Publications by authors named "Elrazi Ali"

23 Publications

  • Page 1 of 1

Urine retention as presenting manifestation of tuberculous meningitis complicated by lacunar infarction and transverse myelitis: Case report and literature review.

Clin Case Rep 2021 Jul 23;9(7):e04489. Epub 2021 Jul 23.

Department of Internal Medicine Hamad Medical Corporation Doha Qatar.

Early diagnosis and management of tuberculous meningitis will prevent lethal and fatal neurological complications such as acute infarction and permanent disability.
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http://dx.doi.org/10.1002/ccr3.4489DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8301553PMC
July 2021

SARS-CoV-2 and guttate psoriasis: A case report and review of literature.

Clin Case Rep 2021 Jul 16;9(7):e04568. Epub 2021 Jul 16.

Internal Medicine Department Hamad Medical Corporation Doha Qatar.

Guttate psoriasis is a rare dermatological presentation of SARS-CoV-2 infection and is seen mainly in patients with an underlying disease psoriasis.
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http://dx.doi.org/10.1002/ccr3.4568DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8283862PMC
July 2021

Interferon-Alpha 2-a and Its Dual Effect in Treating Two Diseases (Hepatitis C and Polycythemia Vera).

Case Rep Oncol 2021 May-Aug;14(2):851-854. Epub 2021 Jun 11.

Department of Medical Oncology, Hamad Medical Corporation, Doha, Qatar.

Hepatitis C and polycythemia vera (PV) co-existence is not rare; it has been reported in the literature. Treatment with interferon (IFN) has been used to treat both conditions; however, the use of IFN in concomitant hepatitis C infection with PV and its outcome are rarely described in the literature. Here, we report a 56-years-old male patient with hepatitis C virus infection and PV, who was treated with IFN for his chronic hepatitis C, which resulted in significant improvement of HB as well as normalization of his bone marrow and eradication of the clone ( V617F).
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http://dx.doi.org/10.1159/000515782DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8255747PMC
June 2021

Priapism in Patients with Chronic Myeloid Leukemia (CML): A Systematic Review.

Acta Biomed 2021 07 1;92(3):e2021193. Epub 2021 Jul 1.

Medical Oncology, Hematology Section, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar.

Background: Priapism is defined as a penile erection that persists four or more hours and is unrelated to sexual stimulation. Priapism resulting from hematologic malignancy is most likely caused by venous obstruction from microemboli/thrombi and hyperviscosity caused by the increased number of circulating leukocytes in mature and immature forms. In patients with leukemia, 50% of cases of priapism are due to Chronic Myeloid Leukemia (CML). We present a systematic review of priapism in CML. Acquisition of evidence: An extensive literature research was carried out in PubMed, Google Scholar, SCOPUS, and Science Citation Index databases... The search included cases up to 4th August 2020. Synthesis of evidence: A total of 68 articles were found and included in our review, including 3 reviews from three different centers.  We found 68 articles (102 patients; figure 1) and several case reports on priapism in CML. Priapism was noticed in some patients at the first presentation of CML. However, it was infrequently reported during the start of treatment, following the stop of medication and post-splenectomy. The mean age at presentation was 27.4 years, and the mean time from onset of priapism to the time to get medical attention (presentation) was 78.2 hours. The mean white blood cell count associated with priapism was 321.29x109/L, and the mean platelet count was 569 x10 9/L. The chronic phase of CML was the most common phase where priapism occurred. Most patients were Asian (>50%). Nearly a quarter of patients (27.4%) developed permanent erectile dysfunction.

Conclusions: Priapism is a urological emergency requiring urgent multidisciplinary management to prevent erectile dysfunction. Because of the relatively rare occurrence of priapism in CML patients, there is no standard treatment protocol.
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http://dx.doi.org/10.23750/abm.v92i3.10796DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8343736PMC
July 2021

Priapism in lymphoproliferative disorders: A systematic review.

Hematol Oncol Stem Cell Ther 2021 Jun 10. Epub 2021 Jun 10.

Department of Hematology and Oncology, Hamad Medical Corporation, Doha, Qatar.

Priapism is defined as a persistent penile erection lasting more than 4 h. We searched the literature for reviews, case reports, and series for patients with lymphoproliferative disorders who developed priapism. The search involved all the lymphoproliferative disorders included in the revised 2016 World Health Organization classification of lymphoid neoplasms including chronic lymphocytic leukemia, multiple myeloma, Waldenström macroglobulinemia, and lymphomas. A total of 16 articles were found. The search included cases up to 4 January 2021. Priapism was seen most commonly as the first manifestation of lymphoproliferative disorders, rarely seen after treatment or after diagnosis.
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http://dx.doi.org/10.1016/j.hemonc.2021.05.003DOI Listing
June 2021

A Case Report of -Positive Chronic Myeloid Leukemia with Complete Hematological and Major Molecular Response to Dasatinib.

Case Rep Oncol 2021 Jan-Apr;14(1):690-694. Epub 2021 Apr 15.

Department of Hematology and Medical Oncology, Hamad Medical Corporation, Doha, Qatar.

Chronic myeloid leukemia (CML) is a myeloproliferative neoplasm (MPN) that harbors the Philadelphia chromosomal translocation resulting in the uncontrolled production of mature granulocytes. Commonly, patients are diagnosed with CML during blood work for other reasons or enlarged spleen. The diagnosis is based on WHO criteria that require the demonstration of Philadelphia chromosome. Typically, mutation is not found in -positive MPN (CML). Most patients with CML are negative. It is rare for CML Philadelphia-positive patients to have a coexisting mutation. Little is known regarding the effect of mutation on the disease course of CML, the complications, and the response to treatment. We report the case of a 57-year-old man with no previous medical illness who presented with elevated white blood cell count on perioperative assessment for hernial repair; on further workup, he was diagnosed with Philadelphia-positive CML. He was found to have mutation and was started on treatment with dasatinib and achieved hematological and cytogenetic remission with loss of the mutation. Patients with -positive -positive CML had a good hematological and cytogenetic response to dasatinib. In such rare coexistence of and , dasatinib is a good option due to multi-kinase activity.
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http://dx.doi.org/10.1159/000514632DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8138239PMC
April 2021

SGLT-2 inhibitors associated euglycemic and hyperglycemic DKA in a multicentric cohort.

Sci Rep 2021 05 13;11(1):10293. Epub 2021 May 13.

Department of Internal Medicine, Hamad General Hospital, Hamad Medical Corporation, PO BOX 3050, Doha, Qatar.

Euglycemic diabetic ketoacidosis (EuDKA) secondary to Sodium-glucose co-transporter-2 inhibitors (SGLT2i) in type 2 diabetes mellitus (T2D) is a rare but increasingly reported phenomenon. Not much is known about the burden of EuDKA in patients on SGLT2i or the associated factors. This retrospective cohort study tries to delineate the differences in factors associated with the development of EuDKA as compared to hyperglycemic DKA. We conducted a multicentre, retrospective study across three tertiary care centers under Weill Cornell affiliated-Hamad Medical Corporation, Qatar. The cohort comprised of T2D patients on SGLT2i who developed DKA between January 2015 to December 2020. The differences between the subjects who developed EuDKA or hyperglycaemic DKA (hDKA) were analyzed. A total of 9940 T2D patients were on SGLT2i during 2015-2020, out of which 43 developed DKA (0.43%). 25 developed EuKDA, whereas 18 had hDKA. The point prevalence of EuDKA in our cohort was 58.1%. EuDKA was most common in patients using canagliflozin, followed by empagliflozin and Dapagliflozin (100%, 77%, and 48.3%, respectively). Overall, infection (32.6%) was the most common trigger for DKA, followed by insulin non-compliance (13.7%). Infection was the only risk factor with a significant point estimate between the two groups, being more common in hDKA patients (p-value 0.006, RR 2.53, 95% CI 1.07-5.98). Canagliflozin had the strongest association with the development of EuDKA and was associated with the highest medical intensive care unit (MICU) admission rates (66.6%). In T2D patients on SGLT2i, infection is probably associated with an increased risk of developing EuDKA. The differential role of individual SGLT2i analogs is less clear and will need exploration by more extensive prospective studies.
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http://dx.doi.org/10.1038/s41598-021-89752-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8119406PMC
May 2021

Thalassemia and Priapism: A Literature Review of a Rare Association.

Cureus 2021 Apr 7;13(4):e14335. Epub 2021 Apr 7.

Department of Hematology, National Centre for Cancer Care and Research, Hamad Medical Corporation, Doha, QAT.

Thalassemia is a hematologic disorder caused by genetic mutation resulting in impaired hemoglobin chain production. Patients with thalassemia commonly experience complications such as anemia, blood transfusion-related issues, hepatic or cardiac involvement, and psychosocial impacts. Rarely, priapism has been associated with thalassemia as an initial presentation or subsequently occurring at any time in the disease course. Our literature review summarizes the reported cases of thalassemia-associated priapism and delves into underlying mechanisms of its pathophysiology and appropriate management.
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http://dx.doi.org/10.7759/cureus.14335DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8105192PMC
April 2021

Eltrombopag Dose Adjustment During Infection-Induced Thrombocytosis in a Patient With Chronic Idiopathic Thrombocytopenic Purpura.

Cureus 2021 Mar 29;13(3):e14166. Epub 2021 Mar 29.

Hematology and Oncology, Hamad General Hospital, Doha, QAT.

Idiopathic thrombocytopenic purpura (ITP) is an immune disorder in which antibodies attack platelets, leading to platelet destruction and increased bleeding risk. Standard treatment is to maintain a platelet count sufficient to mitigate the bleeding risk. First-line therapies include steroids and IV immunoglobulins, and second-line therapy includes thrombopoietin receptor agonists like eltrombopag in combination with other medications (e.g., rituximab) to reduce immune attack. Eltrombopag is a nonpeptide oral thrombopoietin (TPO)-receptor agonist that increases platelet counts by binding to and activating the human TPO receptor. While using eltrombopag, the target platelet count range is usually between 50,000/mm³ and 200,000/mm³, so the dose should be adjusted accordingly. However, this dose adjustment is based on platelet count increments in response to eltrombopag administration. Adjusting the dose when the platelet count is elevated due to a different factor can be challenging. Data are not yet available on whether stopping the treatment or reducing the dose will harm the patient or result in an acute drop in platelet count and increased bleeding. We present the case of a 60-year-old woman with ITP on a stable eltrombopag regimen who completed an eltrombopag-free period after developing infection-induced thrombocytosis.
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http://dx.doi.org/10.7759/cureus.14166DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8080309PMC
March 2021

Acute appendicitis revealing a diagnosis of chronic myelogenous leukemia.

Clin Case Rep 2021 Apr 24;9(4):1913-1916. Epub 2021 Feb 24.

Department of Hematology/Oncology National Centre for Cancer Care & Research Doha Qatar.

Gastrointestinal manifestations of leukemias have been well recognized. Typically, acute leukemias cause typhlitis or appendicitis more commonly than chronic leukemias. Our case points to appendicitis as possible manifestation of chronic myelogenous leukemia.
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http://dx.doi.org/10.1002/ccr3.3902DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8077314PMC
April 2021

Invasive ductal breast carcinoma preceded by CALR-positive essential thrombocythemia.

Clin Case Rep 2021 Mar 9;9(3):1732-1736. Epub 2021 Feb 9.

Medical Oncology and Hematology Department Hamad Medical Corporation Doha Qatar.

Persistent thrombocytosis in patients with cancer needs workup because it can be linked to essential thrombocytosis. The management should be individualized to start treatment for low-risk essential thrombocytosis due to the combined risk of thrombosis.
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http://dx.doi.org/10.1002/ccr3.3892DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7981762PMC
March 2021

Eltrombopag and its beneficial role in management of ulcerative Colitis associated with ITP as an upfront therapy case report.

Clin Case Rep 2021 Mar 21;9(3):1416-1419. Epub 2021 Jan 21.

Department of Hematology and Medical Oncology National Center for Cancer Care and Research Doha Qatar.

Eltrombopag can be used safely as upfront medication in the management of ulcerative colitis as well as ITP, and it showed a beneficial effect in both disorders.
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http://dx.doi.org/10.1002/ccr3.3783DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7981772PMC
March 2021

Severe SARS-CoV-2 infection presenting with acute kidney injury and diabetic ketoacidosis complicated by pancreatitis in a 53-year man with hypertension.

Clin Case Rep 2021 Mar 7;9(3):1202-1206. Epub 2021 Jan 7.

Internal Medicine Department Hamad Medical Corporation Doha Qatar.

Severe COVID-19 infection is associated with significant stress and marked immune response that can affect many organs and precipitate DKA, pancreatitis, and acute renal injury, which might be permanent.
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http://dx.doi.org/10.1002/ccr3.3731DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7981639PMC
March 2021

SGLT2 inhibitors and euglycemic diabetic ketoacidosis.

Eur J Clin Pharmacol 2021 Sep 9;77(9):1431-1433. Epub 2021 Mar 9.

Department of Medicine, Hamad Medical Corporation, PO Box 3050, Doha, Qatar.

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http://dx.doi.org/10.1007/s00228-021-03120-1DOI Listing
September 2021

Clinical Outcome of Eosinophilia in Patients with COVID-19: A Controlled Study.

Acta Biomed 2020 11 10;91(4):e2020165. Epub 2020 Nov 10.

Department of Haematology/Oncology, National Centre for Cancer Care and Research (NCCCR), Hamad Medical Corporation (HMC), Doha, Qatar.

Background: Eosinophils can be considered as multifunctional leukocytes that contribute to various physiological and pathological processes depending on their location and activation status. There are emerging eosinophil-related considerations concerning COVID-19. Variable eosinophil counts have been reported during COVID-19. Whether these changes are related to the primary disease process or due to immunomodulation induced by the treatment has not yet been elucidated.

Aim Of The Study: To describe changes in the differential leukocyte counts including eosinophils, in a cohort of symptomatic patients with confirmed COVID-19 and to correlate these changes, if any, with the severity of the disease.

Patients And Methods: We recorded the clinical data, lab findings, including inflammatory markers and leukocyte and differential count, course of the disease and severity score in 314 confirmed symptomatic cases of COVID-19.

Results: Laboratory tests revealed that 28.7 % (n =86) had mild eosinophilia (eosinophil count > 500 <1,500/µL). Thirty-four patients (11.3%) had elevated absolute neutrophil count (ANC) (>8,000/µL), and 7 (2.3%) had decreased ANC (< 1,500/µl). Seven patients (2.3%) had lymphopenia (<1,000/µL) and 4 (4.67%) had lymphocytosis (> 4,000/µL). C-reactive protein (CRP) was elevated in 83 patients (27.6%). Chest X-Ray changes included: increased broncho vascular markings (38%), ground-glass opacity (GGO) pneumonitis (19.3%), lobar consolidation (5%), bronchopneumonia (8.3%), nodular opacity (1%), acute respiratory distress syndrome (ARDS) (2.3%), pleural effusion (1.0%) and other atypical findings (6.6%). Patients with eosinophilia had significantly lower CRP, and lower % of GGO, lobar and bronchopneumonia and ARDS in their chest images compared to patients without eosinophilia (p: <0.05). They also had a lower requirement for a hospital stay, ICU admission, mechanical ventilation, and oxygen supplementation versus patients without eosinophilia (p: <0.05). The eosinophils count was correlated negatively with the duration of ICU admission, mechanical ventilation, and oxygen supplementation and with CRP level (r: - 0.34, -0.32, -0.61 and - 0.39, respectively) (p: < 0.01).

Conclusions: Our study reports a relatively high prevalence of eosinophilia in symptomatic COVID-19 positive patients. Patients with eosinophilia had a lower level of CRP, milder clinical course and better disease outcomes compared to those without eosinophilia. Our findings indicated a protective role of eosinophils in mitigating the severity of inflammatory diseases through an inhibitory mechanism, as evidenced by lower CRP. This protective role of eosinophils needs to be validated by further prospective studies.
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http://dx.doi.org/10.23750/abm.v91i4.10564DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7927494PMC
November 2020

Essential thrombocythemia with (type2) calreticulin presented as stuttering priapism case report and review of literature.

Clin Case Rep 2021 Jan 18;9(1):399-404. Epub 2020 Nov 18.

Hematology and Oncology Department Hamad Medical Corporation Doha Qatar.

Priapism is a rare presentation and complication of ET that might be underreported. In ET, priapism can present as an ischemic or stuttering type. These patients are more likely to be anemic and have a high platelet count.
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http://dx.doi.org/10.1002/ccr3.3541DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7813073PMC
January 2021

Chronic Lymphocytic Leukemia Concomitant with COVID 19: A Case Report.

Am J Case Rep 2020 Oct 24;21:e926062. Epub 2020 Oct 24.

Department of Hematology and Oncology, Hamad Medical Corporation, Doha, Qatar.

BACKGROUND COVID-19 is a newly emerging disease that is not yet fully understood. It is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel virus that is easily transmitted from human to human through the respiratory route. Usually, it presents with fever, headache, fatigue accompanied by respiratory symptoms like cough and dyspnea, and other systemic involvements. Chronic lymphocytic leukemia (CLL) is a common lymphoproliferative neoplasm characterized by absolute lymphocytosis and demonstration of clonality unlike other causes of lymphocytosis. Patients with CLL are considered immunocompromised because of impaired humoral immunity (mainly) and cellular immunity. Therefore, they are vulnerable to various infections including COVID-19. Little is known about the COVID-19 infection when it unmasks CLL. CASE REPORT A 49-year-old man with no significant previous illnesses, and an unremarkable family history, presented with a moderate COVID-19 infection. He initially presented to the emergency department with fever and mild shortness of breath. A complete blood count showed a high white blood cell count with absolute lymphocytosis. Flow cytometry revealed the clonality of the lymphocytes confirming the diagnosis of CLL. Despite having CLL, he developed a moderate COVID-19 infection and recovered in a few days. To the best of our knowledge, this is the first report of CLL, which presented with a COVID-19 infection as the initial presentation. CONCLUSIONS Lymphocytosis is an unexpected finding in patients diagnosed with COVID-19 infection and the elevated lymphocytes may be indicative of other conditions. Secondary causes of lymphocytosis like malignancy or other infections should be considered in these cases.
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http://dx.doi.org/10.12659/AJCR.926062DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7592339PMC
October 2020

A Case of Fulminant Liver Failure in a 24-Year-Old Man with Coinfection with Hepatitis B Virus and SARS-CoV-2.

Am J Case Rep 2020 Oct 13;21:e925932. Epub 2020 Oct 13.

Department of Hematology and Oncology, Hamad Medical Corporation, Doha, Qatar.

BACKGROUND Coronavirus disease 2019 (COVID-19) is a newly emerging disease that is still not fully characterized. It is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel virus that can be transmitted easily from human to human mainly by the respiratory route. Currently, there is no specific treatment for COVID-19 or a vaccine for prevention. The disease has various degrees of severity. It often presents with nonspecific symptoms such as fever, headache, and fatigue, accompanied by respiratory symptoms (e.g., cough and dyspnea) and other systemic involvement. Severe disease is associated with hemophagocytic syndrome and cytokine storm due to altered immune response. Patients with severe disease are more likely to have increased liver enzymes. The disease can affect the liver through various mechanisms. CASE REPORT We report an unusual case of SARS-CoV-2 infection in a 24-year-old man with no previous medical illness, who presented with mild respiratory involvement. He had no serious lung injury during the disease course. However, he experienced acute fulminant hepatitis B infection and cytokine release syndrome that led to multiorgan failure and death. CONCLUSIONS It is uncommon for SARS-CoV-2 infection with mild respiratory symptoms to result in severe systemic disease and organ failure. We report an unusual case of acute hepatitis B infection with concomitant SARS-CoV-2 leading to fulminant hepatitis, multiorgan failure, and death.
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http://dx.doi.org/10.12659/AJCR.925932DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7568525PMC
October 2020

Prevalence, clinical manifestations, and biochemical data of type 2 diabetes mellitus versus nondiabetic symptomatic patients with COVID-19: A comparative study.

Acta Biomed 2020 09 7;91(3):e2020010. Epub 2020 Sep 7.

National Center for Cancer care and Research, Doha, Qatar. .

Background: There is a scarcity of data regarding the effect of Type 2 diabetes mellitus (T2DM) and associated comorbidities on the clinical presentation and outcome of symptomatic patients with -COVID-19 infection in comparison with non-diabetic patients.

Aim Of The Study: We described and compared the clinical presentation and radiological and hematological data of a cohort of symptomatic COVID19 positive T2DM diabetic patients (n = 59) versus another cohort of non-diabetic symptomatic COVID19 positive patients (n =244) diagnosed at the same time from January 2020 to May 2020. Associated comorbidities were -assessed, and the Charlson Comorbidity Index was calculated. The outcomes including duration of hospitalization, duration of Intensive Care Unit (ICU) stay, duration of mechanical ventilation, and duration of O2 -supplementation were assessed.

Results: Prevalence of T2DM in symptomatic COVID19 positive patients was 59/303 (=19.5%).  Diabetic patients had higher prevalence of hypertension, chronic kidney disease (CKD) and cardiac dysfunction [coronary heart disease (CHD)], and congestive heart failure (CHF). Charlson Comorbidity score was significantly higher in the T2DM patients (2.4± 1.6) versus the non-diabetic -patients (0.28 ± 0.8; p: < 0.001). Clinically and radiologically, T2DM patients had significantly higher percentage of pneumonia, severe pneumonia and ARDS versus the non-diabetic patients. Hematologically, diabetic patients had significantly higher C-reactive protein (CRP), higher absolute neutrophilic count (ANC) and lower counts of lymphocytes and eosinophils compared to non-diabetic patients. They had significantly higher systolic and diastolic blood pressures, longer duration of hospitalization, ICU stay, mechanical ventilation and oxygen therapy. CRP was correlated significantly with the duration of stay in the ICU and the duration for oxygen supplementation (r = 0.37 and 0.42 respectively; p: <0.01).

Conclusions: T2DM patients showed higher inflammatory response to COVID 19 with higher absolute neutrophilic count (ANC) and CRP with lower lymphocytic and eosinophilic counts. Diabetic patients had more comorbidities and more aggressive course of the disease with higher rate of ICU admission and longer need for hospitalization and oxygen use.
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http://dx.doi.org/10.23750/abm.v91i3.10214DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7716959PMC
September 2020

The Relationship Between Sickle Cell Disease and Sudden Onset Sensorineural Deafness.

Cureus 2020 Jul 27;12(7):e9413. Epub 2020 Jul 27.

Internal Medicine, Hamad Medical Corporation, Doha, QAT.

Sickle cell anemia (SCA) is a hereditary hemoglobin (Hb) disorder associated with a very specific molecular lesion, which is the exchange of glutamic acid for valine in the sixth residue of the Hb beta chain, originating the S Hb. It is characterized by intermittent episodes of vascular occlusion and end-organ damage. Progressive organ damage may affect any organ with brain, eyes, pulmonary, hepatobiliary, spleen, genitourinary, and the musculoskeletal systems being the most commonly involved and reported. Other complications of the disease that have not been well described or studied include cranio-orbital syndromes, oropharyngeal syndromes, periodontal disease, and otologic syndromes. Considering the vaso-occlusive nature of sickle cell disease (SCD), the potential for auditory damage is not unexpected. However, the incidence of subjective hearing impairment among SCA is very low and and little is known about the relationship between SCA and hearing loss. Here we report a 43-year-old female with SCA who presented with sudden bilateral hearing loss and generalized body ache and admitted as a case of sensorineural deafness with vascular crisis; she received IV fluid and analgesia and improved after five days from the therapy.
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http://dx.doi.org/10.7759/cureus.9413DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7449647PMC
July 2020

Groove Pancreatitis Associated with Transient Liver Injury Mimicking Ampullary Neoplasm.

Case Rep Gastroenterol 2020 May-Aug;14(2):306-314. Epub 2020 Jun 2.

Department of Hematology and Oncology, Hamad Medical Corporation, Doha, Qatar.

Groove pancreatitis is an unusual form of pancreatitis characterized by fibrous inflammation and pseudo-tumor in the area around the head of the pancreas. The underlying etiology is unknown but is strongly linked to alcohol abuse. We report a 52-year-old male smoker with hypertension, asthma, and alcohol abuse who was admitted with severe epigastric pain radiating to the back. He was found to have acute pancreatitis. A computed tomography scan of the abdomen showed a mass lesion in the peri-ampullary region. MRI of the abdomen revealed dilated common bile duct and duodenal mass and features suggestive of groove pancreatitis. During the hospital stay, bilirubin and liver enzymes started to rise and then decreased gradually to the previous normal range. The secondary workup for liver disease was unremarkable. The patient improved and was discharged. Six-month follow-up showed regression of the duodenal lesion and reduction in the common bile duct dilatation. Excluding malignancy remains the main challenge in managing groove pancreatitis, and a conservative approach is more reasonable in cases with a typical profile.
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http://dx.doi.org/10.1159/000507430DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7315138PMC
June 2020

A Rare Case of Severe Copper Deficiency in an Infant with Exclusive Breast Feeding Mimicking Myelodysplastic Syndrome.

Case Rep Oncol 2020 Jan-Apr;13(1):62-68. Epub 2020 Feb 4.

Department of Hematology, Hamad Medical Corporation, Doha, Qatar.

An 11-month-old full-term female infant was referred to the hematology clinic due to marked anemia and neutropenia. She was almost exclusively breastfed and rejecting all trials for supplementary food including artificial formulas. Bone marrow aspirate revealed cytoplasmic vacuolization in precursors of the myeloid and erythroid series with significant dysgranulopoiesis and dyserythropoiesis and ringed sideroblasts. Flow cytometry analysis revealed increased hematogones with aberrant loss/downregulation of CD33 on granulocytes and monocytes (sign of dysmyelopoiesis). Laboratory investigation revealed low serum copper and ceruloplasmin. Administration of a multivitamin including a high concentration of copper for only 1 week improved her hemoglobin and absolute neutrophil count up to 1.9 × 103/µL, then dropped to 0.3 103/µL after she stopped taking the copper multivitamin. Her blood counts improved till total normalization and up to the time this report is issued. The probable role of unrecognized copper deficiency in causing anemia in infants more than 6 months of age is discussed, and the importance of serum copper examination in refractory anemia and neutropenia is emphasized. This case shows that copper deficiency should be an integral part of the differential diagnosis of refractory anemia including sideroblastic anemia and dysplasia. To the best of our knowledge, no such case has previously been described in the literature.
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http://dx.doi.org/10.1159/000505483DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7036529PMC
February 2020

The effect of interpregnancy interval on obesity/overweight among women in the first trimester of pregnancy.

Int J Gynaecol Obstet 2017 Sep 17;138(3):320-324. Epub 2017 Jun 17.

Faculty of Medicine, University of Khartoum, Khartoum, Sudan.

Objective: To determine the effect of interpregnancy interval (IPI) on obesity/overweight among pregnant Sudanese women in early pregnancy.

Methods: A cross-sectional study was conducted at Saad Abu-Alela Hospital, Khartoum, Sudan, from January to December 2015. Women with a singleton pregnancy and at least one previous pregnancy were enrolled in the first trimester. A questionnaire was used to collect clinical and sociodemographic data from the participants, and current body mass index (BMI) was calculated as weight in kilograms divided by the square of height in meters.

Results: Among 1045 participants, 344 (32.9%), 424 (40.6%), and 277 (26.5%) women had short (<18 months), normal (18-30 months), and long IPIs (>30 months), respectively. BMI indicated 18 (1.7%), 408 (39.0%), 381 (36.5%), and 238 (22.8%) women were underweight (<18.5), normal weight (18.5-24.9), overweight (25.0-29.9), and obese (≥30.0), respectively. Age and proportion using contraceptives were increased among women with long IPI (both P<0.001). When compared with women of normal weight, overweight women and obese women were more likely to have a long IPI (odds ratio 1.72, 95% confidence interval 1.08-2.93; and 1.71, 1.05-2.94, respectively).

Conclusion: Long IPI was associated with obesity and overweight, which were prevalent among pregnant Sudanese women.
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http://dx.doi.org/10.1002/ijgo.12222DOI Listing
September 2017
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