Papers by Ganji Shivalingam
Journal of Cystic Fibrosis, 2008
Objective: To investigate the impact of French CF practice guidelines on patient follow-up at fou... more Objective: To investigate the impact of French CF practice guidelines on patient follow-up at four CF care centers between 1996 and 2005 (three years after implementation of the guidelines in 2002). Methods: Descriptive analysis of all patients (361 children and 301 adults) followed up in one of the CF centers between 1996 and 2005. Retrospective collected data included clinical characteristics, spirometry, microbiological tests and antibiotic therapy. Results: The average age at diagnosis was 3.7±8.0 years old. 38.1% of the patients had a diagnosis suggested by respiratory problems. The average age of the patients was 13.6±9.3 years in 1996 and 15.8±10.4 years in 2005 (p < 0.01). 52% of the children had at least three scheduled visits at a center in 1996 versus 87% in 2005 (p < 0.05). This comparison was also significant in the adult population: 59% in 1996 and 72% in 2005 (p < 0.05). Aerosol therapy was administered to 69% of the patients in 1996 versus 82% in 2005 (p < 0.01). Concerning respiratory function, there was no significant improvement: 64% of adults had %FEV1<80% in 1996 and in 2005 whereas in children, the figures were 56% and 64% respectively. Primocolonization with Pseudomonas aeruginosa was detected in 51% of patients in 1996 and 55% in 2005 (no significant difference). The average annual number of courses of antibiotic therapy per patient increased significantly between 1996 and 2005 (respectively 1.6±2.0 versus 2.4±2.1). Conclusion: The implementation of national guidelines seems to have impacted clinical practices. This study must be continued to show improvement in clinical evolution of the patients.
Journal of Cystic Fibrosis, 2008
Effective patient and parent education is an essential component of up-to-date treatment of CF. T... more Effective patient and parent education is an essential component of up-to-date treatment of CF. This holistic approach often is not accessible by socioeconomic less-favored patients. Other factors which negatively impact patient education include illiteracy, communication barriers between patients and non-native physicians, and lack of printed information in the native language. Our recent data for the North Al Bathina region of Oman reveals a prevalence of CF of 1:2460. This finding highlights the need to provide adequate health care education material for Omani parents and their affected children. The present paper evaluates the translation of the CF brochure "A Manual for CF Patients and their Parents" of the CF European network from English into Arabic and discusses difficulties in the translation process. Furthermore, we analyzed the general perception of this translation among 62 randomly selected parents (mean age 32.4 years) waiting in the pediatric outpatient department of Sohar Regional Hospital. The survey revealed that 97% of parents prefer to read medical information material in Arabic. Furthermore, 91% of parents regarded the translated information as very helpful or helpful for the understanding of CF. Only 9% were indifferent in their opinion. Interestingly, 24% of the parents had a previous knowledge about CF. Many of these parents (33%) indicated a non-media source for the information. We anticipate that the availability of the translated parent/patient manual into Arabic will help to spread local awareness about CF and, hopefully, will reach a regional audience through online publishing.
Journal of Cystic Fibrosis, 2010
We report a series of 3 cases who presented to our neurophysiology department with sciatic nerve ... more We report a series of 3 cases who presented to our neurophysiology department with sciatic nerve palsy secondary to prolonged sitting position in the intensive care unit (ICU). Though iatrogenic sciatic nerve palsy is previously described, it is secondary to total hip replacement surgery, neurosurgical procedures and due to injections. This series describes three cases of sciatic nerve palsy related to prolonged sitting position. This will highlight the need to take adequate preventive measures in the ICU setting and also that such sciatic nerve palsy may be much more common than reported.
Indian pediatrics, 2016
Two weeks ago, I received an e-mail from the editor of a reputed journal requesting me to downloa... more Two weeks ago, I received an e-mail from the editor of a reputed journal requesting me to download an agreement report by using a link in that email. After clicking on the link, I was directed to a web page which requested me to logon with my e-mail credentials. As I am an information technology scientist, I detected that I am facing to a phishing attack. In information security literature, phishing attack is an attempt for stealing users’ sensitive information by using a fake website similar to the authentic one [1]. Hackers steal e-mail credentials of journals’ editor, and then send many spam mails to steal sensitive information of some researchers who know the editor. In a phishing attack, cyber-criminals design a website similar to the target website. After designing fake website, cyber-criminals direct users to their fake page; when researchers open fake website and enter their information, cybercriminals gather this information.
OBJECTIVES Cystic fibrosis transmembrane conductance regulator (CFTR) mutations form distinct mut... more OBJECTIVES Cystic fibrosis transmembrane conductance regulator (CFTR) mutations form distinct mutational panels in different populations and subgroups. The frequency of cystic fibrosis (CF) mutations and prevalence are unknown in Oman. This study aimed to elucidate the mutational panel and prevalence of CF for the North Al Batinah (NAB) region in Oman and to estimate the national prevalence of CF based on the carrier screening of unrelated volunteers. METHODS The study included retrospective and prospective analyses of CF cases in the NAB region for 1998-2012. Genetic analysis of disease-causing mutations was conducted by screening of the entire coding sequence and exon-intron borders. The obtained mutational panel was used for the carrier screening of 408 alleles of unrelated and unaffected Omani individuals. RESULTS S549R and F508del were the major mutations, accounting for 89% of mutations in the patient population. Two private mutations, c.1733-1734delTA and c.1175T>G, were i...
European journal of pediatric surgery reports, 2017
An accessory lobe of the liver is a rare entity in clinical practice which is diagnosed incidenta... more An accessory lobe of the liver is a rare entity in clinical practice which is diagnosed incidentally. Infrequently, it may present as torsion with a clinical picture of an acute abdomen, a palpable mass, and may be associated with liver function abnormalities. Many of these patients have a history of previous surgery for congenital abdominal wall defects such as omphalocele. We present an extremely rare case of torsion of an accessory hepatic lobe in an 11-month-old male patient who presented in a state of shock. The infant underwent laparotomy and excision of the accessory lobe. Here, we aim to emphasize the importance of prompt management and early resection which is the cornerstone of a favorable outcome.
Oman medical journal, 2017
Stridor presenting soon after birth due to bilateral abductor vocal cord paralysis (VCP) is rare.... more Stridor presenting soon after birth due to bilateral abductor vocal cord paralysis (VCP) is rare. We report a family with bilateral VCP affecting four male members in two generations and hence suggesting X-linked recessive inheritance. Severe stridor in the neonatal period requires meticulous airway evaluation, and tracheostomy in 35-70% cases. The current trend is towards conservative management and tracheostomy is avoided unless respiratory distress is severe or life-threatening. Neonatal VCP can be an isolated finding, or it can be familial with or without syndromic features. There are very few reports of non-syndromic familial cases. Unlike the cases reported previously, none of our patients required prolonged intubation or tracheostomy suggesting an excellent prognosis in such cases. This is the first case study of congenital familial non-syndromic VCP reported from the Middle East.
Indian pediatrics, Jan 15, 2016
Saudi Journal of Medical and Pharmaceutical Sciences, 2016
Kawasaki disease (KD) is an acute febrile illness, mostly of under-fives. It is the leading cause... more Kawasaki disease (KD) is an acute febrile illness, mostly of under-fives. It is the leading cause of acquired heart disease in children in the developed countries, with coronary artery abnormalities in 20-25% of untreated patients. This is a retrospective study of patient records of cases of KD in 5 years at Sohar hospital, Oman looking at epidemiology, clinical presentation, investigations and management. In our study, KD occurred mostly in boys under 5,in the first half of the year. All had fever. In decreasing frequency, they had oral mucosal changes, cervical lymphadenopathy, rash, conjunctivitis and extremity changes. Most had raised CRP/ESR, raised platelets, and low haemoglobin. Less than half had a raised white cell count. Serum albumin was done in 44% of admissions, of which 37.5% had low values. 50% admissions had urine microscopy done. Blood cultures, urine cultures, ASOT, Monospot, viral studies, ALT were also done and were all mostly normal. Ultrasound neck was done in one case and chest X-ray in two cases. ECHO showed some abnormality in 50% admissions. 16.7% cases were typical KD, 72.2 % incomplete KD. All (100%) children received the recommended treatment. 5.5% of admissions was unresponsive to IVIG, and responded to methylprednisolone. Our study demonstrates recognition of KD in children in Oman, mostly presenting as incomplete KD. All children(100%) received the recommended treatment.
Saudi Journal of Medical and Pharmaceutical Sciences, 2016
Kawasaki disease (KD) is an acute febrile illness, mostly of under-fives. It is the leading cause... more Kawasaki disease (KD) is an acute febrile illness, mostly of under-fives. It is the leading cause of acquired heart disease in children in the developed countries, with coronary artery abnormalities in 20-25% of untreated patients. This is a retrospective study of patient records of cases of KD in 5 years at Sohar hospital, Oman looking at epidemiology, clinical presentation, investigations and management. In our study, KD occurred mostly in boys under 5,in the first half of the year. All had fever. In decreasing frequency, they had oral mucosal changes, cervical lymphadenopathy, rash, conjunctivitis and extremity changes. Most had raised CRP/ESR, raised platelets, and low haemoglobin. Less than half had a raised white cell count. Serum albumin was done in 44% of admissions, of which 37.5% had low values. 50% admissions had urine microscopy done. Blood cultures, urine cultures, ASOT, Monospot, viral studies, ALT were also done and were all mostly normal. Ultrasound neck was done in one case and chest X-ray in two cases. ECHO showed some abnormality in 50% admissions. 16.7% cases were typical KD, 72.2 % incomplete KD. All (100%) children received the recommended treatment. 5.5% of admissions was unresponsive to IVIG, and responded to methylprednisolone. Our study demonstrates recognition of KD in children in Oman, mostly presenting as incomplete KD. All children(100%) received the recommended treatment.
Journal of Cystic Fibrosis, 2008
Journal of Cystic Fibrosis, 2010
Background: Prevalence of cystic fibrosis in the Sultanate of Oman is unknown. However, an establ... more Background: Prevalence of cystic fibrosis in the Sultanate of Oman is unknown. However, an established mutational panel at the second largest populated area revealed that the mutations S549R and delF508 cover 89.2% of all CF cases. The mutation S549R is the predominant mutation in the patient cohort with an allele frequency of 0.75. CF and other mutations are inherited with specific haplotype patterns. The identification of haplotypes of unrelated CF patients and volunteers will provide information about frequencies of disease associated haplotypes in the normal population, support risk assessment and might be considered as a potential screening tool for CF. Objectives: (1) Identification of allele frequencies of the polymorphism M470V (M/V) at exon 10 and the dimorphic 4-bp GATT structure with either 6 or 7 repeats (6/7) at intron 6. (2) Defining haplotypes for the CF cohort and the Omani unaffected volunteer population (3) Evaluation of the association of CF causing mutations and ...
Cystic Fibrosis (CF) is an autosomal recessive disorder affecting the chloride transport in mucus... more Cystic Fibrosis (CF) is an autosomal recessive disorder affecting the chloride transport in mucus-producing epithelial cells. The disease is caused by mutations in the Cystic Fibrosis Transmembrane conductance Regulator (CFTR), which is responsible for trans-epithelial chloride transport. Approximately 1900 mutations and gene variants of the CFTR have been described. The spectrum of major White-European mutations includes F508del, G542X, G551D and N1303K. F508del is the most common CF-causing mutation, found in approximately 70% of all CF patients worldwide. The spectrum of CF mutations of Arab populations is under-investigated. However, initial molecular-epidemiological studies indicate the existence of specific CF mutation clusters within geographical regions in the Middle East, suggesting specific distributions of CF mutation carrying chromosomes in this part of the world. We showed that the worldwide rare CF mutation S549R is the predominant disease causing mutation in the Omani...
Sultan Qaboos University medical journal, 2014
Cystic fibrosis transmembrane conductance regulator (CFTR) mutations form distinct mutational pan... more Cystic fibrosis transmembrane conductance regulator (CFTR) mutations form distinct mutational panels in different populations and subgroups. The frequency of cystic fibrosis (CF) mutations and prevalence are unknown in Oman. This study aimed to elucidate the mutational panel and prevalence of CF for the North Al Batinah (NAB) region in Oman and to estimate the national prevalence of CF based on the carrier screening of unrelated volunteers. The study included retrospective and prospective analyses of CF cases in the NAB region for 1998-2012. Genetic analysis of disease-causing mutations was conducted by screening of the entire coding sequence and exon-intron borders. The obtained mutational panel was used for the carrier screening of 408 alleles of unrelated and unaffected Omani individuals. S549R and F508del were the major mutations, accounting for 89% of mutations in the patient population. Two private mutations, c.1733-1734delTA and c.1175T>G, were identified in the patient co...
Journal of Cystic Fibrosis, 2008
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Papers by Ganji Shivalingam