Hemoglobin H disease in Muscat, Oman - a 5 year study

Published data indicate that Alpha thalassemia trait is prevalent in 45% of population of Sultanate of Oman. Recent unpublished data suggest that this prevalence is higher than 45%. Yet clinical suspicion or investigations into alpha-thalassemias are lacking. Moreover, Hemoglobin H disease is considered rare in Oman. We decided, therefore to look for Hemoglobin H disease and characterize the clinico-hematopathological features of the disease. Patient demographics, clinical details and detailed hematology parametry of Hemoglobin H disease cases, diagnosed by Department of Laboratory over a period of 5 years between February 2002 and January 2007 in patients presenting at Al-Nahdha Hospital and Genetic counseling unit in Muscat were compiled from hospital and laboratory records and analyzed. Twenty cases of Hemoglobin H disease in Omanis were diagnosed mainly during the second decade. 60% belonged to Al-Balushi tribe. 40% of cases presented with body pains. 35% presented with nonspecific symptoms. 50% of cases were erroneously labeled as Iron deficiency anemia. Microcytic erythrocytosis, high Red Cell Distribution Width, numerous misshapen Red Blood Cells, pseudothrombocytosis, low A2 and normal Ferritin were important diagnostic clues. Hemoglobin H inclusions in special reticulocyte smears and Hemoglobin H on HPLC or Electrophoresis were diagnostic. Hemoglobin H disease is common in Oman. The need to do HPLC, G6PD activity and Ferritin studies in all cases of anemia in Oman to avoid missing diagnosis of Hemoglobin H disease is stressed. This study is intended to create awareness about Hemoglobin H disease in order to diagnose early, treat rightly, counsel correctly and pave the path for prevention of alpha-thalassemia disease in Oman

Hemoglobin A1c in Muscat, Oman-A 3 year study

Glycosylated Hemoglobin [HbA1c] reflects the average blood glucose level during the previous 2-3 months. HbA1c is used as marker for long term blood glucose control in diabetic patients. In this retrospective study, the prevalence of diabetic control was evaluated from HbA1c tests of diabetic patients over a period of 3 years [January 2005-December 2007] from Muscat Region, Sultanate of Oman. Blood samples from a total number of 7442 patients were analysed at Al Nahdha Hospital Laboratory received from different Primary Health Care Centers and Hospitals of Muscat region as this hospital was the referral hospital for HbA1c testing. The method used for the estimation of HbA1c was Turbidimetric inhibition immunoassay and the test was carried out in Hitachi 902 an automated chemistry analyzer. The results show that only 22.8% of patients had good glycemic control and 77.2% had bad glycemic control. Diabetic patients should be informed of the fact that maintaining HbA1c below 7% will minimize their risk of developing the complications

Compound heterozygosity for Hb S and Hb S-Oman: Case report

The haematological and clinical findings of a three year old Omani girl, phenotypically compound heterozygote for Hb S and Hb S Oman, are presented, further substantiated by family studies. The necessity of reviewing cases with sickle cell haemoglobin in Oman is stressed

unusual case of atypical lymphocytosis

Atypical lymphocytosis due to infections is classically seen in viral and chronic bacterial infections. A four year old boy with acute streptococcal infection presented at Al-Nahdha Hospital, Muscat, Oman, with follicular tonsillitis and bilateral cervical lymphadenitis. The blood film showed 33% atypical lymphocytes. Serologically, immunoglobulin M [IgM] antibodies were positive for cytomegalovirus, herpes simplex virus, and Epstein Barr virus, but the patient responded dramatically to antibiotics

four-year study on hepatotropic viruses causing acute viral hepatitis in Muscat

One hundred seventy five clinically suspected cases of acute viral hepatitis from April 1999 to March 2003 were subjected to liver function tests and serological evidence of all hepatotropic viruses [A, B, C, D, E]. One hundred and forty nine patients [85%] had hyperbilirubinemia and 174 patients [99.4%] had elevated Alanine aminotransferase [ALT]. Fifty five percent of the patients had acute viral A hepatitis, 13.7% had acute viral B hepatitis, and 9% had acute viral C hepatitis. None of the hepatitis B patients had viral D hepatitis. Acute viral E hepatitis was observed in 6.3% of patients. None of the viral markers could be detected in 16% of patients

Acute viral E hepatitis in Muscat

Patient demographics,-clinical presentation, liver function tests and serological confirmatory investigations of 4 cases of acute viral E hepatitis seen in Muscat are detailed. In all 4 patients, the request for antibodies to Hepatitis E Virus [HEV] was not from clinicians but from Al Nahdha Laboratory. The need to entertain the diagnosis of Hepatitis E and ask for antibodies to HEV in all clinically and biochemically [liver function tests] suggestive cases of acute viral hepatitis, especially in patients with a history of recent travel abroad to endemic areas, is stressed. Such an approach would possibly unearth more cases of acute viral E hepatitis in the country. Occurrence of hepatitis E in Muscat could be of public health importance and needs to be investigated: further in other regions of the Sultanate of Oman