Application of Esscher Transformed Laplace Distribution in Microarray Gene Expression Data

Microarrays allow the study of the expression profile of hundreds to thousands of genes simultaneously. These expressions could be from treated samples and the healthy controls. The Esscher transformed Laplace distribution is used to fit microarray expression data as compared to Normal and Laplace distributions. The Maximum Likelihood Estimation procedure is used to estimate the parameters of the distribution. R codes are developed to implement the estimation procedure. A simulation study is carried out to test the performance of the algorithm. AIC and BIC criterion are used to compare the distributions. It is shown that the fit of the Esscher transformed Laplace distribution is better as compared to Normal and standard Laplace distributions

The Accuracy of the Broselow™ Pediatric Emergency Tape for Weight Estimation in an Omani Paediatric Population

Objectives: This study aimed to evaluate the accuracy of the Broselow™ Pediatric Emergency Tape (BT) for estimating weight in an Omani paediatric population at a tertiary care hospital. Methods: This retrospective cross-sectional study was conducted during July 2015. The electronic medical records of Omani outpatients <14 years old attending the Sultan Qaboos University Hospital, Muscat, Oman, between July 2009 and June 2013 were reviewed for recorded height and weight data. The BT Version 2002A was used to predict weight based on actual height measurements. Predicted weight measurements were then compared with actual weight to determine the accuracy of the estimation. Results: A total of 3,339 children were included in the study, of which 43.5% were female and 56.5% were male. The mean age was 6.4 ± 3.1 years and the mean height was 93.2 ± 23.5 cm. The mean actual weight was 13.9 ± 6.7 kg while the mean BT-predicted weight was 14.4 ± 6.9 kg. The BT-predicted weight estimations correlated significantly with actual weight measurements (intraclass correlation coefficient: 0.97; P <0.001). A Bland-Altman analysis indicated that the BT performed well when estimating weight among Omani children, with an overestimation of only 0.5 kg for the entire cohort. Conclusion: The BT was found to be an effective tool for estimating weight according to body length in an Omani paediatric population. It should therefore be considered for use in emergency situations when actual weight cannot be determined

Multiple Mini-interview Consistency and Satisfactoriness for Residency Program Recruitment: Oman Evidence

Objectives: Standard interviews are used by most residency programs to assess non-cognitive skills, but variability in the interviewer’s skills, interviewer bias, and context specificity limit reliability. We sought to investigate the consistency and satisfactoriness of the multiple mini-interview (MMI) model for resident selection into an otorhinolaryngology head and neck surgery residency program. Methods: This pilot study was done in an independent academic residency training center for 15 applicants, in seven eight-minute MMI stations with eight raters for the 2015–2016 academic year. The raters included the chief resident and education committee chairman in one of the stations. Candidates were assessed on two items: medical knowledge (two standardized case scenarios) and behavioral knowledge (personality and attitude, professionalism, communication, enthusiasm to the specialty, and English proficiency). Results: Of 15 candidates, 10 (66.7%) were female and five (33.3%) were male; five were recommended for selection, and five were kept on the waiting list. The reliability, intraclass correlation coefficient (ICC), of the scores obtained from seven items of MMI was 0.36 (95% confidence interval (CI): -0.31–0.75; p = 0.110). However, the ICC of the medical interview was 0.54 (95% CI: 0.45–0.84; p = 0.090). The correlation between behavioral items score and MMI total score was r = 0.135 (p = 0.150). Conclusions: The interview evaluation/survey form given to candidates and interviewers has shown that MMI is a fair and effective tool to evaluate non-cognitive traits. Both candidates and interviewers prefer MMI to standard interviews. The MMI process for residency interviews can generate reliable interview results using only seven stations and is acceptable and preferred over standard interview modalities by residency program applicants and faculty members

Trends in prevalence and determinants of severe and moderate anaemia among women of reproductive age during the last 15 years in India

Background: Anaemia is a serious global public health problem that disproportionally affects children, adolescent girls, and women of reproductive age, especially pregnant women. Women of reproductive age are more vulnerable to anaemia, particularly severe and moderate anaemia leads to adverse outcomes among pregnant women. Despite continuous Government efforts, anaemia burden still poses a serious challenge in India. The objective of this study is to assess the trends in prevalence and determinants of severe and moderate anaemia among women of reproductive age between 15 and 49 years. Method: We used three rounds of the large-scale National Family Health Survey (NFHS) India, conducted on a representative sample of households using a cross-sectional design across the country in 2005–06, 2015–16 and 2019–2021. We included all the women aged 15 to 49 years in our analysis. We used the same haemoglobin (Hb) cut-off values for all the three rounds of surveys to ensure comparability. Generalized linear regression analyses with log link were done. Survey weights were incorporated in the analysis. Results: The prevalence of severe or moderate Anaemia (SMA) in non-pregnant women was 14.20%, 12.43% and 13.98%; it was 31.11%, 25.98% and 26.66% for pregnant women in 2006, 2016 and 2021 respectively. The decline in SMA prevalence was 1.54% in non-pregnant women, whereas it was 14.30% in pregnant women in 15 years. Women who were poor, and without any formal education had a higher risk for severe and moderate Anaemia. Conclusion: Despite the intensive anaemia control program in India, SMA has not declined appreciably in non-pregnant women during the last two decades. Despite the decline, the prevalence of SMA was about 26% in pregnant women which calls for a comprehensive review of the existing anaemia control programmes and there must be targeted programmes for the most vulnerable and high-risk women such as rural, poor and illiterate women of reproductive age to reduce the burden of anaemia among them

Feasibility of store-and-forward teledermatology in out-patient care: A prospective study from rural India utilising specialist referral services through an instant messaging platform - "WhatsApp"

Objectives: The COVID-19 pandemic has placed unprecedented demands on the delivery of health care in rural areas of India. We examined the feasibility of store-and-forward mobile teledermatology for outpatient access to specialist dermatologic care in underserved areas in India. Methods: We conducted a prospective study using smartphone-based teledermatology, connecting six underserved clinics manned by primary care physicians (PCP) to three dermatologists, using the instant messaging platform WhatsApp. We assessed the concordance between PCPs and dermatologists (using Cohen’s kappa coefficient), consultation time, the spectrum of conditions, and the outcome. Results: Of the 730 dermatology patients screened in the clinics, (13%) (36 males and 59 females) required teleconsultation, among which 61.1% were non-infective, 34.7% were infective, and the diagnosis could not be ascertained in 4.2 %. The mean time takenwas 13.5 (± 18.4) minutes. Twenty per cent (n=19) required referral, and 80% (n=76) of consultations could be resolved at the clinic, of whom 36.8 % were cured, 38.2% had moderate, 4% had minimal improvement, 13% were lost to follow-up, and 8% refused treatment. Cure was observed in viral infections and eczema. The diagnostic concordance ranged from low values [0.38 (95% CI: 0-0.68)] in infective to moderate [0.66 (95% CI: 0.42-0.83), p=0.033] in non-infective disorders. Conclusion: Asynchronous mobile teledermatology, using specialist referral via instant messaging platforms, is a powerful modality for providing real-time dermatologic care, while offering a very promising alternative for decreasing healthcare disparities and continuity of services even in adverse situations like the Covid-19 pandemic

Randomised open-label trial of docosahexaenoic acid-enriched fish oil and fish meal on cognitive and behavioural functioning in Omani children

Objective: Examine the effect of docosahexaenoic acid (DHA) enriched fish oil supplement and fish meal on cognitive and behavioural functioning manifested as attention-deficit/hyperactivity disorder in primary school students (9-10 years old) in Muscat, Oman. Methods: Randomised open-label trial involving two types of intervention: fish oil supplement or one serving (100 gram) of fish per weekday for 12 weeks. Red cell total lipid docosahexaenoic acid levels were assessed. Verbal Fluency Test, Buschke Selective Reminding Test, and Trail Making Test were used to measure cognitive functioning. Behavioural functioning was assessed using a standardised Arabic version of the National Initiative for Children’s Health Quality Vanderbilt Assessment Scales. All measurements were carried out before and after intervention. Results: DHA levels increased by 72% and 64% in fish oil (Mean: 3.6% to 6.2%) and fish meal (Mean: 3.4% to 5.6%) group, respectively (p=0.000). The Trail Making Test was the only cognitive test that demonstrated marked differences between groups: median inter-quartile range difference between pre and post intervention in the Trail Making Part B score was 61.5 (SE: 19.3, 103.2) in the fish oil vs. Fish meal group, 24.5 (SE: -15.2, 74.7, p=0.005). The Vanderbilt Assessment Scales also showed significant differences between groups (p<0.001). Conclusion: This study contributes to available evidence on the cognitive and behavioural benefits of DHA in healthy school children. Consideration should be made to expand the food fortification programme as part of broader policy to improve child health

The Prevalence and Characteristics of Frequent Attenders in Primary Health Care in A'Dakhiliyah Governorate of Oman

Objectives: Frequent attenders (FAs) in general practice receive significant attention in primary care research due to the financial costs associated with the higher utilization of health care services. The main objective of this study was to determine the prevalence of FAs in Oman by studying the overall rates of adult patient visits to primary health care centers (PHCs) and identify the characteristics of this group of patients. Methods: We conducted a retrospective longitudinal study including all adults aged 18 years and above who visited general practitioner clinics at four selected PHCs in the A'Dakhiliyah governorate of Oman. Sociodemographic data and number of visits were extracted from the electronic medical records system. Results: A total number of 12 902 adult patients contributed to 42 425 patient visits, with the number of visits made by individual patients ranging from 1 to 62. FAs constituted 2.4% (n = 313) of the total subjects and made 5449 (12.8%) visits. The mean rate of visits per patient per year was 3.2, while the median was two visits. The overall rate of visits per day was more than two-times higher in females (79.6 per day) compared to males (36.6 per day) and was about five-times higher in female FA (12.3 vs. 2.6). Conclusions: FAs represent a small proportion of patients attending PHCs in Oman. The proportion of females was higher among FAs and they also contributed to a higher number of visits to PHCs

Effects of an Adenotonsillectomy on the Cognitive and Behavioural Function of Children Who Snore: A naturalistic observational study

Objectives: This study aimed to evaluate cognitive and behavioural changes among 9–14-year-old Omani children with obstructive sleep apnoea (OSA) after an adenotonsillectomy (AT). Methods: This naturalistic observational study was conducted at the Sultan Qaboos University Hospital, Muscat, Oman, between January 2012 and December 2014. Omani children with adenotonsillar hypertrophy (ATH) underwent overnight polysomnography and those with confirmed OSA were scheduled for an AT. Cognitive and behavioural evaluations were performed using standardised instruments at baseline prior to the procedure and three months afterwards. Results: A total of 37 children were included in the study, of which 24 (65%) were male and 13 (35%) were female. The mean age of the males was 11.4 ± 1.9 years, while that of the females was 11.1 ± 1.5 years. Following the AT, there was a significant reduction of 56% in mean apnoea-hypopnoea index (AHI) score (2.36 ± 4.88 versus 5.37 ± 7.17; P <0.01). There was also a significant positive reduction in OSA indices, including oxygen desaturation index (78%), number of desaturations (68%) and number of obstructive apnoea incidents (74%; P <0.01 each). Significant improvements were noted in neurocognitive function, including attention/concentration (42%), verbal fluency (92%), learning/recall (38%), executive function (52%) and general intellectual ability (33%; P <0.01 each). There was a significant decrease of 21% in both mean inattention and hyperactivity scores (P <0.01 each). Conclusion: These results demonstrate the effectiveness of an AT in improving cognitive function and attention deficit hyperactivity disorder-like symptoms among children with ATH-caused OSA. Such changes can be observed as early as three months after the procedure. Keywords: Adenoidectomy; Obstructive Sleep Apnea; Cognitive Function; Behavior; Attention Deficit Hyperactivity Disorders; Children; Oman

Attention deficit hyperactivity disorder and parental factors in school children aged nine to ten years in urban regions of Oman

Objectives: The objectives of this study were to determine the prevalence of attention deficit hyperactivity disorder (ADHD) and specific parental risk factors that may contribute to the development of ADHD. Methods: The study was conducted in Oman among fourth-grade students (aged nine to 10 years). A standardized Arabic version of the National Initiative for Children’s Health Quality Vanderbilt Assessment Scale (Teachers questionnaire) was used to determine the presence of ADHD. Specific parental factors such as socioeconomic status, education and occupation were documented. Results: The prevalence rate of ADHD was 8.8%. Parental factors were significantly associated with increased risk of ADHD; including poor maternal education status, low familial socioeconomic status, and paternal occupation. Conclusions: This was the first study that examined familial and parental characteristics of children with ADHD as potential risk factors for the condition. Such psychosocial factors could be employed to further the development of more proficient preventative measures and remedial services