Oman vision 2050 for health research: a strategic plan for the future based on the past and present experience

Health care delivery in Oman has attained great heights since the modern renaissance in 1970. Although the health service had the main impetus all these years, the importance of health research began to take place by mid 1990's and is now gaining momentum as an important responsibility and activity of the Ministry of Health [MoH]. Although there has been progressively increasing investment and commitment to research activities in the recent Five Year Plan for Health Development, it still lags behind in the quality and quantity of research output. Lack of factors like adequate infrastructure, dedicated human resources, empowerment of existing systems, and societal support for research have adversely affected research output. Centre of Studies and Research in MoH has proposed a strategic plan, the 'Health Vision 2050 for Health Research' with aim of making Oman the regional leader and a research hub of world standards in health research. The mission is to promote, facilitate, and conduct high quality health research addressing national health priorities to improve health care services and enhance the efficiency and effectiveness of the health system, reduce health inequity, and contribute to socioeconomic development. The strategy includes setting health research priorities, strengthening the health research capacity, defining and implementing norms and standards, developing health research [quality and quantity], translating evidence into policy, strategy and practice, monitoring and coordinating research, financing health research, and evaluating the effectiveness of the health research system. It should generate a multifold increase in the quality and quantity of health research in Oman, positively impacting the health system and health care service

Oman world health survey: part 1 - methodology, sociodemographic profile and epidemiology of non-communicable diseases in Oman

The Oman World Health Survey [OWHS] is community-based household survey conducted in first half of 2008 for Omani and non-Omani population aged 18 years and above. It is a part of the World Health Survey [WHS] series which was developed by the World Health Organization [WHO] as a means to compile comprehensive information on the health of populations in different countries. A multi-stage stratified cluster sampling was designed to select about 5000 eligible subjects 18 years and above. The main objectives of the survey were to determine the national prevalence of Hypertension, Diabetes Mellitus, Obesity, Lipoproteins, Anemia, Visual ability and Cognitive functions. Among Omanis, the prevalence of Hypertension [40.3%], Diabetes Mellitus [12.3%], Obesity using BMI [24.1%], Total cholesterol [33.6%], Anemia in males 20% and in non-pregnant females was 32.2%. In Oman, the increase in lifestyle-related non communicable diseases has emerged as new health challenges to the country which need to be addressed

Expression of beta catenin, stromelysin -3 and P63 in relation to tumor DNA image analysis in adenoid cystic carcinoma

Adenoid cystic carcinoma has been described as one of the most biologically destructive and unpredictable tumors of the head and neck. Although the cells of ACC are innocent in appearance and have slow growth rates, local invasion of adjacent structures occurs frequently, and regional or distant metastases are not uncommonly found. DNA abnormalities have been identified by DNA ploidy and its quantitative anomalies have been confirmed in various types of human cancers. While the P63 appeared to be essential for epithelial cell survival and may function as oncogene, other different tissue proteins like beta catenin and stromelysin-3 have been found to play an important role in the invasion and metastasis of cancers. The aim of the present study was to elucidate the expression and cellular localization of beta catenin, stromelysin-3 and p63 and its relation to tumor DNA ploidy in adenoid cystic carcinoma by means of immunohistochemistry and image analysis, respectively. Our results indicated that although both stromelysin-3 and beta catenin were constantly expressed in adenoid cystic carcinoma and seem to play in its pathogenesis, there was no significant correlation between their expressions and DNA ploidy. On the other hand, a significant correlation has been found between p63 expression and DNA ploidy. Since p63 is expressed in the nuclei of the myoepithelial and basal cells of normal human salivary glands and retained in modified myoepithelial cells of adenoid cystic carcinoma, we suggest a role for this gene in the oncogenesis of this type of cancer

Expression of desmosomal and extracellular matrix proteins in human and experimental oral squamous cell carcinomas visualized by desmoglein-1 and 2 and stromelysin-3

Desmosomal and extracellular matrix [ECM] proteins in human oral squamous cell carcinoma from different sites were compared with those of DMBA-induced hamster cheek pouch carcinoma. Immunohistochemical staining utilizing monoclonal antibodies against desmoglein-l and 2 [Dsg-l and 2] and stromelysin-3 [ST-3] as markers for desmosomal and ECM alterations, respectively, on paraffin sections was performed. The results showed that the expression of Dsg-l and 2 was found to be correlated with the state of differentiation of carcinoma cells in both human oral squamous cell carcinoma and hamster cheek pouch carcinoma. The expression of Dsg-l and 2 was remarkably reduced in the poorly differentiated squamous cell carcinoma type compared to the well differentiated form. The expression pattern of ST-3 was, in contrast to Dsg-l and 2, shown to be correlated with tumor invasiveness rather than the differentiation state. Qverexpression of ST-3 was seen in stromal fibroblasts surrounding invasive nests and, also, in cancer cells themselves in both human and hamster cheek pouch squamous cell carcinomas with wide distribution in hamster carcinoma compared to human oral carcinoma. Interestingly, in carcinoma cells, overexpression of ST-3 was constantly associated with infiltrating edges of the tumor cells. This finding suggests that ST-3 expression depends on the interactions of epithelial and stromal cells. The results suggest that Dsg-1 and 2 and ST-3 are useful as tumor markers in human oral squamous cell carcinoma as well as in DMBA-induced cheek pouch squamous cell carcinoma. DMBA-induced hamster cheek pouch squamous cell carcinoma is a reliable model, immunohistochemically, for human oral squamous cell carcinoma

Management of juvenile angiofibroma with intracranial extension

This study included 19 patients with angiofibromas with variable degrees of intracranial extension. Of those, patients with minimal intracranial-extradural extension [Fisch class IIIb] were managed through transmaxillary subcranial approach, while extensive intracranial extension [Fisch class IV] necessitated combined craniofacial approach through frontotemporal craniotomy with maxillary removal and reinsertion. The hospital stay, the blood loss, the operative time accessibility and complications of each approach were evaluated

Dysphagia after total laryngectomy: motility report.

Detailed motility studies of the pharynx and esophagus with its two sphincters were performed in 31 patients having cancer larynx to find the correlation between postoperative motility changes and occurrence of dysphagia. After the operations, there was only one patient complained of dysphagia although all patients showed a well-defined decrease in the intraluminal pressures in the pharynx and upper esophageal sphincter. The upper and middle thirds of the esophageal body showed normal contractions in eight patients and weaker contractions in 23 of the cases postoperatively. All cases showed weaker contractions in the lower esophageal body. All the postoperative recordings resulted in an incomplete relaxation of the upper esophageal segment [UES] and incoordination. Although total laryngectomy completely interrupted the continuity of the proximal digestive tube and may caused derangement in the esophageal motility, dysphagia was not a striking postoperative symptom in those patients