Burnout Syndrome Among Primary Care Physicians in Oman

Objectives: Medical professionals are exposed to many job stressors everyday, which can lead to psychological disturbances as well as burnout syndrome. We sought to assess the level of burnout among primary care physicians (PCPs) in Oman and explore risk factors for its development. Methods: We conducted a cross-sectional, analytical study among a random cluster sample of 190 PCP working in Muscat, Oman. Indices of burnout (emotional exhaustion (EE), depersonalization (DP) and personal accomplishment (PA)) were noted using the Maslach Burnout Inventory-Human Services Survey (MBIHSS). We also used a questionnaire to obtain sociodemographic and job characteristics data. We used a binary logistic regression model and both unadjusted and adjusted odds ratios for statistical analysis. Results: The prevalence of burnout in all three dimensions was 6.3%. High levels of MBI-HSS subscales were reported on EE, DP and PA with 17.8%, 38.2%, and 21.5%, respectively. Logistic regression analysis revealed that working over 40 hours per week was the most important risk factor for burnout among PCPs. Conclusions: A total of 6.3% of PCPs working in urban areas in Oman suffered burnout. Long working hours was strongly associated with high occupational burnout. Solutions to eliminate or decrease the rate of burnout involve institutional changes, primarily respecting weekly working hours, and in more severe cases psychotherapy help is very important

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

Wet-Cupping's Impact on Pancreatitis Induced by Hypertriglyceridemia: A case study and brief literature review

Familial hypertriglyceridemia is a genetic disorder marked by excessive production of very low-density lipoproteins, resulting in elevated serum triglyceride levels. This can lead to various medical conditions, including acute pancreatitis. In cases of recurrence, it may progress to chronic pancreatitis. Cupping therapy, a traditional treatment practiced in numerous cultures worldwide, is utilized to address various medical conditions. This case report presents a 34-year-old male diagnosed with familial hypertriglyceridemia, subsequently developing chronic pancreatitis. During his last presentation with acute-on-chronic pancreatitis, his lipid profile revealed a notable reduction in serum triglycerides. Interestingly, this reduction coincided with the introduction of cupping therapy into his treatment regimen. Remarkably, following the initiation of cupping therapy, his hospital admissions for acute pancreatitis notably decreased. This case report highlights the potential impact of cupping therapy on familial hypertriglyceridemia, potentially mitigating the risk of acute pancreatitis. Keywords: Hyperlipidemia; Hypertriglyceridemia; Pancreatitis

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

Serine Protease Variants Encoded by Echis ocellatus Venom Gland cDNA: Cloning and Sequencing Analysis

Envenoming by Echis saw-scaled viper is the leading cause of death and morbidity in Africa due to snake bite. Despite its medical importance, there have been few investigations into the toxin composition of the venom of this viper. Here, we report the cloning of cDNA sequences encoding four groups or isoforms of the haemostasis-disruptive Serine protease proteins (SPs) from the venom glands of Echis ocellatus. All these SP sequences encoded the cysteine residues scaffold that form the 6-disulphide bonds responsible for the characteristic tertiary structure of venom serine proteases. All the Echis ocellatus EoSP groups showed varying degrees of sequence similarity to published viper venom SPs. However, these groups also showed marked intercluster sequence conservation across them which were significantly different from that of previously published viper SPs. Because viper venom SPs exhibit a high degree of sequence similarity and yet exert profoundly different effects on the mammalian haemostatic system, no attempt was made to assign functionality to the new Echis ocellatus EoSPs on the basis of sequence alone. The extraordinary level of interspecific and intergeneric sequence conservation exhibited by the Echis ocellatus EoSPs and analogous serine proteases from other viper species leads us to speculate that antibodies to representative molecules should neutralise (that we will exploit, by epidermal DNA immunization) the biological function of this important group of venom toxins in vipers that are distributed throughout Africa, the Middle East, and the Indian subcontinent

Health professionals’ perceptions about physical activity promotion in diabetes care within primary health care settings in Oman

Background: As part of formative work to inform an interventional design to increase physical activity (PA) in patients with type 2 diabetes in Oman, this qualitative study aimed to determine health professionals’ perception of barriers and opportunities, personnel responsibilities and plausible PA promotional approaches. Methods: Four focus group discussions were carried out with groups of health care professionals (family physicians, dieticians and health educators, managers and general practitioners). All discussions were audio recorded and transcribed. Responses were analysed using a thematic analysis. Results: Barriers to PA reported by participants (n = 29) were identified at three levels: health care system (e.g. deficient PA guidelines); individual (e.g. obstructive social norms) and community (e.g. lack of facilities). Participants felt that a multilevel approach is needed to address perceived barriers and to widen current opportunities. In the presence of various diabetes primary care providers, the potential for dieticians to include individualised PA consultations as part of their role was highlighted. Participants felt that consultations should be augmented by approaches within the community (volunteer support and/or appropriate facilities). However, despite lack of experience with technology supported approaches and motivational tools, the telephone application “WhatsApp” and use of pedometers were considered potentially suitable. The need for training in behaviour change techniques and clearly communicated intervention guidelines was emphasised. Conclusions: A multi-component approach including PA consultations, possibly led by trained dieticians, technological routes for providing support along with community mapping for resources appear to offer promising approaches for further PA intervention studies within diabetes primary health care

Determinants of Contraceptive Practice in Oman by Using Multilevel Modeling

In this paper, multilevel logistic regression models are developed for examining the hierarchical effects of contraceptive use and its selected determinants in Oman using the 2008 Oman National Reproductive Health Survey (ONRHS). Comparison between single level and multilevel logistic regression models has been made to examine the plausibility of multilevel effects of contraceptive use. From the multilevel logistic regression model analysis, it was found that there is real multilevel variation among contraceptive users in Oman. The results indicate that a multilevel logistic regression model is the best fit over ordinary multiple logistic regression models. Generally, this study revealed that women’s age, education, number of living children and region of residence are important factors that affect contraceptive use in Oman. The effect of regional variation for age of women, education of women and number of living children further implies that there exists considerable differences in modern contraceptive use among regions, and a model with a random coefficient or slope is more appropriate to explain the regional variation than a model with fixed coefficients or without random effects. The study suggests that researchers should use multilevel models rather than traditional regression methods when their data structure is hierarchal

Evaluation of the Intestinal Bacterial Community of Local Omani and Cobb 500 Broiler Chickens Raised in an Open-Sided House Using 16S rDNA-Based Analysis

Little is known about how the intestinal bacterial microbiota differs among different strains of chickens raised in an open sided house, predominantly those with lower growth rates, such as Indigenous chickens. Ninety-one-day-old chicks of each strain of chickens were raised in an open-sided house system and fed a conventional corn-soybean meal diet from Day 0–35 days of age. The objective of this study was to assess the relative abundance of bacteria microbiota identified in the intestinal tract of local Omani and Cobb 500 broiler chickens raised in an open-sided house system using 16S rDNA-based analysis. The results obtained showed the diversity of bacterial populations in different intestinal regions of two chicken strains. Bacilli were found in higher numbers and reached 98.8% of the bacteria in the duodenum on Day 5 in Cobb 500 versus 72.5% in the Omani chickens. Local Omani chickens had significantly higher numbers of Clostridia at an early age period. On Day 5 Clostridia comprised 13.1% of the bacteria in the duodenum of local Omani chickens, versus only 0.062% in the Cobb 500. The relative abundance of the bacterial microbiota differed significantly (p <0.05) across different intestinal segments of the two strains of chickens, suggesting that each region generated its bacterial community with different relative abundances