Sultan Qaboos University Medical Journal最新文献

Conflicting evidence exists regarding the effectiveness of pharmacological interventions in reducing pain during intrauterine device (IUD) insertion. This study aimed to evaluate the safety and efficacy of various analgesics and to rank their effectiveness. A total of 71 randomized controlled trials (RCTs) involving 10,870 women were included. Data were sourced from PubMed, Cochrane Library, Scopus, and other databases up to September 2023. Analyses were performed using the Netmeta package in R, with results reported as standardized mean differences (SMDs) and risk ratios (RRs), each with corresponding 95% confidence intervals (CIs). Lidocaine 4% gel (5 mL) emerged as the most effective option for pain relief during IUD insertion (SMD = -4.5; 95% CI: -5.9- -3.0; low-quality evidence), followed by lidocaine 1% solution (10 mL; SMD = -3.20). Lidocaine 4% gel also ranked highest for reducing pain during tenaculum placement, while misoprostol 400 mcg improved the ease of IUD insertion. Despite the low quality of evidence, lidocaine 4% gel appears to be the most effective pharmacological intervention for pain reduction during IUD insertion.

Thalassaemia, a hereditary blood disorder, remains under-recognised due to limited awareness, particularly among young people. This scoping review aimed to evaluate the characteristics and effectiveness of premarital thalassaemia educational interventions globally. Following PRISMA-ScR guidelines, six databases were searched for English-language studies targeting adolescents and young adults. Eight studies met the inclusion criteria, and data were extracted using a standardised form adapted from the Joanna Briggs Institute, focusing on intervention characteristics, outcomes and key findings. Most studies involved school students and young adults from culturally diverse, resource-limited settings. The interventions-traditional, technology-based or culturally adapted-consistently improved knowledge (P <0.001). However, behavioural outcomes, such as increased uptake of screening, were inconsistent. While educational strategies enhanced knowledge effectively, socio-cultural barriers limited the translation into behavioural changes. These findings support the need for future interventions to integrate behavioural change theories, leverage digital tools and address cultural sensitivities to improve their overall impact.

Objectives: Incidental detection of superior semicircular canal dehiscence (SSCD) in patients without symptoms may lead to misinterpretation if not correlated with clinical presentation, examination findings, and vestibular function testing. This study aimed to assess the rate of radiological SSCD in the asymptomatic Omani population, as the first study of its kind in the country and the Gulf region.

Methods: A retrospective review was conducted of all asymptomatic patients who underwent high-resolution computed tomography (HRCT) of the temporal bones at a tertiary care facility between 2017 and 2021. Dedicated consultant neuroradiologists evaluated both superior semicircular canals (SSCs) for evidence of dehiscence.

Results: Nineteen of 470 ears showed radiological SSCD, giving a prevalence of 4.1% (95% confidence interval = 2.1-8.1). Seven patients (14 ears) had bilateral dehiscence. The mean defect size was 1.3 mm. Females constituted 52% of the 19 patients, and no significant gender difference was observed (P = 0.68).

Conclusion: Radiological SSCD was found in 4.1% of asymptomatic patients on HRCT, comparable to previous reports and substantially higher than post-mortem estimates of asymptomatic SSCD. Therefore, cautious interpretation of HRCT findings is recommended in asymptomatic individuals, with consideration of clinical and audiovestibular assessments.

We report a 22-year-old male, who presented in 2020 to a clinic in Kahramanmaraş, Turkey, with a 5-year history of a fixed preoccupation with the belief of emitting a 'plastic smell' from his anal region. This case illustrates a clinically significant link with a history of childhood sexual abuse. The patient was diagnosed with olfactory reference disorder (ORD) with poor insight and comorbid depressive disorder, based on ICD-11 and DSM-5-TR criteria. Extensive medical workups ruled out organic causes. He responded well to a combination therapy of sertraline and aripiprazole, showing significant symptom reduction. This case supports a diathesis-stress model where ORD can manifest as a somatic metaphor for trauma, mediated by experiential avoidance. It highlights the importance of trauma assessment and a neurobiologically informed psychopharmacological approach in managing ORD.

Objectives: Caring for bedridden patients is physically and emotionally demanding, often resulting in significant caregiver burden. This study aimed to assess caregiver burden and associated factors among caregivers of adult bedridden patients in Muscat, Oman.

Methods: This cross-sectional study was conducted from January 2024 to February 2025 among caregivers of adult bedridden patients registered to get community services in Muscat Governorate and provided care for more than 1 month. Data were collected using the 12-item Zarit Burden Interview and the Katz Index of Independence in Activities of Daily Living.

Results: A total of 200 caregivers participated; 66% were female, with a mean age of 44 years and 58% were caring for a parent. Most patients (88%) had severe functional impairment. Overall, 39.9% of caregivers reported high burden, with an average Zarit burden score of 18.65. Dependency in dressing was significantly associated with caregiver burden (P = 0.030). An association was also found between caregiver marital status and their perception of patient health. Caregivers reported diverse support needs, including psychological support (62.5%), emergency response training (58%), rehabilitation programmes (54%) and access to blood sugar monitoring equipment (48.5%).

Conclusion: Caregiver burden was common in Muscat. Dressing dependency, caregiver marital status and perceptions of patient health contributed significantly to this burden. Targeted support is essential through clinical practice, caregiver education and health policy integration to reduce burden and improve caregiving outcomes.

Objectives: This study aimed to examine a decade-long epidemiology of candidaemia to explore the risk factors associated with it, and describe its clinical outcomes in hospitalised adult patients.

Methods: This retrospective observational study was conducted at Sultan Qaboos University Hospital, Muscat, Oman. Adult patients with candidaemia hospitalised between January 2007 and December 2016 were included. The hospital infection control department surveillance registry on bloodstream infections (BSIs) was used to identify Candida BSIs. Patients' electronic medical records were searched for demographic characteristics, clinical risk factors and outcomes.

Results: Candida albicans was the most common Candida species among 152 patients with candidaemia comprising 25.0% of all Candida blood culture isolates. Nakaseomyces glabrata, C. tropicalis and C. parapsilosis were the most frequently isolated non-albicans species. Past antibiotics use, presence of central venous catheters, intensive care unit admission, diabetes mellitus, sickle cell disease and solid cancer were the most commonly identified underlying risk factors for candidaemia. A total of 30 days' all-cause mortality was 53.3% among all patients with candidaemia.

Conclusions: This study found an increasing trend of non-albicans Candida. Diabetes was the most identified risk factor for candidaemia. A relatively low rate of initiation of empirical antifungal therapy in at-risk patients was found. Unacceptably high mortality rates and prolonged hospital stay of patients with candidaemia are a call for action.

Objectives: This study aimed to investigate the association between ear health, ear care practices, and academic performance among male adolescents in residential schools.

Methods: A cross-sectional study was conducted among 684 male adolescents residing in residential schools in Deoghar, Jharkhand, India, during World Hearing Day 2023. Data were collected on socio-demographic characteristics, ear care practices, and academic performance. Comprehensive ear examinations and pure tone audiometry were performed to assess ear morbidity and hearing thresholds.

Results: Ear morbidity was identified in 43% of participants, with bilateral involvement in 85% of these cases. Ear-related symptoms were reported by 26.3% of participants, including ear pain (46.1%) and hearing difficulty (37.2%). Chronic ear morbidity was present in 36.5% of the cohort. Hearing loss was detected in 5% of participants, with 4.6% experiencing mild and 0.4% moderate hearing loss; among these, 74.1% had bilateral involvement. Self-ear cleaning was commonly practiced (93%), predominantly using cotton buds (85.2%). Multivariate analysis showed that inserting substances into the ear (Spearman's rho [ρ] = -0.095; P = 0.014), exposure to loud firecrackers (ρ = -0.095; P = 0.014), being slapped hard (ρ = -0.102; P = 0.008), presence of chronic ear morbidity (ρ = -0.185; P <0.001), and hearing loss (ρ = -0.292; P <0.001) were significantly and negatively correlated with academic performance.

Conclusion: The study reveals a high prevalence of ear morbidities, which were associated with lower academic performance among the study population. Regular screenings, educational interventions and timely healthcare are crucial to protect this vulnerable group.

Objectives: Obesity is a major health concern, particularly among women of reproductive age. This study aimed to evaluate the effectiveness of a psychosocial-based intervention on weight management and pregnancy outcomes in overweight or obese pregnant women.

Methods: This randomised controlled trial included overweight or obese pregnant women from healthcare centres affiliated with Jundishapur University of Medical Sciences in Ahvaz, Iran and was conducted from June to December 2023. Participants were randomly assigned to an intervention or control group. The intervention group received a comprehensive weight management programme during pregnancy, while the control group received standard prenatal care.

Results: A total of 202 women participated in this study. The intervention helped improve appropriate weight gain, healthier food choices (P < 0.001), and increased physical activity. In overweight women, 29.3% of the intervention group and 20.6% of the control group achieved normal weight gain. Among obese women, 39.3% in the intervention group and 37% in the control group reached the recommended weight gain. Physical activity scores improved significantly in both groups, with the intervention group showing greater changes (P = 0.0001). However, there were no significant differences in pregnancy outcomes, including gestational diabetes (P = 0.533), preeclampsia (P = 0.948), and caesarean section rates (P = 0.489).

Conclusion: The psychosocial-based intervention used in this study positively impacted nutritional behaviour and physical activity but did not significantly reduce adverse pregnancy outcomes. More comprehensive, personalised and long-term interventions are recommended.

This meta-analysis aimed to compare the efficacy of vaginal gel preparations versus placebo in postmenopausal women with sexual dysfunction syndrome. Searches of electronic databases from inception to January 2023 identified 8 trials (N = 672) that reported the Female Sexual Function Index (FSFI) and compared hormonal (oestrogen, oxytocin) and/or non-hormonal (chamomile, fennel) interventions against placebo. The Cochrane Risk of Bias tool was used to assess studies' quality. The vaginal gel group had a significantly higher total FSFI endpoint score (mean difference [MD] = 6.67, 95% confidence interval [CI]: 3.79-9.55; P < 0.001) than placebo. Non-hormonal gels exhibited a greater FSFI total score (MD = 6.73, 95% CI: 4.7-8.76; P < 0.001) than hormonal gels (MD = 2.75, 95% CI: 1.87-3.64; P < 0.001), positively impacting all FSFI domains. These findings indicate that chamomile and fennel vaginal gels may improve the overall FSFI 6 domains score, reflecting enhancements in postmenopausal women's sexual activity and satisfaction.