Sultan Qaboos University Medical Journal最新文献

{"title":"Coexisting Dual Mechanisms of Ischaemic Stroke: <i>Frequency and outcomes in a university hospital-based stroke registry</i>.","authors":"Arunodaya R Gujjar, Darshan Lal, Sunil Kumar, Shyam S Ganguly, Sameer Raniga, Faizal Al-Azri, Abdullah Rashid Al-Asmi","doi":"10.18295/2075-0528.2833","DOIUrl":"10.18295/2075-0528.2833","url":null,"abstract":"<p><strong>Objectives: </strong>Ischaemic stroke (IS) is a heterogeneous condition with varied mechanisms. Some patients have more than 1 stroke mechanism coexisting, irrespective of the mechanism of the incident stroke.~This study aimed to examine the association of coexisting dual stroke mechanisms among IS patients with risk factors and clinical outcomes.</p><p><strong>Methods: </strong>This retrospective study included adult patients with IS diagnosed using the TOAST criteria in Sultan Qaboos University Hospital's stroke registry who were admitted and treated from January 2011 to December 2020. The records were reviewed for the presence of dual IS mechanisms (combinations involving small vessel disease [SVD], cardioembolism [CE] or large artery atherosclerosis [LA]). Outcomes were classified as modified Rankin score (mRS) = 0-3 (favourable) or mRS = 4-6 (poor). Univariate and multivariate methods of analysis were used.</p><p><strong>Results: </strong>Among 1,220 patients with IS (age = 64 ± 13 years; male:female = 63:37), 177 (14.5%) had an additional mechanism of stroke. The most common second mechanism was SVD (53.1%), while CE stroke (23.7%) and LA stroke (23.2%) were similar in frequency. Patients with dual stroke mechanisms were significantly older (<i>P</i> <0.001), had a higher frequency of conventional risk factors (<i>P</i> <0.007), abnormal brain magnetic resonance imaging (<i>P</i> = 0.004) and worse outcomes (<i>P</i> = 0.058). Poor outcomes at hospital discharge or 12-month follow-up were independently associated with older age (<i>P</i> = 0.007), female gender (<i>P</i> = 0.017), poor sensorium (<i>P</i> <0.001) and type of primary stroke (<i>P</i> <0.001).</p><p><strong>Conclusions: </strong>Up to 1 in 7 patients with IS may have an additional mechanism of stroke. Such patients are likely older, with poorly controlled risk factors, worse sensorium and possibly worse outcomes. SVD is the most common additional stroke mechanism. Studies to explore the influence of dual stroke mechanisms on outcomes, as well as strategies for secondary prevention, are indicated.</p>","PeriodicalId":22083,"journal":{"name":"Sultan Qaboos University Medical Journal","volume":"25 1","pages":"200-208"},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12240030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609567","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":"Nurturing the Future: <i>Understanding maternal knowledge of child development in Oman</i>.","authors":"Watfa Al-Mamari, Ahmed B Idris, Saquib Jalees, Muna Al-Jabri, Mohammed A Mirghani, Dina Al Khalili, Asila Al Yarubi, Jamana Al Zadjali, Zahra Al Lawati, Ayat Al Lawati, Ahmed Al Saidi, Kamila Al Alawi, Sathiya Murthi, Wafa S Al-Maamari","doi":"10.18295/2075-0528.2845","DOIUrl":"10.18295/2075-0528.2845","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to examine the knowledge of Omani women of childbearing age concerning infant developmental care.</p><p><strong>Methods: </strong>This cross-sectional study included 1,006 Omani women of childbearing age, recruited from outpatient clinics at Sultan Qaboos University Hospital (response rate = 71%). Their knowledge was evaluated using the Knowledge of Infant Development Inventory (KIDI), a validated self-report questionnaire. The KIDI scores were analysed to identify associations with demographic variables such as women's age, education level, employment status and number of children. Data were collected from June 2023 to October 2023.</p><p><strong>Results: </strong>The mean age of the participating women was 31.6 ± 8.4 years. The majority were from Muscat (49.6%), with over half holding bachelor's degrees (57.1%) and 39% being employed. The mean correct response rate for KIDI was 0.63 ± 0.11, suggesting that, on average, the women answered 63% of the questions accurately. Higher education levels and employment status were significantly associated with better knowledge scores (<i>P</i> < 0.001). Misconceptions were prevalent in areas such as infant sensory capabilities and developmental milestones.</p><p><strong>Conclusions: </strong>The findings reveal significant gaps in knowledge regarding child development among Omani women, particularly those with lower levels of educational attainment. Targeted educational interventions are needed to enhance maternal knowledge and support child development in Oman.</p>","PeriodicalId":22083,"journal":{"name":"Sultan Qaboos University Medical Journal","volume":"25 1","pages":"352-362"},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12244243/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609621","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":"Psoriasis Presenting as Koebner Phenomena.","authors":"Zamzam Al Qutaiti, Ayida Al Khalili, Asem Shalaby","doi":"10.18295/2075-0528.2844","DOIUrl":"10.18295/2075-0528.2844","url":null,"abstract":"","PeriodicalId":22083,"journal":{"name":"Sultan Qaboos University Medical Journal","volume":"25 1","pages":"349-351"},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12244245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609638","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":"Utility of Carboxyhemoglobin Level for the Diagnosis of Invasive Bacterial Infection in a Febrile Neonate at Paediatric Emergency Department.","authors":"Abdulhamid Al Hinai, Laila Al Yazidi, Sanjay Jaju, Nasser Al Sidairi, Khalil Al Habsi, Mohammed Al Lawati, Saeed Al Obeidani","doi":"10.18295/2075-0528.2867","DOIUrl":"10.18295/2075-0528.2867","url":null,"abstract":"<p><strong>Objective: </strong>Carboxyhaemoglobin (COHb), which represents the fraction of carbon monoxide bound to haemoglobin, is available as a point-of-care test in the emergency department. This study aimed to assess the role of COHb in the diagnosis of invasive bacterial infections (IBI) in a paediatric emergency department.</p><p><strong>Methods: </strong>This retrospective study examined a single reading of venous COHb values in otherwise healthy neonates who presented with febrile illness at the paediatric emergency department at Royal Hospital, Muscat, Oman, between December 2019 and December 2022. The optimal COHb level for the diagnosis of IBI was determined using receiver operating characteristic curve analysis. Multivariate regression analysis was applied to assess the effect of age, birth weight and sex as cofounders for the diagnosis.</p><p><strong>Results: </strong>A total of 336 neonates presented to the paediatric emergency department with febrile illnesses and 201 neonates met the inclusion criteria; 43 neonates were culture-confirmed to have IBI. A COHb level ≥1.4% carries a sensitivity of 74% and a specificity of 69% for the diagnosis of IBI. Moreover, it was strongly independent of the diagnosis when adjusted for the confounding factors of birth weight, sex, pediatric early warning score, type of admission and gestational age (odds ratio = 6.080, 95% confidence interval: 2.810-13.155; <i>P</i> <0.001).</p><p><strong>Conclusion: </strong>This is the first study to examine COHb as a biomarker for IBI in a pediatric emergency setting. COHb may be a useful biochemical marker for risk stratification in febrile neonates. Further studies are required to better delineate its clinical utility.</p>","PeriodicalId":22083,"journal":{"name":"Sultan Qaboos University Medical Journal","volume":"25 1","pages":"531-538"},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12293561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733314","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":"IL-6 Induces CD45 Expression on Myeloid Cells.","authors":"Maryam Ahmed Al Barashdi, Ahlam Ali, Mary Frances McMullin, Ken Mills","doi":"10.18295/2075-0528.2872","DOIUrl":"10.18295/2075-0528.2872","url":null,"abstract":"<p><strong>Objectives: </strong>Activation of IL-6 facilitates CD45 expression in myeloma cells, but little has been reported for myeloid malignancies. This study aimed to investigate whether IL-6 enhances CD45 expression on myeloid malignancies and whether myeloid cells are dependent on IL-6 activation to express CD45 on their cell membrane.</p><p><strong>Methods: </strong>This study was conducted from January to March 2022 at the Queen's University Belfast, UK. Myeloid cell lines such as HEL and OCI-AML3 which expressed higher levels of CD45, and UT-7 and the pro-B NALM-6 cell lines that had lower CD45 levels as well as primary cells were used. The correlation between CD45 expression and IL-6 activation in myeloid cells was studied in terms of survival and response to chemotherapy such as cytarabine.</p><p><strong>Results: </strong>It was found that IL-6 enhances cellular survival in myeloid leukaemia cells. Expression of CD45 could be correlated with IL-6 activation in myeloid leukaemia cells. Quantification of IL-6 confirms the significant effect on cellular proliferation. More importantly, IL-6 significantly alters CD45 expressed myeloid leukaemia cellular response to chemotherapy such as cytarabine.</p><p><strong>Conclusion: </strong>IL-6 significantly induced alteration to cytarabine cellular response in those cells of higher CD45 expression, while its effect on cells of lower CD45 expression was minimal. This suggests the importance of CD45 in the activation of IL-6 pathway and initiation of cellular proliferation events with its consequences of cytarabine chemo resistance and enhancement of leukaemia cells survival and proliferation by inhibiting the apoptotic activities of cytarabine.</p>","PeriodicalId":22083,"journal":{"name":"Sultan Qaboos University Medical Journal","volume":"25 1","pages":"552-565"},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12293515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733352","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":"Optimising Healthcare Delivery: <i>Efficiency analysis of Oman's governorate hospital networks</i>.","authors":"Sultana M Al-Sabahi, Avinash D Pinto, Qasem Al-Salmi, Hilal A Al-Sabti","doi":"10.18295/2075-0528.2874","DOIUrl":"10.18295/2075-0528.2874","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to evaluate the efficiency of the healthcare facilities in the Oman to guide the decision-making process and benchmarking.</p><p><strong>Methods: </strong>Input-oriented data envelopment analysis (DEA) was used to assess the relative efficiency of governorate hospitals in Oman using 2022 data extracted in December 2023. In the second stage of data analysis, the Tobit model was applied to assess determinants of governorate hospital inefficiency; 3 DEA models were created (staffing, structure and budget).</p><p><strong>Results: </strong>A total of 10 governorate hospitals were included in this study. The efficiency score change was small for the governorate hospitals and no hospital shifted from full efficiency to very low efficiency between the 3 models. The only explanatory variables that are significantly correlated with efficiency score in the structure model were bed occupancy rate (<i>P</i> = 0.007, 95% confidence interval [CI]: 0.010 to 0.037) and nurse-to-bed ratio (<i>P</i> = 0.099, 95% CI: -1.219 to 0.146). The results of the Tobit regression for the staffing model of DEA show that there are 3 variables which are positively correlated to efficiency score: bed occupancy rate, nurse-to-bed ratio and expenditure. The third model evaluated efficiency by comparing resource utilisation to service outputs, identifying 6 fully efficient hospitals and opportunities for enhancing resource allocation.</p><p><strong>Conclusions: </strong>These results allow for benchmarking against best-performing hospitals, facilitating the identification of areas for sustained improvement. Reallocating resources from overperforming to underperforming hospitals, streamlining workflows and implementing a continuous performance evaluation system can help bridge efficiency gaps.</p>","PeriodicalId":22083,"journal":{"name":"Sultan Qaboos University Medical Journal","volume":"25 1","pages":"566-572"},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12293484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733309","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":"Al Muhalab Bin Aby Sufra Hall, Ibri, Oman, 16 September 2024.","authors":"","doi":"10.18295/2075-0528.2862","DOIUrl":"https://doi.org/10.18295/2075-0528.2862","url":null,"abstract":"","PeriodicalId":22083,"journal":{"name":"Sultan Qaboos University Medical Journal","volume":"25 1","pages":"485-498"},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255335/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627047","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":"Chondromyxoid Fibroma of Phalanges.","authors":"Lubna S Khan, Sifa Farheen, Vijay K Pandey, Vinay P Singh, Manoj G Madakshira","doi":"10.18295/squmj.10.2024.068","DOIUrl":"10.18295/squmj.10.2024.068","url":null,"abstract":"<p><p>Chondromyxoid fibroma (CMF) is a rare, benign metaphyseal bone tumour characterised by a combination of chondroid, myxoid, and fibrous elements. It can affect any bone at any age, with no gender predilection. We report a case of CMF in a 47-year-old female patient who presented with swelling of the left little finger at a tertiary care hospital in Kolkata, India, in 2024. Imaging revealed a lobulated lesion originating from the middle phalanx of the left little finger, extending to involve the base of the distal phalanx. Fine needle aspiration cytology indicated a moderately cellular myxoid lesion. Histopathology, which remains crucial for diagnosis, showed a lobulated tumour with zones of spindle to stellate cells, associated with an abundant myxoid and chondroid matrix in the intercellular spaces. Treatment involves complete local excision with tumour-free margins, as recurrence may occur with local curettage.</p>","PeriodicalId":22083,"journal":{"name":"Sultan Qaboos University Medical Journal","volume":"25 1","pages":"168-174"},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627051","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":"Effectiveness of Vaginal Magnesium Sulfate on Pain and Labor Duration: <i>A systematic review and meta-analysis</i>.","authors":"Somayeh Makvandi, Elham Manouchehri, Mahdieh Razi, Samaneh A Mofrad, Mona Larki","doi":"10.18295/2075-0528.2885","DOIUrl":"10.18295/2075-0528.2885","url":null,"abstract":"<p><p>This systematic review and meta-analysis aimed to evaluate the effectiveness of vaginal magnesium sulfate (MgSO₄) administration during labour. A comprehensive search was conducted across six databases up to 30 July 2024, and updated on 13 January 2025, with no restrictions on time, language, or geographical region. The risk of bias was assessed using the RoB 2 tool, and the certainty of evidence was evaluated using GRADEpro. A total of seven randomised controlled trials were included. The meta-analysis demonstrated that topical magnesium sulfate significantly increased cervical dilatation by 2.27 cm (95% confidence interval [CI]: 1.98 to 2.56; <i>P</i> <0.00001) and cervical effacement by 15.3% (95% CI: 7.79 to 22.82; <i>P</i> <0.0001) two hours after administration, compared to control groups. Furthermore, it shortened the active phase of labour by 1.63 hours (95% CI: -2.15 to -1.11; <i>P</i> <0.00001) and reduced reported pain levels. These findings suggest that vaginal magnesium sulfate may be a promising and easily administered intervention, warranting further investigation in clinical practice.</p>","PeriodicalId":22083,"journal":{"name":"Sultan Qaboos University Medical Journal","volume":"25 1","pages":"697-707"},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12445314/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114060","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":"The Impact of Maternal Diabetes on Sacral Agenesis: <i>A paediatric report</i>.","authors":"Gabriella M Calabrese, Márcio L Duarte, Leonardo F Freitas, Eduardo O Narvaez","doi":"10.18295/2075-0528.2894","DOIUrl":"10.18295/2075-0528.2894","url":null,"abstract":"","PeriodicalId":22083,"journal":{"name":"Sultan Qaboos University Medical Journal","volume":"25 1","pages":"762-764"},"PeriodicalIF":0.0,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12445318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114089","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}