Sultan Qaboos University Medical Journal最新文献

{"title":"Surgical Strategies for Unilateral Pulmonary Artery Agenesis: <i>A case series</i>.","authors":"Amr Abolwafa, Alaa Al-Lawati, Hamood Nasar Al-Kindi, Sunny Zacharias, Pranav Subbaraya Kandachar, Madan Mohan Maddali","doi":"10.18295/2075-0528.2951","DOIUrl":"10.18295/2075-0528.2951","url":null,"abstract":"<p><p>Unilateral pulmonary artery agenesis, typically affecting the right pulmonary artery, is a rare condition that may lead to congestive heart failure or pulmonary hypertension in infants and early surgical intervention improves outcomes. We report 5 cases from Muscat, Oman, of unilateral pulmonary artery agenesis who underwent surgical correction between November 2019 and August 2023, at an average age of 4.4 months. Most presented with cyanosis or respiratory distress and all had pulmonary hypertension confirmed by imaging. Surgical approaches included Gore-Tex conduit placement, autologous pericardial reconstruction and patent ductus arteriosus unifocalisation. All patients successfully restored pulmonary blood flow with no perioperative mortality. The median intensive unit care stay was 13 days and the median hospital stay was 20 days. Only 1 patient required repeat surgery for graft compression. Over a 27.6-month follow-up period, 4 patients showed regression of pulmonary hypertension and 2 underwent pulmonary angioplasty, reinforcing the benefits of timely intervention.</p>","PeriodicalId":22083,"journal":{"name":"Sultan Qaboos University Medical Journal","volume":"26 1","pages":"13-19"},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12797268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145971146","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":"Anthracycline-Induced Cardiomyopathy in Breast Cancer Patients in Oman: <i>A retrospective study</i>.","authors":"Hussain A Al-Lawati, Khalid Al Baimani, Mohammed N Al Rawahi","doi":"10.18295/2075-0528.2891","DOIUrl":"10.18295/2075-0528.2891","url":null,"abstract":"<p><strong>Objectives: </strong>Anthracyclines are widely used in the treatment of breast cancer. One of the known adverse effects of anthracyclines is anthracycline-induced cardiomyopathy. Studies done worldwide showed that the prevalence of chemotherapy-induced cardiomyopathy is approximately 9%. However, studies evaluating this complication prevalence, risk factors and cumulative dose are lacking in Oman. This study aimed to investigate the prevalence of anthracycline-induced cardiomyopathy among breast cancer patients in Oman.</p><p><strong>Methods: </strong>This retrospective study included all breast cancer patients who received anthracycline-based chemotherapy exclusively between September 2008 and December 2020 at Sultan Qaboos University Hospital in Muscat. Patients with partial treatment, coexisting heart failure and who did not receive anthracycline as part of the chemotherapy regimen were excluded. Chemotherapy-induced cardiomyopathy was defined as a drop of left ventricular ejection fraction >10% from the patient's baseline during or after receiving anthracycline-based chemotherapy.</p><p><strong>Results: </strong>A total of 385 patients were included in this study of which 39 (10.1%) developed cardiomyopathy after exposure to anthracyclines. The mean cumulative dose of doxorubicin among these patients was 239 mg/m² (epirubicin was converted to doxorubicin equivalent dose). Univariate analysis showed that the risk of anthracycline-induced cardiomyopathy was influenced by cardiovascular risk factors such as hypertension (33.3%), diabetes (25.6%), dyslipidaemia (20.5%) and previous cardiovascular medications use (10.3%). Trastuzumab exposure significantly correlated with an increased risk of developing cardiomyopathy (<i>P</i> < 0.001). However, multivariate analysis did not show any significant association.</p><p><strong>Conclusions: </strong>Anthracycline-induced cardiomyopathy was influenced by various cardiovascular risk factors as well as trastuzumab exposure. Further studies are recommended to investigate the prevention and management of anthracycline-induced cardiomyopathy.</p>","PeriodicalId":22083,"journal":{"name":"Sultan Qaboos University Medical Journal","volume":"25 1","pages":"839-846"},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12538945/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145347487","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":"Cervical Deciduosis in Early Pregnancy Mimicking Malignancy: <i>A report of two cases</i>.","authors":"Ajit Sebastian, Nada Salih, Shiby Jose, Tamima Al Dughaishi, Vaidyanathan Gowri","doi":"10.18295/2075-0528.2870","DOIUrl":"10.18295/2075-0528.2870","url":null,"abstract":"<p><p>Deciduosis is a benign condition characterised by the transformation of subepithelial connective tissue into decidual-like cells, typically occurring in response to hormonal changes during pregnancy. Although benign, cervical deciduosis may macroscopically resemble malignant lesions, leading to diagnostic uncertainty. This report presents two cases of cervical deciduosis diagnosed in early pregnancy. Both patients presented with first-trimester vaginal bleeding, and speculum examination revealed extensive wart-like lesions covering the cervix. Histopathological examination of cervical biopsies confirmed decidual changes. In pregnant women presenting with threatened miscarriage, a thorough local examination and biopsy of atypical cervical lesions are essential to exclude malignancy. As cervical deciduosis is a benign and self-limiting condition, no further treatment is usually required.</p>","PeriodicalId":22083,"journal":{"name":"Sultan Qaboos University Medical Journal","volume":"25 1","pages":"547-551"},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12445304/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114082","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":"Autosomal Recessive Spastic Ataxia of Charlevoix-Saguenay with Early-Onset Epilepsy and Novel Clinical Features: <i>A rare entity from Morocco in the Middle East and North Africa region</i>.","authors":"Azzeddine Laaraje, Basma Alaoui, Abdelilah Radi, Amal Hasani, Aomar Agadr, Rachid Abilkassem","doi":"10.18295/2075-0528.2906","DOIUrl":"10.18295/2075-0528.2906","url":null,"abstract":"<p><p>We report a novel presentation of autosomal recessive spastic ataxia of Charlevoix-Saguenay (ARSACS) in a 9-year-old Moroccan male patient born to consanguineous parents, expanding the known clinical spectrum of the disease. The patient presented to a tertiary care hospital in Rabat, Morocco, in 2023. This case presents an unusual phenotype with early-onset epilepsy beginning at age 5, significantly broadening the known phenotypic spectrum of ARSACS. While initial neuroimaging was unremarkable, the patient exhibited classical retinal involvement with bilateral nerve fibre layer thickening. Genetic analysis revealed a previously unreported homozygous frameshift mutation in the <i>SACS</i> gene (c.12429delT), representing the first documented case in the Moroccan population. This observation extends both the understanding of ARSACS' clinical heterogeneity and its geographical distribution in North Africa. The patient responded favourably to antiepileptic treatment and physiotherapy which underscores the importance of early recognition and multidisciplinary management in atypical presentations. This case highlights the necessity of considering ARSACS in the differential diagnosis of early-onset ataxia with epilepsy, particularly in consanguineous populations.</p>","PeriodicalId":22083,"journal":{"name":"Sultan Qaboos University Medical Journal","volume":"25 1","pages":"756-761"},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12445317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114065","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 Erectile Dysfunction and its Psychological Impact on Patients with Ischaemic Heart Disease in Oman.","authors":"Almunqith Al-Abri, Reema Al-Majrafi, Ahmed Al-Maskari, Qasim Al-Mamari, Sunil K Nadar","doi":"10.18295/2075-0528.2897","DOIUrl":"10.18295/2075-0528.2897","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to assess the incidence of erectile dysfunction (ED) in male patients with ischaemic heart disease (IHD) and to assess the psychological impact on these patients.</p><p><strong>Methods: </strong>This questionnaire-based pilot study was conducted at the outpatient Cardiology Department of the Sultan Qaboos University Hospital, Muscat, Oman between January and December 2023. ED was assessed using the 5-item International Index of Erectile Function and the psychological state was assessed using the Depression Anxiety Stress Scale.</p><p><strong>Results: </strong>A total of 100 patients were included in this study (mean age = 59.5 ± 10.4 years); 62 patients self-reported ED and 69 had some form of ED based on the questionnaire. Moderate to severe ED was found in 30 patients; these patients were older (66.7 ± 10.4 versus 56.4 ± 8.8; <i>P</i> <0.001), more likely to have hypertension (93.3% versus 65.7%; <i>P</i> = 0.004) and hyperlipidaemia (93.3% versus 70%; <i>P</i> = 0.01) and less likely to have undergone PCI (70% versus 88.6%; <i>P</i> = 0.02). There was no effect of drug therapy or other co-morbidities. By binary logistic regression, age was the only predictive factor for ED (odds ratio = 1.12, 95% confidence interval: 1.04-1.22; <i>P</i> = 0.003). Additionally, 32%, 14% and 13% had severe or very severe anxiety, stress and depression, respectively. The ED score corelated negatively and significantly with the anxiety score (r = -0.485; <i>P</i> <0.001), the stress score (r = -0.36; <i>P</i> <0.001) and depression score (r = -0.38; <i>P</i> <0.001).</p><p><strong>Conclusion: </strong>This study found that ED is common in patients with IHD with significant psychological effects. Physicians should be aware of this while treating patients due to the effect on quality of life.</p>","PeriodicalId":22083,"journal":{"name":"Sultan Qaboos University Medical Journal","volume":"25 1","pages":"784-791"},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12445319/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114097","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":"Characteristics and Outcomes of Cancer Patients Admitted to the Hospital With Community- Acquired Pneumonia.","authors":"Anoud Al-Saleh, Dana Hassouneh, Sara Dhaydel, Nour Faqeer","doi":"10.18295/squmj.10.2024.058","DOIUrl":"10.18295/squmj.10.2024.058","url":null,"abstract":"<p><strong>Objectives: </strong>Community-acquired pneumonia (CAP) poses a significant risk of complications in cancer patients. However, limited studies have evaluated hospitalised cancer patients with CAP. This study aimed to evaluate the characteristics and outcomes of cancer patients hospitalised with CAP.</p><p><strong>Methods: </strong>This retrospective study included adult cancer patients diagnosed with CAP admitted at the King Hussein Cancer Center, Jordan, from January 2021 to August 2022, following the Infectious Diseases Society of America guidelines. Patient characteristics, microbiological cultures, length of hospital stay, intensive care unit (ICU) transfers and all-cause mortality were recorded. Early clinical stability was defined as temperature ≤37.8°C, heart rate ≤100 beats/min, respiratory rate ≤24 breathes/min, systolic blood pressure ≥90 mmHg and oxygen saturation ≥90% while breathing room air on the third day of admission.</p><p><strong>Results: </strong>A total of 632 cancer patients were admitted with CAP. The mean age was 60 ± 13.9 years, with 55.2% of the patients being male. Breast cancer was the most prevalent malignancy (22.9%), and 48.6% had received cancer-related treatment within the last 2 months. Positive blood and sputum cultures were detected in 12.4% and 30.0% of patients, respectively. Early clinical stability was achieved in 48.9%, and 88.9% of those patients were discharged after a median stay of 6 days (range: 1-48). Among the included patients, 3.2% required ICU transfer, and 10.9% died.</p><p><strong>Conclusions: </strong>Early clinical stability was achieved in approximately half of the patients, most of whom were discharged home. Future research should identify interventions to improve clinical outcomes for cancer patients with CAP.</p>","PeriodicalId":22083,"journal":{"name":"Sultan Qaboos University Medical Journal","volume":"25 1","pages":"83-90"},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255339/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627050","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":"Empagliflozin Use in Cardiac Transplant Patients: <i>Real-world experience from Saudi Arabia</i>.","authors":"Muhammad I Butt, Roaa M H Albalwi, Norah Alnassar, Reem Alghamdi","doi":"10.18295/squmj.10.2024.057","DOIUrl":"10.18295/squmj.10.2024.057","url":null,"abstract":"<p><strong>Objectives: </strong>Sodium-glucose transport protein 2 (SGLT2) inhibitors are used in the treatment of patients with type 2 diabetes. Besides their beneficial metabolic effects, such as lowering glycated haemoglobin, body weight and blood pressure, these agents have shown favourable and protective effects on both the heart and kidneys. Notably, these cardio-renal benefits are even seen in individuals without diabetes. However, there is limited evidence regarding the safety and efficacy of SGLT2 inhibitors in cardiac transplant recipients. This study aimed to assess the safety and efficacy of empagliflozin in cardiac transplant recipients with diabetes.</p><p><strong>Methods: </strong>This retrospective study was conducted at the King Faisal Specialist Hospital & Research Centre in Riyadh, Saudi Arabia, from June 2003 to May 2024. Patients from the cardiac transplant recipient register who were taking empagliflozin or a combination of empagliflozin and metformin were included. Consequently, their safety and efficacy parameters were examined.</p><p><strong>Results: </strong>A total of 20 patients were included in this study. There was an improvement in haemoglobin A1C (HbA1C) levels, body weight and stability in serum creatinine. Additionally, there was no increased risk of genitourinary infections, hypoglycaemia or diabetic ketoacidosis.</p><p><strong>Conclusions: </strong>Although larger studies are needed to examine the use of empagliflozin in cardiac transplant patients, this small study provides assurance that empagliflozin is safe for use in cardiac transplant recipients.</p>","PeriodicalId":22083,"journal":{"name":"Sultan Qaboos University Medical Journal","volume":"25 1","pages":"91-97"},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255340/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627055","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":"Improving Clinical Prediction of Pulmonary Embolism in Pregnancy and Postpartum by Modifying Wells Score with a Population Specific Risk Factor: <i>A retrospective study</i>.","authors":"Maryam Al Shukri, AlBayan Al Masalami, Karolina Stachyra, Elias Houari, Vaidyanathan Gowri, Sumaya Al Amri, Waoud Al Saidi, Khadija D B Ishaq, Silja A Pillai","doi":"10.18295/2075-0528.2868","DOIUrl":"10.18295/2075-0528.2868","url":null,"abstract":"<p><strong>Objective: </strong>Pulmonary embolism (PE) is a significant cause of maternal mortality, necessitating accurate clinical prediction tools to optimise diagnosis and reduce unnecessary imaging. This study aimed to examine the Wells score's (WS) predictive value for PE, the effect of incorporating sickle cell disease (SCD) on its predictive accuracy and to estimate prevalence of PE in pregnanct and postpartum women.</p><p><strong>Methods: </strong>This retrospective study included pregnant and postpartum women who underwent computed tomography-pulmonary angiography (CTPA) for suspected PE at two tertiary hospitals (Sultan Qaboos University Hospital and Royal Hospital in Muscat, Oman) from 2013 to 2019. The relationship between WS and CTPA was evaluated before and after adding 3 points for SCD.</p><p><strong>Results: </strong>A total of 193 pregnant and postpartum women with a mean age of 31.45 ± 5.60 years underwent CTPA for suspected PE. PE incidence was 0.31 in 1,000 deliveries and 28 women (14.5%) had PE confirmed in CTPA. WS stratified probability of PE as low in 44 (22.8%) patients, moderate in 142 (73.6%) patients and high in 7 (3.6%) patients. In the women with a low score, 2 (4.5%) had PE, giving 95.2% negative predictive value (NPV) of low WS. High WS had a sensitivity of 33.3% and a specificity of 87.0%. Women with SCD had a higher incidence of PE compared to those without (36.7% versus 10.4%, odds ratio = 4.9, 95% confidence interval: 2.0-12.1; <i>P</i> < 0.001). When modifying WS with additional SCD points, NPV for the low score patients was 94.4%, while for the high score group sensitivity and specificity were 72.3% and 85.7%, respectively.</p><p><strong>Conclusion: </strong>The study confirms that low WS effectively excludes PE, reducing the need of imaging in pregnancy and postpartum. Incorporating SCD enhances sensitivity and specificity of a high score aiding to prioritise women for diagnostic imaging or empirical anticoagulation.</p>","PeriodicalId":22083,"journal":{"name":"Sultan Qaboos University Medical Journal","volume":"25 1","pages":"613-621"},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12293539/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733354","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 Presentation of Osteoid Osteoma with Exacerbating Pain during Menses.","authors":"Wassan Nori, Shaymaa K Abdulqader, Nabeeha N Akram, Raid M Al-Ani, Qays A Hassan, Alexandru C Pantazi","doi":"10.18295/squmj.10.2024.067","DOIUrl":"10.18295/squmj.10.2024.067","url":null,"abstract":"<p><p>Osteoid osteomas (OO) are benign neoplasms commonly present during the second and third decade of life, showing a male predominance with classical nocturnal bone pain dramatically responding to nonsteroidal anti-inflammatory drugs. We report a 22-year-old female patient who presented at a teaching hospital, Baghdad, Iraq, in 2023. She presented with right leg bone pain that was exacerbated during menstruation, a presentation that had never been reported in the literature before. The pain intensity increased and interfered with her daily activity. A computed tomography scan showed OO signs and surgical excision and histopathology confirmed OO. The patient's pain reduced to 0 on the visual analog scale. She has no recurrence signs 2 years after the surgery. This novel OO presentation may increase physician awareness of atypical presentation. A careful evaluation of a challenging presentation added to an imaging study may reveal the underlying cause and exclude other diagnostic dilemmas.</p>","PeriodicalId":22083,"journal":{"name":"Sultan Qaboos University Medical Journal","volume":"25 1","pages":"162-167"},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255331/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627119","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":"Anomalous Origin of the Posterior Descending Artery Causing Inferolateral Myocardial Ischaemia in an Octogenarian.","authors":"Ahmad R Bagheri, Madan M Maddali, Adil A Al-Jabri","doi":"10.18295/squmj.10.2024.062","DOIUrl":"10.18295/squmj.10.2024.062","url":null,"abstract":"","PeriodicalId":22083,"journal":{"name":"Sultan Qaboos University Medical Journal","volume":"25 1","pages":"175-179"},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12244236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609591","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}