Acute myocardial infarction [a Nizwa hospital experience]

One hundred consecutive patients admitted with Acute Myocardial Infarction [AMI] to Nizwa Hospital from March 1995 to June 1997 were studied. The mean age for Omani males was 61.0 +/- 11.33 years [Mean +/- SD] and for Non-Omani male was 46.1 +/- 6.8 years. Similarly for females [all Omani] the mean age was 64.1 +/- 10.12 years. The peak occurrence of AMI for all males was 40 - 69 and for females it was 60 - 69 years. Omani males were affected approximately twice more than Omani females. This study also focuses on existence of modifiable risk factors related to AMI viz. hypertension,. smoking, diabetes mellitus and hyperlipidemias and further recommends emphasis on revealing additional risk factors and risk management strategies in ongoing programmes. Chest pain was the most frequent mode of presentation followed by epigastric pain, arrhythmia and/or left ventricular failure [L VF]. One patient died due to cardiogenic shock. Only 37% patients attended hospital within 4 hours of their symptoms, so advantages of thrombolytic therapy could not be evaluated although 57 patients received Streptokinase and 2 received tissue Plasminogen activator. The study showed that acute myocardial Infarction is significant in the population of Dakhliyah region and it is concluded that recent data information relating to coronary artery disease [CAD] and its sequlae should be disseminated more widely which may help to improve management. Cardiovascular diseases [CVD] are the leading cause of death and the single largest killer of people in the industrialised countries [17,18]. The disease trend differs in different parts of the world depending upon the risk factors[19], which are predictive variables. Atherosclerosis is the basis of Coronary Artery Disease [CAD] and Acute Myocardial Infarction [AMI] is one of the most serious manifestations of CAD. Many studies have been reported on different patterns of AMI for communities where CAD is prevalent but little such information is available for the Dakhliyah Region, Sultanate of Oman. We made a retrospective study of the proven cases of AMI admitted to the ICU of Nizwa Central Hospital [NCH] based on typical chest pain, ECG changes and cardiac enzymes. Nizwa Central Hospital is a 179 bedded regional referral hospital of Dakhliyah region catering to an approximate population of 135,300. The cases from Wilayat Sahla, Sumail and Bidbid usually refer cases of AMI to tertiary care hospitals in Muscat hence excluded. Nizwa hospital is equipped with a modern ICU with a 24-hour cardiac monitoring facilities. The present study was designed to analyse patient's data with AMI and the assessment of the possible impact of risk factors like hypertension, diabetes, smoking, nationality, sex, lipid pattern etc. Similarly data on the site of infarction, complications, thrombolytic therapy and outcome of hospitalisation were collected and analysed

Acute intermittent porphyria

A case of acute intermittent porphyria which occurred in a 24-year old Omani woman is reported here because it is an uncommon condition in Oman

Acute severe hypercalcemia

A case of acute severe hypercalcemia is reported here which was seen in a middle aged omani woman. It is concluded that acute severe hypercalcemia is potentially fatal and one should be aware of how to detect and treat it promptly