ORCID Profile
0000-0002-3443-5972
Current Organisation
Ministry of Health Oman
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Publisher: Elsevier BV
Date: 11-2018
DOI: 10.1053/J.AJKD.2018.04.019
Abstract: Missed hemodialysis (HD) treatments not due to hospitalization have been associated with poor clinical outcomes and related in part to treatment nonadherence. Using data from the Dialysis Outcomes and Practice Patterns Study (DOPPS) phase 5 (2012-2015), we report findings from an international investigation of missed treatments among patients prescribed thrice-weekly HD. Prospective observational study. 8,501 patients participating in DOPPS, on HD therapy for more than 120 days, from 20 countries. Longitudinal and cross-sectional analyses were performed based on the 4,493 patients from countries in which 4-month missed treatment risk was > 5%. The main predictor of patient outcomes was 1 or more missed treatments in the 4 months before DOPPS phase 5 enrollment predictors of missed treatments included country, patient characteristics, and clinical factors. Mortality, hospitalization, laboratory measures, patient-reported outcomes, and 4-month missed treatment risk. Outcomes were assessed using Cox proportional hazards, logistic, and linear regression, adjusting for case-mix and country. The 4-month missed treatment risk varied more than 50-fold across all 20 DOPPS countries, ranging from 5.5mg/dL, parathyroid hormone level > 300pg/mL, hemoglobin level 5%, HD patients were more likely to die, be hospitalized, and have poorer patient-reported outcomes and laboratory measures when 1 or more missed treatments occurred in a 4-month period. The large variation in missed treatments across 20 nations suggests that their occurrence is potentially modifiable, especially in the United States and other countries in which missed treatment risk is high.
Publisher: Springer Science and Business Media LLC
Date: 05-1999
DOI: 10.1007/BF02845526
Publisher: Hindawi Limited
Date: 26-07-2021
DOI: 10.1002/HUMU.24251
Publisher: Informa UK Limited
Date: 11-2021
DOI: 10.2147/IJGM.S323318
Publisher: Elsevier BV
Date: 2020
DOI: 10.2139/SSRN.3520085
Publisher: Springer Science and Business Media LLC
Date: 06-2020
Publisher: Springer Science and Business Media LLC
Date: 18-11-2014
DOI: 10.1007/S40292-014-0074-Z
Abstract: Hypertension (HTN) is a major independent risk factor for the development of stroke, coronary artery disease (CAD), peripheral arterial disease (PAD), heart failure (HF) and chronic kidney disease (CKD). HTN is a growing public health problem in Oman, almost certainly the most prevalent modifiable risk factor for cardiovascular disease (CVD). The risk of CVD in patients with HTN can be greatly reduced with lifestyle modifications and effective antihypertensive therapy. Randomized trials have shown that blood pressure (BP) lowering produces rapid reductions in CV risk. Several studies have shown that the majority of the hypertensive patients remain uncontrolled. It is well established that the observed poor control of the disease is not only related to poor adherence to medications, but also to limited awareness and adherence to evidence-based management of hypertension among physicians. Several guidelines for the management of patients with hypertension have been published. However, the aim of this document is to provide the busy physicians in Oman with more concise and direct approach towards implementing these guidelines into clinical practice.
Publisher: Openventio Publishers
Date: 30-12-2016
Publisher: Scientific Research Publishing, Inc.
Date: 2013
Publisher: BioMed Research Publishers
Date: 04-2017
Publisher: Elsevier BV
Date: 11-1997
DOI: 10.1016/S0026-0495(97)90224-9
Abstract: Impaired growth involving both height and weight accompanying sickle cell disease (SCD) poses diagnostic and therapeutic problems. We undertook this study to test the hypothesis that this impaired growth is associated with abnormalities of the growth hormone (GH)/insulin-like growth factor-I (IGF-I)/IGF binding protein-3 (IGFBP-3) axis in 21 children with SCD and that SCD is associated with GH resistance. Nine of 21 children with SCD had a defective GH response to both clonidine and glucagon provocation (peak < 10 micrograms/L) these children differed from the 12 others in having slower linear growth velocity (GV and GVSDS), lower circulating concentrations of IGF-I and IGFBP-3, and either partial or complete empty sellae in computed tomographic scans of the hypothalamic-pituitary area. In this group of patients with SCD, it appears that defective GH secretion and consequent low IGF-I production are the major etiological factors causing the slow growth. The two groups with SCD did not differ significantly in dietary intake, body mass index (BMI), midarm circumferences, skinfold thickness, serum albumin concentration, or intestinal absorption of D-xylose. A single injection of GH produced a smaller increase in circulating IGF-I in children with SCD with or without defective GH secretion versus 10 age-matched children with idiopathic short stature (ISS) and 11 children with isolated GH deficiency (GHD), suggesting partial GH resistance in the SCD group. The presence of defective GH secretion, decreased IGF-I synthesis, and partial resistance to GH in short children with SCD suggests that treatment with IGF-I may be superior to GH therapy for improving growth.
Publisher: Elsevier BV
Date: 2021
DOI: 10.2139/SSRN.3777236
Publisher: Saudi Medical Journal
Date: 12-2018
Publisher: Scientific Research Publishing, Inc.
Date: 2013
Publisher: Medknow
Date: 2016
Abstract: The Gulf Cooperation Council-Dialysis Outcomes and Practice Patterns Study (GCC-DOPPS) marks the joining of the six Gulf region countries including Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates to the main DOPPS study in 2012. The current review is a descriptive reporting on results related to the management of anemia from these countries. Our data demonstrate consistent anemia management patterns across the GCC countries allowing the achievement of international treatment levels. Overall, the majority of hemodialysis patients were prescribed appropriate erythropoiesis-stimulating agents (ESAs) and supplemental iron, enabling the attainment of mean hemoglobin (Hb) level of 10.9 g/dL. Comparisons of the in idual country profiles reveal in idual differences in the choice and mode of ESA and iron administration. However, all countries displayed good compliance with guideline recommendations. The same challenges as elsewhere are faced in the GCC, with respect to optimizing Hb levels and judiciously using ESA and iron supplements. Some opportunities exist for focused efforts to fine tune inter-facility variability in anemia management based on continued data tracking. The latter is vital in enabling adopting new trends to further improve not only anemia management but also the wholesome care of dialysis patients.
Publisher: Symbiosis Group
Date: 18-07-2018
Publisher: OMICS Publishing Group
Date: 2013
Publisher: Elsevier BV
Date: 06-2021
Publisher: Medknow
Date: 2018
Abstract: BK Polyomavirus-associated nephropathy (BKVAN) has been recognized as an increasing threat in renal transplant patients (RTP) for more than a decade. Reduction in immunosuppression is the mainstay of treatment through various options of treatment has been suggested. Published reports on these protocols have shown mixed results, and no randomized controlled trials have compared one strategy with another. In this context, we hypothesize that the appearance of BKV in the blood compels one to optimize the immunosuppression with possible long-term beneficial effects. We conducted a retrospective study among the RTP being followed up by the Renal Medicine Department at Royal Hospital who tested positive for BKV-polymerase chain reaction and whose immunosuppression was altered with a final aim to get rid of BK viremia, yet avoiding acute rejection. Results were analyzed by the clinical and statistical approach. Extensive literature review was carried out to look into the prevalence, prognosis, and treatment of BKVAN. In all the patients in whom BKV was detected alteration in immunosuppression resulted in eliminating the virus without precipitating acute rejection. The study shows that in the exercise of eliminating BKV by alteration of immunosuppression, we have "tailored" the immunosuppression in each particular RTPs, without precipitating acute rejection.
Publisher: Wiley
Date: 29-07-2020
DOI: 10.1002/CLC.23419
Publisher: Herald Scholarly Open Access
Date: 31-08-2020
Abstract: To Provide up-to-date guidelines for medical and nursing staffs on the pre, during, and post care of a patient undergoing a percutaneous-kidney-biopsy-PKB.
Publisher: Elsevier BV
Date: 12-2019
Publisher: Herald Scholarly Open Access
Date: 31-08-2020
Abstract: Peritoneal Dialysis (PD) utilization increases gradually due to increase of patient's awareness for different types of Renal Replacement Therapy (RRT). Hence, in order to be successful with PD program, we need to build strong strategies to improve patients’ quality of care. One of the risks associated with PD is the Exit-Site-Infection (ESI).
Publisher: Springer Science and Business Media LLC
Date: 14-08-2020
DOI: 10.1186/S12882-020-02013-2
Abstract: There is a high prevalence of rare genetic disorders in the Middle East, and their study provides unique clinical and genetic insights. Autosomal recessive polycystic kidney disease (ARPKD) is one of the leading causes of kidney and liver-associated morbidity and mortality in Oman. We describe the clinical and genetic profile of cohort of ARPKD patients. We studied patients with a clinical diagnosis of ARPKD ( n = 40) and their relatives (parents ( n = 24) and unaffected siblings ( n = 10)) from 32 apparently unrelated families, who were referred to the National Genetic Centre in Oman between January 2015 and December 2018. Genetic analysis of PKHD1 if not previously known was performed using targeted exon PCR of known disease alleles and Sanger sequencing. A clinical diagnosis of ARPKD was made prenatally in 8 patients, 21 were diagnosed during infancy (0–1 year), 9 during early childhood (2–8 years) and 2 at later ages (9–13 years). Clinical phenotypes included polycystic kidneys, hypertension, hepatic fibrosis and splenomegaly. Twenty-four patients had documented chronic kidney disease (median age 3 years). Twenty-four out of the 32 families had a family history suggesting an autosomal recessive pattern of inherited kidney disease, and there was known consanguinity in 21 families (66%). A molecular genetic diagnosis with biallelic PKHD1 mutations was known in 18 patients and newly identified in 20 other patients, totalling 38 patients from 30 different families. Two unrelated patients remained genetically unsolved. The different PKHD1 missense pathogenic variants were: c.107C T, p.(Thr36Met) c.406A G, p.(Thr136Ala) c.4870C T, p.(Arg1624Trp) and c.9370C T, p.(His3124Tyr) located in exons 3, 6, 32 and 58, respectively. The c.406A G, p.(Thr136Ala) missense mutation was detected homozygously in one family and heterozygously with a c.107C T, p.(Thr36Met) allele in 5 other families. Overall, the most commonly detected pathogenic allele was c.107C T (Thr36Met), which was seen in 24 families. Molecular genetic screening of PKHD1 in clinically suspected ARPKD cases produced a high diagnostic rate. The limited number of PKHD1 missense variants identified in ARPKD cases suggests these may be common founder alleles in the Omani population. Cost effective targeted PCR analysis of these specific alleles can be a useful diagnostic tool for future cases of suspected ARPKD in Oman.
Publisher: Saudi Medical Journal
Date: 07-2015
Publisher: Medknow
Date: 2016
Abstract: The prospective cohort Dialysis Outcomes and Practice Patterns Study (DOPPS) initiated data collection in national s les of hemodialysis (HD) units (total of 41 study sites) in all six Gulf Cooperation Council (GCC) countries (Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates) in late 2012. Here, we report initial results regarding mineral bone disorders (MBDs) and its management in the GCC countries. Forty-one randomly selected HD facilities, treating >23 HD patients each, were s led and represent care for >95% of GCC HD patients. Descriptive results for the GCC countries based on a random s le of 20-30 HD patients in each study facility. Initial results for the GCC are from 931 HD patients treated at 41 dialysis units (ranging from 1 unit in Bahrain to 21 in Saudi Arabia). Results are presented as weighted estimates, accounting for the s ling fraction in each unit. Baseline descriptive statistics (e.g., mean, median, or percentage), weighted by facility s ling fraction were calculated for the study s le. For analyses examining the percent of facility patients having (a) serum phosphorus >6.0 mg/dL or (b) parathyroid hormone (PTH) >600 pg/mL, analyses were restricted to facilities having at least 10 HD patients with a reported serum phosphorus or PTH measurement, respectively. Logistic regression analyses of the indicated binary outcomes were based on the use of generalized estimating equations and were adjusted for GCC country, patient age category ( 65 years old), sex, and whether the patient was diagnosed with diabetes mellitus. Logistic models accounted for clustering of patients within facilities, assuming an exchangeable working correlation matrix. Mean age of HD patients in the GCC countries was 53 years vs. 61-64 years in the three other DOPPS regions. MBD markers showed slightly lower mean serum Calcium in the GCC countries, similar mean serum phosphorus, and intermediate median PTH levels compared with the three other DOPPS regions. Among GCC countries, the country mean value of MBD markers ranged from 8.6-9.0 mg/dL for serum calcium, 4.4-5.4 mg/dL for serum phosphorus, whereas median PTH ranged from 163-389 pg/mL. Similar to other DOPPS regions, PTH was higher among patients who were younger or without diabetes, and serum phosphorus was lower with older age (P <0.001 for each). History of parathyroidectomy was lower in the GCC countries versus other regions but did not differ when adjusted for age and dialysis vintage. Among treatments used for managing MBD, the GCC countries showed one of the highest uses of cinacalcet (24%) and phosphorus binder use (81%), whereas intravenous Vitamin D use (24%) was slightly higher than that in EURANZ. A much larger fraction of HD patients in the GCC countries had a dialysate calcium bath ≥3.5 mEq/L (43%) versus 0-4% in the three other DOPPS regions. Although many aspects of MBD management and MBD marker achievement are similar in the GCC countries to that seen in other DOPPS study regions, large variability was seen across countries and facilities in the GCC. Mean serum calcium was lower in the GCC despite the much greater use of dialysate Ca of ~3.5 mEq/L which may be due to the relatively low use of vitamin D and higher cinacalcet use, meriting further study. Future work will focus on GCC facility HD practices and patient characteristics most strongly related to the achievement of MBD target levels and associated outcomes.
Publisher: Research Square Platform LLC
Date: 26-01-2021
DOI: 10.21203/RS.3.RS-151867/V1
Abstract: Background Histologic chorioamnionitis (HCA) is the most common placental lesion measuring maternal/fetal responses to intraamniotic bacterial infection. Study design We reviewed 1400 placentas referred for placental examination and explored the relationship of HCA with clinical information and with total white cells (WBC), differentials, and whether maternal admission WBC and differentials predict HCA. Results The frequency of HCA of the 1400 placentas was 38.8% (543 of 1400), and funisitis 16.9% (237 of 1400). Abnormal white blood count (total WBC .3) within this population was 41.1% with abnormal neutrophil differential of 39.1% and lymphopenia of 33.9%. There is an association between HCA and elevated WBC, neutrophil differentials, and preterm delivery 32 weeks or earlier. The predictive value of WBC, differentials and gestational age was 59% using ROC analysis. Conclusion Prediction of HCA using WBC and differential is suboptimal. Molecular solution to HCA is required to identify patients at risk for maternal/fetal complications.
Publisher: Wiley
Date: 17-10-2018
DOI: 10.1002/JEMT.22958
Publisher: Herald Scholarly Open Access
Date: 31-12-2020
Abstract: Quality of Life (QoL) and Health-Related Quality of Life (HRQoL) are multidimensional concepts. Several tools have been developed to measure these concepts. The aim of this narrative review is to gain a general understanding of QoL concepts, track its theoretical development, and identify the theoretical framework underpinning the concept.
Publisher: Medknow
Date: 2019
Abstract: The incidence of hypertension (HTN) is rising worldwide with an estimated prevalence of 22%, 7.5 million deaths (12.8%). It is a major risk factor for coronary heart diseases and hemorrhagic strokes. In Oman, the crude prevalence of HTN was 33.1%, whereas the age-adjusted prevalence was 38.3%. Among Gulf Cooperation Countries, 47.2% of the in iduals were hypertensive, and women were more likely to have HTN than men. Similarly, the prevalence of low-birth-weight (LBW) is also rising globally with the more prevalent incidence in developing countries reaching almost a rate just lower than 20.0/100 births. In Oman, the prevalence of LBW was 4.2% in 1980, which doubled (8.1%) in 2000 and has shown a slow but steady increase reaching 10.2% in 2013. LBW term is the most commonly used surrogate measure of intrauterine growth retardation and has been related to increased cardiovascular mortality, due to increased risk of cardiovascular risk factors, including blood pressure (BP), diabetes, cholesterol level, and other risk factors. The epidemiologic evidence clearly points to an inverse association between birth weight and many hemodynamic cardiovascular risk markers. Possible mechanisms operating in fetal life that might determine BP include the structural development of resistance arteries, the setting of hormone levels, and nephron endowment. Retarded fetal growth leads to permanently reduced cell numbers in the kidney. Patients with high BP had almost 50% less number of glomeruli compared to that of the normotensive in iduals, and subsequent accelerated growth may lead to excessive metabolic demand on this limited cell mass. It is not merely a reduced nephron number that is responsible for HTN, but compensatory maladaptive changes that occur internally when nephrogenesis is compromised. The likelihood of an adverse outcome is greatly lified in those born with LBW who later develop obesity or an increased ponderal index.
Publisher: Herald Scholarly Open Access
Date: 31-12-2020
Abstract: End-Stage Kidney Disease (ESKD) is a serious and irreversible condition. Understanding the impact of ESKD and its treatment on an in idual's Quality of Life (QoL) is important.
Publisher: Wiley
Date: 27-02-2018
DOI: 10.1002/JEMT.23001
Abstract: Palynological features as well as comparative foliar epidermal using light and scanning electron microscope (SEM) of 17 species (10genera) of Amaranthaceae have been studied for its taxonomic significance. Different foliar and palynological micro-morphological characters were examined to explain their value in resolving the difficulty in identification. All species were histomatic but stomata on abaxial surface were more abundant. Taxonomically significant epidermal character including stomata type, trichomes (unicellular, multicellular, and capitate) and epidermal cells shapes (polygonal and irregular) were also observed. Pollens of this family are Polypantoporate, pores large, spheroidal, mesoporous region is sparsely to scabrate, densely psilate, and spinulose. All these characters can be active at species level for identification purpose. This study indicates that at different taxonomic levels, LM and SEM pollen and epidermal morphology is explanatory and significant to identify species and genera.
Publisher: Saudi Medical Journal
Date: 02-2020
Publisher: Elsevier BV
Date: 10-1996
DOI: 10.1016/S0026-0495(96)90240-1
Abstract: We evaluated growth parameters and hypothalamic-pituitary-gonadal and growth functions in five children with Bardet-Biedl syndrome (BBS). Three of the five children had stature below the fifth percentile for age. Their growth hormone (GH) response to provocation was defective, and computed tomographic (CT) scanning revealed empty sellae in all of them. All the children were obese (body mass index [BMI] > 95th percentile for age). Three had hypercholesterolemia. Their basal serum testosterone concentration and testosterone response to 3-day human chorionic gonadotropin (HCG) stimulation were significantly lower than the levels in 12 age-matched obese normal children. Testosterone secretion failed to respond to HCG therapy for 4 weeks. Both basal gonadotropin levels (luteinizing hormone [LH] and follicle-stimulating hormone [FSH]) and gonadotropin responses to LH-releasing hormone (LHRH) stimulation were normal and did not differ among the two study groups. It appears that primary hypogonadism is a cardinal feature of BBS, and it may be accompanied by hypothalamic and pituitary abnormalities.
Publisher: Elsevier BV
Date: 04-2018
DOI: 10.1016/J.IJID.2018.01.029
Abstract: Deceased and live-related renal transplants (RTXs) are approved procedures that are performed widely throughout the world. In certain regions, commercial RTX has become popular, driven by financial greed. This retrospective, descriptive study was performed at the Royal Hospital from 2013 to 2015. Data were collected from the national kidney transplant registry of Oman. All transplant cases retrieved were ided into two groups: live-related RTX performed in Oman and commercial-unrelated RTX performed abroad. These groups were then ided again into those with and without evidence of fungal infection, either in the wound or renal graft. A total of 198 RTX patients were identified, of whom 162 (81.8%) had undergone a commercial RTX that was done abroad. Invasive fungal infections (IFIs) were diagnosed in 8% of patients who had undergone a commercial RTX of these patients, 76.9% underwent a nephrectomy and 23.1% continued with a functioning graft. None of the patients with RTXs performed at the Royal Hospital contracted an IFI. The most common fungal isolates were Aspergillus species (including Aspergillus flavus, Aspergillus fumigatus, Aspergillus nidulans, and Aspergillus nigricans), followed by Zygomycetes. However, there was no evidence of fungal infection including Aspergillus outside the graft site. Computed tomography (CT) findings showed infarction of the graft, renal artery thrombosis, aneurysmal dilatation of the external iliac artery, fungal ball, or just the presence of a perigraft collection. Of the total patients with IFIs, 23.1% died due to septic shock and 53.8% were alive and on hemodialysis. The remaining 23.1% who did not undergo nephrectomy demonstrated acceptable graft function. This is the largest single-center study on commercial RTX reporting the highest number of patients with IFI acquired over a relatively short period of time. Aspergillus spp were the main culprit fungi, with no Candida spp being isolated. A high index of suspicion might be the most reasonable means to reduce the possible very poor outcomes. Improving legal transplant programs and strengthening the associated laws could prevent commercial transplant tourism.
Publisher: Springer Science and Business Media LLC
Date: 09-1996
DOI: 10.1007/BF02730821
Publisher: Springer Science and Business Media LLC
Date: 09-09-2020
DOI: 10.1186/S41231-020-00066-X
Abstract: Patients with rheumatoid arthritis (RA) represent one of the fragile patient groups that might be susceptible to the critical form of the coronavirus disease − 19 (COVID-19). On the other side, RA patients have been found not to have an increased risk of COVID-19 infection. Moreover, some of the Disease-Modifying Anti-Rheumatic Drugs (DMARDS) commonly used to treat rheumatic diseases like Hydroxychloroquine (HCQ) were proposed as a potential therapy for COVID-19 with a lack of full understanding of their molecular mechanisms. This highlights the need for the discovery of common pathways that may link both diseases at the molecular side. In this research, we used the in silico approach to investigate the transcriptomic profile of RA synovium to identify shared molecular pathways with that of severe acute respiratory syndrome-corona virus-2 (SARS-COV-2) infected lung tissue. Our results showed upregulation of chemotactic factors, including CCL4, CCL8, and CCL11, that all shared CCR5 as their receptor, as a common derangement observed in both diseases RA and COVID-19. Moreover, our results also highlighted a possible mechanism through which HCQ, which can be used as a monotherapy in mild RA or as one of the triple-DMARDs therapy (tDMARDs methotrexate, sulphasalazine, and HCQ), might interfere with the COVID-19 infection. This might be achieved through the ability of HCQ to upregulate specific immune cell populations like activated natural killer (NK) cells, which were found to be significantly reduced in COVID-19 infection. In addition to its ability to block CCR5 rich immune cell recruitment that also was upregulated in the SARS-COV-2 infected lungs. This might explain some of the reports that showed beneficial effects.
Publisher: ClinMed International Library
Date: 31-12-2018
Publisher: Elsevier BV
Date: 2021
Publisher: Springer Science and Business Media LLC
Date: 09-1998
DOI: 10.1007/BF02731057
Publisher: Springer Science and Business Media LLC
Date: 05-1996
DOI: 10.1007/BF02751540
Publisher: Elsevier BV
Date: 11-1998
DOI: 10.1016/S0026-0495(98)90301-8
Abstract: We present the characteristic features of 14 children with the recessive form of Robinow syndrome and the growth hormone (GH) response to provocation with clonidine and the serum insulin-like growth factor-I (IGF-I) concentration in 12 of these children. The gonadotropin (luteinizing hormone [LH] and follicle-stimulating hormone [FSH]) response to gonadotropin-releasing hormone (GnRH) was evaluated in early pubertal and pubertal patients, and the testosterone response to human chorionic gonadotropin (HCG) was evaluated in males. Children with Robinow syndrome, born at full-term, were short at birth (length, 41.4+/-2.1 cm) and had markedly slow growth velocity (GV) during the first year (13.1+/-2.1 cm/yr) consequently, they were significantly short at the end of the first year of life (length, 54.4+/-2.9 cm). This intrauterine and early extrauterine growth delay reflected low growth potential. During childhood, the GV standard deviation score (GVSDS) remained low (-2.17+/-0.83). Despite the presence of empty sella in all of the patients, they had an adequate GH response to clonidine provocation (peak, 19.3+/-5.8 microg/L) and a normal serum IGF-I concentration (309+/-142 ng/mL) for their age. During childhood and early adolescence, boys with Robinow syndrome had low basal testosterone and a low testosterone response to HCG stimulation (3,000 IU/m2/d intramuscularly [IM] for 3 days). However, their basal and GnRH-stimulated FSH concentrations were normal. Two girls (Tanner II breast development) had a normal serum estradiol (E2) concentration but high LH and FSH responses to GnRH stimulation. This suggested either defective feedback of E2 on the hypothalamic-pituitary axis or hyporesponsiveness of the ovaries to gonadotropin. Four weeks of HCG therapy (2,500 IU/m2 IM twice weekly) in three boys with Robinow syndrome increased the penile length and testicular volume, denoting a significant Leydig cell response to prolonged HCG stimulation and the presence of functioning androgen receptors. It is suggested that HCG and/or testosterone therapy during infancy may improve the severe micropenis in these patients.
Publisher: Medknow
Date: 2017
Abstract: Oman is located on the Southeastern coast of the Arabian Peninsula, and its population has high levels of consanguinity. Human leukocytic antigen (HLA) typing analysis in human population holds unexploited potential for elucidating the genetic causes of human disease and possibly leads to personalized medicine. This is a retrospective, descriptive study evaluating HLA frequencies of Omani in iduals who underwent workup for kidney transplantation at the Royal Hospital (RH) from 2005 to 2016. Data on 870 subjects were collected from the Oman kidney transplant registry at RH as well from electronic medical record system. The mean age (standard deviation) years for the cohort were 33.2 (13.0). Males constituted 56.3% (490) while females constituted 43.7% (380). Seven HLA-A alleles accounted for more than 70% of the total alleles. Of which, HLA-A2 contributed the highest frequency (24%), followed by HLA A11 (9.4%), and A32 (8.1%). Ten alleles accounted for 70% of HLA-B alleles. Of which, HLA-B51 was the most common (18.9%), followed by HLA-B-35 (13.6%), and HLA-B8 (7.9%). Seven HLA-DRB1 alleles accounted for more than 70% of the total HLA DRB1 alleles, of which HLA- DRB1*16 contributed the highest frequency (29.56%). This was followed by HLA-DRB1*03 (14.57%) and HLA-DRB1*11 (9.48%). While three alleles accounted for more than 75% of the total HLA DQB1alleles. Of which, HLA-DQB1*05 contributed the highest frequency (37.56%). This was followed by allele HLA-DQB1*02 (26.48%) and HLA-DQB1*03 (17.18%). This study showed considerable heterogeneity in both HLA Class I and Class II antigens, which reflects admixture of our population with rest of old world countries. Despite the high levels of consanguinity, this population is genetically highly heterogeneous. These findings may be useful for transplantation programs, noncommunicable diseases, epidemiology of HLA linked diseases, pharmacogenomics, and anthropology.
Publisher: Open Access Text Pvt, Ltd.
Date: 2018
DOI: 10.15761/IOD.1000214
Publisher: Hindawi Limited
Date: 07-04-2021
DOI: 10.1155/2021/8876559
Abstract: Introduction. Quality of life (QoL) of hemodialysis patients can be examined in two aspects: kidney-specific quality of life and general quality of life. Objective. To determine the QoL among patients undergoing hemodialysis, to assess patients’ QoL on hemodialysis, and to determine the factors associated with QoL among hemodialysis patients in Oman. Method. A cross-sectional study was carried out with 205 patients to measure the QoL across various demographic and clinical variables in Oman. The Arabic version of the KDQOL-SFtool was used to collect data from patients undergoing hemodialysis to give QoL quantitative measures. Results. The physical-QoL was 45.7 (95% CI, 44.3, 47.0), which is less than half that of a healthy human. The emotional-QoL is 53.33 (95% CI, 51.1, 55.5), slightly more than half in a healthy human-QoL. The difference between physical and emotional-QoL scores is −7.66 (95% CI, −10.3, -5.1), showing that physical QoL is significantly less than emotional-QoL. The overall general QoL score was 49.5 (95% CI, 47.8, 51.2), half the QoL score of a healthy human. Younger patients are also more likely to experience emotional problems compared with older patients. Patients with 5–8 mg/l levels of serum creatinine have lower emotional wellbeing. People on low incomes experienced social difficulties, while the maximum burden was found in physical activities and minimum social function. Conclusion. Both physical (45.7) and emotional (53.3) QoL scores in dialysis patients are nearly half those of an average human. Hence, there is a poor QoL among dialysis patients like other studies, and therefore, further improvement of renal rehabilitation in dialysis patients is warranted to improve patients’ QoL.
Publisher: Elsevier BV
Date: 07-2020
Publisher: Springer Science and Business Media LLC
Date: 30-06-2017
DOI: 10.1007/S10067-017-3737-Z
Abstract: Rheumatoid arthritis (RA) is associated with increased cardiovascular disease (CVD) mortality and morbidity, due to the combined effects of traditional and non-traditional cardiovascular risk factors (CV). A serum uric acid (SUA) level has been suggested as one of the non-traditional cardiovascular risk factors. Cardiovascular risk can be assessed by looking at the subclinical atherosclerosis such as ultrasound (US)-measured carotid intima-media thickness (cIMT). This paper aimed to determine the role of SUA as a cardiovascular risk factor, along with the traditional cardiovascular risk factors and inflammation, among RA population. RA patients with no clinically evident CV or renal disease were studied. cIMT US, SUA, traditional cardiovascular, and inflammatory markers were obtained and correlated with cIMT. Among 53 RA patients (5 males, 48 females, mean age 48 ± 14 years), univariate linear-regression showed a positive linear relationship between cIMT and age (p < 0.001), age at RA symptoms onset and diagnosis (p = 0.010 and 0.003, respectively), number of cigarettes/day (p < 0.001), systolic and diastolic blood pressure (p = 0.005 and 0.030, respectively), and SUA (p = 0.007). Rheumatoid factor positivity and level were associated with thicker cIMT (p = 0.042 and 0.039, respectively). SUA maintained a significant correlation with cIMT in the multivariate analysis together with age, low-density lipoprotein, and triglyceride level. The model explained 55% (R2 55) of the causes of thick cIMT among RA population. SUA seems to be a cardiovascular risk factor in RA, as manifested by increase in the cIMT.
Publisher: Informa UK Limited
Date: 2021
Publisher: American Diabetes Association
Date: 2008
DOI: 10.2337/DC07-1170
Abstract: OBJECTIVE—The purpose of this study was to examine the association of birth weight with indexes of glycemia in a population-based survey. RESEARCH DESIGN AND METHODS—A total of 10,788 participants in the Australian Diabetes, Obesity and Lifestyle (AusDiab) Study were asked to complete a birth weight questionnaire. Fasting plasma glucose (FPG), postload glucose (PLG), and A1C were modeled against birth weight. World Health Organization criteria were used to define impaired fasting glucose (IFG), impaired glucose tolerance (IGT), and diabetes. RESULTS—Among 7,157 participants who responded to the questionnaire, 4,502 reported their birth weights, with a mean ± SD of 3.4 ± 0.7 kg. FPG, PLG, and A1C were strongly and inversely correlated with birth weight. The odds ratios (95% CI) for high (& th sex-specific percentile) FPG, PLG, and A1C were 0.83 (0.71–0.96), 0.74 (0.65–0.84), and 0.81 (0.70–0.94), respectively, for a 1-kg increase in birth weight after adjustment for age and sex. In those with low birth weight (LBW), the risks for having IFG, IGT, and diabetes and for all abnormalities combined were increased by 1.75, 2.22, 2.76, and 2.28, respectively, for women and by 1.40, 1.32, 1.98, and 1.49 for men compared with risks for those with normal birth weight. These trends applied across categories of age and BMI. CONCLUSIONS—In an affluent Western country with a good adult health profile, birth weight has an inverse relationship with indexes of glycemia, and in iduals with LBW were predisposed to higher rates of glycemic dysregulation in adult life. These associations were independent of BMI and of other factors significantly correlated with glycemic dysregulation.
Publisher: BMJ
Date: 05-1996
DOI: 10.1136/ADC.74.5.379
Abstract: Seven children, with a mean (SD) age of 4.6 (2.1) years, who as infants (21 (7.5) days) underwent near total (95-98%) pancreatectomy for persistent hyperinsulinaemic hypoglycaemia of infancy (PHHI) were studied. At birth all the infants were macrosomic. Four infants had been born after a difficult labour, of whom three had moderate birth asphyxia and respiratory distress. All had normal thyroid function. After surgery transient hyperglycaemia was manifest in six of the children and required insulin treatment for 5.8 (3.8) weeks, and transient hypoglycaemia was encountered in one child and responded well to increased carbohydrate intake and diazoxide for three weeks. Six of the children rapidly crossed down their length and weight centiles during the first year after surgery. At the end of the first year these children were at or below the 5th centile of height and weight for their age and gender. After a period of 4.6 (2.1) years, their mean (SD) height score was -2.57 (0.5), growth velocity 3.9 (0.75) cm/year, and growth velocity SD score -2.1 (0.55)l these were significantly low and denoted significant growth retardation. The growth hormone peak responses to provocation with clonidine were normal (13.5 (2.8) micrograms/l). However, the circulating insulin-like growth factor-I (IGF-I) concentrations were significantly decreased (79 (34) ng/ml). Three of the children developed diabetes at two and a half, five, and seven years after surgery, two others had impaired oral glucose tolerance and six out of the seven children had an impaired C peptide response to glucagon. Defective insulin secretion in these children might directly inhibit IGF-I synthesis in the liver. The body mass index of the pancreatectomised children was 14.9 (0.5) and was normal for age and gender they had a normal 72 hour faecal fat content and normal serum albumin concentration. These data indicated grossly adequate exocrine pancreatic function. It appears that children requiring near total pancreatectomy for PHHI have normal developmental milestones but defective linear growth with impaired insulin secretion and low IGF-I production despite normal growth hormone response to provocation.
Publisher: SAGE Publications
Date: 08-07-2020
Abstract: COVID-19 disease is one of the most destructive events that humanity has witnessed in the 21st century. It has impacted all aspects of life and all segments of populations, including already vulnerable health care providers. This study sought to detect the prevalence of mental health issues in s le of physicians and nurses working in several health facilities in Oman. We gauged the mental health conditions of 509 physicians (38.1%) and nurses (61.9 %) using the Perceived Stress Scale, Generalized Anxiety Disorder Scale and World Health Organization Well-Being Index. The study revealed a high prevalence of stress, anxiety and poor psychological well-being, especially among females, young health care workers and those who interacted with known or suspected COVID-19 patients. The outcomes of this study support the handful of studies published during this global health crisis that have found that the mental health of health care workers has been harshly affected and predicted that it will continue, to various degrees, to be affected in the foreseeable future. The results of this study highlight the urgency of providing administrative and psychological support as well as current and accurate information on COVID-19 to health care workers.
Publisher: Oxford University Press (OUP)
Date: 10-1996
Abstract: Hypertransfusion therapy has dramatically increased the duration and quality of life in patients with B-thalassemia major however, it leads to chronic iron overload, and is frequently complicated by the development of diabetes mellitus or impaired glucose tolerance. To determine the early effect of iron overload on the endocrine pancreatic function, we studied glucose, insulin, and glucagon responses to oral load of glucose and to arginine provocation in 15 children with B-thalassemia major, before and after (3.1 +/- 0.6 years) high-transfusion and iron chelation and compared them with 15 age matched normal controls. In addition, we evaluated growth hormone (GH) responses to oral clonidine and measured the circulating insulin-like growth factor-I concentration in thalassemic children on long-term transfusion and controls. After long-term high-transfusion, thalassemic children had significantly decreased serum insulin concentrations and low insulin/glucose ratios at 60 and 120 min after an oral glucose load (1.75 g/kg) in comparison with values before therapy and those for controls. None of the thalassemic children had glucose intolerance after this period of frequent blood transfusion however, their serum glucose levels at 60 and 120 min after the oral glucose load were significantly higher compared to control children. Thirty minutes after starting arginine infusion, serum insulin concentration was significantly lower in thalassemic children compared to before therapy. Basal and arginine-stimulated glucagon secretions were significantly elevated in thalassemic children on long-term blood transfusion with significantly low serum insulin/glucagon ratios. In addition, the high basal serum glucagon concentrations were not suppressed after the oral glucose load. Despite hyperglucagonaemia in all thalassemic children, their blood glucose dropped appropriately below 50 per cent of the fasting glucose level after an intravenous insulin dose (0.1 U/kg) ruling out any significant insulin-resistance. GH responses to clonidine provocation were subnormal in thalassemic children after long-term blood transfusion compared to controls. In summary, thalassemic children on long-term blood transfusion and iron chelation have progressive and early loss of B-cell mass, manifested by decreased insulin release in response to secretagogues, before the development of significant insulin resistance or impairment of glucose tolerance.
Publisher: Oxford University Press (OUP)
Date: 10-1996
Abstract: Various alterations in hormonal levels have been suggested to contribute to the development of nutritional oedema and fatty liver in children with kwashiorkor. We present an infant who underwent near-total pancreatectomy at the age of 4 weeks and developed kwashiorkor after 11 weeks. The sequence of events following surgery can be ided into two phases. The first phase was characterized by hyperinsulinaemia and hypoglycaemia before feeds. During this phase, although the weight gain was slow (10 g/day) serum albumin (32 g/I) and prealbumin (0.23 g/I) concentrations were maintained with no oedema or hepatomegaly. In the second phase, insulin deficiency prevailed and he was receiving the same amount of milk (protein)/day (enriched with starch). During that phase he rapidly developed hypoalbuminaemia (18 g/l), hypoprealbuminaemia (0.1 g/l), oedema, hepatomegaly, and dermatosis. This case demonstrates clearly the important role of defective insulin secretion in the development of nutritional oedema and hepatomegaly.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 10-2020
Abstract: The prospective Dialysis Outcomes and Practice Patterns Study (DOPPS) has collected data since 2012 in all six Gulf Cooperation Council (GCC) countries (Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and United Arab Emirates). We report the relationship of PTH with mortality in this largest GCC cohort of patients on hemodialysis studied to date. Data were from randomly selected national s les of hemodialysis facilities in GCC-DOPPS phases 5 and 6 (2012–2018). PTH descriptive findings and case mix–adjusted PTH/mortality Cox regression analyses were based on 1825 and 1422 randomly selected patients on hemodialysis, respectively. Mean patient age was 55 years (median dialysis vintage, 2.1 years). Median PTH ranged from 259 pg/ml (UAE) to 437 pg/ml (Kuwait), with 22% having PTH pg/ml, 24% with PTH of 150–300 pg/ml, 34% with PTH 301–700 pg/ml, and 20% with PTH pg/ml. Patients with PTH pg/ml were younger on dialysis longer less likely to be diabetic have urine ml/d be prescribed 3.5 mEq/L dialysate calcium had higher mean serum creatinine and phosphate levels lower white blood cell counts and more likely to be prescribed cinacalcet, phosphate binders, or IV vitamin D. A U-shaped PTH/mortality relationship was observed with more than two- and 1.5-fold higher adjusted HR of death at PTH pg/ml and pg/ml, respectively, compared with PTH of 301–450 pg/ml. Secondary hyperparathyroidism is highly prevalent among GCC patients on hemodialysis, with a strong U-shaped PTH/mortality relationship seen at PTH and pg/ml. Future studies are encouraged for further understanding this PTH/mortality pattern in relationship to unique aspects of the GCC hemodialysis population.
Publisher: Open Access Text Pvt, Ltd.
Date: 2020
DOI: 10.15761/TIT.1000271
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-07-2020
Publisher: Korean Society for the Study of Obesity
Date: 30-09-2021
DOI: 10.7570/JOMES20135
Publisher: Medknow
Date: 2019
Abstract: Diabetes mellitus (DM) is a common disease in Oman as in rest of Gulf Cooperation Council where metabolic syndrome is of high prevalence. DM is a foremost risk factor for urinary tract infections (UTIs). It is also linked to more complicated infections such as emphysematous pyelonephritis (EPN), emphysematous pyelitis (EP), renal erirenal abscess, emphysematous cystitis, xanthogranulomatous pyelonephritis, and renal papillary necrosis. The diagnosis of these cases is frequently delayed because the clinical manifestations are generic and not different from the typical triad of upper UTI, which include fever, flank pain, and pyuria. A middle-aged female with DM and chronic kidney disease stage IV was admitted with recurrent UTI with extended-spectrum beta-lactamase-producing Escherichia coli. At presentation, she was afebrile, clinically stable, had no flank pain and there was no leukocytosis. Laboratory test for C- reactive protein done twice and was only mildly elevated at 7 and 11 mg/dL. A computed tomography scan of kidney-ureter-bladder (CT-KUB) was recommended and reported as "no KUB stone but small atrophic left kidney with dilatation of the pelvicalycial system and ureter and the presence of air in the collecting system suggestive of EP." Thus, commonly associated with DM, especially in females, debilitated immune-deficient in iduals, and patients harboring obstructed urinary system with infective nidus. Air in the kidney is not always due to EPN. UTI with a gas-producing organism can ascend to the kidney in the presence of vesicoureteral reflux.
Publisher: Medknow
Date: 2020
Publisher: Wiley
Date: 05-05-2020
DOI: 10.1002/LIPD.12242
Publisher: Elsevier BV
Date: 08-2009
DOI: 10.1053/J.AJKD.2008.12.042
Abstract: There has been considerable interest in the hypothesis that low birth weight may be a marker of impaired nephrogenesis and that this is causally related to chronic kidney disease (CKD). Systematic review and meta-analysis of observational studies. Studies of the relationship between birth weight and CKD published before February 1, 2008, were identified by using electronic searches. All studies that had collected data for birth weight and kidney function at greater than 12 months of age were eligible for inclusion, except for studies of extremely low-birth-weight infants, very premature infants, or toxic exposure in utero. STUDY FACTOR: Birth weight. CKD defined as albuminuria, low estimated glomerular filtration rate (<60 mL/min/1.73 m(2) or < 10th centile for age/sex), or end-stage renal disease. We analyzed 31 relevant cohort or case-control studies with data for 49,376 in iduals and data for 2,183,317 in iduals from a single record-linkage study. Overall, 16 studies reported a significant association between low birth weight and risk of CKD and 16 observed a null result. The combination of weighted estimates from the 18 studies for which risk estimates were available (n = 46,249 plus 2,183,317 from the record linkage study) gave an overall odds ratio (OR) of 1.73 (95% confidence interval [CI], 1.44 to 2.08). Combined ORs were consistent in magnitude and direction for risks of albuminuria (OR, 1.81 95% CI, 1.19 to 2.77), end-stage renal disease (OR, 1.58 95% CI, 1.33 to 1.88), or low estimated glomerular filtration rate (OR, 1.79 95% CI, 1.31 to 2.45). A reliance on published estimates and estimates provided on request rather than in idual patient data and the possibility of reporting bias. Existing data indicate that low birth weight is associated with subsequent risk of CKD, although there is scope for additional well-designed population-based studies with accurate assessment of birth weight and kidney function and consideration of important confounders, including maternal and socioeconomic factors.
Publisher: Open Access Text Pvt, Ltd.
Date: 2018
DOI: 10.15761/JIC.1000255
Publisher: Elsevier BV
Date: 12-2008
DOI: 10.1053/J.AJKD.2008.04.028
Abstract: In view of recent reports of the relationship of kidney disease to birth weight, we evaluate the relationship between birth weight and chronic kidney disease (CKD), including end-stage kidney disease, in Australian adults. A case-control study. Patients attending the nephrology department at a major metropolitan hospital in Australia were asked to recall their birth weight, excluding those with structural kidney abnormalities. Two controls for each patient, matched for sex and within 5 years of age, were selected from participants from the Australian Diabetes, Obesity and Lifestyle (AusDiab) Study, who had also been asked to report their birth weight. Birth weight in kilograms. CKD and stages were defined using the National Kidney Foundation-Kidney Disease Outcomes Quality Initiative classification, proteinuria as a marker of kidney damage, and glomerular filtration rate estimates, by using the Modification of Diet in Renal Disease Study equation. Of 189 patients with CKD who reported their birth weights for whom controls were identified, 106 were men. Mean age was 60.3 +/- 15 (SD) years. Mean birth weight overall was 3.27 +/- 0.6 versus 3.46 +/- 0.6 kg for their controls (P < 0.001), and proportions with birth weights less than 2.5 kg were 12.2% and 4.4% (P < 0.001). In patients with CKD, 22.8%, 21.7%, 18%, and 37.6% were in CKD stages 2 (n = 43), 3 (n = 41), 4 (n = 34), and 5 (n = 71), respectively. Birth weights by CKD stage and their AusDiab controls were as follows: stage 2, 3.38 +/- 0.52 versus 3.49 +/- 0.52 kg P = 0.2 stage 3, 3.28 +/- 0.54 versus 3.44 +/- 0.54 kg P = 0.1 stage 4, 3.19 +/- 0.72 versus 3.43 +/- 0.56 kg P = 0.1 and stage 5, 3.09 +/- 0.65 versus 3.47 +/- 0.67 kg P < 0.001. Differences in birth weights applied to women and men and people younger than 60 and 60 years and older and were present in the major "causal" categories of renal disease. Birth weight is by self-recall with a significant nonresponse rate to the questionnaire in both cases and controls. Urban Australian patients with CKD had lower birth weights than their matched Australian controls. In addition, the more advanced the CKD stage, the lower the birth weight. Thus, lower birth weights appear to predispose to CKD and to its progression. Among possible explanations is the documented association between birth weight and nephron number.
Publisher: Hindawi Limited
Date: 2017
DOI: 10.1155/2017/6403985
Abstract: Globally, end-stage kidney disease (ESKD) is a huge burden on health care systems. The aims of this study were to perform a comprehensive epidemiological and etiological report of ESKD patients commencing RRT in Oman with an emphasis on genetic causes and inherited kidney disease. All newly registered Omani patients with ESKD commencing RRT from 2001 until 2015 ( n = 2 ,922) were analysed using the RRT register in Oman. All potentially genetic or inherited causes of ESKD were reviewed. In Oman, ESKD is more prevalent in males (57.1%) than females (42.9%) with a median age of incident ESKD of 53 years. Diabetic nephropathy was the most prevalent cause of ESKD (46%), followed by hypertensive nephropathy (19%), glomerulonephritis (15%), and inherited kidney disease (5%). For patients less than 20 years of age inherited kidney disease accounted for 32.5% of cases. Of this cohort with inherited renal disease, 40.3% had autosomal dominant polycystic kidney disease, 11.5% had congenital anomalies of the kidney and urinary tract, 9.4% had Alport syndrome, and 7.2% had autosomal recessive polycystic kidney disease. This study represents a comprehensive population-based epidemiological and etiological report of ESKD patients in Oman commencing RRT. Inherited kidney disease was the leading cause of paediatric ESKD.
Publisher: Wiley
Date: 23-09-2014
DOI: 10.1002/HPM.2198
Abstract: A strong health system is impossible without health workers who are the ultimate resource. Money and medical supplies are needed, but these inputs require an efficient workforce. Challenges with respect to human resources vary greatly between and within countries, and are associated with the political, economical, cultural and societal context of a country. Moreover, the gaps in the workforce do not generally relate to doctors but to nurses and other classes of health worker who make up the bulk of health workforce. The difficulties caused by low staff numbers are compounded by morale problems, skill imbalances and geographical maldistribution. This paper will discuss how it is difficult for the United Arab Emirates (UAE, a Middle East federation country) to wrestle effectively with the demands of a good health system, exploring how they lack the basis of health systems-motivated, trained and supported people. Additionally, we looked at how the UAE health system further challenged by negative work environment, and weak knowledge-base, out-migration and inadequate investment. At the end of our discussion, we are providing some suggestions to manage human resource problems in the UAE. Highlighting how a national workforce strategic plan is important to guide investments in human resources as the core component of strengthening the UAE national health system.
Publisher: Elsevier BV
Date: 07-2017
Publisher: F1000 Research Ltd
Date: 12-03-2021
DOI: 10.12688/F1000RESEARCH.40338.1
Abstract: Background: Whole exome sequencing (WES) is becoming part of routine clinical and diagnostic practice. In the investigation of inherited cystic kidney disease and renal ciliopathy syndromes, WES has been extensively applied in research studies as well as for diagnostic utility to detect various novel genes and variants. The yield of WES critically depends on the characteristics of the patient population. Methods: In this study, we selected 8 unrelated Omani children, presenting with renal ciliopathy syndromes with a positive family history and originating from consanguineous families. We performed WES in affected children to determine the genetic cause of disease and to test the yield of this approach, coupled with homozygosity mapping, in this highly selected population. DNA library construction and WES was carried out using SureSelect Human All Exon V6 Enrichment Kit and Illumina HiSeq platform. For variants filtering and annotation Qiagen Variant Ingenuity tool was used. Nexus copy number software from BioDiscovery was used for evaluation of copy number variants and whole gene deletions. Patient and parental DNA was used to confirm mutations and the segregation of alleles using Sanger sequencing. Results: Genetic analysis identified 4 potential causative homozygous variants each confirmed by Sanger sequencing in 4 clinically relevant ciliopathy syndrome genes, ( TMEM231 , TMEM138 , WDR19 and BBS9 ), leading to an overall diagnostic yield of 50%. Conclusions: WES coupled with homozygosity mapping provided a diagnostic yield of 50% in this selected population. This genetic approach needs to be embedded into clinical practise to allow confirmation of clinical diagnosis, to inform genetic screening as well as family planning decisions. Half of the patients remain without diagnosis highlighting the technical and interpretational hurdles that need to be overcome in the future.
Publisher: F1000 Research Ltd
Date: 07-07-2021
DOI: 10.12688/F1000RESEARCH.40338.2
Abstract: Background: Whole exome sequencing (WES) is becoming part of routine clinical and diagnostic practice. In the investigation of inherited cystic kidney disease and renal ciliopathy syndromes, WES has been extensively applied in research studies as well as for diagnostic utility to detect various novel genes and variants. The yield of WES critically depends on the characteristics of the patient population. Methods: In this study, we selected 8 unrelated Omani children, presenting with renal ciliopathy syndromes with a positive family history and originating from consanguineous families. We performed WES in affected children to determine the genetic cause of disease and to test the yield of this approach, coupled with homozygosity mapping, in this highly selected population. DNA library construction and WES was carried out using SureSelect Human All Exon V6 Enrichment Kit and Illumina HiSeq platform. For variants filtering and annotation Qiagen Variant Ingenuity tool was used. Nexus copy number software from BioDiscovery was used for evaluation of copy number variants and whole gene deletions. Patient and parental DNA was used to confirm mutations and the segregation of alleles using Sanger sequencing. Results: Genetic analysis identified 4 potential causative homozygous variants each confirmed by Sanger sequencing in 4 clinically relevant ciliopathy syndrome genes, ( TMEM231 , TMEM138 , WDR19 and BBS9 ), leading to an overall diagnostic yield of 50%. Conclusions: WES coupled with homozygosity mapping provided a diagnostic yield of 50% in this selected population. This genetic approach needs to be embedded into clinical practise to allow confirmation of clinical diagnosis, to inform genetic screening as well as family planning decisions. Half of the patients remain without diagnosis highlighting the technical and interpretational hurdles that need to be overcome in the future.
Publisher: Wiley
Date: 10-11-2018
DOI: 10.1002/HPM.2476
Abstract: Although the health care system depends heavily on female physicians, it discriminates against women and tends to concentrate female physicians' work in lower status occupations. Gender discrimination has structural, social, and cultural dimensions. Such discrimination is perceived differently by various stakeholders and the public. In addition, there is reluctance to publicly acknowledge gender discrimination, especially in the culturally conservative Middle East region. Gender discrimination leads to underrepresentation of female physicians in leadership roles and certain specialties and hence leads to less attention and understanding of the working conditions of female physicians and their roles in the health care system. The lack of accessible data in the region regarding gender discrimination among physicians leads to stakeholders failing to recognize the existence and magnitude of this type of discrimination. This article takes up the relatively neglected issue of gender discrimination in the health care workforce among the stakeholders of the Ministry of Health and Prevention of the United Arab Emirates. Future research should explore the extent of gender discrimination among physicians and the gender remuneration gap, together with other sorts of discrimination, perception of equal opportunity, and dominant stereotypes of men and women working in health care in relation to job obligation, promotion, retention, remuneration, and education.
Publisher: Elsevier BV
Date: 03-2023
Publisher: Elsevier BV
Date: 2021
Publisher: Wiley
Date: 06-1996
DOI: 10.1002/(SICI)1096-9136(199606)13:6<582::AID-DIA114>3.0.CO;2-E
Abstract: Larval zebrafish have been established as an excellent model for examining vertebrate biology, with many researchers using the system for neuroscience. Controlling a fast escape response of the fish, the Mauthner cells and their associated network are an attractive model, given their experimental accessibility and fast development, driving ethologically relevant behavior in the first five days of development. Here, we describe methods for immunostaining electrical and chemical synapse proteins at 3-7 days post fertilization (dpf) in zebrafish using tricholoracetic acid fixation. The methods presented are ideally suited to easily visualize neural circuits and synapses within the fish.
Publisher: Oxford University Press (OUP)
Date: 08-1997
Abstract: The aetiology of growth retardation in children with X-linked hypophosphatemic rickets (HPR) has not been totally defined. We evaluated growth hormone (GH)/insulin-like growth factor-I (IGF-I) changes in relation to linear growth and biochemical parameters in seven children with X-linked hypophosphatemic rickets before and after treatment with 1,25-dihydroxyvitaminD3 and phosphate therapy for a year or more. Moreover, we compared patients' growth data and GH/IGF-I changes with those for 20 age-matched children with normal variant short stature (NVSS)[with normal GH secretion and height standard deviation score (HtSDS) before -2]. Before treatment, all children with HPR secreted normal GH in response to clonidine provocation (> 10 microgram/l) and their IGF-I concentration was significantly lower than those with NVSS. The HtSDS and growth velocity (GV) of children with HPR improved significantly after (-3.05, 8.9 cm/year, respectively) v. before (-3.9 and 4.1 cm/year, respectively) therapy. Their serum IGF-I concentration increased significantly from 76.7 ng/ml before to 99.6 ng/ml after treatment. In summary children with HPR had no abnormality of GH secretion but improvement of their linear growth was associated with significant increase of circulating IGF-I concentration after treatment.
Publisher: BMJ
Date: 09-1996
DOI: 10.1136/ADC.75.3.242
Abstract: Short stature is a characteristic feature of pycnodysostosis. We report defective growth hormone secretion in response to provocation and low insulin-like growth factor-I (IGF-I) concentration in five out of six patients with pycnodysostosis. Physiological replacement with growth hormone increased IGF-I concentration and improved linear growth in these children.
Publisher: Medknow
Date: 2016
Abstract: To determine the prevalence of cardiovascular comorbidities and their active risk factors in the selected hemodialysis centers in the Gulf Cooperation Council (GCC) countries, the Dialysis Outcome and Practice Pattern Study (DOPPS) was performed on 40 dialysis centers in the six GCC countries from June 2012 to May 2015. There were 21 dialysis centers from Saudi Arabia, nine from the United Arab Emirates (UAE), four from Kuwait, four from Oman, two from Qatar, and one from Bahrain. There were 922 patients participating in the study 419 patients from Saudi Arabia, 144 from the UAE, 164 from Kuwait, 89 from Oman, 58 from Qatar, and 25 from Bahrain. Baseline data and laboratory investigations were obtained from every study patient, and the patients with any new events, change of dialysis prescription, or death were reported to the DOPPS main center during follow-up. The median age of the patients in the GCC centers was 55 years (range 32- 80 years), and the median percentage of males was 57%. The most common cause of chronic kidney disease among the study patients was diabetes mellitus (median: 43%) followed by hypertension (median: 29%) and glomerulonephritis (median: 9%). Hypertension (median 90%) and diabetes mellitus (median 52%) were the most common predisposing comorbidities to cardiovascular events in the study patients. The median ratios of patients with coronary artery disease, peripheral vascular disease, and congestive heart failure were 34%, 23%, and 24%, respectively. The median ratio for cerebrovascular comorbidities was 9%. The median prevalence of the factors that may predispose to the cardiovascular and cerebrovascular comorbidities such as gender of the patients, adequacy of dialysis, diabetes, hypertension, hypercholesterolemia, levels of anemia, parathormone levels, and calcium and phosphorus levels in the GCC countries were comparable with those in the previous DOPPS in other countries.
Publisher: Medknow
Date: 2016
Publisher: Medknow
Date: 2019
Abstract: Intravenous immunoglobulins (IVIGs) are pooled polyvalent immunoglobulin G antibodies extracted from the human plasma. Stabilizers in IVIG may include sugars, such as sucrose, glucose, or maltose. Sucrose in IVIG preparations may cause acute kidney injury (AKI). We report the case of a renal transplant patient who developed AKI due to sucrose nephropathy following the administration of sucrose-containing IVIG.
Publisher: Elsevier BV
Date: 2017
Publisher: Oman Medical Journal
Date: 15-01-2021
DOI: 10.5001/OMJ.2020.92
Abstract: Objectives: We sought to determine the estimated glomerular filtration rate (eGFR) among patients with COVID-19 and to examine its correlation with different demographic, clinical, and laboratory characteristics. Methods: This study examined patients diagnosed with COVID-19 and enrolled at Al Kuwait Hospital, Dubai, UAE. eGFR was calculated using the Modification of Diet in Renal Disease equation, 186 × (SCr mg/dL)-1.154 × (age)-0203 × 0.742 [if female] × 1.212 [if black], and compared for 250 COVID-19 cases and 153 non-COVID-19 controls. Analysis were performed using univariate statistics. Results: The overall mean age of the cohort was 47.2±14.0 years, and 54.6% (n = 220) were males. The results showed that 45.3% of COVID-19 patients had mild-severe renal impairment, as reflected in the eGFR. When compared to patients with normal eGFR, those with severe renal impairment were older (62.5 vs. 40.2 years p 0.001), more likely to be male (100% vs. 71.1% p = 0.016), and have comorbidities (90.9% vs. 40.0% p 0.001) including diabetes mellitus (72.7% vs. 21.5% p 0.001) and hypertension (72.7% vs. 25.2% p = 0.003). They were also more likely to be associated with those that had severe (36.4% vs. 25.9% p 0.001) and critical (63.6% vs. 16.3% p 0.001) COVID-19 infection as well as intensive care unit admission (72.7% vs. 16.3% p 0.001). Correlational analysis showed a significant association between renal function indicators and different laboratory markers, including hematological indices and different liver enzymes. Conclusions: This is the first study to examine the renal function among COVID-19 cases in the Middle East. Nearly half of COVID-19 patients had moderate to severe renal impairment. Diabetes mellitus and hypertension were the most common underlying comorbidities associated with moderate-severe renal function impairment among COVID-19 patients.
Publisher: Open Access Text Pvt, Ltd.
Date: 2020
DOI: 10.15761/TIT.1000281
Publisher: Medknow
Date: 2018
Abstract: Diabetic kidney disease (DKD), one of the most frequent microvascular complications of diabetes mellitus (DM), is the leading cause of end-stage kidney disease worldwide. We reviewed all kidney biopsies performed at the Royal Hospital, Muscat, Oman, between January 2005 and December 2016, and data of 51 DM patients were analyzed. Of the 51 patients, 54.9% were male and 45.1% were female. The mean age was 50.8 (47.1-55.2) years 86% were between 25 and 64 years old. Edema was the main clinical presentation (70.6%) with clinical urine changes in 84.3%. Diabetic retinopathy was present in 62.2% in ophthalmological examination of 44 patients. Majority (67.5%) of patients were in advanced chronic kidney disease Stages III, IV, and V. About one-quarter underwent hemodialysis at the time of admission. Majority (76.9%) were obese and hypertensive (78.4%). Low hemoglobin (51%), high triglyceride (35.7%), high total cholesterol (56.8%), low serum albumin (78.4%), nephrotic-range proteinuria (75.6%), and microscopic hematuria (77.1%) were the main laboratory findings. In addition, immunological investigations were examined and immunoglobulin A was the most common findings (35.7%) of serological investigations. About 24.4% had positive antinuclear antibody, 20.8% had positive anti-dsDNA, and 23.3% had positive extractable nuclear antigens. Also, p-antineutrophil cytoplasmic antibody (p-ANCA) was positive in 30% and c-ANCA was positive in 9.7%. This study represents the findings of the whole country for more than 10 years. It showed that only a small percentage of patients with DM undergo kidney biopsy. These patients have many clinical and laboratory abnormalities including those of specific immuno-logical investigations. Progression of DM nephropathy seems to be further aggravated by many coexisting risk factors of dyslipidemia and/or obesity. The prevalence of non-DKD is remarkably frequent in diabetics in whom nephrologists should consider kidney biopsy as an appropriate measure to enable better management.
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for issa al salmi.