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Biomedical subjects

E M Scrimgeour

Publications and source records attributed to E M Scrimgeour.

At least 19 recordsLinked to original sources
PubMed2004

Establishing the Diploma in Tropical Medicine and Hygiene (DTM&H) course in the Sultanate of Oman.

Until 1997, there was no formal teaching in tropical medicine in Arabian Peninsular countries, although many tropical diseases (for example, malaria, schistosomiasis, leishmaniasis, filariasis), are endemic in the region. A six month, part time Diploma in Tropical Medicine and Hygiene (DTM&H) course was established in the Sultan Qaboos University, Muscat, Sultanate of Oman, in 1997, for small groups of Omani doctors wishing to sit the annual DTM&H examination in London. To date, 21 doctors have been successful, and the Royal College of Physicians of London has accredited the Tropical Medicine School in Oman as an appropriate training centre for the examination. Since over 20 doctors apply each year for the six available places in the course, a full time DTM&H course for larger groups of doctors, from Oman and regional countries, is under consideration.

Education, Medical, Graduate↗
PubMed2003

Q Fever in human and livestock populations in Oman.

In 2000, Q fever was documented for the first time in the Sultanate of Oman in two patients, one with chronic pericarditis and the other with acute pneumonia. In 2001, a study of a randomly selected group of 102 adult patients from different provinces in northern Oman, presenting to the University Hospital in Muscat with unrelated conditions (e.g., diabetes mellitus, ischemic heart disease), revealed that 10 (9.8%) were seropositive for previous Coxiella burnetii infection. Examination of sera from a randomly selected group of 54 healthy goats from eight different herds from three different provinces of Oman, obtained by the Veterinary Research Center in Muscat, revealed that 28 (52%) had been infected, and 5 sheep, each from one of four herds, were seropositive for C. burnetii. We suspect that Q fever is widely prevalent in human populations in Oman, and that infection is widespread in goat, and probably sheep and other livestock populations, throughout the country.

Adult↗
PubMed2001

Tetanus. A clinical review.

OBJECTIVE: Although tetanus is now uncommon in Oman (The Expanded Program on Immunization was introduced in 1981), patients continue to present from time to time at an average rate of 6 cases per year. Worldwide, the mortality rate for tetanus remains high (ranging from 15-20% in developed countries). At the Sultan Qaboos University Hospital, Muscat, Oman, prolonged Intensive Care Unit treatment and multi-disciplinary management is invariably required for tetanus patients. This study was carried out to evaluate our results over the past decade. METHODS: All tetanus patients admitted to the Sultan Qaboos University Hospital from 1991 up to the end of 1999 were retrospectively reviewed. Patients were diagnosed early, and aggressive treatment in the Intensive Care Unit was instituted, with a coordinated multidisciplinary management. RESULTS: Ten cases were identified and included in the review, comprising 9 adults and one infant aged 2 weeks. Adult patients were aged 36-75 years (mean 59 years), and the average Intensive Care Unit stay of the 9 surviving patients was 5.5 weeks (range 3-7 weeks). All patients presented with severe generalized tetanus. Two patients with traditional cautery marks developed tetanus. A focus of infection could not be found in 2 patients. All patients had early tracheostomy and assisted ventilation with appropriate sedation. One patient required almost 45 gm of diazepam throughout his Intensive Care Unit stay. One adult patient died on the 6th day of admission following myocardial infarction. The neonatal case survived after 35 days care in the Intensive Care Unit. The mortality rate for our patients was therefore 10%. CONCLUSION: Tetanus in Oman remains an infrequent but important disease requiring costly and prolonged Intensive Care Unit treatment. We attribute the comparatively low mortality rate (10%) in this study, to early diagnosis, institution of aggressive treatment, good nursing as well as a well-coordinated multi-disciplinary management.

Adult↗
PubMed2000

Schistosomiasis: clinical relevance to surgeons in Australasia and diagnostic update.

All surgeons working in Australasia should be prepared to encounter imported cases of schistosomiasis. The disease should be considered when typical symptoms are present, and there is evidence of skin exposure to fresh water in an endemic area. Whether or not signs of urinary or intestinal tract schistosomiasis are present, ectopic ova can involve and produce symptoms in almost any structure including the liver, the lungs, the reproductive system and the central nervous system, sometimes producing puzzling clinical abnormalities decades after primary infection. Recovery of ova from urine, stool or their detection in a biopsy confirms diagnosis but, when this is unsuccessful, immunological tests support diagnosis. Imaging techniques (e.g. ultrasonography, standard radiology, computed tomography or magnetic resonance imaging scans) may indicate and define involvement of various organs and structures. The surgeon often has an important role to play in the management of the protean complications of schistosomiasis.

Acute Disease↗
PubMed1999

Tuberculosis in active dialysis patients in Jeddah.

The incidence of tuberculosis in The Kingdom of Saudi Arabia remains high. The objective of this study is to determine the prevalence of Tuberculosis among haemodialysis patients, since they are highly susceptible to this infection. A retrospective study, over a 5-year period, was carried out in the Renal Units of two large hospitals in Jeddah. Diagnosis was established by Ziehl Neelsen microscopy and culture of specimens on Lowenstein-Jensen media, radiological and histological examinations. Tuberculosis was diagnosed in 17 of 210 patients on hemodialysis. Pulmonary tuberculosis was present in 10 cases and tuberculous lymphadenitis in 8 cases. One patient had both pulmonary and lymph node involvement while another one had both pulmonary and peritoneal tuberculosis. Mycobacterium tuberculosis was diagnosed in sputum in 5 cases, by lymph node histopathology in 5 cases, and combined radiological and clinical evidence in the remaining patients. The Mantoux test was positive in 9 (60%) cases. Eight patients were diabetics (47%) and there appears to be some association of tuberculosis with diabetes in patients on dialysis. Treatment with first-line anti-tuberculosis agents was continued for 6-18 months. Fourteen (82%) patients were completely cured while 3 showed clinical improvement only. The study showed that successful therapy of tuberculosis in this group of dialysis patients could be achieved but high index of suspicion is required to recognize the unusual presentation in this group of patients so that early diagnosis can be achieved and prompt treatment instituted. Diabetic patients presenting for dialysis, in areas with high endemicity for tuberculosis, chemoprophylaxis with anti-tuberculosis agents should be considered.

Adult↗
PubMed1999

Infectious and tropical diseases in Oman: a review.

Oman is generally hot and dry, but the Salalah region in southern Dhofar province is relatively cool and rainy during the summer monsoon, and has a distinctive pattern of infection. Important, notifiable infections in Oman include tuberculosis, brucellosis (endemic in Dhofar), acute gastroenteritis, and viral hepatitis: 4.9% of the adults are seropositive for hepatitis B surface antigen and approximately 1.2% for hepatitis C virus. Infection with human immunodeficiency virus is uncommon, and leprosy, rabies, and Crimean-Congo hemorrhagic fever are rare. Between 1990 and 1998, the incidence of malaria, (>70% due to Plasmodium falciparum) decreased from 32,700 to 882 cases. Cutaneous and visceral leishmaniasis (caused by Leishmania tropica and L. infantum, respectively) and Bancroftian filariasis occur sporadically. Intestinal parasitism ranges from 17% to 42% in different populations. A solitary focus of schistosomiasis mansoni in Dhofar has been eradicated. There are major programs for the elimination of tuberculosis, leprosy, and malaria, and to control brucellosis, leishmaniasis, sexually transmitted diseases, trachoma, acute respiratory infection in children, and diarrheal diseases. The Expanded Program on Immunization was introduced in 1981: diphtheria, neonatal tetanus, and probably poliomyelitis have been eliminated.

Communicable Diseases↗
PubMed1996

Creutzfeldt-Jakob disease in Oman: report of two cases.

Sporadic Creutzfeldt-Jakob disease (CJD) was diagnosed in two Oman Arab men, aged 50 and 75 years respectively, both with a history of rapidly developing dementia and myoclonic jerks. Illness developed over a period of 3 months in the first case and over six months in the second. Electroencephalography in both subjects showed periodic triphasic sharp waves characteristic of CJD. In neither case was it possible to obtain a brain biopsy or perform autopsy (autopsy is contrary to Islamic practice in the Middle East), however, electrophoresis of cerebrospinal fluid from the second patient revealed the distinctive double protein spots characteristic of CJD. This is the first report of CJD from Oman.

Aged↗