Maryam Al Shehhi, Mohammed S Al Riyami, Naifain Al Kalbani, Aliya Al Hosni, Ashwaq Al Mimani, Issa Al Salmi, John A Sayer","doi":"10.5001/omj.2024.34","DOIUrl":"10.5001/omj.2024.34","url":null,"abstract":"<p><p>Autosomal recessive polycystic kidney disease is one of the most prevalent inherited cystic kidney diseases in infants and children, common in highly consanguineous societies such as Oman. Karyomegalic interstitial nephritis is a rare cause of hereditary chronic kidney disease presenting with progressive renal impairment and hematoproteinuria. We report a rare case of concurrent karyomegalic interstitial nephritis and autosomal recessive polycystic kidney disease in a two-year-old Omani boy. He presented with failure to thrive, developmental delay, hypotonia, recurrent urinary tract infection, proteinuria, and hematuria. Abdominal ultrasonography showed bilaterally enlarged kidneys with distorted parenchyma, loss of corticomedullary differentiation, and multiple small cysts in addition to an enlarged liver. Whole exome sequencing of the patient DNA revealed a homozygous likely-pathogenic variant in <i>FAN1</i>(NM_014967.4:c.2854C>T, p.R952*) segregating from each parent, in addition to a homozygous missense variantin <i>polycystic kidney and hepatic disease 1</i>(NM_138694.3:c.406A>G, p.T136A). Familial carrier testing in parents and a similarly affected brother revealed segregation of the<i>polycystic kidney and hepatic disease 1</i> variant in a homozygous state in the father and brother, and in a heterozygous state in the mother. This case demonstrates two rare genetic causes of chronic kidney disease within a highly consanguineous family, mimicking an autosomal dominant pattern of inheritance of cystic kidney disease. We recommend whole exome sequencing as a routine molecular diagnostic tool for children with cystic kidney disease, especially those from consanguineous families.</p>","PeriodicalId":19667,"journal":{"name":"Oman Medical Journal","volume":"1 1","pages":"e698"},"PeriodicalIF":0.0,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11979739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70684763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding Pulmonary Vein Thrombosis: Etiology, Risk Factors, and Management.","authors":"Masoud Salim Kashoub, Badar Al Rawahi, Saif Al Mubaihsi","doi":"10.5001/omj.2024.117","DOIUrl":"https://doi.org/10.5001/omj.2024.117","url":null,"abstract":"<p><p>Pulmonary vein thrombosis (PVT) is an uncommon but potentially fatal condition often misdiagnosed due to nonspecific symptoms such as cough, hemoptysis, and dyspnea. The true prevalence of PVT is difficult to determine and is mainly derived from case reports, influenced by the lung's robust venous collateral network. Specific clinical situations, including post-lobectomy, lung transplantation, and metastatic cancer, can precipitate PVT. Accurate and prompt diagnosis, requiring a high index of suspicion and advanced imaging techniques like computed tomography, magnetic resonance imaging, and echocardiography, is crucial to prevent severe complications such as peripheral embolization and acute stroke. Risk factors include surgical procedures, cancers, and potentially atrial fibrillation, with a high post-surgical thrombosis risk, especially after left upper lobectomy. Management must be tailored to the underlying pathology and can include antibiotics, anticoagulation, thrombectomy, and lung resection. This review underscores the need for increased clinical awareness and comprehensive diagnostic approaches to mitigate the severe consequences of PVT.</p>","PeriodicalId":19667,"journal":{"name":"Oman Medical Journal","volume":"39 6","pages":"e688"},"PeriodicalIF":0.0,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11997960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postpartum Hemorrhage Following Vaginal and Cesarean Section Deliveries at a Single Tertiary Hospital: A Five-year Cross-sectional Study.","authors":"Miriam George Fenn, Maisa Al Falahi, Taif Al Hannai, Lubna Al Shukaili, Nihal Al Riyami","doi":"10.5001/omj.2024.116","DOIUrl":"https://doi.org/10.5001/omj.2024.116","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to examine the prevalence, etiology, management, and outcomes of postpartum hemorrhage (PPH) following vaginal and cesarean delivery.</p><p><strong>Methods: </strong>We conducted a cross-sectional study on women who delivered at Sultan Qaboos University Hospital from January 2017 to December 2021 and experienced PPH. PPH was defined as per World Health Organization criteria of blood loss > 500 mL after vaginal delivery and 1000 mL after cesarean delivery. The study evaluated demographic parameters, pre-delivery and discharge hemoglobin, estimated blood loss, etiology, pharmacological, mechanical, and surgical interventions for PPH, and the need for blood products.</p><p><strong>Results: </strong>There were 18 136 vaginal deliveries, of which 729 women had PPH, with a prevalence of 4.0%. Among 2771 cesarean sections, 360 women had PPH, with a prevalence of 13.0%. Hemoglobin < 11 g/dL was found in 278 (38.1%) and 140 (38.9%) women before vaginal delivery and cesarean section, respectively. Grand multiparas had the highest prevalence of PPH after vaginal delivery (42.7%). In cesarean deliveries, the majority (48.6%) were women with parity 2-4. Poor uterine tone was the cause of PPH in 616 (84.5%) vaginal deliveries and 263 (73.1%) cesarean deliveries. Surgical interventions were required in 244 (33.5%) women after vaginal delivery and 82 (22.8%) women after cesarean section. The average blood loss was 860 mL after vaginal delivery and 1400 mL after cesarean section. Blood transfusion was required in 74 (10.2%) women after vaginal delivery and 127 (35.3%) women after cesarean section. There was one maternal mortality due to atonic PPH after vaginal delivery.</p><p><strong>Conclusions: </strong>Active management of the third stage of labor and repeated emergency obstetric drills have reduced adverse outcomes. Addressing anemia in pregnancy and further research on carbetocin use in cesarean sections are recommended.</p>","PeriodicalId":19667,"journal":{"name":"Oman Medical Journal","volume":"39 6","pages":"e695"},"PeriodicalIF":0.0,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11983379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and Laboratory Predictors of Poor Outcomes in Pediatric Cerebral Malaria in Nigeria.","authors":"Olayinka Rasheed Ibrahim, Amudalat Issa, Rafiu Taofeek Babatunde, Michael Abel Alao","doi":"10.5001/omj.2024.112","DOIUrl":"https://doi.org/10.5001/omj.2024.112","url":null,"abstract":"<p><strong>Objectives: </strong>Cerebral malaria remains poorly understood despite being a common manifestation of severe malaria in children, often associated with poor outcomes. We sought to describe the burden of childhood cerebral malaria and identify factors predictive of poor hospitalization outcomes (death and neurological outcomes) and short-term neurological sequelae.</p><p><strong>Methods: </strong>We conducted a retrospective review of children diagnosed with cerebral malaria at a tertiary hospital in northwestern Nigeria from 1 January 2019 to 31 December 2022. We retrieved relevant information, including hospitalization outcomes (discharge, death, and neurological sequelae) and neurological status at follow-up.</p><p><strong>Results: </strong>Of 8295 pediatric admissions, 948 cases were severe malaria; from those, 284 cases of cerebral malaria were identified, representing a prevalence of 3.4% and 30.0%, respectively. Clinical and laboratory features were comparable between survivors and non-survivors, except hypoxemia (<i>p =</i>0.016), duration of loss of consciousness (<i>p</i>< 0.001), acidosis (<i>p =</i>0.002), white blood cell count (<i>p =</i>0.006), serum sodium (<i>p =</i>0.005), and serum creatinine (<i>p</i> < 0.001). Hypoxemia (adjusted odds ratio (AOR) = 6.071; 95% CI: 1.672-22.043), serum creatine > 1.5 mg/dL (AOR = 6.720; 95% CI: 2.160-20.905), and the first 24 hours of hospitalization (AOR = 5.934; 95% CI: 2.423-14.535) were predictors of hospitalization death. Forty-nine (19.6%) of 250 survivors had neurological complications at discharge. Age under five years increased the odds of neurological complications at discharge (OR = 2.059; 95% CI: 1.094-3.876). At follow-up, 24 (49.0%) of the 49 patients with neurological complications recovered fully.</p><p><strong>Conclusions: </strong>This study demonstrates that cerebral malaria is associated with a high mortality rate and significant neurological complications, particularly in children under five years old. Hypoxemia and elevated serum creatinine levels were associated with an increased risk of in-hospital death.</p>","PeriodicalId":19667,"journal":{"name":"Oman Medical Journal","volume":"39 6","pages":"e692"},"PeriodicalIF":0.0,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11980032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}