Sickle Cell Anaemia, A Study from the Capital Area of Oman

One hundred and six Omani children with sickle cell anaemia (SCA) aged between 10 months and 16 years were studied by reviewing their medical notes and following their clinical course. All the cases were diagnosed on clinical presentation. Eighty-five percent were diagnosed below the age of 3 years. The clinical presentations and complications were compared with studies from Saudi Arabia and some other tropical countries. The frequency of hospitalization due to the complications of the disease is higher than that reported in other parts of Arabian Peninsula. The incidence of serious complications such as vasoocclusive, aplastic, hemolytic and sequestration crisis were high (91%, 1.9%, 59%, 6.7% respectively). Infection is more frequent. However, pneumococci were not the commonest isolated organism. G6PD deficiency was reported in 32% of cases which might explain the higher incidence of hemolytic crisis. Our study shows that SCA has a severe clinical course in Omanis. Because of the intermarriage of Omanis with Africans and Arabs, the nature of the SCA gene needs to be identified in this population. Bahrain Med Bull 1995;17: Sickle cell anaemia SCA is prevalent throughout many parts of the world particularly in tropical Africa, the Middle East, the Mediterranean and parts of India and America 1,2 . This disease constitutes one of the most frequent causes of hospitalization of children in Oman. The purpose of this study was to evaluate the epidemiology and clinical presentation of SCA in Omani children. ------------------------------------------------------------ METHODS The study represented a combined retrospective and prospective studies of all of 106 children with SCA seen at the outpatient clinics and/or admitted to the Royal and Sultan Qaboos University Hospitals in Muscat, the capital of Oman during 1992. The medical records of the patients were reviewed for the clinical presentations, complications and laboratory investigations. Routine hematological parameters were measured on a Coulter counter model S plus. Sickledex screening test (Ortho diagnostics) was used for sickle screening. Hemoglobin electrophoresis was done for all sickle cell positive samples using Gelman agarose gel at pH 8.6 (barbitone buffer) and scanning of the electrophoretic strip. Hemoglobin S and Hemoglobin F were quantified on the scanner 3 . It was not possible to rule out sickle cell/beta thalassemia with absolute certainty as globin chain synthesis could not be done at that time. However all patients with SCA with low MCV and/or high hemoglobin A2 had the diagnosis confirmed by family study. Glucose-6-phosphate dehydrogenase (G6PD

Impact of Aberrant Myeloid Antigen Expression on Outcomes of Patients with T-cell Acute Lymphoblastic Leukemia

Objectives: To evaluate the impact of myeloid antigen expression on complete remission (CR), event-free survival (EFS), and overall survival (OS) in patients with T-cell acute lymphoblastic leukemia (T-ALL) treated with intensive chemotherapy. Methods: We retrospectively reviewed consecutive patients diagnosed with T-ALL and treated in Sultan Qaboos University Hospital and Royal Hospital in Oman between 2004 and 2010. The diagnosis of T-ALL was established using French-American-British classification or World Health Organization criteria. Patients were considered having myeloid antigen expression if they expressed CD13, CD33, or both (My+ and My–). Results: Of the 39 patients, 38 were included in the study (25 patients with My– and median age of 18.4 years, 13 patients with My+ and median age of 22.0 years). Median follow-up was 12 months. Thirty-two out of the total cohort were eligible for response-rate assessment. Twenty-nine patients (90.6%) achieved CR with one or two courses of chemotherapy with similar CR rates between the two groups (p = 0.880). Twenty-five percent (5/20) of the patients with My– required two courses of induction, whereas 58.3% (7/12) of My+ required two courses of induction and the difference was statistically significant (p = 0.040). In the multivariable analysis; age, gender, initial white blood cell count, central nervous system disease, and myeloid antigen expression were not statistically significant predictors of CR. The EFS and OS were similar between the My+ and My– groups p = 0.180 and p = 0.440, respectively. Conclusions: Patients with T-ALL with myeloid antigen expression need more courses of induction; however, rates of CR, EFS, and OS are not different from those without myeloid antigen expression. Larger prospective studies are required to confirm these findings

Diabesity in the Arabian Gulf: Challenges and Opportunities

Diabesity (diabetes associated with obesity) is a major global and local public health concern, which has almost reached an epidemic order of magnitude in the countries of the Arabian Gulf and worldwide. We sought to review the lifestyle trends in this region and to highlight the challenges and opportunities that health care professionals face and attempt to address and correct them. In this regard, we aimed to review the regional data and widely held expert opinions in the Arabian Gulf and provide a thematic review of the size of the problem of diabesity and its risk factors, challenges, and opportunities. We also wished to delineate the barriers to health promotion, disease prevention, and identify social customs contributing to these challenges. Lastly, we wished to address specific problems with particular relevance to the region such as minimal exercise and unhealthy nutrition, concerns during pregnancy, the subject of childhood obesity, the impact of Ramadan fasting, and the expanding role of bariatric surgery. Finally, general recommendations for prevention, evidence-based, and culturally competent management strategies are presented to be considered at the levels of the individual, community, and policymakers