Oman Medical Journal最新文献

{"title":"Palivizumab for the Prophylaxis of Respiratory Syncytial Virus Disease: Expert Opinion and Recommendations for the Gulf Cooperation Council Region.","authors":"Adel S Alharbi, Abdul Rahman Alnemri, Ahmed Abushahin, Entesar Alhammadi, Huda Sulaiman Mohammed AlDhanhani, Laila Obaid, Mahmoud Saleh ElHalik, Mariam Kh Ayed","doi":"10.5001/omj.2024.111","DOIUrl":"https://doi.org/10.5001/omj.2024.111","url":null,"abstract":"<p><p>Respiratory syncytial virus (RSV) infection poses a significant health threat to infants and young children. Considering the substantial burden in Gulf Cooperation Council (GCC) countries, prevention of RSV remains a major public health priority. Globally, palivizumab prophylaxis has proven effective in reducing hospitalization and preventing complications in high-risk infants. While several national-level recommendations have been developed for palivizumab prophylaxis, few countries follow external guidelines due to a lack of regional directives. For effective RSV management, recommendations should be based on regional evidence and local clinical practices. Hence, it is imperative to establish uniform recommendations for palivizumab prophylaxis for the GCC region. We reviewed the literature on RSV prevalence, palivizumab immunoprophylaxis's efficacy, and the optimal timing for initiating RSV immunoprophylaxis programs. Experts were invited to share their insights on disease burden, current immunoprophylaxis practices, barriers to compliance, and strategies to improve adherence to palivizumab prophylaxis. These recommendations are intended to bridge the existing gaps and serve as a unified reference guide for local physicians and those recruiting eligible patients in RSV immunoprophylaxis programs, thus allowing for effective RSV management. This collaborative initiative aims to reduce the overall burden of RSV-related illness in the GCC region by promoting alignment in recommendations and addressing obstacles to compliance.</p>","PeriodicalId":19667,"journal":{"name":"Oman Medical Journal","volume":"39 5","pages":"e667"},"PeriodicalIF":0.0,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12004454/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Multiple Antibiotic Resistance Among <i>Salmonella</i> Isolates from Clinical Samples in Dhaka, Bangladesh.","authors":"Rashed Imtiaz, Protyaee Saha, Esfat M Saim Brishty, Sadia Kamal, Manik Chandra Shill, Hasan Mahmud Reza, Preeti Jain","doi":"10.5001/omj.2024.105","DOIUrl":"10.5001/omj.2024.105","url":null,"abstract":"<p><strong>Objectives: </strong>Antibiotic resistance in clinical isolates is often correlated to poor disease management or prolonged hospitalization. The study aimed to determine the prevalence of multidrug-resistant (MDR) <i>Salmonella</i> isolates in clinical samples collected from Dhaka, Bangladesh.</p><p><strong>Methods: </strong>We investigated 150 clinical samples for the presence of <i>Salmonella</i>. The <i>Salmonella</i> isolates were tested against 12 antibiotics categorizable into three groups based on action mechanism and nine classes based on chemical structure. The susceptibility patterns were analyzed using the Kirby-Bauer disk diffusion method on Mueller Hinton agar. The isolates were classified as MDR and extensively drug-resistant based on their resistance patterns against different antibiotics.</p><p><strong>Results: </strong>We used 100 <i>Salmonella</i> isolates for this study. The highest prevalence of resistance was observed against penicillin G (96.0%), cefuroxime (75.0%), and clindamycin (71.0%). The isolates exhibited 33.0% and 43.0% resistance against imipenem and meropenem, respectively. Almost all (98.0%) isolates showed MDR. A quarter of the isolates (23.0%) were resistant to five classes of antibiotics and 18.0% to six classes of antibiotics. Moreover, 20.0% of isolates exhibited extensive drug resistance. Among the cell wall synthesis inhibitors, the highest resistance was observed against penicillin G (31.0%). Resistance rates were in the range 20-30% against protein synthesis inhibitors, clindamycin (29.0%), tetracycline (21.0%), and chloramphenicol (21.0%). Among the <i>Salmonella</i> isolates, 90.0% showed multiple antibiotic resistance index scores of ≥ 0.3, while 65.0% scored ≥ 0.5. The carbapenem group accounted for the maximum sensitivity (62.0%), followed by 60.0% each for gentamicin and norfloxacin.</p><p><strong>Conclusions: </strong>The high prevalence of MDR <i>Salmonella</i> isolates in clinical samples from Bangladesh indicates a serious threat to public health. Our findings emphasize the urgent need to control MDR through promoting responsible use of suitable antibiotics and public awareness of the dangers of antibiotic misuse, increasing testing facilities, and promoting genetic research.</p>","PeriodicalId":19667,"journal":{"name":"Oman Medical Journal","volume":"39 5","pages":"e674"},"PeriodicalIF":0.0,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11915084/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimating Optimal Treatment Rule for Major Depressive Disorder Using Penalized Regression Method.","authors":"Narges Ghorbani, Ghodratollah Roshanaei, Vajihe Ramezani-Doroh, Alireza Soltanian, Mahya Arayeshgary, Leili Tapak","doi":"10.5001/omj.2024.95","DOIUrl":"10.5001/omj.2024.95","url":null,"abstract":"<p><strong>Objectives: </strong>Major depressive disorder (MDD) stands as the primary contributor to disability worldwide. Identifying optimal treatment regimens for patients with MDD using advanced statistical techniques may help improve patient outcomes and reduce the number of hospitalizations.</p><p><strong>Methods: </strong>In a group of patients with MDD from north-western Iran, we compared treatments including work therapy (WT), WT plus electroconvulsive therapy (WT + ECT), WT plus family therapy (WT + FT), and other psychotherapeutic methods (PT). We also estimated the optimal treatment rule and identified essential variables in a loss-based framework using a penalized regression method.</p><p><strong>Results: </strong>The participants were 377 MDD patients of whom 198 (52.5%) received WT alone, 95 (25.2%) received WT + ECT, and 61 (16.2%) were given WT + FT. The remaining 23 (6.1%) patients were treated with PT. A comparison of the treatments revealed that a history of emotional problems was the important variable to consider when selecting WT + ECT, WT + FT, or PT, while patient education level and history of emotional problems were both important for WT + ECT. Applying the above optimal treatment rules is likely to reduce patients' hospital stay days.</p><p><strong>Conclusions: </strong>For patients with MDD, history of emotional problems and education level were the two most important variables for estimating the optimal treatment rules, including personalizing medications. Incorporating important variables into treatment regimens is likely to improve treatment outcomes and decrease the number of hospitalizations.</p>","PeriodicalId":19667,"journal":{"name":"Oman Medical Journal","volume":"39 5","pages":"e668"},"PeriodicalIF":0.0,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11976147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing Fluconazole and Nystatin as Antifungal Prophylactics in Very Low Birth Weight Infants: A Randomized Clinical Trial.","authors":"Leila Asgarzadeh, Majid Mahallei, Manizheh Mostafa Gharehbaghi","doi":"10.5001/omj.2024.90","DOIUrl":"10.5001/omj.2024.90","url":null,"abstract":"<p><strong>Objectives: </strong>Systemic fungal infections (SFIs) account for 12% of all late-onset sepsis among very low birth weight (VLBW) infants and result in adverse long-term neurodevelopmental outcomes among survivors. This study compared the prophylactic efficacies of systemic fluconazole or oral nystatin prophylaxis to prevent SFI in VLBW infants.</p><p><strong>Methods: </strong>In a randomized controlled clinical trial, 120 neonates with gestational age < 32 weeks and birth weight < 1500 g were randomly allocated in two groups. Patients in group A received fluconazole 3 mg/kg intravenously twice weekly from the first 72 hours of life. Patients in group B were administered oral nystatin 1 mL (100 000 units) every eight hours. The primary endpoint was SFI and its associated mortality rate during hospital stay.</p><p><strong>Results: </strong>The mean gestational age of the enrolled infants was 28.2±1.4 weeks. Demographic characteristics were similar in both groups. SFI was detected in six (5.0%) infants with three cases from each group. Three (2.5%) patients died, two of whom were in group B. Four (6.7%) patients in group B and one (1.7%) in group A were treated for retinopathy of prematurity (<i>p =</i> 0.040). Intraventricular hemorrhage was detected in brain ultrasound examination in three (5.0%) neonates in group B and seven (11.7%) in group A (<i>p =</i> 0.020).</p><p><strong>Conclusions: </strong>The intravenous fluconazole and oral nystatin were similarly effective in preventing SFIs in VLBW infants. Future studies are recommended with a larger number of patients before routine administration of nystatin prophylaxis.</p>","PeriodicalId":19667,"journal":{"name":"Oman Medical Journal","volume":"39 4","pages":"e651"},"PeriodicalIF":0.0,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11799877/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143365427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"One-year-old Infant with Rash.","authors":"Laila Al Yazidi, Buthania Al Musalhi, Khuloud Al Maamari, Eman Al Masroori","doi":"10.5001/omj.2024.76","DOIUrl":"10.5001/omj.2024.76","url":null,"abstract":"","PeriodicalId":19667,"journal":{"name":"Oman Medical Journal","volume":"39 4","pages":"e663"},"PeriodicalIF":0.0,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11663245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Polyangiitis Overlap Syndrome: Polyarteritis Nodosa with Leukocytoclastic Vasculitis Associated with Left Ventricular Thrombus and Vocal Cord Palsy: A Case Report.","authors":"Wahinuddin Sulaiman, Henry Foong Boon Bee, Lim Wei Mei, Ng Theng Chun, Chin Yow Wen, Lee Bang Rom, Syed Ibrahim Jamalullail","doi":"10.5001/omj.2024.25","DOIUrl":"10.5001/omj.2024.25","url":null,"abstract":"<p><p>Polyangiitis overlap syndrome (POS) is a systemic vasculitis characterized by overlapping features of more than one well-defined vasculitic syndrome. We present the case of a 38-year-old Malay man with progressive dyspnea and palpable purpura in his lower limbs. The diagnostic evaluation revealed right-sided segmental pulmonary consolidation with pleural effusion, systolic cardiac dysfunction with the presence of an intracardiac thrombus, and left vocal cord palsy secondary to laryngeal mononeuropathy. Anti-neutrophil cytoplasmic antibodies testing yielded negative results, and skin biopsy revealed leukocytoclastic vasculitis (LCV) with negative immunofluorescence studies. The patient fulfilled the American College of Rheumatology diagnostic criteria for polyarteritis nodosa and idiopathic LCV. Only three case reports of POS with a combination of polyarteritis nodosa overlapping with idiopathic LCV have been reported in the medical literature. To the best of our knowledge, this is the first report of POS with cardiopulmonary involvement and laryngeal mononeuropathy. This patient had an excellent response to remission induction therapy using high-dose corticosteroids and mycophenolate mofetil and remains in remission while undergoing a steroid taper. Timely initiation of treatment is essential to prevent vasculitic complications and irreversible organ dysfunction. Mycophenolate mofetil may serve as an acceptable alternative to cyclophosphamide as a remission induction agent in this condition.</p>","PeriodicalId":19667,"journal":{"name":"Oman Medical Journal","volume":"1 1","pages":"e659"},"PeriodicalIF":0.0,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11683395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70684573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unusual Cause of Diffuse Pleural Thickening (Malignant Pleural Mesothelioma Mimic): Undifferentiated Epithelioid Malignant Neoplasm.","authors":"Jamal Al-Aghbari, Amira Al Badi, Radiya Al Ajmi, Saif Al Mubaihsi","doi":"10.5001/omj.2024.27","DOIUrl":"10.5001/omj.2024.27","url":null,"abstract":"<p><p>The symptoms of malignant pleural mesothelioma can be mimicked by some other malignancies, clinically and radiologically. We describe a case of a 57-year-old man whose clinical and radiological findings were consistent with malignant pleural mesothelioma; however, a pleural biopsy showed undifferentiated epithelioid malignant neoplasm.</p>","PeriodicalId":19667,"journal":{"name":"Oman Medical Journal","volume":"1 1","pages":"e657"},"PeriodicalIF":0.0,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11807254/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70684289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute Asthma Management in a Tertiary Hospital in Oman.","authors":"Suhaila Al Farsi, Nasser Al Busaidi","doi":"10.5001/omj.2024.93","DOIUrl":"10.5001/omj.2024.93","url":null,"abstract":"<p><strong>Objectives: </strong>The quality of asthma management in tertiary hospitals' emergency departments (EDs) is key to sustained asthma control. We assessed the quality of asthma care and adherence to guidelines at the Royal Hospital in Oman.</p><p><strong>Methods: </strong>We conducted a retrospective, observational study examining the medical records of asthma patients who presented to the ED between 1 June 2014 and 1 June 2016.</p><p><strong>Results: </strong>A total of 217 patients were included in the study. Lack of proper documentation was observed throughout the study. Only 80 patients (59.7% of 134 available records) were on controller therapy and 51 were reported to be compliant. No asthma severity assessment was conducted, and 57 (32.9%) patients experienced respiratory distress. Peak expiratory flow rate measurements were not performed for all patients; chest X-ray was performed for 145 (66.8%) patients, and blood gas analysis for 83 (38.2%). The mean±SD time from the initial assessment to the treatment initiation was 12.0±11.0 minutes. Systemic steroids and nebulizers were used for initial management in 70.5% (n = 153) and 96.3% (n = 209) of patients, respectively. Reassessments at one and two hours following initial assessment were not done for all patients; reassessment records were missing for 50 (54.9%) patients after the first hour, and 50 patients after the second hour. Out of the total sample, 45 (20.7%) patients required hospital admission, with the majority (93.3%) admitted to the medical ward. Post-discharge procedures recommended by guidelines were rarely employed.</p><p><strong>Conclusions: </strong>There is a serious lack of adherence to asthma management guidelines in the ED. The 2009 Omani Ministry of Health guidelines should be updated, considering the recent updates of Global Initiative for Asthma strategies, adopted as the standard of care, and disseminated with regular monitoring to ensure compliance.</p>","PeriodicalId":19667,"journal":{"name":"Oman Medical Journal","volume":"39 4","pages":"e654"},"PeriodicalIF":0.0,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11814960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143409850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 Pandemic and its Impact on Vaccine Hesitancy: A Review.","authors":"Suci A Widyaningsih, Mohamad S Hakim","doi":"10.5001/omj.2024.103","DOIUrl":"10.5001/omj.2024.103","url":null,"abstract":"<p><p>Vaccination is one of the most successful public health initiatives in human history, significantly reducing the incidence and severity of infectious diseases. The success of any vaccination program depends on several factors, including effective leadership, funding, distribution management, and addressing vaccine hesitancy. Vaccine hesitancy, the delay or refusal to be vaccinated despite the availability of immunization services, has always been prevalent in societies but has become more pronounced during the COVID-19 pandemic. During the pandemic, anti-vaccine activists persistently promoted and increased vaccine hesitancy by using social media to spread rumors, propaganda, and conspiracy theories. The rising vaccine hesitancy among the public became a major challenge to the success of the COVID-19 immunization program. There are also indications that this hesitancy may have generalized against more traditional vaccines. This literature review explores the structure and evolving dynamics of COVID-19 vaccine hesitancy and the resultant generalized skepticism towards other vaccinations. It also suggests future strategies to address and mitigate the phenomenon of vaccine hesitancy.</p>","PeriodicalId":19667,"journal":{"name":"Oman Medical Journal","volume":"39 4","pages":"e646"},"PeriodicalIF":0.0,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11664204/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypothermia in Preterm Neonates in Oman: A Retrospective Study.","authors":"Mohamed Abdellatif, Fatma Musallam Al Ghafri, Murtadha Al Kahbori, Ashfaq Ahmad Khan, Nihal Al Riyami, Moataz Hassan","doi":"10.5001/omj.2024.91","DOIUrl":"10.5001/omj.2024.91","url":null,"abstract":"<p><strong>Objectives: </strong>To determine the prevalence of hypothermia among preterm infants born before 32 weeks of gestation and whether their temperature at admission is associated with neonatal and maternal risk factors and gestational age. Furthermore, the study evaluates the association between admission temperature, neonatal morbidity, and in-hospital mortality.</p><p><strong>Methods: </strong>This study involved an eight-year retrospective analysis of preterm neonates born < 32 weeks of gestation and admitted to the neonatal intensive care unit at a tertiary hospital in Oman, from 2010 to 2017.</p><p><strong>Results: </strong>The study included 587 preterm infants with a mean gestational age of 28.4 weeks, a mean birth weight of 1154.2 g, and a mean admission temperature of 35.5 °C. Hypothermia (axillary temperature < 36.5 °C) was present in 509 (86.7%) infants. In univariate analysis, only birth weight and neonatal resuscitation were associated with admission temperature (< 36.5 °C). In the multivariate analysis, only intraventricular hemorrhage demonstrated a significant association with the incidence of hypothermia.</p><p><strong>Conclusions: </strong>Most preterm newborns had hypothermia upon admission to the neonatal intensive care unit, which is associated with essential morbidities. More aggressive interventions are warranted to reduce the incidence of hypothermia in preterm infants.</p>","PeriodicalId":19667,"journal":{"name":"Oman Medical Journal","volume":"39 4","pages":"e652"},"PeriodicalIF":0.0,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11663241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}