Pub Date : 2023-12-20DOI: 10.18295/squmj.12.2023.094
F. Rahnemaei, Z. A. Kashani, Mohammadamin Jandaghian-Bidgoli, Farinaz Rahimi, F. Zaheri, Fatemeh Abdi
The present study aimed to investigate the effects of date fruit products on the childbirth process and pregnancy complications. MeSH keywords systematically were searched in scientific databases. Finally, 16 articles were reviewed. Overall results of studies illustrated that using seven date fruits per day(average of 80 grams per day) for 2 - 4 weeks before their estimated date of delivery leads to a better cervical dilatation at admission or improvement of bishop score, decrease in the need for induction or stimulation of labor and by increasing effective uterine contractions, decrease duration of pregnancy, and duration of the different stages of labor. Also, date fruit products can improve blood pressure parameters in pregnant women at risk of preeclampsia and accelerate episiotomy healing. Keywords: Pregnancy; Childbirth; Phoenix dactylifera; Date Fruits; Date Palm Fruit.
{"title":"The Impact of the Fruit and Seed of Date on Childbirth Stages and Pregnancy Complications","authors":"F. Rahnemaei, Z. A. Kashani, Mohammadamin Jandaghian-Bidgoli, Farinaz Rahimi, F. Zaheri, Fatemeh Abdi","doi":"10.18295/squmj.12.2023.094","DOIUrl":"https://doi.org/10.18295/squmj.12.2023.094","url":null,"abstract":"The present study aimed to investigate the effects of date fruit products on the childbirth process and pregnancy complications. MeSH keywords systematically were searched in scientific databases. Finally, 16 articles were reviewed. Overall results of studies illustrated that using seven date fruits per day(average of 80 grams per day) for 2 - 4 weeks before their estimated date of delivery leads to a better cervical dilatation at admission or improvement of bishop score, decrease in the need for induction or stimulation of labor and by increasing effective uterine contractions, decrease duration of pregnancy, and duration of the different stages of labor. Also, date fruit products can improve blood pressure parameters in pregnant women at risk of preeclampsia and accelerate episiotomy healing. Keywords: Pregnancy; Childbirth; Phoenix dactylifera; Date Fruits; Date Palm Fruit.","PeriodicalId":22083,"journal":{"name":"Sultan Qaboos University Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139168717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-20DOI: 10.18295/squmj.12.2023.096
Vasantha Dhara, KP Saamaja
Primary extracranial sinonasal meningiomas are one of the rarest tumours involving the head and neck region. Very few reports exist with additional involvement of the palato-antral region. This paper describes a case of primary extracranial sinonasal meningioma with palatal involvement and the management of the same. The patient was taken up for surgical excision via intra-oral and endoscopic approaches. Postoperative healing was uneventful with no recurrence noted over 2 years. A palatal obturator was used for rehabilitation. The diagnosis of this pathology needs additional immunohistochemistry testing for confirmation and treatment entails complete surgical excision which assures no recurrence or delayed presentation of residual disease in follow-up. Keywords: primary extra cranial meningioma; sinonasal; maxilla ; palate.
{"title":"Palato-Antral Involvement of a Primary Extracranial Sinonasal Meningioma","authors":"Vasantha Dhara, KP Saamaja","doi":"10.18295/squmj.12.2023.096","DOIUrl":"https://doi.org/10.18295/squmj.12.2023.096","url":null,"abstract":"Primary extracranial sinonasal meningiomas are one of the rarest tumours involving the head and neck region. Very few reports exist with additional involvement of the palato-antral region. This paper describes a case of primary extracranial sinonasal meningioma with palatal involvement and the management of the same. The patient was taken up for surgical excision via intra-oral and endoscopic approaches. Postoperative healing was uneventful with no recurrence noted over 2 years. A palatal obturator was used for rehabilitation. The diagnosis of this pathology needs additional immunohistochemistry testing for confirmation and treatment entails complete surgical excision which assures no recurrence or delayed presentation of residual disease in follow-up. \u0000Keywords: primary extra cranial meningioma; sinonasal; maxilla ; palate.","PeriodicalId":22083,"journal":{"name":"Sultan Qaboos University Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138953899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-20DOI: 10.18295/squmj.12.2023.091
Neeraja Rajeev, Abdullah M Al-Fataisi, Rajeev Kariyattil
ACTH secreting pituitary adenomas are known to be associated with behavioral changes but acute presentation including psychosis and delirium are less common. We report the case of a 42-year-old lady with a known medical history of hypertension and diabetes mellitus, presenting with acute onset behavioral changes suggestive of psychosis. Further evaluation revealed an ACTH dependent Cushing’s disease with a pituitary microadenoma. The patient was admitted for endoscopic resection of the adenoma. During the peri-operative period, she experienced worsening of psychosis along with delirium. She also developed episodes of unresponsiveness, posturing, severe diaphoresis and dyspnea accompanied by tachycardia and hypertension which were managed with Midazolam and Levetiracetam. A seizure work-up and CT brain were unremarkable. At follow-up, she showed full resolution of symptoms with good blood pressure and glycemic control. ACTH secreting pituitary microadenoma presenting with acute psychosis, delirium and paroxysmal sympathetic hyperactivity. Keywords: Cushing’s disease, neuropsychiatric, dysautonomia.
{"title":"ACTH Secreting Pituitary Microadenoma Presenting with Acute Psychosis, Delirium and Paroxysmal Sympathetic Hyperactivity","authors":"Neeraja Rajeev, Abdullah M Al-Fataisi, Rajeev Kariyattil","doi":"10.18295/squmj.12.2023.091","DOIUrl":"https://doi.org/10.18295/squmj.12.2023.091","url":null,"abstract":"ACTH secreting pituitary adenomas are known to be associated with behavioral changes but acute presentation including psychosis and delirium are less common. We report the case of a 42-year-old lady with a known medical history of hypertension and diabetes mellitus, presenting with acute onset behavioral changes suggestive of psychosis. Further evaluation revealed an ACTH dependent Cushing’s disease with a pituitary microadenoma. The patient was admitted for endoscopic resection of the adenoma. During the peri-operative period, she experienced worsening of psychosis along with delirium. She also developed episodes of unresponsiveness, posturing, severe diaphoresis and dyspnea accompanied by tachycardia and hypertension which were managed with Midazolam and Levetiracetam. A seizure work-up and CT brain were unremarkable. At follow-up, she showed full resolution of symptoms with good blood pressure and glycemic control. ACTH secreting pituitary microadenoma presenting with acute psychosis, delirium and paroxysmal sympathetic hyperactivity. Keywords: Cushing’s disease, neuropsychiatric, dysautonomia.","PeriodicalId":22083,"journal":{"name":"Sultan Qaboos University Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139168714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-20DOI: 10.18295/squmj.12.2023.093
Kanimozhi M, Manisha Bisht, Sikha Morang, Surabhi Thapliyal, Manbir S Bassan, S. Handu
This meta-analysis was conducted by searching PubMed, Scopus, Cochrane, Ovid till November 2022 for randomized controlled trials (RCTs) that utilized dapagliflozin 10 mg as adjunctive therapy in patients with T2DM and CKD stage 2-5 and reported its renal efficacy in terms of mean change in estimated glomerular filtration rate (eGFR) and urinary albumin creatinine ratio (UACR) from baseline. From 1682 identified records, nine studies representing 13,057 patients were selected for this study. Pooled estimate of five studies showed that dapagliflozin did not affect eGFR but caused significantly less chronic eGFR decline than placebo in two studies [Mean difference (MD) +2.74 (95% CI: 1.55, 3.92; p < 0.00001)]. Pooled estimate of four studies showed that dapagliflozin significantly reduced UACR[-23.99 % MD (95% CI - 34.82, -13.15, p-value < 0.0001; = 0%)]. This confirms that long-term dapagliflozin use significantly attenuates eGFR decline and reduces albuminuria in T2DM and CKD stages 2-5 patients. Keywords: Chronic kidney disease, Dapagliflozin, Estimated GFR, eGFR, SGLT2 inhibitors, Type 2 diabetes mellitus, Urine albumin to creatinine ratio, UACR.
{"title":"Impact of Dapagliflozin Adjunctive Therapy on Progression of Chronic Kidney Disease in Patients with Type 2 Diabetes and CKD Stage 2–5","authors":"Kanimozhi M, Manisha Bisht, Sikha Morang, Surabhi Thapliyal, Manbir S Bassan, S. Handu","doi":"10.18295/squmj.12.2023.093","DOIUrl":"https://doi.org/10.18295/squmj.12.2023.093","url":null,"abstract":"This meta-analysis was conducted by searching PubMed, Scopus, Cochrane, Ovid till November 2022 for randomized controlled trials (RCTs) that utilized dapagliflozin 10 mg as adjunctive therapy in patients with T2DM and CKD stage 2-5 and reported its renal efficacy in terms of mean change in estimated glomerular filtration rate (eGFR) and urinary albumin creatinine ratio (UACR) from baseline. From 1682 identified records, nine studies representing 13,057 patients were selected for this study. Pooled estimate of five studies showed that dapagliflozin did not affect eGFR but caused significantly less chronic eGFR decline than placebo in two studies [Mean difference (MD) +2.74 (95% CI: 1.55, 3.92; p < 0.00001)]. Pooled estimate of four studies showed that dapagliflozin significantly reduced UACR[-23.99 % MD (95% CI - 34.82, -13.15, p-value < 0.0001; = 0%)]. This confirms that long-term dapagliflozin use significantly attenuates eGFR decline and reduces albuminuria in T2DM and CKD stages 2-5 patients. \u0000Keywords: Chronic kidney disease, Dapagliflozin, Estimated GFR, eGFR, SGLT2 inhibitors, Type 2 diabetes mellitus, Urine albumin to creatinine ratio, UACR.","PeriodicalId":22083,"journal":{"name":"Sultan Qaboos University Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138954846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-20DOI: 10.18295/squmj.12.2023.095
S. T. Pavirala, A. Khurana, K. Kadian, A. Goyal
Granulomatosis with polyangiitis (GPA) is a rare autoimmune disease with multi‐system involvement. It involves the upper respiratory tract, lungs and kidneys. A 36-year-old female patient presented with complaints of low-grade fever, dry cough and loss of appetite initially followed by dyspnea, purpuric skin lesions, right lower limb swelling with pain and redness. Her chest radiograph revealed right upper lobe cavitary lesion with consolidation in right lower lobe. Mycobacterium tuberculosis was detected in sputum and Broncho alveolar lavage (BAL) via Cartridge based nucleic acid amplification assay (CB-NAAT). Later, Computed Tomography Pulmonary Angiography (CTPA) revealed bilateral pulmonary artery thromboembolism. Furthermore, her C-ANCA was positive, serum creatinine was rising, urine microscopy had red cell casts and lower limb venous doppler revealed DVT. Histopathological examination of the skin lesion revealed vasculitis. Based on the above findings, diagnosis of GPA was comfortably made. Patient improved with pulse steroids, cyclophosphamide, anticoagulants and anti-tuberculous therapy (ATT). Keywords: Granulomatosis with polyangiitis (GPA), Pulmonary Tuberculosis, Pulmonary thrombo-embolism, deep venous thrombosis, vasculitis, c-ANCA.
{"title":"Coexistence of Pulmonary Thromboembolism, Pulmonary Tuberculosis and Granulomatosis with Polyangiitis","authors":"S. T. Pavirala, A. Khurana, K. Kadian, A. Goyal","doi":"10.18295/squmj.12.2023.095","DOIUrl":"https://doi.org/10.18295/squmj.12.2023.095","url":null,"abstract":"Granulomatosis with polyangiitis (GPA) is a rare autoimmune disease with multi‐system involvement. It involves the upper respiratory tract, lungs and kidneys. A 36-year-old female patient presented with complaints of low-grade fever, dry cough and loss of appetite initially followed by dyspnea, purpuric skin lesions, right lower limb swelling with pain and redness. Her chest radiograph revealed right upper lobe cavitary lesion with consolidation in right lower lobe. Mycobacterium tuberculosis was detected in sputum and Broncho alveolar lavage (BAL) via Cartridge based nucleic acid amplification assay (CB-NAAT). Later, Computed Tomography Pulmonary Angiography (CTPA) revealed bilateral pulmonary artery thromboembolism. Furthermore, her C-ANCA was positive, serum creatinine was rising, urine microscopy had red cell casts and lower limb venous doppler revealed DVT. Histopathological examination of the skin lesion revealed vasculitis. Based on the above findings, diagnosis of GPA was comfortably made. Patient improved with pulse steroids, cyclophosphamide, anticoagulants and anti-tuberculous therapy (ATT). \u0000Keywords: Granulomatosis with polyangiitis (GPA), Pulmonary Tuberculosis, Pulmonary thrombo-embolism, deep venous thrombosis, vasculitis, c-ANCA.","PeriodicalId":22083,"journal":{"name":"Sultan Qaboos University Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138957003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-20DOI: 10.18295/squmj.12.2023.087
V. D. dos Santos, Taciana A.M. Sugai
NONE
无
{"title":"Re: Extramammary Paget disease - diagnostic and therapeutic challenges","authors":"V. D. dos Santos, Taciana A.M. Sugai","doi":"10.18295/squmj.12.2023.087","DOIUrl":"https://doi.org/10.18295/squmj.12.2023.087","url":null,"abstract":"<jats:p>NONE</jats:p>","PeriodicalId":22083,"journal":{"name":"Sultan Qaboos University Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138958807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-20DOI: 10.18295/squmj.12.2023.088
Aishwarya Ganesh, Siham Al Shamli, S. Mahadevan, Moon Fai Chan, David T. Burke, Khalid Al Rasadi, Muna Al Saadoon, S. Al-Adawi
Countries in the 'global south' are characterized by factors that contribute to the increased incidence of traumatic brain injury (TBI). This systematic review and meta-analysis aimed to assess the prevalence of neuropsychiatric sequelae following a TBI, specifically among the Western Asian, South Asian, and African regions of the global south. A literature review was conducted until August 20, 2021, for publications that measured psychiatric or cognitive impairment after TBI from the 83 countries that constitute the aforementioned regions. The main databases, such as PsycINFO, Scopus, PubMed/MEDLINE, ProQuest (English), Al-Manhal (Arabic) and Google Scholar, were selected for grey literature. Following the evaluation of the articles using the Joanna Briggs Institute guidelines, the random effects model was used to estimate the prevalence of depression, anxiety, posttraumatic stress disorders (PTSD), sleep disturbance related to TBI (TBI-SD), obsessive–compulsive disorder (OCD), and cognitive impairment. Of 56 non-duplicated studies identified by the initial search, 27 studies were eligible for systematic review and 23 for meta-analysis. The pooled prevalence of depression in a total sample of 1882 was 35·35% (95% CI=24·64–46·87%), of anxiety in a total sample of 1211 was 28·64% (95% CI=17·99–40·65%), of PTSD in a total sample of 426 was 19·94% (95% CI=2·35–46·37%), of OCD in a total sample of 313 was 19·48% (95% CI=0·23–58·06%), of TBI–SD in a total sample of 562 was 26·67% (95% CI=15·63–39·44%), and cognitive impairment in a total sample of 941 was 49·10% (95% CI=31·26–67·07%). To date, this is the first critical review that has examined the spectrum of post–TBI neuropsychiatric sequelae in the specified regions. While existing studies lack homogeneous data due to variability in the diagnostic tools and outcome measures utilised, the reported prevalence rates are significant and comparable to statistics from the global north. Keywords: traumatic brain injury; neuropsychiatric sequelae; global south; systematic review; meta-analysis; cognitive impairment; anxiety; depression
{"title":"The Frequency of Neuropsychiatric Sequelae After Traumatic Brain In-jury in the Global South","authors":"Aishwarya Ganesh, Siham Al Shamli, S. Mahadevan, Moon Fai Chan, David T. Burke, Khalid Al Rasadi, Muna Al Saadoon, S. Al-Adawi","doi":"10.18295/squmj.12.2023.088","DOIUrl":"https://doi.org/10.18295/squmj.12.2023.088","url":null,"abstract":"Countries in the 'global south' are characterized by factors that contribute to the increased incidence of traumatic brain injury (TBI). This systematic review and meta-analysis aimed to assess the prevalence of neuropsychiatric sequelae following a TBI, specifically among the Western Asian, South Asian, and African regions of the global south. A literature review was conducted until August 20, 2021, for publications that measured psychiatric or cognitive impairment after TBI from the 83 countries that constitute the aforementioned regions. The main databases, such as PsycINFO, Scopus, PubMed/MEDLINE, ProQuest (English), Al-Manhal (Arabic) and Google Scholar, were selected for grey literature. Following the evaluation of the articles using the Joanna Briggs Institute guidelines, the random effects model was used to estimate the prevalence of depression, anxiety, posttraumatic stress disorders (PTSD), sleep disturbance related to TBI (TBI-SD), obsessive–compulsive disorder (OCD), and cognitive impairment. Of 56 non-duplicated studies identified by the initial search, 27 studies were eligible for systematic review and 23 for meta-analysis. The pooled prevalence of depression in a total sample of 1882 was 35·35% (95% CI=24·64–46·87%), of anxiety in a total sample of 1211 was 28·64% (95% CI=17·99–40·65%), of PTSD in a total sample of 426 was 19·94% (95% CI=2·35–46·37%), of OCD in a total sample of 313 was 19·48% (95% CI=0·23–58·06%), of TBI–SD in a total sample of 562 was 26·67% (95% CI=15·63–39·44%), and cognitive impairment in a total sample of 941 was 49·10% (95% CI=31·26–67·07%). To date, this is the first critical review that has examined the spectrum of post–TBI neuropsychiatric sequelae in the specified regions. While existing studies lack homogeneous data due to variability in the diagnostic tools and outcome measures utilised, the reported prevalence rates are significant and comparable to statistics from the global north. \u0000Keywords: traumatic brain injury; neuropsychiatric sequelae; global south; systematic review; meta-analysis; cognitive impairment; anxiety; depression","PeriodicalId":22083,"journal":{"name":"Sultan Qaboos University Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138954382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-20DOI: 10.18295/squmj.12.2023.085
Majid T Albusaidi, Ahmed Al Jabri, Al Anood Al Hadhrami, Mutazz O Al Khaldi, Moath Shummo, Karim M Haridi, Ahmed Salah El Din, Salim M Ghawas, A. E. Saleh, Joe Jacob, Taif Alsafy, Anish T Elias, Said Al-Busaidi
Objectives: In this study we review blood stream infections of major burns in a tertiary care burn unit to determine the most prevalent organisms in order to have a better empirical therapy protocol. Methods: This is a retrospective study where blood stream infection of major burns (>20% Total Body Surface Area) were analysed. Results:155 patients fulfilled the criteria. Median age was 33 years. Median TBSA was 38%. 57.42% were males and 42.58% were females. Mortality was 25.16%. 50.9% of patients had positive blood culture. Expired patients had higher TBSA, Abbreviated Burns Severity Index score and earlier first positive blood culture. The most prevalent organisms grown from all blood cultures were Acinetobacter, staphylococci, Klebsiella, Enterococcus and pseudomonas. Candida is also commonly grown in blood cultures. All Acinetobacter species are always multidrug resistant. 8 of 14 patients had multidrug resistant Klebsiella. There were only 4 patients who had Methicilin resistant Staphylococcus Aureus (MRSA) grown. The number of blood cultures samples taken ranged from 1 to 28 (median 6). First positive blood culture showed that Staphylococcus epidermidis and Acinetobacter are the most common organisms. Conclusion: In conclusion multidrug resistant Acinetobcater has become the most predominant microorganism grown in blood cultures of major burns in our unit. Empirical therapy should include antibiotics that are effective against it to reduce the mortality. Keywords: Infection; Blood; Burn; Resistance; Antibiotics; Culture.
{"title":"Analysis of Blood Cultures in Major Burns in Tertiary Care Burn Unit in Oman","authors":"Majid T Albusaidi, Ahmed Al Jabri, Al Anood Al Hadhrami, Mutazz O Al Khaldi, Moath Shummo, Karim M Haridi, Ahmed Salah El Din, Salim M Ghawas, A. E. Saleh, Joe Jacob, Taif Alsafy, Anish T Elias, Said Al-Busaidi","doi":"10.18295/squmj.12.2023.085","DOIUrl":"https://doi.org/10.18295/squmj.12.2023.085","url":null,"abstract":"Objectives: In this study we review blood stream infections of major burns in a tertiary care burn unit to determine the most prevalent organisms in order to have a better empirical therapy protocol. Methods: This is a retrospective study where blood stream infection of major burns (>20% Total Body Surface Area) were analysed. Results:155 patients fulfilled the criteria. Median age was 33 years. Median TBSA was 38%. 57.42% were males and 42.58% were females. Mortality was 25.16%. 50.9% of patients had positive blood culture. Expired patients had higher TBSA, Abbreviated Burns Severity Index score and earlier first positive blood culture. The most prevalent organisms grown from all blood cultures were Acinetobacter, staphylococci, Klebsiella, Enterococcus and pseudomonas. Candida is also commonly grown in blood cultures. All Acinetobacter species are always multidrug resistant. 8 of 14 patients had multidrug resistant Klebsiella. There were only 4 patients who had Methicilin resistant Staphylococcus Aureus (MRSA) grown. The number of blood cultures samples taken ranged from 1 to 28 (median 6). First positive blood culture showed that Staphylococcus epidermidis and Acinetobacter are the most common organisms. Conclusion: In conclusion multidrug resistant Acinetobcater has become the most predominant microorganism grown in blood cultures of major burns in our unit. Empirical therapy should include antibiotics that are effective against it to reduce the mortality. \u0000Keywords: Infection; Blood; Burn; Resistance; Antibiotics; Culture.","PeriodicalId":22083,"journal":{"name":"Sultan Qaboos University Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138954383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-20DOI: 10.18295/squmj.12.2023.089
Munira A Al-Rumhi, Sulaiman D Al Sabei, Huda S Al-Noumani, Adil Al-Riyami, Omar Al-Rawajfah
Objective: To estimate the door-to-balloon (DTB) time and determine the organisational-level factors that influence delayed DTB times among patients with ST-elevation myocardial infarction in the Sultanate of Oman. Methods: A cross-sectional retrospective study was conducted. All patients who presented to the emergency department at two public hospitals and underwent primary percutaneous interventions during the period of two years were included. Results: The sample included 426 patients. The median door-to-balloon time was 142 minutes. The result of bivariate logistic regression showed that patients who presented to the emergency department with atypical symptoms were three times more likely to have a delayed DTB time compared with patients presenting with typical symptoms (OR = 3.003, 95% CI: 1.409–6.400, p = .004). In addition, patients who presented during off-hours were two times more likely to have a delayed DTB time compared with patients who presented during regular working hours (OR = 2.291, 95% CI: 1.284–4.087, p = .005). Conclusion: To meet the door-to-balloon time recommendation, it is important to ensure that there is adequate staffing during both regular and irregular working hours. Results from this study can be used as a baseline for future studies and inform strategies for improving the quality of care. Keywords: Acute Myocardial Infarction; Clinical Management; Door-to-balloon Time; Emergency Care Systems; Staffing and Scheduling; Oman.
{"title":"Influence of Organisational-Level Factors on Delayed Door-to-Balloon Time among Patients with ST-Elevation Myocardial Infarction","authors":"Munira A Al-Rumhi, Sulaiman D Al Sabei, Huda S Al-Noumani, Adil Al-Riyami, Omar Al-Rawajfah","doi":"10.18295/squmj.12.2023.089","DOIUrl":"https://doi.org/10.18295/squmj.12.2023.089","url":null,"abstract":"Objective: To estimate the door-to-balloon (DTB) time and determine the organisational-level factors that influence delayed DTB times among patients with ST-elevation myocardial infarction in the Sultanate of Oman. Methods: A cross-sectional retrospective study was conducted. All patients who presented to the emergency department at two public hospitals and underwent primary percutaneous interventions during the period of two years were included. Results: The sample included 426 patients. The median door-to-balloon time was 142 minutes. The result of bivariate logistic regression showed that patients who presented to the emergency department with atypical symptoms were three times more likely to have a delayed DTB time compared with patients presenting with typical symptoms (OR = 3.003, 95% CI: 1.409–6.400, p = .004). In addition, patients who presented during off-hours were two times more likely to have a delayed DTB time compared with patients who presented during regular working hours (OR = 2.291, 95% CI: 1.284–4.087, p = .005). Conclusion: To meet the door-to-balloon time recommendation, it is important to ensure that there is adequate staffing during both regular and irregular working hours. Results from this study can be used as a baseline for future studies and inform strategies for improving the quality of care. \u0000Keywords: Acute Myocardial Infarction; Clinical Management; Door-to-balloon Time; Emergency Care Systems; Staffing and Scheduling; Oman.","PeriodicalId":22083,"journal":{"name":"Sultan Qaboos University Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138954739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-20DOI: 10.18295/squmj.12.2023.084
Diah K Putri, Rahimi Syaidah, A. A. Jusuf
Objectives: Breast milk is the best baby food because it contains a complete nutritional composition and contains important factors for the baby's immune system, including leukocytes. Store breast milk to guarantee the baby receives it while the mother works. This study aims to determine the effect of morphology, number cells and the population of breast milk leukocytes on various ways of storing breast milk based on differences in temperature and storage duration. Methods: We used transitional breast milk samples from 7 breastfeeding mothers. A total of 50 ml was then divided into 4 tubes of 12.5 ml each and treated based on temperature, storage time, and method of thawing frozen breast milk based on the recommendations of the CDC for breast milk storage. Then the breast milk cells were isolated to calculate the cell number and leukocyte population. After that, breast milk cells were stained with Hematoxylin and Eosin (HE) to analyze the number and morphology of leukocytes. Results: The results showed a significant decrease in the total number, population in breast milk. Besides that, there were also changes in the morphology of breast milk leukocytes after storage. Conclusion: This study indicate that CDC storage recommendations have no effect on the quantity of the CD45+ leukocyte population; though, there is a decreased the total number of leukocytes as well as alterations in their microscopic morphology. However, additional research is still required to determine whether these modifications also influence the function of these cells. Keywords: Breast milk; leukocytes; storage; population; morphology.
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