Omani Subjects Research Articles

Anatomical variations of Koerner's septum: a computed tomography-based, single-centered study.

Koerner's septum (KS) is a bony plate located at the junction of the petrous and squamous parts of the temporal bone. The reported prevalence of KS varied between studies. KS variations are associated with various pathologies and pose difficulties during surgeries. The study aims to determine the KS frequency in Omani patients and analyze its association with sex and side. The present study investigated the KS topography in 344 computed tomography (CT) scans of normal temporal bones of adult Omani patients at Sultan Qaboos University Hospital. The presence of KS and its parts (complete or incomplete), as well as its thickness at three anatomical landmarks were recorded. Additionally, sex and laterality differences in KS parameters were analyzed using a Chi-square test. The overall frequency of KS among Omani subjects was 39.5%. The complete KS was observed only in 14% of cases. The thickness of KS was 0.78 ± 0.21 mm, 0.93 ± 0.28 mm and 0.78 ± 0.21 mm at the head of the malleus (HM), the superior semicircular canal (SSC) and the tympanic sinus (TS), respectively (p<0.01). KS was present most constantly at the level of HM (64.7%), followed by SSC (57.4%), and less constantly at the level of TS (49.3%). KS frequency was similar in both males than females (41.9% vs 37.3%), with statistically insignificant difference (p = 0.38). No side differences were observed concerning KS frequency (p = 0.955). The KS frequency in Omani subjects within the range of previously reported studies. It is incomplete in most of the cases and constantly present at the level of HM. Its thickness is more at the level of SSC.

Age, body composition analysis, and gender differences of morbidly obese Omani subjects

Age, body composition analysis, and gender differences of morbidly obese Omani subjects

Computed-tomography evaluation of parietal foramen topography in adults: a retrospective analysis.

The parietal foramen (PF) of the skull is a variable anatomic feature with important implications for venous drainage, infection, and injury. Its topography is clinically relevant for neurosurgeons for intracranial navigation and preoperative planning. PF topography was investigated in a series of 440 head computed-tomography scans of Omani subjects at Sultan Qaboos University Hospital. The mean age of the patients was 52 ± 17years and there were 160 males and 280 females. The topography features of the PF, including frequency, diameter, patency, and relative position in relation to the superior sagittal sinus (SSS), were recorded. Additionally, sex and laterality differences in PF parameters were analyzed using a Chi-square test. The overall prevalence of PF was 72.3% (318/440). The bilateral presence of PF was identified in 34% of skulls. Unilateral right-side prevalence was 18.2%, while left prevalence was 13.2% (p = 0.62). The prevalence of unilateral accessory PF on the right side was 1.8%, while it was 1.1% on the left (p = 0.69). PF within the sagittal suture/or intra-sutural PF was observed in 6.8% of skulls, with a frequency of 9.4% in men and 5.4% in women (p = 0.29). The diameter of the PF was 1.45 ± 0.74 mm on the right side, and 1.54 ± 0.99 mm on the left side (p = 0.96). There were 2% of incomplete PF. The PF was located over the SSS in 70.3% on the right side and 53.8% on the left side. No significant differences were observed between the PF topography parameters and sex or laterality. The present study for the first time reports the baseline data of PF topography in a large sample of CT scans in the Arab population. The geography and race influence the PF topography differences. PF may be used as a reliable landmark of SSS. The morphological characteristics and distribution of PF reported in this study have clinical implications for imaging diagnosis, intracranial navigation of vascular disorders, and treatment.

Radiological Assessment of Extracranial Vertebral Artery Variations: A Computed Tomography Angiography Study

We evaluated the incidence of intraforaminal and extraforaminal variations of the vertebral artery (VA) in the Omani population using computed tomography angiography (CTA). CTA results of 579 consecutive Omani patients (1158 VAs) were reviewed retrospectively for the analysis of unusual entrance transverse foramen (UE-V2), midline migration (MM), persistent first intersegmental artery (PFIA), and paracondylar process (PP) variations of VA. The anomalous origin and VA dominance were also determined. The sex and side differences in the incidence of these variations were analyzed using the Chi-square test. The incidence of UE-V2 was observed in 10.44% (121 out of 1158) of cases. The incidence of UE-V2 at different vertebral levels was observed in the sequence of C5 (71%) &gt; C4 (20.7%) &gt; C7 (7.43%) &gt; C3 (0.8%). The incidence of MM variation was 1.29%. PFIA and PP variations were found in 0.17% and 0.60% of cases, respectively. Left-dominant VA was identified in 44.7% (259 out of 579) of subjects. The incidence of VA variations was not significantly associated with either sex or side. Anomalous VA origin from arch aorta (3.5%) and right common carotid artery (CCA) (0.08%) was identified. The incidence of UE-V2 in Omani subjects is comparatively higher than that reported in other Asian populations. A rare case of VA originating from the right CCA was also identified.

Radiologic Assessment of Orbital Dimensions among Omani Subjects: A computed tomography imaging-based study at a single tertiary centre.

This study aimed to determine the orbital dimensions of Omani subjects who had been referred for computed tomography (CT) of the brain at Sultan Qaboos University Hospital, Muscat, Oman. Good knowledge of the normal orbital dimensions is clinically essential for successful surgical outcomes. Racial, ethnic and regional variations in the orbital dimensions have been reported. A total of 273 Omani patients referred for CT scans of the brain were retrospectively evaluated using an electronic medical records database. The orbital dimensions were recorded using both axial and sagittal planes of CT images. The mean orbital index (OI) was found to be 83.25 ± 4.83 mm and the prevalent orbital type was categorised as the mesoseme. The mean orbital index was 83.34 ± 5.05 mm and 83.16 ± 4.57 mm in males and females, respectively, with their difference not being statistically significant (P = 0.76). However, a statistically significant association was observed between the right and left orbits regarding horizontal distance (P <0.05) and vertical distance (P <0.01) of orbit and OI (P <0.05). No significant difference between the OI and age groups was observed in males and females. The mean interorbital distance and interzygomatic distance were found to be 19.45 ± 1.52 mm and 95.59 ± 4.08 mm, respectively. These parameters were significantly higher in males (P <0.05). Results of the present study provide reference values of orbital dimensions in Omani subjects. Mesoseme, a hallmark of Caucasian people, is discovered to be the prevalent orbital type of Omani subjects.

The association between fingerprint patterns and blood groups in the Omani population

PurposeFingerprints and blood samples are important for the identification of individuals and criminals. The present study aims to identify the predominant fingerprint patterns and the association between the fingerprint patterns and ABO–Rh blood groups in Omani population.Design/methodology/approachA cross-sectional study was conducted on 200 Omani individuals aged 18 years (104 males and 96 females). The imprints of all right and left-hand fingers were taken, and the types of the fingerprints were determined using a standard protocol. The blood group of all the subjects was recorded. Chi-square test was performed to identify the association between the fingerprint patterns and the ABO and Rh blood groups.FindingsThe loop fingerprint pattern was the most common in Omani subjects (49.4%), followed by whorl (44.9%) and arch (5.7%) pattern. A significant association (p &lt; 0.001) was found between gender and fingerprint pattern. The loop was the highest occurring pattern in the females (54.6%), while the whorl was more in males (50.0%). The whorl pattern was the most common in the AB+ and O− groups. The loop was a predominant pattern in the A+, A−, B+, B− and O+ groups. The Chi-square test also revealed a significant correlation between different fingerprint patterns and blood groups of the subjects (p &lt; 0.001).Originality/valueThe present study is an outcome of undergraduate student's research project thesis for the Doctor of Medicine (MD) program. The results of the present study may help in creating a data bank for biometrics, which can be useful for diagnosing associated diseases and also help in identification of individuals.

Prevalence of cervical ribs and elongated transverse processes in Omani population: a computed tomography-based study

Cervical ribs are the supernumerary ribs that usually arise from the seventh cervical vertebra. Ethnic and geographical variations in cervical ribs and elongated transverse processes have been reported. Therefore, we aimed to study the prevalence of cervical ribs and elongated transverse processes and morphometry of cervical ribs in Omani subjects using computed tomography (CT). A total of 1165 consecutive patients' CT scans of the cervical spine who had visited the tertiary care hospital from January 2016 to December 2020 were included in the study. The CT scans were screened for cervical ribs and elongated C7 transverse processes. Fisher's exact test was used to determine the gender influence. Cervical ribs were identified in 0.94% of patients with a male-to-female ratio of 0.37:1. Most cervical ribs were unilateral (54%). The elongated C7 transverse process was identified in 18.45% of patients, with a male-to-female ratio of 1.36:1. Female patients are more likely to have cervical ribs (effect size = 5.98, 95% CI = 1.58-22.6, p = 0.005) than male patients. In contrast, the elongated C7 transverse process is more frequent in males (effect size = 1.82, 95% CI = 1.34-2.47, p < 0.001). The length and width of the cervical ribs are presented. The prevalence of cervical ribs in Omani subjects is close to that of accepted prevalence worldwide. However, the elongated C7 transverse process prevalence is comparatively high and close to the Saudi population.

Radiologic evaluation of congenital anomalies of anterior and posterior arch of atlas in Omani subjects

The atlas (C1) is known to present congenital anomalies in its anterior and posterior arches. The reported incidence of C1 anomalies is varied among the ethnic groups. We sought to determine the prevalence and various existing variations of C1 arch congenital anomalies in Omani subjects. This study was carried out by reviewing the cervical spine computed tomography scans of all the patients who had been referred to the Radiology Department, Sultan Qaboos University Hospital. Descriptive statistics and chi-square test were employed to analyse the data. A total of 663 subjects aged ≥18 years were included in the present study. Overall prevalence of C1 arch anomalies was 4.37% with 4.07% of isolated posterior arch anomalies, 0.3% of combined anterior and posterior arch anomalies. Among isolated posterior arch anomalies, type A and type B posterior arch defects were found in 3.77% and 0.3% of cases, respectively. Atlanto-occipital assimilation was noted in one case of total study subjects. The prevalence rate of C1 arch anomalies is relatively high in Omani subjects. The baseline data of C1 arch anomalies reported in the present study has a great impact on clinical practice, due to the fact that studying and evaluating the types of congenital anomalies helps in their accurate diagnosis and early intervention.

Radiological study of fabella in Omani subjects at a tertiary care center.

Ethnic diversity is associated with variability in the prevalence rates of fabella. We aimed to evaluate the prevalence and the radiological features of fabella in Omani patients. This is a retrospective analysis of hospital electronic database of patients referred for radiological investigations (radiographs and magnetic resonance imaging) of the knee, at a tertiary care referral center. Descriptive statistics were performed to determine the prevalence of fabella. Chi-square test was used to determine the association between sex or age with respect to the presence of fabella. A total of 813 knee radiographs were reviewed for the presence of fabella. Fabella was found in 24.1% of total cases. A statistically significant sex difference was observed with respect to the presence of fabella in left knees in males (P<0.01). The presence of fabella was significantly associated with age groups for the right (P<0.05) and left knees (P<0.01). In magnetic resonance imaging film reviews, all the identified fabellae (20.2%) were bony structures and were located within the lateral head of the gastrocnemius muscle. There were no cartilaginous fabellae detected. The current study revealed a prevalence of 24.1% of fabella in Omani subjects which is almost similar to the results as seen in Caucasian ethnic populations.

Variations of Peroneus Tertius Muscle in Omani Population: A Surface Anatomical Study.

Peroneus tertius muscle (PTM) is a muscle of the anterior compartment of the leg. It is a highly variable muscle with a prevalence rate ranging from 42%-100% in different populations worldwide. We sought to explore the frequency of PTM and its existing variants, based on surface anatomical evaluation of the foot, in Omani subjects. In this study, a total of 222 adult Omani subjects (total 444 feet) were examined for the presence of PTM. The presence of PTM and its morphological types were identified based on surface anatomical examination using a standard palpation method. Descriptive statistics were used to present the data. The gender influence on the occurrence of PTM was determined by the Chi-square test. The frequency of PTM was observed in 59.9% of total feet. A statistically significant gender difference with male dominance was observed on both right (p = 0.02) and left (p < 0.01) feet. Regarding PTM types, the F2 type was most common on both right (38.5%) and left feet (46.2%). The bilateral occurrence of PTM was found in 47.7% of cases. The frequency of PTM in Omani subjects is considerably high when compared to other Arab populations. The baseline information on the PTM proportion and distribution of its types is clinically important for physiotherapists and orthopedic surgeons.

Agreement analysis of sleep patterns between self-reported questionnaires and actigraphy in adults.

To investigate the agreement in sleep pattern recording by self-reported sleep questionnaires and actigraphy in adults. This is a cross-sectional study. Men and women who metinclusion criteria were recruited for this study. The inclusion criteria were apparently healthy Omani nationalsages 19 to 50 years. Sleep questionnaires were randomly distributed in Muscat either directly or via electronic and paper announcements. Data were collected from the participants using the self-reported questionnaires with four piloted questions for sleep pattern identification and through the actigraphy wristband given to subjects to wear for a week. Cohen's kappa test was performed for agreement analysis. A total of 964 Omani subjects between ages 18 and 59 years of both genders were recruited and completed the questionnaires successfully. Out of these, only 321 subjects wore the actigraphy wristband for 1 week (response rate = 33%). Agreement analysis reported a mild level of agreement for the monophasic (41%), moderate level for biphasic (59%), and good level for polyphasic (70%) sleep patterns. The overall agreement level of sleep patterns between the two methods was 57%. There is a low specificity of self-reported assessment in reporting sleep pattern. The average agreement level of subjective versus objective assessments of sleep patterns was moderate at 57% and self-reported sleep pattern is not specific. The study recommends the use of actigraphy along with sleep questionnaires for accurate assessment of sleep patterns in cohort studies.

Prevalence and distribution of sesamoid bones of the hand in Omani subjects: a radiological study.

Sesamoid bones show considerable variations in their occurrence among various ethnicities. This study aims to evaluate the prevalence and distribution patterns of the sesamoid bones of the hands among Omani patients who were referred for radiological investigations. The influence of gender and different age groups on the occurrence of sesamoid bones of the hand was determined using the Chi-square test. Spearman's rank correlation was used to determine the coexistence of sesamoid bones at the metacarpophalangeal joints. A total of 541 hand radiographs were reviewed. A high prevalence of sesamoid bones at the fifth metacarpophalangeal joint and the interphalangeal joint of the thumb was noted with a frequency of 64% and 49.7%, respectively. There were ten different patterns of sesamoid bones detected, the most common of which was the presence of sesamoid bones at the first and fifth metacarpophalangeal joints found in 32.9% of the radiographs. A statistically significant gender difference was observed at the interphalangeal joint of the thumb (p = 0.025) and fifth metacarpophalangeal joint (p = 0.027) with a female dominance. A significant association between the age and prevalence of sesamoid bones was noted at the fifth metacarpophalangeal joint (p = 0.03). The prevalence of the sesamoid bones of the hand in Omani subjects seems to differ from other Middle Eastern populations, particularly at the fifth metacarpophalangeal joint and the interphalangeal joint of the thumb. In the meantime, the baseline data of our study can be helpful while treating the patients complaining of hand discomfort or pain.

Radiological Study on Sesamoid Bones of the Foot among Omani Subjects.

ObjectivesThe prevalence and appearance of sesamoid bones in the foot vary considerably among different populations and ethnic groups. We sought to evaluate the prevalence and distribution patterns of foot sesamoid bones among Omani patients referred for radiological investigation.MethodsWe conducted a retrospective study among patients who had been referred for foot X-ray from January to December 2018. We used the chi-square test to determine the gender and age influence on the prevalence of sesamoid bones, and the Spearman’s correlation coefficient to assess the coincidence of specific distributions of sesamoid bones at the metatarsophalangeal (MTP) joints.ResultsA total of 774 foot radiographs composed of 442 right foot radiographs and 332 left foot radiographs were reviewed for the presence of sesamoid bones at MTP and interphalangeal (IP) joints of the foot. We observed a high prevalence rate of sesamoid bones at the fifth MTP joint (13.7%), and first IP of the great toe (9.9%). There were nine distinctive patterns of sesamoid bones. The coincidence of sesamoid bones at two or more MTP joints was 14.6%, with a high prevalence rate at first and fifth MTP joints (10.3%). Moreover, the prevalence rate of sesamoid bones increased with increasing age at the fifth MTP joint.ConclusionsThe prevalence of sesamoid bones in the foot is considerably high in Omani subjects and needs further prospective studies. Meanwhile, our findings could be helpful for clinicians to consider ailments of sesamoid bones during differential diagnosis in Omani patients who present with foot pain and discomfort.

Does gender have a significant effect on normal nerve conduction studies values?

Background: nerve conduction study (NCS) is a neurophysiologic medical diagnostic test used commonly to evaluate the function of the peripheral nerves. It is an extension to the clinical examination and extremely useful to diagnose and document a peripheral nerve disorder, localize the lesion, and to establish underlying pathophysiology. Objective: The aim of this study is to evaluate the influence of gender on nerve conduction study values and to generate reference nerve conduction studies (NCS) data for the commonly tested nerves among healthy adults in Oman. Subjects and methods: This study was conducted in the Neurology Department at the Royal Hospital, a tertiary care hospital in Muscat-Oman, for a period of four years (from March 2015 until May 2019) which included a total of 143 (80 females and 63 males) healthy Omani subjects. Sensory and motor nerve conduction studies were performed to the Median, Ulnar, Peroneal and Tibial nerves to establish the normative data. Statistical analysis was performed using Minitab comparing the mean values of all NCS parameters for both genders. Results: Gender comparison concluded that Omani males have longer distal motor latencies for all of the tested nerves and slower motor conduction velocities for the lower limbs’ nerves (p &lt;0.005) than the females. While sensory latencies were significantly delayed in males as compared to Omani females for the upper limbs’ nerves and the ensory nerve potential amplitudes in the upper limbs were greater in females (p&lt;0.0001) than males. A normative data for distal latencies, conduction velocities and responses amplitudes for motor and sensory nerves were sat up for the first time for normal adult Omani population. Conclusion: Gender has a significant influence on distal latencies and conduction velocities of some peripheral nerves in healthy Omani adult subjects, suggesting that different cut-off values for the two genders may be needed for interpreting such studies. These differences could be related to anatomical (height and limbs’ length gender differences) and/or physiological factors. Our normative data for nerve conduction study values are comparable to other published studies in the literature.

Gender has a significant effect on normal nerve conduction values

The aim of this study was to evaluate any significant factors that may influence nerve conduction values and to generate reference nerve conduction study data of the most commonly tested nerves among healthy adults in Oman. This original study was conducted at Royal Hospital, a tertiary care hospital in Oman. A total of 143 (80 females and 63 males) healthy Omani subjects were included in the study. Statistical analysis was performed using Minitab to compare the mean values of all NCS parameter in both genders. Also, a comparison was made between this study and four other similar international reference laboratory values. Gender comparison concluded that males have longer distal latencies and slower conduction velocities (p < .005). Gender differences in height may partially explain these variations. Sensory nerve potential amplitudes in upper limbs were greater in females (p < .0001). Our results are similar to other similar reference standard parameters published in literature. Gender has a significant influence on distal latencies and conduction velocities of peripheral nerves in healthy adult subjects, suggesting that different cut-off values for the two genders may be appropriate for interpreting such studies. Our data present similar values to other published studies in the literature.

Cephalometric Norms in an Omani Adult Population of Arab Descent.

This study aimed to establish cephalometric norms for an Omani population of Arab descent and to compare these with established cephalometric values for Caucasians. This cross-sectional study was conducted at the Military Dental Centre and Oman Dental College in Muscat, Oman, between May 2014 and October 2016. A total of 150 Omani patients between 20-29 years old seeking orthodontic treatment were included. All participants had a symmetrical face, class I molar and canine relationships, proper intercuspation, a normal overjet/overbite (<3 mm) and mild spacing/crowding of the teeth (≤3 mm). Lateral cephalography was performed in centric occlusion with the lips relaxed and the head in a natural position. Cephalometric measurements were then compared with Eastman Standard norms. The Omani subjects were found to have a slightly retrusive maxilla, an increased angle between the maxillary and mandibular planes and shorter facial heights in comparison to the Eastman Standard norms. Furthermore, incisor relations were edge-to-edge in nature and the interincisal angle was reduced, suggesting that the Omani subjects had more proclined incisors. In addition, the lips were more protrusive and the nasolabial angle was more obtuse. In the Omani sample, increased proclination of the incisors was observed in comparison to Eastman Standard norms. As such, slightly more proclined incisors should be considered acceptable and natural among Omani patients of Arab descent. The cephalometric findings of this study may be helpful in the diagnosis and treatment planning of orthodontic problems among Omanis of Arab descent.

First Cytogenetic Profile of Omani Patients with de novo Myelodysplastic Syndromes: Comparison with data from Asia, Africa, Europe and North and South America

Clonal cytogenetic abnormalities have been reported among 30-80% of patients with myelodysplastic syndromes (MDS); however, 20-70% of patients with MDS show a normal karyotype that may nevertheless harbour a cryptic genetic alteration. Earlier reports have suggested that the distribution of specific chromosomal aberrations varies among Western and Asian countries, with geographical and ethnic differences in the frequency of specific chromosomal aberrations. This article compared the cytogenetic data of 36 adult Omani patients with MDS to previously reported data from other populations. Differences were noted between the percentages of clonal aberrations and the median age of Omani subjects at presentation in comparison to individuals of different ethnicities and from various geographical locations. To the best of the authors' knowledge, this is the first report to describe the cytogenetic data of patients with MDS from Oman.

PRELIMINARY STUDY: ROLE OF THE COMBINATION OF SPIRULINA AND MORINDA CITRIFOLIA IN THE CONTROL OF HYPERGLYCEMIA IN OMANI DIABETIC PATIENTS

Diabetes mellitus is a metabolic disorder characterized by hyperglycemia, hyperlipidemia, hyper aminoacidemia, and hypoinsulinemia that leads to a reduction in both insulin secretion and insulin action. The combination of Spirulina and Morinda citrifolia as functional supplements are emerging as important therapeutic food. This preliminary study was aimed to evaluate the hypoglycaemic and hypolipidemic effects of combining Spirulina and Morinda citrifolia to subjects with type 1 diabetes mellitus using a daily dose of 4 g/weight/day tablets for 4 months of Spirulina and 40 ml/day for Morinda citrifolia juice with standard insulin treatment in comparison with diabetic subjects receiving type 1 standard diabetes treatment, insulin injections only. Pre-intervention and post intervention fasting blood glucose levels, glycosylated haemoglobin (HbA1c) levels, and low-density lipoprotein (LDL) serum levels of the diabetic subjects were measured. Four months supplementation of combined Spirulina and Morinda citrifolia resulted in an appreciable lowering of fasting blood glucose blood serum levels. A significant reduction in the HbA1c level was also observed, indicating improved long-term glucose regulation. These findings suggest the beneficial effect of combining Spirulina with Morinda citrifolia supplements in controlling blood glucose levels and in improving components of the lipid profile of Omani subjects with type 1 diabetes mellitus.

Frequencies of the Arg16Gly, Gln27Glu and Thr164Ile Adrenoceptor β2 Polymorphisms among Omanis.

This study aimed to assess the distribution of missense mutations in the adrenoceptor β2 (ADRB2) gene in an Omani cohort. This study was carried out between May 2014 and March 2015 at the Sultan Qaboos University, Muscat, Oman. Blood samples were taken from 316 unrelated Omani subjects. Genotyping for rs1042713 (c.46A>G, p.Arg16Gly), rs1042714 (c.79C>G, p.Gln27Glu) and rs1800888 (c.491C>T, p.Thr164Ile) polymorphisms was performed by real-time polymerase chain reaction using single nucleotide polymorphism (SNP) genotyping assays. The allelic frequencies of these polymorphisms were estimated on the basis of the observed numbers of specific alleles from the genotype data for male and female subjects. The genotype frequencies for each polymorphism were tested for deviation from the Hardy-Weinberg equilibrium. Gly16 and Glu27 were the most frequent variants found among the cohort (63% and 75%, respectively). The Ile164 variant was not detected in the study population. There was a significant linkage disequilibrium between the rs1042713 and rs1042714 SNPs (r(2) = 0.209; P ≤0.001). The most observed haplotypes were Gly16-Gln27 and Arg16-Gln27 (0.37 and 0.38, respectively). The frequency of Gly16-Glu27 was 0.25, comprising all Glu27 carriers. The allelic distribution of variants in this Omani cohort was similar to distributions reported among Caucasian populations.

First report of the spectrum of δ-globin gene mutations in Omani subjects - identification of novel mutations.

Both coinheritance of thalassemic δ-globin mutation and coexistence of iron deficiency anemia (IDA) tend to decrease HbA2 (α2 δ2 ) level and thereby poses a diagnostic conundrum in β-thalassemia trait. We retrospectively studied 78 Omani subjects, presenting with low HbA2 level by high-performance liquid chromatography (HPLC), and their DNA was sequenced for the presence of mutations in the δ-globin gene (HBD). In these subjects, their serum ferritin levels allowed evaluation of the degree of iron deficiency. Overall, six different δ-globin gene mutations were observed in 40 study subjects (51.3%) and IDA in 33 subjects, with the remaining five subjects showing normal HBD sequence and serum ferritin level. Among the subjects with δ-globin gene mutations, seven had an associated IDA confirmed by significantly low serum ferritin levels. Heterozygosity for the delta (+) cd27G-->T mutation (HbA2 -Yialousa; HBD: c.82G>T) was the most common abnormality observed (n = 26, 66.6%) followed by heterozygosity for HBD c.-118C->T (d -68 C->T) (n = 6, 15.4%), for cd16G-->C (n = 4, 10.3%), for cd98G-->A (n = 2, 5.1%), for cd142G-->C (n = 1, 2.6%), and for cd147G-->T (n = 1, 2.6%). These delta mutations exhibit low HbA2 either due to a shift in the HPLC position or due to their bona fide thalassemic feature. Two mutations, namely cd142 G-->C (GCC to CCC, Ala to Pro) and stop codon cd147 G-->T (stop to Leu with elongation of 15 amino acids), herein first reported are novel. Coexistence of IDA could lead to erroneous diagnostic interpretation unless it is specifically looked for.