Oman Medical Journal最新文献

{"title":"Carcinoid Tumor of the Duodenum Presenting as Iron Deficiency Anemia.","authors":"Ahmad Rimawi, Karim Amireh, Andrew Sagalov, Yahia Al-Turk","doi":"10.5001/omj.2025.05","DOIUrl":"10.5001/omj.2025.05","url":null,"abstract":"<p><p>Carcinoid tumors are slow-growing tumors that typically occur in the gastrointestinal (GI) tract, lungs, and other endocrine glands. They are commonly discovered incidentally and usually cause no symptoms. When symptomatic, they tend to present with vague abdominal pain and may lead to carcinoid syndrome after metastasis to the liver. Such tumors rarely present with GI bleeding and thus rarely lead to iron deficiency anemia. In this report, we present an uncommon case of a 71-year-old male who presented with fatigue, weakness, intermittent rectal bleeding, and black stools. He was vitally stable but cachectic. Laboratory studies revealed iron deficiency anemia of unknown origin. Initially, a colonoscopy was performed, which only revealed internal hemorrhoids, so an upper endoscopy was scheduled. Upper GI endoscopy revealed a bleeding duodenal nodule in the upper half of the duodenum that was biopsied. Immunohistochemistry revealed a duodenal carcinoid tumor. The lesion was resected endoscopically as the patient was unfit for surgery due to concurrent comorbidities. Abdominal imaging showed no signs of liver metastasis. The patient was followed periodically by the gastroenterology clinic to ensure no recurrence or metastasis, but he eventually succumbed to other comorbidities. This case highlights the challenges in diagnosing and managing this rare presentation in a significantly ill patient with multiple comorbidities. Upon reviewing the literature, we found that it was uncommon for carcinoid tumors of the GI tract to present with bleeding or anemia. Of those reported in the literature to have caused bleeding, the majority were in the stomach or ileum. To the best of our knowledge, this is the first reported case of a duodenal carcinoid tumor presenting with iron deficiency anemia.</p>","PeriodicalId":19667,"journal":{"name":"Oman Medical Journal","volume":"1 1","pages":"e722"},"PeriodicalIF":0.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12228507/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70694113","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":"Enhancing Respiratory Syncytial Virus Immunoprophylaxis: Addressing Challenges Beyond Palivizumab in the Gulf Region.","authors":"Anas Babar","doi":"10.5001/omj.2025.65","DOIUrl":"10.5001/omj.2025.65","url":null,"abstract":"","PeriodicalId":19667,"journal":{"name":"Oman Medical Journal","volume":"40 1","pages":"e726"},"PeriodicalIF":0.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12302075/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732610","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":"A Genetic Clue to T2DM in Bangladesh: The <i>TCF7L2 rs12255372</i> (G/T) Variant.","authors":"Syed Azmal Mahmood, Md Fariduddin, Laila Anjuman Banu, Shoaib Hossain, Md Mohiuddin Masum, Samira Moyeen, Shahjada Selim","doi":"10.5001/omj.2025.45","DOIUrl":"10.5001/omj.2025.45","url":null,"abstract":"<p><strong>Objectives: </strong>Transcription factor 7-like 2 (TCF7L2) has emerged as a promising candidate gene associated with type 2 diabetes mellitus (T2DM), and the intronic variant rs12255372 of the <i>TCF7L2</i> gene has demonstrated a robust association with T2DM across various ethnic groups. We sought to determine the frequency of rs12255372 polymorphism in the Bangladeshi adult population, both with and without T2DM.</p><p><strong>Methods: </strong>This cross-sectional study was conducted in the Endocrinology Department of Bangabandhu Sheikh Mujib Medical University. Eighty patients with T2DM and 80 normoglycemic controls were included in the study. The rs12255372 polymorphism was genotyped using the polymerase chain reaction-restriction fragment length polymorphism technique.</p><p><strong>Results: </strong>An allelic odds ratio (OR) of 3.29 (95% CI: 1.78-6.05; <i>p</i> < 0.001) was found for the minor T allele of rs12255372, significantly increasing the T2DM risk. A significant difference in TT and GT genotypes was noted between participants with T2DM (OR = 5.26, 95% CI: 1.39-19.9; <i>p =</i> 0.008) and normoglycemic controls (OR = 3.00, 95% CI: 1.33-6.75; <i>p =</i> 0.007), respectively. The dominant model appears to be the most suitable for representing the susceptibility gene effect.</p><p><strong>Conclusions: </strong>The frequency of the minor T allele of rs12255372 was about one-fourth and one-tenth among patients with T2DM and normoglycemic controls, respectively, indicating that this polymorphism may be associated with the risk of developing T2D in the studied population.</p>","PeriodicalId":19667,"journal":{"name":"Oman Medical Journal","volume":"40 1","pages":"e713"},"PeriodicalIF":0.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12319307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144784927","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":"Neck Lump and Cough: The Uncommon Encounter.","authors":"Ramanuj Mukherjee, Raunak Sinha Thakur, Souradip Guha, Anitesh Roychowdhury","doi":"10.5001/omj.2025.38","DOIUrl":"10.5001/omj.2025.38","url":null,"abstract":"","PeriodicalId":19667,"journal":{"name":"Oman Medical Journal","volume":"40 1","pages":"e725"},"PeriodicalIF":0.0,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12242130/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144608993","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 and Risk Factors of Significant Hepatic Fibrosis in Omani Patients with HBeAg-negative Chronic Hepatitis B Virus Infection: A Retrospective Study.","authors":"Halima H Al-Shuaili, Bushra Al Mashikhi, Ahmed Al Sinani, Ahmed Alwassief, Said A Al-Busafi","doi":"10.5001/omj.2024.113","DOIUrl":"https://doi.org/10.5001/omj.2024.113","url":null,"abstract":"<p><strong>Objectives: </strong>Hepatic fibrosis remains a potential complication for hepatitis B e antigen (HBeAg)-negative chronic hepatitis B virus (HBV) infection. The affected individuals, known as inactive HBV carriers, tend to have a favorable prognosis. This study aimed to determine the prevalence of significant fibrosis and associated risk factors among Omani patients diagnosed as inactive HBV carriers.</p><p><strong>Methods: </strong>A retrospective study was conducted on Omani inactive HBV carriers visiting a tertiary hospital in Muscat, Oman, between January 2017 and December 2018. Significant hepatic fibrosis (stage F2 or higher) was identified using two-dimensional shear-wave elastography, with baseline clinical, laboratory, and radiological data analyzed for associations.</p><p><strong>Results: </strong>Among the selected 200 participants (mean age = 44.6 ± 9.3 years), 53.0% were male. Significant fibrosis was present in 40 (20.0%) patients, with a preponderance of male (<i>p =</i>0.007) and those aged ≥ 60 years (<i>p =</i>0.024). Fatty changes, as detected by liver ultrasound, were independent risk factors (<i>p =</i>0.044).</p><p><strong>Conclusions: </strong>The findings underscore the importance of periodic assessment and monitoring of inactive HBV carriers in Oman, particularly those with risk factors for fibrosis progression, such as male sex, older age, and fatty liver. Non-invasive tests can aid in early detection and management of fibrosis, thereby improving patient outcomes.</p>","PeriodicalId":19667,"journal":{"name":"Oman Medical Journal","volume":"39 6","pages":"e693"},"PeriodicalIF":0.0,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11980033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144037346","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":"Surgical Site Infection Rates in Five Middle Eastern Countries: International Nosocomial Infection Control Consortium Findings.","authors":"Victor Daniel Rosenthal, Ruijie Yin, Zhilin Jin, Safaa Abdulaziz Alkhawaja, Saleh Fakher Mohamed Sowar, Athraa S H Naser, Fatema E S Naser, Amani El-Kholy, Victor Bayani, Wafaa Alwakil, Ziad A Memish","doi":"10.5001/omj.2024.108","DOIUrl":"https://doi.org/10.5001/omj.2024.108","url":null,"abstract":"<p><strong>Objectives: </strong>This study of surgical site infection (SSI) rates covers 29 International Nosocomial Infection Control Consortium (INICC) member hospitals in 22 cities across the Middle East, including Bahrain, Egypt, Kuwait, Lebanon, and Saudi Arabia.</p><p><strong>Methods: </strong>Prospective cohort multinational surveillance data were collected through the INICC Surveillance Online System. Centers for Disease Control and Prevention/National Healthcare Safety Network (CDC/NHSN) definitions were applied for SSI. Surgical procedures (SPs) were categorized into 12 types according to the International Classification of Diseases, ninth revision (ICD-9) criteria, 9^thedition.</p><p><strong>Results: </strong>From 2014 to 2023, we collected data on 304 SSIs associated with 21 322 SPs. Among the 12 observed types of SPs, comparable incidences were noted between the INICC hospitals of the Middle East and CDC/NHSN datasets across six types of SPs: breast, 1.1% vs. 0.9% (<i>p =</i>0.870); cholecystectomy, 0.1% vs. 0.2% (<i>p =</i>0.360); craniotomy, 3.0% vs. 2.1% (<i>p =</i>0.510); herniorrhaphy, 0.8% vs. 0.7% (<i>p =</i>0.770); abdominal hysterectomy, 1.2% vs. 1.1% (<i>p =</i>0.880); and laminectomy, 1.6% vs. 0.7% (<i>p =</i>0.100), respectively. INICC hospitals of the Middle East exhibited a significantly lower cesarean section rate compared to CDC/NHSN rates: 1.04% compared to 1.5% (relative ratio (RR) = 0.71, 95% CI: 0.58-0.87; <i>p =</i>0.001). However, the following four types of SPs showed SSI rates significantly higher than those of CDC/NHSN: Appendix surgery, 1.8% vs. 1.1% (RR = 1.55, 95% CI: 1.02-2.36; <i>p =</i>0.041); coronary artery bypass, 4.5% vs.1.4% (RR = 3.32, 95% CI: 1.82-6.08; <i>p</i> < 0.001); open reduction of fracture, 2.5% vs. 1.1% (RR = 2.24, 95% CI: 1.50-3.36; <i>p</i> < 0.001); and exploratory abdominal surgery, 3.8% vs. 1.7% (RR=2.30, 95% CI: 1.56-3.39, <i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>Most SSI rates in this set of hospitals in the Middle East are similar to those of CDC/NHSN. It is recommended to focus on implementing effective interventions to reduce SSI rates for procedures with higher rates.</p>","PeriodicalId":19667,"journal":{"name":"Oman Medical Journal","volume":"39 6","pages":"e689"},"PeriodicalIF":0.0,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11983378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144037566","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":"Epileptic Nocturnal Wanderings in a Young Female: A Rare Case Report and Review of the Literature.","authors":"Alawi A Al-Attas, Attas A Al-Attas, Maryam A Al-Attas, Saleh K Swailem","doi":"10.5001/omj.2024.37","DOIUrl":"10.5001/omj.2024.37","url":null,"abstract":"<p><p>Sleep-related hyperkinetic seizures are a frequent symptom of frontal lobe epilepsy that occurs at night. Although temporal lobe-originating sleep-related seizures have been documented, they often lack hyperkinetic activity. Furthermore, episodic nocturnal wandering is rarely observed and is believed to represent an unusual form of nocturnal epilepsy that responds to anti-seizure medications. In this report, we present a case of a 14-year-old right-handed girl with recurrent sleepwalking and wandering. Interictal electroencephalography revealed an epileptogenic focus in the left temporal lobe and intermittent slow-wave activity originating from that region. During her nighttime wanderings, the patient exhibited unusually violent and nonviolent conduct, putting herself at risk of minor or serious injuries.</p>","PeriodicalId":19667,"journal":{"name":"Oman Medical Journal","volume":"1 1","pages":"e701"},"PeriodicalIF":0.0,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11979738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70684896","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":"Isolated Hypogonadotropic Hypogonadism in a Young Woman with Primary Amenorrhoea.","authors":"Zalkha Al Kharusi, Nadia Al Mabaihsi, Amani Al Rawahi, Abeer Al Hadhrami, Maisa Al Kiyumi, Almundher Al-Maawali, Abdulaziz Al Mahrezi","doi":"10.5001/omj.2024.39","DOIUrl":"10.5001/omj.2024.39","url":null,"abstract":"<p><p>We describe a case of a young woman who presented with delayed secondary sexual development and primary amenorrhoea. She had low levels of oestradiol, follicle-stimulating hormone, and luteinizing hormone with normal levels of other pituitary hormones. Genetic testing revealed a rare diagnosis of autosomal recessive hypogonadotropic hypogonadism 8. She was treated with hormone therapy to promote the growth of the uterus and secondary sexual characteristics. Combined contraceptive pills were initiated. A pelvis ultrasound taken after six months revealed a growing uterus.</p>","PeriodicalId":19667,"journal":{"name":"Oman Medical Journal","volume":"1 1","pages":"e703"},"PeriodicalIF":0.0,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11979737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70685455","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":"Additional Role of Magnetic Resonance Imaging to Ultrasound in Assessing Placenta Accreta Spectrum Disorders: A Retrospective Cross-sectional Study from Vietnam.","authors":"Viet Hung Nguyen, Quang Huy Huynh, To Nguyen Ha, Minh Chau Ngoc Nguyen, Phuc Nhon Nguyen","doi":"10.5001/omj.2024.119","DOIUrl":"https://doi.org/10.5001/omj.2024.119","url":null,"abstract":"<p><strong>Objectives: </strong>Placenta accreta spectrum (PAS) is commonly associated with adverse pregnancy outcomes. While ultrasound (US) is the primary imaging tool, magnetic resonance imaging (MRI) plays a crucial complementary role in assessing PAS disorders. This study aimed to evaluate the MRI features in PAS diagnosis and enhance the role of MRI in conjunction with US for better management. Additionally, the study examined the association between imaging findings and clinical outcomes.</p><p><strong>Methods: </strong>This retrospective cross-sectional study was conducted between January 2017 and June 2022 at Tu Du Hospital, Vietnam. A total of 87 cases were eligible for inclusion. Antenatal MRI and US findings were compared to intraoperative diagnoses and/or histopathological confirmation, which is considered the gold standard. The diagnostic value of each MRI feature was calculated, and the association between MRI/US findings, estimated blood loss, and surgical methods was analyzed. Statistical significance was determined with a <i>p</i>-value < 0.05.</p><p><strong>Results: </strong>Among the 87 women suspected of PAS on US, 83 were confirmed to have PAS through intraoperative diagnosis and/or histology. The mean maternal age was 35.9 5.7 years and the mean gestational age at cesarean section was 31.1 7.1 weeks. MRI sensitivity (Se) in detecting PAS ranged from 10.8-94.0%, while the specificity (Sp) ranged from 25.0-100%. Loss of retroplacental T2 dark zone demonstrated the highest diagnostic value. When combining three to six MRI signs, Se increased from 53.0-100%, and Sp from 25.0-100%. The highest Youden?(tm)s index (0.759) was observed with five MRI signs (Se = 75.9%, Sp = 100%). PAS diagnosed via MRI/US was associated with more significant blood loss during cesarean section (1000 (600-2000) mL vs. 500 (250-850) mL and 1000 (600-2000) mL vs. 300 (300-500) mL, respectively). Furthermore, the percreta type of PAS identified on MRI/US was linked to significantly higher rates of cesarean hysterectomy compared to conservative surgery (56.4% vs. 43.6% and 63.5% vs. 36.5%, respectively).</p><p><strong>Conclusions: </strong>MRI provides a reliable diagnostic value for PAS, particularly following uncertain US findings. Depending on resource availability, a stepwise approach utilizing both imaging modalities should be considered. MRI can guide strict interdisciplinary management in cases of suspected PAS, especially percreta type. Further studies are needed to solidify the role of MRI in severe PAS cases.</p>","PeriodicalId":19667,"journal":{"name":"Oman Medical Journal","volume":"39 6","pages":"e697"},"PeriodicalIF":0.0,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12010303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015626","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":"Chilblain Lupus Masquerading as Tinea Pedis.","authors":"Sarah Al Qassimi, Fatima Abdulla, Mohamed Elarabi, Rajaie Namas","doi":"10.5001/omj.2024.38","DOIUrl":"10.5001/omj.2024.38","url":null,"abstract":"<p><p>Chilblain lupus erythematosus is a frequently misdiagnosed condition. Our case report describes a young Jordanian male who underwent a skin biopsy revealing the diagnosis of chilblain lupus erythematosus after multiple incorrect diagnoses. It emphasizes the importance of skin biopsy in establishing the correct diagnosis and avoiding unnecessary treatment.</p>","PeriodicalId":19667,"journal":{"name":"Oman Medical Journal","volume":"1 1","pages":"e702"},"PeriodicalIF":0.0,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11993907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70685031","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}