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  1. Article ; Online: Hypertensive Crisis in a Patient With a Functioning Mesenteric Paraganglioma: Dramatic Response to Octreotide Treatment.

    Elshafie, Omayma T / Bou Khalil, Abir C / Alshaibi, Maha A / Itkin, Boris L / Ismail, Babikir M / Woodhouse, Nicholas J

    AACE clinical case reports

    2023  Volume 9, Issue 5, Page(s) 149–152

    Abstract: Background/objective: To report a dramatic and immediate clinical and biochemical response during treatment with octreotide in a patient with a functioning mesenteric paraganglioma (PGL).: Case report: A 44-year-old woman was admitted with a severe ... ...

    Abstract Background/objective: To report a dramatic and immediate clinical and biochemical response during treatment with octreotide in a patient with a functioning mesenteric paraganglioma (PGL).
    Case report: A 44-year-old woman was admitted with a severe hypertensive crisis and a blood pressure reaching 260/150 mm Hg. She was 2 months postpartum and had been previously diagnosed with pre-eclampsia. Secondary hypertension was suspected. This was confirmed by finding a 6 × 5-cm
    Discussion: PGLs and pheochromocytomas are neuroendocrine tumors, and most have receptors for octreotide. This case and another patient previously reported responded dramatically to treatment with a high dose of octreotide. Earlier reports of patients failing to respond are likely to have been the result of using a smaller octreotide dose.
    Conclusion: We conclude that high doses of short- and long-acting octreotide are valuable in severely hypertensive patients. Our experience suggests that octreotide is of value in other patients with PGLs and pheochromocytomas. The response is rapid, sustained, effective, and with minimal reported side effects. To the best of our knowledge, this is the first report of a hypertensive crisis in a functional mesenteric PGL.
    Language English
    Publishing date 2023-05-09
    Publishing country United States
    Document type Case Reports
    ISSN 2376-0605
    ISSN (online) 2376-0605
    DOI 10.1016/j.aace.2023.05.003
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: The Diagnosis and Management of Severe Hypercalcaemia: A simplified approach - Report of five cases.

    Elshafie, Omayma T / Woodhouse, Nicholas Jy

    Sultan Qaboos University medical journal

    2010  Volume 10, Issue 3, Page(s) 388–395

    Abstract: Hypercalcaemia is a common medical problem, can be a manifestation of many diseases and, when severe, can represent a life-threatening medical emergency. Making the correct diagnosis is important to prevent unnecessary investigations and ... ...

    Abstract Hypercalcaemia is a common medical problem, can be a manifestation of many diseases and, when severe, can represent a life-threatening medical emergency. Making the correct diagnosis is important to prevent unnecessary investigations and parathyroidectomies. At Sultan Qaboos University Hospital, Oman, we have recently seen five patients with severe hypercalcaemia (calcium ≥3.5 mmol/L), most of whom had been misdiagnosed for months or even years. The clinical examination, evaluation of the fasting serum calcium, phosphate, creatinine and 24-hour urine calcium levels together with a review of their radiographs accurately predicted the pathophysiology of the disorder and successfully guided our investigative procedures well before the results of hormone assays became available.
    Language English
    Publishing date 2010-11-14
    Publishing country Oman
    Document type Journal Article
    ZDB-ID 2650196-X
    ISSN 2075-0528 ; 2075-0528
    ISSN (online) 2075-0528
    ISSN 2075-0528
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  3. Article: Radioactive iodine-131 therapy in the management of ectopic thyroid tissue.

    El-Shafie, Omayma T / Hussain, Samir / Sankhla, Dilip / Woodhouse, Nicholas

    Sultan Qaboos University medical journal

    2014  Volume 14, Issue 4, Page(s) e571–4

    Abstract: The occurrence of ectopic lingual thyroid tissue was first reported over 100 years ago. We report an unusual presentation of ectopic thyroid tissue occurring in the submental area. A 27-year-old female presented to the Sultan Qaboos University Hospital ... ...

    Abstract The occurrence of ectopic lingual thyroid tissue was first reported over 100 years ago. We report an unusual presentation of ectopic thyroid tissue occurring in the submental area. A 27-year-old female presented to the Sultan Qaboos University Hospital in Muscat, Oman, in October 2011 with an 8 × 6 cm mass which caused difficulty in talking and a feeling of heaviness in the jaw. She was clinically and biochemically euthyroid upon presentation. The clinical diagnosis was confirmed by a technetium(-99m) thyroid scan, magnetic resonance imaging and fine needle aspiration. A single dose of 976 megabecquerels of radioactive iodine-131 resulted in hypothyroidism after three months and the complete disappearance of the swelling and associated symptoms. At a two-year follow-up, the patient was healthy and continuing lifelong replacement therapy with thyroxine.
    Language English
    Publishing date 2014-10-14
    Publishing country Oman
    Document type Journal Article
    ZDB-ID 2650196-X
    ISSN 2075-0528 ; 2075-051X
    ISSN (online) 2075-0528
    ISSN 2075-051X
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Radioactive Iodine-131 Therapy in the Management of Ectopic Thyroid Tissue

    Omayma T. El-Shafie / Samir Hussain / Dilip Sankhla / Nicholas Woodhouse

    Sultan Qaboos University Medical Journal, Vol 14, Iss 4, Pp e571-

    2014  Volume 574

    Abstract: The occurrence of ectopic lingual thyroid tissue was first reported over 100 years ago. We report an unusual presentation of ectopic thyroid tissue occurring in the submental area. A 27-year-old female presented to the Sultan Qaboos University Hospital ... ...

    Abstract The occurrence of ectopic lingual thyroid tissue was first reported over 100 years ago. We report an unusual presentation of ectopic thyroid tissue occurring in the submental area. A 27-year-old female presented to the Sultan Qaboos University Hospital in Muscat, Oman, in October 2011 with an 8 x 6 cm mass which caused difficulty in talking and a feeling of heaviness in the jaw. She was clinically and biochemically euthyroid upon presentation. The clinical diagnosis was confirmed by a technetium-99m thyroid scan, magnetic resonance imaging and fine needle aspiration. A single dose of 976 megabecquerels of radioactive iodine-131 resulted in hypothyroidism after three months and the complete disappearance of the swelling and associated symptoms. At a two-year follow-up, the patient was healthy and continuing lifelong replacement therapy with thyroxine.
    Keywords Thyroid abnormalities ; Ectopic Thyroid ; Iodine Radioisotopes therapeutic use ; Fine Needle Aspiration ; Thyroglossal Cyst ; Case Report ; Oman ; Medicine ; R
    Subject code 610
    Language English
    Publishing date 2014-10-01T00:00:00Z
    Publisher Sultan Qaboos University
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article ; Online: Radioactive Iodine-131 Therapy in the Management of Ectopic Thyroid Tissue

    Omayma T. El-Shafie / Samir Hussain / Dilip Sankhla / Nicholas Woodhouse

    Sultan Qaboos University Medical Journal, Vol 14, Iss 4, Pp 571-

    2014  Volume 574

    Abstract: The occurrence of ectopic lingual thyroid tissue was first reported over 100 years ago. We report an unusual presentation of ectopic thyroid tissue occurring in the submental area. A 27-year-old female presented to the Sultan Qaboos University Hospital ... ...

    Abstract The occurrence of ectopic lingual thyroid tissue was first reported over 100 years ago. We report an unusual presentation of ectopic thyroid tissue occurring in the submental area. A 27-year-old female presented to the Sultan Qaboos University Hospital in Muscat, Oman, in October 2011 with an 8 x 6 cm mass which caused difficulty in talking and a feeling of heaviness in the jaw. She was clinically and biochemically euthyroid upon presentation. The clinical diagnosis was confirmed by a technetium-99m thyroid scan, magnetic resonance imaging and fine needle aspiration. A single dose of 976 megabecquerels of radioactive iodine-131 resulted in hypothyroidism after three months and the complete disappearance of the swelling and associated symptoms. At a two-year follow-up, the patient was healthy and continuing lifelong replacement therapy with thyroxine.
    Keywords thyroid ; abnormalities ; ectopic thyroid ; iodine radioisotopes ; therapeutic use ; fine needle aspiration ; thyroglossal cyst ; case report ; oman ; Medicine ; R
    Subject code 610
    Language English
    Publishing date 2014-11-01T00:00:00Z
    Publisher Sultan Qaboos University
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  6. Article: Adrenocorticotropic Hormone-Dependent Cushing's Syndrome: Use of an octreotide trial to distinguish between pituitary or ectopic sources.

    El-Shafie, Omayma T / Al-Saffi, Nooralddin / Al-Sajwani, Ahmed / Woodhouse, Nicholas

    Sultan Qaboos University medical journal

    2015  Volume 15, Issue 1, Page(s) e120–3

    Abstract: Objectives: Adrenocorticotropic hormone (ACTH) overproduction is usually due to a pituitary tumour which is often not visible on magnetic resonance imaging (MRI). However, ACTH overproduction may be due to an ectopic source. This study aimed to develop ... ...

    Abstract Objectives: Adrenocorticotropic hormone (ACTH) overproduction is usually due to a pituitary tumour which is often not visible on magnetic resonance imaging (MRI). However, ACTH overproduction may be due to an ectopic source. This study aimed to develop a simple non-invasive technique to differentiate these sources.
    Methods: This study took place in King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia, and Sultan Qaboos University Hospital, Muscat, Oman, between 1988 and 2012. Serum cortisol levels were measured in nine patients with ACTH-dependent Cushing's syndrome before and during a 72-hour trial of octreotide. All patients underwent computed tomography (CT) scans. MRI scans were performed on six patients.
    Results: CT scans were abnormal in three patients with ectopic ACTH production. MRI scans showed that three patients had pituitary microadenomas. Serum cortisol levels returned to normal in those with confirmed ectopic ACTH production. No response was found in the other six patients.
    Conclusion: A 72-hour trial of octreotide is recommended for patients with ACTH-dependent Cushing's syndrome and a normal pituitary MRI. This trial will be a useful alternative to petrosal sinus sampling.
    Language English
    Publishing date 2015-02
    Publishing country Oman
    Document type Journal Article
    ZDB-ID 2650196-X
    ISSN 2075-0528 ; 2075-051X
    ISSN (online) 2075-0528
    ISSN 2075-051X
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  7. Article ; Online: Adrenocorticotropic Hormone-Dependent Cushing’s Syndrome

    Omayma T. El-Shafie / Nooralddin Al-Saffi / Ahmed Al-Sajwani / Nicholas Woodhouse

    Sultan Qaboos University Medical Journal, Vol 15, Iss 1, Pp e120-

    Use of an octreotide trial to distinguish between pituitary or ectopic sources

    2015  Volume 123

    Abstract: Objectives: Adrenocorticotropic hormone (ACTH) overproduction is usually due to a pituitary tumour which is often not visible on magnetic resonance imaging (MRI). However, ACTH overproduction may be due to an ectopic source. This study aimed to develop a ...

    Abstract Objectives: Adrenocorticotropic hormone (ACTH) overproduction is usually due to a pituitary tumour which is often not visible on magnetic resonance imaging (MRI). However, ACTH overproduction may be due to an ectopic source. This study aimed to develop a simple non-invasive technique to differentiate these sources. Methods: This study took place in King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia, and Sultan Qaboos University Hospital, Muscat, Oman, between 1988 and 2012. Serum cortisol levels were measured in nine patients with ACTH-dependent Cushing’s syndrome before and during a 72-hour trial of octreotide. All patients underwent computed tomography (CT) scans. MRI scans were performed on six patients. Results: CT scans were abnormal in three patients with ectopic ACTH production. MRI scans showed that three patients had pituitary microadenomas. Serum cortisol levels returned to normal in those with confirmed ectopic ACTH production. No response was found in the other six patients. Conclusion: A 72-hour trial of octreotide is recommended for patients with ACTH-dependent Cushing’s syndrome and a normal pituitary MRI. This trial will be a useful alternative to petrosal sinus sampling.
    Keywords Adrenocorticotrophic Hormone ; Cushing’s Syndrome ; Somatostatin Receptors ; Investigational Therapies ; Octreotide ; Saudi Arabia ; Oman ; Medicine ; R
    Subject code 610
    Language English
    Publishing date 2015-01-01T00:00:00Z
    Publisher Sultan Qaboos University
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

    Full text online

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    Inter-library loan at ZB MED

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  8. Article ; Online: Adrenocorticotropic Hormone-Dependent Cushing’s Syndrome

    Omayma T. El-Shafie / Nooralddin Al-Saffi / Ahmed Al-Sajwani / Nicholas Woodhouse

    Sultan Qaboos University Medical Journal, Vol 15, Iss 1, Pp 120-

    Use of an octreotide trial to distinguish between pituitary or ectopic sources

    2015  Volume 123

    Abstract: Objectives: Adrenocorticotropic hormone (ACTH) overproduction is usually due to a pituitary tumour which is often not visible on magnetic resonance imaging (MRI). However, ACTH overproduction may be due to an ectopic source. This study aimed to develop a ...

    Abstract Objectives: Adrenocorticotropic hormone (ACTH) overproduction is usually due to a pituitary tumour which is often not visible on magnetic resonance imaging (MRI). However, ACTH overproduction may be due to an ectopic source. This study aimed to develop a simple non-invasive technique to differentiate these sources. Methods: This study took place in King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia, and Sultan Qaboos University Hospital, Muscat, Oman, between 1988 and 2012. Serum cortisol levels were measured in nine patients with ACTH-dependent Cushing’s syndrome before and during a 72-hour trial of octreotide. All patients underwent computed tomography (CT) scans. MRI scans were performed on six patients. Results: CT scans were abnormal in three patients with ectopic ACTH production. MRI scans showed that three patients had pituitary microadenomas. Serum cortisol levels returned to normal in those with confirmed ectopic ACTH production. No response was found in the other six patients. Conclusion: A 72-hour trial of octreotide is recommended for patients with ACTH-dependent Cushing’s syndrome and a normal pituitary MRI. This trial will be a useful alternative to petrosal sinus sampling.
    Keywords adrenocorticotrophic hormone ; cushing’s syndrome ; somatostatin receptors ; investigational therapies ; octreotide ; saudi arabia ; oman ; Medicine ; R
    Subject code 610
    Language English
    Publishing date 2015-02-01T00:00:00Z
    Publisher Sultan Qaboos University
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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    Inter-library loan at ZB MED

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  9. Article ; Online: The Diagnosis and Management of Severe Hypercalcaemia

    Omayma T Elshafie / Nicholas JY Woodhouse

    Sultan Qaboos University Medical Journal, Vol 10, Iss 3, Pp 388-

    A simplified approach - Report of five cases

    2010  Volume 395

    Abstract: Hypercalcaemia, a common medical problem, can be a manifestation of various diseases. When severe, it can represent a medical emergency. Correct diagnosis is important to prevent unnecessary investigations and parathyroidectomies. We here present five ... ...

    Abstract Hypercalcaemia, a common medical problem, can be a manifestation of various diseases. When severe, it can represent a medical emergency. Correct diagnosis is important to prevent unnecessary investigations and parathyroidectomies. We here present five patients with severe hypercalcaemia, most misdiagnosed for months or years before being referred to Sultan Qaboos University Hospital, Oman. We report how clinical examination, evaluation of fasting serum calcium, phosphate, creatinine and 24-hour urine calcium levels together with a review of their radiographics predicted the pathophysiology of the disorder and guided investigative procedures before hormone assays results were available.
    Keywords hypercalcaemia ; parathyroid hormone ; parathyroid hormone-related peptide ; 1,25 dihydroxy vitamin d ; case report ; oman ; Medicine ; R
    Language English
    Publishing date 2010-12-01T00:00:00Z
    Publisher Sultan Qaboos University
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

    Full text online

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    Inter-library loan at ZB MED

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  10. Article: Familial mineralocorticoid induced hypertension in the sultanate of oman.

    Woodhouse, Nicholas Jy / Elshafie, Omayma T / Ben Abid, Fatma / Doi, Suhail A

    Sultan Qaboos University medical journal

    2011  Volume 8, Issue 2, Page(s) 165–169

    Abstract: Objectives: In Oman, many hypertensive patients with a family history of the disease respond to treatment with spironolactone, a mineralocorticoid receptor (MC-R) blocking agent thus suggesting a high prevalence of mineralocorticoid (MC) induced disease. ...

    Abstract Objectives: In Oman, many hypertensive patients with a family history of the disease respond to treatment with spironolactone, a mineralocorticoid receptor (MC-R) blocking agent thus suggesting a high prevalence of mineralocorticoid (MC) induced disease. The aim of this study was to document the prevalence of MC induced disease in patients with a positive family history of hypertension (HTN).
    Methods: Serum calcium, potassium, creatinine, aldosterone and renin levels were measured under standard conditions in all patients together with an abdominal ultrasound scan and an adrenal computed tomography (CT) scan in four patients.
    Results: In this small study, we show that 18 of the 27 patients (66%) had undetectable (suppressed) renin levels with usually normal aldosterone values (14 patients) and respond to treatment with spironoactone.
    Conclusion: We suggest that MC induced hypertension is likely to be common in the Middle East. In evolutionary terms, this makes sense as the ability to conserve salt in hot climates might be expected to confer a definite survival advantage.
    Language English
    Publishing date 2011-06-30
    Publishing country Oman
    Document type Journal Article
    ZDB-ID 2650196-X
    ISSN 2075-0528 ; 2075-051X
    ISSN (online) 2075-0528
    ISSN 2075-051X
    Database MEDical Literature Analysis and Retrieval System OnLINE

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