Invasive fungal infections in children with leukemia in a tertiary hospital in Oman: An eight-year review.

Background and Purpose: Invasive fungal disease (IFD) is a common and serious consequence of leukemia in children and the incidence of these infections has increased due to chemotherapy. This study aimed to present the epidemiology of IFD in a cohort of children with leukemia from a tertiary reference institution in Oman. Materials and Methods: A retrospective study of IFDs in pediatric patients below 13 years of age with newly diagnosed or relapsed leukemia was conducted at the Royal Hospital in Muscat, Oman. From 2010 to 2017, IFD episodes in children with leukemia were evaluated retrospectively, considering age, gender, type of leukemia, chemotherapy regimen, IFD detection phase, neutropenia, prevention, diagnostic method, and treatment. Results: Between 2010 and 2017, 198 children with leukemia were admitted and treated at Royal Hospital. Invasive fungal infection (IFI) was diagnosed in 32 patients out of 198 (16.1%), and IFI was defined as probable and proven in 53% (n=17) and 47% (n=15) of the cases, respectively. At 1.1:1, the male-to-female ratio was roughly equal. According to chest computed tomography scans, 65.6% of patients had radiological features of fungal infections. Positive fungal cultures were found in the bronchoalveolar lavage of three patients, 37.5% of whom had positive blood cultures, and 3% had positive urine cultures as a neonatal invasive candidiasis. In three patients, invasive aspergillosis caused pulmonary IFD, accounting for 9.3% of all infection sites. Candidaemia was found in 28% of IFD patients, and the most common organism was Candida tropicalis (15.6%), followed by Candida parapsilosis (6.25%). Furthermore, the major risk factor was febrile neutropenia. Conclusion: In children with leukemia, invasive fungal infection is common and serious. Despite aggressive treatment, mortality among these high-risk patients remains high.

Extrarenal Wilms' Tumour of the Ovary: A case report.

Wilms' tumour (nephroblastoma) is the most common abdominal malignancy in children. Extrarenal Wilms' tumour is rare, with limited reports in the literature. We report a two-year-old girl who presented to a tertiary care hospital in Muscat, Oman, in 2019 with an abdominal mass. The patient was diagnosed with unilateral ovarian Wilms' tumour (initially diagnosed by closed biopsy and confirmed later by histopathology study of the excised tumour). This report highlights the unusual location and presentation of Wilms' tumour and presents the medical challenge in both the initial clinical impression and pathological diagnosis. Furthermore, this report details the therapeutic plan and shows the good outcome achieved by using the classic renal Wilms' tumour therapy protocols.

A cluster analysis to explore the burden of primary caregivers of children with cancer in Oman.

PURPOSE: Few studies have sought to evaluate the risk burden of primary caregivers, particularly in Oman. This study aimed to explore whether different risk patterns of caregiver burden exist among the primary caregivers of Omani children with leukemia. DESIGN AND METHODS: A cross-sectional study was conducted between May and November 2020. A total of 101 primary caregivers of children with leukemia were recruited from a public hospital in Oman. The Caregiver Burden Inventory (CBI) was used to assess caregiver burden. RESULTS: A two-step cluster analysis indicated that the cohort was not homogeneous (silhouette value: 1.41). Caregivers in Cluster 1 (n = 42; 41.6%) were relatively older, less educated, and had a higher caregiving burden (mean CBI score: 37.7 ± 19.9). In contrast, caregivers in Cluster 2 (n = 59; 58.4%) were younger, more highly educated, and had a moderate caregiving burden (mean CBI score: 26.3 ± 13.6). As such, Clusters 1 and 2 were characterized as the "high-risk" and "moderate-risk" burden groups, respectively. PRACTICE IMPLICATIONS: This study highlights the need for a policy draft to target and reduce the caregiver burden in Oman, Nursing professionals should seek to develop and implement customized care depending on the caregiver risk burden, including additional financial, psychological, and physical support. They should seek to stratify caregivers by risk burden as some groups may require additional support. However, in light of recent precautionary measures due to the current pandemic situation, such services will have to be provided online or via telephone instead of in person for the foreseeable future.

Factors Contributing to the Unmet Needs of Primary Caregivers of Omani Children Diagnosed with Leukemia.

Objectives: Childhood cancers affect 6.7% of those under 14 in Oman, with leukemia being the most common. The psychological distress of having a child with leukemia is often compounded by perceived unmet needs by the child's primary caregiver. We aimed to identify factors contributing to perceived unmet needs among primary caregivers of Omani children with leukemia. Methods: We conducted a cross-sectional study among 119 Omani caregivers accompanying their children to the National Oncology Center, Muscat, Oman. We used an Arabic version of the Needs Assessment of Family Caregivers-Cancer (NAFC-C) questionnaire to assess perceived unmet needs in seven domains. Results: A total of 119 Omani primary caregivers were contacted; 101 agreed to participate in the study (response rate: 84.9%). Linear regression analysis showed significant correlations between total NAFC-C scores and the child's (p = 0.014) and caregiver's age (p < 0.001), and employment status (p = 0.024) and income (p = 0.028). Unmet needs in the obtaining information domain correlated with caregiver's age (p < 0.001), caring time (p = 0.018), and number of family members (p < 0.001), whereas needs in the maintaining own strength domain correlated with the child's gender (p = 0.028), time since diagnosis (p = 0.004), caregiver's age (p < 0.001), and education level (p = 0.019). Unmet needs in the accompanying the sick child domain were correlated with the child's gender (p = 0.049), caregiver's gender (p < 0.001), and income (p < 0.001). Conclusions: Various sociodemographic variables affected the unmet needs of primary caregivers of children with leukemias in Oman. Healthcare professionals in Oman should be aware of such factors to reduce caregiver distress.

Coronavirus Disease 2019 Infection in Children With Sickle Cell Disease: Case Series From Oman.

BACKGROUND: In March 2020, WHO announced Coronavirus Disease 2019 (COVID-19) outbreak a global pandemic. During this pandemic, patients with sickle cell disease (SCD) have been placed in the "high-risk" category of the population. Although there are numerous publications describing COVID-19 in adult patients, pediatric data are still limited. OBSERVATION: Herein, we report case series of 5 sickle cell disease Omani children who got infected with COVID-19; illustrating their different ways of presentation, management and highlighting the outcomes. CONCLUSION: Although SCD patients are considered as a high-risk group, all of the observed patients, and whose cases are reported here, have recovered. A large scale of SCD cases should be studied to reach more conclusive results.