Sultan Qaboos University Medical Journal

Sultan Qaboos University Medical Journal

Basic info

  • Publisher: Sultan Qaboos University
  • Country of publisher: oman
  • Date added to EuroPub: 2017/Sep/12

Subject and more

  • LCC Subject Category: Biochemistry, Biomedicine, Medicine
  • Publisher's keywords: Medicine, Biomedicine, Community Health, Family Medicine, Health Sciences, Biochemistry
  • Language of fulltext: english
  • Full-text formats available: PDF

Publication charges

  • Article Processing Charges (APCs): No
  • Submission charges: No
  • Waiver policy for charges? No

Editorial information

Open access & licensing

  • Type of License: CC BY
  • License terms
  • Open Access Statement: Yes
  • Year open access content began: 1999
  • Does the author retain unrestricted copyright? False
  • Does the author retain publishing rights? False

Best practice polices

  • Permanent article identifier: DOI
  • Content digitally archived in: LOCKSS
  • Deposit policy registered in: None

This journal has '1136' articles

Myasthaenia Gravis Clinical management issues before, during and after pregnancy

Myasthaenia Gravis Clinical management issues before, during and after pregnancy

Authors: Ali Hassan | Department of Neurology, King Fahd Hospital, University of Dammam, Khobar, Saudi Arabia, Zakia M. Yasawy| Department of Neurology, King F...
( 18 downloads)
Abstract

Myasthaenia gravis (MG) is an autoimmune neuromuscular disorder which is twice as common among women, often presenting in the second and third decades of life. Typically, the frst trimester of pregnancy and frst month postpartum are considered high-risk periods for MG exacerbations. During pregnancy, treatment for MG is usually individualised, thus improving its management. Plasma exchange and immunoglobulin therapies can be safely used to treat severe manifestations of the disease or myasthaenic crises. However, thymectomies are not recommended because of the delayed benefcial effects and possible risks associated with the surgery. Assisted vaginal delivery—either vacuum-assisted or with forceps—may be required during labour, although a Caesarean section under epidural anaesthesia should be reserved only for standard obstetric indications. Myasthaenic women should not be discouraged from attempting to conceive, provided that they seek comprehensive counselling and ensure that the disease is under good control before the start of the pregnancy.

Keywords: Myasthenia Gravis, Pregnancy, Postpartum Period, Neonatal Myasthenia Gravis, Disease Management
Controversies in Odontogenic Tumours Review

Controversies in Odontogenic Tumours Review

Authors: Pooja Siwach| Department of Oral Pathology & Microbiology, Government Dental College & Hospital, Mumbai, Maharashtra, India, Tabita Joy| Department of...
( 17 downloads)
Abstract

Odontogenic tumours are lesions that occur solely within the oral cavity and are so named because of their origin from the odontogenic (i.e. tooth-forming) apparatus. Odontogenic tumours comprise a variety of lesions ranging from non-neoplastic tissue proliferations to benign or malignant neoplasms. However, controversies exist regarding the pathogenesis, categorisation and clinical and histological variations of these tumours. Te recent 2017 World Health Organization classifcation of odontogenic tumours included new entities such as primordial odontogenic tumours, sclerosing odontogenic carcinomas and odontogenic carcinosarcomas, while eliminating several previously included entities like keratocystic odontogenic tumours and calcifying cystic odonogenic tumours. Te aim of the present review article was to discuss controversies and recent concepts regarding odontogenic tumours so as to increase understanding of these lesions.

Keywords: Neoplasms, Oral Cavity, Odontogenic Tumors, Hamartomas, Classifcation, World Health Organization
The Roles and Performance of Professional Driving Instructors in Novice Driver Education

The Roles and Performance of Professional Driving Instructors in Novice Driver Education

Authors: Zulhaidi M. Jawi| Department of Vehicle Safety & Biomechanics, Malaysian Institute of Road Safety Research, Kajang, Selangor, Malaysia, Baba M. Deros|...
( 18 downloads)
Abstract

Tis review article aimed to analyse existing literature regarding the roles and performance of professional driving instructors (PDIs) in novice driver education (DE). A systematic classifcation scheme was adopted to analyse identifed articles to determine the study context of PDIs in novice DE, the competency level of PDIs in relation to experienced and learner drivers and the contributions of PDIs to the novice driver learning process. A total of 14 original research articles were identifed, with no systematic reviews or meta-analyses available. Overall, all of the articles were found to be inadequate in providing an in-depth understanding of the roles and performance of PDIs in novice DE. Tere is an urgent need to improve current understanding of the roles of PDIs in novice DE and to work towards an internationally recognised PDI management approach.

Keywords: Public Health Systems Research, Safety, Accident Prevention, Automobile Driving, Automobile Driver Examination
First Cytogenetic Profle of Omani Patients with de novo Myelodysplastic Syndromes Comparison with data from Asia, Africa, Europe and North and South America

First Cytogenetic Profle of Omani Patients with de novo Myelodysplastic Syndromes Comparison with data from Asia, Africa, Europe and North and South America

Authors: Achandira M. Udayakumar| Departments of Genetics, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman; Department of Maligna...
( 19 downloads)
Abstract

Clonal cytogenetic abnormalities have been reported among 30–80% of patients with myelodysplastic syndromes (MDS); however, 20–70% of patients with MDS show a normal karyotype that may nevertheless harbour a cryptic genetic alteration. Earlier reports have suggested that the distribution of specifc chromosomal aberrations varies among Western and Asian countries, with geographical and ethnic differences in the frequency of specifc chromosomal aberrations. Tis article compared the cytogenetic data of 36 adult Omani patients with MDS to previously reported data from other populations. Differences were noted between the percentages of clonal aberrations and the median age of Omani subjects at presentation in comparison to individuals of different ethnicities and from various geographical locations. To the best of the authors’ knowledge, this is the frst report to describe the cytogenetic data of patients with MDS from Oman.

Keywords: Cytogenetic Abnormalities, Chromosomal Aberrations, Myelodysplastic Syndromes, Population Heterogeneity, Ethnic Groups, Oman
In Vitro Cysteine Reactivates Organophosphate Insecticide Dichlorvos-Inhibited Human Cholinesterases

In Vitro Cysteine Reactivates Organophosphate Insecticide Dichlorvos-Inhibited Human Cholinesterases

Authors: Hamidreza Mohammadi| Pharmaceutical Sciences Research Center, Hemoglobinopathy Institute and Department of Toxicology & Pharmacology, Faculty of Pharm...
( 18 downloads)
Abstract

Objectives: Organophosphate (OP) pesticides inhibit both red blood cell (RBC) and plasma cholinesterases (ChEs). Oximes, especially pralidoxime (2-PAM), are widely used as antidotes to treat OP poisoning. In addition, N-acetylcysteine (NAC) is sometimes used as an adjuvant antidote. Te current study aimed to assess the feasibility of using NAC as a single therapeutic agent for OP poisoning in comparison to in vitro 2-PAM. Methods: Tis study was carried out at the Razi Drug Research Center of Iran University of Medical Sciences, Tehran, Iran, between April and September 2014. A total of 22 healthy human subjects were recruited and 8 mL citrated blood samples were drawn from each subject. Dichlorvos-inhibited blood samples were separately exposed to low and high doses (fnal concentrations of 300 and 600 μmol.L-1, respectively) of 2-PAM, NAC and cysteine. Plasma and RBCs were then separated by centrifugation and their ChE activity was measured using spectrophotometry. Results: Although cysteine—and not NAC—increased the ChE activity of both plasma and RBCs over those of dichlorvos, it did not increase them over those of a high dose of 2-PAM. Conclusion: Tese results suggest that the direct reactions of 2-PAM and cysteine with dichlorvos and the reactivation of phosphorylated ChEs occurr via an associative stepwise addition-elimination process. High therapeutic blood concentrations of cysteine are needed for the elevation of ChE activity in plasma and RBCs; however, both this agent and NAC may still be effective in the reactivation of plasma and RBC ChEs.

Keywords: Organophosphate Poisoning, Antidotes, Cysteine, N-Acetylcysteine, Pralidoxime Compounds, Cholinesterases
Trends and Outcomes of Non-Small-Cell Lung Cancer in Omani Patients Experience at a university hospital

Trends and Outcomes of Non-Small-Cell Lung Cancer in Omani Patients Experience at a university hospital

Authors: Muhammad Furrukh| Department of Medicine, Shifa College of Medicine, Islamabad, Pakistan, Shiyam Kumar| Department of Medicine, Sultan Qaboos Universi...
( 18 downloads)
Abstract

Objectives: Te incidence of lung cancer in Oman has shown a gradual but defnitive increase since 2002. Tis study aimed to evaluate the demographic and epidemiological characteristics and survival outcomes of patients with non-small-cell lung cancer (NSCLC) at a university hospital in Oman. Methods: Tis study was conducted from January to June 2016. A retrospective analysis was performed of consecutive patients diagnosed with NSCLC presenting to the Sultan Qaboos University Hospital (SQUH) in Muscat, Oman, between March 2000 and December 2015. Clinical features at presentation and prognostic and predictive markers were reviewed. Kaplan-Meir estimates were used to determine relapse-free survival, progression-free survival (PFS) and overall survival (OS). Results: A total of 104 patients presented to SQUH during the study period. Te median age at diagnosis was 64 years. Overall, 62 patients (59.6%) had adenocarcinomas. Only 12 patients (11.5%) presented in the early stages (I or II) of the disease and the majority of patients had an Eastern Cooperative Oncology Group performance status of 1 (27.9%) or 2 (26.0%). Te prevalence of epidermal growth factor receptor mutations was 27.9%. Te median PFS for patients with advanced disease (stages III or IV) was fve months and the median OS for all patients was seven months. After fve years, 50.0%, 60.0%, 10.0% and 8.0% of patients with disease stages I, II, III and IV, respectively, were alive. Conclusion: Patients with NSCLC in Oman were found to present at an advanced stage. However, patient outcomes were similar to those reported in the USA.

Keywords: Non-Small-Cell Lung Carcinomas, Adenocarcinomas, Epidermal Growth Factor Receptor, Patient Outcome Assessment, Survival Analysis, Oman
Impact of Educational Activities in Reducing Pre-Analytical Laboratory Errors A quality initiative

Impact of Educational Activities in Reducing Pre-Analytical Laboratory Errors A quality initiative

Authors: Hamed Al-Ghaithi| Department of Haematology, Sultan Qaboos University Hospital, Anil Pathare| Department of Haematology, Sultan Qaboos University Hosp...
( 16 downloads)
Abstract

Objectives: Pre-analytic errors during diagnostic laboratory investigations can lead to increased patient morbidity and mortality. Tis study aimed to ascertain the effect of educational nursing activities on the incidence of pre-analytical errors resulting in non-conforming blood samples. Methods: Tis study was conducted between January 2008 and December 2015. All specimens received at the Haematology Laboratory of the Sultan Qaboos University Hospital, Muscat, Oman, during this period were prospectively collected and analysed. Similar data from 2007 were collected retrospectively and used as a baseline for comparison. Non-conforming samples were defned as either clotted samples, haemolysed samples, use of the wrong anticoagulant, insufcient quantities of blood collected, incorrect/lack of labelling on a sample or lack of delivery of a sample in spite of a sample request. From 2008 onwards, multiple educational training activities directed at the hospital nursing staff and nursing students primarily responsible for blood collection were implemented on a regular basis. Results: After initiating corrective measures in 2008, a progressive reduction in the percentage of non-conforming samples was observed from 2009 onwards. Despite a 127.84% increase in the total number of specimens received, there was a signifcant reduction in non-conforming samples from 0.29% in 2007 to 0.07% in 2015, resulting in an improvement of 75.86% (P <0.050). In particular, specimen identifcation errors decreased by 0.056%, with a 96.55% improvement. Conclusion: Targeted educational activities directed primarily towards hospital nursing staff had a positive impact on the quality of laboratory specimens by signifcantly reducing pre-analytical errors.

Keywords: Healthcare Quality Assurance, Quality Control, Specimen Handling, Blood Specimen Collection, Hematology, Oman
Effectiveness of Prophylactic Cervical Cerclage in Prolonging Higher-Order Multiple Pregnancies

Effectiveness of Prophylactic Cervical Cerclage in Prolonging Higher-Order Multiple Pregnancies

Authors: Nail Obeidat| Departments of Obstetrics & Gynecology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan, Haifa Alchalabi...
( 17 downloads)
Abstract

Objectives: Tis study aimed to assess the value of prophylactic cervical cerclage in prolonging higherorder multiple pregnancies. Methods: Tis retrospective study included all women with higher-order multiple pregnancies beyond 24 gestational weeks treated at the King Abdullah University Hospital in Irbid, Jordan, and King Fahad Medical City in Riyadh, Saudi Arabia, between February 2014 and January 2015. Selected maternal characteristics and obstetric outcomes were compared between women who received prophylactic cervical cerclage and those who did not. Results: A total of 146 women with higher-order multiple pregnancies were included in the study; of these, 94 (64.4%) underwent a prophylactic cervical cerclage insertion procedure and 52 (35.6%) women did not. No signifcant difference was found between the two groups with regards to maternal age, parity or number of fetuses. However, the mean gestational age at delivery was signifcantly higher for women without compared to those with prophylactic cervical cerclage (32.9 weeks versus 31.7 weeks) according to both univariate and multivariate analyses (P = 0.013 and 0.046, respectively). Additionally, 40.4% of women without and 14.9% of women with prophylactic cervical cerclage gave birth after 34 gestational weeks (P = 0.003). Conclusion: Overall, prophylactic cervical cerclage was not associated with prolongation of the pregnancy among women with higherorder multiple pregnancies in the current study.

Keywords: Multiple Pregnancies, Preterm Births, Cervical Cerclage, Prophylactic Surgical Procedure, Jordan, Saudi Arabia
Synoptic Versus Narrative Reporting of Prostate Biopsies at a Tertiary Healthcare Institution Challenges, successes and expectations

Synoptic Versus Narrative Reporting of Prostate Biopsies at a Tertiary Healthcare Institution Challenges, successes and expectations

Authors: Nnamdi O. Orah| Department of Anatomic & Molecular Pathology, Lagos University Teaching Hospital, Yaba, Lagos, Nigeria, Nucleus Diagnostic Center, Iga...
( 19 downloads)
Abstract

Objectives: Cancer pathology reports are expected to contain all information required for patient management and disease surveillance. Moreover, reports for patients with prostate cancer have become increasingly complex with the addition of more pathological details. Tis study aimed to compare narrative and synoptic prostate cancer reports for core needle biopsies received at a tertiary hospital in Nigeria in order to determine which form was most complete according to international standards. Methods: Tis study was conducted from January 2010 to December 2015 at the Lagos University Teaching Hospital, Lagos, Nigeria. All malignant prostate cancer histopathology reports received during this period were analysed for the presence of important clinicopathological parameters, including the numbers of cores taken and those involved by the tumour, percentage of tumour involvement, Gleason score and the presence of high-grade prostatic intraepithelial neoplasms (HGPINs) and perineural and lymphovascular invasion. Results: A total of 83 reports were reviewed, of which 27 were in narrative and 56 in synoptic format. Te documentation of clinicopathological characteristics in narrative reports was signifcantly incomplete compared to synoptic reports in recording the number of cores (33.3% versus 96.4%), number of cores involved by the tumour (11.1% versus 94.6%), percentage of cores involved by the tumour (3.7% versus 100.0%) and the presence of HGPINs (7.4% versus 100.0%) and perineural (59.3% versus 98.2%) and lymphovascular (48.1% versus 100.0%) invasion (P <0.001 each). Conclusion: Synoptic reports of malignant prostate cancer biopsies received at the Lagos University Teaching Hospital were found to contain more complete information than narrative reports.

Keywords: Pathology, Biopsy, Prostate Cancer, Prostatic Intraepithelial Neoplasia, Nigeria
Neurology Research in Saudi Arabia Urgent call for action

Neurology Research in Saudi Arabia Urgent call for action

Authors: Hussein Algahtani| Department of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia& King Abdulaziz Medical City,...
( 18 downloads)
Abstract

Objectives: Research activities in Saudi Arabia are promoted at the governmental and institutional levels. However, the output and quality of research conducted in the feld of neurology has not yet been measured quantitatively. Tis study therefore aimed to analyse neurology-related publications from Saudi Arabia. Methods: Tis study was conducted in January 2016. A systematic search using the PubMed® search engine (National Library of Medicine, Bethesda, Maryland, USA) was conducted to identify all neurology-related articles published from Saudi Arabia between January 1996 and December 2015. Results: A total of 1,292 neurologyrelated publications were identifed. Neurology research increased linearly with time, with most publications originating from Riyadh (67%) and the university sector (≈47%). However, most neurology-related articles were published in journals which had an impact factor of <1 (55%). Conclusion: Neurology research in Saudi Arabia has increased substantially over the last 20 years. However, as most articles were published in low-impact journals, the quality of research remains inadequate and should be improved. It is important that an ofcial research culture be established in both governmental and private universities as well as colleges and health institutions in Saudi Arabia. Te formation of clinical academic departments staffed by research experts is recommended to ensure the quality of neurology research output.

Keywords: Neurology, Research, Publications, Journal Impact Factor, Saudi Arabia
Relationship Between Medication Adherence and Health Beliefs Among Patients with Hypertension in Oman Pilot study

Relationship Between Medication Adherence and Health Beliefs Among Patients with Hypertension in Oman Pilot study

Authors: Huda Al-Noumani| Departments of Adult Health & Critical Care, Sultan Qaboos University, Muscat, Oman, Jia-Rong Wu| Department of Adult Health, School...
( 17 downloads)
Abstract

Objectives: Te prevalence of hypertension (HTN) in Oman is alarmingly high and patient adherence to antihypertensive medications is inadequate. Tis study aimed to assess the relationship between medication adherence and health beliefs among Omani patients with HTN. Methods: Tis descriptive cross-sectional pilot study was conducted in December 2015 and included 45 patients with HTN recruited from four primary health centres in Al Dakhiliyah and Muscat governorates, Oman. Medication adherence and health beliefs were assessed using the Morisky Medication Adherence Scale (MMAS), Beliefs about Medicines Questionnaire, Brief Illness Perception Questionnaire and the revised Medication Adherence Self-Efcacy Scale. Results: Te mean MMAS score was 5.3 ± 2.0, with 48.9% of patients reporting high adherence. Higher self-efcacy and stronger beliefs regarding medication necessity were signifcantly related to adherence (P = 0.012 and 0.028, respectively). Conclusion: Te fndings of this pilot study emphasise the role of health beliefs with regards to Omani patients’ adherence to antihypertensive medications.

Keywords: Hypertension, Health Behavior, Medication Adherence, Self Efcacy, Oman
Bilateral Diaphragmatic Paralysis Following Paediatric Cardiac Surgery Experience of four cases at the Royal Hospital, Muscat, Oman

Bilateral Diaphragmatic Paralysis Following Paediatric Cardiac Surgery Experience of four cases at the Royal Hospital, Muscat, Oman

Authors: Said A. M. Al-Hanshi| Paediatric Intensive Care Unit, Royal Hospital, Muscat, Oman, Mohammed H. R. Al-Ghafri| Paediatric Intensive Care Unit, Royal Ho...
( 20 downloads)
Abstract

Bilateral diaphragmatic paralysis (BDP) is a rare complication of paediatric cardiac surgery. We report four children who developed BDP following cardiac surgery who were managed at the Royal Hospital, Muscat, Oman, between 2009 and 2014. All four children suffered severe respiratory distress soon after extubation and required re-intubation within two hours. In addition, all of the children underwent a tracheostomy as an interim method for ventilation. Te four children were successfully weaned from positive pressure ventilation following the functional recovery of at least one side of the diaphragm.

Keywords: Diaphragmatic Paralysis, Heart Disease, Cardiac Surgical Procedures, Paediatrics, Case Series, Oman
Secondary Adrenal Insuffciency Due to the Co-Administration of Ritonavir and Inhaled Fluticasone Propionate Case report

Secondary Adrenal Insuffciency Due to the Co-Administration of Ritonavir and Inhaled Fluticasone Propionate Case report

Authors: Ali Al-Maqbali| Department of Communicable Disease Surveillance & Control, Directorate General of Health Services, Ministry of Health, Al Batinah Nort...
( 17 downloads)
Abstract

Ritonavir is a powerful inhibitor of the cytochrome P450 3A4 (CYP3A4) isoenzyme. It is used as a pharmaceutical enhancer in the management of HIV-positive patients. However, when co-administered with other drugs that are metabolised via the CYP3A4 pathway, ritonavir can potentially cause serious drug-drug interactions. Inhaled fluticasone propionate, which is used to treat asthma and chronic obstructive airway disease, is particularly prone to such interactions due to its physiological attributes. We report a HIV-positive 48-year-old male patient who presented to Al Nahdha Hospital, Muscat, Oman, in 2012 with weight loss, generalised weakness and fatigue and diagnosed with secondary adrenal insufciency as a result of concomitant ritonavir and inhaled fluticasone.

Keywords: Human Immunodefciency Virus, Ritonavir, Fluticasone, Drug Interactions, Adrenal Insufciency, Case Report
Use of a Minimally Invasive Cardiac Output Monitor to Optimise Haemodynamics in a Patient with Mitral Valve Disease Undergoing Cerebrovascular Surgery

Use of a Minimally Invasive Cardiac Output Monitor to Optimise Haemodynamics in a Patient with Mitral Valve Disease Undergoing Cerebrovascular Surgery

Authors: Ali M. Al-Mashani| Departments of Neurosurgery, Intensive Care Unit & Pain Management, Khoula Hospital, Muscat, Oman, Niranjan D. Waje| Department of...
( 22 downloads)
Abstract

Patients with mitral valve disease undergoing cerebrovascular surgery face increased inherent risks due to their associated cardiac comorbidities. As such, the anaesthetic management of such patients is distinctly challenging. Simultaneous consideration of both the cerebrovascular and underlying cardiac conditions determines key anaesthetic issues, as fluids and vasopressors or inotropes need to be titrated according to haemodynamic variables in order to optimise cerebral blood flow without compromising cardiac function. We report a 45-yearold female patient with mild mitral stenosis and moderate-to-severe mitral regurgitation who presented to the Khoula Hospital, Muscat, Oman, in 2016 following a ruptured anterior communicating artery aneurysm requiring urgent surgical intervention. As highlighted in this case, the VolumeView EV1000™ (Edwards Lifesciences, Irvine, California, USA) system is a minimially invasive haemodynamic monitor that can help immensely in the perioperative management of such patients.

Keywords: Anesthesia, Cerebral Aneurysm, Mitral Valve Stenosis, Mitral Valve Regurgitation, Hemodynamics, Cardiac Output

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