Notes

In-hospital link between COVID-19 an infection throughout sufferers with fundamental heart disease.
This study suggested the possibility of maintaining nutritional condition by administering NYT in elderly patients with chronic wasting disease of various aetiologies. More evidence will be required to confirm these results.
This study aimed to evaluate sympathetic skin response (SSR) among patients with Raynaud phenomenon (RP). SSR is a technique for assessment of the damage of peripheral neuropathies and the disorders of the sympathetic system.

Between January 2015 and December 2018, approximately 20 patients with RP and 20 healthy subjects (control group) were recruited from patients referred to the outpatient clinics of Shiraz University of Medical Sciences, Shiraz, Iran. All participants were clinically examined and the SSR was evaluated using a standard protocol. SSR is abnormal when the latency is prolonged and/or the amplitude is reduced.

The RP group consisted of 19 women (95%) and one male (5%); three patients (15%) had primary Raynaud's phenomenon (PRP) and 17 patients (85%) had secondary Raynaud's phenomenon. The control group consisted of 16 women (80%) and four males (20%). The mean age of the RP group and control subjects was 43.1 ± 9 and 36.7 ± 8.6 years, respectively. The SSR to the electrical stimulus was absent in three patients with PRP. The total median nerve mean latencies in the upper limb were 1.90 ± 0.57 and 1.19 ± 0.52 seconds for the RP group and control groups, respectively (
<0.001). These findings revealed significantly prolonged SSR latencies in the RP group, while the mean amplitude showed no significant differences in both groups (
= 0.756).

Absence or prolonged latency of SSR was associated with the disorders of the unmyelinated axons in the sympathetic system. The findings of the present study suggested the disorders of unmyelinated axons in Raynaud's phenomenon.
Absence or prolonged latency of SSR was associated with the disorders of the unmyelinated axons in the sympathetic system. The findings of the present study suggested the disorders of unmyelinated axons in Raynaud's phenomenon.
To assess the causes of delay for presentation with ST elevation myocardial infarction (STEMI).

Patients who presented with STEMI to the Emergency Department at the Sultan Qaboos University Hospital, Muscat, Oman between January 2017 and December 2019 and were admitted for primary angioplasty were included in this study.

A total of 101 patients were included with a mean age of 54.8 + 10.8 years and the majority were male patients (n = 80; 79.2%). The median (interquartile range) pain-to-door time was 60 min (30-120 min). There were 66 (65.4%) patients who arrived within 90 minutes. All except one arrived by privately arranged transport. Feeling that the pain was not important (61.0%) or not cardiac (22.8%) were the main reasons for delay. Being diabetic was the only patient factor that predicted delay.

A high proportion of patients presenting to our institution with a STEMI arrived within recommended times. However more public education is required to improve awareness about the importance of early evaluation of chest pain.
A high proportion of patients presenting to our institution with a STEMI arrived within recommended times. However more public education is required to improve awareness about the importance of early evaluation of chest pain.Hydatidosis is a common zoonotic disease with a high prevalence in developing countries. While a solitary cyst with unilateral lung involvement is common, bilateral involvement and multiple cysts are rare, only seen in 20% and 30% of the cases, respectively. Likewise, extensive involvement of extrapulmonary tissues and mediastinum is rare. We report an unusual case of mediastinal hydatidosis mimicking an intrathoracic malignancy in a 24-year-old female patient. She presented in the year 2020 with a history of left-sided chest pain and heaviness in the left hemithorax for a period of two months. Diffuse, multiple fluid-filled cystic lesions with internal echoes throughout the mediastinum, lung, pericardium, diaphragm and chest wall were observed in contrast-enhanced computed tomography of the thorax. An incidental cystic lesion in the liver was also noted. Since serology for echinococcosis was negative, a differential diagnosis of intrathoracic malignancy was considered. However, intraoperative and histopathologic findings were suggestive of hydatidosis.Intraperitoneal haemorrhage during pregnancy or postpartum without any history of trauma (spontaneous haemoperitoneum in pregnancy [SHiP]) is a rare condition, causing significant morbidity and mortality for the mother and the neonate. We report a 27-year-old female patient with SHiP at 31 weeks of gestation who was referred to a tertiary care hospital in Muscat, Oman, in 2019, with right iliac fossa pain, pallor and tachycardia. Radiological investigations revealed intraperitoneal bleeding and a right adnexal haematoma. She was managed conservatively with blood transfusion and supportive care. At 36 weeks of gestation, lower segment caesarean section was done and a live baby with good Apgar score was delivered. Pre-operatively, she was found to have a bicornuate uterus, placenta percreta at the junction of the horns and a right adnexal haematoma. click here This case highlights the significance of thorough evaluation of acute abdominal pain in pregnancy in avoiding unnecessary surgical intervention and iatrogenic prematurity.Mycobacterium abscessus complex (MABSC) is a rapidly growing mycobacterium and may rarely cause disseminated infections in immunocompromised patients. In patients with cystic fibrosis (CF), it peaks between the ages of 11 and 15 years. We present a five-month-old infant with coexisting CF and progressive familial intrahepatic cholestasis (PFIC) who had pulmonary and cutaneous dissemination of MABSC infection. The management of this disseminated infection in an infant with two coexisting chronic diseases was challenging and resulted in the rapid deterioration of lung function and progression of PFIC to liver cirrhosis with a fatal outcome.
This study aimed to determine extubation failure (EF) rate among intubated preterm infants (<37 weeks gestational age [GA]) admitted to a tertiary care neonatal intensive care unit (NICU) in Oman and identify the risk factors associated with EF.

This retrospective study included all intubated preterm infants (<37 weeks GA) admitted to the NICU at Sultan Qaboos University Hospital (SQUH) from January 2013 to December 2017. EF was defined as reintubation within seven days of planned extubation. Demographics, ventilation parameters, blood gas values and other possible risk factors of EF were collected. Statistical analysis included comparisons between EF and extubation success (ES) groups and a binary logistic regression analysis.

A total of 190 preterm infants were intubated during the study period with 140 eligible for analysis. A total of 106 infants (75.7%) were successfully extubated while 34 (24.3%) failed extubation. GA <28 weeks (
= 0.029), lower 1-minute Apgar score (
= 0.023) and patent ductus arteriosus diagnosis (
= 0.018) were significantly associated with EF. After the multivariate analysis, only GA <28 weeks predicted EF with an adjusted odds ratio of 2.621 (95% confidence interval 1.118 - 6.146).

EF rate in preterm infants admitted at the NICU of SQUH was within international rates. GA <28 weeks was the only predictor of the identified extubation failure. Neonatal practitioners need to seriously consider extreme prematurity in the extubation process and consider implementing strategies to decrease extubation failure in this group of fragile infants.
EF rate in preterm infants admitted at the NICU of SQUH was within international rates. GA less then 28 weeks was the only predictor of the identified extubation failure. Neonatal practitioners need to seriously consider extreme prematurity in the extubation process and consider implementing strategies to decrease extubation failure in this group of fragile infants.
The coronary sinus (CS) Reducer can be considered for the treatment of refractory angina in patients unsuitable for coronary revascularization, but its effect can be influenced by the significant heterogeneity in the anatomy of the cardiac venous system.

We report the case of a 70-year-old woman with recurrent episodes of rest angina refractory to optimal medical therapy [Canadian Cardiovascular Society (CCS) Class IV] and inducible ischaemia in a large myocardial territory. Given the diffuse and peripheral nature of the coronary disease, the patient was considered ineligible for percutaneous or surgical revascularization and she was regarded as a good candidate for a CS occluder. Since coronary venous angiography showed the middle cardiac vein (MCV) to be at least as relevant as the CS, successful implantation of two devices, one in the CS and the second in the MCV, was performed. At 6-month follow-up, the patient reported a significant improvement in angina, resulting in a reduction of the CCS class fro this strategy needs to be validated in randomized clinical trials.
Maternal tachycardia is the most frequently occurring cardiac complication during pregnancy. Often administration of drugs is required as a treatment. The drug of choice is intravenously administered adenosine because it is considered safe, though there are limited studies regarding safety for the foetus with the use of adenosine.

We report a conversion of maternal atrio-ventricular (AV) nodal reentry tachycardia during pregnancy with the use of intravenous adenosine whilst continuous electrophysiological foetal monitoring. Four seconds after the maternal conversion, the foetal tracing suggests the presence of a ventricular extrasystole or a transient AV block.

This case report illustrates that the administration of adenosine intravenously during pregnancy could have an effect on the foetal conduction system. Therefore, further investigation to assess the electrophysiological effect of adenosine on the foetal electrocardiogram seems required.
This case report illustrates that the administration of adenosine intravenously during pregnancy could have an effect on the foetal conduction system. Therefore, further investigation to assess the electrophysiological effect of adenosine on the foetal electrocardiogram seems required.
The aim of this study was to examine the association between sources of stress and self-reported illness- or injury-related absenteeism (SRIRA) across three wage categories among participants in an employee health and well-being program.

In multivariate analyses, linear regression models were analyzed separately by wage bands (low, <$46,100; moderate, $46,100 to $62,800; high, >$62,800).

In the low-wage category, child care concerns are positively associated ( b = 0.5, P = ≤0.05), whereas illness or injury of a loved one is negatively associated ( b = -0.6, P = 0.05) with SRIRA. Personal illness/injury is positively associated with SRIRA across all wage bands (in ascending order of wage bands b = 4.2, P < 0.001; b = 4.4, P < 0.001; b = 4.1, P < 0.001).

Results provide evidence that employees in different wage categories experience different home-based stressors, which may impact SRIRA. Employers collecting SRIRA data may be better able to respond to the needs of employees in different wage categories.
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