bluuebunny/crossref_metadata_2025_split huggingface dataset:
Management of Diabetes Insipidus following Surgery for Pituitary and Suprasellar Tumors
Authors: Almalki Mussa , Ahmad Maswood M. , Brema Imad , Almehthel Mohammed , AlDahmani Khaled M. , Mahzari Moeber , Beshyah Salem A. 
Published: April 2021

Central diabetes insipidus (CDI) is a common complication of pituitary surgery. However, it is most frequently transient. It is defined by the excretion of an abnormally large volume of dilute urine with increasing serum osmolality. The reported incidence of CDI after pituitary surgery is variable; ranging from 0-90 %. Large tumor size, gross total resection, and intraoperative cerebrospinal fluid (CSF) leak usually have an increased risk of CDI as also seen with craniopharyngioma and Rathke’s cleft cysts. It can be associated with high morbidities and mortality if not promptly recognized and treated on time. It is essential to rule out other causes of postoperative polyuria to avoid unnecessary pharmacotherapy and iatrogenic hyponatremia. Once the diagnosis of CDI is established, close monitoring is required to evaluate the response to treatment and to determine whether the CDI is transient or permanent. This review outlines the evaluation and management of patients with CDI after pituitary and suprasellar tumors surgery to help recognize the diagnosis, consider the differential diagnosis, initiate therapeutic interventions, guide monitoring, and long-term management.
Keywords: Central diabetes insipidus (CDI), polydipsia, polyuria, pituitary adenoma, preoperative risk factor, and pituitary surgery, arginine vasopressin, desmopressin, and treatment.
Sleep patterns and their association with blood pressure and heart rate variability parameters in young Saudi females
Authors: Majeed Farrukh , Latif Rabia , Latif Aamna , Bibi Rehma 
Published: April 2021

Objectives: Disturbed sleep patterns might alter the autonomic tone and may lead to various cardiovascular morbidities. This study aimed to determine sleep patterns (quality, duration, efficiency and day time sleepiness) and explore their association with blood pressure (BP) and heart rate variability (HRV) in young apparently healthy young Saudi females. Methods: This cross-sectional study was conducted in the Physiology department, ------University, Saudi Arabia. Self-reported Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS) questionnaires were used to collect data from 98 female participants. Participant’s blood pressure was recorded with Finometer® and HRV was measured from ECG using PowerLab®. Based on the cut-off values of sleep quality, duration, efficiency and daytime sleepiness scores, students were categorized into groups. HRV and BP were compared between the groups by t test/One-way ANOVA. Results: Poor sleep patterns (quality, duration, efficiency) were observed but no association was found in BP and HRV parameters among groups of different sleep quality, duration, and efficiency. Systolic blood pressure was significantly increased in moderate to severe day time sleepiness group (P=0.039). Dozing off as a passenger in a car doze, in afternoon and after lunch were negatively correlated with HRV parameters (P < 0.05). Conclusion: Sleep quality, duration and efficiency were not found to be statistically significant, but various doze off situations were associated with HRV parameters. Day time sleepiness may augment sympathetic response in apparently healthy female participants.
Keywords: sleep patterns, day time sleepiness, blood pressure, heart rate variability, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale.
Bilateral Chylothorax Following Total Thyroidectomy with Neck Dissection for Papillary Thyroid Cancer
Authors: Kashoob Musallam , Bawain Saleh , Al Badaai Yahya 
Published: April 2021

Bilateral chylothorax is a rare entity that occurs after a thyroidectomy and neck dissection. This rare condition can lead to severe morbidity, and potentially death, if not managed properly. We report a rare complication of neck surgery and subsequent bilateral pleural effusion, regarding a 35-year-old female who presented at Sultan Qaboos University Hospital in 2018 with shortness of breath and respiratory distress. Particularly, the bilateral pleural effusion and related symptoms occurred one week after a total thyroidectomy with central and left lateral neck dissection. Intraoperative findings, management and literature review will be discussed.
Keywords: chylothorax, thyroid cancer, papillary, thyroidectomy, neck dissection, Case report; Oman.
Causal Relationship of Transverse Left Ventricular Band and Bicuspid Aortic Valve
Authors: Dubey Manoj Kumar , Mani Avinash , Ojha Vineeta 
Published: April 2021

Objectives: Bicuspid aortic valve is the most common congenital lesion found in adults. It is can be seen in combination with a transverse left ventricular (LV) band. We aimed to find an essential relationship between the presence of transverse ventricular band and bicuspid aortic valve. Methods: 13 patients with transverse left ventricular band were investigated during a 6 month period from January 2019 to July 2019. LV band thickness and gradients at the site of the LV band were evaluated as part of its effect on LV hemodynamics. Morphology of aortic valve and LV outflow tract gradients were assessed. We aimed to establish the presence of robust LV band as a surrogate marker for bicuspid aortic valve and evaluate the effect of LV band on LV hemodynamics. Results: Mean age of study population was 41yrs. Majority had bicuspid aortic valve(n=11). Average thickness of transverse band was 6.2mm and average mean aortic gradient was4mmHg. Sequestration of blood was noted at the level of transverse band in all the patients with 2 separate jets at LVOT. Anterolateral jet was deflected from transverse band and showed higher velocity in comparison to the other jet, causing turbulence at the bicuspid aortic valve. No co-relation was found between the thickness of transverse band and aortic valve gradient. Conclusion: Presence of a robust transverse LV band can serve as a surrogate marker for bicuspid aortic valve.
Keywords: Bicuspid aortic valve ; aortic stenosis
Ixekizumab for patients with plaque psoriasis affected by multiple sclerosis
Authors: Herrera-Acosta Enrique , Martina Gustavo Guillermo Garriga , Suárez-Pérez Jorge Alonso , Martínez-García Eliseo Alejandro , Herrera-Ceballos Enrique 
Published: April 2021

Multiple sclerosis is an autoimmune demyelinating disorder of the central nervous system that shares similar immunopathogenic mechanisms with chronic plaque psoriasis, such as the overexpression of the Th17 pathway. We report the case of a patient with multiple sclerosis and severe chronic plaque psoriasis successfully treated with ixekizumab (anti IL-17A and IL-17A/F monoclonal antibody). The treatment achieved a complete skin clearance (PASI 100 response) with no adverse events or evidence of progression of the neurological disease.
Keywords: Psoriasis; Ixekizumab; Multiple sclerosis
Women’s Knowledge of Cervical Cancer
Authors: Al-Saadi Aisha N , Al-Muqbali Aisha H , Dawi Eihab 
Published: April 2021

Objectives: This study aimed to assess knowledge of cervical cancer and its prevention among Omani women aged 20 to 65 years. Method: This analytic cross-sectional study took place at primary healthcare institutions, in the Al Buraimi governorate, Oman, between November 2018 I believe that in response to comment #5 too much information may have been removed from the Results section, therefore we return the first two paragraphs that were removed to the Results section and make them more concise during the copy editing stage. and February 2019. The study was carried out on the basis of a predesigned, validated, and self-administered 55 question questionnaire. Results: Data from seven hundred and ninety-one completed questionnaires were included in the final analysis, which represents a response rate of 79.1% of the total. The results of the study indicated that 86.7 percent of surveyed women had previously heard of cervical cancer, and 13.0 per cent assumed the possibility of this disease to affect them in the future. The results showed that women had low awareness of the association between Human Papilloma Virus (HPV) and cervical cancer (24.7%). Participants considered HPV infection and initiation of sexual intercourse at an age younger than 17 years as the lowest risks associated with cervical cancer. The results also indicated that 63.8% of women were unaware of a vaccination 'against HPV related cervical cancer' and many of respondents were unaware of Pap test. Women aged over 30 years, those married, and those with a high level of education were more likely to be aware of cervical cancer. Conclusion: General knowledge of cervical cancer among women aged 20 to 65 years is insufficient. Young women aged 20-30 are largely unaware. Thus, concerted efforts are needed to promote awareness among women in Oman.
Keywords: Cervical cancer, risk factor, Human Papilloma Virus, vaccine, Pap test.
Prevalence and Determinants of Vaccine Hesitancy in Aseer Region, Saudi Arabia
Authors: Alqahtani Youssef A , Almutairi Khalid H , Alqahtani Yahya M , Almutlaq Ahmed H , Asiri Anas A 
Published: April 2021

Objectives: Vaccination is the provision of a vaccine to initiate immunity trough stimulating immune system to develop protection from a certain disease. When a sufficiently large proportion of a population has been vaccinated, herd immunity initiated. The effectiveness of vaccination has been widely studied and verified. Although the harsh vaccine safety systems, some parents remain minded regarding the safety of the childhood vaccines and immunization schedule. These hesitations pushed some parents to not allow their children to receive some or all the scheduled vaccines. The aim of the study is to assess the general population awareness regarding vaccines and to detect prevalence of vaccine hesitancy in Aseer region, southern of Saudi Arabia. Methods: A descriptive cross-sectional approach was used targeting all parents in Aseer region. Data were collected using structured questionnaire which developed by the researchers after intensive literature review and expert’s consultation. The questionnaire data included parents’ socio-demographic data, parents’ awareness regarding child vaccines safety and efficacy, parents’ attitude and adherence to children vaccination and hesitancy towards vaccines. Results: The survey included 796 participants whose ages ranged from 18 to 55 years old. Two thirds (63.4%) of the participants were females. Regarding vaccination adherence and hesitancy among participants, more than three quarters were completely adherent to the child vaccination schedule and only 3.9% were non adherent. As for participants awareness regarding child vaccination safety and efficacy, 89.3% of the respondents agreed on that vaccination keep child healthy, 84.2% reported that child vaccine is safe and effective, 83.4% said that all Saudi scheduled vaccines are effective. Conclusion: In conclusion, the study revealed that vaccine hesitancy among participants was not low and should be considered irrespective of their high awareness level. The recorded antivaccine action was mostly related to vaccines safety not efficacy.
Keywords: Vaccine hesitancy, antivaccine movement, parents, awareness, adherence
Parental Age and the Risk of Autism Spectrum Disorder in Oman
Authors: Al-Mamari Watfa , Idris Ahmed B , Al-Zadjali Aala' A , Jalees Saquib , Murthi Sathiya , Al-Jabri Muna , Gabr Ahlam , Fombonne Eric 
Published: April 2021

Objective: This study aimed at evaluating advanced parental age as a risk factor for Autism Spectrum Disorder (ASD) in an Omani cohort. Methods: Case-control study of 278 ASD cases compared with 722 sex-matched controls retrieved from the electronic records of the Developmental Paediatric Clinic, Sultan Qaboos University Hospital (SQUH) between January 2015 and June 2016. Results: ASD cases (76.6% male) were mostly diagnosed between 3-4 years of age, with more than 50% of them originating from Muscat and Batinah governorates. Compared to controls, mothers from the case group had significantly higher educational level (post-secondary education versus high school/no formal education (odds-ratio (OR)=1.62; 95% C.I. 1.20-2.19). In a multivariate logistic regression, the odds ratio of maternal age as a risk for ASD increased dramatically with advancing age category (using age<25 as a reference, OR was 3.39, 6.12, 7.86 and 13.13 for age categories 25-29, 30-34, 35-39, and ≥40 years, respectively). The ORs of advancing paternal age as a risk for ASD were also statistically significant (using age<30 as referent, OR was 2.20, 2.36, and 3.12 for age categories 30-34, 35-39 and 40-44 years); however, there was a drop in the effect with paternal age ≥ 45 years (OR=1.42; 95% C.I .64-3.15). Conclusion: Both maternal and paternal increased age were associated with a higher risk of ASD; however, the association was more pronounced and more consistent with advanced maternal age compared to paternal age.
Keywords: Autism; parental age; case-control study
The Experience of Healthcare Professionals Providing Mental Health Services to Mothers with Postpartum Depression
Authors: Jannati Nazanin , Farokhzadian Jamileh , Ahmadian Leila 
Published: April 2021

Objectives: This study aims to describe healthcare professionals' experience in providing mental health services to women with postpartum depression. Methods: In this qualitative study, data were collected through semi-structured interviews with five physicians, five midwives, and five psychologists from fourteen urban healthcare centers in Kerman, Iran, from April 2019 to September 2019. We used purposeful sampling to select the participants. Data were qualitatively analyzed using a content analysis approach. Results: Data analysis revealed the main theme of the study, "the long way ahead of comprehensive, integrated and responsive mental health services." This theme includes four categories: "postpartum depression challenges, "social and personal factors," "structural challenges," and "need to change in the mental health services." The participants described that the diagnosis of depression is difficult due to insufficient knowledge of healthcare providers and hidden signs of postpartum depression. The participants described how different factors might cause depression. These factors were economic, cultural factors in the society, personality traits, community lack of knowledge, negative attitude toward depression, and limited family support. Moreover, providing mental health services has some challenges, such as limited human resources, insufficient financial resources, and incomplete or inefficient policy makings. Conclusion: Although measures have been taken to provide mental health services, there are many challenges regarding providing mental health services to mothers. Therefore, there is a need to take serious measures to improve mental health services and re-define the existing measures. Informing the community, empowering the healthcare providers, and planning to change the community's attitude and belief can affect women's mental health care with depression.
Keywords: Postpartum Depression, Mental Health Services, Community Mental Health Services, Mental Disorders, Depressive Disorder.
Exploring Frequency of Event Reporting as Perceived by Intensive Care Units’ Nurses in Sultanate of Oman
Authors: Al Ma'mari Qasim , Al Omari Omar , Abu Sharour Loai 
Published: April 2021

Objectives: Little is known about the factors that affect the perceived frequency of event reporting among healthcare workers especially registered nurses working in Oman. This study aimed to find out whether fatigue, workload, burnout, and work environment as independent variables have a relationship with frequency of event reporting as dependent variable and to what extent the aforementioned independent variables predict the frequency of event reporting between nurses working in different intensive care units in selected hospitals in Oman. Methods: This study used a cross-sectional research design. Also this study used standardized questionnaires which are hospital survey on patient safety culture, fatigue assessment scale, maslach burnout inventory-human services survey, NASA task load index, and practice environment scale of the nursing work index. Registered nurses working in intensive care units participated in this study from two referral hospitals in Oman during the period between June and September 2018. Results: A total of 270 nurses were included in this study (response rate: 90%). There was a statistically significant positive relationship between personal accomplishment and the frequency of event reporting (r = 0.132, p < 0.05). Regression analysis showed that nurses’ feedback and communication about errors predicted the frequency of events reporting between intensive care units’ nurses in Oman (R2 = 0.214, adjusted R2 = 0.046; F = 12.82, p < 0.01). Conclusion: Personal accomplishment and feedback and communication about error of intensive care units’ nurses had positive impact on perceived frequency of event reporting whereas no relationship found between fatigue, workload, work environment and frequency of event. Strategies need to be in place in health organizations to encourage nurses to report errors.
Keywords: Burnout; Intensive care units’ nurses; Fatigue; frequency of event reporting; Work environment.
Characteristics and Outcomes of Critically Ill Patients with Raised Cardiac Troponins Admitted in the Intensive Care Unit
Authors: Nadar Sunil K. , Shaikh Muhammad M. , Khatri Muhammad A. , Abdelmottaleb Wael A. , Ahmed Sheeraz , Alhashim Abdulhakeem , Albusaidi Mujahid , Alkindi Fahad 
Published: April 2021

Objectives: Critically ill patients have been shown to have raised troponins. The aim of our study was to assess the incidence of myocardial injury in the intensive care unit (ICU) a tertiary care hospital in Oman and assess their management and prognosis. Methods: This was a retrospective study involving adult patients admitted to the ICU of our institution between 1st January and 31st December 2019 who had a high sensitive cardiac troponin (Hs-CTn) assay performed. We excluded patients who were admitted with a primary diagnosis of myocardial infarction. Results: A total of 264 patients had a Hs-cTn measured during this period. Of these 128 patients (64.3+17.1 years; 58.5% male) had elevated levels giving an incidence of around 48.4%. Those with raised troponin were older and had more co-morbidities. These patients were also more critical with lower blood pressure, higher heart rates, hypotensive episodes. Of the 128 patients, 47 were treated as acute coronary syndrome and 32 underwent coronary angiography. Of these only 3 patients required stenting. Patients with raised troponin had a poor outcome with only 45 (35.1%) surviving to discharge as compared to 73.5% where troponin was normal. They had a shorter hospital length of stay as compared to those with normal troponin (16(8-25) vs 19(13-28) p=0.017). Conclusion: A high proportion of critically ill patients have evidence of myocardial injury without significant coronary artery disease. It is associated with poor prognosis. Further prospective studies are required to ascertain the best mode of treatment in these patients.
Keywords: Troponin; Biomarkers; Intensive Care; Myocardial Infarction.
Predictors of Nicotine Dependence among Adult Male Midwakh and Cigarette Smokers
Authors: Al Sharbatti Shatah , Shaikh Rizwana B. , Sreedharan Jayadevan , Muttappallymyalil Jayakumary , Weizman Michael 
Published: April 2021

Objectives: Midwakh is a popular form of smoking in the Middle East. This study aimed to assess predictors of nicotine dependence among exclusive cigarette and midwakh smokers in the United Arab Emirates (UAE). Methods: This cross-sectional study was conducted from September to December 2015 in Ajman, UAE. A convenience sampling strategy was used to recruit adult male smokers aged ≥18 years who exclusively smoked either cigarettes or midwakh. A validated self-administered questionnaire was used to collect data from the participants, with nicotine dependence assessed using the Modified Fagerström Test for Nicotine Dependence. In addition, testing was performed to determine levels of salivary cotinine and exhaled breath carbon monoxide (CO). Results: A total of 88 adult male smokers were included in the study, of which 40 (45.5%) were cigarette smokers and 48 (54.5%) smoked midwakh. Most participants were 26–35 years of age (48.9%), followed by 18–25 years (30.7%) and ≥35 years (20.5%). Use of midwakh was associated with a more than three-fold increase in the risk of moderate to high nicotine dependence in comparison with cigarette smoking. Moreover, for each unit increase in CO level, there was a 10% increase in the risk of nicotine dependency. There was also a significant association between nicotine dependence level and depth of inhalation (P = 0.023). Conclusion: Type of smoking and CO levels were found to be significant predictors of nicotine dependence among adult male smokers. In particular, greater dependency was observed among midwakh smokers compared to those who smoked cigarettes.
Keywords: Tobacco Use; Cigarette Smoking; Addictive Behaviors; Nicotine; Risk Assessment; Carbon Monoxide; Cotinine; United Arab Emirates.
Is There Any Sympathetic Skin Response (SSR) Abnormality in Raynaud Phenomenon?
Authors: Emad Mohammad R. , Farpour Hamid R. , Ahmed Faisal , Tayebi Masoumeh , Nazarinia Mohammadali , Askarpour Mohammad R. , Nikbakht Hossein-Ali 
Published: April 2021

Objectives: Sympathetic skin response (SSR) is a technique for assessment of the damage of peripheral neuropathies and the disorders of the sympathetic system. This study aimed to evaluate SSR among patients with Raynaud phenomenon (RP). Methods: Between January 1, 2015 and December 30, 2018, about 20 patients with RP and 20 healthy subjects as the control group were recruited from patients referring to the Outpatient Clinics of Shiraz medical University. All the participants were clinically examined, and the SSR was performed using a standard protocol. SSR is abnormal when the latency is prolonged and/or the amplitude reduced. Results: Raynaud's group consisted of 19 women (95 %) and 1 male (5%). 3 patients (15 %) with primary Raynaud's phenomenon (PRP) and 17 patients (85%) with secondary Raynaud's phenomenon (SRP). The control group consisted of 16 women (80%) and 4 males (20%). The mean age of the Raynaud's group and control subjects was 43.1±9 and 36.7±8.6 years, respectively. The SSR to the electrical stimulus was absent in 3 patients (PRP patients). The total median nerve mean latencies in the upper limb were 1.9±0.57 and 1.19±0.52 seconds for the Raynaud's group and control groups, respectively (p <0.001). These findings revealed significantly prolonged SSR latencies in the Raynaud's group, while the mean amplitude showed no significant differences in both groups (p =0.756). Conclusion: Absence or prolonged latency of SSR was associated with the disorders of the unmyelinated axons in the sympathetic system. Our findings suggested the disorders of unmyelinated axons in Raynaud's phenomenon.
Keywords: Raynaud Disease; Autonomic Nervous System; Electrodiagnosis; Sympathetic Fibers; Nerve Conduction.