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PubMed2004

Distribution of heavy metals in marine bivalves, fish and coastal sediments in the Gulf and Gulf of Oman.

An assessment of marine contamination due to heavy metals was made in the Gulf and Gulf of Oman based on marine biota (fish and various bivalves) and coastal sediment collected in Bahrain, Oman, Qatar, and the United Arab Emirates (UAE) during 2000-2001. Sediment metal loadings were generally not remarkable, although hot spots were noted in Bahrain (Cu, Hg, Pb, Zn) and on the east coast of the UAE (As, Co, Cr, Ni). Concentrations of As and Hg were typically low in sediments and the total Hg levels in top predator fish commonly consumed in the region were < 0.5 microg g(-1) and posed no threat to public health. Very high Cd concentrations (up to 195 microg g(-1)) in the liver of some fish from southern Oman may result from food-chain bioaccumulation of elevated Cd levels brought into the productive surface waters by upwelling in the region. Very high As concentrations (up to 156 microg g(-1)) were measured in certain bivalve species from the region. Although not certain, the As is probably derived from natural origins rather than anthropogenic contamination.

Animals↗
PubMed1999

Prevalence of myopia in school children in the Sultanate of Oman: a nation-wide study of 6292 randomly selected children.

PURPOSE: Between 1992 to 1994 in the Sultanate of Oman, 6292 randomly selected school children from Grade 1 (6-year-olds) and Grade 6 (12-year-olds) were examined for visual acuity. The purpose of this paper is to present results that relate to the prevalence of myopia in this population. METHODS: All children with uncorrected visual acuity below 0.5 in one or both eyes received a thorough eye examination including cycloplegic retinoscopy. RESULTS: In the 6-year-olds there was an overall myopia (> or =-1.0 D) of 0.56% and in the 12-year-olds there was 5.16%. In rural, remote areas there was statistically significantly less myopia in the older group when compared with the rest of the country. In the town of Nizwa in the region of Dakhlia, the value for high myopia (> or =-7.0 diopters) in 12-year-old girls was 2.82% compared to an average prevalence 0.13%. CONCLUSION: In the Sultanate of Oman the prevalence of myopia showed consistency with findings in Europe and North America. There was significantly less myopia in remote areas. An increased prevalence of high myopia was seen in one of Oman's major cities.

Child↗
PubMed1996

The frequency of posterior urethral valves in Oman.

OBJECTIVE: To ascertain the frequency of posterior urethral valves (PUV) in Oman, using hospital records. MATERIALS AND METHODS: The resident population of Oman is 1.5 million and all complex paediatric surgical cases are referred to a single unit in the capital city of Muscat. A register of patients has been kept in that unit since 1988. Hospital case-records were reviewed to determine associated abnormalities, date and place of birth, tribal origin and, from further interviews, the family pedigree and degree of consanguinity. RESULTS: This retrospective survey identified 56 Omani children born between 1989 and 1994 who were treated in the Paediatric Surgery Department at the Royal Hospital, Muscat for congenital PUV. The calculated incidence was 1 in 2375 newborn males, which is 2-4 times higher than that previously reported in other populations. There was no relation to the estimated month of conception and therefore environmental hyperthermia due to the extreme ambient temperature does not seems not to be a causative factor. There was consanguinity in 40 of 46 cases (87%) where a complete family history was available. Parents were first cousins in 54% of cases, compared with the background rate of 24% in over 6000 families interviewed in the antenatal clinics at six hospitals in Oman. There was also a concentration of PUV within specific tribes. About one-third of the cases also had associated congenital abnormalities, the most frequent of which were genitourinary (17%), but gastrointestinal (9%) and spinal (7%) defects were also observed. CONCLUSION: The frequency of PUV in newborn Omani males was 1 in 2375, which is considerably higher than any previously reported series. This was associated with an increased rate of consanguinity, but there was no clear pattern of inheritance.

Child↗
PubMedDate not supplied

A study of consanguinity in the Sultanate of Oman.

Omani society has a long tradition of consanguinity, which goes back to pre-Islamic times. The aim of the present study was to determine the prevalence of consanguineous marriage and the mean coefficient of inbreeding in Oman. Consanguinity rates among 60,635 couples (20.8% of the national population of childbearing age) were determined on the basis of a questionnaire in major delivery units. In this large survey, which included all sections of the community, 24.1% of marriages were reported between first cousins and 11.8% of marriages were between second cousins. In addition, a further 20.4% of marriages were contracted within specific tribal groupings. Because of the strictly endogamous nature of the tribal groups in Oman, all marriages would be expected to be consanguineous to some degree, albeit at a level beyond that of second cousins (F < or = 0.0156). To obtain a more detailed picture of the patterns of consanguinity, and to assess the validity of the questionnaire-based study, 500 pedigrees were investigated in detail. The mean coefficient of inbreeding (alpha) in these pedigrees was 0.0204, compared with 0.0198 in the larger survey, suggesting that the data were broadly comparable and confirming the high degree of consanguinity in the population of Oman.

Consanguinity↗
PubMedDate not supplied

Managing overutilization, quality of care, and sustainable health care outcomes in Oman.

The health care system in Oman is facing a major challenge in managing escalating health care costs. One of the reasons for the dramatic increase in health care cost is overutilization. This article explores the problem of overutilization in Oman and its effect on sustaining the quality of health care. A review of the literature is used to develop a comprehensive model in controlling overutilization that is more applicable to the health system in Oman. Efforts to control costs and increase quality are discussed for possible implementation.

Health Facilities↗
PubMed1999

Permanent neonatal diabetes mellitus: clinical presentation and epidemiology in Oman.

AIM: To estimate the accurate incidence and prevalence of permanent neonatal diabetes mellitus, and to determine the clinical profile of this condition in the Sultanate of Oman. METHODS: All children diagnosed as having permanent neonatal diabetes mellitus between 1991 and 1995 in Oman were included in the study. RESULTS: The mean incidence was 2.2 per 100 000 live births/year and the prevalence among under 5s during 1995 was 2.0/100 000. Intrauterine growth retardation was noted in all (mean birthweight 1.86 kg), and diabetic ketoacidosis (mean plasma glucose 34.4 (SD 8.7) mmol/l, mean pH 7.17 (SD 0.09) in 80%. Hypertriglyceridaemia (mean serum triglyceride 19.06 (6.13) mmol/) was constant. No infant had clinical or immunological evidence of congenital viral infections. None had C-peptide excretion or circulating islet cell antibody during diagnosis or follow up. The other important features were parental consanguinity in all, HLA DR3/DR4 association in 80%, development of autoimmune hypothyroidism in one and observation of autoimmune disorders (insulin dependent diabetes mellitus and Hashimoto's thyroiditis) in family members. CONCLUSIONS: These findings strongly suggest an immune mediated aetiology for diabetes mellitus. The reported incidence of permanent insulin dependent neonatal diabetes mellitus in Oman is the highest in the world.

Consanguinity↗
PubMed2004

Establishing the Diploma in Tropical Medicine and Hygiene (DTM&H) course in the Sultanate of Oman.

Until 1997, there was no formal teaching in tropical medicine in Arabian Peninsular countries, although many tropical diseases (for example, malaria, schistosomiasis, leishmaniasis, filariasis), are endemic in the region. A six month, part time Diploma in Tropical Medicine and Hygiene (DTM&H) course was established in the Sultan Qaboos University, Muscat, Sultanate of Oman, in 1997, for small groups of Omani doctors wishing to sit the annual DTM&H examination in London. To date, 21 doctors have been successful, and the Royal College of Physicians of London has accredited the Tropical Medicine School in Oman as an appropriate training centre for the examination. Since over 20 doctors apply each year for the six available places in the course, a full time DTM&H course for larger groups of doctors, from Oman and regional countries, is under consideration.

Education, Medical, Graduate↗
PubMed1998

Ophthalmomyiasis in Oman: a case report and comments.

A case of external ophthalmomyiasis caused by the first instar larvae of the sheep nasal botfly (Oestrus ovis) has been reported for the first time from the Sultanate of Oman, Southern Arabia. Sixty larvae were removed from the left eye of a 21-year-old male student, who acquired the infection during a field trip. The manual removal of larvae using a swab stick was the only effective treatment. The larval characteristics are described with illustrations, and the status of O ovis ophthalmomyiasis in the Middle East is discussed. The folk treatment administered for fly-mediated ophthalmomyiasis in Oman is also reported. Ophthalmomyiasis may not be a serious public health problem in Oman, but a nationwide survey of all myiases may be worthwhile.

Adult↗
PubMed2005

Visual disabilities among diabetics in Oman.

OBJECTIVE: The magnitude, determinants of visual impairment, bilateral blindness and low vision among diabetics in Oman were estimated as part of Oman Diabetic Eye Study 2002. This study presents the outcomes and additional risk of visual impairment in diabetics. METHODS: A cross-sectional study of 2,520 randomly selected diabetics was conducted in 2002 in 10 regions of Oman. The sample was represented by 5,564 diabetics referred for eye checks. Ophthalmologists noted the vision and ocular manifestations of diabetes. Physicians reported the systemic manifestations of diabetes. The magnitude of visual disabilities, bilateral blindness, legal blindness and low vision were estimated and compared to the rates in the population. RESULTS: The prevalence of visual impairment in diabetics was 28.4% (95% confidence interval [CI] 27.20-29.57). It was 34.6% (95% CI 32.93 to 36.32) in females and 21.2% (95% CI 19.59 to 36.32) in males. The prevalence increased in age. The prevalence of bilateral blindness (vision <0.05) was 0.7%, legal blindness 9.8% (vision <0.1) and low vision 27.7% (vision <0.5). CONCLUSION: The risk of visual impairment is 25 times more in diabetics than in the Omani population. Therefore, to prevent further increase of visual disabilities, the national health program should prioritize the eye care in diabetics and the predictors of visual disabilities should be further investigated.

Cross-Sectional Studies↗
PubMed1988

Microbiological and serological studies on caprine pneumonias in Oman.

Eight of 10 typical cases of contagious caprine pleuro-pneumonia in Oman yielded strain F38-like mycoplasmas from the lungs in high titre, but no other mycoplasmas: both negative animals had been treated with tylosin shortly before death. Among 21 other lungs examined three of six cases of acute pneumonia yielded Mycoplasma ovipneumoniae; one also yielded M capricolum. M ovipneumoniae was also isolated from all eight cases of chronic pneumonia sampled from an abattoir, and from the lungs of three animals which died without overt signs of pneumonia. A single isolate of M arginini and three of unidentified mycoplasmas were also obtained from goats with and without pneumonia. Various bacterial species were isolated, none of which predominated. Antibodies to M mycoides subspecies capri (M m capri) and strain F38 were detected in sera from eight different sources. Assuming titres of 1 in 40 or more as positive in the indirect haemagglutination test used, 29 per cent of 422 serum samples had antibodies to M m capri alone, 2.6 per cent to strain F38 alone and 3.6 per cent to both organisms. These results confirm the presence of F38-like mycoplasmas in Oman, and indicate also widespread infection with M m capri. The role of the latter in caprine pneumonias in Oman requires elucidation.

Animals↗
PubMed1994

Poliomyelitis in Oman: acute flaccid paralysis surveillance leading to early detection and rapid response to a type 3 outbreak.

Countries are increasingly requesting guidance on carrying out acute flaccid paralysis (AFP) surveillance, aimed at detecting and confirming all cases of acute paralytic poliomyelitis. The experience of Oman provides many lessons in this respect. AFP surveillance in Oman was established systematically. First, an epidemiologist was assigned to coordinate surveillance, and a laboratory for performing polio-virus isolation was identified. Next, operational guidelines for AFP surveillance were developed and widely promoted among health staff. The quality of the system has been monitored for more than 3 years with selected performance indicators. From January 1990 to April 1993, 49 AFP cases were reported, corresponding to an average annual rate of 2.1 AFP cases per 100,000 children aged less than 15 years. A total of 98% of the AFP cases were investigated within 48 hours of being reported; two stool samples were obtained from 94% of the cases. Following complete investigation, nearly a third of the reported AFP cases were classified as being clinically compatible with Guillain-Barré syndrome. Four AFP cases, all reported in 1991, were confirmed to be due to wild type 3 poliovirus. Because AFP surveillance detected these cases rapidly, Oman was able to carry out outbreak control measures promptly and more than 350,000 extra doses of oral poliovirus vaccine were delivered to children under 6 years of age.

Adolescent↗
PubMed2005

Chlorinated hydrocarbons in marine biota and coastal sediments from the Gulf and Gulf of Oman.

The spatial distribution of various organochlorinated compounds was investigated in the Gulf and Gulf of Oman based on marine biota (fish and various bivalves) and coastal sediment collected in Bahrain, Oman, Qatar and the United Arab Emirates (UAE) during 2000-2001. Several potential organic contaminants from agricultural (e.g., DDT and its breakdown products, lindane, endrin, dieldrin, endosulfan) and industrial (PCBs) sources were measured. Sediment burdens for all compounds, even for an apparent hot spot near a refinery in Bahrain, were amongst the lowest reported for surface sediments from other seas. Concentrations of DDTs were low in the muscle and liver of all fish (orange spotted grouper and the spangled emperor) analysed. Similarly, the levels of chlorinated hydrocarbons were low in the various bivalve species, notably rock oysters and pearl oysters. These results contribute to the sparse regional database for organochlorinated compounds in the marine environment. Moreover, they can be used as the most recent end point for elucidating temporal trends. Whereas the levels, albeit relatively low, SigmaDDTs in the rock oysters from the Gulf of Oman have remained uniform, there has been an irregular but generally decreasing trend in concentrations of summation SigmaPCBs during the last two decades.

Animals↗
PubMed2004

Treatment results of neo-adjuvant chemotherapy in advanced head and neck cancer in Oman.

BACKGROUND AND OBJECTIVES: A prospective, single-arm study was carried out to evaluate the safety and efficacy of neo-adjuvant chemotherapy in advanced head and neck cancer (HNC) in Oman. MATERIALS AND METHODS: The study was carried out in the Oncology and Ear, Nose and Throat (ENT) Departments, Muscat, Oman between October 1998 and December 2001. Eligible, previously untreated patients with confirmed diagnosis of locally advanced non-metastatic carcinoma of the head and neck were examined. A maximum of three cycles of neo-adjuvant chemotherapy (Cisplatin 100mg/m2 Day 1 plus 5-Fluorouracil 1gm/m2 continuous infusion for four days) were administered, followed by radical radiotherapy according to primary site. The main end-points were toxicity, response rate, disease-free survival and overall survival. RESULTS: Seventy-three patients (45 males and 28 females) were eligible; all were evaluable for response and toxicity. The median age of studied patients was 52 years (range: 17-83 years). Forty-four patients (60%) had stage III disease and 29 (40%) had stage IV disease. After neo-adjuvant chemotherapy, Overall Response (OR) [Complete Response (CR) + Partial Response (PR)] was observed in 50 patients (68%), 33 patients (45%) had clinical CR and 17 patients (23%) had PR. Sixteen patients (22%) showed Stable Disease (SD) and 7 patients (10%) progressed while on chemotherapy. After completion of radiotherapy, the OR rate was 80%. Forty patients (55%) had clinically confirmed CR, 18 (25%) had PR, 9 patients (12%) had SD and 6 patients (8%) had progressive disease (PD). The median follow-up period was 16 months (range 3-48 months). The initial response to chemotherapy had a significant effect on survival (p= 0.011). The nasopharyngeal primary was significantly associated with high CR and longer survival (p= 0.01 and 0.02 respectively). CONCLUSIONS: Head and neck carcinoma is not a common malignancy in Oman. The treatment results with cisplatin and 5-FU compare favorably to similar international studies and treatment-related toxicities are tolerable.

Journal Article↗
PubMed2005

Surgery in Oman.

During the past 3 decades, Oman (a sultanate), a country with deep-rooted history, culture, and traditions, has undergone a remarkable transformation and modernization in all fields, including education and health care. It has progressively established a nationwide network of modern health services that are accessible even at the village level and have ranked Oman with the developed world. More than 300 surgeons provide a full range of surgical services for a population of 2.5 million. Medical education is firmly established, and accredited surgical residency training has assumed increasing importance during the past decade. Given the sustained growth and dynamic planning, the surgical services will continue to develop, with Omani surgeons playing an increasing role in the future.

Delivery of Health Care↗
PubMed1990

Copper deficiency and posterior paralysis (Shalal) in small ruminants in the Sultanate of Oman.

A posterior ataxia or paralysis in goats and sheep is a syndrome known as Shalal within the Sultanate of Oman. An investigation was carried out into the etiology of the syndrome. Samples of blood and tissues were obtained from normal and Shalal-affected goats and sheep. Samples of feed were collected from the affected areas of the Sultanate. Chemical analyses of samples showed that affected animals suffered from severe copper deficiency in spite of sufficient copper contents in feed. However, concentrations of sulphur and iron in the feed were high. It was concluded that the Shalal syndrome in Oman is the condition generally known as swayback or enzootic ataxia caused by conditioned copper deficiency. The deficiency is probably due to copper-sulphur and copper-iron interactions in the rumen, enhanced by feeding of fresh roughage containing rumen degradable proteins.

Animal Feed↗
PubMed1980

A comparison of the complement fixation and immunofluorescent antibody tests in a survey of the prevalence of Babesia equi and Babesia caballi in horses in the Sultanate of Oman.

The incidence of antibodies to Babesia equi and B. caballi in horses in the Royal Stables of His Majesty the Sultan of Oman was assessed by complement fixation (CF) and immunofluorescent antibody (IFA) tests. Two series of samples taken with a 2-year interval, mainly from animals reared in Oman, indicated a stable but high prevalence of antibodies. On the 2 occasions 94.6 and 97.7% respectively were positive to B. equi by IFA and 76.8 and 75.0% were positive by CF. For B. caballi the corresponding percentage figures were lower--67.9 and 40.9 by IFA and 30.4 and 40.9 by CF. A group of animals tested within 4 months of importation gave 60.4% positive reactions by IFA and 62.5% by CF to B. equi; 6.3% positive to B. caballi by IFA and 8.3% by CF. These figures are consistent with the probable relative prevalence of the parasites. The discrepancy between the results obtained by the 2 serological tests was probably due to the greater sensitivity of the IFA test and the faster decay of the antibodies detectable by the CF test.

Animals↗
PubMed2004

An application and evaluation of the CAL3QHC model for predicting carbon monoxide concentrations from motor vehicles near a roadway intersection in Muscat, Oman.

The CAL3QHC model was used to predict carbon monoxide (CO) concentrations from motor vehicles at an existing urban intersection (Star Cinema in Muscat area, Oman). The CO concentrations predicted from the model were compared with those measured in the field. Predicted average CO concentrations were found to compare favorably with measured values obtained at all eight receptors considered within the modeled intersection. In general, the comparison indicates good agreement with some underprediction for CO. For receptor 6, the model overpredicts the average CO concentration. This overprediction is associated with the presence of trees and green area in the location of receptor 6. In general, the measurements and the model results indicated that the highest CO concentrations were found to occur close to the intersection and, hence, a decrease in the concentration levels was seen as the distance from the road increased. The results indicated that the levels of CO were well below the ambient air quality standard and that probably no health risk was present in areas adjacent to the star cinema intersection. However, the predicted worst-case 1-h CO concentrations assuming inversion atmospheric stability conditions (class F) and wind speed of 1 m/s indicated that the levels of CO were close to or higher than the Oman's National Ambient Air Quality Standards (NAAQS) value of 35 ppm at all receptors considered. The results of this study are useful in transport development and traffic management planning.

Air Pollutants↗
PubMed2006

[Microbial keratitis: a 4 year study of risk factors and traditional/complementary medicine in Oman].

PURPOSE: To determine the risk factors and the influence of complementary/alternative medicines (CAM) for infectious keratitis in a monsoon-free region of the Sultanate of Oman. STUDY DESIGN: Retrospective single center cohort study. OUTCOME MEASURES: Demographic data, risk factors, and pathogens. METHODS: Patients with purulent stromal keratitis admitted from 2001-2004 were evaluated for clinical and microbiological data, CAM use, duration of hospitalization, and outcome of treatment. STATISTICS: chi(2)-test, Z-test. RESULTS: A total of 320 patients (326 eyes) out of 7,524 admissions had severe infectious stromal keratitis requiring inpatient treatment. The average age was 35.1+/-2.5 years (range 1.5-63 years), the male:female ratio was 2:3 in the age group >or=13 years and 2:1 in the age group <or=12 years. Unsuccessful treatment by traditional healers prior to presentation was recorded for 203 patients (62.3%). Ocular risk factors included severe trachomatous dry eye conditions, meibomianitis and soft contact lens overwear. Systemic compromising risk factors were diabetes mellitus and medical immunosuppression. A total of 215 patient eyes (66%) had delayed or no healing (therapy drop-outs), and hospitalization (45 days) was significantly prolonged compared to the 111 antibiotic responders (26 days) (p<0.001). All eyes of patients with prior CAM had worse vision at admission and after therapy (p<0.001), and 97 eyes of patients with uncontrolled diabetes (p<0.001) and 68 eyes of patients with immunosuppression (p<0.001) had a poor visual outcome (vision <0.1). Thirteen eyes perforated. A negative microbiological result correlated with worse final vision (p<0.05). All 13 perforated eyes had received prior CAM (p<0.001). CONCLUSIONS: Trachoma, trauma and contact lens overwear are significant risk factors for infectious keratitis in Oman and correlate with specific age groups. Delay in treatment due to the first-line utilization of CAM showed a significant adverse impact on outcome.

Adolescent↗