Pattern of acute pancreatitis in a tertiary care center in Oman

To describe the epidemiology of acute pancreatitis in a tertiary care center in Oman. A retrospective study evaluated all adults [>18 yrs] who presented with first attack of acute pancreatitis to SQUH from 1[st] of January 2006 to 31[st] of December 2012. One hundred seventy-four patients were found. The mean age of the cohort was 44 +/- 11 years 54% [n=95] were male and 45% [n=79] were female Majority of the cases were mild [n=131] compared to moderate [n=29] and severe [n=14] Sixty six percent [n=116] of the cases were secondary to alcohol and biliary tract diseases. Alcoholic pancreatitis occurred in 53% of the males whereas biliary pancreatitis occurred in 51% of the females. Pancreatitis recurred in 40% [n=71] of the cases, especially in alcoholic pancreatitis 56 patients [32%] had complications, especially in the severe cases. The data about acute pancreatitis in Oman was similar to the Western countries. Pancreatitis occurred in males more than females. Alcoholic pancreatitis was more common in males, whereas biliary pancreatitis was more common in females. Alcoholic pancreatitis reoccurred in nearly half of the cases. Severe cases were associated with more complications and recurrence

Comparative study of ambulatory blood pressure monitoring and clinic blood pressure measurement in the risk assessment and management of hypertension

Blood pressure [BP] measurements taken in a physician's clinic do not represent readings throughout the day. Ambulatory blood pressure monitoring [ABPM] overcomes this problem by providing multiple readings with minimal interference with the patient's daily activities. The purpose of our study was to evaluate the value of ABPM in risk assessment and management of hypertension compared to office measurements. A total of 104 consecutive hypertensive patients were retrospectively studied from January 2007 to December 2009. The following data were gathered: 1] clinic BP measurements; 2] routine blood test results; 3] electrocardiography, echocardiography, and 4] 24-hour ABPM. The mean age of patients was 41.1 +/- 8.6 years and 51.9% of them male. Indications for ABPM were: suspected "white coat" hypertension [10.6%], de novo hypertension [18.2%], resistant hypertension [27.9%] and others [43.3%]. Mean daytime and nighttime BP were 134/82 and 124/73 mmHg respectively. A non-dipping pattern was reported in 64.4%. Echocardiographic evidence of left ventricular hypertrophy [LVH] and diastolic dysfunction [LVDD] was encountered in 22.1% and 29.8% respectively. ABPM parameters were significantly correlated with LVDD [P = 0.043]. Patients with proved [white coat] hypertension did not receive antihypertensive therapy. Twenty-four hour ABPM is an important yet underused tool for proper risk stratification of treated hypertensive patients. The non-dipping profile is associated with a higher incidence of diastolic dysfunction. Our collective results revealed the superiority of ABPM over office BP measurement

Safety of simvastatin and goal attainment for low-density lipoprotein cholesterol in Sultan Qaboos University Hospital

Despite the scientific evidence of reducing cardiac events with HMG Co-A reductase inhibitors [statins] therapy in both primary and secondary preventions, these therapies continue to be underutilized in patients receiving convictional care. Simvastatin, a HMG Co-A inhibitor agent, is the most commonly used statin in Sultan Qaboos University Hospital. The aim of this study is to review the safety and the effectiveness of achieving LDL-C targets with Simvastatin according to the NCEP-ATP3 guidelines in patients with different cardiovascular risk categories at Sultan Qaboos University Hospital. A retrospective chart review was conducted for 160 patients. Patients were identified by outpatient prescriptions provided by pharmacy department from April 2008 to May 2008. 98% of the patients were prescribed simvastatin 20 mg and only 2% received 40 mg. The mean age of patients was 57 years +/- 12. While 49% of the patients were male and 45% had diabetes mellitus, 50% had cardiovascular disease, 2.5% were smokers, 67% were hypertensive, and 3% had positive family history of coronary artery disease. 75% of patients were classified as high risk, 7% moderate risk and 18% low risk for coronary artery disease. Among all lipid profiles, only LDL-C was changed from baseline with simvastatin treatment in all patients [3.60 +/- 1.03 to 3.25 +/- 1.34 mmol/L]. LDL-C level at baseline was higher in the high risk group [4.11 +/- 1.06 mmol/L] compared to low and moderate risk groups [3.68 +/- 0.89, 3.42 +/- 1.15] respectively. Achievement of LDL-C goals was achieved in only 43% for high risk, 50% in moderate risk, and 90% in low risk patients. There was no significant increase in liver enzymes and creatinine kinase. This study identified that more than half of the high risk patients were not at the target LDL-C goals which place them at a continuous risk of coronary heart disease. More appropriate lipid lowering therapy using more potent statins or combination therapy should be optimized to improve achievement of LDL-C goals according to ATP-III guidelines