ABSTRACT
Summary: A patient treated with intramuscular testosterone replacement therapy for primary hypogonadism developed blurred vision shortly after receiving his testosterone injection. The symptom resolved over subsequent weeks and recurred after his next injection. A diagnosis of central serous chorioretinopathy (CSR) was confirmed following ophthalmology review. A decision was made to change the patient's testosterone regime from this 12-weekly intramuscular injection to a daily topical testosterone gel, given the possibility that peak blood levels of testosterone following intramuscular injection were causing his ocular complaint. His CSR did not recur after this change in treatment. CSR secondary to testosterone therapy is a rare finding but has been reported previously in the literature. Learning Points: Blurred vision in patients treated with testosterone replacement therapy (TRT) should prompt an ophthalmology review. The potential for reduced risk of central serous chorioretinopathy (CSR) with daily transdermal testosterone remains a matter of conjecture. CSR is a rare potential side effect of TRT.
ABSTRACT
Introduction Food allergies have become a significant health concern worldwide, affecting individuals of all age groups. It is particularly challenging for parents who have children diagnosed with food allergies, as they bear the responsibility of managing their child's condition and ensuring their safety. This study aimed to assess the knowledge and awareness about food allergies among mothers with allergic children in the Aseer region, Saudi Arabia. Methodology A cross-sectional study design was employed, and data were collected through a structured questionnaire administered to 400 mothers. The participants were selected through convenience sampling. Descriptive statistics, including frequencies and percentages, were used to summarize the demographic characteristics, knowledge and awareness levels, prevalence of allergenic foods, manifestations of food allergies, and factors influencing food allergies. Chi-squared tests were conducted to assess associations between variables. Results The study revealed a balanced representation across different age groups among the surveyed mothers, with the highest proportion falling in the 31-40 years range. A significant proportion of mothers had a university education, indicating a relatively higher level of education among the participants. The majority of mothers were employed in governmental positions, followed by housewives and those working in the private sector. Regarding knowledge and awareness, a substantial percentage of mothers correctly identified key aspects of food allergies. However, knowledge gaps were observed, particularly in understanding the hereditary nature. The prevalence of allergenic foods varied, with seafood (fish, shrimp, and tuna) emerging as the most commonly reported allergenic foods, followed by eggs, milk, wheat, chocolate, fruits, nuts, and other food types. Manifestations associated with food allergies were reported, including skin, respiratory, eye, nasal, gastrointestinal, and other symptoms. The associations between different feeding methods and the occurrence of medically diagnosed food allergies were found to be non-significant. However, having other children with food allergies showed a highly significant association with the occurrence of food allergies in the current child. The age of introducing solid food did not demonstrate a significant association with the occurrence of food allergies. Conclusion This study provides insights into the knowledge and awareness about food allergies among mothers with allergic children in the Aseer region, Saudi Arabia. While mothers demonstrated a reasonable understanding of food allergies, knowledge gaps were identified, particularly regarding the hereditary nature. The prevalence of allergenic foods aligns with previous studies, although variations across populations should be considered. The manifestations reported by the participants corroborate known allergic reactions, necessitating further analysis.
ABSTRACT
The principal pathways serving higher visual function comprise the dorsal stream and the ventral stream. The dorsal stream runs between the occipital lobes and the parietal lobes and subserves the ability to process the whole visual scene and carry out visually guided movement. The ventral stream runs between the occipital lobes and temporal lobe tissue and primarily subserves visual recognition and memory. These tissues are susceptible to dysfunction in children with brain damage. We report a series of 40 children in whom damage to the brain has led to a common symptom complex affecting vision. Lower visual field loss was frequently elicited. This was associated with impaired ability to make accurate visually guided movement (particularly of the lower limbs) accompanied by impaired simultaneous perception, and in some cases, with inaccurate saccades and in others, impaired perception of movement. These features are consistent with parietal/dorsal stream dysfunction. Difficulty recognising faces and problems with route finding (which are ventral stream functions) were also present in a number of the children. These visual difficulties can be manifest in the presence of normal visual acuity. Recognition of these problems leads to understanding of the child's visual difficulties and facilitates adaptation of curriculum delivery at school.