Hemophagocytic Lymphohistiocytosis (HLH) implies a benign generalized histiocytic proliferate wit... more Hemophagocytic Lymphohistiocytosis (HLH) implies a benign generalized histiocytic proliferate with erythrophagocytosis and it includes familial hemophagocytic lymphohistiocytosis and secondary hemophgocytosis. Spinal fluid changes like mild to moderate pleocytosis (most of the cells are lymphocytes and macrophages) and sometimes hemophagocytosis are seen in primary HLH but are not reported in secondary HLH. Here we report a case of a previously healthy 10 months old male infant who was diagnosed as familial HLH with evidence of CSF hemophagocytosis. He was started on the HLH 2004 treatment protocol with no improvement. A second bone marrow aspiration revealed leshmania donovani antibodies and he was started on anti-leishmania treatment with dramatic response.To the best of our knowledge, this is the first case of secondary HLH with evidence of hemophagocytosis in cerebrospinal fluid.
Persistent pulmonary interstitial emphysema is a rare disorder of pre-terms seen even in non-vent... more Persistent pulmonary interstitial emphysema is a rare disorder of pre-terms seen even in non-ventilated neonates. The condition needs to be differentiated from other neonatal lung anomalies requiring early surgery, because there is a role for conservative management of these babies. CT scan findings are typically helpful in diagnosis.
Hemophagocytic Lymphohistiocytosis (HLH) implies a benign generalized histiocytic proliferate wit... more Hemophagocytic Lymphohistiocytosis (HLH) implies a benign generalized histiocytic proliferate with erythrophagocytosis and it includes familial hemophagocytic lymphohistiocytosis and secondary hemophgocytosis. Spinal fluid changes like mild to moderate pleocytosis (most of the cells are lymphocytes and macrophages) and sometimes hemophagocytosis are seen in primary HLH but are not reported in secondary HLH. Here we report a case of a previously healthy 10 months old male infant who was diagnosed as familial HLH with evidence of CSF hemophagocytosis. He was started on the HLH 2004 treatment protocol with no improvement. A second bone marrow aspiration revealed leshmania donovani antibodies and he was started on anti-leishmania treatment with dramatic response.To the best of our knowledge, this is the first case of secondary HLH with evidence of hemophagocytosis in cerebrospinal fluid.
The International Study of Asthma and Allergies in Children (ISAAC) highlighted the presence of w... more The International Study of Asthma and Allergies in Children (ISAAC) highlighted the presence of wide variations in asthma prevalence between and within countries. The aim of this study was to determine the changes in the prevalence of asthma and its symptoms across the different regions of Oman. Two cross-sectional surveys were conducted as part of ISAAC phases I (1995) and III (2001) in two age groups (6-7 and 13-14 years) from nation-wide samples of Omani school children, with 7,067 participants in 1995 (3,893 young and 3,174 older group) and 7,879 participants in 2001 (4,126 young and 3,753 older group). Over the period of six years, the Sharqiya (Eastern) region continued to have the highest prevalence of self-reported asthma diagnosis and all asthma symptoms in both age groups, with a significant increase in the prevalence of wheeze in the past 12 months (from 8.7% to 13.8%; p=0.002) and asthma diagnosis (from 13.8% to 17.8 %; p=0.046) in the young group, and a significant incr...
In 1992-94 a nation-wide survey in primary schools in the Sultanate of Oman for ocular disorders ... more In 1992-94 a nation-wide survey in primary schools in the Sultanate of Oman for ocular disorders was conducted. This report focuses on the prevalence of visual acuity loss after injury. A random selection of 6,292 children from Grades 1 and 6 from all primary schools in the country provided the research sample. Children who failed the visual acuity screening test received a complete "on the spot" eye examination by the pediatric ophthalmologist. 12 children were found to have monocular low vision (VA <0.3 to amaurosis) caused by injury. Total prevalence for loss of vision in one eye was 0.19%, with 0.15% in 6-year-olds and 0.25% in 12-year-olds Traumatic cataracts were noted in 4 children, 3 of these were in need of surgery. One child had aphakia after trauma surgery and needed a secondary lens implant. Altogether the prevalence of traumatic monocular visual damage in our study was 0.19%. Next to amblyopia, injury is the main reason for monocular loss of vision in childhood, however, both are preventable. Information about trauma prevention and the need for adequate ophthalmic care should be emphasized. Regular and repeated screening of visual acuity in children is essential.
Cystinosis is a rare metabolic disorder characterised by lysosomal cystine accumulation leading t... more Cystinosis is a rare metabolic disorder characterised by lysosomal cystine accumulation leading to multi-organ damage; clinically, the kidneys are the first organ affected. Respiratory insufficiency caused by overall respiratory muscle myopathy is a life-threatening complication. Treatment with cysteamine should be initiated rapidly and continued lifelong to prolong renal function and protect the extra-renal organs. We report the case of a four-year-old Omani girl, diagnosed with infantile nephropathic cystinosis at 21 months. Cysteamine was prescribed but with no compliance to medications. She presented to the Child Health Department of Sultan Qaboos University Hospital, Oman, two years later with severe failure to thrive, electrolyte disturbance and respiratory failure. The hypoventilation and early respiratory dysfunction, due to intercostal and diaphragm myopathy, was treated by non-invasive positive-pressure ventilation. The patient was discharged after four months of intensive...
The International Study of Asthma and Allergies in Children (ISAAC) highlighted the presence of w... more The International Study of Asthma and Allergies in Children (ISAAC) highlighted the presence of wide variations in asthma prevalence between and within countries. The aim of this study was to determine the changes in the prevalence of asthma and its symptoms across the different regions of Oman. Two cross-sectional surveys were conducted as part of ISAAC phases I (1995) and III (2001) in two age groups (6-7 and 13-14 years) from nation-wide samples of Omani school children, with 7,067 participants in 1995 (3,893 young and 3,174 older group) and 7,879 participants in 2001 (4,126 young and 3,753 older group). Over the period of six years, the Sharqiya (Eastern) region continued to have the highest prevalence of self-reported asthma diagnosis and all asthma symptoms in both age groups, with a significant increase in the prevalence of wheeze in the past 12 months (from 8.7% to 13.8%; p=0.002) and asthma diagnosis (from 13.8% to 17.8 %; p=0.046) in the young group, and a significant incr...
To determine whether known risk factors for cardiorespiratory illnesses will help identify infant... more To determine whether known risk factors for cardiorespiratory illnesses will help identify infants who could experience extreme events during an admission for an apparent life-threatening event (ALTE) or later at home.
Seven children (5 male, 2 female) were seen over the last 16 years with rigid spine syndrome. Six... more Seven children (5 male, 2 female) were seen over the last 16 years with rigid spine syndrome. Six children had rigid spinal muscular dystrophy (selenoprotein N1-related myopathy [SEPN1RM]) and 1 had myopathy associated with rigid spine. The main presenting complaint in all was difficulty in bending the spine. The diagnosis was made on clinical features and imaging of the paraspinal muscles. Muscle histopathology revealed minimal myopathic changes to severe muscle degeneration. Genetic testing, which was only available for the last case, for selenoprotein was negative.
Hemophagocytic Lymphohistiocytosis (HLH) implies a benign generalized histiocytic proliferate wit... more Hemophagocytic Lymphohistiocytosis (HLH) implies a benign generalized histiocytic proliferate with erythrophagocytosis and it includes familial hemophagocytic lymphohistiocytosis and secondary hemophgocytosis. Spinal fluid changes like mild to moderate pleocytosis (most of the cells are lymphocytes and macrophages) and sometimes hemophagocytosis are seen in primary HLH but are not reported in secondary HLH. Here we report a case of a previously healthy 10 months old male infant who was diagnosed as familial HLH with evidence of CSF hemophagocytosis. He was started on the HLH 2004 treatment protocol with no improvement. A second bone marrow aspiration revealed leshmania donovani antibodies and he was started on anti-leishmania treatment with dramatic response.To the best of our knowledge, this is the first case of secondary HLH with evidence of hemophagocytosis in cerebrospinal fluid.
Persistent pulmonary interstitial emphysema is a rare disorder of pre-terms seen even in non-vent... more Persistent pulmonary interstitial emphysema is a rare disorder of pre-terms seen even in non-ventilated neonates. The condition needs to be differentiated from other neonatal lung anomalies requiring early surgery, because there is a role for conservative management of these babies. CT scan findings are typically helpful in diagnosis.
Hemophagocytic Lymphohistiocytosis (HLH) implies a benign generalized histiocytic proliferate wit... more Hemophagocytic Lymphohistiocytosis (HLH) implies a benign generalized histiocytic proliferate with erythrophagocytosis and it includes familial hemophagocytic lymphohistiocytosis and secondary hemophgocytosis. Spinal fluid changes like mild to moderate pleocytosis (most of the cells are lymphocytes and macrophages) and sometimes hemophagocytosis are seen in primary HLH but are not reported in secondary HLH. Here we report a case of a previously healthy 10 months old male infant who was diagnosed as familial HLH with evidence of CSF hemophagocytosis. He was started on the HLH 2004 treatment protocol with no improvement. A second bone marrow aspiration revealed leshmania donovani antibodies and he was started on anti-leishmania treatment with dramatic response.To the best of our knowledge, this is the first case of secondary HLH with evidence of hemophagocytosis in cerebrospinal fluid.
The International Study of Asthma and Allergies in Children (ISAAC) highlighted the presence of w... more The International Study of Asthma and Allergies in Children (ISAAC) highlighted the presence of wide variations in asthma prevalence between and within countries. The aim of this study was to determine the changes in the prevalence of asthma and its symptoms across the different regions of Oman. Two cross-sectional surveys were conducted as part of ISAAC phases I (1995) and III (2001) in two age groups (6-7 and 13-14 years) from nation-wide samples of Omani school children, with 7,067 participants in 1995 (3,893 young and 3,174 older group) and 7,879 participants in 2001 (4,126 young and 3,753 older group). Over the period of six years, the Sharqiya (Eastern) region continued to have the highest prevalence of self-reported asthma diagnosis and all asthma symptoms in both age groups, with a significant increase in the prevalence of wheeze in the past 12 months (from 8.7% to 13.8%; p=0.002) and asthma diagnosis (from 13.8% to 17.8 %; p=0.046) in the young group, and a significant incr...
In 1992-94 a nation-wide survey in primary schools in the Sultanate of Oman for ocular disorders ... more In 1992-94 a nation-wide survey in primary schools in the Sultanate of Oman for ocular disorders was conducted. This report focuses on the prevalence of visual acuity loss after injury. A random selection of 6,292 children from Grades 1 and 6 from all primary schools in the country provided the research sample. Children who failed the visual acuity screening test received a complete "on the spot" eye examination by the pediatric ophthalmologist. 12 children were found to have monocular low vision (VA <0.3 to amaurosis) caused by injury. Total prevalence for loss of vision in one eye was 0.19%, with 0.15% in 6-year-olds and 0.25% in 12-year-olds Traumatic cataracts were noted in 4 children, 3 of these were in need of surgery. One child had aphakia after trauma surgery and needed a secondary lens implant. Altogether the prevalence of traumatic monocular visual damage in our study was 0.19%. Next to amblyopia, injury is the main reason for monocular loss of vision in childhood, however, both are preventable. Information about trauma prevention and the need for adequate ophthalmic care should be emphasized. Regular and repeated screening of visual acuity in children is essential.
Cystinosis is a rare metabolic disorder characterised by lysosomal cystine accumulation leading t... more Cystinosis is a rare metabolic disorder characterised by lysosomal cystine accumulation leading to multi-organ damage; clinically, the kidneys are the first organ affected. Respiratory insufficiency caused by overall respiratory muscle myopathy is a life-threatening complication. Treatment with cysteamine should be initiated rapidly and continued lifelong to prolong renal function and protect the extra-renal organs. We report the case of a four-year-old Omani girl, diagnosed with infantile nephropathic cystinosis at 21 months. Cysteamine was prescribed but with no compliance to medications. She presented to the Child Health Department of Sultan Qaboos University Hospital, Oman, two years later with severe failure to thrive, electrolyte disturbance and respiratory failure. The hypoventilation and early respiratory dysfunction, due to intercostal and diaphragm myopathy, was treated by non-invasive positive-pressure ventilation. The patient was discharged after four months of intensive...
The International Study of Asthma and Allergies in Children (ISAAC) highlighted the presence of w... more The International Study of Asthma and Allergies in Children (ISAAC) highlighted the presence of wide variations in asthma prevalence between and within countries. The aim of this study was to determine the changes in the prevalence of asthma and its symptoms across the different regions of Oman. Two cross-sectional surveys were conducted as part of ISAAC phases I (1995) and III (2001) in two age groups (6-7 and 13-14 years) from nation-wide samples of Omani school children, with 7,067 participants in 1995 (3,893 young and 3,174 older group) and 7,879 participants in 2001 (4,126 young and 3,753 older group). Over the period of six years, the Sharqiya (Eastern) region continued to have the highest prevalence of self-reported asthma diagnosis and all asthma symptoms in both age groups, with a significant increase in the prevalence of wheeze in the past 12 months (from 8.7% to 13.8%; p=0.002) and asthma diagnosis (from 13.8% to 17.8 %; p=0.046) in the young group, and a significant incr...
To determine whether known risk factors for cardiorespiratory illnesses will help identify infant... more To determine whether known risk factors for cardiorespiratory illnesses will help identify infants who could experience extreme events during an admission for an apparent life-threatening event (ALTE) or later at home.
Seven children (5 male, 2 female) were seen over the last 16 years with rigid spine syndrome. Six... more Seven children (5 male, 2 female) were seen over the last 16 years with rigid spine syndrome. Six children had rigid spinal muscular dystrophy (selenoprotein N1-related myopathy [SEPN1RM]) and 1 had myopathy associated with rigid spine. The main presenting complaint in all was difficulty in bending the spine. The diagnosis was made on clinical features and imaging of the paraspinal muscles. Muscle histopathology revealed minimal myopathic changes to severe muscle degeneration. Genetic testing, which was only available for the last case, for selenoprotein was negative.
Uploads
Papers by Hussein al-Kindy