The Evolution of Paediatric Cardiology Service in Oman

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The Sinus Venosus Veno-Venous Bridge: Not a septal defect

This review provides an update on the morphology of the sinus venosus defect. It was earlier believed that a 'common wall' separated the right pulmonary veins from the superior caval vein. In the sinus venosus defects, this wall was absent. Current evidence shows that the superior rim of the oval fossa, rather than forming a second septum or representing a common wall, is an infolding between the walls of the caval veins and the right pulmonary veins. The sinus venosus defect is caused by the anomalous connection of one or more pulmonary veins to a systemic vein. However, the pulmonary vein(s) retain their left atrial connections, leading to a veno-venous bridge that allows interatrial shunting outside the oval fossa. True atrial septal defects are located within the oval fossa or in the anteo-inferior buttress, while sinus venosus defects, ostium defects and coronary sinus defects are morphologically distinct from them. Keywords: Heart Septal Defects, Atrial; Diagnostic Imaging; Sinoatrial Node; Vena Cava, Superior

Device Closure of Superior Sinus Venosus Atrial Septal Defects: A single centre experience

Sinus venosus atrial septal defects present a wide variety of anatomical features and are frequently associated with partial anomalous pulmonary venous drainage of one or more right pulmonary veins. Surgical correction used to be the standard treatment. In recent times, transcatheter correction of superior sinus venosus atrial septal defects has come into vogue. The transcatheter closure of these defects with covered stents at a tertiary care centre in Oman between 2018 and 2023 is reported. Keywords: Heart Septal Defects, Atrial; Vena Cava, Superior; Endovascular Procedures; Stents; Cardiac Catheterization; Echocardiography, Transesophageal; Oman

Unusual case of life threatening subcutaneous hemorrhage in a blunt trauma patient

AbstractIntroductionHemorrhage is the most common cause of shock in injured patients. Bleeding into the subcutaneous plane is underestimated cause of hypovolemic shock.Presentation of caseUnrestrained male driver involved in a rollover car crash. On examination, his pulse rate was 144bpm, blood pressure 80/30mmHg, and GCS was 7/15. His right pupil was dilated but reactive. Back examination revealed severe contusion with friction burns and lacerations. A Focused Assessment Sonography for Trauma (FAST) was performed. No free intraperitoneal fluid was detected. CT scan of the brain has shown right temporo-parietal subdural hematoma and extensive hematoma in the deep subcutaneous soft tissues of the back. Decompressive cranicotomy and evacuation of the subdural hematoma was performed. On the 4th postoperative day, three liters of dark brown altered blood was drained from the subcutaneous plane.DiscussionThe patient developed severe hypovolemic shock and our aim was to identify and control the source of bleeding during the resuscitation. The source of bleeding was not obvious. Severe shearing force in blunt trauma causes separation between the loose subcutaneous tissues and the underlying relatively immobile deep fascia. This is known as post-traumatic closed degloving injury. To our knowledge this is the first reported case in the English Literature with severe subcutaneous hemorrhage in blunt trauma patients without any previous medical disease.ConclusionBleeding into the subcutaneous plane in closed degloving injury can cause severe hypovolemic shock. It is important for the clinicians managing trauma patients to be aware this serious injury

Subcutaneous Pancreatic Transplantation Shows Success In The Treatment Of Experimentally Induced Diabetes Mellitus In Golden Hamsters

Background: to evaluate subcutaneous pancreatic transplantation in an experimentally induced diabetes mellitus in golden hamsters. Methods - many indexes (histological /using two stains, histochemical /using three enzymes, morphometrical and biochemical /blood glucose level) were employed in this assessment. Alloxan was used as ß-cytotoxic therapy (to induce diabetes mellitus), and cyclophosphamide was employed as immunosuppressive agent. Results - high rate of success of transplantation (clearly evident by microscopical features of viable endocrine and exocrine tissue of transplanted pancreas and great tissue vascularization, normal enzymatic activities and significant lowering of blood glucose level) were elicited. Conclusion – subcutaneous pancreatic transplantation should be thank about in treatment of diabetes mellitus

Thymoquinone attenuates diethylnitrosamine induction of hepatic carcinogenesis through antioxidant signaling

Hepatocellular carcinoma accounts for about 80–90% of all liver cancer and is the fourth most common cause of cancer mortality. Although there are many strategies for the treatment of liver cancer, chemoprevention seems to be the best strategy for lowering the incidence of this disease. Therefore, this study has been initiated to investigate whether thymoquinone (TQ), Nigella sativa derived-compound with strong antioxidant properties, supplementation could prevent initiation of hepatocarcinogenesis-induced by diethylnitrosamine (DENA), a potent initiator and hepatocarcinogen, in rats. Male Wistar albino rats were divided into four groups. Rats of Group 1 received a single intraperitoneal (I.P.) injection of normal saline. Animals in Group 2 were given TQ (4 mg/kg/day) in drinking water for 7 consecutive days. Rats of Group 3 were injected with a single dose of DENA (200 mg/kg, I.P.). Animals in Group 4 were received TQ and DENA. DENA significantly increased alanine transaminase (ALT), alkaline phosphatase (ALP), total bilirubin, thiobarbituric acid reactive substances (TBARS) and total nitrate/nitrite (NOx) and decreased reduced glutathione (GSH), glutathione peroxidase (GSHPx), glutathione-s-transferase (GST) and catalase (CAT) activity in liver tissues. Moreover, DENA decreased gene expression of GSHPx, GST and CAT and caused severe histopathological lesions in liver tissue. Interestingly, TQ supplementation completely reversed the biochemical and histopathological changes induced by DENA to the control values. In conclusion, data from this study suggest that: (1) decreased mRNA expression of GSHPx, CAT and GST during DENA-induced initiation of hepatic carcinogenesis, (2) TQ supplementation prevents the development of DENA-induced initiation of liver cancer by decreasing oxidative stress and preserving both the activity and mRNA expression of antioxidant enzymes

Corporate Social Responsibility Program Implementation through Art Event

The Corporate Social Responsibility program is a program created by a company for people who live around the company or communities that are affected by the existence of the company, the CSR program was created to provide a positive image for the company. Besides, the CSR program is also designed to improve the welfare of the community and the surrounding environment as well as a sense of the company's responsibility towards the various parties involved and those affected either directly or indirectly. So that the CSR program, can improve the company's positive image. The community and stakeholders will give a positive view of the company if the company can be accountable properly to the stakeholders. This study aims to observe the CSR program contained in the Pandanaran Prawirotaman Hotel Yogyakarta, namely to find out how a CSR program is implemented and what benefits the company gets, as well as to find out how reciprocity is from the community to the CSR program carried out by Pandanaran Hotel Prawirotaman Yogyakarta. Data collection using observational techniques, literature study, and interviews are carried out in this study. The results of this study indicates that the CSR program created at Hotel Pandanaran is very much adapted to the location of the hotel in the area where many foreign tourists come. The Pandanaran Hotel Public Relations Team also considers that the CSR program in the form of art activities is one of the gaps and opportunities for the existence of the hotel itself

Accessory mitral valve tissue causing severe left ventricular outflow tract obstruction in a post-Senning patient with transposition of the great arteries

Accessory mitral valve tissue is a rare congenital anomaly associated with congenital cardiac defects and is usually detected in the first decade of life. We describe the case of an 18-year old post-Senning asymptomatic patient who was found to have accessory mitral valve tissue on transthoracic echocardiography producing severe left ventricular outflow tract obstruction

Fertility sparing surgery and borderline ovarian tumours

o determine the oncological outcomes following fertility-sparing surgery (FSS) for the management of Borderline Ovarian Tumours (BOTs). A retrospective analysis of participants diagnosed with BOTs between January 2004 and December 2020 at the West London Gynaecological Oncology Centre was conducted. A total of 172 women were diagnosed; 52.3% (90/172) underwent FSS and 47.7% (82/172) non-FSS. The overall recurrence rate of disease was 16.9% (29/172), of which 79.3% (23/29) presented as the recurrence of serous or sero-mucinous BOTs and 20.7% (6/29) as low-grade serous carcinoma (LGSC). In the FSS group, the recurrence rate of BOTs was 25.6% (23/90) presenting a median 44.0 (interquartile range (IQR) 41.5) months, of which there were no episodes of recurrence presenting as LGSC reported. In the non-FSS group, all recurrences of disease presented as LGSC, with a rate of 7.7% (6/78), following a median of 47.5 months (IQR 47.8). A significant difference between the type of surgery performed (FSS v Non-FSS) and the association with recurrence of BOT was observed (Pearson Chi-Square: p = 0.000; x = 20.613). Twelve women underwent ultrasound-guided ovarian wedge resection (UGOWR) as a novel method of FSS. Recurrence of BOT was not significantly associated with the type of FSS performed (Pearson Chi- Square: x = 3.166, p = 0.379). Non-FSS is associated with negative oncological outcomes compared to FSS, as evidenced by the higher rate of recurrence of LGSC. This may be attributed to the indefinite long-term follow up with ultrasound surveillance all FSS women undergo, enabling earlier detection and treatment of recurrences

Evaluate the prevalence of CCP and RF antibodies as a marker for diagnosis and progression of Rheumatoid Arthritis disease and assess the prevalence of HCV in RA patients

Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease characterized by the presence of autoantibodies like rheumatoid factor (RF). In the last few years, several other autoantibodies have been described of which anti-cyclic citrullinated peptide (CCP) antibody is the most specific. Chronic hepatitis C virus (HCV) has extrahepaticautoimmune properties and a variety of autoantibodies were found in patients with HCV. This study is conductedto evaluate the sensitivity and specificity of Anti-CCP in compare with RF in RA patients and assess their association with severity of the disease and evaluate if HCV have beenone of the infectious agent for rheumatoid arthritis.Sixty blood samples were collected from RA patients and twenty from both apparently healthy group and HCV patients. The serum from each subject was tested for anti- CCP, RF and anti HCV by enzyme- linked immunosorbent assay (ELISA). Estimation of erythrocyte sedimentation rate (ESR) by Westergreen' method was included in this study. The result indicated that anti-CCP postivity for RA patients sera (78.3%), (20%) for HCV patients and (0.0%) for healthy group, it showed highly significant differences in RA group in compare with control group (P<0.005).While the percentage of RF positive was (70%) for patients with rheumatoid arthritis with significant differences and 20% for patients with viral hepatitis type (c) with no significant differences in compare with control group (5%). Results also showed that (1.7%) of patients with rheumatoid arthritis showed positive result to HCV