Biomedical subjects

Omar M Malkawi

Publications and source records attributed to Omar M Malkawi.

5 recordsLinked to original sources

PubMed2005

Graves disease and papillary thyroid cancer. An association that can be missed.

Thyroid nodules are frequently found in association with Graves' disease. Papillary carcinoma can arise from these nodules. We report a 65-year-old gentleman who presented with classical features of Graves disease. Technetium 99 scintigraphy revealed diffuse goiter with a cold nodule over the isthmus. Papillary thyroid cancer was suggested by the enlarging thyroid gland, and by the presence of cold nodule, and was proven by fine needle aspiration biopsy of this nodule. The diagnosis was confirmed by histopathology of thyroid specimen after total thyroidectomy, which also showed local invasion; metastatic work up revealed pulmonary and liver metastasis. Despite treatment by total thyroidectomy, twice radioactive iodine I131 ablation and levothyroxine replacement in a thyroid stimulating hormone suppressive dose, he still harbors metastases with elevated thyroglobulin level. This case should raise the index of suspicion of the treating physician to consider similar association, and to prompt early diagnosis and surgical treatment to prevent dreadful consequences that might adversely affect the outcome.

Aged↗

PubMed2002

Diabetes and infarcted papillary thyroid cancer.

A young black Jordanian lady who has type one diabetes, chronic diabetic complication and ischemic heart disease, presented with a picture of diabetic keto-acidosis, precipitated by an acute neck swelling. This was suggestive of acute suppurative thyroiditis with abscess formation causing compressive symptoms. This unfortunate patient had an eventful course despite aggressive treatment by antibiotics and surgery and then succumbed of an acute cardiac event. The operative tissue biopsy revealed an abscess in an infarcted papillary thyroid cancer. We believe this is a rare presentation of such an association with a fatal outcome.

Adult↗

PubMed2002

Thyroid disease and pregnancy.

Several important issues must be considered when thyroid disorders occur during pregnancy. These include establishing the diagnosis (including an understanding of the effect of pregnancy and its hormonal changes on the immune system in general and the thyroid function in particular) treatment and uneventful maternal and neonatal outcome. The evaluation and treatment of women with thyroid disease during pregnancy parallels that of nonpregnant women and men, but presents unique problems. In addition some types of thyroid disorders occur only during pregnancy and the postpartum period. Pregnancy complicated by some thyroid disorders is associated with an increased rate of complications to the mother as well as to the fetus. This review will seek to discuss the diagnosis, management of different thyroid disorders during pregnancy and the postpartum period.

Female↗

PubMed2002

Lipid profile in patients with coronary artery disease.

OBJECTIVE: To determine the lipid profile and to identify and stratify risk factors in diabetic and non-diabetic patients with proven coronary artery disease at King Hussein Medical Center, Amman, Jordan. METHODS: One hundred and ninety-two patients who were admitted to Queen Alia Heart Institute, Amman, Jordan, proving to have coronary artery disease (CAD) by angiogram, with a mean age of 54 +/- 22 years were studied. Seventy-seven patients were diabetics and 115 non-diabetics. Their lipid profiles (T-Cholesterol, high density lipoprotein level (HDL-C), low density lipoprotein level (LDL-C), triglyceride, glucose, glycosylated hemoglobin) and thyroid function test were compared to a control group of 162 individuals with no cardiac events or diabetes, mean age 48.9 +/- 18 years. Prevalence of hyperlipidemia was calculated. Patients with high thyroid stimulating hormone were excluded. RESULTS: The mean (+/- standard deviation) plasma cholesterol for the group with CAD is 231.43 +/- 57.99 mg/dl versus 202.8 +/- 36.58 in the control group (p<0.0003). High density lipoprotein 35.98 +/- 9.37 versus 44.43 +/- 8.34 (p=0.00011). Low density lipoprotein 146.75 +/- 50.93 versus 118.97 +/- 45.9 (p=0.003). Triglyceride level 246.95 +/- 142.1 versus 164 mg/l +/- 93.78 (p=0.0002). Thyroid stimulating hormone level was 1.55 +/- 0.9 versus 1.51 +/- 0.89 ng/l in control group (p=0.35 NS), HbA1c in diabetic group 7 +/- 2.3%. The prevalence of high plasma cholesterol, triglycerides (TG), LDL-C and low HDL-C was 60.9%, 68.3%, 63.5% and 48.4%. Inter-group comparison of patients with CAD (diabetics versus non-diabetics) revealed higher TG level in the diabetic group and statistically significant difference of the HDL and LDL levels between the 2 groups in favor of diabetic group explained by higher percentage of patients on anti-hyperlipidemic drugs than non-diabetics. More females with CAD were found in the diabetic group versus non-diabetic group (16.9% versus 6.1%. z=2.4027 p=0.00820). CONCLUSION: Jordanian patients with CAD have higher cholesterol, LDL-C, Triglyceride and lower HDL-C levels than the control group which comes in accordance of other studies. Hyperlipidemia remains the strongest risk factor for CAD. Diabetic females are at higher risk for CAD versus non-diabetics with the same lipid profile. Aggressive treatment of hyperlipidemia is of paramount importance to reduce the morbidity and mortality of cardiac events in diabetic and non-diabetic patients.

Adult↗

PubMedDate not supplied

Patterns of testicular cytology in men with primary infertility: any change since the Gulf War?

OBJECTIVE: To evaluate the patterns of testicular cytology in men with primary infertility, to compare the morphologic patterns between the periods 1990-1995, immediately after Gulf War II, and 1997-2001 and to determine whether there is a correlation between hormonal profile, testicular volume and morphologic pattern. STUDY DESIGN: Retrospective study of men with primary infertility. History, complete physical examination, hormonal assay and testicular ultrasound were evaluated. A total of 545 patients had samples for testicular cytology obtained from both testes. The patient's consent was obtained in all cases. Smears were interpreted under light microscopy after treatment with Diff-Quik. A total of 104 healthy, fertile subjects were used for comparison of the hormonal profile and testicular volume. RESULTS: The mean (+/- SD) age was 28.66 +/- 4.36 years and duration of marriage 4.4 +/- 4.36 years. There were 11.2% patients with normal cytology, 55.8% with hypospermatogenesis, 28.4% with testicular atrophy, 2.9% with Sertoli cells only and 1.7% with maturation arrest. A significant increase in hypospermatogenesis and decrease in the Sertoli cell-only pattern were noted in 1997-2001 when compared with 1990-1995. The mean left testicular volume was 10.53 +/- 5.51 mL3 in the infertile group vs. 15.2 +/- 4.97 in the fertile group (p < 0.003); right testicular volume was 10.84 +/- 4.77 vs. 15.15 +/- 5.31 (p < 0.003). The hormonal profile revealed higher luteinizing hormone and follicle-stimulating hormone levels in the infertile group vs. control group (8.53 +/- 9.03 and 16.44 +/- 19.243 vs. 6.98 +/- 4.53 and 7.37 +/- 6.63, respectively [p < 0.001]). Free testosterone was higher in the fertile group (39.69 +/- 12.76 vs. 20.28 +/- 8.5 [p < 0.000]). CONCLUSION: The majority of infertile males in our cohort had hypospermatogenesis; testicular atrophy was the next most common disorder. There was no major change in overall absolute numbers since the Gulf War. Testicular cytology by fine needle aspiration is a safe and well-tolerated complementary investigation for unexplained male infertility.

Adult↗