Non-steroidal Anti-inflammatory Drugs (NSAIDs) Use in Primary Health Care Centers in A’Seeb, Muscat: A Clinical Audit

Objective: We sought to assess the trend of non-steroidal anti-inflammatory drug (NSAID) use in primary health care institutions located in A’Seeb, a province in the capital city of Oman, Muscat. Additionally, we evaluated the relationship between a physician’s years of experience and the number of prescription issued, as well as the presence of risk factors and side effects in the patients who received these prescriptions. Method: A clinical audit was conducted in four primary health care centers in the Muscat region over a one-week period in April 2014. The target population included patients aged 18 years or over who attended one of the four health centers and were prescribed NSAIDs. Overall, 272 patients were recruited by systematic random sampling. The data were collected by two methods: direct face-to-face interviews and evaluations of the patient’s electronic medical file. The prescribing doctors were blind to the audit. The collected information included patients demographics, past and current medical history of related comorbidities, NSAID type, dose, duration and indications for use, concomitant warfarin or/and aspirin prescriptions, and co-prescription of gastroprotective agents. Results: In total, 15% of patients received an NSAID prescription: females were issued more prescriptions than males. The percentage of patients who received an NSAID prescription across the health centers ranged from 9% to 24%. The main reason for prescribing NSAIDs was musculoskeletal problems. The most frequently prescribed NSAID was ibuprofen. Sixteen percent of patients who received an NSAID prescription had a risk factor related to its use. The mean and median duration of the NSAID prescriptions of all types were 5.6 and 5.0 days, respectively. Physicians with a greater number of years experience prescribed more NSAIDs. Conclusion: Our study showed that the number of prescriptions of NSAIDs among various institutes varied, which could reflect the level of awareness concerning NSAID risks among the prescribing doctors. NSAIDs were prescribed for patients with comorbidities and patients with previously documented side effects without considering protective agents. Therefore, we suggest that the use of these medications is controlled, especially in high-risk populations

Prevalence of restless legs syndrome in pregnant women in Oman and its effect on pregnancy and neonatal outcomes

BACKGROUND: Restless legs syndrome (RLS) is a common sensorimotor disorder during pregnancy. The purpose of this study was to assess the prevalence of RLS and explore the associated risk factors and outcomes in Omani women in the first and third trimester and at 2-week postpartum. MATERIALS AND METHODS: This cross-sectional study included 305 pregnant women visiting four health centers in Muscat between May 2018 and October 2020. A structured questionnaire was used and data were collected through review of electronic records and face-to-face interviews. The International RLS Study Group criteria were used to diagnose RLS. Participants were interviewed during their first trimester, their third trimester, and at their 2-week postpartum visit. Results were presented as means and standard deviations or percentages, as appropriate. To assess the association between RLS and various variables, unpaired t-test or McNemar's test were used, as appropriate. RESULTS: The mean age at baseline was 29.8 ± 5.28 years. The prevalence of RLS was significantly higher in the third trimester (41.0%) than in the first trimester (15.7%) and postpartum period (15.1%) (P < 0.001), although there was no significant difference in severity. Family history and personal history of RLS were the only independent correlates of RLS (P < 0.001 and 0.002, respectively). No associations were noted with pregnancy and neonatal outcomes or other comorbidities, including anemia. However, there was a significant relationship between the development of RLS and weight gain during pregnancy (P = 0.023). CONCLUSION: One in six pregnant Omani women may be at risk of RLS during the first trimester, while one in 2–3 may be at risk in the third trimester, particularly those with a personal or family history of RLS and those who gain >12 kg during pregnancy

The Effect of Obesity on Pregnancy and its Outcome in the Population of Oman, Seeb Province

Objectives: The World Health Organization estimated that in 2011 worldwide 1.6 billion adults were overweight, and 400 million were obese. The obesity epidemic is a documented phenomenon and Oman is no exception. The aim of this study was to determine the effect of obesity on pregnancy and its prenatal and neonatal outcomes. Methods: A prospective cohort study was carried out among pregnant Omani women attending antenatal clinics in their first trimester in the Seeb province of Muscat, Oman. Results: A total of 700 pregnant women were enrolled in the study and were categorized according to their body mass index: 245 (35%) were normal weight, 217 (31%) were overweight, and 238 (34%) were obese. The relative risk (RR) of cesarean section among obese women compared to women of normal weight was 2.1 (95% confidence interval (CI) 1.2–3.2) and of overweight women was 1.4 (95% CI 0.9–2.3). The risk of elective cesarean section increased to 7.5 (95% CI 1.7–32.8) in obese women and was statistically significant in the obese group. In this study, 100 women (15.7%) developed gestational diabetes (11.8% of normal weight women, 17.8% of overweight women, and 17.9% of obese women). Miscarriages were more common among obese women 11.9% (n = 27) compared to the normal weight and overweight groups (6.7% and 9.4%, respectively). There was a weak yet statistically significant correlation between birth weight and body mass index. The risk of macrosomia was significantly higher in obese women compared to normal weight women. To evaluate the sensitivity of the oral glucose challenge test (OGCT), the oral glucose tolerance test (OGTT) was measured in 203 participants (29%) who had a normal OGCT result. It was found that 14.5% of overweight women and 13.5% of normal weight women had an abnormal OGTT result even when their OGCT result was normal.  Conclusions: Obesity is associated with an increased risk of cesarean section (especially elective cesarean), gestational hypertension, macrosomia, and miscarriage. It also increases the risk of gestational diabetes