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Ekram K, Razawi F, Jalal SN, Sultani MN, Wali AW, Sediqi MS, Hamdard AG, Hemat M, Sahibzada MM. Congenital duodenal web causing partial obstruction with recurrent vomiting and abdominal distention in a toddler boy: a case report. J Med Case Rep 2023; 17:507. [PMID: 37996900 PMCID: PMC10668464 DOI: 10.1186/s13256-023-04179-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 09/14/2023] [Indexed: 11/25/2023] Open
Abstract
BACKGROUND The duodenal web is a thin, elongated, web-like structure that is one of the factors contributing to duodenal obstruction. Only 100 cases have been reported in the literature. We present a 2.5-year-old cachectic Afghan child who did not have any overt signs and symptoms of intestinal obstruction, like recurrent vomiting, abdominal distention, and weight loss. The web was discovered near the intersection of the third and fourth portions, which is an uncommon location for the duodenal web. The late presentation of congenital duodenal web with partial obstruction is rare but well-known and has been reported in this case. CASE PRESENTATION A 2.5-year-old cachectic Afghan child who had recurrent vomiting and experienced abdominal distention was brought to Maiwand Teaching Hospital from the Jabelsuraj region of Parwan province. The patient was suffering from unusual signs and symptoms like recurrent vomiting, abdominal distention, weight loss, and constipation. The diagnosis of these anomalies was established by a detailed history, clinical features, and abdominal CT scan. In the computerized tomography scanning (CT-Scan) image reported, there was a web with stenosis and partial obstruction in the distal aspect of the third-to-fourth portion of the duodenum. After preoperative stabilization, the child was taken for surgery. The abdomen was opened by a right upper abdominal transverse incision. After web resection and duodenoplasty, the patient was shifted to the recovery room in satisfactory condition. The child was allowed to feed after 8 days, which he tolerated well. CONCLUSION Congenital duodenal web with partial obstruction is typically observed in the second and third years of life. It is suspected in patients with recurrent vomiting, abdominal distention, weight loss, and constipation. Partial obstruction may not have an overt presentation, making it a challenging diagnosis for general practitioners. Abdomen X-ray and CT scan usually confirm the diagnosis, and successful surgical intervention is recommended.
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Affiliation(s)
- Khesrow Ekram
- Department of Pediatrics, Maiwand Teaching Hospital, Kabul University of Medical Sciences, 1st District, Jada-e-Maiwand, 1001, Kabul, Afghanistan.
| | - Farida Razawi
- Department of Pediatric Surgery, Kabul University of Medical Sciences, Kabul, Afghanistan
| | - Sayed Najmuddin Jalal
- Department of Pediatrics, Maiwand Teaching Hospital, Kabul University of Medical Sciences, 1st District, Jada-e-Maiwand, 1001, Kabul, Afghanistan
| | - Mohammad Nader Sultani
- Department of Pediatric Surgery, Kabul University of Medical Sciences, Kabul, Afghanistan
| | - Abdul Wali Wali
- Department of Pediatrics, Maiwand Teaching Hospital, Kabul University of Medical Sciences, 1st District, Jada-e-Maiwand, 1001, Kabul, Afghanistan
| | - Mohammad Sharif Sediqi
- Department of Pediatrics, Maiwand Teaching Hospital, Kabul University of Medical Sciences, 1st District, Jada-e-Maiwand, 1001, Kabul, Afghanistan
| | - Abdul Ghafar Hamdard
- Department of Dermatology, Kabul University of Medical Sciences, Kabul, Afghanistan
| | - Massoud Hemat
- Department of Pediatric Surgery, Kabul University of Medical Sciences, Kabul, Afghanistan
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Hakimi T, Mangal M, Ibrahimi MA, Aslamzai M, Ekram K, Shiwa MH, Hakimi Z, Noory AT, Hamdard AG, Halimi SA, Jawed MA. A challenging high-risk surgery for necrotizing pneumonia in a right bilobed lung. BMC Pediatr 2023; 23:170. [PMID: 37046243 PMCID: PMC10099639 DOI: 10.1186/s12887-023-03999-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 04/08/2023] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND Necrotizing pneumonia is rare in children and is one of the most serious complications of a lung infection caused by antibiotic failure. We present a 12-year-old leukopenic child with a long-lasting lung infection, presenting as having a lung hydatid cyst, but diagnosing with necrotizing pneumonia in the right bilobed lung. Failure to medical treatment and ongoing leukopenia justified surgical intervention with positive results. CASE PRESENTATION The patient was referred to our teaching hospital's pediatric surgery department. He had previously been diagnosed with intestinal tuberculosis (TB) and received anti-TB treatment. On referral to our hospital, the patient was suffering from restlessness, frequent coughing, fever, vomiting, and diarrhea. Following the completion of the clinical work-up, a blood test revealed leukopenia (white blood cell count of 2100/microliter), a normal platelet count, and a lesion in the right lung. Computerized tomography scanning (CT-Scan) image reported a lung hydatid cyst. In the pediatrics ward, a broad-spectrum antibiotics regimen with triple-antibiotic therapy (linezolid, vancomycin, and metronidazole) was instituted and continued for a week with no response, but worsening of the condition. In the pediatric surgery ward, our decision for surgical intervention was due to the failure of medical treatment because of a pulmonary lesion. Our team performed right lung upper lobe anterior segment wedge resection due to necrotizing pneumonia and followed the patient 45 days post-operation with a reasonable result. CONCLUSION Living in remote rural areas with low resources and inaccessibility to proper and specialized diagnostic and treatment centers will all contribute to an improper diagnosis and treatment of lung infection. In total, all of these will increase the morbidity and mortality due to lung necrosis in the pediatric population, regardless of their age. In low-resource facilities, high-risk patients can benefit from surgical intervention to control the ongoing infection process.
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Affiliation(s)
- Turyalai Hakimi
- Department of Pediatric Surgery, Kabul University of medical science, Maiwand teaching hospital, Kabul, Afghanistan.
| | - Mohmand Mangal
- Department of Pediatrics, Kabul University of medical science, Maiwand teaching hospital, Kabul, Afghanistan
| | - Mohammad Akbar Ibrahimi
- Department of Pediatrics, Kabul University of medical science, Maiwand teaching hospital, Kabul, Afghanistan
| | - Mansoor Aslamzai
- Department of Neonatology, Kabul University of medical science, Maiwand teaching hospital, Kabul, Afghanistan
| | - Khesrow Ekram
- Department of Pediatrics, Kabul University of medical science, Maiwand teaching hospital, Kabul, Afghanistan
| | - Mohammad Hussain Shiwa
- Department of General Surgery, Kabul University of medical science, Ali Abad teaching hospital, Kabul, Afghanistan
| | - Zamaryalai Hakimi
- Department of Infectious disease, Kabul University of medical science, Ali Abad teaching hospital, Kabul, Afghanistan
| | - Abdul Tawab Noory
- Department of Infectious disease, Kabul University of medical science, Ali Abad teaching hospital, Kabul, Afghanistan
| | - Abdul Ghafar Hamdard
- Department of Dermatology, Kabul University of medical science, Maiwand teaching hospital, Kabul, Afghanistan
| | - Sultan Ahmad Halimi
- Department of Pathology, Kabul University of medical science, Kabul, Afghanistan
| | - Mohammad Anwar Jawed
- Department of Pediatric Surgery, Kabul University of medical science, Maiwand teaching hospital, Kabul, Afghanistan
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Aalemi AK, Hamdard AG, Sobat AS. Correlation of Psoriasis Disability Index and Psoriasis Area and Severity Index: A Study from Afghanistan. Clin Cosmet Investig Dermatol 2022; 15:559-566. [PMID: 35411166 PMCID: PMC8994531 DOI: 10.2147/ccid.s363343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 03/30/2022] [Indexed: 11/23/2022]
Abstract
Background Psoriasis is a common skin disease that affects physical, psychological, and social well-being of patients. Several studies have assessed health-related quality of life of patients with psoriasis in different populations with large variations. Objective To investigate, for the first time, the impact of psoriasis on quality of life of Afghan patients with psoriasis. Methods This is a prospective observational study conducted at the dermatology department of Maiwand Teaching hospital in Kabul City during April 2018 to May 2019. Patients with plaque psoriasis with age ≥16 years were included in the study. Psoriasis Disability Index was used for the assessment of health-related quality of life. Psoriasis Area and Severity Index was used to define the severity of disease. Appropriate tests were performed using Statistical Package for Social Science. Results A total of 174 patients with psoriasis were included in the study, 89 of them were male (51.1%) and 85 of them were female (48.9%). The mean age of the patients was 27.7 years with 13.2 years SD, and the average duration of the disease was 3.2 years with 4.7 years SD. The mean of PASI score was 13.3 with 7.8 SD, while the mean of total PDI was 9.6 with 3.7 SD; there was a strong correlation between total PDI and PASI score (r=0.751, p<0.001). The mean of total PDI was higher among moderate-to-severe psoriasis, female patients, younger age, and those who were single. Conclusion Our study highlighted that psoriasis disability index was highly correlated with psoriasis area and severity index. Furthermore, the quality of life was more affected among female patients, patients younger than 40 years, and those patients who were single.
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Affiliation(s)
- Ahmad Khalid Aalemi
- Department of Oral Medicine, Kabul University of Medical Sciences, Kabul, 1001, Afghanistan.,Department of Dermatology, Maiwand Teaching Hospital, Kabul University of Medical Sciences, Kabul, 1001, Afghanistan
| | - Abdul Ghafar Hamdard
- Department of Dermatology, Maiwand Teaching Hospital, Kabul University of Medical Sciences, Kabul, 1001, Afghanistan
| | - Ahmad Shekeb Sobat
- Department of Oral Surgery, Kabul University of Medical Sciences, Kabul, 1001, Afghanistan
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Aalemi AK, Bahain MB, Hamdard AG. Metabolic Syndrome and Psoriasis: A Case-Control Study in Kabul, Afghanistan. Diabetes Metab Syndr Obes 2021; 14:1465-1471. [PMID: 33833537 PMCID: PMC8019617 DOI: 10.2147/dmso.s305806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 03/11/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Psoriasis is a chronic inflammatory disease that is not limited to the skin. Recently, numerous studies have shown a positive association between metabolic syndrome and psoriasis. OBJECTIVE The current study aimed to examine the association of metabolic syndrome with psoriasis in an Afghan population. METHODS This was a case- control study including 114 patients with psoriasis and 114 controls aged ≥18 years admitted to the dermatology department of Maiwand Teaching Hospital in Kabul, Afghanistan. Height, weight, blood pressure, and waist circumference were measured in all subjects. Blood glucose, triglyceride, cholesterol, and high-density lipoprotein cholesterol levels were tested following overnight fasting. The modified National Cholesterol Education Program - Adult Treatment Panel III criteria were used for the diagnosis of metabolic syndrome. RESULTS In total, 51.8% of the cases and 44.7% of the controls were male. The average age of participants was 33.4±13.1 years in the case group and 41.1±15.4 years in the control group. The average duration of disease for psoriasis was 4.2 years with 5.6 years SD. The average PASI was 10.8 with 5.1 SD. More than half of the cases (62.3%) had moderate to severe psoriasis and 37.7% had mild psoriasis. The prevalence of metabolic syndrome was higher among patients with psoriasis compared to controls (36.8% vs 21.1%) with OR of 2.18 (p=0.009). In addition, overweight/obesity was more prevalent among cases compared to controls (65.8% vs 41.2%) with OR of 2.74 (p<0.001), whereas the waist circumference was not significantly different between the two groups. Furthermore, the mean levels of total cholesterol, triglyceride, and fasting blood glucose were also higher among patients with psoriasis compared to controls. CONCLUSION The results of the study confirm the association between psoriasis and metabolic syndrome. Hence, screening psoriatic patients for metabolic syndrome should be considered.
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Affiliation(s)
- Ahmad Khalid Aalemi
- Department of Epidemiology, Kabul University of Medical Sciences, Kabul, Afghanistan
- Department of Dermatology, Maiwand Teaching Hospital, Kabul University of Medical Sciences, Kabul, Afghanistan
- Correspondence: Ahmad Khalid Aalemi Department of Epidemiology, Kabul University of Medical Sciences, Kabul, 1001, AfghanistanTel +93747947581 Email
| | - Mohammad Barin Bahain
- Department of Pharmacology, Kabul University of Medical Sciences, Kabul, Afghanistan
| | - Abdul Ghafar Hamdard
- Department of Dermatology, Maiwand Teaching Hospital, Kabul University of Medical Sciences, Kabul, Afghanistan
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Aalemi AK, Hamdard AG, Chen H. Association of metabolic syndrome with pediatric psoriasis: a case‐control study in Kabul, Afghanistan. Int J Dermatol 2020; 59:451-456. [PMID: 32043572 DOI: 10.1111/ijd.14805] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 12/06/2019] [Accepted: 01/13/2020] [Indexed: 01/08/2023]
Affiliation(s)
- Ahmad Khalid Aalemi
- Department of Dermatology Union Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan China
- Department of Epidemiology Kabul University of Medical Sciences Kabul Afghanistan
| | - Abdul Ghafar Hamdard
- Department of Dermatology Maiwand Teaching Hospital Kabul University of Medical Sciences Kabul Afghanistan
| | - Hongxiang Chen
- Department of Dermatology Union Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan China
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