Quality of Life Among Postgraduate Medical Residents in Oman: A Cross-sectional Survey.

Objectives: To assess the quality of life (QoL) of medical residents enrolled in the various postgraduate programs of the Oman Medical Specialty Board (OMSB). Methods: The data for this cross-sectional study was collected from January to June 2022. All postgraduate residents who were enrolled in all 19 OMSB training programs were targeted. An online English version of the validated 36-Item Short Form Health Survey (SF-36) was used to assess the participants' self-reported QoL. Results: The participants were 425 OMSB residents (mean age = 29.6±2.2 years), of whom 289 (68.0%) were female, 259 (60.9%) were married, and 295 (69.4%) were enrolled in medical specialties. Overall, female residents reported significantly poorer QoL than male residents in all subscales of SF-36 (p =0.001). Married residents reported lower bodily pain scores than unmarried residents (p =0.005), although the latter endorsed better physical functioning, general health, and mental health. Residents in laboratory specialties had higher scores than those in medical and surgical specialties in most QoL dimensions including physical health, role functioning, energy/fatigue, emotional well-being, bodily pain, and general health (p ≤ 0.003). Psychiatry residents reported the lowest overall QoL. Conclusions: Postgraduate medical residents in Oman reported significant variations in QoL based on specialization, gender, and marital status. These findings underscore the need for targeted interventions to tackle health inequalities and improve the QoL of this population.

Barriers and Attitudes toward Breast Cancer Screening among Omani Women.

BACKGROUND: Breast cancer (BC) is the most common cancer accounting for 24.5% of Omani female cancer. Early detection of BC through regular breast cancer screening (BCS) has been found to decrease mortality rates. The aim of this study was to identify knowledge, attitudes and barriers of Omani women toward BCS. METHODS: A cross-sectional study was conducted among adult Omani women attending the Sultan Qaboos University Hospital (SQUH). RESULTS: A total of 358 Omani women participated from 420 invited (response rate = 85.2%). Most women (92.1%) thought that BC could be cured if detected early, but less than half (46.8%) thought that they were at risk of BC if a relative had BC. The majority (81.1%) were aware that BCS was available in Oman, though less than half (48.5%) knew where to go for BCS and most (83.8%) had not undergone BCS before. The most common personal-related barriers to BCS were fear of BC diagnosis (40.8%), fear of treatment (52.1%) and embarrassment of the breast examination (46.6%). The most perceived system-related barriers to BCS were the concern over the availability of a male doctor (46.6%) or a non-Arabic speaking doctor (38.7%) and not recommended by the doctor (46.3%). Univariate binary logistic regression showed that attitudes toward BCS were influenced by their previous experiences of BCS (odds ratio [OR] = 2.28; 95% confidence interval [CI]: 1.18-4.41) and their willingness to participate in the future BCS [OR = 1.96; 95% CI: 1.14-3.37). CONCLUSION: Although Omani women showed an interest toward BCS, few had undergone BCS. Several cultural, practical and personal-related barriers were noted to interfere with BCS in Oman. Addressing these concerns through involving healthcare providers to reassure the women and implementing a national strategy of BCS could improve BCS screenings and early diagnosis of BC.

Potentially Inappropriate Prescribing among Elderly Patients at a Primary Care Clinic in Oman.

Drug prescribing to the elderly increases the risk of potential adverse drug reactions as well as potentially inappropriate medications. The goal of this study was to describe drug prescribing patterns in elderly patients and to measure the prevalence of potentially inappropriate medications using updated Beers' criteria and the STOPP criteria. This was a retrospective cross-sectional study for all patients aged ≥65 years who attended regularly a primary care clinic at Sultan Qaboos University Hospital in Oman. Data of 377 patients were analyzed using the software Statistical Package for Social Sciences version 23.0 (SPSS™, Chicago, IL, USA). Using Beers criteria, the prevalence of potentially inappropriate medications was 12.7% as 48 patients had at least one potentially inappropriate medication. Beers criteria revealed a statistical association between the occurrence of potentially inappropriate medications with polypharmacy (p < 0.001), with female gender (p = 0.002) and with asthma as a comorbidity (p = 0.020). STOPP criteria showed that the prevalence of potentially inappropriate medications was 17.2% as 65 patients had at least one potentially inappropriate medication. STOPP criteria revealed a statistical association between the occurrence of potentially inappropriate medications and osteoarthritis as a comorbidity (p = 0.032). The study revealed moderate prevalence of potentially inappropriate medications prescribing in elderly patients which was mainly associated with polypharmacy and female gender. Safe prescribing practices in the elderly requires increasing the awareness of healthcare providers and efficiently reporting drug-related problems.

Proportion of night eating syndrome in Arab population of Oman.

OBJECTIVE: Globally obesity has reached epidemic proportions with alarming rates in the Arabian Gulf countries. The impact of behavioral eating habits and in particular night eating syndrome (NES) have not been emphasized in the region. This study assessed the proportion of NES in an Omani Arab adult population sample. METHOD: A night eating syndrome questionnaire (NEQ) was distributed to Omani adults above the age of 20. RESULTS: Out of the 454 respondents, 26.4 % endorsed evening hyperphagia while nocturnal ingestion was present in 4.7 % of the respondents. In addition, 1.5 % of the respondents met the NES criteria. CONCLUSIONS AND IMPLICATIONS: The proportion of NES in Omani adult population is similar to the reported rates in general world populations. In conclusion, night eating syndrome is present in the Omani Arab adults and should be taken into account in national management for increased obesity trends in the region.

Public awareness of warning signs and symptoms of cancer in oman: a community-based survey of adults.

BACKGROUND: The majority of deaths from cancer occur in low and middle income countries, partly due to poor public awareness of the signs and symptoms of cancer. MATERIALS AND METHODS: A community based survey using the Cancer Awareness Measure (CAM) questionnaire was conducted in three different communities in Oman. Omani adults aged 18 years and above were invited to participate in the study. RESULTS: A total of 345 responded from 450 invited participants (response rate=76.7%). The majority of respondents were unable to identify the common signs and symptoms of cancer identified in the CAM (average awareness was 40.6%). The most emotional barrier to seeking help was worry about what the doctor might find (223, 64.6%); a practical barrier was too busy to make an appointment (259, 75.1%) and a service barrier was difficulty talking to the doctor (159, 46.1%). The majority of respondents (more than 60% for seven out of ten symptoms) would seek medical help in two weeks for most signs or symptoms of cancer. Females were significantly more likely than males to be embarrassed (p<0.001), scared (p=0.001), and lack confidence talking about their symptoms (p=0.022). CONCLUSIONS: Urgent strategies are needed to improve public awareness of the signs and symptoms of cancer in Oman. This might leads to earlier diagnosis, improved prognosis and reduced mortality from cancer.

Syringocystadenoma papilliferum of the upper lip.

Syringocystadenoma papilliferum (SCAP) is a rare skin tumour believed to arise from the apocrine or eccrine sweat glands. It appears predominantly in childhood, usually at birth. It is exceedingly rare for it to appear on the upper lip. We report a case of SCAP in a 10-year-old Omani girl who presented to the Sultan Qaboos University Hospital in Muscat, Oman, in February 2012 with a non-tender, non-pruritic, solitary verrucous papule of 4 × 5 mm on the left side of the upper lip. It had been present since birth and had slowly been increasing in size over the years. It was occasionally associated with recurrent ulceration and bleeding and had previously been misdiagnosed and mismanaged. An excisional biopsy was performed and the whole lesion was removed. The surgical site was then sutured and the patient was discharged on the same day.

Awareness of risk factors for cancer among Omani adults--a community based study.

BACKGROUND: Cancer is the leading cause of mortality around the world. However, the majority of cancers occur as a result of modifiable risk factors; hence public awareness of cancer risk factors is crucial to reduce the incidence. The objective of this study was to identify the level of public awareness of cancer risk factors among the adult Omani population. MATERIALS AND METHODS: A community based survey using the Cancer Awareness Measure (CAM) questionnaire was conducted in three areas of Oman to measure public awareness of cancer risk factors. Omani adults aged 18 years and above were invited to participate in the study. SPPSS (ver.20) was used to analyse the data. RESULTS: A total of 384 participated from 500 invited individuals (response rate =77%). The majority of respondents agreed that smoking cigarettes (320, 83.3%), passive smoking (279, 72.7%) and excessive drinking of alcohol (265, 69%) are risks factors for cancer. However, fewer respondents agreed that eating less fruit and vegetables (83, 21.6%), eating more red or processed meat (116, 30.2%), being overweight (BMI>25) (123, 32%), doing less physical exercise (119, 31%), being over 70 years old (72, 18.8%), having a close relative with cancer (134, 34.9%), infection with human papilloma virus (HPV) (117, 30.5%) and getting frequent sunburn during childhood (149, 38.8%) are risk factors for cancer. A significant association was found between participant responses and their educational level. The higher the educational level, the more likely that respondents identified cancer risk factors including smoking (p<0.0005), passive smoking (p= 0.007), excessive drinking of alcohol (p<0.0005), eating less fruit and vegetables (p= 0.001) and infection with HPV (p<0.0005). CONCLUSIONS: The majority of respondents in this study in Oman were not aware of the common risk factors for cancer. It may be possible to reduce the incidence of cancers in Oman by developing strategies to educate the public about these risk factors.

Patients' attitudes and experiences of relational continuity in semi-urban general practices in Oman.

BACKGROUND: Relational continuity is a cornerstone of primary care. In developing countries, however, little research has been conducted to determine the perception and experiences of patients in view of relational continuity in primary care. OBJECTIVE: To study the role of relational continuity in primary care settings and its effect on patients' perceptions and experiences. METHODS: A questionnaire-based survey was conducted at eight primary care health centres (PCHCs) in Al-Seeb province, Muscat, the capital city of Oman. All Omani patients aged 18 years and above attending their PCHCs during the study period were invited to participate in the study. RESULTS: From a total of 1300 patients invited, 958 Omani patients agreed to participate in the study (response rate = 74%). More than half of the patients (61%) expressed the preference of consulting the same primary care physician (PCP) to whom they were accustomed. This increased to 69% if the patients had psychosocial problems and to 71% if the patients had chronic medical conditions. A significant proportion of the respondents (72%) felt comfortable and relaxed when consulting the same PCP and 67% expressed an interest in maintaining continuity with the same PCP. The general perspective held by the majority of the studied patients (61%) indicated that relational continuity improved both the patients' medical conditions (51%) and the quality of services (61%). In actuality, however, only 18% experienced relational continuity in their PCHCs. The preference for relational continuity was significantly increased among patients who identified a favourite PCP (P = 0.029) and among educated patients (P = 0.023). CONCLUSION: Although it is relatively difficult to consult with the same PCP, the majority of Omani patients have experienced several benefits from relational continuity within the context of patient-physician relationship. The preference for relational continuity was highly expressed by patients with chronic or psychosocial problems, patients who were educated and those who identified a named PCP. In view of these findings, the basis of relational continuity if progressed, a great effort is needed to develop and implement strategies to promote relational continuity in primary health care in Oman.

Psychosocial impact of breast cancer diagnosis among omani women.

OBJECTIVES: The aim of this study was to explore different psychosocial impacts on Omani women diagnosed with breast cancer. METHODS: Semi-structured individual interviews were conducted with 19 Omani women diagnosed with breast cancer to describe the impact of the disease on their personal and social life. Women were recruited from wards and out-patient clinics at the Sultan Qaboos University Hospital, Muscat. RESULTS: Four main themes emerged. These were: a) factors related to psychological distress of the disease and uncertainty (worry of death, interference with work and family responsibilities, searching for hope/cure, travelling overseas); b) reactions of family members (shocked, saddened, unity, pressure to seek traditional treatments); c) views of society (sympathy, isolation, reluctant to disclose information); and d) worries and threats about the future (side effects of chemotherapy, spread of the disease, effect on offspring). CONCLUSION: Breast cancer diagnosis has several devastating psychosocial impacts on women in Oman. Healthcare professionals working with women with breast cancer should be aware of the different psychosocial impacts of the disease on women's lives. Appropriate measures must be taken by the decision makers whenever needed, including enforcing positive views and support of Oman's society towards women with breast cancer.

A massive tuberculosis abscess at the erector spinae muscles and subcutaneous tissues in a young man.

Tuberculosis (TB) is a chronic granulomatous infection which can present in an atypical form. Isolated muscle involvement is very rare. We report a 25-year-old man who presented with a massive cystic swelling on the right side of his back, extending from the lower thoracic to the gluteal region. He had a history of contact with a friend who was suspected of having TB. Magnetic resonance imaging (MRI) showed that the origin of the cyst was from the erector spinae muscles. The result of a fluid aspirate showed acid fast bacilli. The swelling disappeared after treatment with anti-tuberculous medications. Muscular involvement in TB is very rare. In our patient, the reports of an ultrasound and MRI confirmed isolated muscle and subcutaneous involvement without bony lesions. This case is reported to increase physician awareness regarding soft tissue TB. Although it is rare, similar cases may be seen in the future.

Effects of Pre-Pregnancy Body Mass Index and Gestational Weight Gain on Low Birth Weight in Omani Infants: A case-control study.

OBJECTIVES: This study aimed to investigate the association between pre-pregnancy maternal body mass index (BMI), gestational weight gain and low birth weight (LBW) in babies born to a sample population of Omani women. METHODS: A case-control study was carried out among deliveries registered between 1(st) May 2010 and 30(th) April 2011 at Sultan Qaboos University Hospital, Muscat, Oman. A case was defined as a woman who delivered a low birth weight baby (<2,500 g); a control was a woman delivering a baby weighing between 2,500 and 4,000 g. A random selection of 150 cases and 300 controls was carried out using the hospital information system. Maternal, pre-natal, and delivery data were extracted from the mothers' follow-up cards. Bivariate and multivariate logistic regression analyses were executed to examine the association between pre-pregnancy maternal BMI and LBW. RESULTS: The percentage of underweight mothers (BMI <18.5) was higher among the cases compared to the controls (17.3% versus 6%; P <0.001). The proportion of mothers with less-than-recommended weight gain was also higher among the cases compared to the controls (57.7% versus 33%; P <0.001). After adjustment for potential confounders, infants of underweight mothers had more than twice the risk of LBW compared to those of mothers with normal weight (odds ratio = 2.27; 95% confidence interval 1.09-4.71). CONCLUSION: Underweight Omani women as well as women with less-than-recommended gestational weight gain were at higher risk of delivering LBW babies. Maternal health promotion programmes should be directed towards improving mothers' nutrition before and during pregnancies.

Risky driving behavior among university students and staff in the Sultanate of Oman.

BACKGROUND: There is a well developed literature on research investigating the relationship between various driving behaviors and road crash involvement. However, this research has predominantly been conducted in developed economies dominated by western types of cultural environments. To date no research has been published that has empirically investigated this relationship within the context of the emerging economies such as Oman. OBJECTIVE: The present study aims to investigate driving behavior as indexed in the driving behavior questionnaire (DBQ) among a group of Omani university students and staff. METHODS: A convenience non-probability self-selection sampling approach was utilized with Omani university students and staff. RESULTS: A total of 1003 Omani students (n=632) and staff (n=371) participated in the survey. Factor analysis of the BDQ revealed four main factors that were errors, speeding violation, lapses and aggressive violation. In the multivariate logistic backward regression analysis, the following factors were identified as significant predictors of being involved in causing at least one crash: driving experience, history of offenses and two DBQ components, i.e., errors and aggressive violation. CONCLUSION: This study indicates that errors and aggressive violation of the traffic regulations as well as history of having traffic offenses are major risk factors for road traffic crashes among the sample. While previous international research has demonstrated that speeding is a primary cause of crashing, in the current context, the results indicate that an array of factors is associated with crashes. Further research using more rigorous methodology is warranted to inform the development of road safety countermeasures in Oman that improves overall Traffic Safety Culture.

Injuries presented at a primary care setting in oman.

OBJECTIVE: This study aims to measure the rate, types, and causes of injuries presented at a primary care setting in the Muscat governorate. METHODS: A cross-sectional study was carried out where all patients who attended the Al Moabelah Health Center from the period of 1(st) January 2010 to the 31(st) December 2010 were identified from the electronic medical records. Patients identified with any type of injury were then selected for further data collection with their age and gender recorded. Details such as the type, cause and nature of the injury at the clinic were gathered from the clinical notes. RESULTS: A total number of 86,554 visits were recorded for the year 2010. The rate of injury visits was 24 per 1000 visits. In this study, the rate of injury visits was found to be four times more common in males (44.4 per 1000) than in females (11.5 per 1000), p≤0.001. While children aged under 12 years accounted for 41.4%, and elderly patients aged over 60 years accounted for 3.5% of the total visits emanating from injuries. The results show that home was the most common place where the majority of injuries occurred (42%), followed by playgrounds (10.2%). The most common causes of injury visits were falls, followed by cutting/piercing by sharp objects and sports injuries, which accounted for 40%, 13.4%, and 12%, respectively. CONCLUSION: Injuries in a primary care setting with close proximity to emergency departments of secondary and tertiary hospitals may only account to less than 3% of the total visits.