Knowledge of Risk Factors, Symptoms and Barriers to Seeking Medical Help for Cervical Cancer among Omani Women Attending Sultan Qaboos University Hospital

Objectives: This study aimed to assess knowledge and attitudes among Omani woman regarding cervical cancer risk factors and symptoms as well as barriers to them seeking medical help. Methods: This cross-sectional study was conducted between December 2017 and March 2018 at the Sultan Qaboos University Hospital (SQUH) in Muscat, Oman. A validated Arabic-language version of the Cervical Cancer Awareness Measure questionnaire was used to collect data from 550 Omani women visiting SQUH during the study period. Results: A total of 490 women participated (response rate: 89.1%) in this study. Overall, the women demonstrated low levels of knowledge of cervical cancer risk factors and symptoms (28.5% and 45.0%, respectively). The most frequently recognised risk factor was having many children (36.1%), while the most recognised symptom was unexplained vaginal bleeding (69.8%). Women reported that being too scared was the greatest barrier to seeking medical help (68.0%). Various factors were significantly associated with greater knowledge of cervical cancer signs and symptoms including education level (odds ratio [OR] = 2.85; 95% confidence interval [CI]: 1.0–8.22; P <0.05), income (OR = 4.34; 95% CI: 1.70–11.12; P <0.05), parity (OR = 3.59; 95% CI: 1.38–9.36; P <0.05) and a family history of cancer (OR = 1.71; CI: 1.0–2.90; P <0.05). Conclusion: Overall, Omani women demonstrated poor knowledge with regards to cervical cancer; in addition, they identified several emotional barriers to seeking medical help. Healthcare practitioners should reassure female patients to encourage care-seeking behaviour. A national screening programme is also recommended to increase awareness and early diagnosis of cervical cancer in Oman.Keywords: Cervical Cancer; Knowledge; Awareness; Risk Factors; Health Care Seeking Behavior; Women; Oman

Knowledge and Health Beliefs Regarding Sickle Cell Disease Among Omanis in a Primary Healthcare Setting : Cross-sectional study

Objectives: Sickle cell disease (SCD) is a global health concern associated with high childhood morbidity and mortality; in Oman, the prevalence of SCD is 0.2%. Public awareness of SCD and the need for premarital screening (PMS) are essential to reduce the incidence of this disease. This study aimed to assess awareness of and beliefs regarding SCD and PMS among Omanis in a primary healthcare setting. Methods: This cross-sectional study took place in five health centres located in Al-Seeb Province, Muscat, Oman, between June and August 2015. A total of 500 Omanis aged ≥18 years old attending the clinics were invited to participate in the study. A previously described questionnaire by Gustafson et al. was used to measure awareness of and beliefs regarding SCD and PMS. Results: A total of 450 Omani adults completed the questionnaire (response rate: 90.0%). The majority (67.8%) were aware that SCD is genetically inherited and 85.1% believed in the value of PMS; however, only 24.4% reported having undergone PMS previously. Few participants were aware that SCD can be very painful (20.2%) and can cause strokes, infections and organ damage (20.0%). More than half (56.7%) reported that the availability of educational material on SCD or PMS in Oman was inadequate. Participants’ education levels were positively associated with accurate SCD knowledge (P <0.05). Conclusion: Despite the free availability of PMS services in local health centres, few Omanis reported having undergone PMS previously. Health promotion and education programmes are therefore needed in Oman in order to increase public awareness of SCD and the value of PMS

The Effect of Antepartum Depression on the Outcomes of Pregnancy and Development of Postpartum Depression: A prospective cohort study of Omani women

Objectives: This study aimed to identify the relationship between antenatal depression and pregnancy outcomes, including the risk of developing postpartum depression in Oman. Methods: This follow-up prospective longitudinal cohort study included pregnant women attending primary healthcare institutions in Muscat, Oman from January to November 2014. The Edinburgh Postnatal Depression Scale (EPDS) was used to screen for antenatal and postnatal depression. Pregnant Omani women with a gestational age ≥32 weeks attending 12 local health centres for antenatal care in Muscat were invited to participate. Recruited women were followed-up at 6–8 weeks after delivery. The following pregnancy outcomes were assessed: mode of delivery (normal or Caesarean section [CS]), gestational age at delivery (preterm or fullterm), baby’s birth weight and development of postnatal depression. Results: A total of 959 women participated in this study (response rate: 97.3%). In total, 233 women (24.4%) had antenatal depression with a score of ≥13 on the EPDS. Of the 592 participants (61.7%) who attended postnatal clinics at 6–8 weeks post-delivery, 126 (21.3%) were positive for postnatal depression. Logistic multivariate regression analysis showed that antenatal depression was associated with increased risk of CS (odds ratio [OR] = 1.79; 95% confidence interval [CI]: 1.20–2.66) and postnatal depression (OR = 8.63; 95% CI: 5.56–13.39). Conclusion: Screening women for antenatal depression and providing appropriate management may reduce adverse pregnancy outcomes and the risk of developing postnatal depression.Keywords: Depression; Postnatal depression; Women Health Services; Maternal Health Services; Pregnancy; Primary Health Care; Oman

The Arabian Sea as a high-nutrient, low-chlorophyll region during the late Southwest Monsoon

© The Authors, 2010. This article is distributed under the terms of the Creative Commons Attribution 3.0 License. The definitive version was published in Biogeosciences 7 (2010): 2091-2100, doi:10.5194/bg-7-2091-2010.Extensive observations were made during the late Southwest Monsoon of 2004 over the Indian and Omani shelves, and along a transect that extended from the southern coast of Oman to the central west coast of India, tracking the southern leg of the US JGOFS expedition (1994–1995) in the west. The data are used, in conjunction with satellite-derived data, to investigate long-term trends in chlorophyll and sea surface temperature, indicators of upwelling intensity, and to understand factors that control primary production (PP) in the Arabian Sea, focussing on the role of iron. Our results do not support an intensification of upwelling in the western Arabian Sea, reported to have been caused by the decline in the winter/spring Eurasian snow cover since 1997. We also noticed, for the first time, an unexpected development of high-nutrient, low-chlorophyll condition off the southern Omani coast. This feature, coupled with other characteristics of the system, such as a narrow shelf and relatively low iron concentrations in surface waters, suggest a close similarity between the Omani upwelling system and the Peruvian and California upwelling systems, where PP is limited by iron. Iron limitation of PP may complicate simple relationship between upwelling and PP assumed by previous workers, and contribute to the anomalous offshore occurrence of the most severe oxygen (O2) depletion in the region. Over the much wider Indian shelf, which experiences large-scale bottom water O2-depletion in summer, adequate iron supply from reducing bottom-waters and sediments seems to support moderately high PP; however, such production is restricted to the thin, oxygenated surface layer, probably because of the unsuitability of the O2-depleted environment for the growth of oxygenic photosynthesizers.Financial support was provided by CSIR through the Network Project CMM0009 to SWAN and by NSF through OCE-0327227S to JWM

A mutation of EPT1 (SELENOI) underlies a new disorder of Kennedy pathway phospholipid biosynthesis.

Mutations in genes involved in lipid metabolism have increasingly been associated with various subtypes of hereditary spastic paraplegia, a highly heterogeneous group of neurodegenerative motor neuron disorders characterized by spastic paraparesis. Here, we report an unusual autosomal recessive neurodegenerative condition, best classified as a complicated form of hereditary spastic paraplegia, associated with mutation in the ethanolaminephosphotransferase 1 (EPT1) gene (now known as SELENOI), responsible for the final step in Kennedy pathway forming phosphatidylethanolamine from CDP-ethanolamine. Phosphatidylethanolamine is a glycerophospholipid that, together with phosphatidylcholine, constitutes more than half of the total phospholipids in eukaryotic cell membranes. We determined that the mutation defined dramatically reduces the enzymatic activity of EPT1, thereby hindering the final step in phosphatidylethanolamine synthesis. Additionally, due to central nervous system inaccessibility we undertook quantification of phosphatidylethanolamine levels and species in patient and control blood samples as an indication of liver phosphatidylethanolamine biosynthesis. Although this revealed alteration to levels of specific phosphatidylethanolamine fatty acyl species in patients, overall phosphatidylethanolamine levels were broadly unaffected indicating that in blood EPT1 inactivity may be compensated for, in part, via alternate biochemical pathways. These studies define the first human disorder arising due to defective CDP-ethanolamine biosynthesis and provide new insight into the role of Kennedy pathway components in human neurological function

The pathogenesis of mucositis: updated perspectives and emerging targets

Published online: 8 July 2019Mucositis research and treatment are a rapidly evolving field providing constant new avenues of research and potential therapies. The MASCC/ISOO Mucositis Study Group regularly assesses available literature relating to pathogenesis, mechanisms, and novel therapeutic approaches and distils this to summary perspectives and recommendations. Reviewers assessed 164 articles published between January 2011 and June 2016 to identify progress made since the last review and highlight new targets for further investigation. Findings were organized into sections including established and emerging mediators of toxicity, potential insights from technological advances in mucositis research, and perspective. Research momentum is accelerating for mucositis pathogenesis, and with this has come utilization of new models and interventions that target specific mechanisms of injury. Technological advances have the potential to revolutionize the field of mucositis research, although focused effort is needed to move rationally targeted interventions to the clinical setting.J. Bowen, N. Al-Dasooqi, P. Bossi, H. Wardill, Y. Van Sebille, A. Al-Azri, E. Bateman, M. E. Correa, J. Raber-Durlacher, A. Kandwal, B. Mayo, R. G. Nair, A. Stringer, K. ten Bohmer, D. Thorpe, R. V. Lalla, S. Sonis, K. Cheng, S. Elad . On behalf of The Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO

A survey of community members' perceptions of medical errors in Oman

<p>Abstract</p> <p>Background</p> <p>Errors have been the concern of providers and consumers of health care services. However, consumers' perception of medical errors in developing countries is rarely explored. The aim of this study is to assess community members' perceptions about medical errors and to analyse the factors affecting this perception in one Middle East country, Oman.</p> <p>Methods</p> <p>Face to face interviews were conducted with heads of 212 households in two villages in North Al-Batinah region of Oman selected because of close proximity to the Sultan Qaboos University (SQU), Muscat, Oman. Participants' perceived knowledge about medical errors was assessed. Responses were coded and categorised. Analyses were performed using Pearson's χ², Fisher's exact tests, and multivariate logistic regression model wherever appropriate.</p> <p>Results</p> <p>Seventy-eight percent (n = 165) of participants believed they knew what was meant by medical errors. Of these, 34% and 26.5% related medical errors to wrong medications or diagnoses, respectively. Understanding of medical errors was correlated inversely with age and positively with family income. Multivariate logistic regression revealed that a one-year increase in age was associated with a 4% reduction in perceived knowledge of medical errors (CI: 1% to 7%; p = 0.045). The study found that 49% of those who believed they knew the meaning of medical errors had experienced such errors. The most common consequence of the errors was severe pain (45%). Of the 165 informed participants, 49% felt that an uncaring health care professional was the main cause of medical errors. Younger participants were able to list more possible causes of medical errors than were older subjects (Incident Rate Ratio of 0.98; p < 0.001).</p> <p>Conclusion</p> <p>The majority of participants believed they knew the meaning of medical errors. Younger participants were more likely to be aware of such errors and could list one or more causes.</p

Loss of UGP2 in brain leads to a severe epileptic encephalopathy, emphasizing that bi-allelic isoform-specific start-loss mutations of essential genes can cause genetic diseases.

Developmental and/or epileptic encephalopathies (DEEs) are a group of devastating genetic disorders, resulting in early-onset, therapy-resistant seizures and developmental delay. Here we report on 22 individuals from 15 families presenting with a severe form of intractable epilepsy, severe developmental delay, progressive microcephaly, visual disturbance and similar minor dysmorphisms. Whole exome sequencing identified a recurrent, homozygous variant (chr2:64083454A > G) in the essential UDP-glucose pyrophosphorylase (UGP2) gene in all probands. This rare variant results in a tolerable Met12Val missense change of the longer UGP2 protein isoform but causes a disruption of the start codon of the shorter isoform, which is predominant in brain. We show that the absence of the shorter isoform leads to a reduction of functional UGP2 enzyme in neural stem cells, leading to altered glycogen metabolism, upregulated unfolded protein response and premature neuronal differentiation, as modeled during pluripotent stem cell differentiation in vitro. In contrast, the complete lack of all UGP2 isoforms leads to differentiation defects in multiple lineages in human cells. Reduced expression of Ugp2a/Ugp2b in vivo in zebrafish mimics visual disturbance and mutant animals show a behavioral phenotype. Our study identifies a recurrent start codon mutation in UGP2 as a cause of a novel autosomal recessive DEE syndrome. Importantly, it also shows that isoform-specific start-loss mutations causing expression loss of a tissue-relevant isoform of an essential protein can cause a genetic disease, even when an organism-wide protein absence is incompatible with life. We provide additional examples where a similar disease mechanism applies