Is Chronic Post-Surgical Pain Preventable?

Chronic post-surgical pain (CPSP) is a common problem following surgery. It has significant impact on the patients’ quality of life, chronic pain treatment services and resources in general. The prevalence of CPSP ranges between 5 and 50% of all surgical patients, but severe CPSP is present in less than 10% of the patients. The recognised potential risk factors for CPSP are young age, female gender, overweight, psychological factors, genetic tendency, pre-operative pain, surgery-related factors and severe post-operative pain. Hence, early identification of patients at risk will help to reduce the proportion of patients who are likely to develop CPSP. Different modalities of treatments or interventions are used to prevent the CPSP. These modalities include pre-emptive use of gabapentin, pregabalin or SNRIs, perioperative administration of ketamine, NSAIDs and steroids. In addition, the following interventions have been studied: surgical technique selection, regional and local anaesthesia, intrathecal administration of morphine and multimodal analgesia. Since the present evidence of these interventions is inconclusive because of methodological issues, further studies are still needed to develop more effective and evidence-based strategies to prevent CPSP

IUCD-Related Knowledge, Attitudes and Practice among Primary Health Care Providers in Oman: Areas for Improvement

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Factors Associated with Choice of Career in Family Medicine Among Junior Doctors in Oman

Objectives: The number of family physicians in Oman is far below that recommended by the World Health Organization. This study aimed to determine factors influencing junior doctors’ choice of a career in family medicine. Methods: This cross-sectional study was conducted between March and June 2018 and targeted applicants to Oman Medical Specialty Board residency programmes during the 2018–2019 academic year. Applicants were grouped according to their choice of either family medicine (n = 64) or other specialities (n = 81). A self-administered questionnaire was utilised to compare the applicants’ sociodemographic characteristics, factors influencing their choice of career and their Myers-Briggs Type Indicator® (MBTI) personality traits. Results: A total of 52 family medicine and 43 other residency applicants participated in the study (response rates: 81.3% and 53.1%, respectively). Most family medicine applicants were female (86.5%), married (65.4%) and resided in rural areas (73.1%); moreover, 19.2% were ≥30 years of age. Overall, emphasis on continuity of care, opportunity to deal with a variety of medical problems, the ability to use a wide range of skills and knowledge, early exposure to the discipline, opportunity to teach and perform research and the influence of family or friends were important factors in determining choice of a career in family medicine. Moreover, the MBTI analysis revealed that family medicine applicants were commonly extroverted-sensing-thinking-judging personality types. Conclusion: Knowledge of the factors influencing career choice among junior doctors may be useful in determining future admission policies in order to increase the number of family physicians in Oman.Keywords: Career Choice; Internship and Residency; Medical Specialty; Family Practice; Family Physicians; Myers-Briggs Type Indicator; Oman

The Role of Cupping Therapy in Pain Management: A Literature Review

Cupping therapy is an ancient method which has been used for centuries for various painful conditions. It is performed by applying cups to selected skin points most commonly in the back aiming to create areas of sub-atmospheric pressure. It has been classified as either dry or wet type of therapy. Its mechanism of action is not well understood but several proposed mechanisms are described in the literature. It is relatively safe with a few reported side effects which include scar formation and skin infection. In this paper, a review of the literature will be presented to determine its potential benefits in pain management particularly in musculo-skeletal conditions such as low back and neck pain

The prevalence of smartphone addiction and its correlation with depression among higher college of technology students, Oman

Background: The aim of this study is to identify the prevalence of smartphone addiction and its correlation with depression among Higher College of Technology students in Oman.Methods: A cross-sectional study was conducted in the Higher College of Technology, Oman. A self-reported questionnaire was distributed electronically to students between January and February 2017. The questionnaire contained a validated short version of the smartphone addiction scale (SAS-SV) and a validated Arabic version of the Patient Health Questionnaire-9 (PHQ-9), along with a single question to self-assess smartphone addiction.Results: With a response rate of 86.2%, a total of 376 students were considered, of whom 34.6% were males and 65.4% were females, with an overall mean age of 20.9 years. This study showed that the prevalence of smartphone addiction in the study population using the SAS-SV was 63.8%; 88.3% of students were using their smartphones for four hours or more per day and 80% had been using smartphones for more than four years. The overall depression rate was 32.2%. As the total depression score increased by 1 point, the smartphone addiction score increased by 0.428 points (p<0.005). The prevalence of smartphone addiction was 54.9% among those who had no depression, 80.3% among those who had mild depression, 75.9% among those who had moderate depression, and 96.2% among those who have severe depression (p<0.005).Conclusions: This study shows high smartphone addiction levels based on SAS-SV scores and found a significant positive correlation between smartphone addiction score and depression scores

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

Self-Reported Knowledge of Diabetes among High School Students in Al-Amerat and Quriyat, Muscat Governate, Oman

Objectives: Type 2 diabetes mellitus (T2DM) is emerging as one of the world’s greatest health problems, and its incidence and prevalence are increasing at an alarming rate and globally reaching epidemic proportions. With this increasing incidence, emphasis is now being placed on implementing primary prevention, early detection, and educational prevention programmes. This study was undertaken to estimate the level of knowledge of T2DM among high school students and to explore the factors influencing the knowledge of T2DM. Methods: A cross-sectional study was conducted in four secondary schools in two wilayats (districts) of Muscat governate, Oman, namely Al-Amerat and Quriyat. The study was conducted using a validated English questionnaire covering all aspects of T2DM in one-to-one interviews. A scoring system was used to assess the students’ knowledge. Results: Of the 541 students enrolled in the study (45% male and 55% female), only 24% achieved a score of over 10 out of 20. The key areas of poor knowledge were wrong perceptions about diabetic meals (73%), and the possibility of a cure for diabetes (63%). Conclusion: Overall poor knowledge levels about T2DM were found among school students. National efforts and school health-based interventions are highly recommended to increase awareness about diabetes among this age group

Impact of Acne on Quality of Life of Students at Sultan Qaboos University

Objective: The purpose of this study was to assess the impact of acne on the quality of life. Its secondary objective was to assess the influence of gender of students and severity of symptoms on the quality of life.  Methods: A cross sectional study was conducted on 100 students at Sultan Qaboos University (SQU) (40 males and 60 females) diagnosed with acne who attended the Student Clinic during a period of three months from September to December 2009. The Acne Quality Of Life index (Acne-QoL) questionnaire was used to assess the patient’s quality of life in four different domains: self-perception, social, emotional, and acne symptoms.  Results: Acne affected all areas of the patients, quality of life with the emotional domain found to be the most affected. Overall, female patients reported more adverse QoL effects. The mean score for self-perception for female students was 2.5 and 2.8 for males (p=0.300). The role-social domain approached a significant difference between genders (p=0.078). There was a statistically significant correlation between severity of acne symptoms and the other three domains. The correlation was highest between acne symptoms score and self-perception score.  Conclusion: This study showed that acne affects the quality of life of affected SQU students treated by primary care physicians at the Student Clinic. Therefore, physicians should take into account the effect of acne on the persons’ quality of life when individualizing treatment

Inflammatory Markers as a Predictor of Postmenopausal Osteoporosis: A cross-sectional study from the Sultan Qaboos University Hospital

Objectives: Postmenopausal osteoporosis is a progressive metabolic bone disease resulting from estrogen deficiency. However, due to the silent nature of the disease, there is an urgent need for a simple, early predictive marker. This study,&nbsp;conducted between January 2017 to December 2019, aimed to assess the potential of three factors—specifically, the neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR)—as inflammatory markers of bone mineral density (BMD) loss. Methods: A retrospective cross-sectional study was conducted among 450 postmenopausal Omani women undergoing dual-energy X-ray absorptiometry at the Sultan Qaboos University Hospital, Muscat, Oman. Participants were allocated into groups based on lumbar spine BMD t-score values. A receiver-operating characteristic curve was used to find the area under the curve (AUC). Multivariate logistic regression was performed to identify independent predictors of low BMD. Results: A total of 65 (14.4%), 164 (36.4%), and 221 (49.1%) women were allocated to the control, osteopenia, and osteoporosis groups, respectively. No significant differences in PLR, MLR, and NLR values were observed based on group allocation. BMD t-score values were reversely correlated with age (P = 0.007) and PLR (P = 0.004), and positively correlated with body mass index (BMI) (P &lt;0.001). The AUC was 0.59. However, the only independent predictors of low BMD were age (&gt;65 years) and BMI (&lt;25 kg/m2). Conclusion: None of the three inflammatory biomarkers studied were found to be useful prognostic indicators of bone loss. Further research is recommended to reject or support&nbsp;theories regarding the role of inflammatory status in the pathogenesis. Keywords: inflammatory markers, neutrophil-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, platelet-to-lymphocyte ratio, Bone mineral density, osteoporosi

The relation between emotional eating and perceived stress among students in tertiary education in Oman: a single-center study

Objectives: Preliminary studies suggested that the high rates of stress are increasingly prevalent in students in tertiary education in the Arabian Gulf countries and that their emotional eating is often triggered by stress. Nevertheless, there is a dearth of studies on this topic and Oman is no exception. In this study, we intended to examine the prevalence of emotional eating and perceived stress in Omani college students and to clarify the relationship between their emotional eating and sociodemographic and risk factors among the population in the college students in Oman. Methods: We used Salzburg Emotional Eating Scale and Perceived Stress Scale to assess emotional eating and variations in perceived stress, respectively. We also study their sociodemographic and risk factors. Results: A total of 422 students took part in the study, with the age of 20.6 ± 1.8 (mean ± standard deviation) years. Of all students, 85.8% (n = 362) were reported to have emotional eating and 78.7% of the sample were reported to experience stress. The multivariate logistic analysis showed that body mass index (BMI) and the student’s major subjects were the significant risk factors. Students who majored in science/engineering/agriculture (odds ratio [OR] = 0.926, p < 0.001) and arts/business/law were 3.1 times (OR = 3.115, p < 0.05) and 2.3 times (OR = 2.347, p < 0.05) were significantly engaged in emotional eating as compared to those majoring in medicine/nursing. Students who are underweight (BMI < 18) were 3.9 times (OR = 3.984, p < 0.05) were also significantly more to engage in emotional eating than those students who were overweight/obese (BMI 25+). Conclusion: In this study, we found that both rates of emotional eating and stress were high among college students in Oman. Contrary to international trends, underweight students (BMI < 18) were more prone to engaging in emotional eating than overweight/obese students (BMI 25+) in our study sample. This suggests that there is likely to be subcultural diversity or artifacts that are intimately tied to emotional eating. More studies on this discrepant finding are warranted