Abdulaziz Almahrezi - Academia.edu (original) (raw)

Papers by Abdulaziz Almahrezi

Research paper thumbnail of Documentation of the management of asthma exacerbation in adults by primary health care physicians in a teaching hospital in oman

Sultan Qaboos University medical journal, 2010

Asthma exacerbation is a major cause of morbidity and it is usually an indication of poor control... more Asthma exacerbation is a major cause of morbidity and it is usually an indication of poor control. Appropriate management and documentation of the clinical assessment of an exacerbation, its severity, contributing factors and treatment are all essential components of asthma control. The aim of this study was to assess the documentation of the management of asthma exacerbations by primary care physicians (PCPs). A retrospective analysis was carried out on patient records from 1 May 2008 to 31 April 2009. We included all acute exacerbation episodes in asthmatic patients aged ≥ 14, who received nebulized bronchodilators in the two family medicine clinics attached to Sultan Qaboos University Hospital (SQUH), Oman. A special form was designed to collect PCP's documented management. A total of 67 patients with 100 episodes were treated by 42 PCPs. Documentation of clinical assessment was low for previous admissions (2%), rescue nebulization (25%), duration of symptoms (57%), trigger f...

Research paper thumbnail of Congenital Fusion of the Trapezium and Trapezoid

Sultan Qaboos University Medical Journal, Dec 1, 2010

... Congenital fusion of the trapezium and trapezoid. Rom J Morphol Embryol. 2008;49:417–9. [PubM... more ... Congenital fusion of the trapezium and trapezoid. Rom J Morphol Embryol. 2008;49:417–9. [PubMed]. 2. Singh P, Tuli A, Choudhry R, Mangal A. Intercarpal fusion – a review. J Anat Soc India. 2003;52:183–8. 3. Cockshott WP. Carpal fusion. ...

Research paper thumbnail of Odontogenic Cutaneous Fistula: Report of two cases

Sultan Qaboos University Medical Journal, Feb 1, 2011

Odontogenic cutaneous fistula or sinus is an uncommon, but well documented condition, which is of... more Odontogenic cutaneous fistula or sinus is an uncommon, but well documented condition, which is often initially misdiagnosed as a sole cutaneous lesion and inappropriately treated. The misdiagnosis as a skin infection often results in inappropriate management. We here present two cases of odontogenic cutaneous fistula that were seen after being treated unnecessarily with antibiotics.

Research paper thumbnail of Marfan Syndrome: Correct diagnosis can save lives

Sultan Qaboos University Medical Journal, Nov 1, 2012

Marfan syndrome is a heritable disorder of the connective tissue that affects many systems of the... more Marfan syndrome is a heritable disorder of the connective tissue that affects many systems of the body. However, the most serious complication in patients with Marfan syndrome is progressive enlargement of the aortic root, which may lead to aortic dissection, rupture, or aortic regurgitation. Prevention of these life threatening complications is very important in the management of this condition. A 39-year-old Omani man presented with progressive shortness of breath and eventually underwent major but successful cardiac surgery. It is very important to recognise Marfan syndrome early as preventive actions are possible if the condition is diagnosed before complications occur.

Research paper thumbnail of Dose-dependent severe arthralgia induced by gabapentin

The Journal of rheumatology, 2004

Research paper thumbnail of An application of educational theories and principles of teaching and learning communication skills for general practitioners in oman

Oman medical journal, 2009

This article discusses the crucial role of teaching and learning communication skills for general... more This article discusses the crucial role of teaching and learning communication skills for general practitioners, based on the theory of experiential and self-directed learning. It also outlines the proposed ways and methods to teach these communication skills in this project.The patient-doctor interview or what is known as office visit in some countries and consultation in others is the cornerstone of the entire General Practice (GP) or Family Medicine. It is from this process and outcome that the reputation is gained or destroyed. The analysis of the consultation is complicated and varied but is most usefully employed to assess effecacy in terms of achieving the means that are mutually desired by patients and their carers.

Research paper thumbnail of Attributes of an ideal family medicine residency training program

Oman medical journal, 2008

Medi cal education has been traditionally based on the pedagogical model of teaching. However, a ... more Medi cal education has been traditionally based on the pedagogical model of teaching. However, a gradual shift away from this model to a student centered approach has been observed. Factors such as the radical expansion of medical knowledge, changing need of the society and technological advances have contributed a lot to the acceleration of this process. Many medical schools worldwide have already implemented the principles of adult education as basis for reforms in their curricula. Moreover, attention has also been focused on a changing role of teachers from a transmitter of knowledge to that of a facilitator of learning. Problem based learning, guided discovery learning, small group teaching, peer evaluation and self assessment all illustrate some examples of application of this approach into medical education. Studies conducted at universities applying the new curriculum have shown higher participation rates by the students compared to universities with traditional programs. 1 Advantages of adopting this approach in teaching and learning can be enormous. Acquiring the skills for lifelong learning, self assessment, critical appraisal and self reflection are all of great value to future doctors.

Research paper thumbnail of Intravenous Lidocaine for Refractory Chronic Orofacial Pain: Two case reports and a literature review

Sultan Qaboos University medical journal, 2008

This report presents the results of treatment of two adults, at the Pain Center of Montreal Gener... more This report presents the results of treatment of two adults, at the Pain Center of Montreal General Hospital, Canada, with intravenous lidocaine for intractable orofacial pain. Repeated lidocaine infusions (1mg/kg in a bolus, followed by 4mg/kg infused over 1 hour) resulted in satisfactory pain relief in both patients, and the drug was well tolerated. Intravenous lidocaine therapy may be considered for intractable orofacial pain; further research is warranted.

Research paper thumbnail of Control and management of hypertension at a university health centre in oman

Sultan Qaboos University medical journal, 2008

To evaluate the prevalence of hypertension, its control and management at Sultan Qaboos Universit... more To evaluate the prevalence of hypertension, its control and management at Sultan Qaboos University (SQU) Health Centre, Oman. This was a retrospective cross-sectional study, in which were enrolled all the subjects (≥18 years), with the diagnosis of essential hypertension, who attended the SQU Health Centre between 1998 and 2002. The systolic and diastolic blood pressure (BP) values of the last three visits were used for analysis. BP control was defined using the Joint National Committee (JNC-7) criteria, <140 mmHg and <90 mmHg for systolic and diastolic BPs, respectively. Analyses were performed using univariate statistics. Among the 7,702 medical records reviewed, the prevalence of hypertension was 2.4% (n = 187). The overall mean age of the cohort was 55±11 years, 54% (n = 101) were females, and majority of the subjects were Omanis (n = 123; 66%). The proportion of subjects who had their BP controlled was 41% (n = 77) with Omanis significantly less likely to have their BP co...

Research paper thumbnail of Clinical profile of rheumatic disease patients referred to a multidisciplinary pain center

The Journal of rheumatology, 2004

Good pain control is a prerequisite for success in the management of many rheumatological disease... more Good pain control is a prerequisite for success in the management of many rheumatological diseases. However, some rheumatology patients may present challenges in terms of pain management and be subsequently referred to a specialized pain clinic. We examined the characteristics and assessed the outcome of patients with rheumatic diseases who were referred to a tertiary care pain center. All new patients with a primary rheumatological diagnosis referred over a 9 year period to the McGill University Pain Centre were studied. Patients were identified through a computer search according to both diagnoses and symptoms. Demographic information, clinical and pain characteristics, and subsequent management and final outcome were assessed. Out of a total of 1120 new patients, 60 (5%) had a primary rheumatologic diagnosis to account for pain and referral. The diagnoses were as follows: fibromyalgia in 26 (43%), inflammatory arthritis 17 (28%), degenerative arthritis 9 (15%), and soft tissue rh...

Research paper thumbnail of Edit orial Attributes of an ideal Family Medicine residency training progra m

Medi cal education has been traditionally based on the pedagogical model of teaching. However, a ... more Medi cal education has been traditionally based on the pedagogical model of teaching. However, a gradual shift away from this model to a student centered approach has been observed. Factors such as the radical expansion of medical knowledge, changing need of the society and technological advances have contributed a lot to the acceleration of this process. Many medical schools worldwide have already implemented the principles of adult education as basis for reforms in their curricula. Moreover, attention has also been focused on a changing role of teachers from a transmitter of knowledge to that of a facilitator of learning. Problem based learning, guided discovery learning, small group teaching, peer evaluation and self assessment all illustrate some examples of application of this approach into medical education. Studies conducted at universities applying the new curriculum have shown higher participation rates by the students compared to universities with traditional programs. 1 Advantages of adopting this approach in teaching and learning can be enormous. Acquiring the skills for lifelong learning, self assessment, critical appraisal and self reflection are all of great value to future doctors.

Research paper thumbnail of Subcutaneous administration of testosterone. A pilot study report

Saudi medical journal, 2006

To investigate the effect of low doses of subcutaneous testosterone in hypogonadal men since the ... more To investigate the effect of low doses of subcutaneous testosterone in hypogonadal men since the intramuscular route, which is the most widely used form of testosterone replacement therapy, is inconvenient to many patients. All men with primary and secondary hypogonadism attending the reproductive endocrine clinic at Royal Victoria Hospital, Monteral, Quebec, Canada, were invited to participate in the study. Subjects were enrolled from January 2002 till December 2002. Patients were asked to self-administer weekly low doses of testosterone enanthate using 0.5 ml insulin syringe. A total of 22 patients were enrolled in the study. The mean trough was 14.48 +/- 3.14 nmol/L and peak total testosterone was 21.65 +/- 7.32 nmol/L. For the free testosterone the average trough was 59.94 +/- 20.60 pmol/L and the peak was 85.17 +/- 32.88 pmol/L. All of the patients delivered testosterone with ease and no local reactions were reported. Therapy with weekly subcutaneous testosterone produced serum...

Research paper thumbnail of CASE STUDY: Using A Continuous Glucose Monitoring System In A Patient With Diabetes and Beta-Thalassemia Hemoglobinopathy

Pediatric Hematology-Oncology, 2009

Optimum glycemic control is extremely important in patients with diabetes mellitus to avoid long-... more Optimum glycemic control is extremely important in patients with diabetes mellitus to avoid long-term complications. Glycemic control relies mainly on the use of hemoglobin A1c, which unfortunately showed inaccurate results in patients with hemoglinopathies. The authors describe a case of beta-thalassemia with poorly controlled diabetes mellitus that has misleading low levels of HbA1c. The use of a continuous glucose monitoring system was useful in documenting her poor glycemic control, with prolonged periods of hyper- and hypoglycemia. Based on these results, her insulin regimen was adjusted and the blood glucose levels were greatly improved throughout and the patient was able to meet her target blood glucose range (72-140 mg/dL [4-7.8 mmol/L]) in 70% of the time.

Research paper thumbnail of Universal Precautions in Pain Medicine: A Rational Approach to the Treatment of Chronic Pain

Pain Medicine, 2005

The heightened interest in pain management is making the need for appropriate boundary setting wi... more The heightened interest in pain management is making the need for appropriate boundary setting within the clinician-patient relationship even more apparent. Unfortunately, it is impossible to determine before hand, with any degree of certainty, who will become problematic users of prescription medications. With this in mind, a parallel is drawn between the chronic pain management paradigm and our past experience with problems identifying the "at-risk" individuals from an infectious disease model.

Research paper thumbnail of A Dramatic Response to Inhaled Cannabis in a Woman with Central Thalamic Pain and Dystonia

Journal of Pain and Symptom Management, 2002

mechanisms of action, and the safety and efficacy of cannabinoid treatment in this and other chro... more mechanisms of action, and the safety and efficacy of cannabinoid treatment in this and other chronic pain syndromes. The possibility that cannabinoids may have opioid-sparing effects and may ameliorate opioid withdrawal should also be further investigated.

Research paper thumbnail of Prevalence and predictors of microalbuminuria in patients with type 2 diabetes mellitus: A cross-sectional observational study in Oman

Diabetes Research and Clinical Practice, 2006

Aim: To evaluate the prevalence and predictors of microalbuminuria in type 2 diabetics in Oman. M... more Aim: To evaluate the prevalence and predictors of microalbuminuria in type 2 diabetics in Oman. Methods: All patients attending an outpatient diabetic clinic at the Sultan Qaboos University Hospital between 2002 and 2003 were enrolled in the study. Results: A total of 261 patients were included in this study. The mean overall age of the cohort was 50 AE 13 years, and 57% were male. The proportion of subjects who had microalbuminuria was 27% (n = 70; N = 261). The logistic regression model indicated that significant predictors for the development of microalbuminuria include HbA 1c , log creatinine, and the presence of hypertension. A one unit increase in HbA 1c was associated with a 23% increase in the odds of developing microalbuminuria (OR 1.23; 95% CI: 1.10-1.37; p < 0.001). Additionally, patients that had a one unit increase in log creatinine were 5.72 times more likely to develop microalbuminuria (OR 5.72; 95% CI: 1.86-17.59; p = 0.002). Furthermore, patients who were hypertensive were 2.37 times more likely to have microalbuminuria (OR 2.37; 95% CI: 1.11-5.09; p = 0.026). Conclusions: The prevalence of microalbuminuria in patients with type 2 diabetes in this study was 27%. Significant predictors of microalbuminuria included HbA 1c , creatinine, and the presence of hypertension. #

Research paper thumbnail of Acquired C1-esterase Deficiency and Optic Neuropathy in Non-Hodgkin's Lymphoma

Clinical Oncology, 2006

Radiotherapy was planned using Helax TMS 6.1B software. All patients were treated with three-dime... more Radiotherapy was planned using Helax TMS 6.1B software. All patients were treated with three-dimensional conformal radiotherapy after computed tomography planning with four field plans (ant, post, R lat, L lat beams). Patients were treated with an Elekta linear accelerator using 10 MV photons. Most (86%) were treated with a two-phase treatment plan.

Research paper thumbnail of Pain: Understanding and challenges for the rheumatologist

Arthritis & Rheumatism, 2005

Research paper thumbnail of Chronic adreno-cortical insufficency associated with a unilateral adrenal mass

Oman medical journal, 2008

Adreno-cortical insufficiency in the context of an adrenal mass can be a challenging clinical pro... more Adreno-cortical insufficiency in the context of an adrenal mass can be a challenging clinical problem. The two main possibilities are either a benign mass or a malignant pathology. We describe here a patient who was investigated for chronic adreno-cortical insufficiency and was found to have a left adrenal mass that was later confirmed histopathologically to be tuberculous in nature.

Research paper thumbnail of Documentation of the management of asthma exacerbation in adults by primary health care physicians in a teaching hospital in oman

Sultan Qaboos University medical journal, 2010

Asthma exacerbation is a major cause of morbidity and it is usually an indication of poor control... more Asthma exacerbation is a major cause of morbidity and it is usually an indication of poor control. Appropriate management and documentation of the clinical assessment of an exacerbation, its severity, contributing factors and treatment are all essential components of asthma control. The aim of this study was to assess the documentation of the management of asthma exacerbations by primary care physicians (PCPs). A retrospective analysis was carried out on patient records from 1 May 2008 to 31 April 2009. We included all acute exacerbation episodes in asthmatic patients aged ≥ 14, who received nebulized bronchodilators in the two family medicine clinics attached to Sultan Qaboos University Hospital (SQUH), Oman. A special form was designed to collect PCP's documented management. A total of 67 patients with 100 episodes were treated by 42 PCPs. Documentation of clinical assessment was low for previous admissions (2%), rescue nebulization (25%), duration of symptoms (57%), trigger f...

Research paper thumbnail of Congenital Fusion of the Trapezium and Trapezoid

Sultan Qaboos University Medical Journal, Dec 1, 2010

... Congenital fusion of the trapezium and trapezoid. Rom J Morphol Embryol. 2008;49:417–9. [PubM... more ... Congenital fusion of the trapezium and trapezoid. Rom J Morphol Embryol. 2008;49:417–9. [PubMed]. 2. Singh P, Tuli A, Choudhry R, Mangal A. Intercarpal fusion – a review. J Anat Soc India. 2003;52:183–8. 3. Cockshott WP. Carpal fusion. ...

Research paper thumbnail of Odontogenic Cutaneous Fistula: Report of two cases

Sultan Qaboos University Medical Journal, Feb 1, 2011

Odontogenic cutaneous fistula or sinus is an uncommon, but well documented condition, which is of... more Odontogenic cutaneous fistula or sinus is an uncommon, but well documented condition, which is often initially misdiagnosed as a sole cutaneous lesion and inappropriately treated. The misdiagnosis as a skin infection often results in inappropriate management. We here present two cases of odontogenic cutaneous fistula that were seen after being treated unnecessarily with antibiotics.

Research paper thumbnail of Marfan Syndrome: Correct diagnosis can save lives

Sultan Qaboos University Medical Journal, Nov 1, 2012

Marfan syndrome is a heritable disorder of the connective tissue that affects many systems of the... more Marfan syndrome is a heritable disorder of the connective tissue that affects many systems of the body. However, the most serious complication in patients with Marfan syndrome is progressive enlargement of the aortic root, which may lead to aortic dissection, rupture, or aortic regurgitation. Prevention of these life threatening complications is very important in the management of this condition. A 39-year-old Omani man presented with progressive shortness of breath and eventually underwent major but successful cardiac surgery. It is very important to recognise Marfan syndrome early as preventive actions are possible if the condition is diagnosed before complications occur.

Research paper thumbnail of Dose-dependent severe arthralgia induced by gabapentin

The Journal of rheumatology, 2004

Research paper thumbnail of An application of educational theories and principles of teaching and learning communication skills for general practitioners in oman

Oman medical journal, 2009

This article discusses the crucial role of teaching and learning communication skills for general... more This article discusses the crucial role of teaching and learning communication skills for general practitioners, based on the theory of experiential and self-directed learning. It also outlines the proposed ways and methods to teach these communication skills in this project.The patient-doctor interview or what is known as office visit in some countries and consultation in others is the cornerstone of the entire General Practice (GP) or Family Medicine. It is from this process and outcome that the reputation is gained or destroyed. The analysis of the consultation is complicated and varied but is most usefully employed to assess effecacy in terms of achieving the means that are mutually desired by patients and their carers.

Research paper thumbnail of Attributes of an ideal family medicine residency training program

Oman medical journal, 2008

Medi cal education has been traditionally based on the pedagogical model of teaching. However, a ... more Medi cal education has been traditionally based on the pedagogical model of teaching. However, a gradual shift away from this model to a student centered approach has been observed. Factors such as the radical expansion of medical knowledge, changing need of the society and technological advances have contributed a lot to the acceleration of this process. Many medical schools worldwide have already implemented the principles of adult education as basis for reforms in their curricula. Moreover, attention has also been focused on a changing role of teachers from a transmitter of knowledge to that of a facilitator of learning. Problem based learning, guided discovery learning, small group teaching, peer evaluation and self assessment all illustrate some examples of application of this approach into medical education. Studies conducted at universities applying the new curriculum have shown higher participation rates by the students compared to universities with traditional programs. 1 Advantages of adopting this approach in teaching and learning can be enormous. Acquiring the skills for lifelong learning, self assessment, critical appraisal and self reflection are all of great value to future doctors.

Research paper thumbnail of Intravenous Lidocaine for Refractory Chronic Orofacial Pain: Two case reports and a literature review

Sultan Qaboos University medical journal, 2008

This report presents the results of treatment of two adults, at the Pain Center of Montreal Gener... more This report presents the results of treatment of two adults, at the Pain Center of Montreal General Hospital, Canada, with intravenous lidocaine for intractable orofacial pain. Repeated lidocaine infusions (1mg/kg in a bolus, followed by 4mg/kg infused over 1 hour) resulted in satisfactory pain relief in both patients, and the drug was well tolerated. Intravenous lidocaine therapy may be considered for intractable orofacial pain; further research is warranted.

Research paper thumbnail of Control and management of hypertension at a university health centre in oman

Sultan Qaboos University medical journal, 2008

To evaluate the prevalence of hypertension, its control and management at Sultan Qaboos Universit... more To evaluate the prevalence of hypertension, its control and management at Sultan Qaboos University (SQU) Health Centre, Oman. This was a retrospective cross-sectional study, in which were enrolled all the subjects (≥18 years), with the diagnosis of essential hypertension, who attended the SQU Health Centre between 1998 and 2002. The systolic and diastolic blood pressure (BP) values of the last three visits were used for analysis. BP control was defined using the Joint National Committee (JNC-7) criteria, <140 mmHg and <90 mmHg for systolic and diastolic BPs, respectively. Analyses were performed using univariate statistics. Among the 7,702 medical records reviewed, the prevalence of hypertension was 2.4% (n = 187). The overall mean age of the cohort was 55±11 years, 54% (n = 101) were females, and majority of the subjects were Omanis (n = 123; 66%). The proportion of subjects who had their BP controlled was 41% (n = 77) with Omanis significantly less likely to have their BP co...

Research paper thumbnail of Clinical profile of rheumatic disease patients referred to a multidisciplinary pain center

The Journal of rheumatology, 2004

Good pain control is a prerequisite for success in the management of many rheumatological disease... more Good pain control is a prerequisite for success in the management of many rheumatological diseases. However, some rheumatology patients may present challenges in terms of pain management and be subsequently referred to a specialized pain clinic. We examined the characteristics and assessed the outcome of patients with rheumatic diseases who were referred to a tertiary care pain center. All new patients with a primary rheumatological diagnosis referred over a 9 year period to the McGill University Pain Centre were studied. Patients were identified through a computer search according to both diagnoses and symptoms. Demographic information, clinical and pain characteristics, and subsequent management and final outcome were assessed. Out of a total of 1120 new patients, 60 (5%) had a primary rheumatologic diagnosis to account for pain and referral. The diagnoses were as follows: fibromyalgia in 26 (43%), inflammatory arthritis 17 (28%), degenerative arthritis 9 (15%), and soft tissue rh...

Research paper thumbnail of Edit orial Attributes of an ideal Family Medicine residency training progra m

Medi cal education has been traditionally based on the pedagogical model of teaching. However, a ... more Medi cal education has been traditionally based on the pedagogical model of teaching. However, a gradual shift away from this model to a student centered approach has been observed. Factors such as the radical expansion of medical knowledge, changing need of the society and technological advances have contributed a lot to the acceleration of this process. Many medical schools worldwide have already implemented the principles of adult education as basis for reforms in their curricula. Moreover, attention has also been focused on a changing role of teachers from a transmitter of knowledge to that of a facilitator of learning. Problem based learning, guided discovery learning, small group teaching, peer evaluation and self assessment all illustrate some examples of application of this approach into medical education. Studies conducted at universities applying the new curriculum have shown higher participation rates by the students compared to universities with traditional programs. 1 Advantages of adopting this approach in teaching and learning can be enormous. Acquiring the skills for lifelong learning, self assessment, critical appraisal and self reflection are all of great value to future doctors.

Research paper thumbnail of Subcutaneous administration of testosterone. A pilot study report

Saudi medical journal, 2006

To investigate the effect of low doses of subcutaneous testosterone in hypogonadal men since the ... more To investigate the effect of low doses of subcutaneous testosterone in hypogonadal men since the intramuscular route, which is the most widely used form of testosterone replacement therapy, is inconvenient to many patients. All men with primary and secondary hypogonadism attending the reproductive endocrine clinic at Royal Victoria Hospital, Monteral, Quebec, Canada, were invited to participate in the study. Subjects were enrolled from January 2002 till December 2002. Patients were asked to self-administer weekly low doses of testosterone enanthate using 0.5 ml insulin syringe. A total of 22 patients were enrolled in the study. The mean trough was 14.48 +/- 3.14 nmol/L and peak total testosterone was 21.65 +/- 7.32 nmol/L. For the free testosterone the average trough was 59.94 +/- 20.60 pmol/L and the peak was 85.17 +/- 32.88 pmol/L. All of the patients delivered testosterone with ease and no local reactions were reported. Therapy with weekly subcutaneous testosterone produced serum...

Research paper thumbnail of CASE STUDY: Using A Continuous Glucose Monitoring System In A Patient With Diabetes and Beta-Thalassemia Hemoglobinopathy

Pediatric Hematology-Oncology, 2009

Optimum glycemic control is extremely important in patients with diabetes mellitus to avoid long-... more Optimum glycemic control is extremely important in patients with diabetes mellitus to avoid long-term complications. Glycemic control relies mainly on the use of hemoglobin A1c, which unfortunately showed inaccurate results in patients with hemoglinopathies. The authors describe a case of beta-thalassemia with poorly controlled diabetes mellitus that has misleading low levels of HbA1c. The use of a continuous glucose monitoring system was useful in documenting her poor glycemic control, with prolonged periods of hyper- and hypoglycemia. Based on these results, her insulin regimen was adjusted and the blood glucose levels were greatly improved throughout and the patient was able to meet her target blood glucose range (72-140 mg/dL [4-7.8 mmol/L]) in 70% of the time.

Research paper thumbnail of Universal Precautions in Pain Medicine: A Rational Approach to the Treatment of Chronic Pain

Pain Medicine, 2005

The heightened interest in pain management is making the need for appropriate boundary setting wi... more The heightened interest in pain management is making the need for appropriate boundary setting within the clinician-patient relationship even more apparent. Unfortunately, it is impossible to determine before hand, with any degree of certainty, who will become problematic users of prescription medications. With this in mind, a parallel is drawn between the chronic pain management paradigm and our past experience with problems identifying the "at-risk" individuals from an infectious disease model.

Research paper thumbnail of A Dramatic Response to Inhaled Cannabis in a Woman with Central Thalamic Pain and Dystonia

Journal of Pain and Symptom Management, 2002

mechanisms of action, and the safety and efficacy of cannabinoid treatment in this and other chro... more mechanisms of action, and the safety and efficacy of cannabinoid treatment in this and other chronic pain syndromes. The possibility that cannabinoids may have opioid-sparing effects and may ameliorate opioid withdrawal should also be further investigated.

Research paper thumbnail of Prevalence and predictors of microalbuminuria in patients with type 2 diabetes mellitus: A cross-sectional observational study in Oman

Diabetes Research and Clinical Practice, 2006

Aim: To evaluate the prevalence and predictors of microalbuminuria in type 2 diabetics in Oman. M... more Aim: To evaluate the prevalence and predictors of microalbuminuria in type 2 diabetics in Oman. Methods: All patients attending an outpatient diabetic clinic at the Sultan Qaboos University Hospital between 2002 and 2003 were enrolled in the study. Results: A total of 261 patients were included in this study. The mean overall age of the cohort was 50 AE 13 years, and 57% were male. The proportion of subjects who had microalbuminuria was 27% (n = 70; N = 261). The logistic regression model indicated that significant predictors for the development of microalbuminuria include HbA 1c , log creatinine, and the presence of hypertension. A one unit increase in HbA 1c was associated with a 23% increase in the odds of developing microalbuminuria (OR 1.23; 95% CI: 1.10-1.37; p < 0.001). Additionally, patients that had a one unit increase in log creatinine were 5.72 times more likely to develop microalbuminuria (OR 5.72; 95% CI: 1.86-17.59; p = 0.002). Furthermore, patients who were hypertensive were 2.37 times more likely to have microalbuminuria (OR 2.37; 95% CI: 1.11-5.09; p = 0.026). Conclusions: The prevalence of microalbuminuria in patients with type 2 diabetes in this study was 27%. Significant predictors of microalbuminuria included HbA 1c , creatinine, and the presence of hypertension. #

Research paper thumbnail of Acquired C1-esterase Deficiency and Optic Neuropathy in Non-Hodgkin's Lymphoma

Clinical Oncology, 2006

Radiotherapy was planned using Helax TMS 6.1B software. All patients were treated with three-dime... more Radiotherapy was planned using Helax TMS 6.1B software. All patients were treated with three-dimensional conformal radiotherapy after computed tomography planning with four field plans (ant, post, R lat, L lat beams). Patients were treated with an Elekta linear accelerator using 10 MV photons. Most (86%) were treated with a two-phase treatment plan.

Research paper thumbnail of Pain: Understanding and challenges for the rheumatologist

Arthritis & Rheumatism, 2005

Research paper thumbnail of Chronic adreno-cortical insufficency associated with a unilateral adrenal mass

Oman medical journal, 2008

Adreno-cortical insufficiency in the context of an adrenal mass can be a challenging clinical pro... more Adreno-cortical insufficiency in the context of an adrenal mass can be a challenging clinical problem. The two main possibilities are either a benign mass or a malignant pathology. We describe here a patient who was investigated for chronic adreno-cortical insufficiency and was found to have a left adrenal mass that was later confirmed histopathologically to be tuberculous in nature.