Omani Adults Research Articles

Biochemical and nutritional determinants of non-alcoholic fatty liver disease in Omani adult patients: a case-control study

Background: Non-Alcoholic Fatty Liver Disease (NAFLD) is a risk factor for atherosclerosis, diabetes, kidney disease, and liver cirrhosis. Limited research exists on the biochemical and nutritional elements influencing NAFLD among adult patients in Oman. Objective: This study aimed to characterize the biochemical parameters and nutritional factors of Omani adults diagnosed with NAFLD at the Diwan Polyclinic in Muscat, Oman. Methods: This retrospective case–control study included 104 participants (52 cases and 52 controls) who have 2 or more risk factors for NAFLD and were referred to the Radiology department from January 2021 to January 2022 for abdominal ultrasound after Internal Medicine consultations. A validated scale, incorporating a semi-quantitative food frequency questionnaire, was employed. Results: The study revealed a significantly higher risk of NAFLD among men (69%) compared to women (31%). A common characteristic among participants was a prior diabetes diagnosis, 61.5% of the case group and 65% of the control group. While average liver enzyme levels were within the normal range for both groups, alanine transaminase levels were notably elevated in the case group. The case group exhibited a significantly higher average caloric intake than the control group. Conclusion: NAFLD is significantly more common among men. Alanine transaminase is significantly high in NAFLD group, which might be considered as a biochemical marker for NAFLD, but further investigations are needed. Moreover, high daily caloric intake is directly related to NAFLD.

Adverse childhood experiences and risky behaviors in Oman: A cross-sectional study

ObjectiveAdverse childhood experiences (ACEs), which refer to potentially traumatic events occurring during childhood, have been consistently linked to detrimental effects on high-risk behaviors through various studies. Nonetheless, such an association has rarely been examined in the context of Arab culture. This study aimed to investigate the association between ACE levels and high-risk behaviors (e.g., smoking, alcohol consumption, drug use, high-risk sexual behavior, and physical inactivity) among Omani adults. MethodsThis was a cross-sectional study with convenience sampling. The participants were recruited from a university-affiliated medical facility in Oman. Data were collected in 2022. They were asked to complete the Adverse Childhood Experience International Questionnaire (ACE-IQ) ResultsThe study included 1648 Omani adults. Analyses revealed that the adjusted odds ratios (ORs) for engaging in some of the identified high-risk behaviors increased as the level of ACEs increased. Specifically, individuals with an ACE level of 4 exhibited higher odds of smoking (OR: 2.6), alcohol consumption (OR: 2.9), and risky sexual behavior (OR: 32) than those without ACEs. ConclusionThe findings of this study underscore a notable association between ACEs and high-risk behaviors among Omani adults. Consequently, there is a pressing need for intensified efforts to prevent ACEs when possible and to alleviate their adverse effects, emphasizing the importance of public health initiatives and interventions in Oman.

Health-related Quality of Life of Omani Adult Patients with β-Thalassemia Major at Sultan Qaboos University Hospital.

The impact of beta-thalassemia major (β-TM) on health-related quality of life (HRQoL) in Oman is not yet known. Affected individuals suffer from a wide range of physical, mental, and social consequences due to the need for regular hospital visits for blood transfusions and complications related to iron overload. This study aimed to assess the HRQoL of adult patients with β-TM attending a single tertiary care center in Muscat, Oman, to identify factors influencing Omani patients' QoL for improved management and counseling. A cross-sectional study was conducted among adult patients (≥ 18 years) with β-TM at Sultan Qaboos University Hospital between September and November 2022. A validated Arabic version of the self-reported 36-item short-form health survey was used to determine HRQoL. A total of 78 patients with β-TM were enrolled in the study; 53.8% were male and the mean age was 26.0±0.8 years, ranging from 21-53 years. Most patients were from Al Batinah North governorate (n = 21; 26.9%) and Muscat (n = 20; 25.6%), unmarried (n = 44; 56.4%), did not have university-level education (n = 45; 57.7%), and were unemployed (n = 44; 56.4%). The HRQoL domain with the highest score was role limitations due to emotional problems (median score = 100), while general health and vitality received the lowest scores (mean scores were 60.2±15.9 and 59.1±20.5, respectively). Several variables were associated with better HRQoL in certain domains, including being married, having a high level of education, being employed, exercising regularly, and receiving family support (p < 0.05). However, iron overload and having ≥ 3 β-TM-related disease complications were associated with poorer general health scores (p = 0.031 and 0.038, respectively), while a history of mental issues was associated with poorer scores in six out of eight HRQoL domains (p < 0.05). Moreover, negative perceptions regarding the social impact of the disease including delayed marriage, workplace difficulties, and reduced academic achievement were associated with poorer HRQoL in various domains (p < 0.05). Although the studied sample reported generally good QoL, several factors were found to affect HRQoL in various domains. Healthcare providers should prioritize maintaining acceptable iron overload levels in Omani patients with β-TM to help avoid the development of disease-related complications, thereby ensuring better control of their clinical conditions and consequently improving their HRQoL.

Health-Related Quality of Life of Omani Adult Patients with Sickle Cell Disease at the Sultan Qaboos University Hospital.

This study aimed to determine the health-related quality of life (HRQoL) of adult Omani patients with sickle cell disease (SCD). The quality of life of these patients in Oman is unknown. This cross-sectional study was conducted at the Sultan Qaboos University Hospital, Muscat, Oman, from June to October 2022 and included patients with SCD. A validated Arabic version of the 36-Item Short-Form Health Survey (SF-36) was used to assess HRQoL in 8 domains. A total of 235 patients with SCD were included in this study, the majority of whom were female (74.9%) and between 18 and 35 years of age (64.6%). The lowest HRQoL was reported for the domain of role limitations due to physical health (median score = 25.0, interquartile range [IQR] = 35.0), while the highest was seen for role limitations due to emotional problems (median score = 66.7, IQR = 100.0). Frequent SCD-related emergency department visits/hospital admissions and the adverse effect of SCD on patients' social lives had a significant negative impact on SF-36 scores for all 8 HRQoL domains (P ≤0.05). Additionally, SCD's impact on academic performance and a history of having been bullied due to SCD had a significant negative impact on SF-36 scores for 7 domains (P ≤0.05). Omani adult patients with SCD reported relatively poor HRQoL in several domains, with various factors found to be significantly associated with this. Healthcare providers and policy makers should consider offering additional clinical, educational and financial support to these patients to enhance their HRQoL.

Frequency of Asthma Exacerbations and Upper Respiratory Tract Infections Among Adults With Asthma According to Vaccination Status: Does the annual influenza vaccine have a protective effect?

Annual influenza vaccinations are recommended for asthma patients to prevent seasonal influenza and influenza-triggered asthma exacerbations. However, data on the beneficial effect of this vaccine on the frequency of asthma exacerbations are conflicting. Therefore, this study aimed to assess the effectiveness of the influenza vaccine in terms of reducing the frequency of asthma-related exacerbations and upper respiratory tract infections among adult patients with asthma. This retrospective cohort study was performed from January to December 2018 in Muscat Governorate, Oman. A total of 466 patients attending 9 randomly selected primary health centres in Muscat Governorate were enrolled in the study and followed up for one year post vaccination. Most of the patients were female (70.6%) and had moderate persistent asthma (42.9%). There were 203 patients (43.6%) in the vaccinated group and 263 patients (56.4%) in the non-vaccinated group. A proportion of patients in each group had allergic rhinitis (28.6% and 25.5%, respectively). The frequency of upper respiratory tract infections over the one-year follow-up period was significantly lower in the vaccinated group than in the non-vaccinated group (37.9% versus 73%; relative risk [RR]: 2.299; 95% confidence interval [CI]: 1.834-2.882; P <0.001); however, there was no significant difference in terms of the frequency of asthma exacerbations (41.9% versus 45.2%; RR: 0.925; 95% CI: 0.750-1.141; P >0.050). The influenza vaccine significantly reduces the frequency of upper respiratory tract infections over the following year. However, it does not significantly reduce the frequency of asthma exacerbations among Omani adults with asthma. Further studies are recommended to support the protective effect of the vaccine in this regard.

Medical Tourism and Neurological Diseases: Omani Patients' Experience Seeking Treatment Abroad.

There is a dearth of research regarding the motivations and experiences of Omani nationals who travel abroad for medical treatment, especially for neurological diseases. The primary objective was to examine and draw comparisons between Omani adults and children with neurological disorders who pursued medical treatment abroad after being evaluated by local specialists. The study also aimed to gain insights into these patients' motivations and experiences. A related objective was to explore the sociocultural factors and family dynamics that shape the attitudes towards illness and treatment seeking. In this cross-sectional study, Omani patients treated at a major tertiary hospital in Muscat for neurological disorders and subsequently traveled overseas for treatment were identified and administered a structured questionnaire. The participants were 116 Omani nationals (62 children and 54 adults) with neurological disorders, diagnosed predominantly with epilepsy (71.6%) followed by developmental delay, muscular dystrophy, and encephalopathy. Only 19.8% of patients received government sponsorship. The majority (69.8%) followed the recommendations of family members. Most (63.8%) participants reported positive outcomes after treatment abroad, though 4.3% developed complications and 5.2% acquired nosocomial infections. Most (83.6%) participants opined that the treatment they received overseas was comparable to what they would have received in Oman. There were no significant differences between children and adults in most of these aspects. Public awareness should be increased regarding the pros and cons of medical tourism. Patients must be made aware of the advanced treatment facilities available locally. Efforts should be made to enhance patient outcomes and satisfaction by adopting more efficient and patient-friendly processes.

Idiopathic intracranial hypertension in Omani adults: A tertiary center experience.

To evaluate the clinical profile, risk factors, and ophthalmic diagnostic and monitoring tools in Omani patients with idiopathic intracranial hypertension (IIH) using optical coherence tomography (OCT). A retrospective single institutional cohort study on Omani patients with a fulfilled diagnosis of IIH from January 1, 2014, to January 1, 2020, was conducted. The data obtained from the neuro-ophthalmic clinic contained age of onset of the disease, gender of patients, body mass index (BMI), presence of other associated conditions, and medication use. Our study group comprised 21 patients with IIH with an annual incidence rate of 2.8 per 100,000 population. Female-to-male ratio was 9.5:1 with a mean age of 27.24 ± 7.1. Headaches appeared to be the most prevalent symptom in 21 (100%) patients, followed by transient obscuration of vision in 9 (42.9%) patients and diplopia in 3 (14.3%) patients, and the least common symptom was pulsatile tinnitus in 2 (9.5%) patients. Increased BMI was seen in 19 (90.5%) patients and noted to be the most prevalent predisposing factor among our study group. The use of oral contraceptive pills was documented in 4 (19%) patients and 1 (4.8%) patient was noted to have polycystic ovary syndrome. All patients (100%) had a best-corrected visual acuity of 1.0 in both eyes pre- and postrecovery and 7 (33.3%) patients had an enlarged blind spot on visual field testing. All patients had papilledema on presentation and an average of 14.1 months to resolve to normal clinically and on OCT monitoring. All patients were treated with medications and only 1 (4.8%) continued to have intractable headaches that did not respond to maximum medical therapy and required surgery. The incidence of IIH in the Omani population was found to be less than neighboring countries but comparable worldwide. OCT is considered a useful tool to confirm and document papilledema and more importantly monitor recovery.

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.

Oral Health Knowledge, Attitudes, and Practices of Individuals with Diabetes Mellitus in the Sultanate of Oman

Introduction: Diabetes mellitus is a chronic disease with an increasing global prevalence. The condition has several oral health implications, with oral health in turn affecting diabetes control. People with diabetes are at higher risk of oral health problems, including periodontal disease, dental caries, and candidiasis; in particular, there appears to be a two-way relationship between periodontitis and blood glucose control. While previous research has indicated that diabetics have poor awareness of oral health, there is a gap in the literature from the Sultanate of Oman. This study aimed to determine oral health knowledge, attitudes, and practices among Omani diabetics. Materials and Methods: A cross-sectional study was conducted using a convenience sample of 400 adult Omani diabetics who attended the outpatient clinic of the National Diabetes and Endocrine Center, Oman, in the period between May 2019 and May 2020. A self-administered, Arabic language questionnaire to assess oral health knowledge, attitudes, and practices was developed and validated. Mean scores were calculated to determine overall levels of oral health knowledge, attitudes, and practice. Ethical approval was obtained from the Center of Studies and Research of the national Ministry of Health. Results: A total of 136 (34.0%) male and 264 (66.0%) female Omani adult diabetics participated in the study. The majority of participants (76.8%) demonstrated poor knowledge of oral health, especially with regards to complications like gingivitis (32.4%), dental caries (27.3%), halitosis (27.1%), and gingival abscesses (21.5%). Moreover, most (76.6%) were unaware that oral diseases affected glycated hemoglobin levels. In terms of practices, more than half (54.74.8%) routinely brushed their teeth twice a day. However, only 14.6% and 12.6% regularly flossed and used mouthwash, respectively. With regards to attitudes, 0.5%, 23.8%, and 75.8% of the participants demonstrated poor, moderate, and good attitudes toward oral health, respectively. Smokers more frequently demonstrated poor attitudes compared to nonsmokers (6.3% vs. 1.6%). Conclusion: Omani adults with diabetes mellitus demonstrated poor to moderate levels of oral health knowledge. Various studies conducted elsewhere around the world have similarly shown that diabetics have limited knowledge and awareness of oral health. Oral self-care behaviors are imperative to minimize the risk of oral health complications associated with diabetes. Previous researchers have shown that education is an effective method of reducing the incidence and burden of diabetes-related oral health complications. Thus, additional multidisciplinary initiatives are needed to raise awareness of good oral hygiene practices among diabetics in Oman.

The Lived Experiences of COVID-19 Quarantined Omani Adults: A Phenomenological Study

This study aimed to promote an in-depth understanding of lived experiences of Omani adults who were quarantined with COVID-19. Giorgi's descriptive phenomenological qualitative method was used to collect and analyze data from twelve eligible participants, who were selected through purposive snowball sampling. Data were collected from eligible participants using interrogatory statements during semi-structured audio-recording individualized phone interviews. Five general structural descriptions (GSDs) reflected the essence of the lived experiences of Omani adults who had been diagnosed with COVID-19 and experienced home quarantine. The GSDs of their lived experiences represented five phases: (1) before catching the infection (“No way I will get infected”), (2) between catching the infection and the quarantine (“I may be infected”), (3) early in the quarantine (“Oh my God, I am infected”), (4) in the middle and end of the quarantine (“So what? Yes, I am infected”), and (5) after the quarantine (“Praising God because I was infected”). The findings show that they experienced the quarantine period positively, as a time of self-growth and empowerment, highlighting the need to look at the brighter side of life. This qualitative study highlights that a positive outlook will help people regain their balance in any negative situation. It is the mindset that matters, not the situation.

Factors Associated with Coping Strategies Due to COVID-19 Pandemic-related Stressors among Omani Adults.

ObjectivesWe sought to examine stressors and coping strategies adopted by Omani adults during the COVID-19 pandemic and explore the relationships between coping strategies (avoidant and approach coping) and sociodemographic characteristics.MethodsThis national cross-sectional survey was conducted throughout Oman between September and December 2020. An online questionnaire was distributed to collect information concerning sociodemographic characteristics, potential stressors experienced during the pandemic, and coping strategies.ResultsA total of 790 Omani adults submitted completed questionnaires (response rate 88.4%). High, moderate, and low stress were reported by 492 (62.3%), 139 (17.6%), and 159 (20.1%) participants, respectively. Approach coping mechanisms received a higher mean score than avoidant mechanisms (22.01±6.55 vs. 8.88±4.80). Regarding specific coping strategies, planning had the highest mean score (5.15±1.31), followed by acceptance (4.95±1.34), religion (4.56±1.52), and positive reframing (4.28±1.89), while substance use (0.01±0.19) was the least reported followed by humor (0.86±1.43), denial (0.97±1.56), and behavioral disengagement (1.02±1.60). Associations were observed between the different coping strategies and participants’ gender, age, marital status, exercise level, and stress level (p ≤ 0.05).ConclusionsDuring a large-scale pandemic, the psychological impact on the general population is significant, even among individuals not infected with the disease. These results underscore the need for a mental health support system in Oman that can address the general population’s needs. Public education on coping strategies and stress management may be helpful.

Socioeconomic Inequality in Health Domains in Oman: Evidence from Oman World Health Survey

&#x0D; Socioeconomic inequality in health domains is a major challenge in public health in both developed and developing countries. The objective of this study was to assess the socioeconomic inequalities in various health domains in Oman. Data for the study was obtained from the 2008 World Health Survey in Oman, which covered a nationally representative sample of 3,370 Omani adults. Overall self-rated health (SRH) status and the functional difficulties with eight health domains: mobility; self-care, pain and discomfort, cognition, interpersonal activities, vision, sleep and energy, and affect, were used as the outcome variables. Level of education and wealth quintiles were used as the proxy measures of the socioeconomic status (SES). Both descriptive and inferential statistical techniques were used for data analysis. The results revealed significant socioeconomic inequalities in health outcomes for most of the health domains and for overall SRH in Oman. Adults with no education as well as with poorest wealth quintiles had significantly higher rate of poor health. For most of the health domains, a descending gradient in the prevalence of poor health with the level of education and wealth quintiles have been observed. However, education-related inequalities in poor health across the eight domains and the overall health status were found to be more pronounced and consistent than the wealth-related inequalities in poor health. Wealth quintiles showed no significant association with overall SRH and many health domains. The prevailing educational and wealth related inequalities in health underscores the need for policy-making in regard to reduce the inequalities in specific domains of health and overall health. There is a need for research to examine the ways in which socioeconomic factors mediate changes in health domains as well as overall health. The results from this study are of relevance to public health policymakers in developing interventions for specific health domains and overall health status.

Epidemiology and prevalence of somatic symptom disorder at the primary care level in Muscat, Oman: A cross-sectional study.

Somatic symptom disorder (SSD) is a diagnostic classification to describe the occurrence of physical symptoms without organic cause. This study aimed to identify prevalence rates and associated characteristics of SSD among adults in primary care settings. This cross-sectional study took place between July 2020 and March 2021 and included a random selection of 3383 Omani adults attending 12 primary healthcare centres in Muscat Governorate. Screening was conducted using an Arabic version of the Somatic Symptom Scale-8 (SSS-8). A total of 2000 adults participated in the study (response rate: 67.3%), of which most were female (71.7%) and under 50 years old (86.2%). Based on their SSS-8 scores, 602 participants (17.8%) had SSD, resulting in an overall prevalence estimate of 30.1% (95% confidence interval: 28.13-32.15). Significant associations were observed between SSD and age (p = 0.002), gender (p < 0.001), marital status (p = 0.030) and chronic comorbidities (p = 0.001). In addition, adjusted odds ratio estimates revealed SSD to be significantly associated with gender (p < 0.001), education level (p < 0.001) and chronic comorbidities (p = 0.001). The estimated prevalence of SSD in primary care settings is high compared to reports from elsewhere in the Gulf region. There is an urgent need to enhance the diagnosis of SSD at the primary care level in order to reduce healthcare service overutilisation and patient dissatisfaction. Moreover, healthcare practitioners should be aware of the effect of age, gender, educational status and chronic comorbidities on somatic symptoms.

First results on financial literacy in Oman

PurposeThis study aims to examine the financial literacy level among the Omani adults and investigate the determinants of financial literacy and its impact on savings and investment behavior.Design/methodology/approachThe data were collected using a survey instrument adopted from Organisation for Economic Co-operation and Development (OECD) survey for financial literacy and composed of 310 individuals' responses. The authors used a multiple regression analysis to determine the impact of the socio-demographics variables on the financial literacy level.FindingsThe findings are three-fold: first, financial literacy score of Omanis is 10.5 out of 21, which is lower than OECD average. Interestingly, the attitude and behavior scores are in line with the OECD average. However, the knowledge score is drastically lower. Second, financial literacy level is found to be affected by age, gender and the monthly income. Third, individuals with a higher level of financial knowledge are more likely to have monthly savings and investment in stock and bond.Research limitations/implicationsThe Gulf countries have started to modernize their economies. Governments that want to design effective economic reforms need to understand the financial skills of their citizens. The study may have implications for policymakers and financial educators in enhancing the financial knowledge programs for individuals.Originality/valueThe analysis reported in this study is unique because it provides the first systematic research on financial literacy in Oman. This paper contributes to the study of financial literacy from the perspective of emerging markets.

Depression in Urban Omani Adults with Type 2 Diabetes: A cross-sectional study.

ObjectivesThis study aimed to identify the prevalence of clinically significant depression among adult Omani patients with type 2 diabetes mellitus (T2DM) and explore potential associations with sociodemographic and clinical variables in this population.MethodsThis descriptive cross-sectional study was conducted between August 2018 and September 2019 and included 427 Omani T2DM patients from 12 randomly selected government health centres in Muscat, Oman. An Arabic version of the validated Patient Health Questionnaire-9 was administered to the participants via face-to-face interviews to determine the prevalence of depression.ResultsA total of 111 T2DM patients (response rate: 100%) had depression (26%). The presence of a personal history of depression was the only variable significantly associated with depression (P <0.001). Other sociodemographic and clinical factors including age, gender, duration of diabetes, glycated haemoglobin level, mode of diabetes treatment or the presence of diabetes-related complications such as cardiac complications, renal impairment, retinopathy, neuropathy and erectile dysfunction, were not associated with depression, (P >0.050 each).ConclusionThis study revealed a high prevalence of depression among urban Omani adults with T2DM and a personal history of depression, which was found to be significantly associated with depression. Therefore, early screening for depressive symptoms is necessary to improve the quality of life of diabetic patients in this region.

The Prevalence and Sociodemographic Correlates of Social Anxiety Disorder: A Focused National Survey

Background Social Anxiety Disorder (SAD) is among the most common anxiety disorders worldwide with data largely emerging from the Euro-American and Pacific Rim populations. In contrast, there is a dearth of studies among the populations of Arabian Gulf countries including Oman. This study has two interrelated aims: (i) to explore the prevalence of SAD among Omani adults, and (ii) to tease out the links between socio-demographic factors and SAD in Oman. Methods A cross-sectional study via an online survey was conducted among 1019 adult Omani nationals residing in Oman. The presence of SAD was assessed using the Arabic version of the Liebowitz Social Anxiety Scale (LSAS). Results Nearly half the participants (45.9%, n = 468) exhibited “caseness” for SAD as defined by LSAS. In the multivariate logistic analysis, participants below 40 years of age were 1.6 times (OR = 1.568, p = .026) more likely to have caseness for SAD than those who were 40 and older. Women were 1.3 times (OR = 1.348, p = .038) more likely to exhibit caseness for SAD than men. Participants who had secondary or undergraduate education were respectively 1.5 times (OR = 1.45, p = .014) and 2.5 times (OR = 2.509, p < .001) to have caseness for SAD than those who were graduates. Conclusion The present data suggest that 45.9% of the participants reached the cut-off for caseness in LSAS, which is high compared to reports from other populations. The present accrued frequency is discussed within the context of the accrued response rate, socio-cultural factors as well as the tendency for self-reported measures to “produce” spurious results is also highlighted which, in turn, calls for studies that adopt more inclusive survey methods.

Cognitive Function in Adults with Beta-Thalassemia Major in Oman: A Pilot Study.

ObjectivesNeurocognitive dysfunction has been established in several studies in children with beta-thalassemia major (TM). However, despite its wide occurrence in populations across the Arabian Peninsula, scant attention has been paid to shedding light on neuropsychological functioning among adults with TM. This study aimed to examine the level of neuropsychological functioning among Omani adults with TM regularly followed-up at a tertiary care hospital in Oman. A related aim was to examine the factors associated with neuropsychological performance.MethodsStandard neuropsychological tests were used to measure attention and concentration, learning and remembering, verbal fluency, and executive functioning. Participants were also gauged on indices of intellectual ability and affective range. As normative data for neuropsychological functioning in Oman is scarce, healthy age- and sex-matched controls underwent the same testing procedure. The log-linear model was used to identify factors associated with TM patients on demographic and neuropsychological performance.ResultsThis study recruited 28 adult patients with TM (age 30.0±6.5) and 39 healthy controls (age 29.2±6.1). Findings suggested that having a diagnosis of TM was significantly associated with symptoms of depression (p < 0.001) and anxiety (p < 0.001), indices of executive functioning (verbal fluency) (p =0.003), working memory (digit span) (p < 0.001), and verbal and auditory attention scores (California Verbal Learning, p = 0.002).ConclusionsThe data appears to suggest that short-term memory capacity, verbal fluency, and verbal and auditory attention may be impaired in TM compared to controls. Studies on a larger cohort are therefore warranted.

Life Expectancy and Healthy Life Expectancy of Adults in Oman: Does Women’s Longer Life Expectancy than Men Mean Success or Burden for Women?

Objectives: The objective of this study was to examine the life expectancy (LE) and healthy life expectancy (HLE) of Omani adults with age and gender differentials, focusing on whether the higher LE of women than men is a gain or burden for women. Method: Data for the study come from multiple sources such as the 2010 population census, the 2008 World Health Survey in Oman, and secondary data published in the Statistical Yearbook of Oman. The life table and the modified life table proposed by Sullivan were used for estimating the LE and HLE of adult people of age 20 and above, respectively. Results: LE in Oman reached 76 years for both sexes in recent times. However, since 2010 LE has been stalled in the vicinity of 76 years in Oman. Women had higher LE than men (79 years versus 74 years). In terms of HLE, men outweighed women in Oman. At the age of 20, the gap between male-female LE was found to be 4.7 years in favor of females, whereas the gap between male-female HLE was found to be 5.8 years in favor of males. Females spent a relatively long time in poor health status than males (20.8 years versus 10.8 years) and the proportion of life spent in poor health was greater for females than males (35.0% vs. 19.3%). This revealed the paradox of less mortality but higher morbidity among women, supporting the “Failure of Success” hypothesis. Conclusion: Appropriate health policy and strategy need to be taken to reduce the gender gap in LE and HLE in Oman.

Prevalence of Coeliac Disease in Omani Adults with Iron Deficiency Anaemia of Unknown Cause: Case-finding study.

ObjectivesThis study aimed to estimate the serological prevalence of coeliac disease in patients with iron deficiency anaemia (IDA) of unknown cause at a primary healthcare facility in Oman.MethodsThis prospective case-finding study was conducted at the primary care clinics in Sultan Qaboos University Hospital, Muscat, Oman from September 2018 to June 2020. Patients aged 18 to 55 years, with a haemoglobin (Hb) level <11.5 g/dL for males and <11.0 g/dL for females and a ferritin level <30 ng/mL for males and <13 ng/mL for females, were included in the study. Blood samples were obtained for initial serological screening using serum immunoglobulin (Ig)A level; those samples with normal levels of IgA, IgA anti-tissue transglutaminase antibody (tTG) and IgA anti-deamidated gliadin peptide (DGP) were determined. Positive IgA-tTG test was confirmed using IgA-endomysial antibodies. Patients with low IgA levels were tested using IgG-tTG and IgG-DGP.ResultsA total of 104 patients participated in this study. Eight patients (7.7%) were found to have a positive serological screening result for coeliac disease; of these patients, three (37.5%) had a positive IgA-tTG result. Two of those three (66.7%) had a positive IgA-endomysial antibody. The IgA-DGP result was positive in seven (6.7%) of the 104 patients. Out of those seven patients, two also had a positive IgA tTG.ConclusionCoeliac disease is not a rare disorder. There is a need to increase awareness among healthcare professionals about coeliac disease and its non-classical manifestations such as IDA.

Retention in HIV care and factors associated with loss to follow-up in Oman: a countrywide study from the Middle East

ABSTRACT We conducted a cross-sectional analysis to determine the rate of retention in HIV care and the factors associated with loss to follow-up (LTFU) among Omani adults living with HIV who were linked to care as of 31 December 2019. Patients (n = 1610) were identified from a central national HIV surveillance dataset. The majority (68.3%) of patients were male, and the median age was 39 years (IQR, 31–48 years). A total of 1480 patient (91.9%) were retained in care. On multivariate analysis, compared to those who received antiretroviral therapy (ART), patients who had never been on ART were 6.8 (95% CI: 3.05–15.16) times more likely to be lost to follow-up. Patients who had a latest HIV viral load (VL) of 200–999 copies/ml (adjusted odds ratio [aOR]: 4.92, 95% CI: 2.27–10.69) and ≥ 1000 copies/ml (aOR: 15.03, 95% CI: 8.31–27.19) compared to those who had a latest HIV VL of <200 copies/ml had higher odds of loss to follow-up. Moreover, patients who were divorced or widowed were 2.64 (95% CI: 1.14–6.07) times more likely to disengage from HIV services, compared to those who were married. These findings will be invaluable in developing targeted interventions that further improve patients’ retention in HIV care in Oman.