Chikungunya masquerading as acute rheumatism in an Omani traveler

Chikungunya is a mosquito-borne viral disease. It typically presents as an acute febrile illness associated with a varying degree of arthralgia and musculoskeletal sequelae. Cases of chikungunya have been reported from more than 40 countries in several continents. Chikungunya is often reported in travelers returning to non-endemic/epidemic countries. With increasing international travel, it is vital that clinicians in non-endemic areas are made aware of this rapidly spreading infection. Increasing international travel [for social, leisure, and business] between Oman and several chikungunya endemic countries including Pakistan may facilitate the introduction of chikungunya to Oman. We report the first imported case of chikungunya in an Omani traveler with a link to the current outbreak in Pakistan

Cephalometric norms in an omani adult population of arab descent

Objectives: This study aimed to establish cephalometric norms for an Omani population of Arab descent and to compare these with established cephalometric values for Caucasians

Methods: This cross-sectional study was conducted at the Military Dental Centre and Oman Dental College in Muscat, Oman, between May 2014 and October 2016. A total of 150 Omani patients between 20.29 years old seeking orthodontic treatment were included. All participants had a symmetrical face, class I molar and canine relationships, proper intercuspation, a normal overjet/overbite [<3 mm] and mild spacing/crowding of the teeth [

Results: The Omani subjects were found to have a slightly retrusive maxilla, an increased angle between the maxillary and mandibular planes and shorter facial heights in comparison to the Eastman Standard norms. Furthermore, incisor relations were edge-to-edge in nature and the interincisal angle was reduced, suggesting that the Omani subjects had more proclined incisors. In addition, the lips were more protrusive and the nasolabial angle was more obtuse

Conclusion: In the Omani sample, increased proclination of the incisors was observed in comparison to Eastman Standard norms. As such, slightly more proclined incisors should be considered acceptable and natural among Omani patients of Arab descent. The cephalometric findings of this study may be helpful in the diagnosis and treatment planning of orthodontic problems among Omanis of Arab descent

Methods: This cross-sectional study

was conducted at the Military Dental Centre and Oman Dental College in Muscat, Oman, between May 2014 and

October 2016. A total of 150 Omani patients between 20.29 years old seeking orthodontic treatment were included.

All participants had a symmetrical face, class I molar and canine relationships, proper intercuspation, a normal

overjet/overbite [<3 mm] and mild spacing/crowding of the teeth [.3 mm]. Lateral cephalography was performed

in centric occlusion with the lips relaxed and the head in a natural position. Cephalometric measurements were

then compared with Eastman Standard norms. Results: The Omani subjects were found to have a slightly retrusive

maxilla, an increased angle between the maxillary and mandibular planes and shorter facial heights in comparison

to the Eastman Standard norms. Furthermore, incisor relations were edge-to-edge in nature and the interincisal

angle was reduced, suggesting that the Omani subjects had more proclined incisors. In addition, the lips were more

protrusive and the nasolabial angle was more obtuse. Conclusion: In the Omani sample, increased proclination of the

incisors was observed in comparison to Eastman Standard norms. As such, slightly more proclined incisors should be

considered acceptable and natural among Omani patients of Arab descent. The cephalometric findings of this study

may be helpful in the diagnosis and treatment planning of orthodontic problems among Omanis of Arab descent

Diabetic foot disease research in gulf cooperation council countries

Objectives: Countries in the Gulf Cooperation Council [GCC] have some of the highest prevalence rates of diabetes mellitus [DM] in the world; however, DM-related research activity in this region is limited. This study aimed to examine trends in published diabetic foot disease [DFD] research undertaken in GCC countries

Methods: This bibliometric study was conducted in December 2016. Standardised criteria were used to search the MEDLINE database [National Library of Medicine, Bethesda, Maryland, USA] for DFD-related publications authored by GCC researchers between January 1990 and December 2015. Various details such as the type of publication, journal impact factor and number of article citations were analysed

Results: A total of 96 research articles were identified. The number of publications per year significantly increased from nil prior to 1991 to 15 in 2015 [P <0.01]. Basic/clinical research articles accounted for 96.9% of publications, with three randomised controlled trials and no systematic reviews/meta-analyses. When adjusted for population size, Kuwait had the highest number of published papers per year, followed by Bahrain and Qatar. The number of authors per publication significantly increased during the study period [P = 0.02]. However, 16 articles [16.7%] had no citations. The median journal impact factor was 0.15 +/- 1.19 [range: 0-6.04]

Conclusion: The number of publications authored by GCC researchers has risen in recent years. Increasing research funding and promoting collaboration between local and international researchers and institutes are recommended to bolster research regarding DFD prevention and management in GCC countries

Validation of the existing modified screening criteria for detection of all cases of retinopathy of prematurity in preterm babies - 11 year study from a governorate referral hospital in Oman

Purpose: To study appropriateness of our modified screening criteria for detection of all cases of Retinopathy of Prematurity [ROP] among preterm babies

Method: Retrospective observational cohort study among preterm neonates who underwent ROP screening as per set protocol for 11 years at Nizwa Hospital, Al Dhakilya Governorate, Oman. We screened all babies with gestational age 32 weeks of GA or BW > 1500 g with unstable clinical course believed to be at high risk by the attending neonatologist also were screened

Results: During the study period 528 babies were screened for ROP of which 76 babies were excluded due to death, associated congenital ocular malformation and loss for follow-up either due to transfer to other institution or defaulting. Thus 452 babies were included in the final analysis. Incidence of ROP was 46.4% of which 27.9% had mild ROP, 11.3% had severe ROP which regressed and 7.3% had severe ROP who were treated. The incidence of ROP among infants with GA < 26 wks, 26-28 wks, 29-30 wks, 31-32 wks and above 32 weeks was 100.0%, 80.0%, 59.3%, 34.4% and 19.4% respectively. 56 babies of this cohort belonged to Extended [modified] criteria group. Among these 12 babies had ROP out of which 9 had mild ROP and 3 had severe ROP. Among cases with severe ROP, two cases regressed spontaneously and one case needed treatment. Multivariate analysis using stepwise regression model showed statistically significant association of GA and BW to development of ROP. We would have missed few babies with ROP if we had followed other criteria

Conclusion: Our modified screening criteria seem to be appropriate as no infant with severe ROP was missed during the study period. Incidence of severe ROP among babies in the extended criteria group [5.4%] is low but significant compared to lower gestational age. We plan to formulate a scoring system following all risk factor analysis to enable us to optimize the number of infants screened. Detection of all babies with ROP is important as they need long-term follow-up for the timely detection and management of associated ocular comorbidities

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