Publications (GME)

Permanent URI for this collectionhttps://repository.mbru.ac.ae/handle/1/1596

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Glomus tumor: A rare differential diagnosis for subungual lesions.
(2024-09) Alnajjar, Anas
Glomus tumors are rare, benign vascular hamartomas of the glomus apparatus with unknown etiology. They can arise from anywhere in the body. However, up to 90% of them are located in the subungual region of the fingers, as in the case of our patient. These tumors typically present with the classic triad of pain, cold sensitivity, and point tenderness. Characteristic US and MRI findings aid the clinical diagnosis; nevertheless, a histopathologic examination is confirmatory. There is a well-documented mean delay in diagnosis of around 7 years, due to the rarity, benignity, small size, and lack of proper knowledge about the condition. However, we reported a case with a delay in diagnosis that reached 40 years, which is much longer than what is documented in the literature. A high index of suspicion is required for early diagnosis and management of glomus tumors to relieve the patient's long-term suffering and prevent possible secondary nail deformities. The curative treatment of glomus tumor is complete surgical excision, which is crucial to prevent recurrence and relieve the patient's symptoms.
Acquired methemoglobinemia in infancy secondary to diarrhea: a case report.
(2024-09) Aly, Mariam Hany; Bukhari, Hessa Mohammed
Methemoglobinemia (MetHb) is a life-threatening condition that reduces the oxygen-carrying ability of hemoglobin. Acquired methemoglobinemia usually results from exposure to specific oxidizing agents. Symptoms and complications depend on the MetHb level, which can sometimes be fatal. We present a case of a 6-week-old infant exhibiting hypoxia alongside gastroenteritis, fever, poor oral intake and low activity, with confirmed methemoglobinemia in blood gas analysis. Despite negative results in the workup for underlying causes, including genetic testing conducted later, methylene blue administration only partially reduced methemoglobinemia level. Treatment involved managing diarrhea by transitioning to a hydrolyzed formula. Interestingly, an incidental discovery of partial central venous sinus thrombosis occurred during the diagnostic process, although no established correlation with methemoglobinemia was evident in the literature. This case report illustrates the complex presentation of methemoglobinemia in a previously healthy infant, occurring concurrently with gastrointestinal infection and unexpected thrombosis. It underscores the need for interdisciplinary collaboration and comprehensive management in addressing such multifaceted clinical scenarios in pediatric practice. This case emphasizes the importance of considering diarrhea as a possible cause of methemoglobinemia, especially in infancy. It also highlights the need for increased clinical awareness and prompt management approaches towards the various presentations of acquired methemoglobinemia in pediatric populations.
Central Pontine Myelinolysis Induced by Rapid Correction of Hyponatremia in a Patient With Chronic Alcohol Use Disorder: A Case Report
(Springer Science and Business Media LLC, 2024-11-28) Mohamadiyeh, Amjad M
Central pontine myelinolysis (CPM) is a demyelinating disorder often associated with the rapid correction of hyponatremia. Elevated creatine phosphokinase (CPK) levels have been observed in some cases of CPM but are not well studied. A 38-year-old patient with chronic alcohol use disorder presented with jerky movements, confusion, and disorientation following severe hyponatremia. Initial lab results revealed severe hyponatremia (113 mmol/L) (reference range: 136-145 mmol/L), elevated liver enzymes, and extremely high CPK levels (up to 92,763 U/L) (reference range: <190 U/L). Imaging showed bilateral thalamic and pontine hypodensities, with MRI confirming CPM in the central pons. This case highlights the risk of CPM due to rapid sodium correction in patients with chronic alcohol use disorder and suggests that elevated CPK levels may be associated with CPM. The patient's condition improved with gradual sodium correction and alcohol withdrawal management. This underscores the importance of careful electrolyte management to prevent CPM and suggests further investigation into the role of highly elevated CPK in CPM. The occurrence of CPM in a patient with chronic alcohol use disorder and elevated CPK levels emphasizes the need for cautious sodium correction, with the association between elevated CPK and CPM warranting further study.
Osteomyelitis of the Patella With Extension Into Parapatellar Soft Tissues in a Six-Year-Old Boy: A Case Report
(Springer Science and Business Media LLC, 2024-11-07) Abdelwahab, Abdulla; Nidal, Abdulla
Acute osteomyelitis (OM) of the patella is an exceptionally rare condition in children. The rarity of this condition, coupled with its nonspecific symptoms and varied clinical presentations, makes early diagnosis challenging and often results in delayed treatment. Prompt identification and initiation of antibiotic therapy are essential for a full recovery and to prevent the disease from progressing to a chronic, more severe form. This case report discusses a previously healthy six-year-old boy who developed OM of the left patella following a fall from standing height after tripping three days prior to his presentation at the emergency department. Due to the unusual and infrequent nature of patellar OM, it is often overlooked as a potential cause of knee pain in pediatric patients. Clinicians must consider patellar OM in the differential diagnosis for children presenting with knee pain. Accurate and timely diagnosis relies on thorough clinical assessments, laboratory testing, and appropriate imagining techniques (i.e., X-ray and magnetic resonance imaging (MRI)). Early identification and appropriate treatment are critical in preventing the infection from spreading within the joint and ensuring a favorable outcome.
The Impact of Brain Tumors on Emotional and Behavioral Functioning.
(2024-12) Mousa, Ahmed Hafez
While the physical manifestations of brain tumors are well-documented, their impact on the emotional and psychological landscape of patients is of equal importance. Patients frequently experience a range of challenges from depression, apathy, and increased aggression to personality changes. The complexity of these changes and their effects on emotional functioning are shaped by tumor characteristics, including location, growth rate, and the corresponding hormonal imbalances. These challenges may ripple outward, affecting not only the patients themselves but also their caregivers. This review aims to examine the diverse emotional experiences associated with various brain tumor types and locations, through understanding the neurobiological mechanisms underlying these changes. The impact of psychosocial factors on emotional distress and coping strategies is also explored, focusing on the critical role of social support and resilience. The need for integrated care that addresses both the physical and psychological aspects of brain tumors is essential for improving the quality of life (QoL) for patients and their families. The close relationship between emotional and cognitive difficulties is analyzed, stressing how these challenges can mutually reinforce each other, creating a convoluted and challenging situation for brain tumor patients. By understanding and addressing these issues, healthcare providers can better support patients and improve their overall QoL. This review seeks to consolidate the current understanding of this complicated relationship, drawing from an array of studies, reviews, and meta-analyses.
A Rare Case of Plantar Intramuscular Hemangioma: Diagnostic Challenges and Surgical Management in a 34-Year-Old Female
(Springer Science and Business Media LLC, 2025-01-05) Mohamadiyeh, Amjad M
Hemangiomas are benign tumors of the soft tissues, with intramuscular hemangiomas (IMHs) being an exceptionally rare subtype. Intramuscular hemangiomas (IMHs) typically occur in younger adults and often involve the lower limbs, particularly the thigh. Localization in the foot is exceedingly rare. These tumors are often asymptomatic but may present with pain and swelling, especially during activity, posing diagnostic challenges. A 34-year-old female presented with a one-year history of progressive, persistent pain on the plantar side of her left foot. The pain, described as a deep ache exacerbated by weight-bearing activities, led to gait impairment and limping. Physical examination revealed significant tenderness but no swelling, erythema, or muscle atrophy. The X-ray reveals no abnormalities, prompting further evaluation with MRI. Imaging revealed an ill-defined vascular lesion involving the flexor digitorum longus and brevis tendons and adjacent muscles. Surgical excision was performed, and histopathology confirmed a cavernous hemangioma. The patient's postoperative course was uneventful, with immediate pain relief and restored function. Intramuscular hemangiomas (IMHs) are rare, locally aggressive benign tumors that are often misdiagnosed due to their nonspecific symptoms and rarity, particularly in the plantar region. Imaging, particularly MRI, plays a pivotal role in identifying characteristic features and guiding management. Histological confirmation remains essential for diagnosis. While surgical excision is the preferred treatment for symptomatic intramuscular hemangiomas (IMHs), recurrence and functional impairment remain concerns, underscoring the importance of proper diagnosis and intervention. This case emphasizes the importance of recognizing rare presentations of intramuscular hemangiomas (IMHs), such as in the plantar foot. A multidisciplinary approach, imaging, and histological analysis are crucial for accurate diagnosis and management. Long-term follow-up is necessary to monitor recurrence and ensure functional recovery.
Resolvin E1 and calvarial defects in rats: a comprehensive histological analysis
(Springer Science and Business Media LLC, 2025-04-14) Allam, Eman
Bone loss, linked with numerous oral conditions such as periodontal diseases and periimplantitis, poses a signifcant challenge for dental clinicians. The current study evaluated the in vivo efects of local application of Resolvin E1 (RvE1) on bone regeneration in critical size calvarial defects in rats. Thirty female Wistar rats with 5mm induced calvarial defects were randomly allocated into four groups: no treatment (negative control, n=5), treatment using bovine bone grafts (positive control, n=5), treatment using local delivery of RvE1 (n=11) and treatment using RvE1 mixed with bovine bone graft (n=9). After 12weeks, the animals were sacrifced and the calvarial defects with the adjacent tissues were sectioned en-bloc and prepared for histological examination. A comprehensive qualitative and quantitative histological examination was performed to assess bone regeneration and its relation to the defect, the presence of remnant bone and RvE1 particles, the integration of the native bone with the newly formed bone, bone density and bony trabeculae, the infammatory reaction, the connective tissue bridging in the defect, and the encapsulating fbrous tissue. Signs of neovascularization, increased cellularity, lack of the organized lamellated appearance of mature bone, disorganized arrangement of osteocytes, osteoblasts and osteoclasts were also assessed. Comparisons of the quantitative values between all studied groups indicated statistically signifcant differences (p≤0.05) in all parameters except for the increased cellularity and granulation tissue. Histological fndings indicate that RvE1 with adjunct bone graft signifcantly enhanced the bone formation compared to RvE1 or bovine graft alone.
Integrated metagenomics and transcriptomics analysis reveals pathways associated with oral periapical lesions formation and progression.
(2025) Rawat, Surendra Singh
Periapical abscesses, radicular cysts, and periapical granulomas are among the most frequently identified pathological lesions in the alveolar bone. Although many studies have investigated bacterial metagenomics in periapical abscesses, little is known about the genome mining of abundant bacteria in periapical lesions and its correlation to human transcriptome. This study aims to explore the enriched metabolic environment of periapical lesions associated with microbial diversity and their role in lesion progression. Bacterial DNA and human RNA were isolated from periapical lesions and healthy pulp tissue and sequenced using next-generation sequencing (NGS). The sequences of the most abundant bacteria were then analyzed to identify secondary metabolites, pathogenic proteins, and their associated metabolic pathways. The results revealed that was the predominant bacterium in periapical abscesses and radicular cysts, whereas was the most abundant in periapical granulomas. Integrated bacterial and human metabolic pathways indicated that the augmentation of similar pathways is important in lesions pathogenesis. In periapical abscesses, inflammatory response, humoral immune response, positive regulation of cell migration, and hemopoiesis were enriched. In radicular cysts, pathways linked to NABA matrisome associated, inflammatory response, immune response-regulating signaling pathway, neutrophil degranulation, and P73 pathway were enriched. Meanwhile, periapical granulomas exhibited significant enrichment of pathways related to response to bacterium, regulation of immune effector process, and positive regulation of cell migration. In conclusion, this study is the first to elucidate the interplay between microbial and human metabolic activity associated with inflammation in abscesses, apoptosis in cysts, and inflammatory regulation in granulomas. These findings have significant clinical implications for the early diagnosis, prevention, and treatment of periapical lesions.
The need for implementing a standardized, evidence-based emergency department discharge plan for optimizing adult asthma patient outcomes in the UAE, expert meeting report.
(2024-11-06) Buhumaid, Rasha
Asthma is a common chronic respiratory inflammatory disease that adversely affects patients' quality of life (QoL) and overall well-being. When asthma is not adequately controlled, there is a higher risk of exacerbations and hospitalizations, thereby increasing the direct and indirect costs associated with the treatment and productivity loss. Overreliance on SABA and underutilization of ICS in the management of asthma can result in suboptimal treatment and poor asthma control. Patients who visit the emergency department are more likely to have poorly controlled asthma. Ensuring that these patients are provided with an evidence-based treatment plan during discharge can help reduce the risk of future exacerbations and consequently reduce the burden on the UAE healthcare system.
Occurrence of Femoral Nerve Palsy After Total Hip Arthroplasty (THA) Using the Direct Lateral Approach.
(2024-11) Nached, Yasmin; Al-Rawi, Zeinab; Abdelwahab, Abdulla; Elsayed, Ahmed; Ismaeil, Ali H
Femoral nerve palsy (FNP) is a rare but serious complication after total hip replacement (THP). Despite its rarity, FNP can significantly impact patient recovery and quality of life. This case report examines the occurrence of FNP in a patient following a primary THP and highlights the importance of surgical technique and postoperative detection and its management. We present the case of a 38-year-old male with a history of microscopic polyangiitis on long-term steroid treatment, who developed FNP following THP. The patient was admitted with non-traumatic right hip pain with osteoporotic fracture of the femoral head and underwent elective THP. Postoperatively, the patient showed quadriceps weakness and related sensory deficits. Postoperative assessments included physical examination, electromyography (EMG), nerve conduction studies (NCS), and magnetic resonance imaging to assess the extent of the nerve injury. EMG and NCS confirmed severe femoral mononeuropathy with profound active denervation changes. A subsequent magnetic resonance imaging revealed atrophy of the right sartorius and quadriceps femoris muscles. Conservative management was decided, including physiotherapy and close follow-up, which led to significant gradual improvement over six months, with enhanced knee range of motion (ROM), increased quadriceps strength, and improved sensation on the medial side of the leg and foot. Femoral nerve injuries, although uncommon, pose significant risks in THP. Excessive retraction during surgery may contribute to these injuries. Early diagnosis, conservative management, and interdisciplinary coordination are crucial to achieve optimal recovery.
Glomus tumor: A rare differential diagnosis for subungual lesions
(2024-09) Alnajjar, Anas
Glomus tumors are rare, benign vascular hamartomas of the glomus apparatus with unknown etiology. They can arise from anywhere in the body. However, up to 90% of them are located in the subungual region of the fingers, as in the case of our patient. These tumors typically present with the classic triad of pain, cold sensitivity, and point tenderness. Characteristic US and MRI findings aid the clinical diagnosis; nevertheless, a histopathologic examination is confirmatory. There is a well-documented mean delay in diagnosis of around 7 years, due to the rarity, benignity, small size, and lack of proper knowledge about the condition. However, we reported a case with a delay in diagnosis that reached 40 years, which is much longer than what is documented in the literature. A high index of suspicion is required for early diagnosis and management of glomus tumors to relieve the patient's long-term suffering and prevent possible secondary nail deformities. The curative treatment of glomus tumor is complete surgical excision, which is crucial to prevent recurrence and relieve the patient's symptoms.
The need for implementing a standardized, evidence-based emergency department discharge plan for optimizing adult asthma patient outcomes in the UAE, expert meeting report.
(2024-11-06) Buhumaid, Rasha; Mahboub, Bassam; Iqbal, Mohammed Nizam
Background: Asthma is a common chronic respiratory inflammatory disease that adversely affects patients' quality of life (QoL) and overall well-being. When asthma is not adequately controlled, there is a higher risk of exacerbations and hospitalizations, thereby increasing the direct and indirect costs associated with the treatment and productivity loss. Overreliance on SABA and underutilization of ICS in the management of asthma can result in suboptimal treatment and poor asthma control. Patients who visit the emergency department are more likely to have poorly controlled asthma. Ensuring that these patients are provided with an evidence-based treatment plan during discharge can help reduce the risk of future exacerbations and consequently reduce the burden on the UAE healthcare system.

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