Sultan Qaboos University Medical Journal最新文献

Objectives: This study aimed to adapt the myofascial release technique (MRT) in the form of massage, which will reduce pain and functional restriction of the shoulder joint compared to manual lymphatic drainage (MLD).

Methods: This study was conducted in a tertiary care hospital in South India from September 2021 to September 2023. The study population included 98 patients older than 18 years who underwent surgery/adjuvant radiotherapy for breast cancer and developed complications. Patients with tendon/muscle injuries in neck/skin conditions, which made MRT difficult, were excluded. A trained physiotherapist delivered the interventions. Patient pain, range of movements at shoulder joint, shoulder dysfunction and quality of life were assessed at the time of the first (T0) and fourth session (T1) and after one month of the completion of treatment (T2).

Results: Compared to the MLD group, the MRT group experienced significant reduction in pain (7-3 versus 6-4; P < 0.001), improvement in the shoulder range of movement (ROM) (1000-1320 to 1140-1400 with P < 0.001), reduction in shoulder dysfunction (52-40; P < 0.001 versus 45-40; P < 0.001) and improved QOL (22 and 83.5-26 and 92; P < 0.001 versus 24 and 79-24 and 83; P > 0.05).

Conclusions: The use of MRT for a reduction in postoperative pain, reduction in shoulder dysfunction and improvement in shoulder ROM is effective and can be proposed to be employed in routine practice for better QOL postoperatively.

Objectives: This study aims to evaluate the predictors and rate of permanent pacemaker (PPM) implantation among patients undergoing transcatheter aortic valve replacement (TAVR) at two institutions in Oman. TAVR has become the standard of care for patients with severe aortic stenosis at high risk for surgery. However, it is associated with a high PPM implantation rate.

Methods: This was a retrospective study involving all patients undergoing TAVR at two leading cardiac centres in Oman over seven years, from May 2013 to September 2020. We included patients who survived the procedure to discharge and those who were followed-up for at least 1 year post-procedure.

Results: A total of 153 patients (mean age = 74.2 ± 8.2 years; 82 males [53.6%]) were enrolled in the study. Of these, 15 patients (age = 74.3 ± 9.8 years, 46.6% male) required a permanent pacemaker within 1 year of follow-up, giving a pacemaker implantation rate of 9.8% following TAVR in the cohort. The factors that predicted the requirement of a pacemaker were pre-existing right bundle branch block (odds ratio [OR] = 10.9, 95% confidence interval [CI]: 3.31-36.33; P < 0.001); abnormal QRS axis (OR = 9.11, 95% CI: 2.77-29.91; P < 0.001); prolonged QRS duration (OR = 3.26, 95% CI: 1.06-9.92; P = 0.03); and any pre-existing conduction abnormality (OR = 1.18, 95% CI: 1.08-1.29; P = 0.01).

Conclusions: The PPM implantation rates post-TAVR at two Omani institutions are comparable to those reported in the literature. Close rhythm surveillance is crucial, especially in patients with any of the predictors identified above, for the timely identification of susceptible patients who might require PPM implantation.

Objectives: This study aimed to evaluate the effectiveness of fibrin glue versus quilting in preventing post-mastectomy seroma formation in breast cancer patients.

Methods: This study was a prospective, randomised interventional trial conducted between July 2021 and June 2022 at Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria. It involving patients with breast cancer undergoing modified radical mastectomy. Patients were randomly assigned to Group A (fibrin glue) or Group B (quilting). The level of statistical significance was set at P < 0.05, corresponding to a 95% confidence interval.

Results: A total of 42 patients were recruited for the study. The total volume of drainage for Group A was lower, and there was a statistically significant difference (P = 0.00) between the two groups. Similarly, the evaluation of the length of hospital stay and duration of drainage revealed a shorter period for Group A, with a statistically significant difference (P = 0.00) between the two groups. However, a comparison of seroma formation and post-mastectomy wound infection between the two groups revealed no statistically significant differences (P = 1.00).

Conclusions: This study has demonstrated that there was no statistically significant difference in the effectiveness of fibrin glue compared to quilting in preventing post-mastectomy seroma in breast cancer patients. However, the fibrin glue group exhibited a lower volume of drainage, shorter duration of drainage and reduced length of hospital stay.

Objectives: This study aimed to investigate the relationship between consanguinity and the severity of autism spectrum disorder (ASD), a neurodevelopmental condition influenced by both genetic and environmental factors.

Methods: This retrospective study, conducted at the Genetic & Developmental Medicine Clinic at Sultan Qaboos University Hospital (SQUH), Muscat, Oman, examined the records of 139 children aged 1.5 to 14 years who were diagnosed with ASD between June 2011 and May 2024. The study analysed the correlation between consanguinity, homozygosity and ASD severity.

Results: Of the 139 cases evaluated, 74.1% were male, with an average age of diagnosis of 4.5 ± 2 years. Most ASD cases were classified at severity levels 2 (63.3%) and 3 (35.3%). Consanguinity was reported in 59% of the cases, with a mean homozygosity rate of 4.6%. No significant correlation was found between consanguinity or homozygosity rates and ASD severity.

Conclusions: No significant association was found between consanguinity or homozygosity rates and ASD severity. Further research is necessary to explore the genetic mechanisms underlying ASD in consanguineous populations.

Endobronchial metastases extending to the heart from gastric cancer are rare. This case report describes a 69-year-old man who presented to a tertiary care hospital in Shahrekord, Iran, in 2022 with a history of cough and haemoptysis. He had previously undergone total gastrectomy and adjuvant chemotherapy for gastric adenocarcinoma three years earlier. Imaging and pathological evaluation confirmed endobronchial metastasis with extension to the left atrium. The patient responded well to chemoradiotherapy, maintaining a good quality of life.

Objectives: Inborn errors of immunity (IEI) are a diverse group of disorders arising from defects in the development and/or function of the immune system. However, data concerning the microbiological aspects of infections and direct causes of mortality in patients with IEI are limited and fragmented. This study aimed to elucidate the causes of disease and terminal events leading to death in a cohort of patients with IEI.

Methods: This retrospective study included deceased patients who were diagnosed with primary immunodeficiency at Sultan Qaboos University Hospital in Muscat, Oman, over an 18-year period between 2005 and 2023. Data on clinical features, infections, isolated microorganisms and terminal events leading to death were collected and analyzed.

Results: A total of 53 cases were included in this study. The mean age at death was 9.1 ± 10.4 years (median: 3.9 years, interquartile range: 15.2 years, range: 0.2-45.2 years). Prior to death, the most frequently isolated microorganisms included Pseudomonas spp. (41.5%), Pseudomonas aeruginosa (34%), Candida spp. (28.3%), cytomegalovirus (26.4%) and Hemophilus influenzae (20.8%), among others. The predominant terminal events leading to death were septicemia/septic shock (64.2%), pneumonia/adult respiratory distress syndrome/multiorgan dysfunction syndrome (49.1%), disseminated viral disease (22.6%) and bronchiectasis/pulmonary hypertension/haemorrhage (20.8%).

Conclusion: Understanding factors contributing to terminal events in IEI patients can inform early intervention strategies and potentially reduce mortality rates.