Non-steroidal Anti-inflammatory Drugs (NSAIDs) Use in Primary Health Care Centers in A’Seeb, Muscat: A Clinical Audit

Objective: We sought to assess the trend of non-steroidal anti-inflammatory drug (NSAID) use in primary health care institutions located in A’Seeb, a province in the capital city of Oman, Muscat. Additionally, we evaluated the relationship between a physician’s years of experience and the number of prescription issued, as well as the presence of risk factors and side effects in the patients who received these prescriptions. Method: A clinical audit was conducted in four primary health care centers in the Muscat region over a one-week period in April 2014. The target population included patients aged 18 years or over who attended one of the four health centers and were prescribed NSAIDs. Overall, 272 patients were recruited by systematic random sampling. The data were collected by two methods: direct face-to-face interviews and evaluations of the patient’s electronic medical file. The prescribing doctors were blind to the audit. The collected information included patients demographics, past and current medical history of related comorbidities, NSAID type, dose, duration and indications for use, concomitant warfarin or/and aspirin prescriptions, and co-prescription of gastroprotective agents. Results: In total, 15% of patients received an NSAID prescription: females were issued more prescriptions than males. The percentage of patients who received an NSAID prescription across the health centers ranged from 9% to 24%. The main reason for prescribing NSAIDs was musculoskeletal problems. The most frequently prescribed NSAID was ibuprofen. Sixteen percent of patients who received an NSAID prescription had a risk factor related to its use. The mean and median duration of the NSAID prescriptions of all types were 5.6 and 5.0 days, respectively. Physicians with a greater number of years experience prescribed more NSAIDs. Conclusion: Our study showed that the number of prescriptions of NSAIDs among various institutes varied, which could reflect the level of awareness concerning NSAID risks among the prescribing doctors. NSAIDs were prescribed for patients with comorbidities and patients with previously documented side effects without considering protective agents. Therefore, we suggest that the use of these medications is controlled, especially in high-risk populations

Applicability of the Existing CVD Risk Assessment Tools to Type II Diabetics in Oman: A Review

Patients with type II diabetes (T2DM) have an elevated risk for cardiovascular disease (CVD), and it is considered to be a leading cause of morbidity and premature mortality in these patients. Many traditional risk factors such as age, male sex, hypertension, dyslipidemia, glycemic control, diabetes duration, renal dysfunction, obesity, and smoking have been studied and identified as independent factors for CVD. Quantifying the risk of CVD among diabetics using the common risk factors in order to plan the treatment and preventive measures is important in the management of these patients as recommended by many clinical guidelines. Therefore, several risk assessment tools have been developed in different parts of the world for this purpose. These include the tools that have been developed for general populations and considered T2DM as a risk factor, and the tools that have been developed for T2DM populations specifically. However, due to the differences in sociodemographic factors and lifestyle patterns, as well as the differences in the distribution of various CVD risk factors in different diabetic populations, the external applicability of these tools on different populations is questionable. This review aims to address the applicability of the existing CVD risk models to the Omani diabetic population

Trends of Sickness Certifications in Primary Health Care in Muscat, Sultanate of Oman

Objectives: Sickness certification (SC) is common practice in primary health care with proven implications on the health system. To assess the rate of sickness certifications in the Bowsher province and describe related demographic, occupational and medical factors. Methods: Our retrospective, cross-sectional study retrieved data for all consultations, with patients aged six to 65 years old, which ended with SC. The data from four primary health care centers in the Bowsher provice were collected during 2011 using the electronic medical record system. Collected data included patient demographics, occupation, date issued, duration of sickness certification, recorded vital signs, and clinical diagnosis. Suitable rates were calculated as percentages and important differences were compared using the chi-square test. Results: The total number of consultation visits for the targeted population was 189,275. Of these 26,096 consultations resulted in SC to a total of 15,758 patients. The overall rate of SC was 13.8 per 100 consultation-years (confidence interval (CI): 13.6–14). SC rates in males were significantly higher than females (17 and 11 per 100 consultations/year, respectively). Patients aged 19–29 years old had the highest rate of SC (18.6/100 consultations/year). School students aged six to 18 years made up 28% of patients, and 24% and 22% of patients were working in the private and public sectors, respectively. No vital signs record was found for 30% of SC visits. The highest rate of SC was in October (17%) and the lowest was in August (9%). Acute respiratory infections were the most frequent diagnoses (31%) resulting in certifications. The rate of SC issued for Omanis and non-Omanis was 14 and 9 per 100 consultations per year, respectively. Conclusion: Sickness certification is a burden on primary health care in the studied health centers with approximately one in seven consultations ending with SC issued. More investigations are needed to identify determinates of high sickness absence. Robust guidelines are important to regulate the number of sickness certificates issued

Oral Health Knowledge, Attitudes, and Practices of Individuals with Diabetes Mellitus in the Sultanate of Oman

Introduction: Diabetes mellitus is a chronic disease with an increasing global prevalence. The condition has several oral health implications, with oral health in turn affecting diabetes control. People with diabetes are at higher risk of oral health problems, including periodontal disease, dental caries, and candidiasis; in particular, there appears to be a two-way relationship between periodontitis and blood glucose control. While previous research has indicated that diabetics have poor awareness of oral health, there is a gap in the literature from the Sultanate of Oman. This study aimed to determine oral health knowledge, attitudes, and practices among Omani diabetics. Materials and Methods: A cross-sectional study was conducted using a convenience sample of 400 adult Omani diabetics who attended the outpatient clinic of the National Diabetes and Endocrine Center, Oman, in the period between May 2019 and May 2020. A self-administered, Arabic language questionnaire to assess oral health knowledge, attitudes, and practices was developed and validated. Mean scores were calculated to determine overall levels of oral health knowledge, attitudes, and practice. Ethical approval was obtained from the Center of Studies and Research of the national Ministry of Health. Results: A total of 136 (34.0%) male and 264 (66.0%) female Omani adult diabetics participated in the study. The majority of participants (76.8%) demonstrated poor knowledge of oral health, especially with regards to complications like gingivitis (32.4%), dental caries (27.3%), halitosis (27.1%), and gingival abscesses (21.5%). Moreover, most (76.6%) were unaware that oral diseases affected glycated hemoglobin levels. In terms of practices, more than half (54.74.8%) routinely brushed their teeth twice a day. However, only 14.6% and 12.6% regularly flossed and used mouthwash, respectively. With regards to attitudes, 0.5%, 23.8%, and 75.8% of the participants demonstrated poor, moderate, and good attitudes toward oral health, respectively. Smokers more frequently demonstrated poor attitudes compared to nonsmokers (6.3% vs. 1.6%). Conclusion: Omani adults with diabetes mellitus demonstrated poor to moderate levels of oral health knowledge. Various studies conducted elsewhere around the world have similarly shown that diabetics have limited knowledge and awareness of oral health. Oral self-care behaviors are imperative to minimize the risk of oral health complications associated with diabetes. Previous researchers have shown that education is an effective method of reducing the incidence and burden of diabetes-related oral health complications. Thus, additional multidisciplinary initiatives are needed to raise awareness of good oral hygiene practices among diabetics in Oman