Knowledge Regarding Secondary Prevention Lifestyle Practices Among Patients with Ischaemic Heart Disease in Oman : Pilot study

Objectives: Secondary prevention of ischaemic heart disease (IHD) is very important. This study aimed to assess knowledge of necessary lifestyle changes among Omani patients diagnosed with IHD. Methods: This cross-sectional pilot study took place between October 2015 and February 2016 at the Sultan Qaboos University Hospital (SQUH), Muscat, Oman. A total of 30 random patients with IHD from the Cardiology Outpatient Clinic of SQUH were included. A 30-item survey was used to determine patients’ knowledge of necessary lifestyle practices following their IHD diagnosis, with scores of <70% indicating poor knowledge. Results: Overall, 21 patients (70.0%) had low knowledge levels. Scores ranged from 38.9−94.4% (mean: 60.7% ± 14.1%). No demographic factors were found to predict low scores, although there were some differences in individual questions. Conclusion: Low knowledge levels regarding lifestyle changes were observed among IHD patients in Oman. More efforts should be made to educate these patients for the secondary prevention of IHD

Semi-Parametric Method to Estimate the Time-to-Failure Distribution and its Percentiles for Simple Linear Degradation Model

Most reliability studies obtained reliability information by using degradation measurements over time, which contains useful data about the product reliability. Parametric methods like the maximum likelihood (ML) estimator and the ordinary least square (OLS) estimator are used widely to estimate the time-to-failure distribution and its percentiles. In this article, we estimate the time-to-failure distribution and its percentiles by using a semi-parametric estimator that assumes the parametric function to have a half- normal distribution or an exponential distribution. The performance of the semi-parametric estimator is compared via simulation study with the ML and OLS estimators by using the mean square error and length of the 95% bootstrap confidence interval as the basis criteria of the comparison. An application to real data is given. In general, if there are assumptions on the random effect parameter, the ML estimator is the best; otherwise the kernel semi- parametric estimator with half-normal distribution is the best

The Identification of Pompe Disease Mutations in Archival Tissues and Development of a Rapid Molecular-based Test

Objectives: Pompe disease (glycogen storage disease type II) is a rare autosomal recessive lysosomal storage disease that is caused by acid alpha-glucosidase deficiency. Early enzyme replacement therapy can benefit infants with the disease but the diagnosis is complicated by the rarity of the disease and the heterogeneity of the clinical manifestations. In this study, DNA extracted from archival postmortem formalin-fixed paraffin-embedded tissues was used to identify Pompe disease mutations in Oman and develop a rapid molecular-based test. Methods: Intronic primers were designed to amplify short fragments (193–454 base pairs [bp]) from coding exons (2–20) and screen for mutations using direct sequencing (DS). Results: Two mutations known to cause severe disease were identified in two infants. One was a coding mutation, c.2560C>T (p.Arg854X), and the second was found at a splice acceptor site, c.1327-2A>G. Polymerase chain reaction- and restriction fragment length polymorphism-based tests were designed for the rapid genotyping of the identified mutations. Conclusion: These tests can facilitate prenatal diagnosis and help in identifying carriers in families with the identified mutations

Characterisation of Nicotine and Cancer-Enhancing Anions in the Common Smokeless Tobacco Afzal in Oman

Objectives: Afzal is a common smokeless tobacco product (STP) available illegally in Oman. This study aimed to assess pH and moisture levels and determine cancer-enhancing factors in a randomly selected sample of Afzal. Methods: This study was carried out at the Sultan Qaboos University in Muscat, Oman, between April and December 2013. A package of Afzal was purchased from a single provider and divided into samples. The pH and moisture content of the samples were measured according to the protocols of the Centers for Disease Control and Prevention. Gas chromatography-mass spectrometry was used to analyse nicotine levels and ionexchange chromatography (IC) was used to determine concentrations of nitrate, nitrite, chloride, fluoride, bromide, sulphate and phosphate anions. Results: The samples had an alkaline pH of 10.46 with high levels of total (48,770.00 μg per g of STP [μg/g]) and unionised (48,590.00 μg/g) nicotine. The concentration of nitrate (8,792.20 μg/g) was alarmingly high. The chloride concentration (33,170.80 μg/g) showed a surge on IC chromatography. The moisture content percentage was 52.00%. Conclusion: The moisture content percentage and chloride concentration of Afzal was consistent with those of other STPs. In contrast, nitrite, sulphate and phosphate concentrations were below reported levels of other STPs. All anion concentrations were below the maximum daily limit set by international health organisations. However, the high concentrations of nitrite, nitrate and nicotine and the elevated alkaline pH observed in the analysed Afzal samples suggest that STP users will face health risks as a result of their use

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

Evaluation of a task-based community oriented teaching model in family medicine for undergraduate medical students in Iraq

BACKGROUND: The inclusion of family medicine in medical school curricula is essential for producing competent general practitioners. The aim of this study is to evaluate a task-based, community oriented teaching model of family medicine for undergraduate students in Iraqi medical schools. METHODS: An innovative training model in family medicine was developed based upon tasks regularly performed by family physicians providing health care services at the Primary Health Care Centre (PHCC) in Mosul, Iraq. Participants were medical students enrolled in their final clinical year. Students were assigned to one of two groups. The implementation group (28 students) was exposed to the experimental model and the control group (56 students) received the standard teaching curriculum. The study took place at the Mosul College of Medicine and at the Al-Hadba PHCC in Mosul, Iraq, during the academic year 1999–2000. Pre- and post-exposure evaluations comparing the intervention group with the control group were conducted using a variety of assessment tools. RESULTS: The primary endpoints were improvement in knowledge of family medicine and development of essential performance skills. Results showed that the implementation group experienced a significant increase in knowledge and performance skills after exposure to the model and in comparison with the control group. Assessment of the model by participating students revealed a high degree of satisfaction with the planning, organization, and implementation of the intervention activities. Students also highly rated the relevancy of the intervention for future work. CONCLUSION: A model on PHCC training in family medicine is essential for all Iraqi medical schools. The model is to be implemented by various relevant departments until Departments of Family medicine are established

Endocytic uptake, transport and macromolecular interactions of anionic PAMAM dendrimers within lung tissue

Purpose: Polyamidoamine (PAMAM) dendrimers are a promising class of nanocarrier with applications in both small and large molecule drug delivery. Here we report a comprehensive evaluation of the uptake and transport pathways that contribute to the lung disposition of dendrimers. Methods: Anionic PAMAM dendrimers and control dextran probes were applied to an isolated perfused rat lung (IPRL) model and lung epithelial monolayers. Endocytosis pathways were examined in primary alveolar epithelial cultures by confocal microscopy. Molecular interactions of dendrimers with protein and lipid lung fluid components were studied using small angle neutron scattering (SANS). Results: Dendrimers were absorbed across the intact lung via a passive, size-dependent transport pathway at rates slower than dextrans of similar molecular sizes. SANS investigations of concentration-dependent PAMAM transport in the IPRL confirmed no aggregation of PAMAMs with either albumin or dipalmitoylphosphatidylcholine lung lining fluid components. Distinct endocytic compartments were identified within primary alveolar epithelial cells and their functionality in the rapid uptake of fluorescent dendrimers and model macromolecular probes was confirmed by co-localisation studies. Conclusions: PAMAM dendrimers display favourable lung biocompatibility but modest lung to blood absorption kinetics. These data support the investigation of dendrimer-based carriers for controlled-release drug delivery to the deep lung

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020