Pulmonary Function Test Outcomes in Adult Omani Patients: Preliminary findings from a single-centre study.

Objectives: This study aimed to document the distribution of PFT outcomes among adult Omani patients. There is limited information regarding the distribution of pulmonary diseases (PD) in Oman. Pulmonary function test (PFT) outcome patterns could indicate an indirect distribution of PD. Methods: This retrospective cross-sectional study was conducted from January to December 2015 at a tertiary hospital in Oman. A total of 1,118 adults referred for PFTs during this period were included. Results: There were 605 (54.1%) female and 513 (45.9%) male patients. The mean age of the patients was 47.11 ± 18.1 years. Most patients underwent spirometry with reversibility (36.8%) or full lung function testing with reversibility (29.7%). Among the 1,064 patients with conclusive PFT outcomes, 39.9% had normal findings, 26.1% had obstructive defects, 19.6% demonstrated restrictive defects and 10.6% had mixed obstructive/restrictive defects. Conclusion: This study generated important preliminary data regarding PFT outcomes (defects) in Omani patients.

Incidence, patterns, risk factors and clinical outcomes of intravenous acyclovir induced nephrotoxicity.

Objectives: Acyclovir is approved to treat herpes simplex virus (HSV) type 1, type 2 and varicella-zoster virus. It is mainly eliminated via the kidneys, for which drug crystals accumulation might lead to nephrotoxicity. This study aimed to determine the incidence, risk factors, preventive measures, and clinical outcomes of acyclovir induced-nephrotoxicity. Methods: This is a retrospective cohort study of patients >12 years of age at Sultan Qaboos University Hospital (SQUH) receiving IV acyclovir therapy between January 2016 and December 2020. Results: Out of 191 included patients, 40 (20.1%) developed acyclovir induced-nephrotoxicity. Age (per year older: OR 1.04, 95 %CI 1.01-1.07), total duration of treatment (per day OR1.19, 95 %CI 1.06-1.33), and concomitant use of vancomycin (OR 5.96, 95 %CI 1.87-19.01) were significant independent risk factors for acyclovir induced-nephrotoxicity development. Nine patients (4.5%) died during the same hospitalization, including those three patients who required renal replacement therapy (1.5%). Conclusion: Frequent monitoring of kidney function for older patients with concurrent use of vancomycin and IV hydration is essential to prevent IV acyclovir induced-nephrotoxicity. Antimicrobial stewardship is a crucial method to reduce the duration of treatment with IV acyclovir as appropriate.

Evaluation of Hospital Referral Notes for Pulmonary Function Tests at Tertiary Care Teaching Hospital in Oman.

OBJECTIVES: There is substantial increase in referrals for investigations at Sultan Qaboos University Hospital (SQUH). Evaluating the quality of hospital referral notes (RNs) is necessary from diagnostic, patient, and economic perspectives. RNs for pulmonary function tests (PFTs) can be considered as representative of the array of tests performed at SQUH. METHODS: This cross-sectional study evaluated the quality of RNs based on 'completeness' for all consecutive patients referred for PFTs at SQUH over six months. Evaluation included documentation of demographic features, RNs date, priority for investigation, referral reason, pulmonary and relevant medical and smoking history for spirometry RNs, and addition of hemoglobin level for full lung functions (Full-LuFs) tests. The proportion of complete RNs was determined and analyzed separately to study association of spirometry and full-LuFs tests with source and reasons for referral. RESULTS: Only 644 of 683 RNs were available for analysis. Smoking history was stated in only 3.3% of all RNs; hence, it was excluded from the analysis. RNs were complete only in 12.4% of cases for spirometry and 14.4% for full-LuFs tests. RNs for patients who primarily had pulmonary disease were proportionately incomplete than those for patients with other reasons (p < 0.050). There was no significant association between incompleteness of RNs and referral hospital (SQUH vs. non-SQUH) and SQUH inpatient or outpatient status implying that the overall proportion of completeness of RNs from all concerned referral locations was similar and low in both types of RNs. CONCLUSIONS: There is a need to improve the quality of RNs at SQUH. Referring doctors must be made aware of the importance of completeness of RNs to improve test reporting, patient management and satisfaction, and reduce financial burden on hospital exchequer.