Kawther El-Shafie

Psychosocial Impact of Breast Cancer Diagnosis Among Omani Women

OBJECTIVES The aim of this study was to explore different psychosocial impacts on Omani women diagnosed with breast cancer. METHODS Semi-structured individual interviews were conducted with 19 Omani women diagnosed with breast cancer to describe the impact of the disease on their personal and social life. Women were recruited from wards and out-patient clinics at the Sultan Qaboos University Hospital, Muscat. RESULTS Four main themes emerged. These were: a) factors related to psychological distress of the disease and uncertainty (worry of death, interference with work and family responsibilities, searching for hope/cure, travelling overseas); b) reactions of family members (shocked, saddened, unity, pressure to seek traditional treatments); c) views of society (sympathy, isolation, reluctant to disclose information); and d) worries and threats about the future (side effects of chemotherapy, spread of the disease, effect on offspring). CONCLUSION Breast cancer diagnosis has several devastating psychosocial impacts on women in Oman. Healthcare professionals working with women with breast cancer should be aware of the different psychosocial impacts of the disease on womens lives. Appropriate measures must be taken by the decision makers whenever needed, including enforcing positive views and support of Omans society towards women with breast cancer.

A Massive Tuberculosis Abscess at the Erector Spinae Muscles and Subcutaneous Tissues in a Young Man

Tuberculosis (TB) is a chronic granulomatous infection which can present in an atypical form. Isolated muscle involvement is very rare. We report a 25-year-old man who presented with a massive cystic swelling on the right side of his back, extending from the lower thoracic to the gluteal region. He had a history of contact with a friend who was suspected of having TB. Magnetic resonance imaging (MRI) showed that the origin of the cyst was from the erector spinae muscles. The result of a fluid aspirate showed acid fast bacilli. The swelling disappeared after treatment with anti-tuberculous medications. Muscular involvement in TB is very rare. In our patient, the reports of an ultrasound and MRI confirmed isolated muscle and subcutaneous involvement without bony lesions. This case is reported to increase physician awareness regarding soft tissue TB. Although it is rare, similar cases may be seen in the future.

Thyroid Diseases in Omani Type 2 Diabetics: A Retrospective Cross-Sectional Study

Background. Diabetes mellitus and thyroid diseases are common endocrine disorders in the general population and found to exist simultaneously. This study aimed to establish the prevalence of thyroid dysfunction among Omani type 2 diabetics and its association with glycemic control. Methodology. A retrospective cross-sectional randomized primary and secondary care based study of 285 Omani type 2 diabetics, ≥ 30 years of age with known thyroid function. The following parameters were examined: age, sex, duration of diabetes, duration of thyroid disease, thyroid morphology, thyroid function, thyroid antibodies, and the mean glycated hemoglobin (mean HbA1C). The prevalence of thyroid dysfunction was compared to an independent control group of randomly selected healthy individuals with known thyroid function. Results. Thyroid dysfunction was found in 12.6% of the diabetic patients compared to 4.9% in the control group. The prevalence was higher among the diabetic females (86%) compared to diabetic males (14%). The commonest thyroid dysfunction among diabetics was overt hypothyroidism (4.6%). Subclinical hypothyroidism was the commonest thyroid dysfunction seen in less controlled diabetics at a mean HbA1c of 7.8 (± 0.7). Conclusion. Screening for thyroid dysfunction in patients with type 2 diabetes mellitus should be routinely performed considering the higher prevalence of thyroid diseases in this group compared to the general population.

Palpitations caused by a Seizure with Autonomic Features.

Palpitations are a common symptom of presentation in medical practice. They are usually caused by cardiac arrhythmias, psychiatric problems or other miscellaneous causes, such as anaemia or endocrine causes. They are rarely due to autonomic seizures. We report a 55-year-old woman who presented at Sultan Qaboos University Hospital, Oman, with recurrent episodes of palpitations. Her associated symptoms included breathlessness and excessive sweating, followed by a sensation of dizziness. During subsequent episodes, she experienced symptoms of rising abdominal pain followed by a loss of consciousness. Positive electroencephalogram findings, as well as the response of the symptoms to antiepileptic drugs, were strongly suggestive of temporal lobe epilepsy as the possible diagnosis. The fact that the cardiac investigations, performed during an interictal period, were unremarkable also supports the hypothesis that the palpitations were linked to seizures. Epilepsy should be considered as a differential diagnosis of palpitations, especially if the palpitations are episodic.