Reference values for arterial stiffness indices in an Omani Arab population

To determine the reference values of arterial stiffness indices, particularly augmentation index [AIx] and pulse wave velocity [PWV] using applanation tonometry in a healthy Omani Arab population. This prospective study was carried out in the Department of Clinical Physiology, Sultan Qaboos University Hospital, Muscat, Oman over a 2-year period from June 2011 to June 2013. The central AIx, aortic PWV [AoPWV], and central pulse pressure [CPP] were recorded from 120 healthy subjects recruited randomly from a normal population using a SphygmoCor device. The 2.5[th] and 97.5[th] percentiles were used to determine the reference ranges for men and women separately. Analyses were performed using univariate statistics. The mean age of the cohort was 38 years for men, and 35 years for women, with the ages ranging from 20-53 years. The overall mean central AIx was 13 +/- 11%, and for AoPWV was 6.7 +/- 1.6 m/s. The central AIx was higher in women [17 versus 10%; p<0.001], whereas the AoPWV was higher in men [7.1 versus 6.3 m/s; p=0.003]. Subjects were categorized according to the gender and age decade, and reference values for CPP, central AIx, and AoPWV were obtained. This study reports the reference values for arterial stiffness indices from an Omani Arab population; the results of which should be interpreted in the context of its limitations

Characteristics, management, and in-hospital outcomes of diabetic acute coronary syndrome patients in Oman

To determine clinical characteristics, management, and in-hospital outcomes of diabetic and non-diabetic patients admitted with acute coronary syndrome [ACS] in Oman. Data were analyzed from 1583 consecutive patients admitted to various hospitals in Oman with ACS from May 8 to June 6, 2006, and from January 29 to June 29, 2007, as part of the Gulf RACE [Registry of Acute Coronary Events]. The ACS patients were stratified into those with and without diabetes mellitus. In this study, 588 [37%] patients were diabetic with a mean age of 59 years and included more female than male diabetics [43% versus 33%; p<0.001]. Diabetic patients were more likely to present with unstable angina [55% versus 44%; p<0.001] and less likely to present with ST elevation myocardial infarction [20% versus 27%; p=0.001]. Both groups received ACS treatment equally; however, diabetic patients were more likely to be treated with glycoprotein IIb/IIIa antagonists and angiotensin-converting enzyme inhibitors or receptor blockers. Diabetic patients experienced more recurrent ischemia [12% versus 8%; p=0.043], heart failure [29% versus 23%; p=0.009], cardiogenic shock [7.5% versus 4.6%; p=0.018], and ventilator requirement [7.3% versus 4.1%; p=0.006]. When adjusted for age and gender, diabetes status was an independent risk factor of in-hospital mortality in ACS patients [adjusted odd ratio, 1.68; 95% confidence interval, 1.02-2.77; p=0.042]. Diabetic ACS patients have different clinical characteristics and poorer outcomes. Present treatment strategies are not sufficient to counter the adverse impact of diabetes. More effective and evidence-based therapeutic strategies should be identified and used in diabetic ACS patients

Hypoparathyroidism in adult patients with beta-thalassemia major

To evaluate the prevalence of hypoparathyroidism in adult transfusion-dependent patients with beta-thalassemia major in a teaching referral hospital in Oman. All adult [>13 years] patients with beta-thalassemia major seen at Royal Hospital in Oman between 2004 and 2006 were studied. Demographic, pharmaceutical, clinical and biochemical data were collected for all the subjects. Analyses were performed using both descriptive and univariate statistics. A total of 31 patients were included into the study with an overall mean age of 19 +/- 3 years ranging from 14 to 30 years. Just over half of the subjects were males [n=16; 52%]. All the patients were on hypertransfusion and combined chelation therapy with desferrioxamine 40-60 mg/kg 5 days per week and deferiprone 75 mg/kg/day. Three of the patients had low levels of parathyroid hormone [<1.6 pmol/l]. A further three patients had normal levels of parathyroid hormone [1.6 - 9.3 pmol/l] in the presence of low serum calcium levels [<2.1 mmol/l]. These patients [with normal hypoparathyroid hormone levels, but lower calcium levels] were also defined to have hypoparathyroidism bringing the total prevalence of hypoparathyroidism in this cohort of adult patients with Beta-thalassemia major to 19% [6 out of 31]. The patients with hypoparathyroidism had statistically significantly lower levels of parathyroid hormone [2.7 versus 5.3 pmol/l; p=0.031] and serum calcium [1.7 versus 2.3 pmol/l; p=0.004] compared to those without hypoparathyroidism. The prevalence of hypoparathyroidism in adult beta-thalassemia major patients at this referral center was significantly higher [19%] than those reported elsewhere [2.5 and 10.7%]