Asthma Clinics in Primary Healthcare Centres in Oman: Do they make a difference?

Objectives: This study aimed to determine the effect of newly established asthma clinics (ACs) on asthma management at primary healthcare centres (PHCs) in Oman. Methods: This retrospective crosssectional study was conducted between June 2011 and May 2012 in seven PHCs in the Seeb wilayat of Muscat, Oman. All ≥6-year-old asthmatic patients visiting these PHCs during the study period were included. Electronic medical records were reviewed to determine which clinical assessment and management components had been documented. Results: A total of 452 asthmatic patients were included in the study. The mean age was 35 ± 21 years old (range: 6–95 years) and the majority (57%) were female. In total, 288 (64%) cases were managed at ACs and 164 (36%) were managed at general clinics (GCs). Significant differences were noted in the documentation of cases managed at ACs compared to those at GCs, including history-taking information regarding signs and symptoms (91% versus 19%; P <0.001), trigger factors (79% versus 16%; P <0.001) and a history of atopy (81% versus 17%; P <0.001), smoking (61% versus 7%; P <0.001), asthma exacerbations (73% versus 10%; P <0.001) or previous admissions (63% versus 10%; P <0.001). Furthermore, prescription rates of inhaled corticosteroids (72% versus 61%; P = 0.021) and short-acting β-agonists (93% versus 82%; P = 0.001) were significantly higher at ACs compared to GCs. Conclusion: Overall, the findings indicated that ACs have had a positive impact on asthma management at the studied PHCs.Keywords: Asthma; Disease Management; Patient Compliance; Medical History Taking; Medical Records; Documentation; Oman

The mycobiota of herbal drug plants in Oman and possible decontamination by gamma radiation

The mycobiota of seven herbal plant species were surveyed: Nigella sativa, Zataria multiflora, Trigonella foenum-graecum, Rhazya stricta (seeds and leaves), Haplophyllum tuberculatum, Aristolochia bracteolata and Teucrium muscatense. A total of 24 species of fungi were isolated from the plants (seeds, leaves, flowers and/or stems). No significant differences were found between the mycobiota of the herbal plant species or between the six samples of each plant. Aspergillus niger and Penicillium sp. were the most common species, followed by A. flavus and Rhizopus spp. A. flavus was found in all herbal plants except R. stricta (leaves) and Z. multiflora. Aflatoxins were extracted from a number of herbal plants. Some strains of A. flavus isolated from the plants were aflatoxigenic. Gamma radiation at 905.4 Gy showed an average percent inhibition of fungi on some herbal plants between 88.6 and 99.1%. Complete inhibition was obtained at 1836 Gy

Hepatocellular Carcinoma in Oman: An analysis of 284 cases

Objectives: Hepatocellular carcinoma (HCC) is the most common type of primary liver tumour worldwide and is increasing in incidence. This study aimed to describe the clinical characteristics of HCC among Omani patients, along with its major risk factors, outcomes and the role of surveillance. Methods: This retrospective case-series study was conducted between January 2008 and December 2015 at the three main tertiary care hospitals in Oman. All adult Omani patients diagnosed with HCC and visited these hospitals during the study period were included. Relevant data were collected from the patients’ electronic medical records. Results: A total of 284 HCC patients were included in the analysis. The mean age was 61.02 ± 11.41 years and 67.6% were male. The majority had liver cirrhosis (79.9%), with the most common aetiologies being chronic hepatitis C (46.5%) and B (43.2%). Only 13.7% of cases were detected by the HCC surveillance programme. Approximately half of the patients (48.5%) had a single liver lesion and 31.9% had a liver tumour of >5 cm in size. Approximately half (49.2%) had alpha-fetoprotein levels of ≥200 ng/mL. The majority (72.5%) were diagnosed using multiphase computed tomography alone. Less than half of the patients (48.9%) were offered one or more HCC treatment modalities. Conclusion: The majority of Omani HCC patients were male and had cirrhosis due to viral hepatitis. In addition, few patients were identified by the national surveillance programme and presented with advanced disease precluding therapeutic or even palliative treatment.Keywords: Hepatocellular Carcinoma; Liver Cirrhosis; Human Viral Hepatitis; Public Health Surveillance; Early Detection of Cancer; Alpha-Fetoprotein; Oman