Keystone Design Sliding Skin Flap for the Management of Small Full Thickness Burns

Deep dermal burns and full thickness burns are generally managed by excision and split thickness skin grafting. The skin graft may lead to unacceptable colour changes and be aesthetically unacceptable. Also, there may be a contour defect and, furthermore, it is followed by varying degrees of contracture. The keystone design sliding flap, first described in 2003, avoids the need for grafting and is not associated with any skin graft problems. We report two cases of the use of this flap as the primary surgery in reconstruction of small full thickness burn defects.

Sustainable Clinical Academic Training Pathways: A framework for implementation in Oman

Clinical academics—medical doctors with additional training in basic science or clinical research—play a pivotal role in translating biomedical research into practical bedside applications. However, international studies suggest that the proportion of clinical academics relative to the medical workforce is dwindling worldwide. Although efforts to reverse this trend are ongoing in many countries, there is little perceptible dialogue concerning these issues in Oman. This article explores the current status of clinical academic training pathways worldwide, concluding with a framework for the implementation of a dual-degree medical-research training programme in Oman in order to stimulate and develop a sustainable national clinical academic workforce.Keywords: Training Programs; Undergraduate Medical Education; Graduate Medical Education; Internship and Residency; Medical Students; Research; Oman

The Accuracy of the Broselow™ Pediatric Emergency Tape for Weight Estimation in an Omani Paediatric Population

Objectives: This study aimed to evaluate the accuracy of the Broselow™ Pediatric Emergency Tape (BT) for estimating weight in an Omani paediatric population at a tertiary care hospital. Methods: This retrospective cross-sectional study was conducted during July 2015. The electronic medical records of Omani outpatients <14 years old attending the Sultan Qaboos University Hospital, Muscat, Oman, between July 2009 and June 2013 were reviewed for recorded height and weight data. The BT Version 2002A was used to predict weight based on actual height measurements. Predicted weight measurements were then compared with actual weight to determine the accuracy of the estimation. Results: A total of 3,339 children were included in the study, of which 43.5% were female and 56.5% were male. The mean age was 6.4 ± 3.1 years and the mean height was 93.2 ± 23.5 cm. The mean actual weight was 13.9 ± 6.7 kg while the mean BT-predicted weight was 14.4 ± 6.9 kg. The BT-predicted weight estimations correlated significantly with actual weight measurements (intraclass correlation coefficient: 0.97; P <0.001). A Bland-Altman analysis indicated that the BT performed well when estimating weight among Omani children, with an overestimation of only 0.5 kg for the entire cohort. Conclusion: The BT was found to be an effective tool for estimating weight according to body length in an Omani paediatric population. It should therefore be considered for use in emergency situations when actual weight cannot be determined

Hazard analysis and critical control point (HACCP) in seafood processing: an analysis of its application and use in regulation in the Sultanate of Oman

When considering the supply of fish products to consumers, the adoption of food safety management systems throughout the 'net to plate' continuum is of a paramount importance. It is essential to safeguard consumers and to facilitate regional and international trade. This study has assessed the technical barriers and benefits associated with the implementation of management system incorporating HACCP and related pre-requisite programmes in the seafood processors in the Sultanate of Oman. A survey, using qualitative surveys and interviews, was conducted out to verify the level of implementation of the seafood safety and quality requirements. A total of 22 (92% returned) HACCP processors, and 15 (83% returned) non-HACCP processors and 15 (75%) officials completed the questionnaires. Differences between processors operating with or without a HACCP system in place have been identified. The survey of local officials provided an additional perspective on the issues involved. The implications of handling practices in the seafood supply chain, seafood trade and the cost implications of implementing HACCP-based food safety management systems were also assessed. In comparison to the non-HACCP processors, the results indicated that HACCP firms were more diversified in their export markets and were able to target the more lucrative markets such as EU, Japan and America. However, the processors felt that the main barrier for exporting to these markets was the restriction imposed by the government on exporting certain species which reduced their ability to meet contracts with these countries. The study has also shown inadequate execution of prerequisite programmes due mainly to lack of training delivered to food handlers and a poor knowledge of food safety concepts. In particular there is an overreliance on the use of CCPs to control hazards when prerequisite programmes would be more appropriate is many situations. When considering whether to implement HACCP-based control systems, the seafood processors identified barriers linked to costs as their main concerns. However, whilst recognising this issue, the officials also highlighted barriers linked to the lack of expertise, skills and commitment of the staff. In general, the study highlighted significant gaps which undermine the effectiveness and success of implementing safety and quality requirements to meet national legislative obligations. These include: poor attitudes and understanding toward HACCP and its pre-requisite programmes, lenient enforcement by the authorities, the lack of training and consultancy organizations in the country, a lack of awareness. The overlapping structure of the regulatory authorities in the country and the distribution of national inspection resources have also been identified as an issue of concern

Seafood safety and quality: an analysis of the supply chain in the Sultanate of Oman

The globalization of trade in fish has created many challenges for the developing world specifically with regard to food safety and quality. International organisations have established a good basis for standards in international trade. Whilst these requirements are frequently embraced by the major importers (such as Japan, the EU and the USA), they often impose additional safety requirements and regularly identify batches which fail to meet their strict standards. Creating an effective national seafood control system which meets both the internal national needs as well the requirements for the export market can be challenging. Many countries adopt a dual system where seafood products for the major export markets are subject to tight control whilst the majority of the products (whether for the local market or for more regional trade) are less tightly controlled. With regional liberalization also occurring, deciding on appropriate controls is complex. In the Sultanate of Oman, fisheries production is one of the countries' chief sources of economic revenue after oil production and is a major source of the national food supply. In this paper the structure of the fish supply chain has been analysed and highlighted the different routes operating for the different markets. Although much of the fish are consumed within Oman, there is a major export trade to the local regional markets. Much smaller quantities meet the more stringent standards imposed by the major importing countries and exports to these are limited. The paper has considered the development of the Omani fish control system including the key legislative documents and the administrative structures that have been developed. Establishing modern controls which satisfy the demands of the major importers is possible but places additional costs on businesses. Enhanced controls such as HACCP and other management standards are required but can be difficult to justify when alternative markets do not specify these. These enhanced controls do however provide additional consumer protection and can bring benefits to local consumers. The Omani government is attempting to upgrade the system of controls and has made tremendous progress toward the implementation of HACCP and introducing enhanced management systems into its industrial sector. The existence of strengthened legislative and government support, including subsidies, has encouraged some businesses to implement HACCP. The current control systems have been reviewed and a SWOT analysis approach used to identify key factors for their future development. The study shows that seafood products in the supply chain are often exposed to lengthy handling and distribution process before reaching the consumers, a typical issue faced by many developing countries. As seafood products are often perishable, they safety is compromised if not adequately controlled. The enforcement of current food safety laws in the Sultanate of Oman is shared across various government agencies. Consequently, there is a need to harmonize all regulatory requirements, enhancing the domestic food protection and to continue to work towards a fully risk-based approach in order to compete successfully in the global market

Epidemiology of End Stage Renal Disease (ESRD) of Oman since 1983 to 2018: a secondary data analysis study

No abstract available

Effective seafood safety and quality management systems: an analysis of the situation in the Sultanate of Oman

Globally there have been many challenges in establishing effective food safety control systems. Of particular interest to the Sultanate of Oman is the control of the safety and quality of seafood for its importance to the national economy, food security and trade. The research focused on the particular issue of food safety management systems (including the application of the Hazard Analysis Critical Control Point (HACCP) system within the Omani seafood processors. To understand the whole context, a wider review was initially conducted which looked into the whole structure of food control in Oman including the legal documents and the administrative structures. The evidence indicates that there is no unified national food safety agency and that current laws and regulations are shared across various governmental authorities. By investigating the various challenges, weaknesses and strengths of the existing system it is noted that there are still deficiencies in comparison to international guidance. Subsequently the structure of the seafood supply chain was analysed and a survey was conducted to assess the issues pertinent to HACCP implementation in the seafood industry and the role of the regulatory authorities in governing the safety of seafood products. The survey identified more precisely the benefits and barriers of implementing the HACCP system for the HACCP processors and the non-HACCP processors, which are usually small industry. In conclusion, the research has shown the importance of adopting strategies to enhance safety and quality requirements from farm to fork covering all aspects of seafood harvesting, processing and distribution regardless of the target markets. A legal requirement to adopt HACCP systems and the application of related food safety management systems (FSMSs) and their pre-requisites programmes is recommended. It should be imposed on all seafood processors regardless of their markets to ensure conformity with national and international requirements

Decision-to-Delivery Time Intervals in Emergency Caesarean Section Cases : Repeated cross-sectional study from Oman

Objectives: In cases of fetal intolerance to labour, meeting the standard decision-to-delivery time interval (DDI) of ≤30 minutes is challenging. This study aimed to assess DDIs in emergency Caesarean section (CS) cases to identify factors causing DDI delays and the impact of a delayed DDI on perinatal outcomes. Methods: This repeated cross-sectional study included all emergency CS procedures performed due to acute fetal distress, antepartum haemorrhage or umbilical cord prolapse at the Nizwa Hospital, Nizwa, Oman. Three audit cycles of three months each were conducted between April 2011 and June 2013, including an initial retrospective cycle and two prospective cycles following the implementation of improvement strategies to address factors causing DDI delays. Poor perinatal outcomes were defined as Apgar scores of <7 at five minutes, admission to the Special Care Baby Unit (SCBU) or a stillbirth. Results: In the initial cycle, a DDI of ≤30 minutes was achieved in 23.8% of 84 cases in comparison to 44.6% of 83 cases in the second cycle. In the third cycle, 60.8% of 79 women had a DDI of ≤30 minutes (P <0.001). No significant differences in perinatal outcomes for cases with a DDI of ≤30 minutes versus 31–60 minutes were observed; however, a DDI of >60 minutes was significantly associated with poor neonatal outcomes in terms of increased SCBU admissions and low Apgar scores (P <0.001 each). Factors causing DDI delays included obtaining consent for the CS procedure, a lack of operating theatre availability and moving patients to the operating theatre. Conclusion: The identification of factors causing DDI delays may provide opportunities to improve perinatal outcomes