Screening for dysglycaemia using anthropometric indices in an adult population in Oman

Background: A previous community-based cross-sectional survey conducted in a semi-urban community revealed that 44% of people aged 18+ years manifest dysglycaemia, which appears to echo the national trend. There is lack of studies examining the role of anthropometric indices in people with dysglycaemia.

Aim: We explored the screening ability of anthropometric indices, body mass index [BMI], waist circumference [WC], waist-to-hip ratio [WHR], and waist-to-height ratio [WHtR] to detect dysglycaemia in the adult Omani population based on a community-based survey conducted in 2005. The potential of anthropometric indices to detect the presence of glycaemic disorder could aid in detection, prevention and health education.

Methods: A total of 480 male and 795 female subjects aged 18+ years were included in this study. The prevalence of dysglycaemia was analysed using the American Diabetic Association criteria. Logistic regression approach and Receiver-Operating Characteristic [ROC] curve analysis was performed.

Results: The analysis revealed that mean values of age, BMI, WC, WHR and WHtR increased significantly from normoglycemic to pre-diabetic and further to diabetic in both sexes [P<0.0001]. Dysglycemia showed an increasing prevalence with age. WHtR showed the highest sensitivity for detecting dysglycemia in all age groups compared to other anthropometric indices with sensitivity rate of 94.4% in .45 years, 88.6% in [25- 44] years and 45.6% in age group <25 years

Conclusion: Among the anthropometric indices we investigated, WHtR was the best predictor of dysglycaemia among Omani adults aged > 25 years

Attention deficit hyperactivity disordern and parental factors in school children aged nine to ten years in Muscat, Oman

Objectives: The objectives of this study were to determine the prevalence of attention deficit hyperactivity disorder [ADHD] and specific parental risk factors that may contribute to the development of ADHD in children

Methods: The study was conducted in Oman among fourth-grade students [aged nine to 10 years]. A standardized Arabic version of the National Initiative for Children's Health Quality Vanderbilt Assessment Scale [Teachers questionnaire] was used to determine the presence of ADHD. Parental factors such as socioeconomic status, education, and occupation were documented

Results: The prevalence rate of ADHD was 8.8%. Poor maternal education status, low familial socioeconomic status, and paternal occupation were significantly associated with an increased risk of ADHD

Conclusions: This was the first study that examined familial and parental characteristics of children with ADHD as potential risk factors for the condition. Such psychosocial factors could be employed to further the development of more proficient preventative measures and remedial services

Daytime sleepiness among young adult omani car drivers

Objectives: Sleepiness and fatigue play significant roles in exacerbating the occurrence of car crashes.However, there is a dearth of studies examining the prevalence of sleepiness while driving among Omanis. This study aimed

to determine the proportion of young Omani adults who confess to daytime sleepiness while driving and to investigate associations between gender, daytime sleepiness and risk of obstructive sleep apnoea syndrome [OSAS]

Methods: This cross-sectional study took place at the Sultan Qaboos University Hospital, Muscat, Oman, between May and July 2014 and included 600 young adult Omani non-commercial drivers. The Berlin Questionnaire and Epworth Sleepiness Scale [ESS] were distributed among the participants, along with additional questions about their sleeping habits. Associations between daytime sleepiness while driving and nocturnal sleep duration, risk of OSAS and gender were determined

Results: A total of 492 private vehicle drivers took part in the study [response rate: 82%], of which 50.4% were male. Overall, 124 Omanis [25.2%] reported experiencing daytime sleepiness while driving at least once per month. There was a significant association between nocturnal sleep duration of <6 hours and sleepiness while driving [P = 0.042]. Female participants were significantly more likely to score >10 on the ESS, indicating a greater propensity for daytime sleepiness [P = 0.006].However, male drivers were significantly more likely to report sleepiness while driving [P = 0.001]

Conclusion: Sleepiness while driving was common among young male drivers in Oman and might be due to nocturnal sleep deprivation. Further studies are needed so that preventative measures can be developed

Culture-specific pathogenicity of Dhat [semen loss] syndrome in an Arab/Islamic society, Oman

A number of reports from different parts of the world have challenged the assumption that Dhat syndrome is confined to populations in and around the Indian subcontinent. This single case study reports an Omani with features typical of Dhat syndrome. Psychometric measures showed elevated scores on indices of hypochondriasis, psychasthenia, and gender role development as defined in the Minnesota Multiphasic Personality Inventory. He rated adequately in measures assessing cognitive and executive functioning. Implementation of cognitive behavioral therapy, concurrent with a successful marriage proposal, resulted in a gradual resolution of the symptoms. This report concludes with a discussion on whether his Dhat syndrome should be viewed as a culture-reactive or culture-specific syndrome

Research misconduct: the peril of publish or perish

There is a spurt of interest in research productivity in the Gulf Cooperation Council [GCC] to lay the foundation for national development. From a global perspective, increased research productivity could conceivably be accompanied by an exponential increase in research misconduct [RM]. Inevitably, erroneous or falsified data will be expected to adversely affect public health by misleading policy makers and clinicians alike into embarking on health policy and allocation of resources that are byproducts of RM. This will contribute significantly to the emerging crisis of confidence of the public in the integrity of scientific research. For a long time, RM has been considered only as plagiarism or data fabrication and falsification. However, the concept of RM nowadays encompasses more and, in this review, we discuss its possible implications in emerging economies, such as those of the GCC countries. We suggest that GCC countries ought to consider implementing remedial and punitive policies to deal with RM

Profile of mental and behavioral disorders among preschoolers in a tertiary care hospital in Oman: a retrospective study

Objectives: Early diagnosis and prompt treatment of mental and behavioral disorders in preschoolers is critical for a better prognosis, ultimately leading to improved quality of life for both the child and the family. Our study investigated the clinical profile of mental and behavioral disorders in children < 7 years of age, seeking consultation at Sultan Qaboos University Hospital, Muscat, Oman, between 1 June 2006 and 31 December 2010. The objective was to explore demographic variables, intervention types, and annual Trends

Methods: this retrospective, descriptive study was conducted by reviewing the electronic records of preschoolers seeking consultation on mental and behavioral disorders at the Department of Behavioral Medicine. The diagnosis was based on the Diagnostic and Statistical Manual of Mental Disorders [DSM-IV] criteria

Results: the total number of cases was 466, the majority [77.9%] being boys. The cumulative frequencies and annual hospital-based prevalence rates were estimated for each category of mental and behavioral disorders. Our findings showed increased service utilization among preschoolers, as reflected in the annual trend and case-specific prevalence rates. While comorbidity was common, the most frequent disorders encountered were attention deficit hyperactivity disorder [70.8%], developmental language disorder [23.6%], autism spectrum disorders [20.2%], and disruptive behavior disorders [11.6%]. The most commonly prescribed drugs/supplementation were risperidone [18.7%], atomoxetine [9.7%], omega-3 [8.8%], and methylphenidate [6.2%]

Conclusions: consultations for mental and behavioral disorders are being sought for Omani preschoolers. Beside pharmacotherapy, other interventions, which are an integral part of a much desired multidisciplinary approach should be introduced. Readdressing the missing needs is essential for a comprehensive approach to managing mental and behavioral disorders

Underlying factors behind the low prevalence of autism spectrum disorders in Oman sociocultural perspective

Epidemiological surveys from various countries indicate an increased prevalence of autism spectrum disorders [ASD], leading researchers to debate whether there are now 'more affected' or 'more detected'. The epidemiology of ASD in developing countries, such as Oman, has generally indicated a lower prevalence compared to developed countries in the West. In Oman, the prevalence is low; however, this article highlights some of the factors that could contribute to the appearance of a low ASD rate: cross-cultural variations in the presentation of distress; a lack of reliable biological markers for diagnosing ASD, and a lack of health services for children with ASD, thus limiting the number of participants in epidemiological surveys. While the defining features of ASD have yet to be established, pilot studies in Oman indicate a substantial number of children with these disorders. Therefore, it is important that these discrepancies be addressed and the need for appropriate services for this patient population in Oman be highlighted

Patient safety culture assessment in Oman

To illustrate the patient safety culture in Oman as gleaned via 12 indices of patient safety culture derived from the Hospital Survey on Patient Safety Culture [HSPSC] and to compare the average positive response rates in patient safety culture between Oman and the USA, Taiwan, and Lebanon. This was a cross-sectional research study employed to gauge the performance of HSPSC safety indices among health workers representing five secondary and tertiary care hospitals in the northern region of Oman. The participants [n=398] represented different professional designations of hospital staff. Analyses were performed using univariate statistics. The overall average positive response rate for the 12 patient safety culture dimensions of the HSPSC survey in Oman was 58%. The indices from HSPSC that were endorsed the highest included 'organizational learning and continuous improvement' while conversely, 'non-punitive response to errors' was ranked the least. There were no significant differences in average positive response rates between Oman and the United States [58% vs. 61%; p=0.666], Taiwan [58% vs. 64%; p=0.386], and Lebanon [58% vs. 61%; p=0.666]. This study provides the first empirical study on patient safety culture in Oman which is similar to those rates reported elsewhere. It highlights the specific strengths and weaknesses which may stem from the specific milieu prevailing in Oman

Clinical and demographic profile of attendees at Baghdad's walk-in psychiatric clinic

Few studies have examined clinical and demographic profile of attendees of a walk-in psychiatric clinic in countries ravaged by wars. The aim of this study is to quantify the characteristics of attendees of an open walk-in psychiatric clinic in a general hospital in Baghdad and the suburb towns of Iraq in the year 2010. As part of a retrospective survey, information on specific variables [socio-demographic background, clinical characteristics and attendance rate] was sought from medical records in the year 2010 [January to December]. Despite the shortcomings expected from a country coming out of the ravage of war, the survey included 2,979 attendees [1,864 [63%] males and 1,115 [37%] females] of a walk-in psychiatric clinic who fulfilled the inclusion criteria. The profile of attendees indicated that a majority of the cohort was self-referred with a predominance of employed males, aged 19 to 49 years, residing in Baghdad City. Depression and psychosis were the most common diagnosis given. The observed patterns are discussed within the available literature relevant to consultation liaison psychiatry, and specific to situations in Iraq and Arab/Islamic cultural patterning.

Reasons for consultation among patients attending primary healthcare centres in Oman

Pathways to care or care-seeking, which translate into healthcare utilization, have been investigated in many parts of the world, but there is a dearth of studies in the Arabian Gulf. The aim of this study was to examine the characteristics of attendees at primary healthcare centres in northern Oman and their reasons for visiting. Face-to-face interviews were conducted with 676 participants attending 12 primary healthcare centres between June and July 2006. The catchment area was selected to represent the population structure in Oman. The 12-item questionnaire was read to every fifth eligible patient entering each healthcare centre for a routine appointment. Analyses were conducted using univariate statistics. About a third [n = 200; 29.6%] of the participants had a history of chronic illness; 231 [34%] were on regular medications; 211 [31%] were taking part in health education programmes; 130 [19%] were open to complementary medicine. The majority of the participants mentioned physician's advice [n = 570; 84%] as the strongest reason for seeking consultation. Conversely, physician's advice was strongly related to particular demographic factors. This observational study identified some characteristics and reasons for visiting healthcare facilities in northern Oman. These are discussed within the context of prevailing sociocultural factors. The implications for the prevention and detection of ill health in Oman are also discussed

Emerging burden of frail young and elderly persons in Oman for whom the bell tolls?

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

Biomedical publications profile and trends in Gulf cooperation council countries

There is a dearth of studies examining the relationship between research output and other socio-demographic indicators in the Gulf Cooperation Council [GCC] countries [Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates]. The three interrelated aims of this study were, first, to ascertain the number of biomedical publications in the GCC from 1970 to 2010; second, to establish the rate of publication according population size during the same period and, third, to gauge the relationship between the number of publications and specific socio-economic parameters. The Medline database was searched in October 2010 by affiliation, year and publication type from 1970 to 2010. Data obtained were normalised to the number of publications per million of the population, gross domestic product, and the number of physicians in each country. The number of articles from the GCC region published over this 40 year period was 25,561. Saudi Arabia had the highest number followed by Kuwait, UAE, and then Oman. Kuwait had the highest profile of publication when normalised to population size, followed by Qatar. Oman is the lowest in this ranking. Overall, the six countries showed a rising trend in publication numbers with Oman having a significant increase from 1990 to 2005. There was a significant relationship between the number of physicians and the number of publications. The research productivity from GGC has experienced complex and fluctuating growth in the past 40 years. Future prospects for increasing research productivity are discussed with particular reference to the situation in Oman

diagnostic yield of thyroid function tests and their cost-effectiveness in the student clinic at Sultan Qaboos University: retrospective chart review

To assess the significance of requesting thyroid function tests [TFT] and their cost effectiveness for specific and non-specific symptoms of thyroid disease in a specific population in Oman. A retrospective chart review study was conducted in the student clinic at Sultan Qaboos University in Oman in the year 2007-2008. It included all patients [N=319] of both sexes for whom TFTs were requested. The patients' main complaints and the final diagnoses were collected from their medical records. The most common presentations for which TFTs were requested were irregular periods [n=82]; fatiguability [n=49], palpitations [n=39]; weight changes [n=22]; hair changes [n=20]; sensation of heat and cold [n=18]; diarrhoea and constipation [n=13], and neck swelling [n=13].The most common diagnoses reached in relation to these complaints were polycystic ovarian syndrome [n=51]; iron deficiency anaemia [n=42]; anxiety and depression [n=11]; thyroid disease [n=18], and no specific diagnosis [n=193]. The percentage of thyroid diseases among females [7.1%] compared to males [1.2%] was statistically significant [P <0.05]. Thyroid disease accounted for 61.5% of those patient with neck swelling, 7.7% of those with palpitations, 4.1% of those with fatigue, 3% of those with other complaints, and 1.2% of those with irregular periods. The cost of the tests was around 20,000 US dollars. TFT is necessary for those presenting with neck swelling, but restraint should be used in administering the test for those complaining of palpitations or fatigue. Additionally, irregular periods have little link with TFT abnormality

Silent epidemic of depression in women in the Middle East and North Africa region: emerging tribulation or fallacy?

As the world is being gripped by economic depression, international psychological epidemiologists have amassed evidence to suggest that psychological depression and its variants are becoming leading contributors to the global burden of disease with the Middle East and North Africa [MENA] region being no exception. The main aim of the present discourse, based on a review of the available literature, is to discuss critically whether women in the MENA region have a higher rate of psychological depression than those in other parts of the globe. From the present synthesis, it emerges that the rate of depression may not be necessarily unique to the region. Although no society has totally overcome the marginalisation and lack of empowerment of women, in order to come to grips to this complex issue more vigorously designed epidemiological studies, using taxonomies that are standardised for cross-cultural populations, are needed to quantify the psychological functioning of women

Relatives' advice and health care-seeking behaviour in Oman

It has been well established that pathways to care are considerably modified by local, social and psychological characteristics as well as the doctor-patient relationship. Scant attention has been paid to the role of family advice in care-seeking. In Omani society, traditional family values and a collective mindset are the norm rather than the exception. This paper examines how family advice affects the trajectory of care seeking. Methodology: During 2006-2007, data was collected through face-to-face interviews among a randomised sample of patients seeking medical consultation in various primary health care centres in the northern region of Oman. This study enrolled a total of 493 patients. The association between the advice of family members as a reason to seek health care and other predictors was analysed using multivariable logistic regression. Results: The data suggest that the advice of family members in care-seeking is strongly associated with gender, education, history of chronic illness, previous exposure to traditional medicine, and health education, as well as the history of immunisation. These findings suggest that the advice of family members remains a strong catalyst for care-seeking in Oman. The psychosocial factors affecting care-seeking leading to underutilisation of services or otherwise are discussed

Impact of geographical proximity on health care seeking behaviour in northern Oman

Despite its impact on health policy, the relationship between geographical proximity and health care seeking has received scant attention in the medical literature. This paper aims to evaluate the relationship between geographic proximity and health care usage behaviour among patients seeking medical consultation in the northern region of Oman. During 2006- 2007, data was collected via face-to-face interviews among 428 randomized patients seeking medical consultation in various primary health care centres in the northern region of Oman. The association between geographical proximity as a reason to seek health care and other predictors was also analysed using multivariable logistic regression. The data suggest that preference for geographical proximity as a reason for seeking health care is strongly associated with marital status, previous exposure to traditional medicine and health education, as well as history of immunisation. This finding supports the view from elsewhere that geographical proximity remains a strong catalyst for care seeking in Oman. The psychosocial factors affecting care seeking are discussed