PlantMedOman: an online database for Oman's medicinal plants.

The Sultanate of Oman has a rich biodiversity, particularly in medicinal plants, and plays a crucial role in traditional healthcare practices. However, the wealth of knowledge about these plants is scattered across various literature, making it challenging for researchers, practitioners, and the public to access comprehensive information. Therefore, the availability of a centralized, user-friendly online database to catalog Oman's medicinal plants is of great importance. PlantMedOman presented here, which currently holds 186 records helps to enhance academic research, support drug discovery studies, promote the conservation of medicinal plants, and foster greater awareness of Oman's ethnomedicinal heritage.

Assessment of Total Cardiovascular Risk Using WHO/ISH Risk Prediction Chart Among Adults in Oman: A Nationally Representative Survey.

Objectives: Cardiovascular diseases (CVDs) are the major cause of morbidity and mortality globally and in Oman. Stratifying the population under different risk levels based on the total CVD risk approach using the World Health Organization/International Society of Hypertension (WHO/ISH) risk prediction chart would be more effective in primary prevention of CVD to prioritize and utilize valuable resources. Hence, this study aimed to assess the total 10-year CVD risk among adults in Oman and to ascertain the proportion of the population in need of pharmacotherapy. Methods: We used the data from the 2017 national community-based STEPS survey conducted among men and women in Oman aged 40-80 years. Ten-year total cardiovascular risk was measured using the WHO/ISH risk prediction chart for Eastern Mediterranean Sub-Region B. Independent t-test and Chi-square were used to test significance. Results: There were 2510 participants in the study. Their mean age was 51.5±10.1 years and 51.3% were male. The prevalence of low, moderate, and high CVD risk was 68.0%, 19.1%, and 12.9%, respectively, as benchmarked by the WHO/ISH chart. Immediate pharmacotherapy was needed by 30.3% of participants. Factors significantly associated with elevated CVD risk were the participant's age (p < 0.001), education level (p < 0.001), and employment status (p < 0.001). Conclusions: A substantial fraction of the population in Oman are at moderate or high CVD risk. Prompt pharmacological interventions are warranted for at least one in every five individuals in conjunction with lifestyle changes.

Persistence of Symptoms Following Hospitalization for COVID-19 in Oman: A Bidirectional Observational Study.

Objectives: This study sought to assess the prevalence of persistent COVID-19-related symptoms in patients with mild, severe, and critical disease. Methods: We conducted a bidirectional cohort observational study that included all adult patients ≥ 18 years, admitted to Armed Forces Hospital, Muscat between July 2020 and June 2022, with COVID-19 infection and discharged alive. Patients were requested to attend outpatient clinic at weeks six and 12 post-discharge, where they filled out a questionnaire and underwent a chest X-ray. Additionally, blood tests were performed if necessary. Healthcare workers with mild infections were also requested to fill out a questionnaire about their initial symptoms, persistent symptoms, and comorbidities. Results: The study included 468 patients, comprising 261 hospitalized patients and 207 healthcare workers. On follow-up, 39.7% of patients presented with residual symptoms, such as cough, breathlessness, and joint pain. These symptoms were more common in patients with medical comorbidities, particularly hypertension, diabetes, and dyslipidemia. Notably, these symptoms were also observed in patients with mild disease. Post-COVID-19 pulmonary fibrosis was observed in 21 patients, mainly among those admitted to the intensive care unit or requiring prolonged hospitalization. Conclusions: This study highlights the persistence of symptoms and the prevalence of post-COVID-19 syndrome at two months post-discharge, especially among patients with severe and critical disease during the acute phase. Various predictors of post-COVID-19 syndrome were identified, including female gender, older age, presence of comorbidities, disease severity, and hypertension. Therefore, patients in these categories require thorough evaluation and long-term follow-up to manage residual symptoms.

Respiratory Complications after COVID-19.

COVID-19 pandemic has been associated with high short-term morbidity and mortality. Lungs are the main organs affected by SARS-CoV-2 infection. In the long-term, the pulmonary sequelae related to COVID-19 are expected to rise significantly leading to an extended impact on community health and health care facilities. A wide variety of long-term respiratory complications secondary to COVID-19 have been described ranging from persistent symptoms and radiologically observable changes to impaired respiratory physiology, vascular complications, and pulmonary fibrosis. Even after two-years, respiratory sequalae related to post-acute SARS-CoV-2 infection have not been fully explored and understood. The main treatment for most COVID-19 respiratory complications is still symptomatic and supportive-care oriented. In this review article, we shed light on current knowledge of the post-COVID-19 complications, focusing on pulmonary fibrosis, treatment directions, and recommendations to physicians.

Structural equation modeling to identify the direct and indirect risk factors of diabetes in adults: Findings from a national survey.

BACKGROUND: Few previous studies have investigated the multiple pathways that contribute to diabetes mellitus (DM) because of the complex, simultaneous interplay of attributing covariates. Structural equation modelling (SEM) is a robust multivariate approach that measures both direct and indirect effects of variables by simultaneously utilizing several regression equations. The current study applied SEM to test a hypothesized model of the covariates affecting DM among the adult population of the Sultanate of Oman. METHODS: Data from a large nationally representative 2017 WHO STEPwise approach to surveillance survey were analyzed. Stata 16 software was used to perform SEM and path analysis of the sociodemographic, behavioral, anthropometric, and metabolic variables affecting normoglycemia and DM. A priori factor structure was hypothesized with special emphasis on observing direct and indirect effects, and the correlations that defined them. RESULTS: Eight paths that directly affected DM status were established based on eight sociodemographic, metabolic, and behavioral variables (age, sex, educational status, physical activity level, body mass index, waist-to-hip ratio, systolic blood pressure, and family history of DM). The remaining variables (marital status, employment status, smoking, high-density lipoprotein level, total blood cholesterol level, fruit and vegetable intake, and type of oil used for cooking) showed variable indirect effects. CONCLUSIONS: The results of this study further reinforce the evidence that lifestyle changes are vital for the prevention and control of DM. Individuals with a family history of DM and a high waist-to-hip ratio comprise a high-risk group and should be targeted with screening and lifestyle-intervention programs.

Hypertension and Pre-Hypertension in Middle East and North Africa (MENA): A Meta-Analysis of Prevalence, Awareness, Treatment, and Control.

Hypertension (HTN) is one of the most important public health challenges, especially in developing countries. Despite individual studies, information on the exact prevalence of prehypertension (pre-HTN) and HTN in the Middle East and North Africa is lacking. This meta-analysis was conducted to evaluate prevalence of pre-HTN and HTN, awareness, treatment, and control in the Middle East and North Africa region. PubMed, Web of Science, and Scopus databases were searched from inception to April 30, 2021. Keywords included hypertension, pre-hypertension, awareness, treatment, and control. The quality of the included studies was evaluated using the Hoy scale. A random-effects model was evaluated based on overall HTN. The heterogeneity of the preliminary studies was evaluated using the I2 test. A total of 147 studies involving 1,312,244 participants were included in the meta-analysis. Based on the results of the random-effects method (95% CI), the prevalence of pre-HTN and HTN were 30.6% (95% CI: 25.2, 36.0%; I2 = 99.9%), and 26.2% (95% CI: 24.6, 27.9%; I2 = 99.8%), respectively. The prevalence of HTN awareness was 51.3% (95% CI: 47.7, 54.8; I2 = 99.0%). The prevalence of HTN treatment was 47.0% (95% CI: 34.8, 59.2; I2 = 99.9%). The prevalence of HTN control among treated patients was 43.1% (95% CI: 38.3, 47.9; I2 = 99.3%). Considering the high prevalence of HTN, very low awareness, and poor HTN control in the region, more attention should be paid to preventive programs for HTN reduction.

Psychological impact of COVID-19 on healthcare workers: cross-sectional analyses from 14 countries.

Background: Healthcare workers (HCWs) have been impacted psychologically due to their professional responsibilities over the prolonged era of the coronavirus disease 2019 (COVID-19) pandemic. The study aimed to identify the predictors of psychological distress, fear, and coping during the COVID-19 pandemic among HCWs. Methods: A cross-sectional online survey was conducted among self-identified HCWs across 14 countries (12 from Asia and two from Africa). The Kessler Psychological Distress Scale, the Fear of COVID-19 Scale, and the Brief Resilient Coping Scale were used to assess the psychological distress, fear, and coping of HCWs, respectively. Results: A total of 2447 HCWs participated; 36% were doctors, and 42% were nurses, with a mean age of 36 (±12) years, and 70% were females. Moderate to very-high psychological distress was prevalent in 67% of the HCWs; the lowest rate was reported in the United Arab Emirates (1%) and the highest in Indonesia (16%). The prevalence of high levels of fear was 20%; the lowest rate was reported in Libya (9%) and the highest in Egypt (32%). The prevalence of medium-to-high resilient coping was 63%; the lowest rate was reported in Libya (28%) and the highest in Syria (76%). Conclusion: COVID-19 has augmented the psychological distress among HCWs. Factors identified in this study should be considered in managing the wellbeing of HCWs, who had been serving as the frontline drivers in managing the crisis successfully across all participating countries. Furthermore, interventions to address their psychological distress should be considered.

Period-prevalence and Publication Rate of Health Research Productivity in Seven Arabian Gulf Countries: Bibliometric Analysis from 1996 to 2018.

OBJECTIVES: Despite the worldwide increase in health research, few studies have evaluated the health research productivity in member states of the Gulf Health Council (GHC). This study solicited the period-prevalence and publication rates of health research productivity in the seven GHC countries. METHODS: We searched the Scopus database for publications between 1996 and 2018 and used the SCImago Journal and Country Rank portal to obtain the relevant information. We also recorded qualitative (citation-based) and quantitative (document recount) indicators. Overall and country-specific period-prevalence and publication rates were estimated and standardized to the corresponding overall Gulf Cooperation Council (GCC) population and country-specific population size. RESULTS: Overall, 112 409 articles were enumerated during the study period. The majority (59.8%) were from Saudi Arabia, followed by UAE (11.9%). The GCC publications were associated with 1 315 778 citations, which revealed a 46.0 Hirsch-index. The period-prevalence of health publications for the overall GCC region was 1320 publications per million population over 22 years, and the publication rate estimate was 13.2 (95% confidence interval (CI): 13.1-13.3) publication per 10 000 population. The highest publication rate estimate was noted in Qatar (36.5; 95% CI: 35.8-37.3), followed by Kuwait, Bahrain, Saudi Arabia, UAE, Oman, and Yemen. CONCLUSIONS: This study is the first study in the context of GCC to utilize period-prevalence and publication rates to chart health research productivity in the GCC region. Concerted efforts are required to improve the quality and quantity of the health research output in the GCC region.

Prevalence of risk factors of non-communicable diseases in the Sultanate of Oman: STEPS survey 2017.

BACKGROUND: Non-communicable diseases (NCD) represent a major public health issue and currently cause 185.75 deaths per 100,000 population in Oman. Hence, there is a need for comprehensive, up-to-date and internationally comparable data on NCD risk factors in order to evaluate the effectiveness of ongoing public health policies and to develop further NCD prevention and control interventions. The aim of the study was to provide evidence-based, up-to-date, extensive, and reliable baseline data on the behavioural and biological risk factors of NCDs in the Sultanate of Oman. METHODS: A cross-sectional, prospective, observational community-based survey designed to be nationally representative of the Sultanate of Oman was conducted based on the WHO STEPwise approach to Surveillance (STEPS). Multi-stage stratified random sampling according to geographical distribution selected a total of 9053 households (Omani nationals and non-Omani residents). Cluster sampling was used to randomly select equal clusters from each governorate. 823 households were randomly selected from the list of all households in all selected clusters from each governorate and one eligible adult selected from each household randomly accounting for 6582 consenting participants. The survey used demographic and behavioural information questionnaires along with physical and biochemical measurements among adults aged 18 years and above. RESULTS: The prevalence of behavioural risk factors such as tobacco use was 9%, alcohol consumption was 2%, insufficient fruit or vegetable intake was 61%, and insufficient physical activity was 39%. The prevalence of biological risk factors such as overweight and obesity was 66%, raised blood pressure was 33%, raised blood glucose was 16%, and raised blood cholesterol was 36%. The prevalence of multiple risk factors was also determined and 95% of the population were found to have more than one risk factor. Three or more risk factors were found among 33% of population aged 18 years and above and 45% of the population aged 45 years and above. CONCLUSION: A high prevalence of various NCD risk factors was found which needs to be addressed through health promotion, education, and policy. The findings are important to support the formulation and implementation of NCD-related policies and action plans that improve health status and prevent mortality due to NCDs in Oman.

COVID-19: Factors associated with psychological distress, fear, and coping strategies among community members across 17 countries.

BACKGROUND: The current pandemic of COVID-19 impacted the psychological wellbeing of populations globally. OBJECTIVES: We aimed to examine the extent and identify factors associated with psychological distress, fear of COVID-19 and coping. METHODS: We conducted a cross-sectional study across 17 countries during Jun-2020 to Jan-2021. Levels of psychological distress (Kessler Psychological Distress Scale), fear of COVID-19 (Fear of COVID-19 Scale), and coping (Brief Resilient Coping Scale) were assessed. RESULTS: A total of 8,559 people participated; mean age (±SD) was 33(±13) years, 64% were females and 40% self-identified as frontline workers. More than two-thirds (69%) experienced moderate-to-very high levels of psychological distress, which was 46% in Thailand and 91% in Egypt. A quarter (24%) had high levels of fear of COVID-19, which was as low as 9% in Libya and as high as 38% in Bangladesh. More than half (57%) exhibited medium to high resilient coping; the lowest prevalence (3%) was reported in Australia and the highest (72%) in Syria. Being female (AOR 1.31 [95% CIs 1.09-1.57]), perceived distress due to change of employment status (1.56 [1.29-1.90]), comorbidity with mental health conditions (3.02 [1.20-7.60]) were associated with higher levels of psychological distress and fear. Doctors had higher psychological distress (1.43 [1.04-1.97]), but low levels of fear of COVID-19 (0.55 [0.41-0.76]); nurses had medium to high resilient coping (1.30 [1.03-1.65]). CONCLUSIONS: The extent of psychological distress, fear of COVID-19 and coping varied by country; however, we identified few higher risk groups who were more vulnerable than others. There is an urgent need to prioritise health and well-being of those people through well-designed intervention that may need to be tailored to meet country specific requirements.

Mental health outcomes among health-care workers in Oman during COVID-19: A cluster analysis.

AIM: Despite the much heralded epidemic of adjustment difficulties, health-care workers (HCW), who are likely to be at risk and impacted with mental health issues, have received scant attention. This study aimed to determine whether definable profiles exist in a cohort of HCWs associated with demographic and mental health problems. METHODS: An online cross-sectional survey was conducted in Oman. Demographic and mental health data were collected from 8 to 17 April 2020. A total of 1132 participants returned their completed questionnaire. A two-step cluster analysis was used to split the sample into three clusters. RESULTS: Cluster A (n = 416) was from HCW in non-frontline roles, and constituted "low-risk and least-impacted". Cluster B (n = 412) and Cluster C (n = 304) were from frontline HCW and constituted 'high-risk and moderate-impacted' and 'high-risk and high-impacted' groups, respectively. HCWs in Cluster C reported more depression (P < 0.001), anxiety (P < 0.001), stress (P < 0.001) and clinical insomnia (P < 0.001) compared with those in the other clusters. HCWs in Cluster C were at the highest risk for mental health problems during the pandemic. CONCLUSIONS: Early psychological interventions targeting this vulnerable group may be beneficial. Management should develop different tailor-made strategic plans to address different mental health needs for each profile group.

Demographic and socioeconomic determinants of COVID-19 across Oman - A geospatial modelling approach.

Local, bivariate relationships between coronavirus 2019 (COVID-19) infection rates and a set of demographic and socioeconomic variables were explored at the district level in Oman. To limit multicollinearity a principal component analysis was conducted, the results of which showed that three components together could explain 65% of the total variance that were therefore subjected to further study. Comparison of a generalized linear model (GLM) and geographically weighted regression (GWR) indicated an improvement in model performance using GWR (goodness of fit=93%) compared to GLM (goodness of fit=86%). The local coefficient of determination (R2) showed a significant influence of specific demographic and socioeconomic factors on COVID-19, including percentages of Omani and non-Omani population at various age levels; spatial interaction; population density; number of hospital beds; total number of households; purchasing power; and purchasing power per km2. No direct correlation between COVID- 19 rates and health facilities distribution or tobacco usage. This study suggests that Poisson regression using GWR and GLM can address unobserved spatial non-stationary relationships. Findings of this study can promote current understanding of the demographic and socioeconomic variables impacting the spatial patterns of COVID-19 in Oman, allowing local and national authorities to adopt more appropriate strategies to cope with this pandemic in the future and also to allocate more effective prevention resources.

Prevalence of Diabetic Retinopathy in Oman: A Two Decade National Study.

OBJECTIVES: Diabetes mellitus (DM) is one of the major chronic diseases with a world prevalence of 8.5%. Oman has shown a consistent rise in the prevalence of DM, reaching 14.5% in 2017. A major complication of DM is diabetic retinopathy (DR). There is limited information available about the prevalence of DR and its subtypes in Oman. This is the largest national study conducted to determine the prevalence of DR and its subtypes in Oman. METHODS: We extracted the records of 2000 Omani patients with DM and retrospectively screened for DR, non-proliferative diabetic retinopathy (NPDR), and proliferative diabetic retinopathy (PDR) reported between 2000 and 2017. The sample included patients from 79 medical centers from all governorates of Oman. A total of 616 patients were included in the study. We investigated the prevalence of DR among both genders and different age groups. We studied the association between the progression of DM into DR. RESULTS: The prevalence of DR, NPDR, and PDR within patients diagnosed with DM was 19.2% (95% confidence interval (CI): 16.2-22.5), 8.6% (95% CI: 6.6-11.1), and 1.3% (95% CI: 0.7-2.5), respectively. Moreover, females have shown a higher prevalence of any DR, compromising 60.2% of all patients diagnosed with DR, 62.3% of all NPDR patients, and 75.0% of all PDR patients. However, there was no significant association between sex and DR (p = 0.840). There was a significant association between having DM for 10 years and DR (p = 0.010). CONCLUSIONS: The prevalence of DR increased from 14.3% in 2003 to 19.3% in 2017. Effective health policies and screening programs should be employed to control the increased prevalence of DM and DR.

Prevalence and risk factors of diabetes in a large community-based study in the Sultanate of Oman: STEPS survey 2017.

BACKGROUND: Type 2 diabetes in the Gulf Cooperation Council countries, including Oman, is currently the fastest growing health crisis and is a significant cause of premature mortality and disability. There is currently insufficient up-to-date information available on prevalence of type 2 diabetes. This study aimed to assess the latest prevalence of type 2 diabetes mellitus and its associated demographic, behavioural, and clinical risk factors. METHODS: Using the WHO STEPwise approach to chronic disease surveillance, a nationally representative population-based survey was conducted from January to April 2017 of adults aged 18 years and above. A multi-stage, stratified, geographically clustered random sampling surveyed 9053 households including Omani nationals and non-Omani residents. Univariate and multiple logistic regression analysis was performed to determine the predictors of diabetes. RESULTS: Overall prevalence of diabetes among the population was 15.7% (95% CI: 14.0-17.5%) whereas prevalence of prediabetes was 11.8% (95% CI: 11.4-12.2%). Age, educational level, raised blood pressure, family history of diabetes, abnormal waist-to-hip ratio, and hypertriglyceridemia were found to be significantly associated with diabetes mellitus. Of the cases of diabetes mellitus, 17% were newly diagnosed and 13.2% were on medication and had an uncontrolled glucose level while 55.5% were not taking medication (although diagnosed) and had an uncontrolled blood glucose level. CONCLUSIONS: The present study provides reliable information regarding the high prevalence of diabetes mellitus among the adult population in Oman with urgent attention needed to address this significant burden on the health system. The high proportion of uncontrolled cases warrants further research, awareness programmes, and community interventions.

Forecasting the type 2 diabetes mellitus epidemic and the role of key risk factors in Oman up to 2050: Mathematical modeling analyses.

AIMS/INTRODUCTION: To investigate and forecast type 2 diabetes mellitus epidemic, its related risk factors and cost in Oman by 2050. MATERIALS AND METHODS: An age-structured mathematical model was used to characterize type 2 diabetes mellitus epidemiology and trends in Oman between 1990 and 2050. The model was parametrized using current and quality data, including six nationally representative population-based epidemiological surveys for type 2 diabetes mellitus and its key risk factors. RESULTS: The projected type 2 diabetes mellitus prevalence increased from 15.2% in 2020 to 23.8% in 2050. The prevalence increased from 16.8 and 13.8% in 2020 among women and men to 26.3 and 21.4% in 2050, respectively. In 2020, 190,489 Omanis were living with type 2 diabetes mellitus compared with 570,227 in 2050. The incidence rate per 1,000 person-years changed from 8.3 in 2020 to 12.1 in 2050. Type 2 diabetes mellitus' share of Oman's national health expenditure grew by 36% between 2020 and 2050 (from 21.2 to 28.8%). Obesity explained 56.7% of type 2 diabetes mellitus cases in 2020 and 71.4% in 2050, physical inactivity explained 4.3% in 2020 and 2.7% in 2050, whereas smoking accounted for <1% of type 2 diabetes mellitus cases throughout 2020-2050. Sensitivity and uncertainty analyses affirmed these predictions. CONCLUSIONS: The type 2 diabetes mellitus epidemic in Oman is expected to increase significantly over the next three decades, consuming nearly one-third of the national health expenditure. The type 2 diabetes mellitus burden is heavily influenced by obesity. Interventions targeting this single risk factor should be a national priority to reduce and control the burden of type 2 diabetes mellitus in Oman.

National survey to estimate sodium and potassium intake and knowledge attitudes and behaviours towards salt consumption of adults in the Sultanate of Oman.

OBJECTIVES: To estimate population sodium and potassium intakes and explore knowledge, attitudes and behaviour (KAB) towards the use of salt in adults in the Sultanate of Oman. DESIGN: National cross-sectional population-based survey. SETTING: Proportional random samples, representative of Omani adults (18 years or older), were obtained from all governorates of the Sultanate of Oman. PARTICIPANTS: Five hundred and sixty-nine (193 men, 376 women; 18 years or older) were included in the analysis (response rate 57%). Mean age was 39.4 years (SD 13.1). Participants attended a screening including demographic, anthropometric and physical measurements. PRIMARY AND SECONDARY OUTCOME MEASURES: We assessed dietary sodium, potassium and creatinine by 24-hour urinary sodium (UNa), potassium (UK) and creatinine (UCr) excretions. We collected KAB by a questionnaire on an electronic tablet. RESULTS: Mean UNa was 144.3 (78.8) mmol/day, equivalent to 9.0 g of salt/day and potassium excretion 52.6 (32.6) mmol/day, equivalent to 2.36 g/day, after adjusting for non-urinary losses. Men ate significantly more sodium and potassium than women. Only 22% of the sample had a salt intake below the WHO recommended target of 5 g/day and less than 10% met WHO targets for potassium excretion (>90 mmol/day). While 89.1% of those interviewed knew that consuming too much salt could cause serious health problems and only 6.9% felt they were using too much added salt, one in two participants used always or often salt, salty seasonings or salty sauces in cooking or when preparing food at home. CONCLUSIONS: In the Sultanate of Oman, salt consumption is higher and potassium consumption lower than recommended by WHO, both in men and in women. The present data provide, for the first time, evidence to support a national programme of population salt reduction to prevent the increasing burden of cardiovascular disease in the area.

Factors associated with mental health outcomes across healthcare settings in Oman during COVID-19: frontline versus non-frontline healthcare workers.

OBJECTIVE: This study aims to assess and compare demographic and psychological factors and sleep status of frontline healthcare workers (HCWs) in relation to non-frontline HCWs. DESIGN, SETTINGS, PARTICIPANTS AND OUTCOMES: This cross-sectional study was conducted from 8 April 2020 to 17 April 2020 using an online survey across varied healthcare settings in Oman accruing 1139 HCWs.The primary and secondary outcomes were mental health status and sociodemographic data, respectively. Mental health status was assessed using the Depression, Anxiety, and Stress Scale (DASS-21), and insomnia was evaluated by the Insomnia Severity Index. Samples were categorised into the frontline and non-frontline groups. χ2 and t-tests were used to compare groups by demographic data. The Mantel-Haenszel OR was used to compare groups by mental health outcomes adjusted by all sociodemographic factors. RESULTS: This study included 1139 HCWs working in Oman. While working during the pandemic period, a total of 368 (32.3%), 388 (34.1%), 271 (23.8%) and 211 (18.5%) respondents were reported to have depression, anxiety, stress and insomnia, respectively. HCWs in the frontline group were 1.5 times more likely to report anxiety (OR=1.557, p=0.004), stress (OR=1.506, p=0.016) and insomnia (OR=1.586, p=0.013) as compared with those in the non-frontline group. No significant differences in depression status were found between the frontline and non-frontline groups (p=0.201). CONCLUSIONS: To our knowledge, this is the first study to explore the differential impacts of the COVID-19 pandemic on different grades of HCWs. This study suggests that frontline HCWs are disproportionally affected compared to non-frontline HCWs, with managing sleep-wake cycles and anxiety symptoms being highly endorsed among frontline HCWs. As psychosocial interventions are likely to be constrained owing to the pandemic, mental healthcare must first be directed to frontline HCWs.

Clinical and genetic characteristics of autosomal recessive polycystic kidney disease in Oman.

BACKGROUND: There is a high prevalence of rare genetic disorders in the Middle East, and their study provides unique clinical and genetic insights. Autosomal recessive polycystic kidney disease (ARPKD) is one of the leading causes of kidney and liver-associated morbidity and mortality in Oman. We describe the clinical and genetic profile of cohort of ARPKD patients. METHODS: We studied patients with a clinical diagnosis of ARPKD (n = 40) and their relatives (parents (n = 24) and unaffected siblings (n = 10)) from 32 apparently unrelated families, who were referred to the National Genetic Centre in Oman between January 2015 and December 2018. Genetic analysis of PKHD1 if not previously known was performed using targeted exon PCR of known disease alleles and Sanger sequencing. RESULTS: A clinical diagnosis of ARPKD was made prenatally in 8 patients, 21 were diagnosed during infancy (0-1 year), 9 during early childhood (2-8 years) and 2 at later ages (9-13 years). Clinical phenotypes included polycystic kidneys, hypertension, hepatic fibrosis and splenomegaly. Twenty-four patients had documented chronic kidney disease (median age 3 years). Twenty-four out of the 32 families had a family history suggesting an autosomal recessive pattern of inherited kidney disease, and there was known consanguinity in 21 families (66%). A molecular genetic diagnosis with biallelic PKHD1 mutations was known in 18 patients and newly identified in 20 other patients, totalling 38 patients from 30 different families. Two unrelated patients remained genetically unsolved. The different PKHD1 missense pathogenic variants were: c.107C > T, p.(Thr36Met); c.406A > G, p.(Thr136Ala); c.4870C > T, p.(Arg1624Trp) and c.9370C > T, p.(His3124Tyr) located in exons 3, 6, 32 and 58, respectively. The c.406A > G, p.(Thr136Ala) missense mutation was detected homozygously in one family and heterozygously with a c.107C > T, p.(Thr36Met) allele in 5 other families. Overall, the most commonly detected pathogenic allele was c.107C > T; (Thr36Met), which was seen in 24 families. CONCLUSIONS: Molecular genetic screening of PKHD1 in clinically suspected ARPKD cases produced a high diagnostic rate. The limited number of PKHD1 missense variants identified in ARPKD cases suggests these may be common founder alleles in the Omani population. Cost effective targeted PCR analysis of these specific alleles can be a useful diagnostic tool for future cases of suspected ARPKD in Oman.

Global Prevalence and Device Related Causes of Needle Stick Injuries among Health Care Workers: A Systematic Review and Meta-Analysis.

Background: Healthcare workers (HCWs) suffer more than 2 million occupational needle-stick injuries (NSIs) annually. Goal: To determine the global prevalence and causes of NSIs among HCWs. Methods: In this systematic review and meta-analysis, three databases (PubMed, Web of science, and Scopus) were searched for reports from January 1, 2000 to December 31, 2018. The random effects model was used to determine the prevalence of NSIs among HCWs. Hoy et al.'s instrument was employed to evaluate the quality of the included studies. Findings: A total of 87 studies performed on 50,916 HCWs in 31 countries worldwide were included in the study. The one-year global pooled prevalence of NSIs among HCWs was 44.5% (95% CI: 35.7, 53.2). Highest prevalence of NSIs occurred in the South East Asia region at 58.2% (95%, CI: 36.7, 79.8). By job category, prevalence of NSIs was highest among dentists at 59.1% (95% CI: 38.8, 79.4), Hypodermic needles were the most common cause of NSIs at 55.1% (95% CI: 41.4, 68.9). Conclusion: The current high prevalence of NSIs among HCWs suggests need to improve occupational health services and needle-stick education programs globally.