Oman Medical Journal最新文献

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.

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.

Objectives: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Objectives: Globally, the preparedness of frontline healthcare providers (HCPs) to deliver timely and appropriate medical care has emerged as a significant concern. The training of HCPs in containment measures is considered pivotal in elevating the quality of care for COVID-19 patients while simultaneously mitigating the risk of viral transmission to both fellow patients and HCPs. This study investigates the impact of training on HCPs readiness to manage COVID-19 patients in a tertiary hospital in Oman.

Methods: Employing a mixed-method design, we extended invitations to HCPs at the Royal Hospital in Muscat using electronic forms. We collected data about HCPs demographics, their comprehension of the hospital's core objectives and protocols, and any knowledge acquired through official training or self-directed study. Our analytical approach encompassed descriptive and univariate statistical methods, complemented by thematic analysis for the qualitative component.

Results: Our survey acquired responses from a total of 241 individuals. Among the respondents, 67.6% were female nurses, and 49.8% were aged between 31-40 years old. Significant differences were observed concerning gender (p = 0.018 and p = 0.001) and profession (p < 0.001 and p < 0.001) with the total score in awareness and knowledge, respectively. Stress and fear of handling confirmed or potentially contagious patients negatively impacted nearly half of the HCPs, with doctors and nurses reporting this effect significantly. Remarkably, 61.0% of HCPs expressed that their confidence in managing COVID-19 cases was positively influenced by their faith in national pandemic plans.

Conclusions: While the hospital's protocols and procedures were well comprehended, the lack of preparedness and skills training for managing highly contagious patients resulted in diminished confidence and heightened stress. To fortify their ability to respond to future outbreaks and work with resilience and confidence, HCPs require ongoing, comprehensive, and hands-on training.

We report a rare case of a middle-aged Omani woman who was known to have primary antiphospholipid syndrome, glucose-6-phosphate dehydrogenase deficiency, and iron deficiency anaemia. Cannulation attempts caused bulla which progressed to ulceration. A pathergy phenomenon with high suspicion of pyoderma gangrenosum was postulated. Management with corticosteroids, cyclosporin, and finally ustekinumab, a novel biologic agent, yielded a beneficial response.

Acute myeloid leukemia (AML) is rarely associated with central diabetes insipidus (CDI) with unclear underlying pathophysiological mechanisms. The most commonly reported cytogenetic abnormality in cases of AML-associated CDI is monosomy 7, followed by chromosome 3 abnormalities. We report a case of a woman with newly diagnosed AML with 9q34 deletion (ABL1 gene region), who developed symptoms of polyuria and polydipsia with an investigation confirming CDI. This is the first reported case of cytogenetic abnormality of 9q34 deletion (ABL1 gene region) in AML with CDI.