Total Articles: 43
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Jobin Rajan Benjamin1*, Anisha Ibrahim1, Vinny Sarah Varghese2, Regan Boaz Lloyd Devanandh Lloyd3
Background: Headache disorders, particularly migraine and tension-type headaches (TTH), are
major global health concerns. The burden of migraine and TTH in the Middle East exceeds the global average. The present study aimed to evaluate the prevalence, clinical features, and radiological findings of primary headache disorders comparing regional clinical and epidemiological characteristics with national and international studies to improve the treatment strategies in the Middle East.
Methods: A single-centre retrospective cohort study analyzed headache patients over 34 months. Clinical presentations, radiological features, and patient parameters were recorded and evaluated.
Results: Among 1,500 patients, 73.6% had migraines, 20.6% had TTH, and 5.5% had trigeminal
autonomic cephalalgia (TAC). Migraine prevalence peaked between ages 20 and 25 (28.1%), while TTH (29.19%) and TAC (28.2%) were most common between ages 36 and 40. Migraine (59.8%) and TTH (57.9%) were more prevalent in females, while TAC (51%) and other primary headaches (83.3%) were more common in males. Positive family history was noted in migraine (63.8%) and TAC (22.2%). Migraine was often aggravated by head bathing and lack of sleep (23.3%), while TTH and TAC were triggered by physical stress (43.7%), and sunlight exposure (37%). MRI findings were normal in 85.6% of all headache types and 99.6% of migraines without aura. In contrast, migraines with aura showed white matter hyperintensities (WMH) in 95.96% of cases.
Conclusion: The study highlights a high prevalence of migraines, though lower than global estimates. Clinically significant MRI findings were observed in migraines with aura, aligning with international data. Multi-centre studies are required to further refine treatment strategies.
Keywords: Global health, Headache disorders, Migraine disorders, Prevalence, Tension-type headache, Trigeminal autonomic cephalalgias
Fajer S Albuainain*, Rana AlGhatam
Background: Cleft lip and/or palate (CL/P) requires timely, multidisciplinary care to optimize health outcomes. In Bahrain, no prior data describe access to such services. This study aimed to establish a hospital-based registry and assess baseline patterns of attendance across specialty clinics at Bahrain Defense Force - Royal Medical Services before the implementation of a national cleft care pathway.
Methods: In this retrospective cohort study, all patients with CL/P who attended cleft-related clinics between June 2017 and September 2020 were identified. Electronic records were reviewed to collect demographics, cleft type, and age at first visit to Pediatrics, Ear, Nose, and Throat (ENT), Speech and Language Therapy (SLT), Pedodontics, Orthodontics, and Psychology.
Results: Among 51 children (57% female, 43% male), cleft palate alone was most common (37.3%), followed by unilateral cleft lip ± palate (UCLP, 35.3%), cleft lip (17.7%), and bilateral cleft lip ± palate (BCLP, 3.9%). The mean age at first visit was 29 days for Pediatrics, 5.5 months for ENT, and 7.5 years for Orthodontics. Substantial delays were observed for SLT (mean: 8.3 years) and Pedodontics (2.2 years), and no patient had attended a Psychology clinic.
Conclusion: Timely access to core services such as Pediatrics, ENT, and Orthodontics was observed. However, substantial delays in Speech and Language Therapy, Pedodontics, and Psychology highlight gaps in referral pathways, coordination of care, and caregiver awareness. This hospital-based registry offers essential baseline data to guide and measure future improvements in Bahrain’s national multidisciplinary cleft care program.
Keywords: Cleft lip, Cleft palate, Multidisciplinary care, Healthcare access, Bahrain
Shooq Alsubaie*1, Ali Anwar Abro2
Neovascular glaucoma secondary to carotid occlusive disease is uncommon. We report the case of a 60-year-old female who presented to the emergency department with right eye pain, redness, blurred vision, dizziness, and body pain for three days. Examination revealed an intraocular pressure (IOP) of 45 mmHg in the right eye. Carotid Doppler ultrasound, performed to evaluate for carotid occlusive disease, demonstrated 80% occlusion of the right internal carotid artery. Subsequent computed tomography angiography (CTA) confirmed significant stenosis (at least 70%) of the proximal right internal carotid artery. The patient was referred to vascular surgery and underwent a thromboendarterectomy of the right internal carotid artery. At nine months of follow-up, the patient demonstrated significant improvement in ocular pain and noticeable reduction in IOP to 16 mmHg. This case highlights the importance of clinical reasoning in identifying less common etiologies, such as carotid artery stenosis, in patients with treatment-resistant neovascular glaucoma.
Keywords: Glaucoma, Neovascular diabetic retinopathy, Carotid artery diseases, Diabetes mellitus
Abdulla Aljalahma*, Saeeda Almuhannadi, Mohammed Lubbad, Omar Mustafa
Prader-Willi Syndrome (PWS) is a complex genetic, neurodevelopmental disorder that affects both males and females equally, causing a broad range of physical, cognitive, and behavioural challenges. Patients exhibited symptoms including low muscle tone, hyperphagia, and increased risk of obesity. PWS has three different molecular genetic classes. The most common cause is the deletion of the paternal copy of chromosome 15q11-q13. Healthcare providers are likely to observe mild cognitive impairment and behavioural problems, such as self-injury, compulsions, and sudden outbursts during diagnosis. Currently, there are no approved therapeutics for managing PWS; however, controlling hyperphagia and improving food-related complications are proposed as effective strategies. A ten-year-old Arab male diagnosed with PWS attended the orthodontic clinic, presenting with concerns about the appearance of his teeth. Clinical examination revealed a high palatal arch, dysmorphic features, a slightly arched foot, and extremely fisted fingers, indicative of developmental abnormalities. The patient underwent an EEG, which revealed epileptiform discharges in the frontal-temporal region, and an EMG for seizure evaluation. Additionally, dental examination revealed severe tooth wear on the maxillary permanent central incisors and the mandibular molars bilaterally.
Keywords: Prader-Willi syndrome, Periodontics, Orthodontics, Hypotonia, Behavioural management, Multidisciplinary approach