Candida species: the silent enemy

Candida species are known to causeserious infections in immunocompromised patients but uncommon cases have been reported in immunocompetent individuals regardless of the harmless co-existence of the fungi with the host. Recently, the incidence rate of candidiasis has increased dramatically alongside the emergence of antifungal resistance. Although conventional methods to ensure prompt diagnosis of candidiasisfor effective therapy have been established, thescientific world is witnessing progress in the development of more accurate, timelyand cost-effective methods that is coinciding with the molecular revolutionand advanced DNA analysis. Moreover, the challenges of resistance of Candida to available antifungal agents are being met with the deployment of molecular techniques to investigate the mechanisms of resistance. This review is an attempt to provide up-to-date information on the persistent problems of Candidawith highlights on the clinical importance, molecular diagnosis,and resistance to candidate antifungal drugs;azoles and echinocandins

Knowledge, attitudes and intended behaviours towards HIV testing and self-protection: a survey of Omani pregnant women

Routine HIV testing of all pregnant women in Oman has been introduced without prior knowledge of women's attitudes towards testing or their behaviour in the event of a positive test. This study recruited 1000 Omani pregnant women from antenatal clinics to explore their knowledge of HIV/AIDS, attitudes towards HIV testing and intended behaviours in the event of a positive test. Mother-to-child transmission was recognized by 86.6% of the women but only 21.0% knew that it was preventable and a few acknowledged the important role of antiviral drugs. Half of the women [51.9%] reported having been tested for HIV and 75.8% agreed about routine HIV testing for all pregnant women. A higher level of knowledge was significantly associated with a favourable intended behaviour related to voluntary testing, disclosure and seeking professional assistance in the event of a positive HIV test. The results are discussed in relation to opt-in and opt-out approaches to voluntary testing during pregnancy

Complications of diabetes mellitus encountered in a tertiary care hospital in Ajman, UAE

Objectives: To determine the profile of complications in patients with diabetes in the region of Ajman

Materials and Methods: Data was collected from GMC Hospital records of patients presenting with complications of diabetes from 1 January 2010 - 31 December 2010. Data analysis was done on SPSS and Chi square test was done to test associations

Results: Out of 162 patients, there were 15 patients with acute complications of which the most commonly observed was hyperglycemia [69.6%] and there were 90 patients with chronic complications of which CVD was the most frequently [48.8%]. It was also found that the age group with the most cases of acute and chronic complications were 20-39 years [66%] and 40-59 years [55.6%]. 24.7% out of 162 patients had co-morbidities, with the most common being liver disorders, followed by thyroid disorders and anemia

Conclusion: Most patients in our study presented with hyperglycemia and cardiovascular disease, with the former seen most commonly in the younger age group and the latter in the older age group. Also a significant number of patients with complications had high RBG and HbAlc levels. Therefore greater efforts are needed in controlling the blood glucose level in order to prevent long term complications

Child maltreatment types and effects: series of six cases from a university hospital in Oman

Child maltreatment [CM] is common worldwide, and can take many forms. It may even endanger the child's life, especially when younger children are the victims. CM affects the child's quality of life and consequently leads to long term issues to be dealt with by the child, family and community. This case series discusses six children who have been subjected to CM, and diagnosed by the child protection team of the departments of Child Health and Behavioural Medicine at Sultan Qaboos University Hospital [SQUH], Oman. The aim of this case series is to increase the level of awareness of CM among Oman's medical professionals and to highlight the difficulties encountered in diagnosing and providing optimal care for these children. Although treatment is provided in Oman's health care system, it is clear that there are gaps in the existing system which affect the quality of child protection services provided to the children and their families

Microsporidiosis among children with malignant diseases in Basrah, Iraq

To estimate the prevalence of microsporidiosis among children with malignant diseases. Stool samples were collected from 58 children [37 males and 21 females] with malignant diseases and 107 apparently healthy children [55 males and 52 females]. Direct smear method was done for all stool samples to detect the intestinal parasites. Fecal smears were prepared and stained by Trichrome stain method for the recovery of Microsporidium spores. The results showed that acute lymphocytic leukemia [ALL] was the most prevalent [55.2%] malignant disease among the studied patients. The highest rate of Microsporidium infection among the 12 types of malignant diseases was found in patients with Hodgkin and non-hodgkin lymphoma [83.3%]. Prevalence of various species of intestinal parasites [including Microsporidium] was 48.3%. The highest rate of parasitic infections was observed in patients with ALL [34.4%]. No Microsporidium spores were observed in stool samples of the control group. The clinical symptoms among patients included weight loss [77.6%], fever [29.3%] and diarrhea [27.6%]. Microsporidium and other intestinal parasites should be considered among the patients with malignant diseases in order to minimize their symptoms

Complications of diabetes mellitus encountered in a tertiary care hospital in Ajman, United Arab Emirates

To determine the profile of complications in patients with diabetes in the region of Ajman. Data was collected from GMC Hospital records of patients presenting with complications of diabetes from 1 January 2010-31 December 2010. Data analysis was done on SPSS and Chi square test was done to test associations. Out of 162 patients, there were 15 patients with acute complications of which the most commonly observed was hyperglycemia [69.6%] and there were 90 patients with chronic complications of which CVD was the most frequently [48.8%]. It was also found that the age group with the most cases of acute and chronic complications were 20-39 years [66%] and 40-59 years [55.6%]. 24.7% out of 162 patients had co-morbidities, with the most common being liver disorders, followed by thyroid disorders and anemia. Most patients in our study presented with hyperglycemia and cardiovascular disease, with the former seen most commonly in the younger age group and the latter in the older age group. Also a significant number of patients with complications had high RBG and HbAlc levels. Therefore greater efforts are needed in controlling the blood glucose level in order to prevent long term complications

Shaken baby syndrome as a form of abusive head trauma

Shaken baby syndrome [SBS] is a form of abuse that is characterised by brain injury. Because of the subtle and yet debilitating neurobehavioural impairment which ensues, SBS represents a diagnostic dilemma for attending clinicians. The situation is made worse by the young age of the affected child who may not be capable of explaining what happened. SBS has been reported in many parts of the world. To our knowledge, there is a dearth of literature on the topic from Arab/Islamic countries. This article attempts to shed light on the syndrome by reviewing information on the aetiology of SBS, as well as on its diagnosis and the reasons for delayed diagnosis. The central aim of this review is to increase awareness of SBS so that enlightened policies for prevention and intervention could be developed in the region and particularly in Oman

Central nervous system tumors: a pathological study of 462 cases in Nineveh province

Objective: To define different types of central nervous system [CNS] tumours, their incidence and relative frequencies, age, and sex distribution, in addition to their anatomical location

Design: Retrospective study

Setting: One of the authors’ private laboratory over 11 years period from January 1991 to December 2001 inclusive

Participants: Four hundred sixty two cases of CNS tumours

Intervention: Clinical data including the age, sex, site, in addition to the histological study of slides

Result: One hundred seventeen cases of CNS tumours were diagnosed in the first two decades of life while three hundred forty five cases were seen in adults. Glioma was the most common tumour [38.1%] followed by meningioma [29.9%] and medulloblastoma [5.8%]. Forty four percent of astrocytomas were of grade II while [19.6%] were of grade IV [glioblastoma multiforme]. There is a rise in the frequency rate of intracranial tumours [lCT] in all age groups strikingly in those over the age of sixty in which the rise was more than three fold in the last two years of the study

Conclusion: The incidence of CNS tumours in the North part of Iraq is [1. 7/100 000] population, glioma was the most frequent diagnosis followed by meningioma. There is a rise in the number of cases in all age groups especially in those over the age of sixty

Biochemical evaluation in patients with chronic renal failure undergoing maintenance haemodialysis

Twenty five [18 Males and 7 Females] with end stage renal failure maintained on hemodialysis program at Basrah general hospital were evaluated for biochemical changes in serum calcium, phosphate, alkaline phosphatase, urea, creatinine and total serum proteins. Blood samples were obtained monthly before and after dialysis, followed up for 6 months and the results were compared with 32 healthy controls [24 Males and 8 Females]. The overall mean of serum phosphate, alkaline phosphatase, urea, and creatinine, were significantly higher than controls [P < 0.01] while mean serum calcium was significant lower than controls [P <.0.05]. No significant difference in serum total protein was obtained compared to the controls [P > 0.05]. There was a significant correlation between serum alkaline phosphatase and time [r = 0.47, p = 0.017] over the 6 months period of maintenance hemodialysis

clinical profile of the initial attack of rheumatic fever in Iraq

The clinical profile of the initial attack of acute rheumatic fever was studied prospectively in 86 patients, who were admitted to the medical and pediatric units of Barash Republican Hospital [Teaching], over a period of 2 years. The most common features of the initial attack of ARF were fever, arthritis, and high erythrocyte sedimentation rate. Arthritis was found in 79 patients [91.9%], cordites in 40 patients [46.5%], and chorea in one patients [1.2%]. Erythema marginatum and subcutaneous nodules were not observed. No mortality was recorded in this series. The findings of this study show that the clinical profile of the initial attack of acute rheumatic fever in Iraq dose not differ substantially from that in the West or in the Third World countries