Prevalence and Correlates of Depressive Symptoms among Medical Students: a Crosssectional Single-centre Study

Background: Depressive symptoms are common among medical students. The aim of the present study was to determine the prevalence and risk factors of depressive symptoms among medical students in Sultan Qaboos University in Oman. Method: A cross-sectional study was conducted among a random sample selected from 1041 medical students at Sultan Qaboos University, Oman. The Patient Health Questionnaire-9 (PHQ-9) was used to screen for depressive symptoms. A logistic regression model was used to determine risk factors for depressive symptoms. Results: Of 197 medical students selected, 189 (61 men and 128 women) responded. The PHQ-9 results showed that the prevalence of depressive symptoms was 41.3%. In multivariate analysis, female students were more likely than male students to develop depression (adjusted odds ratio = 2.866, p = 0.004). Medical students with a family history of depression were more likely to develop depression than those without a family history of depression (adjusted odds ratio = 4.150, p = 0.014). Conclusion: Depressive symptoms are common among medical students in Sultan Qaboos University. Risk factors for depressive symptoms are female sex and family history of depression

Methylphenidate improves executive functions in patients with traumatic brain injuries : a feasibility trial via the idiographic approach

Background: Road traffic accidents are known to be the main cause of traumatic brain injury (TBI). TBI is also a leading cause of death and disability. This study, by means of the idiographic approach (single-case experimental designs using multiple-baseline designs), has examined whether methylphenidate (MPH - trade name Ritalin) had a differential effect on cognitive measures among patients with TBI with the sequel of acute and chronic post-concussion syndromes. The effect on gender was also explored. Methods: In comparison with healthy controls, patients with TBI (acute and chronic) and accompanying mild cognitive impairment (MCI) were screened for their integrity of executive functioning. Twenty-four patients exhibiting executive dysfunction (ED) were then instituted with the pharmacological intervention methylphenidate (MPH). The methylphenidate was administered using an uncontrolled, open label design. Results: The administration of methylphenidate impacted ED in the TBI group but had no effect on mood. Attenuation of ED was more apparent in the chronic phases of TBI. The effect on gender was not statistically significant with regard to the observed changes. Conclusions: To our knowledge, this is the first feasibility trial from the Arabian Gulf to report the performance of a TBI population with mild cognitive impairment according to the IQCODE Arabic version. This investigation confirms anecdotal observations of methylphenidate having the potential to attenuate cognitive impairment; particularly those functions that are critically involved in the integrity of executive functioning. The present feasibility trial should be followed by nomothetic studies such as those that adhere to the protocol of the randomized controlled trial. This evidence-based research is the foundation for intervention and future resource allocation by policy- or public health decision-makers

Predictors of Burden of Care Among Caregivers of Drug-Naive Children and Adolescents With ADHD: A Cross-Sectional Correlative Study From Muscat, Oman.

The study assessed the prevalence of burden of care among caregivers of children with ADHD in Oman. A related aim is to explore the predictors of the burden of care, subtypes of ADHD, and socio-demographic factors. Arabic version of the Zarit Burden Interview (ZBI) was administered to 117 caregivers of drug-naive children with ADHD. Sociodemographic background and clinical data were gathered from medical records and from the attending caregivers themselves. The ADHD symptoms were grouped under three categories : hyperactive, inattentive, or mixed. the prevalence of the burden of care was estimated to be 34%. Income levels and the child's ADHD diagnosis being of "mixed" type have significant impact on the burden of care. the results of this study indicate that the prevalence of the burden of care among the caregivers of ADHD children in Oman is comparable with that in the other regions of the world

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

Interaction of the Retinoblastoma Protein with Orc1 and Its Recruitment to Human Origins of DNA Replication

Background: The retinoblastoma protein (Rb) is a crucial regulator of cell cycle progression by binding with E2F transcription factor and repressing the expression of a variety of genes required for the G1-S phase transition. Methodology/Principal Findings: Here we show that Rb and E2F1 directly participate in the control of initiation of DNA replication in human HeLa, U2OS and T98G cells by specifically binding to origins of DNA replication in a cell cycle regulated manner. We show that, both in vitro and inside the cells, the largest subunit of the origin recognition complex (Orc1) specifically binds hypo-phosphorylated Rb and that this interaction is competitive with the binding of Rb to E2F1. The displacement of Rb-bound Orc1 by E2F1 at origins of DNA replication marks the progression of the G1 phase of the cell cycle toward the G1-S border. Conclusions/Significance: The participation of Rb and E2F1 in the formation of the multiprotein complex that binds origins of DNA replication in mammalian cells appears to represent an effective mechanism to couple the expression of gene

Guidelines for diagnosis and management of the cobalamin-related remethylation disorders cblC, cblD, cblE, cblF, cblG, cblJ and MTHFR deficiency

BACKGROUND: Remethylation defects are rare inherited disorders in which impaired remethylation of homocysteine to methionine leads to accumulation of homocysteine and perturbation of numerous methylation reactions. OBJECTIVE: To summarise clinical and biochemical characteristics of these severe disorders and to provide guidelines on diagnosis and management. DATA SOURCES: Review, evaluation and discussion of the medical literature (Medline, Cochrane databases) by a panel of experts on these rare diseases following the GRADE approach. KEY RECOMMENDATIONS: We strongly recommend measuring plasma total homocysteine in any patient presenting with the combination of neurological and/or visual and/or haematological symptoms, subacute spinal cord degeneration, atypical haemolytic uraemic syndrome or unexplained vascular thrombosis. We strongly recommend to initiate treatment with parenteral hydroxocobalamin without delay in any suspected remethylation disorder; it significantly improves survival and incidence of severe complications. We strongly recommend betaine treatment in individuals with MTHFR deficiency; it improves the outcome and prevents disease when given early

Elevated Peripheral Blood Eosinophils (PBE) During Acute Exacerbation of COPD (AECOPD): Prevalence and clinical significance

Objectives: An elevated peripheral blood eosinophil (PBE) count during acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is a potential predictor of treatment responsiveness and future exacerbation risk. This study aimed to evaluate the prevalence and clinical significance of elevated PBE counts in hospitalized patients with AECOPD in Oman. Methods: This single-center retrospective study included all patients with AECOPD who were admitted to Sultan Qaboos University Hospital between January 2017 and July 2019. The patients were classified as having eosinophilic or noneosinophilic AECOPD based on blood eosinophil counts. An elevated eosinophil count was defined as a blood eosinophil count > 0.3 × 109 cells/L on admission. The length of hospital stay, use of oral and inhaled steroids, number of readmissions in a year, and use of mechanical ventilation on admission were compared between the eosinophilic and non-eosinophilic AECOPD groups. Results: Of the 102 patients included in the study, 42.2% had eosinophilic AECOPD. The eosinophilic AECOPD group had a reduced length of hospital stay (P = 0.02) but an increased risk of readmission in a year (P = 0.04). Most patients in both the groups were treated with inhaled and oral steroids. The need for mechanical ventilation did not differ between the groups. Conclusion: Eosinophilia is highly prevalent in patients with AECOPD and is associated with a reduced length of hospital stay but an increased risk of readmission in a year. It can be used as a surrogate marker to predict the health outcomes of patients with AECOPD and select treatment options. Keywords: Chronic Obstructive Pulmonary disease (COPD); Eosinophils; Steroids; length of stay; hospital readmission

Risk factors underlying depressive symptoms among parents/primary care providers of kids with autism spectrum disorder: A study from Muscat, Oman

Aim To explore the prevalence and correlates of depressive symptoms among parents/primary care providers of children with autism spectrum disorder (ASD). Design and Methods A cross-sectional analytical study was conducted among a systematic random sample of parents/caregivers of children with diagnosis of ASD in Muscat, Oman. Depressive symptoms were quantified using the Patient Health Questionnaire-9. Findings The response rate was at 86% (n = 80) and the prevalence of depressive symptoms, at 71.3% (95% confidence interval, 60.5-80.1). Logistic regression analyses indicated that unemployment and being the sole parent/caregiver in the family were both significant correlates of depressive symptoms. Practice Implications With an increase in the number of children being diagnosed with ASD, multidimensional preventive and remedial service programs for parents/caregivers will be essential

Level and determinants of patient satisfaction with psychiatric out-patient services, Muscat, Oman

Recent advancements in biomedical care in Oman, a society in transition, has implied a move away from traditional methods of healing. Psychiatric services have now made their way into mainstream healthcare. However, along with the issue of social stigma, little information exists regarding satisfaction with psychiatric services in such under-researched populations. In order to lay the groundwork for an empirical approach to dispensing psychiatric services, this study aimed at measuring the level of service-related satisfaction and level of functioning among a systemic random sample of psychiatric outpatients. The second aim was to investigate the sociodemographic and clinical determinants of satisfaction across its various indices. This was a cross-sectional correlative study conducted over a 3-month period on 128 patients (18–60 years old) receiving treatment for at least six months from the psychiatric outpatient department at Sultan Qaboos University Hospital. Satisfaction was assessed by the previously well-validated Patient Satisfaction Questionnaire-18 (PSQ-18)---a self-reported measure covering domains of “general satisfaction,” “technical quality,” “interpersonal aspect,” “communication,” “financial aspect,” “time spent with the doctor,” and “accessibility and convenience.” Participants ranked “financial aspect” as providing the highest level of satisfaction, followed by “interpersonal aspect,” while “technical quality” and “accessibility and convenience” were endorsed the least. Using linear regression analysis we found that diagnosis (schizophrenia), education, and Global Assessment of Functioning (GAF) were the main predictors of the various satisfaction/dissatisfaction domains. This was the first ever study to examine the level and determinants of satisfaction among attendees at a psychiatric outpatient unit within the Arabian Peninsula. The present study could lay solid groundwork for benchmarking and quality assurance in the future