Optimal aquifers and reservoirs for CCS and EOR in the Kingdom of Saudi Arabia : An overview

Peer reviewedPublisher PD

Patients’ Perceptions of Communication and Clinical Skills of Primary Healthcare Physicians in Oman

ABSTRACT: Objectives: As a large proportion of patients are seen in primary healthcare (PHC) centres, it is important to explore patients’ perceptions of communication and clinical skills of PHC physicians. In Oman, PHC is provided by both trained family physicians (FPs) and general practitioners (GPs). Methods: This crosssectional study was conducted at 12 PHC centres in Muscat Governorate, Oman between November 2014 and August 2015. Adult Omani patients’ perceptions of Omani and other Arabic-speaking doctors were examined using an Arabic translation of a validated self-administered questionnaire. Results: A total of 626 patients completed the questionnaire (response rate: 100%). The patients’ responses were significantly more positive towards FPs compared to GPs on whether the doctor provided reassurance (P = 0.03), took a complete medical history (P = 0.03) and gave the patient the opportunity of a follow-up with the same doctor (P = 0.01). Conclusion: Certain skills in communication and clinical aspects of FPs were favourably viewed by patients compared to GPs.Keywords: Patient Satisfaction; Physicians, Primary Health Care; Communication; Clinical Competence; Quality of Health Care; Oman

The Transcription Factor OVOL2 Represses ID2 and Drives Differentiation of Trophoblast Stem Cells and Placental Development in Mice

Trophoblasts are the first cell type to be specified during embryogenesis, and they are essential for placental morphogenesis and function. Trophoblast stem (TS) cells are the progenitor cells for all trophoblast lineages; control of TS cell differentiation into distinct trophoblast subtypes is not well understood. Mice lacking the transcription factor OVO-like 2 (OVOL2) fail to produce a functioning placenta, and die around embryonic day 10.5, suggesting that OVOL2 may be critical for trophoblast development. Therefore, our objective was to determine the role of OVOL2 in mouse TS cell fate. We found that OVOL2 was highly expressed in mouse placenta and differentiating TS cells. Placentas and TS cells lacking OVOL2 showed poor trophoblast differentiation potential, including increased expression of stem-state associated genes (Eomes, Esrrb, Id2) and decreased levels of differentiation-associated transcripts (Gcm1, Tpbpa, Prl3b1, Syna). Ectopic OVOL2 expression in TS cells elicited precocious differentiation. OVOL2 bound proximate to the gene encoding inhibitor of differentiation 2 (ID2), a dominant negative helix-loop-helix protein, and directly repressed its activity. Overexpression of ID2 was sufficient to reinforce the TS cell stem state. Our findings reveal a critical role of OVOL2 as a regulator of TS cell differentiation and placental development, in-part by coordinating repression of ID2

Evaluation of antidepressant activity of ondansetron alone and in combination with fluoxetine-an experimental study

Background: Direct antagonism at 5HT3 receptor site may be associated with antidepressant activity as conventional antidepressants also possess affinity for central 5HT3 binding site. So in this study, an effort is made to investigate the antidepressant effect of ondansetron (OND), a selective 5HT3 antagonist, alone and in combination with fluoxetine (FLX).Methods: Acute and chronic models of Forced swimming test (FST), tail suspension test (TST), open field test (OFT) and mice brain serotonin estimation  by UV spectrophotometry were applied for the evaluation of antidepressant activity.Results: In FST and TST (acute and chronic models), ondansetron showed statistically significant antidepressant activity (p<0.05) as compared to control. The combination groups (OND 0.25 mg/kg + FLX 5mg/kg & OND 0.5 mg/kg + FLX 5 mg/kg) showed statistically significant antidepressant activity (p<0.05) as compared to fluoxetine (5 mg/kg) and ondansetron (0.25 mg/kg and 0.5 mg/kg) in FST and TST (acute and chronic models). Open field test in chronic study showed ondansetron (0.25 mg/kg and 0.5 mg/kg) increases number of central squares crossed as compared to control which is statistically significant (p<0.05). The combination group (OND 0.25 mg/kg + FLX 5 mg/kg) showed significantly increased (p<0.05) number of central squares crossed as compared to fluoxetine (5 mg/kg). The combination group (OND 0.5 mg/kg + FLX 5 mg/kg) showed significantly increased (p<0.05) brain serotonin compared to control, ondansetron (0.25 mg/kg and 0.5 mg/kg) and fluoxetine (5 mg/kg).Conclusions: Our study concludes that ondansetron alone and in combination with fluoxetine possesses significant antidepressant activity in animal models of depression

A study on the clinico-epidemiological profile and the outcome of snake bite cases in the tertiary care hospital

Background: Snake bite is a common medical emergency and an occupational hazard in India. It is also a major public health issue in rural India where farming is a major source of employment. Very few studies describe epidemiology of snake bite from India. Hence, this study was planned to collect information on various aspects of snake bite in a tertiary care hospital.Methods: A prospective observational study of 167 patients of snake bite and unknown bite carried out from September 1, 2012 to August 31, 2013.Results: Among a total 167 cases, majority were males (54.49%), aged between 20 and 40 years (38.92%). Most of the cases were laborers (61.67%) and farmers (17.36%). Peak incidence was observed during monsoon (64.67%). Bite mark was seen in 46.70% cases, upper extremity being common site (52.09%). Most cases were of vasculotoxic bite (65.26%) and few were of neurotoxic bite (19.76%). Major complications were respiratory failure (4.79%) and acute renal failure (1.8%). Average bite to needle time was 365 min. Bleeding & clotting time was raised in 44.03% & 35.19% cases, respectively. Average dose of anti-snake venom (ASV) required was 17.1 vials. Allergic reactions to ASV observed in 8.38% cases. Mean duration of hospital stay was 4.3 days. Recovery rate was 94.01% with three cases referred to higher center. Mortality rate was 2.39%.Conclusions: Our study highlights various aspect of snake bite cases and tries to find out ways to improve quality of life of patients, decrease mortality and morbidity and decrease economic burden on society

Urinary Incontinence Among Omani Women: Prevalence, risk factors and impact on quality of life

Objectives: Urinary incontinence (UI) in women is a common health problem which can have a negative impact on quality of life (QOL). This study aimed to determine the prevalence, risk factors and impact of UI on the QOL of Omani women attending primary healthcare centres in Muscat, Oman. Methods: This crosssectional study was conducted at three primary healthcare centres in Muscat from April to August 2018. Women who were 20–50 years of age, not pregnant, not in the six-month postnatal period, not seriously ill and not diagnosed with pelvic organ prolapse were included. A self-administered questionnaire using the International Consultation Incontinence Questionnaire-Short Form was used to evaluate the frequency, severity and impact of UI on QOL. Results: A total of 1,070 women were included in this study (response rate = 92.5%). The mean age was 31.39 ± 7.64 years. UI was reported by 369 (34.5%) women, of whom 182 (49.3%) had stress UI, 97 (26.3%) had urgency UI, 88 (23.8%) had mixed UI and two (0.5%) had other UI. Age, body mass index (BMI), having been married or employed, hypertension, cough, constipation and vaginal or assisted vaginal delivery during the previous birth were significant risk factors for UI. Only 41 (11.1%) out of the 369 women with UI had ever sought medical advice despite the fact that more than two thirds of the women with UI reported negative effects on their QOL. Conclusion: UI is a common medical problem in Oman. Several risk factors, including age and BMI, were identified. Despite its negative consequences for QOL, women were found to be reluctant to seek medical attention for the condition.Keywords: Urinary Incontinence; Prevalence; Risk Factors; Quality of Life; Oman

Evaluation of antidepressant activity of tramadol in mice: an experimental study

Background: In spite of availability of effective antidepressant drugs, depression continues to be a major problem. Hence, great interest is being taken in development of innovative antidepressants. Tramadol (TRM) is a centrally acting opioid agonist, which is clinically effective in the treatment of moderate to severe pain. By virtue of its action of inhibiting norepinephrine and serotonin uptake, it can function as an antidepressant like venlafaxine. Hence, this study was planned to evaluate antidepressant activity of TRM in comparison and in combination with fluoxetine (FLX) in albino mice.Methods: TRM (20 and 40 mg) and FLX (20 mg) were administered i.p., alone and in combination once daily for acute (7 days) and chronic (14 days) period to Swiss albino mice of either sex. The immobility period of control and treated mice was recorded in forced swimming test (FST) and tail suspension test (TST). The open field test was also done for same period to test the locomotor activity in animal. The antidepressant effect of TRM was compared with FLX and normal saline treated group for acute and chronic study period.Results: TRM (20 and 40 mg) treated group produced significant antidepressant effect alone and in combination with FLX (20 and 40 mg) as indicated by reduction in immobility period compared with control group in FST and TST. TRM and FLX treated groups did not show significant activity in open field test when compared with control group.Conclusions: This study shows TRM has antidepressant activity in standard models of depression

Timely use of anti-snake venom improves maternal and fetal outcome: a case report

Snake bite is a common medical emergency and an occupational hazard in a rural population of India. Though it is uncommon in pregnancy, it is associated with poor maternal and fetal outcome. Early gestational age and delay in the treatment are the factors responsible for unfavorable prognosis. Here, we report a case of primigravida, aged 22 years, with 22 weeks of gestation presenting with a history of snake bite on the left frontal region of the face. While on anti-snake venom treatment, patient developed anaphylactic reaction. In spite of this, the maternal and the fetal outcome were good in this case

Study of evaluation of anti-inflammatory activity of macrolide antibiotics in rats: an experimental study

Background: Inflammation is a complex and dynamic condition in which many changes take place at the site of inflammation, as well as systemically. In general, inflammatory response acts to protect the host, but many times it goes unchecked with tissue destruction leading to a spectrum of inflammatory disorders. Anti-inflammatory drugs have long been used to treat spectrum of inflammatory conditions. Anti-inflammatory agents, in use today, though have efficacy, cause a variety of side effects causing major problems during their clinical use. Amongst newer approaches to treat inflammation, macrolides, the anti-bacterial agents, seem to be beneficial in decreasing the inflammation. Still there is much speculation about the anti-inflammatory activity of macrolide antibiotics. So, we planned this study to assess anti-inflammatory activity of macrolide antibiotics (erythromycin, roxithromycin, azithromycin, and clarithromycin) and to compare their anti-inflammatory activity with control and indomethacin (standard non-steroidal anti-inflammatory drugs).Methods: To assess anti-inflammatory activity of macrolides, we used acute (carrageenin-induced paw edema and turpentine oil-induced arthritis), as well as chronic model of inflammation (cotton pellet induced granuloma).Results: All the macrolides, i.e., erythromycin, roxithromycin, azithromycin and clarithromycin showed significant (p<0.05) anti-inflammatory activity in acute models of inflammation as compared to control group. However, macrolides showed insignificant activity as compared to indomethacin (acute and chronic models of inflammation) and as compared to control (chronic model of inflammation).Conclusions: This study shows macrolide antibiotics have anti-inflammatory activity in animal models of acute inflammation

Carbamazepine induced toxic epidermal necrolysis in a patient of seizure disorder

Toxic epidermal necrolysis (TEN), also known as Lyell's syndrome, is a widespread life-threatening mucocutaneous disease where there is extensive detachment of the skin and mucous membrane. Many factors are involved in the aetiology of TEN, the most common being the adverse drug reactions. Here we report a case of TEN in a 12 year old female child who presented with fever and blisters all over her body after taking carbamazepine for uncontrolled generalised tonic-clonic seizure. This case has been reported to highlight the importance of using carbamazepine cautiously as this case shows the “probable” association between carbamazepine and TEN, which is a life threatening condition