Biomedical subjects

N A Moussa

Publications and source records attributed to N A Moussa.

3 recordsLinked to original sources

PubMed2000

Pernicious anaemia and neurophysiological studies in Arabs.

While pernicious anaemia is a disease predominantly affecting people of north European descent, there is increasing awareness of its occurrence in other ethnic populations. We document herein details of six Arabs who had pernicious anaemia and significant neurophysiological abnormalities. All the patients made a complete haematological and symptomatic recovery following parenteral administration of hydroxycobalamin. The diagnosis of pernicious anaemia should be considered in Arab patients of all ages who have macrocytic anaemia, or symptoms of peripheral neuropathy. We caution against the empirical use of folic acid and vitamin B12 in the management of patients with chronic anaemia.

Adult↗

PubMed1998

Acute hyponatremic encephalopathy after a cerebrovascular accident.

A 66-year-old hypertensive male with acute intracerebral hemorrhage developed acute hyponatremic coma 3 days after the addition of enalapril and a combination of amiloride and a thiazide diuretic to his hypotensive regimen. The patient recovered consciousness and serum sodium normalized 2 days after fluid restriction and withdrawal of both medications. Three weeks later, upon inadvertent reinstitution of enalapril and indapamide, severe hyponatremic encephalopathy promptly recurred; recovery was again rapid following fluid restriction and withdrawal of both medications. This temporal relationship establishes the thiazide diuretic or the angiotensin converting enzyme inhibitor or both as the cause of the profound symptomatic hyponatremia in this patient. Results of simultaneous serum and urine osmolality assays on several occasions were consistent with a decrease in free water clearance, a result of either increased antidiuretic hormone (ADH) secretion or potentiation of its peripheral action, and thiazide-induced natriuresis. The use of a thiazide diuretic in the presence of either of these aberrations of ADH homeostasis most likely explains the profound and rapid development of hyponatremia. Drug-induced disturbances in serum osmolality are a potentially reversible cause of deterioration of the mental state in a patient with an acute cerebrovascular accident.

Aged↗

PubMed1987

Benign thoracic pain.

Seventy-three patients with mid-dorsal and/or unilateral chest pain seen consecutively in the rheumatology clinic by a single clinician over a three-year period were studied, after exclusion of visceral disease. The majority were young women. The pain was dull and continuous, was aggravated by coughing and sneezing and relieved by rest. There was frequently tenderness over the thoracic spine (T4-5) and an adjacent rib, and pain at extremes of thoracic spinal movement in one or two directions was invariable. Cutaneous hyperaesthesia in a radicular distribution was found in 16.4%, but there were no other neurological abnormalities. This clinical picture is probably the result of a thoracic disc prolapse, though confirmation by myelography was not thought to be ethically justified. The condition settled in most of the patients following manipulative treatment and advice on back care. No patient developed spinal cord compression. It is concluded that this is a common benign condition which deserves wider recognition.

Adolescent↗