Hussein Abdullatif

Posterior cranial fossa volume in patients with rickets: insights into the increased occurrence of Chiari I malformation in metabolic bone disease.

OBJECTIVE:Some have proposed that the calvarial thickening seen in patients with rickets results in an increased rate of Chiari I malformation (CIM) in these patients. The present study measures the posterior fossa volume in children with rickets to verify previous case reports indicting a small posterior fossa as the cause for an increased rate of CIM in children with rickets. METHODS:Patients were chosen by use of a computer database to search for individuals diagnosed with rickets. Nineteen patients were identified with this diagnosis. Seven patients were found from this cohort to have imaging of the head. Axial computed tomographic and magnetic resonance images were analyzed by use of the Cavalieri method to define posterior fossa volumes. These data were then compared with those from age-matched control subjects. RESULTS:Mean volumes of the posterior fossa were significantly reduced in all patients compared with age-matched control subjects (P < 0.0001). CONCLUSION:We have found that the volume of the posterior fossa is significantly smaller in children with rickets versus age-matched control subjects. Furthermore, 29% of our study group had an associated CIM. We may hope that these data will aid in the further understanding of the pathophysiology of CIM in cases of metabolic bone disease.

Unusual case of neonatal diabetes mellitus due to congenital pancreas agenesis

Abstract:  Congenital absence of the pancreas is an extremely rare condition. We participated in the care of a patient with an unusual presentation of neonatal diabetes attributable to agenesis of the pancreas. Additional clinical features of the patient included cardiac septal defects, gall bladder agenesis and duodenal malrotation. Appropriate institution of insulin, exocrine pancreatic supplements and surgical repair of the cardiac and intestinal anomalies resulted in the infants survival. Of the reported cases of congenital pancreas agenesis, two cases have been ascribed to mutations in the insulin promoter factor‐1(Ipf‐1) gene. Deletion of the Ipf‐1‐homolog pdx‐1 in mice results in the failure of pancreas to develop. Analysis of both exons of the Ipf‐1 coding sequence from the presented patients genomic DNA, however, did not identify a mutation. These results suggest that a congenital or genetic perturbation occurred in this infant most likely before the appearance of dorsal pancreatic bud in the 3 mm long embryonic stage, around the embryonic day 25 in human development, before the onset of Ipf‐1 expression.

REVERSIBLE SUBCLINICAL HYPOTHYROIDISM IN THE PRESENCE OF ADRENAL INSUFFICIENCY

OBJECTIVE To describe 3 different scenarios of reversible hypothyroidism in young patients with adrenal insufficiency. METHODS We present 3 case reports of patients with adrenal insufficiency--one with delayed puberty, the second with type 1 diabetes and poor weight gain, and the third with hypoglycemia-related seizures and glucocorticoid deficiency--who had biochemical evidence of hypothyroidism. RESULTS Our first patient (case 1) initially had a mildly elevated thyrotropin (thyroid-stimulating hormone or TSH) level and a normal free thyroxine (FT4) level that, on follow-up assessment, had progressed to persistent mild elevation of TSH and low FT4 concentration. The other 2 patients (cases 2 and 3) had low FT4 and mildly elevated TSH values at the time of diagnosis of adrenal insufficiency. In all 3 patients, the results of thyroid function tests normalized with use of physiologic doses of adrenal hormone replacement therapy, without thyroid hormone replacement. All 3 patients remained euthyroid after 4, 3, and 1 year of follow-up, respectively. CONCLUSION These observations add insights into the complexities of the thyroadrenal interactions. These examples are important because thyroid hormone replacement in the setting of adrenal insufficiency could be unwarranted.

Prevalence of hypovitaminosis D in early infantile hypocalcemia

AIM To further define the pathogenesis of infantile hypocalcemia, the prevailing vitamin D status, and treatment outcomes. METHODS AND RESULTS Of the 23 infants admitted with infantile hypocalcemia, 21 had biochemical evidence of hypocalcemia and hyperphosphatemia and the other two had isolated hypocalcemia. The majority of these infants had relatively low serum intact parathyroid hormone responses against the backdrop of hypocalcemia. Thirteen (56.5%) of these infants had low 25-hydroxyvitamin D (25-OHD) levels, of whom 69% were Hispanic and 23% were African American. Infantile serum vitamin D status reflected that of the mother in all the 16 instances in which it was measured. Treatment with calcitriol hastened recovery from hypocalcemia in our series. CONCLUSIONS Relative hypoparathyroidism is the etiology in the majority of cases of late onset and early infantile hypocalcemia. We identified vitamin D deficiency in a significant percentage of infants with hypocalcemia, especially Hispanics and African Americans. Maternal 25-OHD concentrations should be ascertained if the infant has low 25-OHD levels.

Investigating the Islamic Perspective on Homosexuality

ABSTRACT In his 2006 article in the Journal of the Islamic Medical Association of North America (JIMA), Dr. Ahmed qualified the predominant psychiatric view on homosexuality by recourse to opinions prevalent within reparative therapy circles. Conservative Muslim thinkers, online counselors, and other professionals continue to hold opinions similar to those delineated by Dr. Ahmed in his journal article. We use his article as a focal point to critique the general opinions upheld by conservative Muslim thinkers by alluding to the harms associated with reparative therapy and by rejecting the unreasonable prescription of permanent celibacy. We critique Dr. Ahmed’s association of homosexuality with mental health issues, fatal diseases, alcoholism, and illicit sexual intercourse. Investigating the Muslim tradition, we encourage conservative Muslim leaders to facilitate Muslim gays and lesbians in their legitimate human need for intimacy, affection, and companionship.

Same-sex unions in Islam

ABSTRACT The objective of this paper was to streamline the case for Muslim same-sex unions that was comprehensively made in Jahangir and Abdullatif (2016). Additionally, we try to address same-sex unions on the basis of non-binary gender, gender expression and sexual orientation. Based on our work, we argue that the case for Muslim same-sex unions can be made on the basis of broad principles of human dignity and affection and therefore through marriage or through the specific arguments of repelling harm and legal authority. In this regard, going beyond the overarching Islamic value of human dignity, we specifically argue that the case for same-sex unions can be anchored on verse 4:28 on facilitating a legal outlet for sexual expression.