Medical Tourism Abroad : A new challenge to Oman’s health system - Al Dakhilya region experience

Objectives: This study aimed to understand why people seek medical advice abroad given the trouble and expense this entails. The types of medical problems for which treatment abroad was sought, preferred destinations and satisfaction with the treatment were explored. A secondary aim was to give feedback to stakeholders in the health care system on how to handle this issue and meet the needs of the community. Methods: 45 patients who had recently travelled abroad for treatment were asked to complete a questionnaire or were interviewed by telephone. Results: 40 questionnaires were received. 68% of the respondents were male. Orthopaedic diseases were the most common conditions leading patients to seek treatment abroad. Thailand was the most popular destination followed by India (50% and 30% respectively). 85% of respondents went abroad for treatment only, 10% for treatment and tourism and 2.5% were healthy, but travelled abroad for a checkup. Interestingly, 15% of the participants went abroad without first seeking medical care locally. Out of those initially treated in Oman, 38.2% had no specific diagnosis and 38.2% had received treatment, but it was not effective. 73% of respondents obtained information on treatment abroad from a friend. The Internet and medical tourism offices were the least used sources of information. 15% of the patients experienced complications after their treatment abroad. Conclusion: Various facts about medical treatment abroad need to be disseminated to the public. This will necessitate greater effort in public health promotion and education. 

Postpartum depression in the Occupied Palestinian Territory:a longitudinal study in Bethlehem

BACKGROUND: Postpartum depression (PPD) affects women from different cultures around the world. No previous studies have investigated PPD among women in Palestine. Fertility rates in Palestine are among the highest in the world, hence even low rates of PPD could have considerable national impact. The aim of this study was to determine the prevalence of, and risk factors for, PPD among Palestinian mothers. METHODS: 101 mothers were recruited during the registration of their child’s birth (within 1 week) at the Bethlehem branch of the Ministry of Interior. Participants were assessed via a face to face interview, and were followed up 1 week, 2 weeks, 6 weeks, 3 months, and 6 months later by telephone interview. Interviews included the Arabic Edinburgh Postnatal Depression Scale (EPDS), with PPD indicated by depressive symptoms (EPDS score ≥11) at ≥2 follow-up time points. Pearson’s correlation was calculated between repeated EPDS scores, and multivariable logistic regression was used to investigate risk factors for PPD. RESULTS: The prevalence of depressive symptoms was fairly constant (14–19%) over the follow-up period. Most depressive symptoms developed within 1 month of delivery; mothers with depressive symptoms at 3 months postpartum were highly likely to still have symptoms at 6 months. 27.7% (28/101) of women met our criteria for PPD. High parity (odds ratio (OR) 4.52 (95% CI 0.90, 22.8) parity 3+ versus primiparous), unplanned pregnancy (OR 2.44 (0.99, 6.01)) and sex of child not being the one desired (OR 5.07 (1.12, 22.9)) were associated with PPD, but these associations were attenuated in multivariable analysis. CONCLUSIONS: The prevalence of PPD in Palestine appears to be higher than in high income countries, but similar to the prevalence in other Middle Eastern countries. High parity and unplanned pregnancy were identified as risk factors for PPD, suggesting that fully meeting the need for family planning could reduce the incidence of PPD in the Palestinian population

Effect of Spacing on Seed Yield of Indigenous Rangeland and Forage Grass Species Grown under Drip Irrigation

Two indigenous rangeland forage species, Cenchrus ciliaris and Coelachyrum piercei, were investigated for their response to varying inter-row (50 and 100-cm) and inter plant spacing (25, 50 and 100-cm) under drip irrigation along with the perennial popular forage, Rhodes grass (Chloris gayana). Expression of traits, such as plant stand, plant height, number of tillers, number of panicles and seed yield, differed under varying inter-row and inter-plant spacing in different harvests. The grass species produced higher seed yield due to less interplant competition under wider (100-cm) than under narrow row (50-cm) spacing. Chloris gayana produced highest mean seed yield in wider inter-plant spacing (100-cm) under both inter-row spacings, viz. 100-cm (488 kg/ha) and 50-cm (449 kg/ha), followed by Cenchrus ciliaris (449 kg/ha under 100-cm and 377 kg/ha under 50-cm row spacing) and Coelachyrum piercei (274 kg/ha under 100-cm and 210 kg/ha under 50-cm row spacing). In respect of seed quality for samples harvested selectively or in bulk, the three grasses showed very low germination when tested immediately (1-2 weeks) after harvest, not only for bulk seed (0 to 1.5%) but also for selected seed (0.8% to 2.8%). Mean germination of grass species recorded after 12 months of harvests was significantly greater (53 %) than that recorded after 5 months (34 %) of harvests. Of the three grass species, Cenchrus ciliaris recorded significantly (p<0.01) highest germination % (50 %) followed by Chloris gayana (41 %) and Coelachyrum piercei (39 %). Selected seeds had significantly (p<0.01) higher germination (53 %) than bulk seeds (33 %).Keywords

Effect of Spacing on Seed Yield of Indigenous Rangeland and Forage Grass Species Grown under Drip Irrigation

Two indigenous rangeland forage species, Cenchrus ciliaris and Coelachyrum piercei, were investigated for their response to varying inter-row (50 and 100-cm) and inter plant spacing (25, 50 and 100-cm) under drip irrigation along with the perennial popular forage, Rhodes grass (Chloris gayana). Expression of traits, such as plant stand, plant height, number of tillers, number of panicles and seed yield, differed under varying inter-row and inter-plant spacing in different harvests. The grass species produced higher seed yield due to less interplant competition under wider (100-cm) than under narrow row (50-cm) spacing. Chloris gayana produced highest mean seed yield in wider inter-plant spacing (100-cm) under both inter-row spacings, viz. 100-cm (488 kg/ha) and 50-cm (449 kg/ha), followed by Cenchrus ciliaris (449 kg/ha under 100-cm and 377 kg/ha under 50-cm row spacing) and Coelachyrum piercei (274 kg/ha under 100-cm and 210 kg/ha under 50-cm row spacing). In respect of seed quality for samples harvested selectively or in bulk, the three grasses showed very low germination when tested immediately (1-2 weeks) after harvest, not only for bulk seed (0 to 1.5%) but also for selected seed (0.8% to 2.8%). Mean germination of grass species recorded after 12 months of harvests was significantly greater (53 %) than that recorded after 5 months (34 %) of harvests. Of the three grass species, Cenchrus ciliaris recorded significantly (p&lt;0.01) highest germination % (50 %) followed by Chloris gayana (41 %) and Coelachyrum piercei (39 %). Selected seeds had significantly (p&lt;0.01) higher germination (53 %) than bulk seeds (33 %).Keywords:

Global variation in diabetes diagnosis and prevalence based on fasting glucose and hemoglobin A1c

: Fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) are both used to diagnose diabetes, but these measurements can identify different people as having diabetes. We used data from 117 population-based studies and quantified, in different world regions, the prevalence of diagnosed diabetes, and whether those who were previously undiagnosed and detected as having diabetes in survey screening, had elevated FPG, HbA1c or both. We developed prediction equations for estimating the probability that a person without previously diagnosed diabetes, and at a specific level of FPG, had elevated HbA1c, and vice versa. The age-standardized proportion of diabetes that was previously undiagnosed and detected in survey screening ranged from 30% in the high-income western region to 66% in south Asia. Among those with screen-detected diabetes with either test, the age-standardized proportion who had elevated levels of both FPG and HbA1c was 29-39% across regions; the remainder had discordant elevation of FPG or HbA1c. In most low- and middle-income regions, isolated elevated HbA1c was more common than isolated elevated FPG. In these regions, the use of FPG alone may delay diabetes diagnosis and underestimate diabetes prevalence. Our prediction equations help allocate finite resources for measuring HbA1c to reduce the global shortfall in diabetes diagnosis and surveillance