Spectrum of AIDS defining opportunistic infections in a series of 77 hospitalised HIV-infected Omani patients

Most of the morbidity and mortality in human immunodeficiency virus/acquired immune deficiency syndrome [HIV/AIDS] result from opportunistic infections [OIs]. Although the spectrum of OIs in HIV infected patients from developing countries has been reported, there is a paucity of data on the natural history, pattern of disease, and survival of hospitalised patients with HIV/AIDS, particularly in Arab countries. The aim of this study was to study retrospectively the spectrum and frequency of various OIs in a cohort of hospitalised HIV-infected Omani patients. Included in the study were 77 HIV-infected Omani patients admitted to a tertiary care teaching hospital in Muscat, Oman, between January 1999 and December 2008. They were diagnosed on their first admission and hence were not on highly active antiretroviral therapy [HAART] at presentation. The frequency of various clinical and laboratory findings and individual OIs were analysed. In total, 45 patients [58%] had one or more AIDS-defining OIs. Pneumocystis jiroveci pneumonia [PCP] was commonest [25%], followed by cryptococcal meningitis [22%], cytomegalovirus [CMV], retinitis [17%], disseminated tuberculosis [15%], and cerebral toxoplasmosis [12.5%]. Only one patient with Mycobacterium avium-intracellulare [MAI] was identified and one patient had disseminated visceral leishmaniasis. The majority of patients [77%] had CD4+ counts <200 cells/ micro L. Ten patients [22%] died during hospital stays, with five deaths [50%] being caused by disseminated CMV infection. A wide spectrum of OIs is seen in hospitalised HIV-infected patients in Oman. P. jiroveci pneumonia and cryptococcal meningitis were the commonest OIs, while disseminated CMV was the commonest cause of death. We hope these results will advance the knowledge of specialists treating HIV in Oman and the Gulf region

Obstetric and non-obstetric risk factors for cesarean section in Oman

This study aims to explore the risk factors, profiles and neonatal outcomes of Cesarean sections among selected women in Oman. In this hospital-based case-control study, a total of 500 participants [250 cases who had cesarean section and 250 controls who had spontaneous vaginal delivery], were randomly selected from four hospitals. Cases and controls were matched according to timing and place of delivery. The following predictors were found to be significantly associated with increased risk of cesarean section: a] advancing age [above the age of 25 years, OR=1.42; p=0.03], b] prior cesarean section [previous cesarean section=1, OR=22.71; p=0.001], c] increased body mass index [obesity, OR=2.11; p=0.07], d] extremes of neonatal birth weight [neonates birth weight <2.5 kg, OR=5.2; neonates birth weight >4.0 kg, OR=7.3; p<0.001], and e] prepregnancy diabetes [OR=9.3; p=0.04]. On the contrary, increased parity and history of the use of birth spacing methods [OR=0.38; p=0.03] were associated with decreased risk of cesarean section. The study calls for increasing awareness about clinical and public health majors that would lead to prevention of risk factors associated with increased risk of cesarean section such as maintaining normal BMI and prevention of gestational and type 2 diabetes mellitus