Hussain Alsaffar

Sultan Qaboos University | SQU · Department of Child Health

Introduction: Patients with congenital adrenal hyperplasia (CAH) require life long glucocorticoid (GC) therapy. In CAH, the adverse effect of GC on bone health (BH) may be counteracted by the effect of modest elevations in adrenal androgens. Aim: To examine relationships between BH index (BHI) SDS, calculated by BoneXpert on bone age (BA) x-rays,...

To help children live with T1DM understanding how to manage their diabetes during illness

Glycogen hepatopathy is a rare complication seen mainly in patients with diabetes mellitus whom having a poor glycemic control. We report an 11-year-old female with type 1 Diabetes Mellitus and autoimmune hypothyroidism presenting with transaminitis and hepatomegaly, secondary poor glycemic profile. After excluding the common causes of hepatitis, a...

b> Introduction: Celiac disease (CD) is among the diseases most commonly associated with type 1 diabetes (T1D). This study aimed to evaluate the worldwide practices and attitudes of physicians involved in pediatric diabetes care regarding diagnosing and managing CD in children with T1D. Methods: The 30-item survey was conducted between July and Dec...

In the management of obesity, it is essential to adhere to evidence-based principles of chronic disease management, recognizing patients’ lived experiences and addressing the underlying factors contributing to obesity. Simplistic approaches, such as “eat less, move more,” should be avoided in favor of comprehensive strategies. Access to evidence-b...

Background Congenital generalized lipodystrophy (CGL) is a rare inherited disease characterized by a near-total absence of adipose tissue and is associated with organ system abnormalities and severe metabolic complications. Here, we have analyzed the disease characteristics of the largest CGL cohort from the Middle East and North Africa (MENA) who...

Background and Aims: Ramadan fasting increases the risk of metabolic distress among people with type 1 diabetes (T1DM). Automation of insulin delivery using the advanced hybrid closed loop (AHCL) system may improve glycemic control without compromising safety. Nevertheless, the effectiveness and safety of AHCL with prolonged fasting have not been w...

Introduction: Since its emergence, the COVID-19 pandemic has had a radical effect on different aspects of health worldwide. The burden created by the COVID-19 pandemic on healthcare systems has also involved educational and academic activities among healthcare professionals. Objectives: This study aimed to explore the effect of the COVID-19 pandem...

Conclusion > It is important to have a multidisciplinary team approach and clear pathway of care for the management of these patients to achieve the best outcome. > It is essential to do preoperative surveillance as well as regular postoperative surveillance of endocrine sequalae as pituitary insufficiency is one of the common complications related...

Introduction Diabetic ketoacidosis (DKA) is a common complication of type 1 diabetes mellitus. Unfortunately, medical errors are not uncommon during the management of DKA leading to significant morbidity and mortality. There are many studies conducted to assess the knowledge of junior doctors in the management of DKA in many countries including Bah...

Recombinant growth hormone (GH) is a widely used hormonal therapy for children and adolescents with GH deficiency or short stature related to certain conditions. Generally, GH therapy has a good safety profile; however, it could have rare but significant orthopaedic complications including slipped capital femoral epiphysis (SCFE). Pediatric endocri...

Introduction Clinical teaching is essential for the continuity of education of health care professionals. Developing teaching skills is highly required to communicate efficiently and transfer experience and knowledge to others. To our knowledge, medical students across Iraq did not give their perception of clinical teaching in a comprehensive way....

Rickets, a growth plate disorder, is classified into calcipenic and phosphopenic types based on the etiology. Phosphopenic rickets can be further classified into fibroblast growth factor 23 (FGF23) mediated and non-FGF23 mediated. FGF-23 has a phosphaturic effect which results in hypophosphatemia and, therefore, the accumulation of hypertrophied ch...

Moyamoya disease is a progressive rare type of cerebrovascular disease marked by stenosis and occlusion of the distal internal carotid arteries and circle of Willis branches, leading to the development of a collateral network of blood vessels at the base of the brain. For Moyamoya angiopathy, endocrinopathies may be risk factors, sequelae, or just...

Gigantomastia is a rare and benign disorder that is characterized by excessive breast enlargement. Although a definition has yet to be established, it is generally known as approximately 1.5 kg per breast that requires a reduction. With regards to juvenile gigantomastia specifically, most of the cases are sporadic, but familial incidences have also...

Background and objective Neonatal hypoglycemia (NH) is one of the most common causes of admission to the neonatal intensive care unit (NICU). Persistent NH despite adequate feeding and intravenous dextrose may often require medications to maintain normal blood glucose levels (BGL). Several medications are used in the management of persistent NH, su...

Thyroid hormone profile is variable among patients with nephrotic syndrome. Hypothyroidism has been reported in patients with recurrent and congenital nephrotic syndrome1. It is non-autoimmune hypothyroidism caused by glomerular pathology leading to the urinary loss of thyroid hormone, thyroid binding protein (TBP), and iodine. Children with Finnis...

Introduction: Coeliac disease (CD) is one of the autoimmune disorders that has been increasingly recognized to be associated with type 1 diabetes mellitus (T1DM). 10 years ago, the prevalence of CD in T1DM patients was reported to be 5.5% in our centre. Objectives: To determine the prevalence of CD in T1DM in our cohort of patients who receive thei...

Introduction: Congenital generalized lipodystrophy (CGL) is a rare autosomal recessive disorder characterized by a generalized lack of adipose tissues in the body leading to deposition in ectopic tissues. Insulin resistance is one of the common features of the disease especially in type 2 congenital lipodystrophy .Most of the affected individuals a...

Introduction: Carbohydrate counting (CC) became fundamental in the management of T1DM. In Paediatric Diabetes Unit of Sultan Qaboos University Hospital, our patients do have an access to a dietitian as soon as they get diagnosed and on demand thereafter. However, their adherence to the CC despite being educated is still poor which results in a poor...

Introduction: COVID-19 pandemic had let to disruption of routine and medical education especially in the first few months from announcing the pandemic status globally. At Al-Mustansiriyah University in Baghdad - Iraq, there was a shift towards providing online classes where students could attend their classes from home in order to reduce the risk o...

There are still some gaps in knowledge to be bridged about management of paediatric DKA. Continuous educational activities are desired. Therefore more sessions about DKA management to be scheduled and perhaps apply simulation training to boost their confidence. https://abstracts.eurospe.org/hrp/0095/hrp0095p2-74

https://abstracts.eurospe.org/hrp/0095/hrp0095p2-115 Pseudohyponatremia can occur in patients with hypertriglyceridemia. Therefore, lowering the elevated triglycerides results in improvement of sodium levels.

Routine assessment of Transfusion Dependant Thalassaemia (TDT) patients for adrenal insufficiency is highly recommended, as early detection of adrenal insufficient patients and implementing an appropriate treatment plan may results into saving lives and reducing the possibility of unexpected adrenal crisis for TDT patients during intercurrent infec...

Objectives To assess the perceptions of genetic and metabolic bone disorders with a focus on X-linked hypophosphatemia (XLH) in the Middle East and Africa. Methods An online survey of a convenience sample of physicians from relevant disciplines. The questions covered respondents' profiles, awareness of rare bone diseases, and XLH's burden, symptoms...

Background: Inducing puberty in hypogonadal patients enables achieving normal final adult height and healthy bone mass accrual and improves fertility potential. Reliable availability and access to medicines remain a challenge around the world, particularly in low-income countries. Aim: We aimed to describe the availability/access to medications...

Introduction: The novel coronavirus disease 2019 (COVID-19) pandemic had an impact on different health services due to the lockdowns, curfews, or reducing provision of some clinical services to infection control. Aims: This study looked at the impact of the pandemic on the pediatric diabetes services in Arab countries during the first 6 months of...

Prader-Willi syndrome (PWS) is a genetic disorder described by multifaceted clinical features with implications on the endocrine system, metabolism, and behavior. Some symptoms of PWS syndrome can be confused with the relative clinical aspects of hypothyroidism, such as lethargy, muscular hypotonia, and poor sucking ability. In this review, we woul...

Background: Diabetic ketoacidosis (DKA) is a leading cause of mortality in children with type 1 diabetes mellitus. Pediatric residents in Iraqi hospitals are usually the front liners in managing pediatric emergencies. Therefore, it is important to make sure they are practicing at the highest possible standards to ensure patients’ safety. Objectives...

Background: Overweight and obesity are defined as abnormal or excessive fat accumulation that may impair health. Childhood obesity continues to increase in prevalence, this will lead to increases in adult overweight and obesity together with the consequent health problems. Hence the development of effective prevention programs in childhood is impor...

Diabetes mellitus is one of the most common non-communicable illnesses worldwide. About 1.4 million Iraqis are living with diabetes mellitus. An Online survey consists of 38 questions was distributed among 86 of year-6 medical students during May 2020 to assess the knowledge of final-year medical students at College of Medicine, Wasit University, I...

Objectives: This study aimed to investigate the impact of lockdowns caused by COVID-19 pandemic ‎on the glycemic control and body mass index (BMI) of children live with type 1 diabetes mellitus.‎ Methods: A cross-sectional study was conducted between January 2020 and August 2021 in ‎pediatric diabetes unit at Sultan Qaboos University Hospital. The...

Aims Diabetes mellitus type 1 as a chronic disease represents a heavy burden on its patients and families. In the absence of health insurance in Iraq, the public sector should provide these patients with standard care to not compel them to get it from the costly, private one. This study aimed to overview the provided public service for children and...

Multiple factors control the growth of a child, including genetics, nutrition, and socioeconomic factors. Referral of tallboys who are otherwise well is very rare. However, sometimes, extraordinary tall stature for the age can be a cause of great concern to the parents. We report a case of an Omani child with a de novo mutation of NSD1 that led to...

Early control of glycaemia is key to reduce vascular complications in individuals with Type 1 diabetes. Therefore, encouraging children and adolescents with T1DM to take responsibility for controlling glucose levels is an important yet a challenging task. The rapid expansion of continuous glucose monitoring (CGM) systems has allowed for more compre...

Introduction: One of the most important autoimmune diseases which affect children is type 1 diabetes mellitus (T1DM). Various risk factors for this chronic condition have been considered including genetic and environmental factors. Objectives: To identify the most important risk factors related to type 1 diabetes mellitus among children and adolesc...

Introduction: Diabetes mellitus (DM) is one of the most common noncommunicable illnesses worldwide. About 1.4 million Iraqis are living with diabetes mellitus. Awareness of its early symptoms and signs may contribute to an early diagnosis, for which there will be less risk for developing complications. Diabetes Mellitus is a subject that is taught...

Background: Diabetes mellitus type 1 as a chronic disease represents a heavy burden on its patients and their families. In the absence of health insurance in Iraq, the public sector should provide these patients with standard care in order not to compel them to get it from the costly, private one. Purpose: This study aims to overview the provided p...

Background: Diabetes mellitus is the second most common chronic disease of childhood. It requires appropriate management and follow up to reduce the complications. Type 1 diabetes mellitus (T1DM) is the most common type of diabetes that affects children. Most of the developed countries launched registries. In Iraq, there is no access to statistics...

Introduction: Diabetic ketoacidosis (DKA) is a known complication of diabetes mellitus, mainly type1. It is a medical emergency condition. The recent British paediatric DKA guideline clearly recommends involving a senior clinician at time of diagnosis, usually either an emergency medicine or general paediatric doctor. There is no clear recommendati...

Introduction: During management of Diabetic ketoacidosis (DKA), and after starting the insulin infusion, it is crucial to monitor the blood glucose level frequently. If the glucose level drops quickly or below certain limit when there is still an evidence of ketonemia, it is recommended to add dextrose to the maintenance fluids and continuing the i...

Introduction: Diabetes is a global disease with approximately 425 millions of people affected throughout the world. The treatment cost for diabetes constitutes a significant economic burden and is estimated to increase in areas of Africa, South East Asia and the middle east in parallel to the increase to the disease incidence. These regions contrib...

Introduction: More than 1.1 million children and adolescents are living with Type 1 diabetes mellitus (T1DM) in 2019 worldwide1. Transition period is considered a crucial phase in management of T1DM, where movement of adolescents to adult health care is initiated. During this period, physical, psychological and behavioral changes may make this inte...

Introduction: The COVID19 pandemic had an impact on different health services due to the lockdowns, curfews, or reducing provision of some clinical services in order to minimise the infection spread. Cancellation of clinic appointments was observed. Some patients also did not attend their appointments due to the fear of contracting the infection....

Introduction: Since diabetes mellitus is one of the major non-communicable diseases, therefore it is important taking this subject in some details during the undergraduate medical course, to prepare the students for recognizing the disease and understanding its management. In Sultan Qaboos University, the medical students go through a pre-internshi...

Introduction: Diabetic ketoacidosis (DKA) is a common medical emergency and is the most common cause of death in children with type 1 diabetes mellitus due its complications. Paediatric residents are usually the first line whom managing paediatric emergencies in Iraqi hospitals. They form the backbone of the provided service. It is important to mak...

Introduction: Adrenal insufficiency can be caused by different factors. Biotin deficiency is either nutritional or related to synthesis/recycling defects. We are reporting a rare case of adrenal insufficiency complicating a late diagnosis of holocarboxylase synthetase deficiency in an infant who also had protein-S-deficiency, later thought to be se...

Objectives Testosterone is the main agent used to induce puberty in boys in Arab countries. It is recommended to monitor haematocrit before and during androgen replacement. However, data from single centre studies indicated that this recommendation is rarely practiced by paediatricians compared to adult physicians. The aim of this study is to evalu...

Background: The most important autoimmune disease which affects children is Type 1 Diabetes Mellitus (T1DM). The main risk factor for this chronic condition is genetic that contributed to loci within the HLA complex. Even, the environmental issues triggering the disease are still unclear so this study aimed to identify the most important risk facto...

https://youtu.be/gd8o9fxxvmA The talk is recorded and available on my YouTube Channel

عام منذ بداية الجائحة، والناس في خضمّ تحديات جديدة وتغيّات حياتية غير معتادة، فمنذ الإعلان عن الجائحة في مارس 2020 قامت عدة مدن كبيرة في دول مختلفة بالاغلاق التام حينًا، والحضر الجزئي حينًا آخر مع التعليمات الواردة من المؤسسات الصحية بتقليص عدد العيادات الخارجية والاقتصار على المرضى ذوي الاحتياجات الاسعافية الطارئة. لكن ماذا حصل للأطفال الذي يعيشون...

Introduction: DKA is one of the leading causes of mortality and morbidity among children with type 1 diabetes mellitus and a very frequently encountered medical emergency. Establishing a high level of knowledge about the appropriate management details of DKA is crucial among training residents. Objectives: This article aims to assess the level of k...

Introduction: The art of medicine glorifies when a clinician listens carefully to the patient's story, gives a thorough examination, performs appropriate investigations, and finally links findings together to reach a definite diagnosis. An interesting case was reported here, highlighting the integration of different symptoms and manifestations wit...

University of Cincinnati International Virtual Mini Conference with the theme, "Responding to the Global Pandemic with Research" https://ucintlconference.live/sessions/19 https://youtu.be/prFNdwe5f6U

With the population growth and increasing urban mobility, cities are getting more congested and the environment is becoming more polluted. Therefore, innovators started thinking about smart solutions, such as ride sharing or station-based carsharing or free-floating carsharing using connectivity and the Internet of things, as well as other faciliti...

Humans are social creatures. Every individual looks for an accompany to live with. Living in groups gives a feeling of strength to face the challenges. Subsequently a sense of security gets developed, for which humans feel safe to breed saving the existence of the race. The harmony between individuals in such groups creates certain environment that...

Background and aim Diabetes mellitus imposes a significant burden around the world generally and in the Middle East and North Africa specifically. Glucose monitoring is a cornerstone of diabetes management. Methods Glycated haemoglobin has always been the main metric for assessing glycaemic control, but its use is linked with multiple pitfalls. As...

In this report we are going to carry on a comparative study of the equity performance of both Pfizer Inc. and AstraZeneca Inc, through a financial analysis. They are both listed companies in the London Stock Exchange. Pfizer Inc.’s headquarter is based at the Unites States of America. It is specialised in six therapeutic areas (Anti-infectives, inf...

Study Objectives: The COVID-19 pandemic has affected the whole world in different levels from numerous aspects. This deadly, highly contagious viral infection has led to lockdown in many cities across the world; significantly disrupting previously planned educational activities. For instance, many international medical conferences were either cance...

Teamwork is defined as an efficient and effective combination of actions from a group of people. It has been considered as an essential requirement for a safe medical practice with a higher patient satisfaction. For better outcomes and sustainable productivity of the team itself Dr Hussain Alsaffar -Paediatric Endocrinologist Consultant from the Ch...

The Department of Child Health at Sultan Qaboos University Hospital, Muscat, Oman, initiated virtual clinic services in order to maintain the care given to children in outpatient clinics when the country went into lockdown on March 16th 2020

Neonatal severe primary hyperparathyroidism (NSHPT) is a rare and life-threatening autosomal recessive genetic disorder caused by a wide range of inactivating mutations in Calcium sensing receptors. We introduced a three-day-old neonate with poor feeding, failure to thrive, and lethargy. The laboratory results showed uncontrolled hypercalcemia with...

A consultancy report that provide concepts, techniques and models used for planning, managing and improving operations and information systems in contemporary organisations across a range of business sectors.. It shows some use of knowledge about operations and information management. Part A: Analysis – Business Process Models and strategy analys...

The world celebrates World Diabetes Day on the fourteenth of November annually, and this celebration began in 2006 to commemorate the two scientists, “Frederick Banting” and “Charles Best,” who discovered insulin in 1922, which is used in the treatment of diabetes. This celebration also emphasise the diagnosis, treatment and avoidance of complicati...

This report is aiming to show an evidence of applying some learned operations concepts during the first half of “Operations and Information Management” module. This exercise is to critically examine the current process design of Paediatric Diabetes Service at XX Hospital. In the first section, there will be an illustration of the operational proce...

Purpose Inducing puberty in hypogonadal patients enables achieving normal final adult height, healthy bone mass accrual and improves fertility potential. Reliable availability and access to medicines remain a challenge around the world, particularly in low income countries. We aim to study the availability/access to medications used for inducing an...

Background: Insulin requirement, measured by the total daily dose (TDD) in patients with type 1 diabetes mellitus (T1DM) is known to increase during puberty. A study from a neighbour country indicated the daily requirement is 1.02±0.33 u/kg/day for 10-18-year age group. However it was less in European study 0.93 u/kg/day for the 13 years age group....

Background: Linear growth which determines the adult height has been reported to be negatively correlating with mean HbA1c and duration of diabetes1. However other researchers could not correlate the HbA1c with any growth pattern2. Results: 105 (55 F) patients fulfilled the inclusion and exclusion criteria, aged between 2.8 to 17.3 years, mean ± s...

- Critically reviewing the gap model of service quality , and its strengths and weaknesses. - Reviewing customer relationships. - Evaluating the linkages between the gaps model of service quality and customer relationships.

Physiological actions of Thyroid hormone (TH) are mediated through TH alpha and TH beta receptors. Resistance to thyroid hormone is characterized by a lack of peripheral tissues' response to the active form of thyroid hormone. TH receptor beta has been extensively studied. Mutations in this receptor were considered the main reason for Thyroid hormo...

Abstract Objectives There are some variations in the practice of puberty induction between different regions; however, data from Arab countries are lacking. We aimed to survey the practice of pediatric endocrinologists in Arab countries on the timing and regimen for puberty induction in girls and boys with hypogonadism. Methods An online questionn...

Knowledge and Understanding 1. Through critical analysis of current and future issues in strategic marketing management, assess how marketing is managed internally and externally by organisations from different sectors and how such organisations are impacted by issues in sustainability, business ethics and corporate social responsibility; 2. Criti...

Dear Medical and Nursing Colleagues from different specialities in different countries I will be grateful if you can respond to this 2-minute survey, which is aiming to capture an idea about the scientific and academic activities during COVID-19 pandemic. Please feel free to share with your colleagues. Thank you https://www.surveymonkey.com/r/PH...

In this article, a review of a two issues considered to be humanitarian and ethical, were observed during the COVID-19 pandemic. In the midst of these exceptional circumstances that humankind is going through, it is necessary to think about moral standards that do not prioritise age, wealth, political status over the human life and dignity. https...

X-linked hypophosphatemia (XLH) is the most common form of inherited hypophosphatemic rickets. Phosphate wasting results in weak, soft and deformed bones, impaired growth, and affected mobility. It is mainly caused by a loss of function mutation in PHEX gene that leads to elevated fibroblast growth factor-23 which mediates the phosphate wasting. Du...

http://www.ijmbs.org/downloadpdf.asp?issn=1947-489X;year=2019;volume=11;issue=3;spage=131;epage=131;aulast=Alsaffar;type=2

http://abstracts.eurospe.org//hrp/0092/hrp0092P3-183 Introduction: The Middle East and North Africa (MENA) region has witnessed increasing number of researchers over last decade; for example, in-between 2015 and 2016, the number of researchers (in full time equivalent) per 1 million inhabitants was 2.4K in UAE, 1.1K in Morocco, 680 in Egypt, 604 i...

Introduction: Primary adrenal insufficiency in paediatrics is uncommon but lethal condition, it results most commonly from congenital adrenal hyperplasia1. Short Synacthen Test (SST) is widely used to assess the glucocorticoid synthesis in the adrenal glands. Synacthen doses are age-based; 62.5mcg for babies younger than 6months, 125mcg for infants...

Introduction: More than 1,106,500 worldwide children were living with type1 diabetes mellitus (T1DM) in 20171. Researchers concluded that better glycaemic control is associating with lesser complications of this chronic condition. Target HbA1c is recommended to be <48mmol/mol(<6.5%) and <53mmol/mol(<7%) as per NICE and ISPAD respectively2. The glyc...

Background: Type2 diabetes mellitus(T2DM)is a worldwide epidemic. It is less common in paediatrics compared to adults. Obesity is still one of the leading risk factors. The following case describes an adolescent female was diagnosed with T2DM found to have polycystic ovary syndrome (PCOS). The aim of this case report is to raise the awareness of he...

Longstanding hypothyroidism can lead to reduce glomerular filtration rate leading to reduce creatinine clearance

X-linked hypophosphatemia (XLH) is an inherited disorder characterized by low levels of phosphate in the blood. Phosphate levels are low because phosphate is abnormally processed in the kidneys, which causes urinary phosphate wasting and leads to rickets in the young patients and osteomalacia in adults in addition to several other complications the...

https://www.endocrine-abstracts.org/ea/0058/ea0058p016 Background: Disorders of sexual development (DSD) are estimated to occur in every 1 in 4500 births. This project builds upon previous work by the authors to explore the knowledge and management of paediatric junior doctors in a single deanery. The majority of junior doctors stated that they wo...

Background: The factory calibrated FreeStyle Libre (FSL) flash glucose monitoring system has been recently introduced for use in patients with diabetes mellitus. There are no reports available regarding its use in patients with congenital hyperinsulinism (CHI). We have assessed the accuracy of FSL compared to the finger prick capillary blood gluco...