Going alone: the lived experience of female Arab-Muslim nursing students living and studying in the United States

Since 2004, international student enrollment in the United States has increased. Middle Eastern students studying in the United States have been part of the increase. In 2008-2009 there were 29 140 Middle Eastern students, representing an 18% increase from the previous academic year. Despite these increases, there is limited research examining the experience of Arab-Muslim international students or international nursing students studying in the United States. Phenomenological inquiry was used to describe the experience of 12 female Omani nurses living in the United States while studying for their baccalaureate degrees in nursing. The women described the experience of going alone and being away from the support and presence of their large, extended families; this influenced their international student experience. They also described their religious, cultural, and educational adaptation. The experience of living and studying nursing in the United States was transformational as they became self-reliant, learned their capabilities, and adapted to cultural and educational expectations.     

Sporadic Colon Cancer: Mismatch Repair Immunohistochemistry and Microsatellite Instability in Omani Subjects

Background Colorectal carcinoma (CRC) is the most common gastrointestinal malignancy in the world, and there are suggestions of a particularly high incidence in the Middle East, including those of African origin. Defects in DNA mismatch repair (MMR) systems are involved in the carcinogenesis of both sporadic and inherited human cancers. We assessed colonic cancers in an attempt to identify tumors with DNA MMR deficiency and microsatellite instability (MSI). Additionally, we tested the ability of cell cycle regulator p16 that effects cell proliferation and can be abrogated by hypermethylation of the promoter region. Methods We reviewed the charts of 756 patients who were referred to the Oman major colonoscopy unit of the Sultan Qaboos University Hospital and Royal Hospital from the years 2000 to 2004. Colon cancer tissue was assayed using immunohistochemistry for expression of hMLH1 and hMSH2, and a panel of five pairs of microsatellite primers (NR21, NR22, NR24, BAT25, and BAT26) for MSI-H analysis and additional dinucleotide markers (D17S250, D5S346, and D2S123) used for MSI-L. The expression status of MMR genes and MSI was correlated with cancer stage, location, and histology. A total of 49 tumors were analyzed for histopathology, MSI, and hMLH1/hMSH2 protein expression analysis. The methylation status of the p16 promoter was determined by methylation-specific polymerase chain reaction (PCR). Results The mean age for the carcinomas was 52.2 years and 53% of the patients were male. The majority of the tumors were left-sided. The information currently available indicates that there is an incidence of 4.7% colon cancer (49/1036) and 12.1% (126/1290) colon adenoma among the cases who underwent colonoscopy at these centers. The rate of MSI-H was 12.2% (n = 6), which appears to be the same as previously reported in literature. Eight of 49 tumors (16.3%) were MMR defective by IHC. Defects in the mismatch repair genes hMLH1 and hMSH2 were found in four (66.7%) and two (33.3%) of CRCs MSI-H cases, respectively. Defects in hMLH1 expression in tumors were commonly associated with moderate differentiation. The p16 promoter was methylated in 4% of tumors. Conclusion This is the first genetic study of CRC in this region of the world to demonstrate the incidence of MSI, p16 methylation, and hMLH1 and MSH2 expression in the Omani population. In addition, a relatively high frequency of CRC in younger age groups was noted, which is an important observation. The left-sided preponderance of MMR defective tumors was mostly associated with hMLH1, and with possible loss of hMSH2 expression, an observation that differs from studies on other populations. In conclusion, although the overall rate of CRC is unknown in this region, the frequency of MSI in CRC in this region appears to be the same as in Caucasians in the USA.     

Ecological and molecular studies on emerging schistosomiasis mansoni in Dhofar Governorate,Sultanate of Oman

The recent detection of some cases of autochtonous schistosomiasis mansoni in Dhofar, Oman, prompted a search for the transmission sites. The five field surveys we conducted from November 2000 to February 2002 provided ecological data on schistosomiasis in Dhofar. Twenty-eight water bodies situated within 8-160 km from Salalah, the largest city of Dhofar and at altitudes of up to 900 m, were surveyed for freshwater snails. Biomphalaria arabica was found in 15 of them. Three sites (Tibraq, Siginitti and Arazat) had Schistosoma infected snails, the first snails shedding cercariae of this parasite ever collected in Oman. The parasite from Dhofar was analysed by Random Amplified Polymorphic DNA comparisons using 11 primers and 167 polymorphic fragments and had 87-88% similarity with Schistosoma mansoni from Guadeloupe, but only 37-38% similarity with S. rodhaini from Burundi. Thus, it is a strain of S. mansoni. During the November 2000 survey, the prosobranch snail Melanoides tuberculata was associated with B. arabica in 10 of the 13 B. arabica sites. Cercariae from other species of Digenea emerged from five of the B. arabica sites, including the three named above. This paper presents the first finding of S. mansoni in the Dhofar Governorate and represents an initial study of the biology of S. mansoni transmission. This parasite and its cycle need further biological and molecular characterization, and the clarification of its epidemiological status in Dhofar Governorate is an urgent task.     

Asymptomatic MERS-CoV Infection in Humans Possibly Linked to Infected Dromedaries Imported from Oman to United Arab Emirates,May 2015

In May 2015 in United Arab Emirates, asymptomatic Middle East respiratory syndrome coronavirus infection was identified through active case finding in 2 men with exposure to infected dromedaries. Epidemiologic and virologic findings suggested zoonotic transmission. Genetic sequences for viruses from the men and camels were similar to those for viruses recently detected in other countries.     

Annual direct medical cost and contributing factors to total cost of epilepsy in Oman

OBJECTIVES: To describe the pharmaceutical use, health care resource utilisation patterns, and annual direct medical cost of epilepsy as well as determining the impact of various demographic and clinical characteristics on total costs of epilepsy in Oman. METHODS: Medical and pharmacy data were collected for 6 months on all patients aged > or =13 years attending the Sultan Qaboos University Hospital. Unit pharmacy and medical costs were retrieved for each patient, and multiple linear regression was utilised to analyse the impact of various demographic and clinical characteristics on total cost. RESULTS: A total of 486 patients were seen over the study period. Annual direct medical costs of epilepsy amounted to 1,426 US dollars. In-patient care, the antiepileptic drug (AED) lamotrigine and specialist visits, respectively, were the first, second and third most significant predictors of total cost. Age was associated positively, and was the most significant predictor of total costs among demographic and clinical parameters. CONCLUSIONS: This analysis, the first economic study of epilepsy in Oman, could assist in health care allocation of scarce resources and in pharmacoeconomic analysis of AEDs. Besides in-patient admission, our findings demonstrate that the newer drugs are significant predictors of total cost, and hence any incremental benefits derived from them must be rigorously assessed for their cost-effectiveness.     

Family and community health in a new medical school

The planning and implementation of a curriculum for a department of family and community health in a new medical school in a developing country presents special problems. The evolution of the programme at Sultan Qaboos University in the Sultanate of Oman is described and discussed.     

Validation of the existing modified screening criteria for detection of all cases of Retinopathy of Prematurity in preterm babies – 11 year study from a governorate referral hospital in Oman

Purpose

To study appropriateness of our modified screening criteria for detection of all cases of Retinopathy of Prematurity (ROP) among preterm babies.

Method

Retrospective observational cohort study among preterm neonates who underwent ROP screening as per set protocol for 11 years at Nizwa Hospital, Al Dhakilya Governorate, Oman. We screened all babies with gestational age ⩽32 weeks or BW ⩽ 1500 g. Preterm babies >32 weeks of GA or BW > 1500 g with unstable clinical course believed to be at high risk by the attending neonatologist also were screened.

Results

During the study period 528 babies were screened for ROP of which 76 babies were excluded due to death, associated congenital ocular malformation and loss for follow-up either due to transfer to other institution or defaulting. Thus 452 babies were included in the final analysis. Incidence of ROP was 46.4% of which 27.9% had mild ROP, 11.3% had severe ROP which regressed and 7.3% had severe ROP who were treated. The incidence of ROP among infants with GA < 26 wks, 26–28 wks, 29–30 wks, 31–32 wks and above 32 weeks was 100.0%, 80.0%, 59.3%, 34.4% and 19.4% respectively.56 babies of this cohort belonged to Extended (modified) criteria group. Among these 12 babies had ROP out of which 9 had mild ROP and 3 had severe ROP. Among cases with severe ROP, two cases regressed spontaneously and one case needed treatment.Multivariate analysis using stepwise regression model showed statistically significant association of GA and BW to development of ROP.We would have missed few babies with ROP if we had followed other criteria.

Conclusion

Our modified screening criteria seem to be appropriate as no infant with severe ROP was missed during the study period. Incidence of severe ROP among babies in the extended criteria group (5.4%) is low but significant compared to lower gestational age. We plan to formulate a scoring system following all risk factor analysis to enable us to optimize the number of infants screened. Detection of all babies with ROP is important as they need long-term follow-up for the timely detection and management of associated ocular comorbidities.     

Potential of Aucklandia Lappa Decne Ethanolic Extract to Trigger Apoptosis of Human T47D and Hela Cells

Breast and cervical cancers are global health concerns and major cause of deaths among women. Current treatmentssuch as chemotherapy are associated with several drawbacks that limit their effectiveness. Several anticancer remedieshave been found with natural products in the past and the search continues for more examples. Cytotoxic naturalcompounds may have considerable benefits for cancer therapy either in potentiating the impact of chemotherapy orcurtailment of harmful effects. Therefore, discovery and identification of new drugs for breast and cervical cancertreatment are of high priority. The present study addressed the potential role of the ALD (Aucklandia lappa Decne) insuppressing proliferation of T-47D, HeLa and HEp-2 cells in comparison with the non-cancer HCC1937 BL cell line.Treatment with an ALD extract of T-47D, HeLa, and HEp-2 cells resulted in reduction in cell viability in MMT assays.Furthermore, lyophilized ALD principally suppressed cancer cell line growth and proliferation through induction ofeither intrinsic or extrinsic apoptotic pathways as demonstrated by significantly suppressed release of LDH, and NOproduction in a dose-dependent manner, and activation of death receptors in T-47D and HeLa cells but not the HEp-2cell line. Interestingly, lyophilized ALD significantly (p<0.005) repressed the growth of HEp-2 and T-47D cells aftertreatment for 48hrs while 24hrs treatment significantly suppressed T-47D and HeLa cells. We report for the first timethat lyophilized ALD selectively influences apoptosis through alternative apoptotic pathways in both breast and cervicalhuman cancer cells.     

The relationship of variations in children's growth rates to seasonal climatic variations

The growth rates in stature of 300 children in the Orkney Islands, measured at monthly intervals over 2 years, were negatively correlated with various measures of light and temperature. All correlations were small but statistically significant, the highest being with the mean of the maximal daily temperatures (?0·32) for the boys and with hours of bright sunshine (?0·29) for the girls.

The children's mean growth rates reached maxima at midwinter and minima at midsummer but the maximum in the winter 1971–72 was much lower than those at the beginning of 1971 and at the end of 1972. The climatic variables were not appreciably different in the two years.

Only about 35 per cent of children showed cycles of growth rates which could be regarded as seasonal in that they rose to peak values at approximately the same time in the two successive years.

The difference between the maximal and minimal rates exhibited by Orkney children (5·26±0·12 cm/yr for boys; 5·46±0·14 cm/yr for girls) was almost identical to that in London children. The synchronization of the maximal growth rates was no more precise in Orkney than in London.

It is concluded that seasonal variations in light and temperature exert at most only a small effect on growth rate and perhaps none at all. The influence of other factors, as yet unidentified, is greater.