Adherence to levothyroxine treatment among patients with hypothyroidism in Oman: a national cross-sectional study.

OBJECTIVE: Hormone replacement therapy with levothyroxine is considered the treatment of choice for hypothyroidism; however, non-adherence is a major contributor to poor treatment outcomes. This study aimed to evaluate levels of drug adherence (DA) to levothyroxine therapy among Omani adults with hypothyroidism and to explore related sociodemographic and clinical factors. METHODS: A national, multi-center, cross-sectional survey was carried out from August to December 2021 at 18 primary healthcare centers across all governorates of Oman. A total of 415 Omani adults were recruited. Data were collected using a pre-tested, Arabic-language questionnaire completed by trained researchers during face-to-face interviews with the participants. Level of DA was determined using the 8-item Morisky Medication Adherence Scale (MMAS-8). RESULTS: A total of 400 Omani adults participated in the study (response rate: 96.4%). The mean age was 41.9 ± 12.4 years old (range: 18-78 years) and 90.3% were female. According to their MMAS-8 scores, 157 (39.2%), 139 (34.8%), and 104 (26.0%) participants demonstrated low, medium, and high DA, respectively. No significant correlations were observed between level of DA and any sociodemographic or clinical characteristics, including age, gender, education, duration of treatment, and family history of thyroid disease (p > 0.050). CONCLUSIONS: Only a quarter of Omani patients with hypothyroidism reported high levels of adherence to levothyroxine treatment, likely as a result of lack of awareness of the disease and the importance of maintaining an euthyroid state. Further studies using more objective measures of DA are recommended to determine correlates of non-compliance to levothyroxine therapy among Omani patients.

Intimate Partner Violence in Khaliji Women: A Review of the Frequency and Related Factors.

The Gulf Cooperation Council (GCC), locally known as Khaliji, is a group of six Arab nations, including Saudi Arabia, Bahrain, Kuwait, Oman, Qatar, and the United Arab Emirates (UAE). Intimate partner violence (IPV) is a significant public health concern in the aforementioned region, but research that synthesises this trend has remained scarce. The present narrative review examines existing research on the prevalence and frequency of IPV among Khaliji women who inhabit the GCC nations. This review synthesised studies on physical and sexual violence, emotional abuse, and controlling behaviours perpetrated by an intimate partner. The prevalence rates of IPV among Khaliji women were observed to be high: women reported facing different types of abuse from their partners, namely physical (7-71%), sexual (3.7-81%), financial (21.3-26%), and psychological (7.5-89%), which is a culmination of controlling behaviour (36.8%), emotional violence (22-69%), and social violence (34%). Existing studies in the GCC region suggest that the most endorsed IPV was psychological abuse (89%), followed by sexual violence (81%). Qualitative analysis of the content of associated factors resulted in four significant descriptors, such as victim demographics, sociocultural factors, socioeconomic factors, and perpetrator-related issues. Research on IPV is still in its nascent stages, with very few studies emanating from the GCC region. The way forward will require developing culturally appropriate interventions that address the unique risk factors for IPV among the Khaliji population, strengthening institutional responses, and increasing awareness and social support for victims of IPV.

The Role of Serial Follow-up and Sleep Deprivation Methods in Improving Electroencephalography Diagnostic Yield in a Cohort of Omanis Aged 13 Years and Above: A Clinical Audit Study.

The aim of this audit study was to establish the utility of follow-up and sleep-deprived electroencephalography testing to improve the detection of interictal abnormalities in a tertiary referral center in Oman. As part of our ongoing auditing process, a total of 3010 EEGs were included in this study. All EEGs were routinely performed for Omanis aged 13 years and above, who were referred for possible diagnosis of seizure disorders. Each EEG was performed over an average period of 20-30 minutes. Of the 3010 EEGs, there were 553 follow-up and sleep-deprived EEGs, including initial baseline EEG studies which were analyzed for this study. The total progressive yield of serial follow-up EEGs to detect overall EEG changes was 53.5%, distributed as 8.8%, 11.4%, 0%, and 33.3% for the second, third, fourth, and fifth serial EEG studies, respectively. For the sleep deprivation EEG group, the yield was 6.5% for detecting overall EEG changes compared to the initial EEG studies. A limitation in this study was the small sample size in the subsequent follow-up and sleep deprivation EEGs. In conclusion, we found a minimal contribution of serial follow-up and sleep deprivation methods in improving the EEG abnormality detection in our study. National guidelines and an increase in awareness among physicians are required to increase the benefit of these well-established, yet not optimally utilized EEG methods.