Oasis Hospital

Background:The urachus is a vestigial remnant of the allantois which naturally degenerates after birth. Failure of closure of the urachus can result in urachal malformations, with the most common being a urachal cyst. Diagnosing a urachal cyst is challenging due to its diverse presentations, often leading to misdiagnosis. Although they are often asymptomatic, urachal cysts can be significant because they can lead to complications.Case Report:We report a late preterm male infant born at 36 weeks + 5 days, in whom an antenatal anomaly scan revealed a unilocular intra-abdominal cyst adjacent to the bladder. Postnatal ultrasound kidney, ureter, and bladder (KUB) at 3 days of age demonstrated a cystic structure anterior and superior to the bladder, accompanied by mild bilateral hydronephrosis. A voiding cystourethrogram (VCUG) at 2 weeks revealed a cystic mass connected to the bladder by a fistulous tract, raising differential diagnoses of urachal cyst, bladder diverticulum, or incomplete bladder duplication. At 2 months, diagnostic cystoscopy and laparoscopy were performed. Cystoscopy showed a small opening at the bladder dome, while laparoscopy identified a 5 × 5-cm cyst extending from the bladder dome to the umbilicus. The cyst was excised laparoscopically, and bladder repair was completed. Histopathology revealed benign urothelium with mild chronic inflammation and a muscular wall, suggestive of a urachal diverticulum. Postoperative recovery was uneventful, and follow-up imaging demonstrated normal bladder morphology and renal function.Conclusions:Our case supports the efficacy of diagnostic and therapeutic laparoscopy in accurately diagnosing urachal anomalies, aiding in treatment decisions, and preventing future complications.

BACKGROUND Sleeve gastrectomy (SG) is widely used in obesity treatment, although it is associated with new onset of gastroesophageal reflux disease (de novo GERD) and weight regain. Roux-en-Y gastric bypass (RYGB) is the standard revisional procedure for GERD, though it offers limited additional weight loss. Ileal-based procedures have demonstrated superior outcomes regarding weight loss but have uncertain results in GERD. This study presents preliminary findings on gastric bipartition with functional duodenal exclusion (GBp-FDE) as a revisional approach following SG in this scenario. CASE REPORT A retrospective data analysis was conducted on 10 patients who underwent GBp-FDE due to de novo GERD and obesity recurrence after SG (mean BMI: 37.2±3.2 kg/m²). Nine patients presented with hiatal hernia and 8 with sleeve dilation. GERD was assessed pre- and postoperatively using a validated questionnaire, endoscopy, and contrast radiology. The surgical technique involved a pre-pyloric antroileostomy in Roux-en-Y configuration using a 40% proportion biliopancreatic limb. One-year postoperative findings included pyloric spasm (endoscopy), very preferential contrast flow to the ileum (radiology), and endoscopic access preservation to the duodenum. GERD symptoms resolved in 90% (P=0.0059) and esophagitis healed in 80% (P=0.008), likely due to gastric decompression. Mean percent total weight loss and percent excess weight loss were 35.2±6.6 and 108.0±11.14, respectively. CONCLUSIONS GBp-FDE seems to be a promising surgery for managing de novo GERD and obesity recurrence after SG, through SG pouch decompression and ileal stimuli, promoted by the antroileostomy. Further controlled studies with extended follow-up are necessary to validate these findings.

Abstract Cardiovascular disease and its associated risk factors impose a huge morbidity, mortality, and disability burden on the UAE population, to an extent exceeding the global rates. In the last two decades, the UAE cardiovascular healthcare sector has undergone massive development, with the establishment of highly specialized centers, partnerships with world-renowned health institutions, high-quality clinical cardiovascular research, and the initiation of cardiovascular training programs. However, further efforts are warranted to increase public awareness of the burden of cardiovascular disease, promote healthy behaviors, tackle cardiovascular risk factors, and improve adherence to recent guidelines in order to improve patient outcomes. Here, we present epidemiological data on cardiovascular disease in the UAE, a historical perspective, major milestones in the care of cardiac patients, and current challenges and future directions in the field.

Sleeve gastrectomies are widely used for weight loss and metabolic improvement in individuals with obesity. Although its effects on metabolic parameters are well established, its short-term impact on cardiac inflammatory markers and cardiovascular outcomes has not been clearly defined. This review examined how sleeve gastrectomy influences markers such as C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), adiponectin, and leptin hormones, along with associated cardiovascular indicators. We conducted a systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses PRISMA guidelines. Articles published from January 2012 to January 2025 were retrieved from PubMed, Embase (Ovid), Cochrane, and Scopus databases. Eligible studies included clinical trials and cohort studies involving adults who underwent sleeve gastrectomy with follow-up data on inflammatory or cardiovascular markers. Twenty-six studies involving 1269 patients met the inclusion criteria. Most studies have shown reductions in CRP and leptin levels within the 1 st year after surgery. TNF-α and IL-6 showed variable changes, whereas adiponectin increased in several reports. Improvements in blood pressure, glycemic control, and lipid profiles are common. A few studies have also reported early changes in cardiac structure or vascular markers. Sleeve gastrectomy is associated with the early improvement of systemic inflammation and cardiometabolic risk factors. However, the short follow-up duration, variations in measurement techniques, and limited cardiac imaging restrict broader conclusions. Further research is needed to clarify the long-term cardiovascular effects and standardize the assessment of inflammatory outcomes.

Introduction: Diagnosis of brain death in a pregnant patient is highly challenging both ethically and clinically when the usual medical criteria for brain death cannot be utilized completely because of pregnancy-related restrictions. The situation is compounded by the requirement to weigh the medical limitations posed by the patient’s critical status. Pregnancy itself can interfere with some diagnostic tests, making it difficult to conclude brain death, this case is reported which aims to discuss the ethical challenges and clinical intricacies in diagnosing brain death when critical diagnostic tests are restrained or limited. Case Report: A 31-year-old pregnant patient at her12 weeks gestation was admitted. We reported her history of headache, vomiting and acute loss of consciousness. Presenting with GCS 3/15 on arrival, unequal, non-reactive pupils on physical examination, she was intubated. Imaging scans revealed a thalamic hematoma on the left side as well as extensive brain edema and signs of herniation of the brain. decompressive craniectomy was carried out to lower intracranial pressure. Due to the patient’s pregnancy, an apnea test was not feaasible, The patient also had a craniectomy which made it impossible to use an EEG to determine brain function. Conclusion: Presented case illustrates ethical and clinical dilemma of establishing a diagnosis of brain death in a pregnant woman when pregnancy-related constraints hamper use of routine tests. Inability to perform critical tests like the apnea test and EEG show complexity of making an irreversibility diagnosis while weighing the risk of harm to both maternal and fetal health.

The article presents the possibilities of obtaining potassium sulfate through the conversion of calcium sulfate with potassium carbonate according to the reaction: CaSO₄ + K₂CO₃ → ↓CaCO₃ + K₂SO₄. Optimal conditions for the conversion process have been determined. It has been shown that in an aqueous medium at a temperature of 30°C, with a stoichiometric ratio of the initial components of 1:1 and a stirring speed of 300 rpm for 15–30 minutes, the utilization rate of Ca²⁺ ions reaches 90–93%. Potassium sulfate obtained in the liquid phase was isolated by evaporation followed by crystallization. The obtained samples were subjected to chemical analysis, with the results presented in tabular form. Additionally, scanning electron microscopy analysis of sunflower ash and the basic chemical analyses of phosphogypsum are provided.

This study examines the effect of bank-specific factors on the financial stability of Sharia Commercial Banks in Indonesia from 2013 to 2023. Using a quantitative approach and panel data regression analysis on secondary data from 15 Islamic banks listed on the IDX, the study finds that Non-Performing Finance (NPF) has a significant negative effect, Bank Size has a significant positive effect, and Bank Age has a positive but insignificant effect on financial stability. Collectively, NPF, Bank Size, and Bank Age significantly influence financial stability.

Risk stratification in pulmonary arterial hypertension is critical in determining therapeutic strategies for patients. Patients are stratified into low-, intermediate-, and high-risk groups based on determinants of prognosis like clinical assessment, exercise tests, biochemical markers, echocardiography, and haemodynamic tests. The primary objective of treatment is to shift each of the component tests into a low-risk zone either by treatment escalation alone, as in the case of intermediate-risk patients, or by a combination of treatment escalation and repeat evaluation by right heart catheterisation in high-risk patients. Low-risk patients should be clinically assessed at least every 3 months, but follow-up is more frequent for intermediate- and high-risk patients. Apart from improving survival rates, health-related quality of life is also assessed at baseline and followup visits, which may predict the prognosis. Additionally, therapeutic drug monitoring is also essential during visits due to the risk of major side effects during treatment initiation or dose escalation. Initial and follow-up risk stratification can prevent delays in the intensification of therapy, but insurance denials act as a barrier to this approach. Therefore, a dedicated insurance team is required for approval of testing and therapies and a fasttrack process to communicate with the pulmonary hypertension expert centre. It can be concluded that risk stratification improves the treatment approach and helps make individualised treatment decisions. It also helps healthcare professionals better allocate treatment resources in cases of scarcity.

Background: Maternal obesity (BMI ≥30 kg/m²) increases risks of GDM, hypertensive disorders, preeclampsia, and neonatal complications. This meta-analysis evaluates intervention effectiveness in reducing these risks. Objective: To assess the relationship between maternal obesity and adverse outcomes, including metabolic disorders and neonatal adversities, and to evaluate the efficacy of lifestyle and medical interventions in mitigating these risks. Methods: A systematic search of PubMed, EMBASE, and Cochrane Library databases identified nine studies involving 2,700 participants. Studies included were RCTs or prospective cohort studies focusing on obese or overweight pregnant women and reporting outcomes such as GDM, preeclampsia, pregnancy weight gain, and neonatal health. Data were extracted independently, and pooled odds ratios (Ors) or weighted mean differences (WMDs) were calculated using random-effects models. Subgroup and sensitivity analyses assessed outcome variations based on intervention types, maternal BMI categories, and other factors. Results: Maternal obesity was significantly associated with adverse outcomes. For pregnancy weight gain, dietary and exercise interventions showed a pooled effect size of 0.75 (95% CI: 0.60–0.90), with low heterogeneity (I² = 20%). GDM management reduced adverse fetal growth outcomes (0.85, 95% CI: 0.70–1.00; I² = 25%). Neonatal outcomes, including preterm birth and NICU admissions, improved with a pooled effect size 1.20 (95% CI: 1.05–1.35), with moderate heterogeneity (I² = 15%). Subgroup analyses revealed intervention-specific benefits, such as supervised exercise improving maternal weight outcomes (0.88, 95% CI: 0.78–0.98; I² = 15%). Conclusion: Maternal obesity raises pregnancy-related risks, but dietary changes and exercise help. Integrating effective interventions into prenatal care is crucial for better outcomes.