prevalence and characteristics of frequent attenders in primary health care in A'Dakhiliyah governorate of Oman

Objectives: Frequent attenders [FAs] in general practice receive significant attention in primary care research due to the financial costs associated with the higher utilization of health care services. The main objective of this study was to determine the prevalence of FAs in Oman by studying the overall rates of adult patient visits to primary health care centers [PHCs] and identify the characteristics of this group of patients

Methods: We conducted a retrospective longitudinal study including all adults aged 18 years and above who visited general practitioner clinics at four selected PHCs in the A'Dakhiliyah governorate of Oman. Sociodemographic data and number of visits were extracted from the electronic medical records system

Results: A total number of 12 902 adult patients contributed to 42 425 patient visits, with the number of visits made by individual patients ranging from 1 to 62. FAs constituted 2.4% [n = 313] of the total subjects and made 5449 [12.8%] visits. The mean rate of visits per patient per year was 3.2, while the median was two visits. The overall rate of visits per day was more than two-times higher in females [79.6 per day] compared to males [36.6 per day] and was about five-times higher in female FA [12.3 vs. 2.6]

Conclusions: FAs represent a small proportion of patients attending PHCs in Oman. The proportion of females was higher among FAs and they also contributed to a higher number of visits to PHCs

asthma clinics in primary healthcare centres in oman do they make a difference?

Objectives: This study aimed to determine the effect of newly established asthma clinics [ACs] on asthma management at primary healthcare centres [PHCs] in Oman

Methods: This retrospective crosssectional study was conducted between June 2011 and May 2012 in seven PHCs in the Seeb wilayat of Muscat, Oman. All >/=6-year-old asthmatic patients visiting these PHCs during the study period were included. Electronic medical records were reviewed to determine which clinical assessment and management components had been documented

Results: A total of 452 asthmatic patients were included in the study. The mean age was 35 +/- 21 years old [range: 6.95 years] and the majority [57%] were female. In total, 288 [64%] cases were managed at ACs and 164 [36%] were managed at general clinics [GCs]. Significant differences were noted in the documentation of cases managed at ACs compared to those at GCs, including history-taking information regarding signs and symptoms [91% versus 19%; P <0.001], trigger factors [79% versus 16%; P <0.001] and a history of atopy [81% versus 17%; P <0.001], smoking [61% versus 7%; P <0.001], asthma exacerbations [73% versus 10%; P <0.001] or previous admissions [63% versus 10%; P <0.001]. Furthermore, prescription rates of inhaled corticosteroids [72% versus 61%; P = 0.021] and short-acting Beta-agonists [93% versus 82%; P = 0.001] were significantly higher at ACs compared to GCs

Conclusion: Overall, the findings indicated that ACs have had a positive impact on asthma management at the studied PHCs

Characteristics of chronic pain patients attending a primary health care center in Oman

Objectives: To determine the characteristics of patients presenting with chronic pain in a primary health care setting in Oman

Methods: A retrospective cross-sectional study was carried out including all patients aged >/= 18 years who attended Sultan Qaboos University Health Center during 2010. Patients were identified to have chronic pain if they were prescribed an analgesic medication for at least three months. Patients were compared to a control group which consisted of age- and gender-matched patients with no chronic pain

Results: Out of 6 609 patients, 241 [3.6%] were found to have chronic pain. The mean age of patients with chronic pain was 54.0 +/- 13.0 years. The majority of patients were female [n = 174; 72.1%], and most were Omani [n = 201; 83.4%]. The prevalence of chronic pain was found to be significantly higher among females compared to males [4.5% vs. 2.5%; p < 0.001] and also among Omani nationals to non-nationals [83.4% vs. 70.1%; p < 0.001]. Chronic pain was significantly associated with the following comorbidities; diabetes [33.1% vs. 20.7%; p < 0.001], obesity [35.2% vs. 26.5%; p = 0.001], and hypertension [51.0% vs. 38.5%; p = 0.002]. Osteoarthritis was the most common pain condition [n = 104; 43.1%]. Diclofenac was the most commonly prescribed drug [n = 168; 69.7%]

Conclusions: The findings of our study point towards a higher prevalence of chronic pain in Omani females. These patients were also found to have a higher prevalence of other common comorbid conditions

Marfan syndrome. Correct diagnosis can save lives

Marfan syndrome is a heritable disorder of the connective tissue that affects many systems of the body. However, the most serious complication in patients with Marfan syndrome is progressive enlargement of the aortic root, which may lead to aortic dissection, rupture, or aortic regurgitation. Prevention of these life threatening complications is very important in the management of this condition. A 39-year-old Omani man presented with progressive shortness of breath and eventually underwent major but successful cardiac surgery. It is very important to recognise Marfan syndrome early as preventive actions are possible if the condition is diagnosed before complications occur

Odontogenic cutaneous fistula: Report of two cases

Odontogenic cutaneous fistula or sinus is an uncommon, but well documented condition, which is often initially misdiagnosed as a sole cutaneous lesion and inappropriately treated. The misdiagnosis as a skin infection often results in inappropriate management. We here present two cases of odontogenic cutaneous fistula that were seen after being treated unnecessarily with antibiotics