Publications by authors named "Abdul Majeed Maliyakkal"

7 Publications

  • Page 1 of 1

Non-ST-Segment Elevation Myocardial Infarction Shortly After Starting Steroid Replacement Therapy in a Patient With Adrenal Insufficiency.

Cureus 2022 May 16;14(5):e25061. Epub 2022 May 16.

Clinical Medicine, QU Health, Qatar University, Doha, QAT.

Adrenal insufficiency is a rare disorder that results from etiological factors affecting either the hypothalamic-pituitary axis or the adrenal gland itself. Studies have associated an inherently increased risk of cardiovascular events with this condition. It is treated with exogenous steroid supplementation. However, in recent years, there have been an increasing number of reports regarding the potential of steroid therapy to precipitate acute cardiac events. However, this risk is generally assumed to be dose-dependent and could be absent in patients receiving low-dose glucocorticoid treatment. We present a case of a 71-year-old woman who was admitted to our institution with bilateral lower limb swelling. Blood investigation revealed hypoalbuminemia and hyponatremia. Upon further evaluation she was diagnosed to have adrenal insufficiency and was started on hydrocortisone replacement therapy; however, the patient developed non-ST-segment elevation myocardial infarction (NSTEMI) and acute pulmonary edema a few days after starting steroid replacement therapy. Here, we discuss the possible association between hydrocortisone use and the development of acute cardiac events.
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http://dx.doi.org/10.7759/cureus.25061DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9201412PMC
May 2022

Gas Under Diaphragm: A Rare Case of Ruptured Liver Abscess With Gas Forming Organism.

Cureus 2022 Jan 27;14(1):e21672. Epub 2022 Jan 27.

Department of Medicine, Hamad Medical Corporation, Doha, QAT.

Acute abdominal pain with free air under the diaphragm visible on chest/abdomen X-ray (pneumoperitoneum) is a medical emergency. Most of such cases of pneumoperitoneum are attributable to perforated hollow viscus; however, other possibilities like rupture of liver abscess (by a gas-forming organism) also need to be considered. Further imaging like a CT scan might help in the diagnosis and would also obviate the need for laparotomy in some of such cases. We report a case of acute abdominal pain with gas under the diaphragm due to a ruptured liver abscess caused by . The patient was managed successfully with ultrasound-guided percutaneous aspiration and insertion of a drain along with antibiotics and supportive measures, and no laparotomy was performed.
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http://dx.doi.org/10.7759/cureus.21672DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8884540PMC
January 2022

Carbimazole-Induced Jaundice in Thyrotoxicosis: A Case Report.

Cureus 2021 May 25;13(5):e15241. Epub 2021 May 25.

Cardiology, Malabar Institute of Medical Sciences, Calicut, India, Calicut, IND.

Carbimazole is a commonly used antithyroid drug in thyrotoxicosis. It is generally well tolerated, and its side effects include allergic skin reactions, gastrointestinal upset, agranulocytosis, and hepatotoxicity. Hepatitis is a rare but serious side effect. Here we report a case of carbimazole-induced hepatitis with severe cholestasis that was managed by switching to propylthiouracil. Most of the literature recommends radioiodine or surgery as the definitive treatment for hyperthyroidism in thionamide-induced hepatitis rather than switching to other thionamide. However, substitution of one thionamide for another can be tried as we did in this case, without any increased risk of hepatotoxicity as the mechanism of liver injury differs in both groups. A previously healthy 30-year-old lady who was diagnosed with thyrotoxicosis one month earlier that was treated with carbimazole 60 mg daily was admitted to the medical ward with yellowish discoloration of sclera, urine, and pruritus of one-week duration. Systemic examination was unremarkable except for icterus. Investigation showed hyperbilirubinemia and elevated liver enzymes. A probable diagnosis of carbimazole-induced cholestatic hepatitis was made and the drug was discontinued. Other causes of hepatitis and cholestasis were excluded. Attempts to arrange radioiodine or treat the patient surgically were not successful. She was continued on propranolol and later started on steroids and propylthiouracil. The patient's liver function tests (LFTs) started improving gradually. On follow-up, LFTs normalized at four weeks and thyroid function tests (TFTs) showed signs of improvement. The patient was followed up for six months after discharge and was doing well clinically on follow-up; her repeat TFT and LFT were completely normal. Carbimazole-induced hepatitis is exceedingly rare; however, it should be considered in patients with jaundice and thyrotoxicosis. Despite reports of cross-reactivity of the two available antithyroid drugs, switching from carbimazole to propylthiouracil and steroid therapy may be an option if other options of definitive therapy could not be arranged or are contraindicated.
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http://dx.doi.org/10.7759/cureus.15241DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8224534PMC
May 2021

Primary Pericardial Synovial Sarcoma: An Extremely Rare Cardiac Neoplasm.

Cureus 2021 Apr 20;13(4):e14583. Epub 2021 Apr 20.

Medicine, Hamad Medical Corporation, Doha, QAT.

Primary pericardial tumors are an entity that is infrequently encountered and may be a cause of pericardial effusion. Primary synovial sarcomas of the pericardium are even rarer malignant invasive tumors that are a challenge to recognize due to their vague presentation and difficulty in diagnosing non-invasively. Here, we report a case of a 48-year-old gentleman of South Asian descent, who was incidentally found to have pericardial and bilateral pleural effusions and subsequently diagnosed to have primary pericardial synovial sarcoma.
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http://dx.doi.org/10.7759/cureus.14583DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8136297PMC
April 2021

A Systematic Review of the Impact of Disaster on the Mental Health of Medical Responders.

Prehosp Disaster Med 2019 Dec 18;34(6):632-643. Epub 2019 Oct 18.

Department of Pediatrics, Los Angeles Biomedical Research Institute, Harbor-UCLA Medical Center, Los Angeles County, California USA.

Introduction: Medical responders are at-risk of experiencing a wide range of negative psychological health conditions following a disaster.

Aim: Published literature was reviewed on the adverse psychological health outcomes in medical responders to various disasters and mass casualties in order to: (1) assess the psychological impact of disasters on medical responders; and (2) identify the possible risk factors associated with psychological impacts on medical responders.

Methods: A literature search of PubMed, Discovery Service, Science Direct, Google Scholar, and Cochrane databases for studies on the prevalence/risk factors of posttraumatic stress disorder (PTSD) and other mental disorders in medical responders of disasters and mass casualties was carried out using pre-determined keywords. Two reviewers screened the 3,545 abstracts and 28 full-length articles which were included for final review.

Results: Depression and PTSD were the most studied outcomes in medical responders. Nurses reported higher levels of adverse outcomes than physicians. Lack of social support and communication, maladaptive coping, and lack of training were important risk factors for developing negative psychological outcomes across all types of disasters.

Conclusions: Disasters have significant adverse effects on the mental well-being of medical responders. The prevalence rates and presumptive risk factors varied among three different types of disasters. There are certain high-risk, vulnerable groups among medical responders, as well as certain risk factors for adverse psychological outcomes. Adapting preventive measures and mitigation strategies aimed at high-risk groups would be beneficial in decreasing negative outcomes.
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http://dx.doi.org/10.1017/S1049023X19004874DOI Listing
December 2019

An Unusual Cause of a Pancreatic Mass: Pancreatic Tuberculosis.

Cureus 2019 May 23;11(5):e4732. Epub 2019 May 23.

Emergency Medicine, Hamad Medical Corporation, Doha, QAT.

Isolated pancreatic tuberculosis (TB) is an exceedingly rare disease, even in countries with a high burden of TB. We report the case of a 40-year-old gentleman who presented with a two-week history of fever and abdominal pain. Computed tomography of the abdomen showed a large heterogeneous mass arising from the pancreas with peri-pancreatic lymphadenopathy, infiltration of the stomach, and encasement of the celiac vessels-highly suggestive of pancreatic malignancy. Oesophagogastroduodenoscopy with endoscopic ultrasonography was performed, which showed a necrotic area in the body of pancreas. Fine needle aspiration from the necrotic area was positive for  by polymerase chain reaction (PCR)and culture methods. This case demonstrates an unusual presentation of TB with predominant involvement of the pancreas in the absence of pulmonary or systemic involvement. Clinicians need to be aware of this unique presentation of tuberculosis in order to avoid misdiagnosis and institute timely treatment.
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http://dx.doi.org/10.7759/cureus.4732DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6649878PMC
May 2019

A Lady with Severe Abdominal Pain Following a Zumba Dance Session: A Rare Presentation of Bochdalek Hernia.

Cureus 2018 Apr 5;10(4):e2427. Epub 2018 Apr 5.

Department of Surgery, Hamad Medical Corporation.

A Bochdalek hernia is a congenital diaphragmatic hernia that results from a failure of closure of the pleuroperitoneal folds during embryologic development. While it is most often diagnosed in neonates and infants, Bochdalek hernias can rarely present in adulthood for the first time. We describe the case of a 42-year-old lady who presented with sudden onset of severe abdominal pain following a Zumba dance session. Her chest radiograph showed an elevated left hemi-diaphragm with visualization of a gastric bubble in the thorax. A computed tomography (CT) scan of the abdomen showed a defect in the left hemi-diaphragm with herniation of the stomach and abdominal viscera through the defect. The patient was taken for diagnostic laparoscopy, and the diaphragmatic defect was repaired with a synthetic mesh. Perioperatively, perforation of the anterior wall of the stomach was noted, and a diagnosis of Bochdalek hernia with gastric strangulation was made. This case demonstrates a rare presentation of Bochdalek hernia in an adult with strangulation and perforation of the stomach. Clinicians need to be aware of this rare but life-threatening clinical entity in order to secure a timely diagnosis and institute appropriate management.
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http://dx.doi.org/10.7759/cureus.2427DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5988205PMC
April 2018
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