Successful Management of Rhino-Orbital-Cerebral Mucormycosis in a Child with Acute-on-Chronic Kidney Disease and Malnutrition: Case report and literature review

Mucormycosis is a very rare fungal infection in children. It is caused by opportunistic fungi, and mainly affects immunocompromised patients. Early diagnosis is very important for a good outcome. Successful management requires the reversal of the underlying predisposing risk factors, surgical debridement and prompt administration of active antifungal agents, with liposomal amphotericin B being the first line therapy. This case, to the best of the authors’ knowledge, is the first rhino-orbital-cerebral mucormycosis to be reported on among Omani children. We highlight the importance of early diagnosis and prompt surgical and medical interventions in achieving a satisfactory outcome and we review the published literature in regard to the management. Keywords: Mucormycosis; Sinusitis; Proptosis; Liposomal amphotericin B; Rhizopus; Posaconazole; Malnutrition

Primary Cytomegalovirus-Related Eosinophilic Pneumonia in a Three-year-old Child with Acute Lymphoblastic Leukaemia : Case report and literature review

A diagnosis of eosinophilic pneumonia (EP) is rare in patients with acute lymphoblastic leukaemia (ALL). We report a case of EP in association with a primary cytomegalovirus (CMV) infection in a three-yearold Omani child with ALL. The patient presented with fever while undergoing maintenance chemotherapy. He was admitted to the Child Health Department of Royal Hospital, in Muscat, Oman, in November 2011. He was initially thought to have sepsis but failed to respond to antibiotics. Chest computed tomography showed diffuse ground glass lung opacification. Bronchoalveolar lavage (BAL) cytology was consistent with the diagnosis of EP. Polymerase chain reaction tests for CMV were performed on the BAL and blood samples and were both markedly elevated. The patient made a full recovery after treatment with prednisolone and ganciclovir. The association between CMV infection and EP as well as the management of this combination in immunocompromised patients has never been reported in the English literature

Social influences on risky driving behaviors among young drivers in Oman

Young drivers represent approximately 20% of the Omani population, yet account for over one third of crash injuries and fatalities on Oman's roads. Internationally, research has demonstrated that social influences play an important role within young driver safety, however, there is little research examining this within Arab gulf countries. This study sought to explore young driver behaviour using Akers' social learning theory. A self-report survey was conducted by 1319 (72.9% male and 27.1% female) young drivers aged 17-25 years. A hierarchical regression model was used to investigate the contribution of social learning variables (norms and behaviour of significant others, personal attitudes towards risky behaviour, imitation of significant others, beliefs about the rewards and punishments offered by risky behaviour), socio-demographic characteristics (age and gender), driving experience (initial training, time driving and previous driving without supervision) and sensitivity to rewards and punishments upon the self-reported risky driving behaviours of young drivers. It was found that 39.6% of the young drivers reported that they have been involved in at least one crash since the issuance of their driving licence and they were considered ‘at fault’ in 60.7% of these crashes. The hierarchical multiple regression models revealed that socio-demographic characteristics and driving experience alone explained 14.2% of the variance in risky driving behaviour. By introducing social learning factors into the model a further 37.0% of variance was explained. Finally, 7.9% of the variance in risky behaviour could be explained by including individual sensitivity to rewards and punishments. These findings and the implications are discussed

Severe thrombocytopenia in a child with typhoid fever: a case report

Background: Although thrombocytopenia is common in typhoid fever, its course, response to treatment, and need for specific therapies such as platelet transfusion are not well characterized. Case presentation: We report a case of typhoid fever in a 4-year-old Asian male returned traveler, admitted with prolonged fever and found to have severe thrombocytopenia (platelets 16 × 109/L). Despite appropriate antibiotic therapy, his platelet recovery was slow, but did not lead to complications and he did not require platelet transfusion. Conclusions: There is no consensus in the medical literature guiding the optimal management of severe thrombocytopenia in typhoid fever, but it may improve with conservative management, as in our case. The epidemiology and management of this condition merits further research to guide clinical practice

A huge brain cyst in left temporal fossa

A 27-year-old male with left temporal protrusion from childhood presented with complaints of headache, nausea and vomiting. Cranial magnetic resonance imaging (MRI) showed fluid collection measuring 6.00 cm × 7.00 cm × 8.00 cm in left temporal fossa. The diagnosis of epidermoid cyst of brain was made and surgical resection of the tumor was done. Epidermoid cysts of brain grow slowly and are composed of epidermoid cells debris rich in cholesterol. The prophylactic removal of these tumors with goal of preventing recurrence is recommended

Focus group discussions exploring major social influences on young driver safety in Oman. Report to the Research Council of Oman, Muscat

This report documents the findings of in-depth focus groups conducted with 17 young drivers. The main aim of these focus groups was to explore key themes related to the risky behaviour of young drivers (17-25 years) in Oman. Specifically the interviews explored the influence of parents and peers, who may serve as a source of imitation, reward and punishment. Additionally, the interviews explored the influence of policing and licensing on young driver behaviour

Personality of young drivers in Oman: relationship to risky driving behaviors and crash involvement among Sultan Qaboos University students

Objective - Drivers’ behaviors such as violations and errors have been demonstrated to predict crash involvement among young Omani drivers. However, there is a dearth of studies linking risky driving behaviors to the personality of young drivers. The aim of the present study was to assess such traits within a sample of young Omani drivers (as measured through the behavioral inhibition system, BIS, and the behavioral activation system, BAS) and determine links with aberrant driving behaviors and self-reported crash involvement. Methods - A cross-sectional study was conducted at the Sultan Qaboos University (SQU) that targeted all licensed Omani's undergraduate students. A total of 529 randomly selected students completed the self-reported questionnaire that included an assessment of driving behaviours (e.g., Driver Behaviour Questionnaire: DBQ) as well as the BIS/BAS measures. Results - A total of 237 participants (44.8%) reported involvement in at least one crash since being licensed. Young drivers with lower BIS-anxiety scores, higher BAS-Fun seeking tendencies as well as male drivers were more likely to report driving violations. Statistically significant gender differences were observed on all BIS and BAS subscales (except for BAS-Fun) and the DBQ subscales, as males reported higher trait scores. While personality traits were related to aberrant driving behaviors at the bivariate level, the constructs were not predictive of engaging in violations or errors. Furthermore, consistent with previous research, a supplementary multivariate logistic regression analysis revealed that only driving experience was predictive of crash involvement. Conclusions - The findings highlight that while personality traits influence self-reported driving styles (and differ between the genders), the relationship with crash involvement is not as clear. This paper further outlines the key findings of the study in regards to understanding core psychological constructs that increase crash risk

Preliminary analysis of self-report questionnaire with young drivers in Oman. Fourth report of the novice driver safety research in Oman project for the Research Council of Oman

This report document the recent progress (current as of December 2014) of the research project investigating novice driver safety in Oman. Included in this report is a summary of progress with publications to date, as well as description of the preliminary results of the first phase of the quantitative survey with young drivers. With regards to the publications which have resulted from this research, two journal articles have been published in print, one is under review, and a fourth is in the late stages of development for submission..