Development and validation of a culturally-tailored breast cancer health education programme for Arab women

Objectives: This study aimed to develop and validate a health education programme to encourage breast cancer awareness and early detection behaviours among Arab women

Methods: This study took place between December 2015 and March 2016. The Enabling Systems Raising Awareness model was used to develop a breast cancer health education programme which was subsequently implemented by trained health educators at three female-only fitness clubs in Muscat, Oman. Breast cancer knowledge among 53 women was assessed using the breast module of the Cancer Awareness Measure before and after each health education session. Overall pre- and post-session knowledge scores were then compared. Additionally, three focus group discussions were conducted with 10 participants from each location. Thematic analysis was used to analyse the transcribed discussions and collect feedback on the programme

Results: The health education sessions resulted in a statistically significant increase in overall mean knowledge scores [P <0.001]. Participants also reported significantly improved intentions to undertake early detection practices [P <0.001]. The focus group discussions yielded distinct themes and valuable feedback which can be utilised in the future to create an improved version of the programme

Conclusion: While the health education programme significantly improved breast cancer and early detection knowledge among a cohort of Arab women, it still required critical improvements in terms of structure and administration. Additional studies are required in order to evaluate long-term behavioural outcomes resulting from the improved programme

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

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.

Obstetric and non-obstetric risk factors for cesarean section in Oman

This study aims to explore the risk factors, profiles and neonatal outcomes of Cesarean sections among selected women in Oman. In this hospital-based case-control study, a total of 500 participants [250 cases who had cesarean section and 250 controls who had spontaneous vaginal delivery], were randomly selected from four hospitals. Cases and controls were matched according to timing and place of delivery. The following predictors were found to be significantly associated with increased risk of cesarean section: a] advancing age [above the age of 25 years, OR=1.42; p=0.03], b] prior cesarean section [previous cesarean section=1, OR=22.71; p=0.001], c] increased body mass index [obesity, OR=2.11; p=0.07], d] extremes of neonatal birth weight [neonates birth weight <2.5 kg, OR=5.2; neonates birth weight >4.0 kg, OR=7.3; p<0.001], and e] prepregnancy diabetes [OR=9.3; p=0.04]. On the contrary, increased parity and history of the use of birth spacing methods [OR=0.38; p=0.03] were associated with decreased risk of cesarean section. The study calls for increasing awareness about clinical and public health majors that would lead to prevention of risk factors associated with increased risk of cesarean section such as maintaining normal BMI and prevention of gestational and type 2 diabetes mellitus

Early versus late parenteral nutrition in very low birthweight neonates: a retrospective study from Oman

The aim of this study was to compare the biochemical parameters, weight gain, osteopenia and phosphate supplementation in very low birth weight [VLBW] neonates receiving early versus late parenteral nutrition [EPN versus LPN]. A retrospective study was undertaken in the level III Neonatal Intensive Care Unit at Sultan Qaboos University Hospital, Oman: from January 2007 to October 2008 [LPN group, n = 47] and from January 2009 to June 2010 [EPN group, n = 44]. Demographic data, anthropometric and laboratory parameters were extracted from the electronic record system. The mean age of PN initiation was LPN = 47.3 hours versus EPN = 14.3 hours. Biochemical parameters analysed during the first week of life revealed a reduction in hypernatraemia [12.7% versus 6.8%] and non-oliguric hyperkalemia [12.7% versus 6.8%] in EPN, with no significant differences in acidosis and urea levels between the two groups. Hyperglycemia >12 mmol/L in <1000g was higher in EPN. Nutritional parameters in 81 babies who survived/stayed in the unit up to a corrected gestational age [CGA] of 34 weeks [40 in LPN and 41 in EPN], revealed a reduction in metabolic bone disease [osteopenia of prematurity [OOP], 17.5% versus 7.3%] and the need for phosphate supplementation [22.5% versus 7.3%] in the EPN group. There was no increase in acidosis or cholestasis. No difference was noted in albumin levels, time to full feeds, time to regain birthweight and mean weight gain per day till 34 weeks corrected CGA. EPN in VLBW newborns is well tolerated and reduces hypernatraemia, non-oliguric hyperkalemia, OOP and the need for phosphate supplementation

Technicity as a quality indicator of excellence in gynaecology

The objective of this study was to calculate the technicity index [TI] for hysterectomies at a tertiary care university hospital in Oman. This is a retrospective chart review of patients who had hysterectomies at Sultan Qaboos University Hospital [SQUH], a tertiary care university hospital. Profiles were reviewed for all patients who had hysterectomies at SQUH in the period 2003-2009. The cumulative frequencies for all types of hysterectomies were tallied and the year-specific TI was calculated. Overall, we enumerated a total of 258 hysterectomies, of which 6 [2.3%] were laparoscopic assisted hysterectomies, 42 [16.3%] vaginal hysterectomies, and 208 [80.6%] total abdominal hysterectomies. The average TI was 19% [48/258], and it ranged from 11% to 24%. The trend of change fluctuated over the years starting with 16% [2003] and increasing gradually during 2004-2006, but then declining again during 2007-2008 [trend P value 0.02]. This low and fluctuating trend was mainly attributed to the inconsistency in the availability of trained surgeons and laparoscopic equipment. TI at our institution can be improved by increasing the number of minimally invasive hysterectomies through providing more trained surgeons and laparoscopic equipment

Satisfaction and perceived quality of an electronic medical record system in a tertiary hospital in Oman

To evaluate the knowledge, attitude and practice [KAP] of physicians towards the Electronic Medical Record [EMR] system. A cross-sectional survey including physicians from various clinical specialties was conducted. An existing questionnaire was adapted to assess the KAP of physicians towards the EMR system. Information was analyzed using Statistical Package for Social Sciences [SPSS] software. Out of 200 distributed questionnaires, 141 [70.5%] responses were received. Overall, only 22 physicians [15.6%] rated the current EMR system as an effective tool. A substantial proportion [29.4%] of respondents considered EMR not worth the time and effort required to use it. The majority [67.4%] reported increasing difficulty with the performance of work after applying the EMR system. The overall quality of work was perceived not to have changed [41.2% of the respondents] or declined [27.4% of the respondents]. The low satisfaction and underperformance was found to be associated with younger age [p=0.032], junior designation [p=0.041], and low familiarity with computers [p=0.047]. We report low satisfaction and perceived quality of work among physicians in our institution with the current EMR system. Inappropriate and inadequate usage of the system was found to be the main cause of the underlying poor satisfaction

Effect of preoperative aspirin on blood lossand blood transfusion in patients undergoingcoronary artery bypass grafting: Impactof discontinuation prior to surgery

The aim of our study is to evaluate the impact of recent aspirin use before CABG on the post operative bleeding, blood transfusion and re-exploration. Retrospectively collected data from 67 patients who were operated in Sultan Qaboos University Hospital from 2008-2009 was included in this study. Patients were divided into two groups, [1] Aspirin stopped >7 days before surgery [34 patient] and [2] Aspirin received within 7 days before surgery [33 patients]. Platelet transfusion and length of hospital stay was more in patients where Aspirin stopped < 7 days [P value 0.03 and 0.002 respectively]. There was trend of increase in intraoperative bleeding and PRBC transfusion in the group who received Aspirin within seven days. Postoperative blood loss was higher in aspirin users than non aspirin users but not statistically significant. There was no difference between two groups regarding re-exploration or operative mortality. Patients who take aspirin within 7 days before surgery have more tendency to have post-operative bleeding and receiving blood products. They also have longer length of stay in the hospital. Our recommendation is to stop aspirin more than 7 days before surgery

Compliance of amblyopic patients with occlusion therapy: a pilot study

Increasing evidence shows that good compliance with occlusion therapy is paramount for successful amblyopia therapy. To study the degree of compliance and explore factors affecting compliance in patients undergoing occlusion therapy for amblyopia in our practice. Nonrandomized clinical intervention study. A total of 31 families with a child [aged 2-12 years], undergoing unilateral amblyopia treatment at the pediatric ophthalmology clinic of Sultan Qaboos University Hospital, Oman, were recruited for this one month study. Parents were interviewed and completed a closed-ended questionnaire. Clinical data including, visual acuity, refraction, diagnosis and treatment, for each patient was collected from the hospital chart and was entered in a data collection sheet. Compliance with occlusion therapy was assessed by self-report accounts of parents and was graded into good, partial, or poor. Association between various factors and degree of compliance was studied using logistic regression modeling. Only 14 [45%] patients showed good compliance to occlusion therapy. 17 [55%] patients were noncompliant. Improvement in visual acuity strongly correlated with compliance to patching [P = 0.008]. Other variables that were studied included, age at onset of therapy; gender; degree of amblyopia; type of amblyopia; use of glasses; and compliance with glasses. These did not emerge as significant predictors of compliance. All but one family with poor compliance stated that the main challenge in following the recommendation to patch for requisite hours was in getting their child to cooperate. Only in one instance, the family cited nonavailability of patches as the main hindrance to compliance. 10/31 [32%] families expressed a desire for more information and 18/31 [58%] parents did not understand that amblyopia meant decreased vision. Poor compliance is a barrier to successful amblyopia therapy in our practice. Improvement in visual acuity is associated with better compliance with patching. Parents find it difficult to comprehend and retain verbal explanations of various components regarding occlusion therapy for amblyopia. Future study with a larger sample of patients is recommended to investigate the factors affecting compliance with amblyopia therapy and determine predictors for poor compliance