Complications of Open Reduction and Internal Fixation of Mandibular Condyle Fractures in Oman

Objectives: This study aimed to report the complication rate associated with open reduction and internal fixation (ORIF) of mandibular condyle fractures in Oman. Methods: This retrospective cohort study was conducted among patients who underwent ORIF of mandibular condyle fractures at Al-Nahdha Hospital and the Sultan Qaboos University Hospital in Muscat, Oman, from January 2008 to December 2020. Data collected included patient demographics, fracture aetiology, fracture side and type, surgical approach and recorded complications and outcomes. Results: A total of 68 patients (59 males and 9 females; mean age of 30.1 years) with 83 mandibular condyle fractures underwent ORIF during the study period. Subcondylar fractures were the most common type, occurring in 62.7% of patients, while bilateral fractures were observed in 21 (30.8%) patients. The most common surgical approach was retromandibular, used in 42.2% of patients. The overall complication rate was 42.6%, with the most frequently reported complications being transient facial nerve palsy (18.1%), malocclusion (14.7%) and restricted mouth opening (10.3%). Subsequent surgical interventions to correct malocclusion were performed in 6 cases. There was no statistically significant association between the overall complication rate and the patients’ clinical characteristics. Conclusion: Although ORIF of mandibular condyle fractures generally offers favourable outcomes, it carries a risk of complications. Keywords: Mandibular Fracture; Mandibular Condyle; Open Fracture Reduction; Complications; Facial Nerve Injuries; Oman

Gender Difference in Relationship of Apnoea/Hypopnoea Index with Body Mass Index and Age in the Omani Population

Objectives: Obstructive sleep apnoea/hypopnoea syndrome (OSAHS) is a disorder characterised by repetitive upper airway collapse during sleep in association with daytime sleepiness. It has an estimated prevalence of 2% and 4% among middle-aged women and men respectively. The aim of the study was to look at the association of body mass index (BMI), age and gender and prevalence of OSAHS in the Omani population. Methods:Polysomnography reports and hospital medical records of all patients who took part in the Sleep Study at the Sleep Laboratory of the Clinical Physiology Department, Sultan Qaboos University Hospital, between January 1995 and December 2006, were retrospectively reviewed. Data from both sources was gathered and analysed. Results: A total of 1,042 sleep studies were conducted with 608 valid studies for analysis. The study showed that the apnoea/hypopnoea index (AHI) >15 was more prevalent in men compared to women (47.9% versus 33.5%, P = 0.001). There was significant correlation of AHI with BMI (P <0.0001) among men compared to women (P = 0.1); however, age was significantly correlated with AHI among women (P <0.0001), but not with men (P = 0.1). Conclusion: The results indicate that there is a gender difference in the prevalence of OSAHS and obesity is a major risk factor for OSAHS among Omani men whereas age is found to be a risk factor for OSAHS among women.

Modified Le Fort I Osteotomy and Genioplasty for Management of Severe Dentofacial Deformity in β-Thalassaemia Major: Case report and review of the literature

β-thalassaemia major is an autosomal recessive form of haemoglobinopathy that is characterised by complete lack of production of the β-chains resulting in multiple complications that include severe anaemia, failure to thrive and skeletal abnormalities. Facial deformities induced by β-thalassaemia major are rare and are very challenging to treat from a surgical point of view. We report a 33-year-old female patient with β-thalassaemia major who presented to the Dental & Maxillofacial Surgery Department, Sultan Qaboos University Hospital, Muscat, Oman, in 2017 with gross dentofacial skeletal deformity contributing to her psychosocial issues. The facial deformity was corrected surgically by excision of the enlarged maxilla, modified Le Fort I osteotomy and advancement genioplasty. This case highlights the pre-operative preparation, surgical management, encountered complications and treatment outcome within 24 months of follow-up.Keywords: Beta-Thalassaemia; Thalassaemia Major; Cooley's Anemia; Le Fort Osteotomy; Genioplasty; Dentofacial Deformities; Case Report; Oman

Awareness of the Dangers of High Salt Intake among the Urban Omani Population

Objectives: This study aimed to assess the knowledge, attitudes and practices of the general public in Oman regarding the dangers of high salt intake. Methods: This cross-sectional questionnaire-based survey was conducted among the urban population in Oman. Individuals aged ≥18 were invited to join the study. Results: A total of 1,214 respondents (mean age 34 ± 10 years) answered the questionnaire. The majority were male (65.8%), employed (69.4%) and some were hypertensive (14.3%). Most (90.9%) were aware that excess salt can cause diseases such as hypertension and that it is either somewhat important (51.2%) or very important (42.9%) to reduce salt in the diet. However, only 42.2% said that they actively try to reduce salt in their diet. Conclusion: Although most people in urban areas of Oman appear to be aware of the dangers of high salt intake, only a few are actively trying to reduce it. More educational activities are required to improve awareness.Keywords: Cross-Sectional Survey; Sodium; Low Salt Diet; Oman

Basic Education Students’ Perceptions on Sustainable Healthy Lifestyles and Disease Prevention Methods in Light of Some Variables in the Sultanate of Oman

هدفت الدراسة تعرف تصورات طلبة التعليم الأساسي بسلطنة عُمان عن الأنماط الصحية المستدامة وطرائق الوقاية من الأمراض في ضوء بعض المتغيرات. استخدمت الدراسة المنهج الوصفي. ولتحقيق هدف الدراسة؛ طُبِّقَتْ أداة الاستبانة، التي تكوَّنت من (36) عبارة، موزَّعة على محورين؛ هُمَا: الأنماط الصحية، والوقاية من الأمراض. وحُسِبَ ثبات الأداة؛ باستخدام طريقتَيْ: ثبات الاتساق الداخلي؛ حيث بلغ معامل كرونباخ ألفا (0.808)، وثبات التجزئة النصفية، وبلغ (0.753). وقد طُبِّقَتِ الدراسة على عَيِّنَة مكوَّنة من (3570)؛ من طلبة الصفين التاسع، والعاشر الأساسيَّيْنِ. وخَلُصَتْ نتائج الدراسة إلى وجود تصورات إيجابية لدى طلبة التعليم الأساسي عن محور الأنماط الصحية المستدامة، حيث حصل نمط النظافة الشخصية على أعلى نمط صحي، يليه نمطي النشاط الرياضي، والتغذية، ثم يأتي نمط النوم باعتباره أقل نمط صحي، وتظهر النتائج أيضًا وجود تصورات إيجابية في محور طرائق الوقاية من الأمراض، كما كشفت الدراسة عن عدم وجود فروق دالة إحصائيًّا في متغيِّرات: النَّوْع الاجتماعي، والمحافظة التعليمية في محوري: الأنماط الصحية، وطرائق الوقاية من الأمراض، وعليه أَوْصَتْ الدراسة بتعزيز وَعْي طلبة التعليم الأساسي بأهمية ممارسة الأنماط الصحية المستدامة

Metabolic dysfunction-associated fatty liver disease: current therapeutic strategies

The definition of "Metabolic Associated Fatty Liver Disease - MAFLD" has replaced the previous definition of Nonalcoholic Fatty Liver Disease (NAFLD), because cardiometabolic criteria have been added for the prevention of cardiological risk in these patients. This definition leads to an in-depth study of the bidirectional relationships between hepatic steatosis, Type 2 Diabetes Mellitus (T2DM), Cardiovascular Disease (CVD) and/or their complications. Lifestyle modification, which includes correct nutrition combined with regular physical activity, represents the therapeutic cornerstone of MAFLD. When therapy is required, there is not clear accord on how to proceed in an optimal way with nutraceutical or pharmacological therapy. Numerous studies have attempted to identify nutraceuticals with a significant benefit on metabolic alterations and which contribute to the improvement of hepatic steatosis. Several evidences are supporting the use of silymarin, berberine, curcumin, Nigella sativa, Ascophyllum nodosum, and Fucus vesiculosus, vitamin E, coenzyme Q10 and Omega-3. However, more evidence regarding the long-term efficacy and safety of these compounds are required. There is numerous evidence that highlights the use of therapies such as incretins or the use of Proprotein Convertase Subtilisin/Kexin type 9 (PCSK9) inhibitors or other similar therapies which, by assisting existing therapies for pathologies such as diabetes, hypertension, insulin resistance, have given a breakthrough in prevention and the reduction of cardiometabolic risk. This review gave an overview of the current therapeutic strategies that are expected to aid in the treatment and prevention of MAFLD

Rate of Screening for Obstructive Sleep Apnea Syndrome in Patients with Apparent Resistant Hypertension Attending a Tertiary Care Hospital

Objectives: This study aimed to evaluate the screening rate and the prevalence of obstructive sleep apnea syndrome (OSAS) in patients with apparent resistant hypertension (ARH) attending Sultan Qaboos University Hospital, and to assess sex differences. Methods: A cross-sectional retrospective study was conducted using the data from 500 patients with ARH between January 2018 and January 2023. The cohort included 270 women and 230 men. Data extracted from hospital records included demographic and clinical characteristics, antihypertensive medications, results of OSA screening tools (e.g., Epworth Sleepiness Scale and STOP-Bang questionnaire), and polysomnography outcomes. Results: Of the 500 patients with ARH, 54 (10.8%) were diagnosed with OSAS. Only 6.6% (n = 33) were screened for OSA using the Epworth Sleepiness Scale or STOP-Bang questionnaire, while the majority (93.4%, n = 467) were not screened. Women constituted 54.0% of the cohort and had a higher mean body mass index than men (32.7 kg/m2 vs. 30.2 kg/m2, p < 0.001). OSAS prevalence was significantly higher in women than men (14.1% vs. 7.0%, p =0.013). Conclusions: There was a low rate of screening for OSAS among patients with ARH at Sultan Qaboos University Hospital, which may explain the lower-than-expected prevalence observed. Contrary to published literature, OSAS was more frequently diagnosed in women, who were screened more often, suggesting that OSA may be underdiagnosed in men

Systemic Oxidative Stress Is Increased in Postmenopausal Women and Independently Associates with Homocysteine Levels

Oxidative stress plays a pivotal role in the pathogenesis of cardiovascular diseases (CVD). Postmenopausal women have an increased risk of developing CVD due to decreased estrogen availability, which is accompanied by increased oxidative stress. Serum free thiols (R-SH) provide a robust and powerful read-out of systemic oxidative stress. In this study, we aimed to establish serum levels of free thiols and explore associations between free thiols and demographic, clinical, and biochemical parameters related to obesity and the risk for developing CVD in both pre-and postmenopausal women. Serum free thiols were measured in a cohort consisting of healthy pre-(n = 223) and postmenopausal (n = 118) Omani women. Postmenopausal women had significantly lower levels of serum free thiols as compared to premenopausal women (762.9 ± 85.3 vs. 780 ± 80.9 µM, age-adjusted p < 0.001). Women′ s age was positively associated with serum free thiol levels in premenopausal women (β = 0.36, p = 0.002), whereas an inverse association was observed in postmenopausal women (β = −0.29, p = 0.002). Homocysteine levels were significantly inversely associated with serum free thiol levels in both pre-(β = −0.19, p = 0.005) and postmenopausal (β = −0.20, p = 0.032) women, independent from known cardiovascular risk factors. In this study, we show that postmenopausal women are affected by increased systemic oxidative stress, which independently associates with homocysteine levels

Aldosterone/Renin ratio : methods of measurement, physiological correlates and prediction of therapeutic outcome

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