Australasian Medical Journal
Not a member yet
1482 research outputs found
Sort by
Clinical insights on Tolosa Hunt syndrome: A multidisciplinary approach on neurological-related symptomatology in maxillofacial region
Get PDFBackgroundTolosa–Hunt syndrome (THS) related neurological symptoms are described in literature as “unilateral”, “recurrent”, “episodic”, “intense”, “severe”, “lancinating” or “stabbing” pain on the upper face and forehead and may be misdiagnosed due to the similarity of few symptoms and a significant number of common characteristics between both conditions.AimsThe aim of this brief report is to indicate some important clinical insights related to Tolosa Hunt syndrome, and to give a frank account on the multidisciplinary approach on neurological-related symptomatology in maxillofacial region.Methods We analysed a selection of patients with such clinical picture. To better describe the proper management of clinical cases, we report a 50-year-old female reporting an history of two years of recurrent, severe stabbing pain around the right eye, prominence of her cheek and forehead. Her general dentist first mistakenly diagnosed toothache and, thus, it was subsequently misdiagnosed the trigeminal neuropathy (TN). Results Reported exemplificative case presented a mild ptosis, diplopia of the right eye, corneal reflex loss, paresthesia and hyperesthesia of upper part of left side of face. Magnetic resonance imaging (MRI) findings were suggestive of THS. Complete resolution of symptoms was achieved with oral Prednisolone and constant monitoring of symptoms.ConclusionTHS may be added to the long list of differential diagnosis of TN and general dentist and oral surgeons should be informed about such rare causes of facial pain through continued medical education programs
Meningococcemia as an initial manifestation of systemic lupus erythematosus
Get PDFSystemic lupus erythematosus (SLE) is an inflammatory disease with a wide range of clinical manifestations and complications related to disease activity. One of them is the increase risk to infections secondary to immunological alterations due to pharmacological therapy (especially steroids). Few reports have documented the association of SLE and meningococcal infection with subsequent development of immunological activation (continuous inflammation) and intolerance of the immune system. The attempts to make an early and appropriate approach to these type of patients, generate benefits in survival rates and decrease sequelae among those who survive, especially in those in whose infection compromised central nervous system. We present the case of a patient that presented with neurological symptoms compatible with neuroeffector by Neisseria meningitis isolated in CSF cultures. Despite adequate antibiotic treatment the patient continued to deteriorate neurologically, and alternative diagnosis were evaluated after findings of vasculitis in brain CT scan. Immunological panel was performed with positivity of antibodies commonly present in SLE considering that infection by Neisseria meningitis was a trigger of immunological intolerance and development of SLE. We present the following case to understand the physiopathology and relationship between meningococcal infections, complement consumption, immunological intolerance and the development of autoimmune disease
Incidence and outcome of renal anomalies in children with down syndrome
Get PDFBackgroundDown syndrome is one of the most common occurring chromosomal disorders, which involves multiple systems. Renal and urinary tract anomalies have been reported to occur at increased frequency among this population.AimsThis study aims to estimate the prevalence of renal anomalies in Down syndrome patients, as well as to evaluate their outcome.Methods A retrospective study was conducted in the tertiary hospital, KAUH, from the period of August to October 2016. Files and medical records of 261 patients diagnosed with Down syndrome were reviewed and retrieved from the years 2005–2016.Results Out of the 241 patients, 113 (46.9 per cent) were screened by ultrasound imaging. Renal abnormalities were detected in 51 (21.2 per cent) patients. Of whom 20 (39.2 per cent) were females and 31 (60.8 per cent) males. Abnormalities detected on imaging consisted of: hydronephrosis, vesicoureteral reflux, obstruction, malpositioned kidney, renovascular anomalies and others.The outcomes of the patients with renal involvement were as following: five patients (9.8 per cent) developed chronic kidney disease, eight (15.7 per cent) died due to different causes: (DIC, multiple organ failure, Respiratory arrest, sepsis, and unspecified), and 38 (74.5 per cent) showed no progression of the renal disease. ConclusionThe prevalence of renal abnormalities in Down syndrome was found to be high so early screening for Down syndrome patients is recommended to help diagnose them earlier. Further studies are recommended to follow up Down syndrome patients with renal abnormalities
Gastric mucosal status in patients with reflux esophagitis
Get PDFBackgroundReflux esophagitis and atrophic gastritis has increased in its frequency in patients with dyspepsia, heartburn and regurgitation.AimsTo determine the association of reflux esophagitis, endoscopic gastric mucosal atrophy and histolopathologic atrophy of the gastric mucosa in patients living in Iraq.Methods A group of 130 consecutive patients who were referred to Gastrointestinal Tract Center at Al-Kindy Teaching Hospital (Baghdad-Iraq) from January 2015 to January 2016. The presence or absence of reflux esophagitis, hiatal hernia and atrophic gastritis were determined by endoscopist. Collected gastric biopsy specimens from those patients were examined by for assessment gastric mucosal status and the presence of atrophic gastritis.Results A total of 130 patients were included: 91 men and 39 women, and with mean age of 42.5±6.7 years. According to patients profile, endoscope and histopathological examination of gastric biopsies; there was a significant increase (P=0.0001) in number of patients with diffuse antral gastritis (84(70 per cent)) compared to environmental metaplastic atrophic gastritis (36(30 per cent)). There was a significant increase (P=0.041) in the frequency of reflux esophagitis in patients with diffuse antral gastritis (76.19 per cent) than environmental metaplastic atrophic gastritis (55.55 per cent). There was no significant difference (P=0.479) in the assessment of gastric atrophy between endoscopy or histopathology in patients with reflux esophagitis.ConclusionThe endoscopic investigation of atrophic gastritis was inversely associated with reflux esophagitis. Endoscopy investigates patients with symptoms of reflux esophagitis because it can confirm or exclude this disease with or without gastric atrophy with certainty
Public knowledge and awareness of the effect of diabetes mellitus on oral health
Get PDFBackgroundDiabetes mellitus (DM) is a common chronic disease with an increasing prevalence, affecting general and oral health, with several oral manifestations. A bidirectional effect of diabetes and periodontal diseases has been reported by many researchers.AimThis study aimed to evaluate public awareness and knowledge of the association between DM and oral health among public living in Saudi.Methods A cross-sectional survey was done in Saudi Arabia to determine knowledge, attitudes, and awareness to assess public regarding knowledge of DM-related oral health. Questionnaire was designed and distributed in local Language to a convenient sample group through social media outlets.Results One hundred-ninety completed questionnaires. Our study findings indicated a general awareness of the association between DM and oral health but demonstrated a lack of awareness concerning some oral diseases related with DM. 134 out 190 participants (70.5 per cent) of the respondents confirmed that DM had a negative effect on oral health, and 46.9 per cent considered periodontal disease to have a negative effect on glycemic control. There was a reasonable knowledge concerning DM-related oral manifestations. In contrast, one third of the respondents considered it possible to treat patients with DM and with a blood glucose below 3.9mmol/Which indicated that they think a low blood glucose level has good prognosis and 43.7 per cent agreed that patients with DM should take antibiotics after tooth extraction, while 33.7 per cent of respondents agreed that antibiotics should be administered prior to tooth extraction. These are important considerations for early diagnosis and onset management of oral disease.ConclusionThese findings indicate the need for targeted and specific health information education. They also support a greater need for collaboration between physicians and dentists
Future vital prospect of gene expression factors of lef-7 (baculovirus expression): Old body, young cherub
Get PDFBackgroundBaculovirus; late expression factors (Lef-7) have potential roles for protein expression in insect and mammalian cells; Efficient expression of recombinant proteins to facilitate the practical and structural investigation.AimsLef-7 might play crucial roles in transcription and translation reactions of insect cell lines.Methods Materials and Methods: All required information regards Lef-7 was generated by exploring the internet search engine like as (PubMed, Wiley, ScienceDirect, CNKI, ACS, Google Scholar, Web of Science, SciFinder, and Baidu Scholar) and libraries.ResultsThese properties issue crucial scope for DNA cloning and act as a vital vector for insect and mammalian cells. Left-7 could be the significant site in the development of the vaccine for a couple of chronic diseases. Further investigation needs to study on therapeutic vaccines with few immunologic advantages over proteins derived from mammalian sources, and animal sources. Lef-7 demonstrates the significant impact in the fields of DNA immunology research to insight into the mechanistic and utilitarian link between autoimmunity, infectious diseases, and cancer.ConclusionThis review reveals Lef-7 gene function offers a workable strategy for the expression of whole viral protomers as the future prospect of Lef-7
Remedies in asthma treatment: Introduce a new remedy from perspective of Persian medicine
Get PDFBackgroundAsthma is a chronic inflammatory disease of the airways. Mucus plug formation, oxidative stress, swelling of the airway walls, inflammatory process and vascular changes are important events in asthma pathogenesis.AimsAlthough bronchodilators and steroids are two main drugs in asthma treatment, many adults and children still use complementary and alternative (CAM) medicine. This study was conducted to determine the most popular remedies in asthma treatment from perspective of Traditional Persian medicine (TPM) manuscripts.Methods The main Traditional Persian textbooks from the 9th to 18th centuries AD were collected and analysed. Thereafter, the most listed plants in asthma treatment were gathered. The plants in this list were searched and compared in recent studies. Results Some of these plants have anti- inflammatory and anti- oxidant effects; a few of them have undergone animal or human researches in conventional medicine.ConclusionAccording to long history of medicine in Persia the collected list of remedies could be helpful in selecting plants for future studies in asthma treatment
Type 1 diabetes mellitus (T1DM) in toddlers and schoolchildren in Najran region, Southwestern Saudi Arabia
Get PDFBackgroundThere is an ongoing interest in the relationship between vitamin D status and diabetes control and complications. However, data from Saudi Arabia are limited. Human studies demonstrated the positive association between insulin secretion, insulin sensitivity and serum levels of osteocalcin and vitamin D.AimsThis study aimed to explore the possible role of circulating osteocalcin in the pathogenesis of T1DM and its correlation with fasting plasma glucose (FPG) and vitamin D levels in Saudi Arabia children with T1DM.Methods This cross-sectional observational hospital based- case control study that included 132 Saudi children clinically diagnosed as type 1 diabetes mellitus and 72 apparently healthy children.Results There were statistically weak negative correlations for FPG with UCOC and TOC in diabetic children (r=-0.294, p < 0.01 and -0.358, p < 0.0001 respectively). A moderately significant positive correlation between FPG and BMI and a significantly negative correlation between 25(OH)D3 and FPG (r=-0.62, p < 0.0001) were found. Moreover, there was a moderately significant positive correlation between levels of vitamin D and UCOC in healthy control group (r=0.457, p < 0.0001). Such significance was not present in diabetic group (r=-0.077, p < 0.38).ConclusionLevels of 25(OH)D3, TOC, and UCOC were significantly diminished in children with T1DM suggesting the bidirectional influence of β cells on vitamin D and osteocalcin and vice versa. The reverse correlation between UCOC and HbA1c may indicate the probable prognostic value of UCOC as the lower UCOC, the worse glycaemic control in diabetic children
A case of complicated bullous systemic lupus erythematosus managed with Rituximab
Get PDFSkin Involvement is seen nearly 76 per cent of Systemic lupus erythematosus (SLE) patients, but bullous lesion however accounting for less than one per cent of cutaneous manifestation of lupus erythematosus. A 21-year-old female presented with fever, polyarthalgia and vesicobullous skin lesion and acute renal failure. Clinico-pathological evaluation imparted she was having bullous systemic lupus erythematosus (BSLE) with lupus nephritis. She was put on rituximab after initial resuscitation. She had responded dramatically with resolution of skin lesion and recovery from acute renal failure. She was followed up for one year without complication with stable disease course
