Epidemiology of diabetes mellitus in Oman results from two decades of research

This study aimed to describe the epidemiology of diabetes mellitus over the past two decades in Oman, particularly in terms of its prevalence and incidence. In addition, the study sought to estimate the future incidence of diabetes in Oman. Three national and three regional surveys conducted between 1991 and 2010 were analysed to obtain the age-adjusted prevalence and undiagnosed proportion of type 2 diabetes mellitus [T2DM] among Omani subjects aged >/=20 years. Diabetes mellitus registers and published studies were used to determine incidence rates of both type 1 diabetes mellitus [T1DM] and T2DM in Oman. Linear regression was used to determine trends and projections for diabetes in 2050. The age-adjusted prevalence of T2DM in Oman varied from 10.4% to 21.1%, while the highest prevalence of impaired fasting glucose was found in males [35.1%]. In comparison to men, higher incidence rates of T2DM were found in women [2.7 cases compared to 2.3 cases per 1,000 person-years, respectively]. No significant trends were observed for the prevalence or incidence of T2DM in both genders. Undiagnosed T2DM was more common in men [range: 33-68%] than women [range: 27-53%]. The results of this study show that by 2050, there will be an estimated 350,000 people with T2DM living in Oman [a 174% increase compared to estimates for 2015]. Health authorities need to prioritise diabetes prevention and control in order to prevent or delay long-term complications and avert a potential epidemic of diabetes in Oman

Ocular malignant tumors. Review of the tumor registry at a tertiary eye hospital in central Saudi Arabia

To present the epidemiologic profile and magnitude of ocular malignant tumors [MT] representative of the Saudi population from the Tumor Registry [TR] at King Khaled Eye Specialist Hospital [KKESH]. This study evaluated the demographic information, clinical features including tumor laterality, ocular tissue of origin, and diagnosis of patients from the TR registry between 1983 and 2012 at KKESH, Riyadh, Kingdom of Saudi Arabia. The incidence of MT among Saudi adults [>/= 15 years old], and children [<15 years old] was estimated. The TR recorded 4,146 neoplasms [2,509 [60.5%] benign tumors, and 1,637 [39.5%] MT]. The incidence of MT in children was 3.6 per million/year [M/Y], and 2.4/M/Y for adults. Retinoblastoma [Rb] [n=763, 91%] was the most common ocular malignancy in children. In adults, the most common MT was squamous cell carcinoma [SCC] [n=363, 45.8%], basal cell carcinoma [BCC] [n=186, 23%], uvealmelanoma [n=94, 11.9%], sebaceous gland carcinoma [n=54, 6.8%], lymphomas [orbital, adnexal] [n=46, 5.8%], and others [n=53, 6.8%]. The Rb [7.7/M/Y in <5 years old Saudi children] was less frequent than that reported in some Gulf countries, but higher than that reported from the West. The SCC was less frequent in countries with comparable sun exposure than in other continents, but the incidence remained unchanged over 3 decades. There was a significant increase in BCC between 1983-1992 and 2003-2012. The rates of all cancers remained stable over 3 decades except BCC, which showed a significant rise

impact of spectacle wear compliance on the visual function related quality of life of Omani students: a historical cohort study

Eye screening and refractive services to students are part of a school health initiative in Oman. We evaluated the impact of the compliance of spectacle wear on the vision related quality of life [VFQ] among 12-13 years old and 15-16 years old Omani students with refractive error. This historical cohort study was conducted in 2012. Students using spectacles and those not using spectacles after 1 year of prescribing/ providing spectacles were interviewed to assess their VFQ. The VQ 20 questionnaire with 5 graded close-ended responses was adopted for this purpose. The responses for the VFQ related to different visual functions of students who were/were not spectacle wear compliant, were compared. Our cohort had 124 students in each group. The overall VFQ was significantly higher among the compliant spectacle wearers [compliant group] compared with the non-complaint wearers [non-compliantgroup] [relative risk [RR] =4.7% [95%of the confidence interval [CI]: 2.8-6.6]]. The association of gender and the grade level was not significant [P > 0.05]. However, the variation of governorate was significantly associated to the difference of VFQ in both groups [x[2] = 16.6, degrees of freedom = 4, P = 0.0003]. The VFQ related to the near work [RR = 1.3] and school related activities [RR =1.3] was better in the compliant group. VFQ was better among those students who were spectacle wear compliant compared with those who were not. VFQ related to near work and school related activities seem to be the most influenced by spectacle wear compliance

Short term outcome of Ahmed glaucoma valve implantation in management of refractory glaucoma in a tertiary hospital in Oman

We present outcomes of Ahmed Glaucoma Valve [AGV] implantation in treating refractory glaucoma in a tertiary hospital in Oman. Refractory glaucoma was defined as previously failed conventional glaucoma surgery and an uncontrolled intraocular pressure [IOP] of more than 21 mmHg despite treatment with three topical and/or oral therapy. This historical cohort study was conducted in 2010. Details of medical and surgical treatment were recorded. Ophthalmologists examined eyes and performed glaucoma surgeries using AGV. The best corrected distant vision, IOP, and glaucoma medications were prospectively reviewed on 1[st] day, 1[st], 6[th], 12[th] week postoperatively, and at the last follow up. Glaucoma specialists examined and treated 40 eyes with refractory glaucoma of 39 patients [20 males + 19 females]. Neo-vascular glaucoma was present in 23 eyes. Vision before surgery was <3/60 in 21 eyes. At 12 weeks, one eye had vision better than 6/12, seven eyes had vision 6/18 to 6/60, and eight eyes had vision 6/60 to 3/60. Mean IOP was reduced from 42.9 [SD 16] to 14.2 [SD 8] and 19.1 [SD 7.8] mmHg at one and 12 weeks after surgery, respectively. At 12 weeks, five [12.5%] eyes had IOP controlled without medication. In 33 [77.5%] eyes, pressure was controlled by using one or two eye drops. The mean number of preoperative anti-glaucoma medications [2.38; SD 1.1] was reduced compared to the mean number of postoperative medications [1.92; SD 0.9] at 12 weeks. We succeeded in reducing visual disabilities and the number of anti-glaucoma medications used to treat refractory glaucoma by AGV surgery

Visual outcome and impact on quality of life after surgeries differ in children operated for unilateral and bilateral cataract [pune study 2011]

We compared vision and quality of life [VQL] of children aged 5-15 years and operated for unilateral and bilateral cataract between 2008 and 2010 in western India. In this cohort study, ophthalmologists assessed vision, anterior and posterior segment of eyes with cataract. Children completed a functional vision questionnaire [LVP-FVQ]. Follow up at 6 months after surgery included the best corrected visual acuity [BCVA], FVQ and eye assessment. The improvement of BCVA and quality of life were compared in group of unilateral and bilateral cataract. A total of 20 [70%] bilateral and 7 [39%] unilateral cataract were operated within 1 month of detection. All 48 eyes with bilateral cataract were congenital and 12 [67%] unilateral cataract were traumatic. Among bilateral group, 27 eyes [56.2% [95% confidence interval [CI] 44.4-72.2]] and in unilateral group 11 eyes [61.1% [95% CI 38.6-83.6]] had vision >/= 20/60 at 6 months follow up. The visual gain was significantly higher in children who were operated between 1 month and 1 year of detection [adjusted Odds ratio [OR] = 15.6 P = 0.03]. Positive impact on VQL in bilateral group was noted in 50%, 27%, and 13% children for subscale of distant vision, near vision, and field of vision, respectively. There was positive impact in these subscales among children with unilateral cataract. Thirty percent eyes with bilateral cataract and 22% of eyes with unilateral cataract improved their vision. Surgery within 1 month of cataract was significant predictor of improved vision [OR = 16.6 P = 0.02]. Vision and VQL improved in children with unilateral and bilateral cataract. However, it was better 6 months following surgery in children with bilateral cataract than in children with unilateral cataract

Should the health information glaucoma be hospital based or community based?

To compare the prevalence and incidence of glaucoma in 2005 of >/= 30 years-old Omani population. This was a retrospective review of health data type of study conducted in 2007. The study was conducted in the Eye and Ear Health Care Section, Department of Non-Communicable Disease Control, Ministry of Health, The prevalence of glaucoma was estimated through community based modified cluster type of survey. Incidence was estimated from Health Information and Management System [HIMS] Formula to calculate the prevalence from incidence of a chronic disease to compare these 2 estimates. We examined 3,324 persons of >30 years of age. The prevalence was 4.75% [95% confidence intervals 4.02-5.47] with an estimated 20,700 glaucoma cases in Oman. Ophthalmologists reported 1,290 new cases of glaucoma in the same age group. The incidence was 0.30%. The prevalence if calculated from the incidence rates among the population >/= 30 years of age would be 0.30x16.1=4.8%. The survey results are more reliable for policy making. However, HIMS could also generate reliable, periodic, low cost information on glaucoma that could help in estimating the prevalence, and monitoring the program approach to control glaucoma

Magnitude and determinants of osteoporosis in adult population of South Sharqiya region of Oman

To estimate the incidence of hip fractures as an indicator for osteoporosis in the >40 years old Omani population of the South Sharqiya region of Oman. We also recommended a policy for addressing osteoporosis in this community. Orthopedic surgeons noted and treated patients with hip fracture that were due to a fall over 5 years September 2002 to August 2007 at Sur Hospital, Oman. Their preoperative information, such as bone involved, co-morbidities, history of fractures, and the type of treatment were collected. We used the population of the study area to calculate the annual incidence of fractures. In our study, 147 persons 70 male, and 77 female of >40 years with hip fractures were included. The age adjusted annual incidence rate of hip fracture in >40 population of South Sharqiya was 0.14%. While operating on 96 65.3% patients, we used dynamic hip screw. Hemi-arthroplasty with Austin-Moore prosthesis was performed in 37 [24.5%] patients. Eighteen [12.2%] patients had previous bone fractures. The incidence of hip fracture was high. Osteoporosis screening programs and adequate interventions could detect the high-risk group and prevent such fractures in the future

Magnitude and determinats of refractive error in Omani school children

To estimate the magnitude and determinants of refractive error in school children, a study was undertaken to review the school screening and refraction data. Trained physicians screened 416,157 students to evaluate their visual status and identified 28,765 students with defective vision. Refractionists refracted 25,733 [89.5%] of them, determined the refractive error and prescribed spectacles. Students with ocular co-morbidity and visual disability were re-examined and treated by the ophthalmologists. This study was conducted between June 2003 and December 2003 in the Ministry of Health, Muscat, Sultanate of Oman. The prevalence of myopia was 4.1% [95% confidence interval [CI] 4.06-4.18]. It was higher among female than male students [rate ratio [RR] 1.69 [95% CI 1.64-1.74]]. The rate was more in students of higher age groups [x2 = 11,179 degrees of freedom = 2 p<0.00001]. Regional variation in myopic trend was marked. The prevalence of hypermetropia was 0.4% [95% CI 0.37-0.41]. However, it could be an underestimation as presence of accommodative spasm was not taken into account. The risk of low vision disability was significantly higher in male students than female students. The prevalence of ambiopia was 0.3%. It was significantly higher in male than female students. First primary students had strabismus of 0.5%. The study enabled to undrestant trends of refractive error in Omani children [Arabic tribe] and demonstrated the importance of vision screening in providing timely eye care and identifying visually disabled school children