Idiopathic Granulomatous Mastitis Diagnostic strategy and therapeutic implications in Omani patients

Objectives: Idiopathic granulomatous mastitis (IGM) is a rare benign disorder of the breast whose aetiology is controversial, and is often misdiagnosed clinically and radiologically as mammary malignancy; as a result, it may be incorrectly treated. Although no standard treatment is available for this chronic disease, surgery with or without corticosteroids has been tried with controversial results. This study discusses the clinical presentation, diagnosis, management, recurrence, and follow-up data of IGM with a review of relevant literature. Methods: From 2009–2012, the Breast Unit at Sultan Qaboos University Hospital, Oman, conducted a clinical study on 20 patients with breast lumps. Their clinical and radiological examinations were indeterminate, and a diagnosis of granulomatous mastitis was established only by histopathology. Results: The majority of the patients were cases of unknown aetiology, who presented with a unilateral breast mass. A few patients had a mass with an abscess, along with axillary lymphadenopathy. A total of 4 patients were suspected of malignancy using radiology. In all patients, sterilised pus was sent for culture and sensitivity. Microscopy showed the characteristic pattern of granulomatous inflammation. All patients were treated with antibiotics for 6 weeks, and the mean follow-up period was 15 months (11–33 months). All patients had complete remission with no further recurrence. Conclusion: This single largest study of cases of IGM in Oman highlights the pitfalls in diagnosing this non-neoplastic disease of unknown aetiology and uncertain pathogenesis. It emphasises IGM’s excellent response to antibiotics, which is crucial, as IGM is a disease which is notoriously difficult and controversial to treat

The antibacterial properties of Malaysian tualang honey against wound and enteric microorganisms in comparison to manuka honey

<p>Abstract</p> <p>Background</p> <p>Antibiotic resistance of bacteria is on the rise, thus the discovery of alternative therapeutic agents is urgently needed. Honey possesses therapeutic potential, including wound healing properties and antimicrobial activity. Although the antimicrobial activity of honey has been effectively established against an extensive spectrum of microorganisms, it differs depending on the type of honey. To date, no extensive studies of the antibacterial properties of tualang (<it>Koompassia excelsa</it>) honey on wound and enteric microorganisms have been conducted. The objectives of this study were to conduct such studies and to compare the antibacterial activity of tualang honey with that of manuka honey.</p> <p>Methods</p> <p>Using a broth dilution method, the antibacterial activity of tualang honey against 13 wound and enteric microorganisms was determined; manuka honey was used as the control. Different concentrations of honey [6.25-25% (w/v)] were tested against each type of microorganism. Briefly, two-fold dilutions of honey solutions were tested to determine the minimum inhibitory concentration (MIC) against each type of microorganism, followed by more assays within a narrower dilution range to obtain more precise MIC values. MICs were determined by both visual inspection and spectrophotometric assay at 620 nm. Minimum bactericidal concentration (MBC) also was determined by culturing on blood agar plates.</p> <p>Results</p> <p>By visual inspection, the MICs of tualang honey ranged from 8.75% to 25% compared to manuka honey (8.75-20%). Spectrophotometric readings of at least 95% inhibition yielded MIC values ranging between 10% and 25% for both types of honey. The lowest MBC for tualang honey was 20%, whereas that for manuka honey was 11.25% for the microorganisms tested. The lowest MIC value (8.75%) for both types of honey was against <it>Stenotrophomonas maltophilia</it>. Tualang honey had a lower MIC (11.25%) against <it>Acinetobacter baumannii </it>compared to manuka honey (12.5%).</p> <p>Conclusion</p> <p>Tualang honey exhibited variable activities against different microorganisms, but they were within the same range as those for manuka honey. This result suggests that tualang honey could potentially be used as an alternative therapeutic agent against certain microorganisms, particularly <it>A. baumannii </it>and <it>S. maltophilia</it>.</p

Bat Oasis Historical Archaeology Project: Interim Report on 2014 Field Season

This paper presents the results of the first field season carried out in the abandoned mud brick structures of the Bat Oasis in Oman. Drawing on planning, building analysis, excavation and ethnographic interviews, this project is exploring the recent and contemporary past of the mud brick village which was occupied up until the 1970s. The vast majority of the rural population of Oman lived in mud brick villages and the Bat Oasis provides an excellent opportunity to understand more about the ways in which vernacular architecture shaped social structures, and the reverse. Excavation and oral histories provide historical context for this understanding, and can also help inform heritage plans for the site