Modified Le Fort I Osteotomy and Genioplasty for Management of Severe Dentofacial Deformity in β-Thalassaemia Major: Case report and review of the literature

β-thalassaemia major is an autosomal recessive form of haemoglobinopathy that is characterised by complete lack of production of the β-chains resulting in multiple complications that include severe anaemia, failure to thrive and skeletal abnormalities. Facial deformities induced by β-thalassaemia major are rare and are very challenging to treat from a surgical point of view. We report a 33-year-old female patient with β-thalassaemia major who presented to the Dental & Maxillofacial Surgery Department, Sultan Qaboos University Hospital, Muscat, Oman, in 2017 with gross dentofacial skeletal deformity contributing to her psychosocial issues. The facial deformity was corrected surgically by excision of the enlarged maxilla, modified Le Fort I osteotomy and advancement genioplasty. This case highlights the pre-operative preparation, surgical management, encountered complications and treatment outcome within 24 months of follow-up.Keywords: Beta-Thalassaemia; Thalassaemia Major; Cooley's Anemia; Le Fort Osteotomy; Genioplasty; Dentofacial Deformities; Case Report; Oman

Awareness of the Dangers of High Salt Intake among the Urban Omani Population

Objectives: This study aimed to assess the knowledge, attitudes and practices of the general public in Oman regarding the dangers of high salt intake. Methods: This cross-sectional questionnaire-based survey was conducted among the urban population in Oman. Individuals aged ≥18 were invited to join the study. Results: A total of 1,214 respondents (mean age 34 ± 10 years) answered the questionnaire. The majority were male (65.8%), employed (69.4%) and some were hypertensive (14.3%). Most (90.9%) were aware that excess salt can cause diseases such as hypertension and that it is either somewhat important (51.2%) or very important (42.9%) to reduce salt in the diet. However, only 42.2% said that they actively try to reduce salt in their diet. Conclusion: Although most people in urban areas of Oman appear to be aware of the dangers of high salt intake, only a few are actively trying to reduce it. More educational activities are required to improve awareness.Keywords: Cross-Sectional Survey; Sodium; Low Salt Diet; Oman

Basic Education Students’ Perceptions on Sustainable Healthy Lifestyles and Disease Prevention Methods in Light of Some Variables in the Sultanate of Oman

هدفت الدراسة تعرف تصورات طلبة التعليم الأساسي بسلطنة عُمان عن الأنماط الصحية المستدامة وطرائق الوقاية من الأمراض في ضوء بعض المتغيرات. استخدمت الدراسة المنهج الوصفي. ولتحقيق هدف الدراسة؛ طُبِّقَتْ أداة الاستبانة، التي تكوَّنت من (36) عبارة، موزَّعة على محورين؛ هُمَا: الأنماط الصحية، والوقاية من الأمراض. وحُسِبَ ثبات الأداة؛ باستخدام طريقتَيْ: ثبات الاتساق الداخلي؛ حيث بلغ معامل كرونباخ ألفا (0.808)، وثبات التجزئة النصفية، وبلغ (0.753). وقد طُبِّقَتِ الدراسة على عَيِّنَة مكوَّنة من (3570)؛ من طلبة الصفين التاسع، والعاشر الأساسيَّيْنِ. وخَلُصَتْ نتائج الدراسة إلى وجود تصورات إيجابية لدى طلبة التعليم الأساسي عن محور الأنماط الصحية المستدامة، حيث حصل نمط النظافة الشخصية على أعلى نمط صحي، يليه نمطي النشاط الرياضي، والتغذية، ثم يأتي نمط النوم باعتباره أقل نمط صحي، وتظهر النتائج أيضًا وجود تصورات إيجابية في محور طرائق الوقاية من الأمراض، كما كشفت الدراسة عن عدم وجود فروق دالة إحصائيًّا في متغيِّرات: النَّوْع الاجتماعي، والمحافظة التعليمية في محوري: الأنماط الصحية، وطرائق الوقاية من الأمراض، وعليه أَوْصَتْ الدراسة بتعزيز وَعْي طلبة التعليم الأساسي بأهمية ممارسة الأنماط الصحية المستدامة

Aldosterone/Renin ratio : methods of measurement, physiological correlates and prediction of therapeutic outcome

EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Obstructive Sleep Apnoea/Hypopnoea Syndrome and Hypertension

The obstructive sleep apnoea/hypopnoea syndrome (OSAHS) is a common disorder, affecting around 2–4% of the middle-aged population. There is a strong association between OSAHS and hypertension, based on animal, large epidemiological and interventional studies. The epidemiological studies have shown a dose-response relationship between apnoea/hypopnoea index (AHI) and the risk of developing hypertension. Different mechanisms may have a role in the process of elevated blood pressure in OSAHS. Sympathetic activity is increased in OSAHS patients during sleep and wakefulness. This increase in sympathetic activity is probably due to activation of baroreflexes and chemoreflexes by frequent arousals and hypoxaemia a result of apnoea or hypopnoea events. Continuous positive airway pressure (CPAP) has been shown to reduce sympathetic stimulation and blood pressure in OSAHS patients. Altered endothelial function may also have a role in the pathogenesis of hypertension in OSAHS subjects. Reduction of nitric oxide (NO) production and increase in the formation of free radicals may be responsible for the impairment of the vasodilatation of micro-vasculature in these subjects as a result of hypoxaemia. It has been shown that effective CPAP therapy has a reversible effect on endothelial dysfunction

The Impact of Traffic Law Enforcement Regulations on the Incidence and Severity of Maxillofacial Injuries

Objectives: Road traffic accidents (RTAs) are the main cause of facial injuries in Oman. This study aimed to assess the effectiveness of the new traffic law enforcement regulations (TLERs) on the incidence and severity of maxillofacial injuries in Oman. Methods: A retrospective longitudinal analytic study was conducted at three tertiary care hospitals in Muscat, Oman. All patients with RTA-related maxillofacial injuries for a five-year period from January 2005 to December 2009 (before the new TLERs) and the five-year period from January 2015 to December 2019 (after the new TLERs) were included in the study. Results: A total of 1127 patients were included in the study. Of these, 646 (57.3%) patients sustained RTA-related maxillofacial injuries before the implementation of the new TLERs compared to 481 (42.7%) after the introduction of TLERs. There was no significant difference in gender sustained injuries between the two study periods. The incidence of injury before the implementation of the TLERs was 22.7 per 100,000 population, which then reduced significantly to 11 per 100,000 after the new TLERs. Overall, there was a significant reduction in the mean facial injury severity score from 3.2 to 2.3 before and after the implementation of the new TLERs, respectively. Conclusion: The findings of this study indicate that the newly introduced TLERs have resulted in a reduction in the incidence and severity of RTA-related maxillofacial injuries. Continuous improvement and reinforcement of TLERs will further help to reduce the burden of these injuries to the society in general and health services in particular. Keywords: Law Enforcement; Traffic Accidents; Maxillofacial Injuries; Injury Severity Score; Oman

COVID-19 and the Clinical Phase of the Medical Doctorate Curriculum in Oman: Challenges and the way forward

COVID-19 has gripped the world with lightning speed. Since the onset of the pandemic, activity throughout the world came to a grinding halt. However, business had to continue and people have to learn to live with the virus while the pandemic continues to rage. Medical education is no exception and may even deserve special mention, as it prepares frontline workers against the endemics of tomorrow. We discuss here the journey of medical education at the College of Medicine and Health Sciences at Sultan Qaboos University, Muscat, Oman, as the pandemic struck the world and Oman. This work suggests a roadmap for changes, discusses challenges and proposes measures to mitigate the effects of COVID-19 on medical schools. Keywords: COVID-19; Medical Education; Curriculum; Computer Simulation; Artificial Intelligence; Oman

Criteria for Diagnosis of Familial Hypercholesterolemia: A Comprehensive Analysis of the Different Guidelines, Appraising their Suitability in the Omani Arab Population

Subjects with Familial hypercholesterolemia are at increased risk for cardiac events such as premature myocardial infarction and early death from coronary heart disease, especially in patients with severe forms of the disease if left unattended. Therefore, there is an ardent need for the early diagnosis followed by aggressive therapeutic intervention and lifestyle modification. Three groups have developed clinical diagnostic tools for Familial hypercholesterolemia: the US MedPed Program, the Simon Broome Register Group in the United Kingdom, and the Dutch Lipid Clinic Network. In this article, the individual criteria are reviewed with particular emphasis on their advantage(s) and disadvantage(s), and in turn assess their suitability in diagnosing Familial hypercholesterolemia in the Omani Arab population. A brief insight into the process of "Cascade Screening" is also provided, this is a procedure that we are in the process of establishing in Oman