Characteristics of chronic pain patients attending a primary health care center in Oman

Objectives: To determine the characteristics of patients presenting with chronic pain in a primary health care setting in Oman

Methods: A retrospective cross-sectional study was carried out including all patients aged >/= 18 years who attended Sultan Qaboos University Health Center during 2010. Patients were identified to have chronic pain if they were prescribed an analgesic medication for at least three months. Patients were compared to a control group which consisted of age- and gender-matched patients with no chronic pain

Results: Out of 6 609 patients, 241 [3.6%] were found to have chronic pain. The mean age of patients with chronic pain was 54.0 +/- 13.0 years. The majority of patients were female [n = 174; 72.1%], and most were Omani [n = 201; 83.4%]. The prevalence of chronic pain was found to be significantly higher among females compared to males [4.5% vs. 2.5%; p < 0.001] and also among Omani nationals to non-nationals [83.4% vs. 70.1%; p < 0.001]. Chronic pain was significantly associated with the following comorbidities; diabetes [33.1% vs. 20.7%; p < 0.001], obesity [35.2% vs. 26.5%; p = 0.001], and hypertension [51.0% vs. 38.5%; p = 0.002]. Osteoarthritis was the most common pain condition [n = 104; 43.1%]. Diclofenac was the most commonly prescribed drug [n = 168; 69.7%]

Conclusions: The findings of our study point towards a higher prevalence of chronic pain in Omani females. These patients were also found to have a higher prevalence of other common comorbid conditions

Marfan syndrome. Correct diagnosis can save lives

Marfan syndrome is a heritable disorder of the connective tissue that affects many systems of the body. However, the most serious complication in patients with Marfan syndrome is progressive enlargement of the aortic root, which may lead to aortic dissection, rupture, or aortic regurgitation. Prevention of these life threatening complications is very important in the management of this condition. A 39-year-old Omani man presented with progressive shortness of breath and eventually underwent major but successful cardiac surgery. It is very important to recognise Marfan syndrome early as preventive actions are possible if the condition is diagnosed before complications occur

Odontogenic cutaneous fistula: Report of two cases

Odontogenic cutaneous fistula or sinus is an uncommon, but well documented condition, which is often initially misdiagnosed as a sole cutaneous lesion and inappropriately treated. The misdiagnosis as a skin infection often results in inappropriate management. We here present two cases of odontogenic cutaneous fistula that were seen after being treated unnecessarily with antibiotics

Acne

Acne is one of the commonest dermatological problems encountered in outpatient clinics. It is often associated with significant psychological trauma. The psychological effects can lead to problems like social withdrawal, lack of self confidence and sometimes even unemployment. If not addressed appropriately and promptly, acne scars can be long lasting. Therefore it is important for family physicians to educate patients about available treatment options and their expected outcomes. Topical retinoids, benzoyl peroxide and azelaic acid are effective in patients with mild to moderate comedonal acne. Topical erythromycin or clindamycin can be added in patients with mild to moderate inflammatory acne or mixed acne. A six-month course of oral erythromycin, doxycycline, tetracycline, or minocycline can be used in patients with moderate to severe inflammatory acne. Hormonal therapy is also an option in patients with moderate to severe acne. Systemic retinoids are reserved for the treatment of the most severe or refractory cases of inflammatory acne due to their poor side effect profile