The epidemiology of acute pancreatitis in a tertiary care hospital in Dubai.

Background: The prevalence of acute pancreatitis is rising especially in the Western world, but the prevalence remains unknown in most Middle Eastern Countries. Acute pancreatitis has been attributed with multiple etiologies with the two most common being alcohol abuse disorder and gallstones. The incidence and prevalence of it in the United Arab Emirates are yet to be reported. Materials and Methods: The Atlanta criteria were used for the diagnosis of acute pancreatitis and applied to patients that have been admitted to a single tertiary center in the year 2021. Several variables were investigated including gender, age, clinical presentation, etiology, radiological and laboratory results, complications, and outcome. Moreover, the Bedside Index for Severity in Acute Pancreatitis score was used to assess and determine the severity of acute pancreatitis in these patients. Results: Nineteen patients were identified in our database with 52% being males. The mean age of patients was 41 years. The most frequent presentation was abdominal pain in 100% of our patients. Moreover, the most common etiology identified was idiopathic (52.63%), followed by biliary (21.05%). The mortality rate was 0%. Conclusion: This is the first retrospective study in Dubai on acute pancreatitis. Pancreatitis is a life-threatening condition with multiple etiologies. Physicians should consider multifactorial acute pancreatitis in patients with different comorbidities.

Résumé Contexte: La prévalence de la pancréatite aiguë augmente particulièrement dans le monde occidental, mais elle reste inconnue dans la plupart des pays du Moyen-Orient. La pancréatite aiguë a été attribuée à de multiples étiologies, les deux plus courantes étant l'abus d'alcool et les calculs biliaires. Son incidence et sa prévalence aux Émirats arabes unis n'ont pas encore été signalées. Matériels et méthodes: Les critères d'Atlanta ont été utilisés pour le diagnostic de pancréatite aiguë et appliqués aux patients admis dans un seul centre tertiaire en 2021. Plusieurs variables ont été étudiées, notamment le sexe, l'âge, la présentation clinique, l'étiologie, les données radiologiques et de laboratoire. résultats, complications et issue. De plus, le score de l'indice de gravité de la pancréatite aiguë au chevet a été utilisé pour évaluer et déterminer la gravité de la pancréatite aiguë chez ces patients. Résultats: Dix-neuf patients ont été identifiés dans notre base de données dont 52 % étaient des hommes. L'âge moyen des patients était de 41 ans. La présentation la plus fréquente était des douleurs abdominales chez 100 % de nos patients. Par ailleurs, l'étiologie la plus fréquemment identifiée était idiopathique (52,63 %), suivie par la biliaire (21,05 %). Le taux de mortalité était de 0%. Conclusion: Il s'agit de la première étude rétrospective réalisée à Dubaï sur la pancréatite aiguë. La pancréatite est une maladie potentiellement mortelle aux étiologies multiples. Les médecins devraient envisager une pancréatite aiguë multifactorielle chez les patients présentant différentes comorbidités. Mots-clés: Pancréatite aiguë, COVID-19, Dubaï, Moyen-Orient, rétrospective.

An Unusual Presentation of Cardiofaciocutaneous Syndrome Diagnosed Through Whole Genome Sequencing: A Case Report.

Cardiofaciocutaneous syndrome is a rare, sporadic disease caused by germline mutations in the Ras/MAPK (mitogen-activated protein kinase) pathway. Patients usually present with craniofacial anomalies, cardiac defects, and neurocutaneous abnormalities. The features of cardiofaciocutaneous syndrome overlap with two other syndromes known as Noonan's syndrome and Costello's syndrome. Similarly, those two syndromes are caused by mutations in the Ras/MAPK pathway. The diagnosis of cardiofaciocutaneous syndrome is suspected based on the clinical presentation and confirmed by genetic analysis. We report a case of a seven-month-old boy who presented with complaints of developmental delay, poor weight gain, and seizures. Physical examination revealed several dysmorphic features, including coarse facies, long philtrum, thin upper lip, a broad forehead, and long toes. Neurological examination showed hypotonia in all four limbs, with normal power and reflexes. However, the infant did not have any remarkable cutaneous abnormalities. Whole-exome sequencing picked up a BRAF gene mutation, and the patient was diagnosed with cardiofaciocutaneous syndrome. On follow-up, the patient developed findings suggestive of autoimmune hepatitis. Cardiofaciocutaneous syndrome remains a challenging diagnosis that requires a detailed assessment of the patient, as well as qualified centers with genetic analysis for diagnosis confirmation. Management of cardiofaciocutaneous patients requires a multidisciplinary team approach in order to improve the outcomes. Further exploration is required into atypical presentations of the disease as well as autoimmune disease associated with RASopathies.

Bladder leiomyoma treated with transurethral resection of bladder tumor (TURBT): Case report.

INTRODUCTION AND IMPORTANCE: Bladder leiomyomas are rare benign mesenchymal tumors, accounting only about 0.43 % of all bladder tumors. These tumors are classified based on their location, where they can be endovesical, extravesical, and intramural with the endovesical subtype being the most common. There are roughly 250 cases of bladder leiomyoma reported worldwide. In the following case report, we discuss the case of a bladder leiomyoma presenting with obstructive urinary symptoms and managed with TURBT. CASE PRESENTATION: A 24-year-old female presented complaining of incomplete bladder emptying accompanied by urgency, frequency, hesitancy, and urinary incontinence. MRI and US confirmed the presence of an oval-shaped mass lesion arising from the base of the urinary bladder. Tissue biopsy and immunohistochemistry confirmed the diagnosis of bladder leiomyoma. Following confirmation of the diagnosis, the patient underwent an uneventful trans-urethral resection of bladder tumor (TURBT). During the surgery, one large bladder tumor was resected. Surgical biopsy report confirmed bladder leiomyoma. CLINICAL DISCUSSION: In this case report, we discuss the various management options of bladder leiomyoma and our surgical approach to this condition. CONCLUSION: This case highlights a rare bladder leiomyoma presenting with obstructive urinary symptoms. Trans-urethral resection of bladder tumor (TURBT) remains the mainstay of treatment for small, endovesical tumors. Our patient had a successful surgery with no recurrence on follow up.