ABSTRACT
Objectives: Tobacco smoking is the single most avoidable cause of morbidity and mortality around the world. Patients with psychiatric disorders tend to smoke tobacco at a higher rate than the general population, with significant adverse health consequences. This study aimed to determine the rate of tobacco smoking among psychiatric outpatients attending Sultan Qaboos University Hospital, a tertiary care hospital in Muscat, Oman
Methods: We conducted a cross-sectional study among psychiatric outpatients attending a psychiatric clinic from 1 January to 1 August 2017. The patients' demographic information, history of smoking, previous hospitalizations, and the number of and specific psychotropics used during treatment was documented. The degree of dependence on tobacco smoking was measured using the Fagerstrom test for nicotine dependence
Results: A total of 272 patients were included in this study. The overall rate of smoking among psychiatric patients was 13.6%. Patients with schizophrenia had the highest rate of smoking [22.2%], followed by those with bipolar [13.1%], and anxiety disorders [11.1%]. Patients who smoked tobacco were more likely to be admitted to the psychiatric ward than non-smokers [p < 0.050]
Conclusions: Tobacco smoking is common among psychiatric patients, a finding consistent with similar studies conducted in different parts of the world. Assessment of smoking status and its associated adverse health associations among patients with mental disorders is of paramount importance
ABSTRACT
Objectives: This study aimed to review general anaesthesia protocols for patients undergoing electroconvulsive therapy [ECT] at a tertiary care hospital in Oman, particularly with regards to clinical profile, potential drug interactions and patient outcomes
Methods: This retrospective study took place at the Sultan Qaboos University Hospital [SQUH], Muscat, Oman. The electronic medical records of patients undergoing ECT at SQUH between January 2010 and December 2014 were reviewed for demographic characteristics and therapy details
Results: A total of 504 modified ECT sessions were performed on 57 patients during the study period. All of the patients underwent a uniform general anaesthetic regimen consisting of propofol and succinylcholine; however, they received different doses between sessions, as determined by the treating anaesthesiologist. Variations in drug doses between sessions in the same patient could not be attributed to any particular factor. Self-limiting tachycardia and hypertension were periprocedural complications noted among all patients. One patient developed aspiration pneumonitis [1.8%]
Conclusion: All patients undergoing ECT received a general anaesthetic regimen including propofol and succinylcholine. However, the interplay of anaesthetic drugs with ECT efficacy could not be established due to a lack of comprehensive data, particularly with respect to seizure duration. In addition, the impact of concurrent antipsychotic therapy on anaesthetic dose and subsequent complications could not be determined
ABSTRACT
Objectives: To evaluate new residents' perceptions of their own preparedness for clinical practice and examine the associated factors
Methods: This is a cross-sectional study conducted on August 20-23, 2016. New residents accepted for postgraduate training by Oman Medical Specialty Board were asked to complete the Preparation for Hospital Practice Questionnaire [PHPQ]. Data was analyzed using the Statistical Package for the Social Sciences version 22
Results: A total of 160 residents were invited to participate in this study. Out of 160, 140 residents participated [87.5%], 70.7% were female and 59.3% were graduates from Sultan Qaboos University [SQU]. Ninety-nine percent of the graduates were either 'well prepared' or 'fairly well prepared' for hospital practice. Male residents scored higher in the confidence scale, while residents who did a postinternship general practice placement scored higher in understanding science. Graduates from Oman Medical College felt more prepared compared to graduates from SQU
Conclusions: Most of the new residents were well prepared to clinical work. Factors such as place of undergraduate study, training, and duration of internship significantly influenced the residents' perception of preparedness. Addressing these factors will enhance residents' preparedness for clinical work
ABSTRACT
Suicide is a global phenomenon in all regions of the world affecting people of all age groups. It has detrimental consequences on patients, their families, and the community as a whole. There have been numerous risk factors described for suicide including mental illness, stressful life situations, loss of social support, and general despair. The association of suicide with Islam has not been extensively studied. The common impression from clinical practice is that being a practicing Muslim reduces the risk of suicide. Another factor associated with suicide is starting a patient on antidepressants. However, this has been questioned recently. This report describes a middle-aged man with depression and multiple social stressors who survived a serious suicide attempt. The discussion will focus on the factors that lead him to want to end his life and the impact of the assumed protective factors such as religious belief and family support on this act of selfharm. Such patients can be on the edge when there is an imbalance between risk factors [such as depression, insomnia, and psychosocial stressors] and protective factors [like religious affiliation and family support]. All physicians are advised to assess the suicide risk thoroughly in patients with depression regardless of any presumed protective factor
ABSTRACT
Objectives: To evaluate the prevalence of polypharmacy in relation to gender, comorbidity, and age among elderly patients upon discharge from an academic tertiary care hospital in Muscat, Oman
Methods: This cross-sectional study was conducted at Sultan Qaboos University Hospital between February and July 2014. We reviewed the electronic medical records of elderly patients aged >/= 60 years who were admitted to any of the hospital's medical wards during the study period and collected data on age, gender, and diagnoses. We also collected information on the medications prescribed on discharge. Polypharmacy was defined as the concurrent use of >/= 5 medications
Results: A total of 431 elderly inpatients were enrolled, of which approximately 50% were female. Polypharmacy was identified in 76.3% of discharge prescriptions. Gender [adjusted odds ratio [aOR], 1.17; 95% CI 0.73, 1.88, p = 0.502] and age [aOR, 0.98; 95% CI 0.95, 1.00, p = 0.075] had no impact on polypharmacy. On the other hand, a significant association between polypharmacy and comorbidity was observed [aOR, 1.31; 95% CI 1.12, 1.54, p = 0.001]. Cardiovascular diagnosis on admission was also identified as being associated with polypharmacy [aOR, 2.66; 95% CI 1.49, 4.75, p = 0.001]. More patients had cardiovascular diseases on admission [31.0%], followed by infections [23.0%], and gastrointestinal diseases [13.0%]. The most commonly prescribed drugs on discharge were cardiovascular drugs [48.0%], followed by drugs acting on the gastrointestinal system [11.0%], endocrine system [9.2%], and nutrition and blood [7.5%]
Conclusions: The prevalence of polypharmacy among elderly medical patients discharged from our hospital was high [76.3%] and was associated with a number of comorbidities and cardiovascular disease as a cause of admission, but not with age or gender. The prevalence of polypharmacy in our institution raises significant concerns over its potential impact on patients' health outcomes and requires further investigation. Raising physicians' awareness of health implications of polypharmacy may help reduce the incidence of medication-related adverse events and improve treatment outcomes
ABSTRACT
Recent improvements in health and an increased standard of living in Oman have led to a reduction in environment-related and infectious diseases. Now the country is experiencing an epidemiological transition characterised by a baby boom, youth bulge and increasing longevity. Common wisdom would therefore suggest that Omanis will suffer less ill health. However, a survey of literature suggests that chronic non-communicable diseases are unexpectedly becoming common. This is possibly fuelled by some socio-cultural patterns specific to Oman, as well as the shortcomings of the 'miracle' of health and rapid modernisation. Unfortunately, such new diseases do not spare younger people; a proportion of them will need the type of care usually reserved for the elderly. In addition, due to their pervasive and refractory nature, these chronic non-communicable diseases seem impervious to the prevailing 'cure-oriented' health care system. This situation therefore calls for a paradigm shift: a health care system that goes beyond a traditional cure-orientation to provide care services for the chronically sick of all ages
ABSTRACT
The Objective Structured Clinical Examination [OSCE] has been a common tool of assessment in both undergraduate and postgraduate medicine, and has been reported to have both higher reliability and validity over the oral exam. In addition, another advantage is that it reduces luck by standardizing both examiners and patients. This article describes our experience in organizing and conducting an OSCE for Oman Medical Specialty Board residents in Psychiatry