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Mineralogy of atmospheric suspended dust in three indoor and one outdoor location in Oman.

The aim of this work is to characterize the mineral phases present in the atmosphere at three locations in northern Oman. Samples of atmospheric particles were collected using a high volume sampler. Three indoor and one outdoor location were chosen in this investigation. Sampling locations included a residential house located nearby the cement plant, a residential house located nearby a refinery plant, and a residential house located at Al-Suwayq residential area. Indoor air was sampled from these three houses. Moreover, for the Al-Suwayq residential house, sampling was also taken outside the house for comparison. The dust samples were analysed for their microanalysis characterization and their mineral contents as well. The microanalysis enabled us to identify the metals present in the particles. Furthermore, the mineralogical analysis of the sample filters showed the presence of quartz as the principal phase inside the house of Al-Suwayq, whereas quartz, dolomite, and gypsum were common phases outside the house. In the residential house nearby the cement plant, it was found that calcite, quartz, dolomite and goethite were the principal phases whereas the particles collected from the house nearby the refinery composed primarily of dolomite and calcite. The airborne dust collected at the refinery and Al-Suwayq were probably sourced in the natural environment and mobilised by natural processes. However, at the cement factory the crushing and grinding of limestone during the industrial process has contributed significantly to the airborne dust load. Generally, the information obtained in this study will be invaluable as no data for the mineral content of atmospheric dust existed in the Oman.

Air Pollutants↗

Creutzfeldt-Jakob disease in Oman: report of two cases.

Sporadic Creutzfeldt-Jakob disease (CJD) was diagnosed in two Oman Arab men, aged 50 and 75 years respectively, both with a history of rapidly developing dementia and myoclonic jerks. Illness developed over a period of 3 months in the first case and over six months in the second. Electroencephalography in both subjects showed periodic triphasic sharp waves characteristic of CJD. In neither case was it possible to obtain a brain biopsy or perform autopsy (autopsy is contrary to Islamic practice in the Middle East), however, electrophoresis of cerebrospinal fluid from the second patient revealed the distinctive double protein spots characteristic of CJD. This is the first report of CJD from Oman.

Aged↗

A report on the composition of mercurials used in traditional medicines in Oman.

A brick red powder, used by a 'native physician' (a practitioner of traditional medicine in Oman) to treat a female patient for vitiligo, has been analysed by X-ray powder diffraction and scanning electron microscopy (S.E.M.). It was found to be a mixture of cinnabar (HgS) and calomel (Hg2Cl2). Symptoms of acute mercury poisoning resulted from the patient repeatedly breathing in elemental mercury vapour after this brick red powder and elemental mercury encased in a lime, were thrown on an open fire in a closed room. The patient also presented with central nervous system toxicity which improved gradually after treatment with Dimercaprol was discontinued. The use of mercurials as traditional medicines in Oman is briefly reviewed; as is the variation in literature values for 'normal'/'abnormal'/toxic levels of mercury in human blood.

Adult↗

Neonatal screening for hearing impairment--The Oman experience.

BACKGROUND: Oman introduced universal hearing screening at a national level in 2002 after piloting it in limited regions. Authors present their experiences. METHODS: The screening had three phases. In Phase I, trained health staff of the delivery suits screened newborns by transient evoked otoacoustic emissions (TEOAE) test. In Phase II, otologists examined ears and repeated hearing tests after 6 weeks. Those who failed the repeat test were referred to a tertiary unit for the Phase III. Audiometrists tested their hearing by an Automated Auditory Brainstem Response (AABR). The rates of hearing disabled, false positive, yield and cost of screening were estimated. RESULTS: The coverage of Phase I was 66.6% (21,387/32,125) and it had significant regional variation. Two thousand two hundred and eighty-seven (10.7%) newborns were suspected with hearing impairment. We detected 262 (1.2%) children with hearing impairment. In Phase II, 55 (0.26%) neonates failed the test. In Phase III, 36 neonates were tested with ABR. Eleven were lost to follow up and eight children were advised to undergo further investigations. Ten children were found normal and 26 had hearing impairment. Six neonates had sensory-neuronal hearing loss, 17 children had otitis media with effusion and three children had atresia of the middle ear. The yield of hearing screening was 1.2/1000. The cost of screening was US$7.1/newborn. CONCLUSION: Universal hearing screening in Oman was useful but had teething problems. Proper planning, advocacy to the health staff and parents, commitment of the staff and care of the equipment are important. Such screening should be complimented with a defaulter retrieval and rehabilitation facilities for the hearing disabled.

Ear↗

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

The composition and spatial distribution of aliphatic and polycyclic aromatic hydrocarbons (PAHs) were investigated in biota and coastal sediments from four countries surrounding the Gulf (Bahrain, Qatar, United Arab Emirates and Oman). The levels of total petroleum hydrocarbons (TPH), aliphatic unresolved mixture and PAHs in sediments and biota were relatively low compared to world-wide locations reported to be chronically contaminated by oil. Only in the case of the sediments collected near the BAPCO oil refinery in Bahrain, having concentrations of 779 microg g(-1) total petroleum hydrocarbon equivalents and 6.6 microg g(-1) Sigma PAHs, can they be categorized as chronically contaminated. Some evidence of oil contamination was also apparent in sediments and bivalves around Akkah Head and Abu Dhabi in the UAE, and near Mirbat in Oman. Contaminant patterns in sediments and biota indicated that the PAHs were mainly from fossil sources, with the exception of the high PAH concentrations in sediments near the BAPCO refinery that contained substantial concentrations of carcinogenic PAH combustion products.

Animals↗

Molecular basis for the apparent mineralocorticoid excess syndrome in the Oman population.

11beta-Hydroxysteroid dehydrogenase type 2 (11beta-HSD2) plays a crucial role in converting hormonally active cortisol to inactive cortisone, thereby conferring specificity upon the mineralocorticoid receptor (MR). Mutations in the gene encoding 11beta-HSD2 (HSD11B2) account for an inherited form of hypertension, the syndrome of "Apparent Mineralocorticoid Excess" (AME) where cortisol induces hypertension and hypokalaemia. We report five different mutations in the HSD11B2 gene in four families from Oman with a total of 9 affected children suffering from AME. Sequence data demonstrate the previously described L114Delta6nt mutation in exon 2 and new mutations in exon 3 (A221V), exon 5 (V322ins9nt) and for the first time in exon 1 (R74G and P75Delta1nt) of the HSD11B2 gene. These additional mutations provide further insight into AME and the function of the 11beta-HSD2 enzyme. The prevalence of monogenic forms of hypertension such as AME remains uncertain. However, our data suggests AME may be a relevant cause of hypertension in certain ethnic groups, such as the Oman population.

11-beta-Hydroxysteroid Dehydrogenases↗

Poliomyelitis in Oman. II. Toward eradication.

In the past decade, the Sultanate of Oman has experienced three outbreaks of paralytic poliomyelitis--a widespread polio type 1 epidemic in 1988/1989, four cases of polio type 3 in three different regions in 1991, and a localized type 1 outbreak in 1993. The lessons learnt from each of these epidemics have guided us to modify and improve our polio eradication activities. Currently, these activities include administration of five primary and three booster doses of trivalent oral polio vaccine, yearly national immunization campaigns (NIDs) since 1995 with coverage of >90%, localized immunization campaigns, acute flaccid paralysis (AFP) surveillance which involves reporting of all cases by facsimile to the Department of Surveillance within 24 h of detecting a case and weekly zero reporting from 22 sentinel sites, and virological testing of stool specimens of all AFP cases and their close contacts at the national, World Health Organization accredited laboratory. The cumulative success of these activities has resulted in Oman being free from polio for the past 6 years. However, the possibility of importation of wild poliovirus, particularly from southern and western Asia still exists.

Adolescent↗

Capillary gas chromatography determination of aliphatic hydrocarbons in fish and water from Oman.

Aliphatic hydrocarbon residues were monitored in two fish species, Indian mackerel (Rastrelliger Kanaguria) and Indian scad (Decapterus russelli) collected from local markets in three different cities in Oman. Residues were also monitored in water samples collected from two sites of the Gulf of Oman. Sampling was conducted twice, in July and again in February to have a thorough understanding of the dynamics of aliphatic hydrocarbon residues. Results indicated the presence of petrogenic aliphatic hydrocarbons ranging from C12-C28 in fish and water samples alike. Fish and water chromatograms were characterized by an unresolved complex mixture (UCM), a confirmatory sign of petrogenic origin of monitored hydrocarbons. Residue levels showed some variations related to sampling sites and time of sampling.

Animals↗

Women's autonomy, education and employment in Oman and their influence on contraceptive use.

Since 1970 political and economic changes have brought about great improvements in health and education in Oman, and since 1994 the government has provided free contraceptives to all married couples in primary health care centres. Despite rapid socio-economic development, the fertility rate was 4.2 in 2001. The aim of this study was to define baseline data on ever-married women's empowerment in Oman from a national study in 2000, analyse the correlates of women's empowerment and the effect of empowerment on unmet need for contraception. Two indicators of empowerment were used: women's involvement in decision-making and freedom of movement. Bivariate analysis was used to link these measures and their proxies, education and employment status, with use of a family planning method. Education was a key indicator of women's status. Unmet contraceptive need for women exposed to pregnancy was nearly 25%, but decreased significantly with educational level and paid employment. While empowered women were more likely to use contraception, women's education was a better predictor of "met need" than autonomy, as traditional factors and community influence remain strong. For nearly half the 1,830 women in the study, the husband decided whether contraception was used. Fewer than 1% were using contraception before their first child as women are expected to have a child within the first year of marriage.

Adult↗

Annual direct medical cost and contributing factors to total cost of epilepsy in Oman.

OBJECTIVES: To describe the pharmaceutical use, health care resource utilisation patterns, and annual direct medical cost of epilepsy as well as determining the impact of various demographic and clinical characteristics on total costs of epilepsy in Oman. METHODS: Medical and pharmacy data were collected for 6 months on all patients aged > or =13 years attending the Sultan Qaboos University Hospital. Unit pharmacy and medical costs were retrieved for each patient, and multiple linear regression was utilised to analyse the impact of various demographic and clinical characteristics on total cost. RESULTS: A total of 486 patients were seen over the study period. Annual direct medical costs of epilepsy amounted to 1,426 US dollars. In-patient care, the antiepileptic drug (AED) lamotrigine and specialist visits, respectively, were the first, second and third most significant predictors of total cost. Age was associated positively, and was the most significant predictor of total costs among demographic and clinical parameters. CONCLUSIONS: This analysis, the first economic study of epilepsy in Oman, could assist in health care allocation of scarce resources and in pharmacoeconomic analysis of AEDs. Besides in-patient admission, our findings demonstrate that the newer drugs are significant predictors of total cost, and hence any incremental benefits derived from them must be rigorously assessed for their cost-effectiveness.

Adolescent↗

Isolation and identification of arboviruses from the Sultanate of Oman.

Sentinel herds and a vector surveillance system were used to identify the presence of arboviruses in Oman. Two strains of bluetongue virus (BTV) serotype 4 and two strains of Akabane virus, were isolated and identified. Both BTV isolates and one Akabane virus isolate came from goats while the second Akabane isolate came from Culicoides imicola. This is the first isolation of an Akabane virus from Culicoides in Arabia. Vector competence studies with the Oman viruses in laboratory reared C. variipennis showed that after oral infection both viruses replicated in Culicoides and were maintained at high titre for at least 10 days post infection.

Animals↗

Bluetongue in the Sultanate of Oman, a preliminary epidemiological study.

A group specific agar-gel immunodiffusion test was used to demonstrate that there is a frequent and widespread distribution of bluetongue virus throughout the Sultanate of Oman. The Culicoides midges C. imicola and C. schultzei, both capable of transmitting bluetongue group viruses, were recorded throughout the year. Although these studies did not establish that bluetongue is enzootic in Oman, type-specific neutralizing antibody results supported previous evidence for the existence of a Saudi Arabian bluetongue ecosystem. Variations in antibody evidence of virus activity within a restricted locality suggested a hot-spot theory concerning the perpetuation of the virus.

Animals↗

First report of Albizia lebbeck dieback caused by Scytalidium dimidiatum in Oman.

Over 200 Albizia lebbeck trees at Sultan Qaboos University campus wilted and died. The symptoms were dieback of large branches due to infection by Scytalidium dimidiatum. The fungus has also infected Ficus benghalensis, F. carica, F. retusa, Thespesia populnea, Delonix regia and Peltophorum petrocarpum. This is the first report of the fungus in Oman and on A. lebbeck, T. populnea, D. regia and P. petrocarpum. The strain of this fungus has not been found to cause human disease in Oman.

Fabaceae↗

Crimean-congo haemorrhagic fever: a seroepidemiological and tick survey in the Sultanate of Oman.

In 1995 and 1996, 4 persons from the Sultanate of Oman were confirmed with clinical Crimean-Congo haemorrhagic fever (CCHF). To assess the prevalence of CCHF virus infection in Oman, a convenience sample of imported and domestic animals from farms, abattoirs and livestock markets was examined by enzyme-linked immunosorbent assay (ELISA) for immunoglobulin G (IgG) antibodies to CCHF virus. Ticks were collected from selected animals, identified, pooled by species, host and location and tested for evidence of infection with CCHF virus by antigen-capture ELISA. Serum samples from individuals working in animal and nonanimal contact-related jobs were also tested for CCHF antibodies. Serological evidence of infection was noted in 108 (22%) of 489 animals. Most of the ticks collected (618 of 912) from all species of sampled livestock were Hyalomma anatolicum anatolicum, a competent vector and reservoir of CCHF virus. 243 tick pools were tested for CCHF antigen, and 19 pools were positive. Of the individuals working in animal contact-related jobs, 73 (30.3%) of 241 non-Omani citizens and only 1 (2.4%) of 41 Omani citizens were CCHF antibody-positive. Butchers were more likely to have CCHF antibody than persons in other job categories. The presence of clinical disease and the serological results for animals and humans and infected Hyalomma ticks provide ample evidence of the presence of CCHF virus in yet another country in the Arabian Peninsula.

Adolescent↗

Deliberate self-poisoning in Oman.

OBJECTIVE: To describe the demographics, precipitating factors, substances and methods used for deliberate self-harm in Oman. METHODS: Data were extracted from the Accident and Emergency (A & E) records of patients treated at the A & E units in Muscat from 1993 to 1998. Data were obtained form the history, and clinical findings resulting form deliberate self-harm. RESULTS: During the 5-year study period, 123 persons presented to various hospitals in the Muscat area with injuries that resulted form deliberate self-harm. Most of these cases were women, students and unemployed. There was a high incidence of family, marital and psychiatric or social problems. The methods of self-harm were most often analgesics (such as paracetamol) and non-pharmaceutical chemicals. CONCLUSIONS: The rate of self-injurious behaviour is low in Oman, compared with other countries, including other Islamic countries. The data illustrate a rising rate and a tendency to ingest toxic doses of analgesics or non-pharmaceutical chemicals.

Acculturation↗

Ecological and molecular studies on emerging schistosomiasis mansoni in Dhofar Governorate, Sultanate of Oman.

The recent detection of some cases of autochtonous schistosomiasis mansoni in Dhofar, Oman, prompted a search for the transmission sites. The five field surveys we conducted from November 2000 to February 2002 provided ecological data on schistosomiasis in Dhofar. Twenty-eight water bodies situated within 8-160 km from Salalah, the largest city of Dhofar and at altitudes of up to 900 m, were surveyed for freshwater snails. Biomphalaria arabica was found in 15 of them. Three sites (Tibraq, Siginitti and Arazat) had Schistosoma infected snails, the first snails shedding cercariae of this parasite ever collected in Oman. The parasite from Dhofar was analysed by Random Amplified Polymorphic DNA comparisons using 11 primers and 167 polymorphic fragments and had 87-88% similarity with Schistosoma mansoni from Guadeloupe, but only 37-38% similarity with S. rodhaini from Burundi. Thus, it is a strain of S. mansoni. During the November 2000 survey, the prosobranch snail Melanoides tuberculata was associated with B. arabica in 10 of the 13 B. arabica sites. Cercariae from other species of Digenea emerged from five of the B. arabica sites, including the three named above. This paper presents the first finding of S. mansoni in the Dhofar Governorate and represents an initial study of the biology of S. mansoni transmission. This parasite and its cycle need further biological and molecular characterization, and the clarification of its epidemiological status in Dhofar Governorate is an urgent task.

Animals↗

Increasing prevalence of diabetes mellitus in Oman.

AIMS: To determine the prevalence of diabetes mellitus and impaired fasting glucose by age, gender, and by region and compare results with the 1991 survey; and estimate previously undiagnosed diabetes mellitus in the Omani population. METHODS: Cross-sectional survey containing a probability random sample of 5838 Omani adults aged >or= 20 years. Diabetes and impaired fasting glucose (IFG) were assessed by fasting venous plasma glucose using 1999 World Health Organization's diagnostic criteria (normoglycaemia < 6.1 mmol/l, IFG >or= 6.1 but < 7 mmol/l,and diabetes >or= 7 mmol/l). The 1991 survey was reanalysed using the same diagnostic criteria, and results were compared. RESULTS: In 2000, the age-adjusted prevalence of diabetes among Omanis aged 30-64 years reached 16.1% (95% confidence interval (CI) 14.7-17.4) compared with 12.2% (95% CI11.0-13.4) in 1991. IFG was found among 7.1% (95% CI6.2-8.1) of males and 5.1% (95% CI 4.4-6.0) of females. Generally, diabetes was more common in urban then rural regions. Only one-third of diabetic subjects knew that they had diabetes. Nearly half of the study population had a body mass index > 25 kg/m2. CONCLUSIONS: The prevalence of diabetes is high in Oman and has increased over the past decade. The high rate of abnormal fasting glucose together with high rates of overweight and obesity in the population make it likely that diabetes will continue to be a major health problem in Oman. Primary prevention programmes are urgently needed to counteract major risk factors that promote the development of diabetes.

Adult↗

Incidence and spectrum of congenital heart disease in Oman.

We analysed the incidence and spectrum of congenital heart disease (CHD) in the Sultanate of Oman from 1994 to 1996. CHD was detected in 992 of 139,707 live births (incidence 7.1/1000 live births). The common CHDs were ventricular septal defect (24.9%), atrial septal defect (14.4%) and patent ductus arteriosus (10.3%). The frequency of atrioventricular septal defects (5.9%) was higher than reported from other countries. Age at diagnosis was under 1 month in 38% and 1-12 months in 40%. Cyanotic CHD was found in 21.7% of the whole group and 35% of neonates. Although this was a hospital-based study, we believe we included almost all the infants and children with CHD in the country. The incidence and pattern of CHD in Oman were similar to those reported from developed countries in Europe and America, except for a higher frequency of atrioventricular septal defects. The high prevalence of consanguinity in the country did not affect the overall incidence of CHD.

Health Services↗