A national survey to estimate sodium and potassium intake, and knowledge attitudes and behaviours towards salt consumption of adults in the Sultanate of Oman

Objectives. To estimate population sodium and potassium intakes, and explore knowledge, attitudes and behaviour (KAB) towards the use of salt in adults in the Sultanate of Oman. Design. National cross-sectional population-based survey. Setting. Proportional random samples, representative of Omani adults (18 years or older), were obtained from all Governorates of the Sultanate of Oman. Participants. Five hundred and sixty-nine (193 men, 376 women; 18 years or older) were included in the analysis (response rate 57%). Mean age was 39.4 years (SD 13.1). Participants attended a screening including demographic, anthropometric and physical measurements. Primary and secondary outcome measures. We assessed dietary sodium, potassium and creatinine by 24h urinary sodium (UNa), potassium (UK) and creatinine (UCr) excretions. We collected KAB by a questionnaire on an electronic tablet. Results. Mean UNa was 144.3 (78.8) mmoL/day, equivalent to 9.0 g of salt/day and potassium excretion 52.6 (32.6) mmoL/day, equivalent to 2.36 g/day, after adjusting for non-urinary losses. Men ate significantly more sodium and potassium than women. Only 22% of the sample had a salt intake below the World Health Organization (WHO) recommended target of 5 g/day and less than 10% met WHO targets for potassium excretion (>90 mmoL/day). Whilst 89.1% of those interviewed knew that consuming too much salt could cause serious health problems and only 6.9% felt they were using too much added salt, 1 in 2 participants used always or often salt, salty seasonings or salty sauces in cooking or when preparing food at home. Conclusions. In the Sultanate of Oman, salt consumption is higher, and potassium consumption lower, than recommended by WHO, both in men and in women. The present data provides, for the first time, evidence to support a national programme of population salt reduction to prevent the increasing burden of CVD in the area

Predictive value of computed tomography-based diagnosis of intracranial tuberculomas

The need to obtain histological diagnoses of intracranial tuberculomas, before initiating therapy, is not universally accepted, because some clinicians believe that an image-based diagnosis is fairly accurate in patients from endemic regions. To evaluate the sensitivity, specificity, and predictive value of computed tomography (CT)-based diagnosis of an intracranial tuberculoma, we prospectively compared the preoperative imaging diagnoses with histological diagnoses in 105 consecutive patients with intracranial masses. CT differential diagnoses (first or second) of tuberculomas were considered in 21 patients. Seven of them were histologically confirmed to have tuberculomas (true-positive results); 14 had other diseases (false-positive results). The 14 false-positive cases included 6 cases of astrocytomas, 5 of metastases, and 3 with miscellaneous diagnoses. All tuberculomas were correctly diagnosed on the CT scans (5 by both surgeons and 2 by one surgeon). During the study period, we encountered 11 patients who were referred by other clinicians with diagnoses of tuberculomas on the basis of their CT scans. We concurred with their CT diagnoses in 5 of them, but only 1 patient had a histologically verified tuberculoma. Astrocytomas (4 patients), metastases (3 patients), and solitary cysticercus granulomas (3 patients) were the causes of misdiagnosis in this group of patients. Although the sensitivity of CT in the diagnosis of intracranial tuberculomas is 100%, and its specificity is 85.7%, the positive predictive value is only 33% (confidence limits, 24-42%). The negative predictive value is 100%. The low positive predictive value for a diagnosis of intracranial tuberculoma on CT alone indicates the need for a confirming histological diagnosis

Incidence, prevalence, clinical features, and outcomes of COVID-19 in persons with cystic fibrosis: a systematic review protocol

OBJECTIVE: The objective of this review is to determine the incidence and prevalence, clinical features, and outcomes of COVID-19 in persons with cystic fibrosis. INTRODUCTION: Cystic fibrosis, predominantly a chronic respiratory illness, has long been known to be fatal with concomitant bacterial or viral infections. Consequently, the effects of COVID-19 on this protracted disease need to be understood, especially since the major manifestations affect the respiratory system. Hence, this review aims to examine the burden, clinical features, and outcomes of COVID-19 on individuals with cystic fibrosis. INCLUSION CRITERIA: This review will consider studies of persons in all age groups with preexisting cystic fibrosis who are diagnosed with COVID-19 using either a polymerase chain reaction, serology, or point-of-care test for SARS-CoV-2. Eligible studies will report the incidence, prevalence, clinical features, or outcomes of COVID-19 in individuals with cystic fibrosis. Studies in community or health care settings from any geographic location will be considered. METHODS: The JBI methodology for systematic reviews of prevalence and incidence will be used for this review. A methodical search for eligible studies in English (as well as available translations) in MEDLINE, Embase, Scopus, and CINAHL, and unpublished literature in Google Scholar, Dissertation Abstracts International, ProQuest Dissertations and Theses, and MedNar will be conducted from the year 2020 onwards. Studies meeting the inclusion criteria will be selected for appraisal and their methodological quality will be assessed by two independent reviewers based on study titles and abstracts, followed by full-text review focusing on sampling and statistical analysis. Data extraction will be accomplished using a standardized tool. If adequate synthesized data are obtained, a meta-analysis will be conducted; otherwise, the findings will be presented in narrative format, including tables and figures to aid in data presentation. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42021237792

Oman Vision 2050 for Health Research: A Strategic Plan for the Future Based on the Past and Present Experience

Health care delivery in Oman has attained great heights since the modern renaissance in 1970. Although the health service had the main impetus all these years, the importance of health research began to take place by mid 1990’s and is now gaining momentum as an important responsibility and activity of the Ministry of Health (MoH). Although there has been progressively increasing investment and commitment to research activities in the recent Five Year Plan for Health Development, it still lags behind in the quality and quantity of research output. Lack of factors like adequate infrastructure, dedicated human resources, empowerment of existing systems, and societal support for research have adversely affected research output. Centre of Studies and Research in MoH has proposed a strategic plan, the ‘Health Vision 2050 for Health Research’ with aim of making Oman the regional leader and a research hub of world standards in health research. The mission is to promote, facilitate, and conduct high quality health research addressing national health priorities to improve health care services and enhance the efficiency and effectiveness of the health system, reduce health inequity, and contribute to socioeconomic development. The strategy includes setting health research priorities, strengthening the health research capacity, defining and implementing norms and standards, developing health research (quality and quantity), translating evidence into policy, strategy and practice, monitoring and coordinating research, financing health research, and evaluating the effectiveness of the health research system. It should generate a multifold increase in the quality and quantity of health research in Oman, positively impacting the health system and health care service

A novel multiplex real-time PCR for the detection of Salmonella Typhi, Salmonella Paratyphi A and Burkholderia pseudomallei in clinical samples

Enteric fever, caused by infection with Salmonella Typhi or Paratyphi A, B, or C (typhoidal Salmonella) and melioidosis are among the most common bacterial causes of acute febrile illness in tropical and subtropical countries. The diseases are widely spread even in developed countries mainly affecting travellers returning from endemic areas. Melioidosis is an increasingly recognized fatal septicemic infection also mimicking tuberculosis. These pathogens are largely underreported due to lack of sensitive and specific diagnostic tools. In this study, an inhouse multiplex real-time PCR assay was developed for the simultaneous detection of Salmonella Typhi, S. Paratyphi A and B. pseudomallei using specific primers. The inhouse developed assay was evaluated on buffy coat and serum samples collected from patients with acute febrile illness at four different centres. The assay had a detection limit of less than 1 genome copy for S. Typhi and S. Paratyphi A and 18 genome copies per 10 µl of PCR input for B. pseudomallei. Among the 1101 samples tested by multiplex real-time PCR, one (0.09%) sample was positive for S. Typhi. One sample was positive for blood culture identified as S. Typhi but negative by real-time PCR. The samples were negative for S. Paratyphi A and B. pseudomallei. The multiplex real-time assay would be highly useful as a diagnostic aid for the syndromic approach and comprehensive diagnosis of enteric fever and melioidosis. The assay could improve the overall diagnostic capability and be a useful tool during outbreak investigations