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

Attention deficit hyperactivity disorder and parental factors in school children aged nine to ten years in urban regions of Oman

Objectives: The objectives of this study were to determine the prevalence of attention deficit hyperactivity disorder (ADHD) and specific parental risk factors that may contribute to the development of ADHD. Methods: The study was conducted in Oman among fourth-grade students (aged nine to 10 years). A standardized Arabic version of the National Initiative for Children’s Health Quality Vanderbilt Assessment Scale (Teachers questionnaire) was used to determine the presence of ADHD. Specific parental factors such as socioeconomic status, education and occupation were documented. Results: The prevalence rate of ADHD was 8.8%. Parental factors were significantly associated with increased risk of ADHD; including poor maternal education status, low familial socioeconomic status, and paternal occupation. Conclusions: This was the first study that examined familial and parental characteristics of children with ADHD as potential risk factors for the condition. Such psychosocial factors could be employed to further the development of more proficient preventative measures and remedial services

Methylphenidate improves executive functions in patients with traumatic brain injuries : a feasibility trial via the idiographic approach

Background: Road traffic accidents are known to be the main cause of traumatic brain injury (TBI). TBI is also a leading cause of death and disability. This study, by means of the idiographic approach (single-case experimental designs using multiple-baseline designs), has examined whether methylphenidate (MPH - trade name Ritalin) had a differential effect on cognitive measures among patients with TBI with the sequel of acute and chronic post-concussion syndromes. The effect on gender was also explored. Methods: In comparison with healthy controls, patients with TBI (acute and chronic) and accompanying mild cognitive impairment (MCI) were screened for their integrity of executive functioning. Twenty-four patients exhibiting executive dysfunction (ED) were then instituted with the pharmacological intervention methylphenidate (MPH). The methylphenidate was administered using an uncontrolled, open label design. Results: The administration of methylphenidate impacted ED in the TBI group but had no effect on mood. Attenuation of ED was more apparent in the chronic phases of TBI. The effect on gender was not statistically significant with regard to the observed changes. Conclusions: To our knowledge, this is the first feasibility trial from the Arabian Gulf to report the performance of a TBI population with mild cognitive impairment according to the IQCODE Arabic version. This investigation confirms anecdotal observations of methylphenidate having the potential to attenuate cognitive impairment; particularly those functions that are critically involved in the integrity of executive functioning. The present feasibility trial should be followed by nomothetic studies such as those that adhere to the protocol of the randomized controlled trial. This evidence-based research is the foundation for intervention and future resource allocation by policy- or public health decision-makers

Cognitive Profiles in Patients with Multi-Infarct Dementia: An Omani Study

Background: Studies on neurocognitive impairment among patients presenting with multi-infarct dementia (MID) have received little attention from non-Western societies, and the Arab world is no exception. To our knowledge, this is the first study to characterize neurocognitive, affective and vegetative functioning in patients with MID in Oman. Methods: In this study, we recruited 20 Omani patients presenting with MID and age- and gender-matched controls at the outpatient clinic of the Department of Behavioral Medicine, Sultan Qaboos University Hospital, Sultan Qaboos University, Muscat, Oman. In addition to the collection of clinical and demographic information, various cognitive batteries were administered to the consenting participants, including those indexing nonverbal reasoning abilities, working memory (attention, concentration and recall) and executive functioning. Questionnaires that elicit the affective range and the quality of sleep were also administered. Results: Compared with the matched healthy subjects, the patients diagnosed with MID significantly differed in the presently operationalized indices of visuospatial function, semantic memory and affective and vegetative functioning. In contrast, episodic memory and some attentional capacities were not significantly different compared with the control subjects. Conclusions: The present study was explorative and clinically designed to describe neurocognitive functioning in patients with MID seeking consultation at a tertiary care center in Oman. Our data are necessary for planning and setting up community services and health care programs for demented patients in a society where dementia is a growing silent epidemic. © 2014 S. Karger AG, Base

Socio-demographic characteristics and clinical profile of suicide attempters attending the Emergency Department at a Tertiary Care Hospital in Oman: a retrospective study

Objective: This study examined socio-demographic and clinical characteristics of individuals who attended the emergency department (Muscat, Oman) following a suicide attempt. Methods: A retrospective study (n= 154) was conducted between January 2015 and June 2018. Information accrued included socio-demographic variables (age, nationality, sex, marital status, and occupation), risk (medical co-morbidities, psychiatric history, substance misuse, alcohol consumption, and previous history of suicide attempts), and precipitating factors, as well as the chosen methods of the suicide attempt. Result: 83.1% were Omanis and women constituted 69.5% of the sample with a mean age of 27 years. 40.9% of the sample had a history of psychiatric disorders. 30% were students, and 42% were unemployed. Family conflict, suffering from chronic illness, and having social problems were the most common precipitating factors for the suicide attempt. The most common method used in the suicide attempt was drug overdose (48.1%) and mainly paracetamol (40%). Significant gender differences emerged to precipitating factors, a history of substance misuse, and methods of suicide. Conclusion: The present data aligns with international trends that suggest that women and younger age groups are the most vulnerable to suicide attempts. Although in its infancy, the present research’s findings could lay the groundwork for preventative interventions and programs

An Evaluation of the Effectiveness of Repetitive Transcranial Magnetic Stimulation (rTMS) for the Management of Treatment-Resistant Depression with Somatic Attributes: A Hospital-Based Study in Oman

Depressive illnesses in non-Western societies are often masked by somatic attributes that are sometimes impervious to pharmacological agents. This study explores the effectiveness of repetitive transcranial magnetic stimulation (rTMS) for people experiencing treatment-resistant depression (TRD) accompanied by physical symptoms. Data were obtained from a prospective study conducted among patients with TRD and some somatic manifestations who underwent 20 sessions of rTMS intervention from January to June 2020. The Hamilton Rating Scale for Depression (HAMD) was used for clinical evaluation. Data were analysed using descriptive and inferential techniques (multiple logistic regression) in SPSS. Among the 49 participants (mean age: 42.5 ± 13.3), there was a significant reduction in posttreatment HAMD scores compared to baseline (t = 10.819, p < 0.0001, and 95% CI = 8.574–12.488), indicating a clinical response. Approximately 37% of the patients responded to treatment, with higher response rates among men and those who remained in urban areas, had a history of alcohol use, and were subjected to the standard 10 HZ protocol. After adjusting for all extraneous variables, the rTMS protocol emerged as the only significant predictor of response to the rTMS intervention. To our knowledge, this is the first study to examine the effectiveness of rTMS in the treatment of somatic depression

The characteristics and patterns of utilization of healthcare services among Omanis with substance use disorders attending therapy for cessation.

BACKGROUND:It is indicated that Oman is witnessing an increase in issues pertinent to alcohol and psychoactive substance use. AIM:The aim of this study was to identify the characteristics of Omanis with substance use disorder attending a specialized hospital in Oman and the pattern of their utilization of healthcare services. A related aim was to ascertain the age group most vulnerable to alcohol and substance use in Oman. METHOD:A cross-sectional study was conducted in a tertiary care center specialized for treatment of those engaging in substance use in Oman. The participants in the study were selected from a convenience sample among patients seeking consultation at the center for alcohol and substance use. A six-part questionnaire was designed to obtain information regarding socio-demographic background, clinical history, healthcare utilization and perceived hurdles to access. Chi-square analyses were used to evaluate the significance of differences among categorical data. Logistic regression modelling was used to obtain measures of association after adjusting for confounding factors. RESULTS:Among the patients (n = 293) seeking cessation therapy, 99% were male and less than 30 years of age. Peer influences on the initiation of substance use were significant. Most patients had a history of polysubstance use, including intravenous substance use. Cannabis and alcohol were the first substances consumed by most patients and Hepatitis C and psychiatric disorders were found to be the most common co-morbidities. The participants that reported use of cannabis and benzodiazepines were more likely to perceive "improvement" upon receiving treatment. CONCLUSION:This study indicated that males below 30 years of age with a history of polysubstance use were likely to attend a hospital specialized in treating substance use disorder in Oman. This study identified information regarding socio-demographic background, risk factors and perceived hurdles to healthcare that could serve as groundwork for further studies conducted on newly emerging issues of substance use in Oman

The relation between emotional eating and perceived stress among students in tertiary education in Oman: a single-center study

Objectives: Preliminary studies suggested that the high rates of stress are increasingly prevalent in students in tertiary education in the Arabian Gulf countries and that their emotional eating is often triggered by stress. Nevertheless, there is a dearth of studies on this topic and Oman is no exception. In this study, we intended to examine the prevalence of emotional eating and perceived stress in Omani college students and to clarify the relationship between their emotional eating and sociodemographic and risk factors among the population in the college students in Oman. Methods: We used Salzburg Emotional Eating Scale and Perceived Stress Scale to assess emotional eating and variations in perceived stress, respectively. We also study their sociodemographic and risk factors. Results: A total of 422 students took part in the study, with the age of 20.6 ± 1.8 (mean ± standard deviation) years. Of all students, 85.8% (n = 362) were reported to have emotional eating and 78.7% of the sample were reported to experience stress. The multivariate logistic analysis showed that body mass index (BMI) and the student’s major subjects were the significant risk factors. Students who majored in science/engineering/agriculture (odds ratio [OR] = 0.926, p < 0.001) and arts/business/law were 3.1 times (OR = 3.115, p < 0.05) and 2.3 times (OR = 2.347, p < 0.05) were significantly engaged in emotional eating as compared to those majoring in medicine/nursing. Students who are underweight (BMI < 18) were 3.9 times (OR = 3.984, p < 0.05) were also significantly more to engage in emotional eating than those students who were overweight/obese (BMI 25+). Conclusion: In this study, we found that both rates of emotional eating and stress were high among college students in Oman. Contrary to international trends, underweight students (BMI < 18) were more prone to engaging in emotional eating than overweight/obese students (BMI 25+) in our study sample. This suggests that there is likely to be subcultural diversity or artifacts that are intimately tied to emotional eating. More studies on this discrepant finding are warranted

Attention Deficit Hyperactivity Disorder and Parental Factors in School Children Aged Nine to Ten Years in Muscat, Oman

Objectives: The objectives of this study were to determine the prevalence of attention deficit hyperactivity disorder (ADHD) and specific parental risk factors that may contribute to the development of ADHD in children. Methods: The study was conducted in Oman among fourth-grade students (aged nine to 10 years). A standardized Arabic version of the National Initiative for Children’s Health Quality Vanderbilt Assessment Scale (Teachers questionnaire) was used to determine the presence of ADHD. Parental factors such as socioeconomic status, education, and occupation were documented. Results: The prevalence rate of ADHD was 8.8%. Poor maternal education status, low familial socioeconomic status, and paternal occupation were significantly associated with an increased risk of ADHD. Conclusions: This was the first study that examined familial and parental characteristics of children with ADHD as potential risk factors for the condition. Such psychosocial factors could be employed to further the development of more proficient preventative measures and remedial services

Methylphenidate improves executive functions in patients with traumatic brain injuries: a feasibility trial via the idiographic approach

Background Road traffic accidents are known to be the main cause of traumatic brain injury (TBI). TBI is also a leading cause of death and disability. This study, by means of the idiographic approach (single-case experimental designs using multiple-baseline designs), has examined whether methylphenidate (MPH - trade name Ritalin) had a differential effect on cognitive measures among patients with TBI with the sequel of acute and chronic post-concussion syndromes. The effect on gender was also explored. Methods In comparison with healthy controls, patients with TBI (acute and chronic) and accompanying mild cognitive impairment (MCI) were screened for their integrity of executive functioning. Twenty-four patients exhibiting executive dysfunction (ED) were then instituted with the pharmacological intervention methylphenidate (MPH). The methylphenidate was administered using an uncontrolled, open label design. Results The administration of methylphenidate impacted ED in the TBI group but had no effect on mood. Attenuation of ED was more apparent in the chronic phases of TBI. The effect on gender was not statistically significant with regard to the observed changes. Conclusions To our knowledge, this is the first feasibility trial from the Arabian Gulf to report the performance of a TBI population with mild cognitive impairment according to the IQCODE Arabic version. This investigation confirms anecdotal observations of methylphenidate having the potential to attenuate cognitive impairment; particularly those functions that are critically involved in the integrity of executive functioning. The present feasibility trial should be followed by nomothetic studies such as those that adhere to the protocol of the randomized controlled trial. This evidence-based research is the foundation for intervention and future resource allocation by policy- or public health decision-makers.Other Information Published in: BMC Neurology License: http://creativecommons.org/licenses/by/4.0/See article on publisher's website: http://dx.doi.org/10.1186/s12883-020-01663-x</p