Recent Increase in HIV cases in Oman

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Cardiac involvement in beta-thalassaemia: current treatment strategies

Despite the advances in the management of thalassemia major, heart disease remains the leading cause of mortality in patients afflicted with this disorder. Cardiac involvement in thalassemia encompasses a spectrum of disorders including myocardial dysfunction, arrhythmias, pulmonary hypertension, and peripheral vascular disease. Although cardiac siderosis (accumulation of iron in cardiac myocytes) as a consequence of repeated blood transfusions is deemed to be the main etiologic factor for myocardial dysfunction in transfusion-dependent patients, the significance of other pathophysiologic mechanisms is being increasingly recognized especially in non-transfusion dependent patients. Management of cardiac complications in thalassemia major hinges on the treatment of the underlying pathophysiology, which often is unmitigated iron overload. The prevalence and predictors of cardiac complications in ‘ex-thalassaemics’ [thalassaemic patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT) is unknown at present. In this review, we look at the pathogenesis of cardiac involvement in patients with beta-thalassemia major, the advances in the management of these patients and the future prospects. © 2019, © 2019 Informa UK Limited, trading as Taylor & Francis Group

Clinical and molecular epidemiology of Crimean-Congo hemorrhagic fever in Oman

BackgroundCrimean-Congo hemorrhagic fever (CCHF) is a serious disease with a high fatality rate reported in many countries. The first case of CCHF in Oman was detected in 1995 and serosurveys have suggested widespread infection of humans and livestock throughout the country.MethodologyCases of CCHF reported to the Ministry of Health (MoH) of Oman between 1995 and 2017 were retrospectively reviewed. Diagnosis was confirmed by serology and/or molecular tests in Oman. Stored RNA from recent cases was studied by sequencing the complete open reading frame (ORF) of the viral S segment at Public Health England, enabling phylogenetic comparisons to be made with other S segments of strains obtained from the region.FindingsOf 88 cases of CCHF, 4 were sporadic in 1995 and 1996, then none were detected until 2011. From 2011-2017, incidence has steadily increased and 19 (23.8%) of 80 cases clustered around Eid Al Adha. The median (range) age was 33 (15-68) years and 79 (90%) were male. The major risk for infection was contact with animals and/or butchering in 73/88 (83%) and only one case was related to tick bites alone. Severe cases were over-represented: 64 (72.7%) had a platelet count ConclusionsCCHF is well-established throughout Oman, with a single strain of virus present for at least 20 years. Most patients are men involved in animal husbandry and butchery. The high mortality suggests that there is substantial under-diagnosis of milder cases. Preventive measures have been introduced to reduce risks of transmission to animal handlers and butchers and to maintain safety in healthcare settings

Efficacy and Safety of Pharmacological Thromboprophylactic Agents for the Prevention of Venous Thromboembolism after Major Abdominal Surgery

Statement of the problem: The type and duration of pharmacological thromboprophylaxis post major abdominal surgery remains controversial. Methods of investigation: A systematic review and pooled analysis of literature was performed to assess the risk benefit ratio of the different pharmacological thromboprophylaxis agents compared to placebo or no thromboprophylaxis post major abdominal surgery. A survey of the clinical practice among both general surgeons and thrombosis expert was conducted. Results: The systematic review demonstrated that all five pharmacological thromboprophylaxis regimens were associated with similar rates of overall VTE. The 95% CI of the different estimates overlapped indicating no statistically significant difference between any of the pharmacological interventions and placebo. While all the surgeons and thrombosis experts recommended thromboprophylaxis post major abdominal surgery, over 70% of them recommended it during hospitalization only. Conclusion: Pharmacological thromboprophylaxis was not associated with a significant benefit in reducing the rate of overall VTE events post major abdominal surgery. There is an agreement between general surgeons and thrombosis experts in using LMWH for thromboprophylaxis post major abdominal surgery. However, there is still equipoise around the use of pharmacological thromboprophylaxis post discharge

Human rabies importation to the Middle East: An emerging threat?

International audienc

Effective vaccine management and Oman’s healthcare system’s challenge to maintain high global standards

The prevention of infection through vaccination has been among the most successful public health interventions. Nearly 2.5 million deaths per year globally are saved by immunization against vaccine-preventable disease (VPD) (WHO, 2013) [1]. Oman has experienced a sharp decline in VPDs over the last 40 years due to the introduction of new vaccines and the maintenance of high vaccination coverage of over 99%.The World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) launched the effective vaccine management (EVM) framework to assist countries to gauge the performance of their immunization supply chains. Oman underwent the assessment in 2016 and scored the best score to date. This report looks at the process of EVM and the challenges for the Oman healthcare system to maintain high global standards. Keywords: Vaccine, Immunization, Effective, Management, Oma