New Emirates Medical Journal - Volume 5, Issue 1, 2024

The risk of the post-operative severe atrioventricular block is high when infective endocarditis spreads to the conduction system. However, a clear surgical method to prevent post-operative severe atrioventricular block in infective endocarditis patients has not been developed.

A 39-year-old man with a persistent fever was referred to our hospital. Echocardiography showed mitral valve infective endocarditis with severe aortic regurgitation due to a congenital bicuspid aortic valve. Before the surgery, a paroxysmal atrioventricular block appeared. Intraoperative inspection revealed an aortic-root abscess with ulcerated lesions below the commissure of the noncoronary-right coronary cusps and perforation of the anterior leaflet of the mitral valve. Considering the risk of atrioventricular block, the ulcerated lesions were only cleared with saline solution. After replacing the mitral valve with a mechanical mitral valve, the interventricular fibrous body and aortic annulus were reconstructed with a bovine pericardial patch. The mechanical aortic valve was sutured to the reconstructed aortic annulus. Two years after the surgery, severe atrioventricular block did not occur.

Our method may be effective when the risk of post-operative severe atrioventricular block is high and the patient’s prognosis worsens.

Nephrogenic adenoma is an uncommon, benign, tumour-like lesion within the urothelial mucosa of the urinary tract caused by reimplantation and proliferation of the renal tubular cells that have been shed by chronic irritation of the mucosa of the urinary tract.

We report a case of the rare fibromyxoid variant of nephrogenic adenoma in the prostate urethra. To the best of our knowledge, only a few cases have been described in the literature.

This tumour can have variable morphological patterns with occasional worrisome features that can mimic carcinoma of the lower urinary tract.

Domperidone is an antiemetic and prokinetic agent that is widely used to treat nausea and vomiting, gastroparesis, and as a galactagogue.

This review article focuses on QT prolongation, torsades de pointes, severe ventricular arrhythmia, and sudden cardiac death associated with the use of domperidone or domperidone-containing products.

The online databases, such as Medline/Pubmed/PMC, Google Scholar, Science Direct, Ebsco, Scopus, Web of Science, Embase, and reference lists, were searched using keywords like Domperidone, Cardiotoxicity, QT prolongation, Cardiac arrhythmia, Torsades de pointes, Ventricular arrhythmia, and Sudden Cardiac Death, to identify published articles relevant to domperidone-associated cardiotoxicity.

Domperidone has been linked to an increased risk of QT prolongation, torsades de pointes, severe ventricular arrhythmia, and sudden cardiac death, according to a number of epidemiological studies and meta-analyses.

Domperidone can only be used to treat nausea and vomiting in patients between the ages of 12 and 60, and a maximum daily dose of 30 mg has been set by a number of regulatory bodies. The risk of severe ventricular arrhythmia and sudden cardiac death caused by domperidone should be made clear to clinicians along with the recommendations from regulatory bodies to avoid any potential complications.

More than 175,000 new cases of cancer in children are diagnosed every year worldwide.

This study aimed to investigate the recorded cancer frequency in children and adolescents in Isfahan Province, Iran.

As one of the main reasons for death among children and adolescents is reported as cancer with different prevalence worldwide, therefore, reporting the occurrence of cancers in this population is crucial.

Information from the years between 2013 to 2015 related to the Surveillance, Epidemiology, and End Results; (SEER) was collected from the Isfahan Cancer Registry. The cancer sites studied were defined according to the International Classification of Diseases and recorded by related topography codes.

Among all 30,465 registered cancers, there were 582 cases (2%) of cancer, including 57% of children and 43% of adolescents. The mean ± SD age of patients was 11.5 ± 5.9 years (Min; 1, Max 19). The top four ranked cancers were (n=264; 45%) comprised of; 1) hematopoietic and reticuloendothelial system (n= 122), 2) secondary and unspecified malignant neoplasm of lymph nodes (n=56), 3) malignant neoplasm of the brain (n=43) 4), thyroid gland (n=43). Death-reported data was associated with 32% of the total population studied. The neoplasm was reported in 174 cases, which was associated with 95% death.

This frequency source of children and adolescents cancers could be used for health strategy. The observed variations in the frequency of different cancers require continuous monitoring and investigation. Therefore, plan of health-system should focus based on greater efforts toward advanced evidence-based drug therapy in Isfahan, Iran.

Student nurses are the future healthcare providers. Safe nursing practice is crucial as they often are exposed to multiple infections, including bloodborne pathogens, during their clinical practice.

To assess the factors that influence adherence to standard precautions among nursing students and to find the association between adherence to standard precautions with their selected demographic variables.

A cross-sectional study was conducted among 103 undergraduate nursing students recruited by convenience sampling technique from a selected health sciences university. Adherence to standard precautions was assessed using a standardized questionnaire, ‘Factors Influencing Adherence to Standard Precautions Scale-Student Version’ (FIASPS-SV). Using SPSS version 23 the data were analysed with descriptive and inferential statistics. Frequency and percentage were used to describe the socio-demographic characteristics. Inferential statistics, namely the Chi-Square test, was used to find out the association between FIASPS-SV and their demographic variables. The P value less than 0.05 was taken as statistically significant.

The ‘contextual cues’ was found to be the most influencing factor [Total Mean 21.98(6.148), Range 0-28; Mean Response Range of 3.18(.32), Response Range 1-4] while the factor ‘justification’ was found to be the least influencing factor [Total Mean 7.31(6.1285), Range 0-28; Mean Response Range -1.06 (.23), Response Range 1-4] for the adherence of standard precautions among the study participants. A statistically significant association was found between age and specific factors of ‘Leadership’ & ‘Contextual cues’. Gender was found to be associated with specific factors of ‘Justification’ and ‘Contextual cues.’

The study findings showed that the overall student adherence to standard precautions was good. However, they need to improve in some areas, like wearing gloves when drawing blood or cannulation, following standard precautions when handling needles, and confronting people when they are not adhering to these precautions. The faculty should reinforce and encourage the students to implement standard precaution practices effectively at clinical settings to promote safe practice.

Phagophobia is characterized by conditioned excessive fear of swallowing or choking that is usually triggered by an incident. It usually leads to avoidance of certain types of food or, in severe forms, a complete refusal to eat solid food and/or liquids. The condition is commonly associated with physical and psychological symptoms impacting the health condition of the individual due to deprivation of essential nutrients.

A 12-year-old boy developed acute onset fear of swallowing (Phagophobia) following a dream he had of someone choking. This was exacerbated by watching an online video of a person choking. This has led to an avoidance of solid food and dependence on soft food and liquids. Fear of swallowing along with food avoidance has led to malnutrition, weight loss, and several physical complaints for which the patient was admitted under pediatric care. A course of Cognitive Behavioral Therapy (CBT) resulted in limited response and was augmented with fluoxetine. Full remission was achieved within six weeks.

A systematic review of all peer-reviewed English literature was performed for articles related to the pharmacological treatment of pediatric phagophobia (0-18 years) following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines.

A total of 17 case reports were identified describing 17 children with phagophobia (females = 70%). The mean age was 9.3 and the average was between 2 and 15 years who were diagnosed with choking phobia/ phagophobia or different but equivalent diagnoses like Avoidant/Restrictive Food Intake Disorder or Post Traumatic Feeding Disorder. Different classes of medications were used in variable doses for different durations which were associated with significant improvement in eating patterns and reduction in fear and anxiety associated with eating.

Phagophobia is a serious and potentially life-threatening illness that can cause physical complications and functional impairment in the psychosocial aspect. Pharmacological treatment can be a beneficial and safe option either alone or in combination with therapeutic interventions for children presenting with phagophobia.