Effects of an Adenotonsillectomy on the Cognitive and Behavioural Function of Children Who Snore: A naturalistic observational study

Objectives: This study aimed to evaluate cognitive and behavioural changes among 9–14-year-old Omani children with obstructive sleep apnoea (OSA) after an adenotonsillectomy (AT). Methods: This naturalistic observational study was conducted at the Sultan Qaboos University Hospital, Muscat, Oman, between January 2012 and December 2014. Omani children with adenotonsillar hypertrophy (ATH) underwent overnight polysomnography and those with confirmed OSA were scheduled for an AT. Cognitive and behavioural evaluations were performed using standardised instruments at baseline prior to the procedure and three months afterwards. Results: A total of 37 children were included in the study, of which 24 (65%) were male and 13 (35%) were female. The mean age of the males was 11.4 ± 1.9 years, while that of the females was 11.1 ± 1.5 years. Following the AT, there was a significant reduction of 56% in mean apnoea-hypopnoea index (AHI) score (2.36 ± 4.88 versus 5.37 ± 7.17; P <0.01). There was also a significant positive reduction in OSA indices, including oxygen desaturation index (78%), number of desaturations (68%) and number of obstructive apnoea incidents (74%; P <0.01 each). Significant improvements were noted in neurocognitive function, including attention/concentration (42%), verbal fluency (92%), learning/recall (38%), executive function (52%) and general intellectual ability (33%; P <0.01 each). There was a significant decrease of 21% in both mean inattention and hyperactivity scores (P <0.01 each). Conclusion: These results demonstrate the effectiveness of an AT in improving cognitive function and attention deficit hyperactivity disorder-like symptoms among children with ATH-caused OSA. Such changes can be observed as early as three months after the procedure. Keywords: Adenoidectomy; Obstructive Sleep Apnea; Cognitive Function; Behavior; Attention Deficit Hyperactivity Disorders; Children; Oman

Impact of Initial Population Density of the Dubas Bug, Ommatissus lybicus (Hemiptera: Tropiduchidae), on Oviposition Behaviour, Chlorophyll, Biomass and Nutritional Response of Date Palm (Phoenix dactylifera)

The Dubas bug (Ommatissus lybicus) is an economically significant pest of date palms. In this study, the effect of the population density of O. lybicus on chlorophyll, measured by the soil plant analysis development (SPAD) chlorophyll meter, palm biomass, and the nutritional composition of date palms, were investigated. A further objective was to determine significant relationships between the population density of O. lybicus, the number of honeydew droplets, and oviposited eggs. Reductions of up to 8–11% and 29–34% in chlorophyll content and plant biomass, respectively, were caused by infestations exceeding 300 nymphs per palm seedling. Increasing the population density of O. lybicus to 600 insects per palm decreased oviposition by females, suggesting intraspecific competition for resources. There was a significant relationship between honeydew droplets produced by the pest population and chlorophyll content in the rachis, suggesting that treatment can be triggered at 3–6 nymphs/leaflet. Egg oviposition was preferentially on the rachis. Ca, Mg, K, and P were the main nutrients affected by the activity of the pest. Mg content was associated with reduced chlorophyll content under increasing pest density, suggesting that supplemental nutrition can be potentially utilized to sustain chlorophyll and increase palm tolerance to pest infestation

Date Value Chain Analysis, Development, and Competitiveness of Date Palm Products in the Sultanate of Oman

This paper considers the vision of how to develop an efficient value chain and development strategies to improve the value chain in Oman. The main key factors of inclusive and sustainable development of the date value chain are determined to carry out the appropriate actions for improving the date palm sector in Oman. To explore the challenges and opportunities leading to the improvement of the marketing, commercialization, and competitiveness of dates and date palm products in this country, an analytical tool guideline (SWOT) was framed. Such analysis is useful to raise awareness to create policies for improved marketing of dates. Based on the SWOT analysis, the diversification of date varieties, and orientation toward modern plantations are the most important strengths of the date value chain. However, the increasing competition in regional and global date markets is the major threat to the date sector in Oman. There is a good possibility to promote the date processing industry in Oman given the rising demand for fresh and processed dates in national and international markets. A profitable and competitive date palm sector could be achieved by focusing on high yield and commercial varieties to ensure higher date palm productivity and the orientation toward adoption of quality standards to meet international market demand

IMPACT AND BIOLOGICAL CONTROL OF OMMATISSUS LYBICUS DE BERGEVIN (HEMIPTERA: TROPIDUCHIDAE) ON DATE PALM (PHOENIX DACTYLIFERA L.)

The dubas bug, Ommatissus lybicus De Bergevin (Hemiptera: Tropiduchidae), is a piercing-sucking insect species of significant economic importance. The insect attacks date palms (Phoenix dactylifera L.), consuming phloem sap and producing large volumes of honeydew on crop leaves. The deposited honeydew on leaves results in dust accumulation and secondary growth of sooty moulds, which are likely to reduce photosynthesis. Both adults and nymphs cause damage to the palms, with the females also causing necrosis to the palm tissue through oviposition. Major efforts are made every year to control this pest in Oman using repeated applications of insecticides on more than twenty thousand acres infested with O. lybicus. Despite these applications, control has been inconsistent and more research are needed to develop more sustainable and environmentally safe control strategies. The aim of this study was to quantify the effects of O. lybicus on date palm growth and to identify and develop biological control measures using native and commercial entomopathogenic fungi. The effect of different infestation levels of O. lybicus on chlorophyll, date palm biomass, and date palm nutritional composition were investigated. Initial infestations of O. lybicus nymphs exceeding 300 nymphs per palm seedling caused a reduction in palm chlorophyll of up to 40% and plant biomass of 29-34%. Ommatissus lybicus populations of more than 600 insects per palm reduced oviposition by females, possibly due to intraspecific competition over resources. Honeydew droplets showed significant association with chlorophyll content or eggs oviposited on the rachis, which suggests that control can be performed at 3-6 nymphs/leaflet. The pest activities affected the palm nutrients Mg, Ca, P, and K. Magnesium content in palms was associated with chlorophyll reduction as O. lybicus density increased. To investigate the abundance, diversity, and distribution of local entomopathogenic fungi (EPF) in Omani soils, a survey was conducted using the Galleria bait method. The obtained EPF with high sporulation and growth rate were further characterized for their optimal temperature, and infection potential against O. lybicus adults was assessed using scanning electron microscopy (SEM). Fungal species known to be biological agents against insects were identified from 46 isolates collected through this survey and belonged to five genera, Metarhizium spp., Beauveria bassiana, Clonostachys spp., Fusarium spp., and Aspergillus spp. along with five entomopathogenic nematode species that were identified as Acrobeloides saeedi, Oscheius tipulae, Pratylenchus goodeyi, Heterorhabditis indica, and Mesorhabditis sp. In vitro, B. bassiana and M. quizhouense were able to grow and sporulate at temperatures between 25°C and 35°C. Clonostachys rosea had rapid growth on O. lybicus adult cuticle and was first seen after 2 hours post inoculation (hpi). Beauveria bassiana was the most effective fungi against O. lybicus adults, with a 93.4% mortality rate within 3 days post inoculation (dpi). To evaluate the efficacy of native and commercial entomopathogenic fungi control of O.lybicus, four native fungal pathogen isolates, Clonostachys rosea, Metarhizium guizhouense and Beauveria bassiana and Metarhizium anisopliae together with three commercial products, Bio-Power B. bassiana, Bio-Catch Verticillium lecanii, and Botanigard 22WP B. bassiana strain GHA were evaluated for their pathogenicity against O. lybicus eggs, nymphs, and adults. The insects were hosted in Petri dishes and palm seedlings. Furthermore, two fungi M. anisopliae and B. bassiana, were evaluated against the O. lybicus adults under different relative humidity treatments. The highest death rate was achieved by B. bassiana with 76.7% mortality at the adult stage of O. lybicus after 2 weeks of inoculation. The best formulated fungi against O. lybicus nymphs and adults was Botanigard 22WP with a 90.8% and 84.2% mortality rate at the 1st and 2nd instars, and 100% mortality rate at the 3rd, 4th, 5th, and adult stages after 7 dpi. Ommatissus lybicus egg hatching was significantly reduced by Botanigard 22WP and C. rosea with 75.8% and 74.7% unhatched eggs, respectively. Ommatissus lybicus adults inoculated with two native fungi B. bassiana and M. anisopliae had a significantly higher mortality rate of 100% when incubated at a relative humidity of 50% and above. This study showed a promising biological control alternative against O. lybicus as part of Integrated Pest Management (IPM)

Ortner’s syndrome: Cardiovocal syndrome caused by aortic arch ps

72-year-old hypertensive presented with two weeks history of left sided chest pain and hoarseness. Workup demonstrated a pseudoaneurysm in the lesser curvature of the distal aortic arch opposite the origin of the left subclavian artery from a penetrating atherosclerotic ulcer. Following a left carotid-subclavian bypass, endovascular stenting of the aorta was performed excluding the pseudoaneurysm. Patient had excellent angiographic results post-stenting. Follow up at 12 weeks demonstrated complete resolution of his symptoms and good stent position with no endo-leak. Ortner’s syndrome describes vocal changes caused by cardiovascular pathology. It should be included in the differential diagnosis of patients with cardiovascular risk factors presenting with hoarseness. This case demonstrates the use of endovascular stents to treat the causative pathology with resolution of symptoms. In expert hands, it represents low risk, minimally invasive therapeutic strategy with excellent early results in patients who are high risk for open procedure

Impact of Initial Population Density of the Dubas Bug, <i>Ommatissus lybicus</i> (Hemiptera: Tropiduchidae), on Oviposition Behaviour, Chlorophyll, Biomass and Nutritional Response of Date Palm (<i>Phoenix dactylifera</i>)

The Dubas bug (Ommatissus lybicus) is an economically significant pest of date palms. In this study, the effect of the population density of O. lybicus on chlorophyll, measured by the soil plant analysis development (SPAD) chlorophyll meter, palm biomass, and the nutritional composition of date palms, were investigated. A further objective was to determine significant relationships between the population density of O. lybicus, the number of honeydew droplets, and oviposited eggs. Reductions of up to 8–11% and 29–34% in chlorophyll content and plant biomass, respectively, were caused by infestations exceeding 300 nymphs per palm seedling. Increasing the population density of O. lybicus to 600 insects per palm decreased oviposition by females, suggesting intraspecific competition for resources. There was a significant relationship between honeydew droplets produced by the pest population and chlorophyll content in the rachis, suggesting that treatment can be triggered at 3–6 nymphs/leaflet. Egg oviposition was preferentially on the rachis. Ca, Mg, K, and P were the main nutrients affected by the activity of the pest. Mg content was associated with reduced chlorophyll content under increasing pest density, suggesting that supplemental nutrition can be potentially utilized to sustain chlorophyll and increase palm tolerance to pest infestation