11 research outputs found
Alarming Antibiotic Resistance in Pediatric Oncology Patients: A Three-Year Prospective Cohort Study from Oman
No full textAbeer Al Battashi,1 Bishara Al Harrassi,2 Nawal Al Maskari,3 Hilal Al Hashami,3 Salah Al Awaidy4 1Department of Pediatric Hematology and Oncology, The National Oncology Centre, Royal Hospital, Ministry of Health, Muscat, Oman; 2Oman Medical Specialty Board, Muscat, Oman; 3Pediatric Infectious Diseases, Child Health Department, Royal Hospital, Ministry of Health, Muscat, Oman; 4Office of Health Affairs, Ministry of Health, Muscat, OmanCorrespondence: Salah Al Awaidy, Office of Health Affairs, Ministry of Health, Al Khuwair Street, Muscat, Oman, Tel +968 99315063, Fax +968 24946381, Email [email protected]: Bloodstream infections (BSI) are severe and challenging oncological complications, with a consequent high morbidity and mortality in the immunocompromised. We reviewed the profile and susceptibility of bacteria associated with infections in children under 13 years of age receiving chemotherapy.Methods: Prospective cohort study of pediatric oncology patients was conducted between January 2015 and October 2017 at the Royal Hospital in Oman. Patient demographics, clinical data, laboratory parameters, microbial etiology and susceptibility, and outcomes were retrieved and analyzed.Results: A total of 74 episodes of positive bacterial blood cultures were detected in 38 oncology patients (positive blood culture rate of 51%). Fifty-seven percent were positive for gram-negative organisms with Klebsiella (21%) being the most common gram-negative organism cultured, and the most common gram-positive organism was Staphylococcus (coagulase negative Staphylococcus (CONs) and S. Aureus) (30%). The majority of patients had gastrointestinal complaints (74%), and almost half (51%) had prolonged periods of neutropenia (> 7 days). One third of gram-negative organisms were resistant to four or more antibiotics with a major resistance of 31% to piperacillin-tazobactam. Of the gram-positive organisms, 38% were resistant to at least four antibiotics and 30% were pan-resistant (except for vancomycin).Conclusion: The gram-negative organisms were dominant in BSIs with Klebsiella being the most common culprit. Bacteremia was prevalent, however, high resistance to first-line antibiotics was documented amongst gram-negative isolates, demanding strategies to ensure our patients’ safety.Keywords: neutropenia, pediatric oncology, bloodstream infections, antibiotic susceptibility, Oma
Field redevelopment optimization to unlock reserves and enhance production
No full textA cluster area "H" consists of 4 carbonate gas fields producing dry gas from N-A reservoir in the Northern area of Oman. These fields are producing with different maturity levels since 1968. An FDP (Field Development Plan) study was done in 2006 which proposed drilling of 7 additional vertical wells beside the already existing 5 wells to develop the reserves and enhance gas production from the fields. The FDP well planning was based on a seismic amplitude "Qualitative Interpretation (QI)" study that recommended drilling the areas with high amplitudes as an indication for gas presence, and it ignored the low amplitude areas even if it is structurally high. A follow up study was conducted in 2010 for "H" area fields using the same seismic data and the well data drilled post FDP. The new static and dynamic work revealed the wrong aspect of the 2006 QI study, and proved with evidence from well logs and production data that low seismic amplitudes in high structural areas have sweet spots of good reservoir quality rock. This has led to changing the old appraisal strategy and planning more wells in low amplitude areas with high structure and hence discovering new blocks that increased the reserves of the fields.Furthermore, water production in these fields started much earlier than FDP expectation. The subsurface team have integrated deeply with the operation team and started a project to find new solutions to handle the water production and enhance the gas rate. The subsurface team also started drilling horizontal wells in the fields to increase the UR, delay the water production and also reduce the wells total CAPEX by drilling less horizontal wells compared to many vertical as they have higher production and recovery. These subsurface and surface activities have successfully helped to stabilize and increase the production of "H" area cluster by developing more reserves and handling the water production
Eosinophilic Pneumonia in a Patient with Bronchial Myiasis; Case report and literature review
No full textPulmonary myiasis is an unusual form of myiasis in humans and has been recently identified as a cause
of eosinophilic pneumonia. We report the case of a 13-year-old Omani boy who presented to the Royal Hospital,
Muscat, Oman, in October 2014 with respiratory distress. Bronchial aspirates revealed features of eosinophilic
pneumonia. Possible larvae identified in the cytology report, a high immunoglobulin E level and the patient history
all indicated bronchial myiasis. The patient was treated with steroids and ventilation and has since been diseasefree
with no long-term side-effects. To the best of the authors’ knowledge, this is the first case of bronchial myiasis
in Oman
Operating Costs for Trucks
No full textThis study estimates the operating costs for commercial vehicle operators in Minnesota. A survey of firms that undertake commercial truck road movements was performed. The average operating cost per kilometer for commercial vehicle operators was calculated from the survey responses. Results show that the translog and Cobb-Douglas models have approximately equal explanatory power in estimating the total cost from the data. The models also revealed the presence of nearly constant returns to scale, a finding consistent with earlier studies; an increase in output (total truckloads) of 1% increases total costs by 1.04%.
Genetic diversity and transmissibility of imported Plasmodium vivax in Qatar and three countries of origin
No full textAbstractMalaria control program in the Arabian Peninsula, backed by adequate logistical support, has interrupted transmission with exception of limited sites in Saudi Arabia and sporadic outbreaks in Oman. However, sustained influx of imported malaria represents a direct threat to the above success. Here we examined the extent of genetic diversity among imported P. vivax in Qatar, and its ability to produce gametocytes, compared to parasites in main sites of imported cases, the Indian subcontinent (india) and East Africa (Sudan and Ethiopia). High diversity was seen among imported P. vivax in Qatar, comparable to parasites in the Indian subcontinent and East Africa. Limited genetic differentiation was seen among imported P. vivax, which overlapped with parasites in India, but differentiated from that in Sudan and Ethiopia. Parasite density among imported cases, ranged widely between 26.25–7985934.1 Pv18S rRNA copies/µl blood, with a high prevalence of infections carried gametocytes detectable by qRT-PCR. Parasitaemia was a stronger predictor for P. vivax gametocytes density (r = 0.211, P = 0.04). The extensive diversity of imported P. vivax and its ability to produce gametocytes represent a major threat for re-introduction of malaria in Qatar. The genetic relatedness between P. vivax reported in Qatar and those in India suggest that elimination strategy should target flow and dispersal of imported malaria into the region.</jats:p
The strategic plan for combating antimicrobial resistance in Gulf Cooperation Council States
No full textSummaryThe Gulf Cooperation Council Center for Infection Control (GCC-IC) has placed the emergence of antimicrobial resistance (AMR) on the top of its agenda for the past four years. The board members have developed the initial draft for the GCC strategic plan for combating AMR in 2014. The strategic plan stems from the WHO mandate to combat AMR at all levels. The need for engaging a large number of stakeholders has prompted the GCC-IC to engage a wider core of professionals in finalizing the plan. A multi-disciplinary group of more than 40 experts were then identified. And a workshop was conducted in Riyadh January 2015 and included, for the first time, representation of relevant ministries and agencies as well as international experts in the field. Participants worked over a period of two and a half days in different groups. International experts shared the global experiences and challenges in addressing human, food, animal, and environmental aspects of controlling AMR. Participants were then divided into 4 groups each to address the human, animal, microbiological and diagnostic, or the environmental aspect of AMR. At the end of the workshop, the strategic plan was revised and endorsed by all participants. The GCC-IC board members then approved it as the strategic plan for AMR. The document produced here is the first GCC strategic plan addressing AMR, which shall be adopted by GCC countries to develop country-based plans and related key performance indicators (KPIs). It is now the role of each country to identify the body that will be accountable for implementing the plan at the country level
Headache Among Medical And Psychology Students [cefaléia Em Estudantes De Medicina E Psicologia]
No full textHeadaches occur frequently and thus are a key component of sociocentric medical education. Objective: To study headaches among students of medicine and psychology in a single university. Method: This was a questionnaire-based survey of a cohort of students of medicine and psychology. Results: The overall lifetime prevalence of headache was 98% and over the last year, 91%. Tensional headache accounted for 59% and migraine 22% in medicine; and 48.5% and 32% respectively in psychology. Forty-five percent reported that headaches had a variable sporadic impact on their productivity. The self-medication rate was 77%. Thirty-six percent reported worsening since admission to the university. Conclusion: The prevalence of headaches was very high. Tension-type headaches predominated in males and migraine in females. Tension-type was more frequent among medical students than among psychology students; migraine was more frequent in psychology (more females) than in medicine. Both kinds of students reported that headaches caused low interference with daily activities. The students reported that their symptoms had worsened since admission to the university.693502508Marcondes, E., Montes, G.S., Bianco, A.C., A proposta do curriculo nuclear (1998) Educação Medica, pp. 174-182. , In: Marcondes E, Gonsalves EL (Eds), São Paulo, SarvierFerri-de-Barros, J.E., Veiga, J.C.E., Priante, A.V.M., Transtornos neurológicos mais frequentes: Contribuição para a definição de temas do conteúdo programático do curso de Neurologia, para a graduação médica (2000) Arq Neuropsiquiatr, 58, pp. 128-135Ferri-de-Barros, J.E., Nitrini, R., Que pacientes atende um neurologista? Alicerce de um currículo em Neurologia (1996) Arq Neuropsiquiatr, 54, pp. 637-644Raffaelli, E., Martins, O.J., (2001) Dor De Cabeça. O Que Se Diz. O Que Se Sabe, p. 25. , 4a ed. São Paulo, Lemos EditorialSanvito, W.L., Monzillo, P.H., Peres, M.F.P., The epidemiology of migraine in medical students (1996) Headache, 36, pp. 316-319Costa, M.Z.G., Soares, C.B., Heinisch, L.M.M., Heinisch, R.H., Frequency of headache in the medical students of Santa Catarina's Federal University (2000) Headache, 40, pp. 740-744Muñiz, R., Montiel, I., Asensio, M., Martin, R., Matias-Guiu, J., La prevalência de la migraña en una poblácion de estudiantes universitários (1995) Rev Neurol, 23, pp. 866-869Migraine headaches in a group of medical students at the Kenyatta National Hospital, Nairobi (1996) East 4fr Med J, 73, pp. 594-597Deleu, D., Khan, M.K., Humaidan, H., AL Mantheri, Z., Hashami, S., Prevalence and clinical characteristics of headache in medical students in Oman (2001) Headache, 41, pp. 798-804Rabello, G.D., (2000) Estudo Transversal Em Uma População Hospitalar: Fatores Constitucionais E Ambientais Relacionados À Enxaqueca, pp. 33-51. , Tese de doutorado. Faculdade de Medicina da Universidade de São Paulo. São Paulo(2004) The International Classification of Headache Disorders, 24 (SUPPL. 1), pp. S16-S54. , Headache Classification Subcommittee of the International Headache Society, 2nd Edition. CephalalgiaFeldman, A.S., (1994) Enxaqueca: Alívio Para a Sofrimento, , São Paulo, SicilianoHo, K.H., Ong, B.K.A., Community-based study of headache diagnosis and prevalence in Singapore (2003) Cephalalgia, 23, pp. 6-13Rasmussen, B.K., Jensen, R., Schroll, M., Olesen, J., Epidemiology of headache in a general population: A prevalence study (1991) J Clin Epidemiol, 44, pp. 1147-1157Gobel, H., Petersen-Braun, M., Soyka, D., The epidemiology of headache in Germany: A nationwide survey of a representative sample on the basis of the headache Classification of International Headache Society (1994) Cephalalgia, 14, pp. 97-106Alders, E.E., Hentzen, A., Tan, C.T., A community-based prevalence study on headache in Malaysia (1996) Headache, 36, pp. 379-384Nikiforow, R., Headache in a random sample of 200 persons: A clinical study of a population in northern Finland (1981) Cephalalgia, 1, pp. 99-107Ho, K.H., Ong, B.K., Headache and self-assessed depression scores in Singapore University undergraduates (1997) Headache, 37, pp. 26-30Martinez, S.F., Sanchez, H.A., Prevalencia de cefaleas en una poblácion universitária (1992) Rev Sanid Hig Publica (Madr), 66, pp. 313-317Blau, J.N., Common headaches: Type, duration, frequency and implications (1990) Headache, 30, pp. 701-704Monteiro, J.M., Matos, E., Calheiros, J.M., Headaches in medical school students (1994) Neuroepidemiology, 13, pp. 103-107Muniz, R., Macia, C., Montiel, I., Prevalence of migraine in the medical student population as determined by means of the "Alcoi 1992" questionnaire (1995) Rev Neurol, 23, pp. 870-87
Determinación de mercurio, plomo, cadmio y arsénico en carne e hígado de ganado ovino comercializado en el departamento de Córdoba: Evaluación de riesgos en la salud humana
No full textEn el presente estudio se realizó una evaluación de riesgos para la salud humana asociados con la exposición a arsénico (As), cadmio (Cd), mercurio (Hg) y plomo (Pb) a través del consumo de carne e hígado de ovinos comercializados en el departamento de Córdoba, Colombia. Para ello, se determinaron las concentraciones de estos metales pesados en muestras provenientes de las diferentes subregiones, se analizó el grado de contaminación en función de la normatividad vigente y se evaluó la relación entre las zonas de riesgo de inundación con la presencia de metales en los animales. Además, se estimó la ingesta diaria y el cociente de peligro en la población local.
Los resultados indicaron que las concentraciones de As, Cd, Hg y Pb en músculo e hígado de ovinos fueron inferiores a los límites máximos permisibles según la norma GB2762-2017 de China, excepto en nueve muestras de hígado (7,38%) que superaron el límite de 0,50 μg/g para Cd. Se observó que las concentraciones de As, Cd y Hg fueron significativamente mayores en el hígado que en la carne (p0,05). Además, los valores del Índice de Contaminación Metálica (MPI) evidenciaron una mayor acumulación de metales en el hígado que en la carne.
Las concentraciones de metales en carne se presentaron en el siguiente orden decreciente As > Pb > Hg > Cd, mientras que en hígado el orden fue Cd > As > Pb > Hg. El análisis del grado de contaminación indicó que el consumo de carne e hígado de ovinos es seguro (Pi ≤ 0,7), lo que sugiere que la presencia de metales pesados no compromete la seguridad alimentaria en la región. Asimismo, no se identificaron diferencias significativas en las concentraciones de metales entre terrenos inundables y no inundables (p>0,05), lo que sugiere una exposición homogénea de los animales a posibles fuentes de contaminación.
En cuanto a la evaluación del riesgo para la salud humana, se analizaron los hábitos de consumo de carne e hígado en dos grupos poblacionales: mujeres en edad fértil (MEF) y el resto de la población adulta (RP). Se encontró que las tasas de consumo diario fueron de 18,4 g/día y 9,0 g/día para carne e hígado en MEF, y de 31,0 g/día y 13,6 g/día en RP. Los cálculos del cociente de peligro (HQ) indicaron que la exposición a los metales a través del consumo de ovinos no representa un riesgo significativo para la salud.
En conclusión, aunque los niveles de contaminación por metales pesados en carne e hígado de ovinos en Córdoba son bajos y no suponen un riesgo alimentario inmediato, la detección de Cd en algunas muestras de hígado resalta la importancia de implementar programas de monitoreo periódico para identificar y mitigar posibles fuentes de contaminación en la región.The present study evaluated the human health risks associated with exposure to arsenic (As), cadmium (Cd), mercury (Hg) and lead (Pb) through the consumption of sheep meat and liver marketed in the department of Córdoba, Colombia. The concentrations of these heavy metals were determined in samples from different subregions, the degree of contamination was analyzed according to current regulations, and the relationship between flood risk zones and the presence of metals in the animals was evaluated. In addition, the daily intake and the hazard quotient in the local population were estimated.
The results indicated that the concentrations of As, Cd, Hg and Pb in sheep muscle and liver were lower than the maximum permissible limits according to the Chinese GB2762-2017 standard, except in nine liver samples (7,38%) that exceeded the limit of 0,50 μg/g for Cd. It was observed that the concentrations of As, Cd and Hg were significantly higher in liver than in meat (p0,05). In addition, the Metal Pollution Index (MPI) values showed a greater accumulation of metals in the liver than in the meat.
The concentrations of metals in meat were presented in the following decreasing order As > Pb > Hg > Cd, while in liver the order was Cd > As > Pb > Hg. The analysis of the degree of contamination indicated that the consumption of sheep meat and liver is safe (Pi ≤ 0,7), suggesting that the presence of heavy metals does not compromise food safety in the region. Likewise, no significant differences in metal concentrations were identified between flooded and non-flooded land (p>0,05), suggesting homogeneous exposure of animals to possible sources of contamination.
Regarding human health risk assessment, meat and liver consumption habits were analyzed in two population groups: women of childbearing age (WCHA) and the rest of the adult population (RP). Daily consumption rates were found to be 18,4 g/day and 9,0 g/day for meat and liver in WCHA and 31,0 g/day and 13,6 g/day in RP. Hazard quotient (HQ) calculations indicated that exposure to metals through sheep consumption does not pose a significant health risk.
In conclusion, although the levels of heavy metal contamination in sheep meat and liver in Córdoba are low and do not pose an immediate food risk, the detection of Cd in some liver samples highlights the importance of implementing periodic monitoring programs to identify and mitigate possible sources of contamination in the region.ResumenAbstractIntroducción2. Marco de referencia2.1. Antecedentes2.2. Marco Teórico2.2.1. Ganaderia ovina en Colombia2.2.2. Inocuidad en alimentos cárnicos2.2.3. Metales valorados en alimentos como indicadores de contaminación medioambiental2.3. Marco conceptual2.3.1. Metales pesados2.4. Marco normativo3. Objetivos3.1. Objetivo general3.2. Objetivos especificos4. Marco metodológico4.1. Tipo de investigación4.2. Área y objeto de estudio4.3. Fases de la investigación4.3.1. Selección de muestras4.3.2. Pretratamiento y digestión de muestras4.3.3. Análisis de muestras4.3.4. Índice de contaminación metálica (MPI)4.3.5. Grado de contaminación4.3.6. Exposición y riesgos a la salud humana4.3.7. Análisis de datos5. Resultados y discusión5.1. Concnetraciones de metales pesados en carne e hígado de ovinos5.2. Evaluación de riesgos a la salud humana5.2.1. Características sociodemográficas de la población5.2.2. Evaluación de IDE, HQ y CRlim6. Conclusiones y recomendacionesBibliografíaAnexosMaestríaMagíster en Ciencias AmbientalesTrabajos de Investigación y/o Extensió
