The Sinus Venosus Veno-Venous Bridge: Not a septal defect

This review provides an update on the morphology of the sinus venosus defect. It was earlier believed that a 'common wall' separated the right pulmonary veins from the superior caval vein. In the sinus venosus defects, this wall was absent. Current evidence shows that the superior rim of the oval fossa, rather than forming a second septum or representing a common wall, is an infolding between the walls of the caval veins and the right pulmonary veins. The sinus venosus defect is caused by the anomalous connection of one or more pulmonary veins to a systemic vein. However, the pulmonary vein(s) retain their left atrial connections, leading to a veno-venous bridge that allows interatrial shunting outside the oval fossa. True atrial septal defects are located within the oval fossa or in the anteo-inferior buttress, while sinus venosus defects, ostium defects and coronary sinus defects are morphologically distinct from them. Keywords: Heart Septal Defects, Atrial; Diagnostic Imaging; Sinoatrial Node; Vena Cava, Superior

PENGARUH BISING MESIN PEMARUT KELAPA DENGAN NILAI AMBANG DENGAR PEDAGANG DI PASAR TRADISIONAL KOTA JAMBI

Background : Noise Induced Hearing Loss (NIHL) is a hearing impairment resulted from noise exposure persistently. Hearing loss is the most common problem for a worker who expossed by enviromental high noise level, especially the worker in industrial society including coal mine worker, quarry (explossive, drilling), sailing, flight, textile machine and jet trial. As the result, we interested to study about does coconut shredding worker experiencing hearing loss. Objective: This study aimed to defining the effect of coconut shredder machine noise with coconut shredder hearing loss in Jambi city traditional markets. Methods : This was an observational study with cross setional approach. Twenty nine coconut shredder originate from 3 traditional market in Jambi city included in this study. Coconut shredder undergoing interview to collect demographic data, and investigator measuring the noise level from the coconut shredder machine. Subsequently, the coconut shredder worker undergoing audiometry test. Statistical analysis carried out by Fisher’s Exact test using SPSS software version 23. Result : Ten (34.5%) coconut shredder worker diagnosed by NIHL. Based on data analysis result, coconut shredder machine didn’t have significant difference  between coconut shredder worker hearing treshold (p=0.270). Conclussion: Coconut shredder machine didn’t have significant relationship with coconus shredder worker hearing treshold. Keywords: Noise, Hearing treshold, Coconut shredder machine, NIHL

Measuring supply chain complexity based on multi-criteria decision approach

This study identified twenty-two drivers that cause the complexity in supply chain. The level of such complexity is quantified by using hybrid AHP and GRA method. A case company is studied in order to demonstrate the applicability of the proposed method. The results from the case company were analyzed and it is seen that the level of supply chain complexity of the case company is 0.44, which is signifying that there is a considerable scope of improvement in terms of minimizing complexity in its supply chain. From the study outcomes, it is realized that the case company mainly needs substantial improvement on the issues of “government regulation,” “internal communication and information sharing,” and “company culture” in order to minimize the level of accompanied complexity in its supply chain.©2020 IEOM Society.fi=vertaisarvioitu|en=peerReviewed

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

Persistent Pneumothorax: Alveolar pleural fistula due to a hole in a bulla

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Thermo-economic assessment of flexible nuclear power plants in the UK’s future low-carbon electricity system: role of thermal energy storage

Nuclear power plants are commonly operated as baseload units due to their low variable costs, high investment costs and limited ability to modulate their output. The increasing penetration of intermittent renewable power will require additional flexibility from conventional generation units, in order to follow the fluctuating renewable output while guaranteeing security of energy supply. In this context, coupling nuclear reactors with thermal energy storage could ensure a more continuous and efficient operation of nuclear power plants, while at other times allowing their operation to become more flexible and cost-effective. This study considers options for upgrading a 1610-MWel nuclear power plant with the addition of a thermal energy storage system and secondary power generators. The analysed configuration allows the plant to generate up to 2130 MWel during peak load, representing an increase of 32% in nominal rated power. The gross whole-system benefits of operating the proposed configuration are quantified over several scenarios for the UK’s low-carbon electricity system. Replacing conventional with flexible nuclear plant configuration is found to generate system cost savings that are between £24.3m/yr and £88.9m/yr, with the highest benefit achieved when stored heat is fully discharged in 0.5 hours (the default case is 1 hour). At an estimated cost of added flexibility of £42.7m/yr, the proposed flexibility upgrade to a nuclear power plant appears to be economically justified for a wide range of low-carbon scenarios, provided that the number of flexible nuclear units in the system is small

Awareness and Attitude Towards the Premarital Screening Programme Among High School Students in Muscat, Oman

Objectives: This study aimed to explore high school students’ awareness and attitude towards premarital screening (PMS). Methods: This cross-sectional study was conducted in 10 public high schools in Muscat, Oman from May to July 2016. A three-part self-administered questionnaire was used to collect data from grade 12 students. The first part focused on respondents’ sociodemographic characteristics, while the second part dealt with awareness of the national PMS programme and the third part explored attitudes towards the national PMS programme. Results: A total of 1,541 participants (response rate: 91.1%) completed the questionnaire. Most participants (78.1%) were aware of the availability of the PMS programme and their main source of information was family and friends (34.3%). The majority of students (87.4%) believed that PMS is important and most students (87.2%) indicated that they would undergo PMS. Over half of the students (55.3%) agreed that PMS should be mandatory before marriage and approximately one-third (38.3%) were in favour of having laws and regulations to prevent consanguineous marriages. Females were significantly more in favour of making PMS mandatory (P = 0.002) and enforcing PMS laws (P = 0.010) compared to males. Conclusion: Most respondents had good levels of knowledge about the PMS programme and half thought it is important to be tested. However, some students were not in favour of PMS. Increasing awareness about Oman’s PMS programme is important and motivating students could contribute significantly to increasing the utilisation of the PMS programme and to limiting genetic blood disorders.Keywords: Awareness; Knowledge; Attitude; Secondary School; Students; Premarital Examinations; Genetic Carrier Screening; Oman

A Newly Detected Left Ventricular Mass Following A Complex Intracardiac Repair

Appearance of unexpected masses in the chambers of the heart during cardiac surgery can be intriguing. We report the case of a mass in the left ventricle that appeared at the time of separation from cardiopulmonary bypass in a child after a complex intracardiac repair. The child presented for surgery to a tertiary care hospital in Muscat, Oman, in 2022. Prior to the surgical repair the mass was not appreciated by echocardiography. An intraventricular baffle was used to divert left ventricular blood flow towards the outflow tract, after which an intraventricular “mass” was observed. Intraoperative transoesophageal echocardiography identified the mass as a portion of the interventricular septum that was located between the inlet and outlet ventricular septal defects. Keywords: Echocardiography; Heart Septal Defects; Heart Ventricles; Diagnostic Imaging

Sudden Cardiac Death in Patients Under 49 Years Including Adolescents: A single-centre study from Oman

Objectives: This study aimed to identify the incidence of sudden cardiac death (SCD0 in adult patients under the age of 49 years, including adolescents with an out-of-hospital cardiac arrest that presented to the emergency department of a tertiary care hospital. Methods: This retrospective cross-sectional study was conducted at the Royal Hospital, Muscat, Oman, between January 2015 and December 2019. All patients with out-of-hospital cardiac arrest were enrolled. The incidence of SCD was evaluated. Information about the patient's demographic data, the site of cardiac arrest, the mode of arrival, the duration of pre-arrest symptoms and if cardiopulmonary resuscitation was performed was gathered. Survival data at 3-year follow-up was obtained. Results: A total of 117 out of 769 (15%) patients met the criteria for SCD. Male gender was predominant, with a median age of 33 years. In about 79.5% of the patients, cardiac arrest was witnessed. Only 43 patients (36.8%) received cardiopulmonary resuscitation at the arrest site; 21 patients (17.9%) had a shockable rhythm and 96 patients (82.1%) had a non-shockable rhythm. Spontaneous circulation was returned in 15 patients (12.8%). Nine patients (7.7%) were discharged from the hospital and 8 (6.8%) survived at least 36 months. Conclusion: The study findings indicate the prevalence of SCD among patients who experienced a cardiac arrest outside the hospital. Unfortunately, only a small number of patients were able to survive in the long term. By implementing preemptive screening for individuals and their families, it may be possible to prevent SCD and improve outcomes for those affected. Keywords: Death, Sudden, Cardiac; Epidemiology; Etiology; Risk Factors; Incidence; Cardiopulmonary Resuscitation; Retrospective Studies; Oman

Problems of Electronic Commerce Applications in a Developing Country: A Descriptive Case Study of the Banking Industry of Oman

ABSTRACT Internet banking is a relatively new area and there are several issues, which have been generally untouched and are therefore open to further investigation, especially in the developing countries. Hence, this study is a step in this direction. This research has been focused on investigating to identify and highlight the main potential factors or impediments that are currently inhibiting the incorporation or adoption of Electronic Commerce (EC) applications expansion in the Omani banking sector. Data, obtained for the first time, were collected using semi-structured interviews and a survey questionnaire as well as by reviewing some bank documents. The study explores the slow uptake of EC application in the banking industry. The objectives of the research, therefore, were to identify factors enabling or inhibiting the successful adoption and use of ecommerce applications within the banking industry of Oman. The results provide a pragmatic picture of the adoption of EC applications in the country's core financial sector domain. One of its main findings is that security and privacy issues were found to be a serious inhibiting factor. Other factors such as power relationships (as conflict between managers can often emerge during the process of IS/IT adoption). Banks adopting and implementing Internet banking services and applications face several management and social problems and challenges. Although the research context is quite specific, it is believed that the findings are of relevance to other industries and other developing countries