effect of obesity on pregnancy and its outcome in the population of Oman, Seeb Province

Objectives: The World Health Organization estimated that in 2011 worldwide 1.6 billion adults were overweight, and 400 million were obese. The obesity epidemic is a documented phenomenon and Oman is no exception. The aim of this study was to determine the effect of obesity on pregnancy and its prenatal and neonatal outcomes

Methods: A prospective cohort study was carried out among pregnant Omani women attending antenatal clinics in their first trimester in the Seeb province of Muscat, Oman

Results: A total of 700 pregnant women were enrolled in the study and were categorized according to their body mass index: 245 [35%] were normal weight, 217 [31%] were overweight, and 238 [34%] were obese. The relative risk [RR] of cesarean section among obese women compared to women of normal weight was 2.1 [95% confidence interval [CI] 1.2-3.2] and of overweight women was 1.4 [95% CI 0.9-2.3]. The risk of elective cesarean section increased to 7.5 [95% CI 1.7-32.8] in obese women and was statistically significant in the obese group. In this study, 100 women [15.7%] developed gestational diabetes [11.8% of normal weight women, 17.8% of overweight women, and 17.9% of obese women]. Miscarriages were more common among obese women 11.9% [n = 27] compared to the normal weight and overweight groups [6.7% and 9.4%, respectively]. There was a weak yet statistically significant correlation between birth weight and body mass index. The risk of macrosomia was significantly higher in obese women compared to normal weight women. To evaluate the sensitivity of the oral glucose challenge test [OGCT], the oral glucose tolerance test [OGTT] was measured in 203 participants [29%] who had a normal OGCT result. It was found that 14.5% of overweight women and 13.5% of normal weight women had an abnormal OGTT result even when their OGCT result was normal

Conclusions: Obesity is associated with an increased risk of cesarean section [especially elective cesarean], gestational hypertension, macrosomia, and miscarriage. It also increases the risk of gestational diabetes

Management of infants and children who are contacts of contagious tuberculous patients

Contact investigation and management form the key for tuberculosis [TB] control in countries with a low tuberculosis incidence. Oman, with a low TB incidence, has implemented contact investigation and management as one important strategy to control TB. However there is a lack of clear guidelines for the investigation and treatment of contacts, especially with regard to children who are contacts of TB cases. The failure to manage children in contact with infectious TB cases indicates a missed opportunity to prevent TB disease in a population which is prone to progress rapidly to severe and complicated illness. This article attempts to provide a concise and practical approach for managing infants and children who are in contact with TB patients. Essential steps in a variety of possible scenarios are briefly discussed

hospital acquired outbreak of bacillus cereus gastroenteritis, Oman

To investigate the course of a hospital acquired outbreak of Bacillus cereus gastroenteritis outbreak, and the interventions that were taken to prevent such an outbreak from occurring again. On May 3-5 2008, 58 cases of gastroenteritis were reported among patients and their attendants in a referral hospital in Oman. All affected had eaten meals served by the hospital kitchen the previous day. An outbreak investigation team conducted active surveillance and interviewed people about symptoms and food consumed on the preceding day in the hospital. Food samples from the kitchen and faecal samples from the kitchen staff and those affected were cultured. An environmental audit of the kitchen was conducted. The majority of the 58 persons affected by the outbreak were adult females, predominantly attendants of patients. 90% had diarrhoea and 10% had vomiting, usually mild. All those affected were managed symptomatically except for two patient attendants who required intravenous rehydration. The meal exposure histories implicated at least one meal from the kitchen. Many violations of basic food hygiene standards were observed in the kitchen. Toxin producing B. cereus was isolated from faeces of 3/12 [25%] patients and 19/25 [76%] of food handlers, and 35/61 [57%] of food samples from the kitchen. This is the first report of a nosocomial outbreak of foodborne B. cereus infection from this region. The importance of appropriate epidemiological and microbiological investigation and public relations management is emphasized, in addition to the need for continuing training of food handlers and rigorous enforcement of food hygiene regulations

Low birth weight as a determinant of protein energy malnutrition in 0 - 5 years' Omani children of South Batinah region, Oman

To determine the risk factors of protein energy malnourishment [PEM] among 0-5 year old children in South Batinah region, Oman. Five hundred and ninety-nine randomly selected children with PEM and 599 children without PEM were identified from the child health registers that are maintained at the primary health institutions of the study area. This case control study was conducted between March 2003 and May 2003. The information of their birth weight, birth interval, birth order, twin pregnancy, history of underweight and death among siblings, presence of congenital anomalies, breast feeding status, social problem and other ail The median birth order among PEM cases was significantly higher compared to the children without PEM [Mann Whitney test; p=0.029]. Using multivariate logistic regression technique, we found that low birth weight [odds ratio [OR] 2.32; confidence intervals [CI] 95% 1.61-3.33], higher birth order [OR 1.04; CI 95% 1.01-1.08] and sibling with history of under weight [OR 1.79 [CI 95% 0.97- 3.28]] were significant predictors of PEM. It is possible to identify children with high-risk of PEM using information on birth weight, birth order and history of PEM in sibling. This non-anthropometric method can be used as an additional tool for monitoring growth of children and formulate preventive interventions