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Objectives: This study aimed to determine the risk factors associated with the failure of arteriovenous fistulae (AVF) maturation. Methods: This retrospective cohort study was conducted from January 2014 to December 2018 in Sultan Qaboos University Hospital, Muscat, Oman. Patients were followed-up 3 months after surgery, and their electronic medical records were accessed for demographic and clinical data. Univariate analysis was used to determine the risk factors associated with early AVF maturation and multivariant analysis was used to determine the predictive factors for AVF failure. Results: A total of 269 patients were included. Female gender was a significant factor affecting AVF maturity (P = 0.049), while age (P = 0.626), diabetes (P = 0.954), hypertension (P = 0.378), dyslipidaemia (P = 0.907), coronary artery disease (P = 0.576), cerebrovascular accident (P = 0.864), congestive heart failure (P = 0.685), previous central venous catheterisation (P = 0.05), fistula type (P = 0.863) and fistula site (P = 0.861) did not affect AVF maturation. Binary logistic regression showed that all the risk factors were insignificant. Failure of early AVF maturation affected 11.5% in the cohort. Conclusion: This study found that the proportion of early AVF maturation at our hospital is at par with that in the international literature. Failure of AVF maturation was significantly associated with the female gender. These findings can help nephrologists and vascular surgeons prognosticate AVF maturation rates. However, a larger study is needed for definitive conclusions. [ABSTRACT FROM AUTHOR]

Objectives: Stroke is the second leading cause of death worldwide, resulting in 5.5 million deaths in 2016. Vascular interventions, including carotid endarterectomy (CEA) and carotid artery stenting, play a major role in stroke prevention, especially when performed early after onset of symptoms. This study aimed to define the role of vascular surgeons in ischaemic stroke management and hence improve referral patterns by creating an algorithm for the referral process. This could reduce time to intervention and optimise patient benefit from intervention. Methods: This retrospective study reviewed symptomatic and asymptomatic patients with atherosclerotic disease of the carotid artery who were referred to the Vascular Surgery Unit of Sultan Qaboos University Hospital, Muscat, Oman, from April 2018 to March 2020 to examine factors influencing recognition of suitable candidates for intervention. Following analysis of the data, algorithms/protocols were created to simplify the referral process of symptomatic and asymptomatic carotid artery disease for surgical intervention. Results: A total of 38 patients with ischaemic stroke were recognised as having carotid artery stenosis and were referred to the vascular surgery service during the study period. Only six met the criteria for CEA, four of which underwent the procedure. Conclusion: Choice of patients for CEA involves multiple steps, with potential for missed opportunities. By involving a multidisciplinary team approach, the recommended protocol aims to lead to early and appropriate referral to a vascular surgeon or an interventional radiologist, resulting in increased and optimised intervention in stroke prevention. [ABSTRACT FROM AUTHOR]

We report a 32-year-old female patient who was referred to a tertiary care hospital in Muscat, Oman, in 2021 with an iatrogenic arteriovenous fistula (AVF) that presented as a neck swelling which developed few weeks after an attempt of central venous catheterisation through the right internal jugular vein. The fistula was corrected surgically with a successful outcome. AVF is an abnormal communication between an artery and vein which can occur as a congenital anomaly, after trauma or iatrogenic following central venous catheter or endovenous thermal ablation. [ABSTRACT FROM AUTHOR]

Background: The HIV cascade of care is a framework for monitoring HIV care, identifying gaps and informing appropriate interventions. This study aimed to describe the cascade of care in Oman in 2019 and highlight disparities at the sub-population level. Methods: We used the UNAIDS Spectrum modelling software to estimate the number of people living with HIV. A national HIV surveillance database was used to identify Omani people (≥13 years old) diagnosed with HIV from 1984 through December 2019. We calculated the cascade indicators as of 31 December 2019 stratified by sex, age, HIV risk factor, residence, and region of HIV care. We also performed multivariate logistic regression to determine the predictors of attrition at linkage, retention, on ART, and viral suppression. Results: As of December 2019, the estimated number of people living with HIV in Oman was 2440. Out of the estimated number of people living with HIV, 69% were diagnosed, 66% were linked to care, 61% were retained in care, 60% were on ART, and 55% were virally suppressed. Of the 1673 diagnosed individuals, 96% were linked to care, 88% were retained in care, 87% were on ART, and 81% were virally suppressed. People who received HIV care outside Muscat had the largest attrition (11% loss) in the transition from linkage (97%) to retention (86%). Similarly, people aged 13–24 years had the largest attrition (13% loss) from "on ART" (88%) to viral suppression (75%). Logistic regression showed that both not reporting a specific HIV risk factor and receipt of HIV care outside Muscat independently predicted attrition at each cascade stage from linkage to care through viral suppression. Conclusions: Our findings identified substantial disparities across various subpopulations along the cascade of care in Oman. This analysis will be invaluable in informing future interventions targeting patient subgroups who are at the highest risk of attrition. [ABSTRACT FROM AUTHOR]

Objectives: The aim of the current study was to describe COVID-19’s epidemiological characteristics in Oman during the initial stages of the outbreak and compare findings with other countries’ reports. Methods: Data were drawn from a descriptive, records-based review of reported cases of COVID-19 collected through the national COVID-19 Surveillance System from February to April 2020. Results: A total of 2,443 confirmed cases were reported during the study period. The overall first-time testing rate for this period was 851.7 per 100,000, the positivity rate was 53.1 (confidence intervals [CI]: 51.0–55.2) and the death rate was 0.32 (CI: 0.20–0.54) per 100,000 population, respectively. The overall national positive ratio was 5.7% and ranged from 2.2–7.1% across various governorates. Muscat Governorate had the highest positive ratio (12.5%). People in the 51–60 year old age group (RR = 1.97), males (RR = 1.24), non-Omanis (RR = 2.33) and those living in Muscat (RR = 2.14) emerged as categories with significant demographic risk for COVID-19 cases when compared to the national average. The mean age was 35.6 ± 13.4. Asymptomatic cases accounted for nearly 16%. Conclusion: The overall rate of COVID-19 cases and deaths were low in Oman compared to the rest of the world during the study period. [ABSTRACT FROM AUTHOR]

We conducted a cross-sectional analysis to determine HIV virologic failure and its associated factors among Omani people living with HIV who are on ART for > 6 months. Patients (n = 1427) were identified from a central national HIV surveillance dataset. Two-thirds (67%) of patients were male, and the median age was 39 years (IQR, 32-48 years). Out of 1427 patients, 14.4% had virologic failure (HIV viral load [VL] ≥ 200 copies/ml). The multivariate analysis showed that patients aged 25-49 years (adjusted odds ratio [aOR]: 1.76, 95% CI: 1.01-3.08) were significantly more likely to fail treatment, compared to those aged ≥ 50 years. Besides, having "Other" HIV risk factor (compared to heterosexuals, aOR: 1.82, 95% CI: 1.02-3.24) and receiving HIV care outside the capital Muscat (compared to those cared for in Muscat, aOR: 1.73, 95% CI: 1.11-2.7) were independently associated with virologic failure. HIV viral suppression (85.6%) in Oman is encouraging; however, further strategies, mainly targeting patients who are young (<50 years), those not disclosing their HIV risk factor and those attending HIV treatment centres outside Muscat, are required to enhance HIV treatment outcome in Oman. [ABSTRACT FROM AUTHOR]

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Aureobasidium mangrovei was isolated from plant debris in Muscat, Sultanate of Oman. The isolate was characterised and compared with related species of this genus for its growth, colony morphology, and micromorphology. Molecular analysis of the LSU and ITS rDNA supported final identification of the isolate. Our record is the second find in the world and the first in the Sultanate of Oman. DNA sequences of the isolated strain showed 99% (ITS) and 100% (LSU) similarity, respectively, with the sequences of the type isolates from Iran, as well as similar growth and colony morphology. A complete microscopic characterisation, which was not described for the Iranian strain, was made. The Iranian strains were isolated from saline habitats of the protected Hara forests, while our strain was isolated from the leaves of freshwater habitats. A comparison of growth characteristics of both strains under different conditions is provided. Aureobasidium mangrovei bylo izolováno z rostlinných zbytků v Maskatu (Omán). Izolát byl srovnán s příbuznými druhy po stránce růstu, morfologie kolonií a mikromorfologie; určení bylo potvrzeno molekulární analýzou LSU a ITS rDNA. Jde o druhý nález tohoto druhu na světě a první v Ománu. Sekvence DNA izolovaného kmene vykázaly 99% (ITS) and 100% (LSU) podobnost s typovým izolátem z Íránu, s nímž se shoduje i v charakteru růstu a morfologii kolonií. Je prezentována kompletní mikroskopická charakteristika, která doplňuje údaje z popisu kmene z Íránu. Zatímco íránské kmeny byly izolovány ze salinního prostředí v pobřežních porostech kolíkovníku, tento kmen byl izolován z listů ve sladké vodě. V práci je uvedeno srovnání růstových charakteristik obou kmenů. [ABSTRACT FROM AUTHOR]

The aim of this study was to estimate the residue levels of five commonly used antibiotics in poultry tissue samples using enzyme linked immunosorbent assay (ELISA). A total of 200 samples that comprised breast and liver (100 each) were collected from five poultry farms randomly selected from Muscat regions. The samples were analyzed for enrofloxacin (ENR), gentamicin (GEN), oxytetracycline (OTC), sulfamethazine (SMZ), and tylosin (TYL) residue concentrations. Comparisons of antibiotic residues between breast and liver of chickens under investigations showed a significant difference of ENR, GEN, OTC, SMZ, and TYL residue concentrations (p < 0.05). The highest antibiotic residue concentrations reported in the chicken liver were TYL, GEN, OTC, SMZ, and ENR, respectively. The lowest residual antibiotic concentrations observed in the chicken breast were TYL, GEN, OTC, SMZ, and ENR, respectively. Furthermore, the Kruskal–Wallis statistical test revealed a significant difference between the five antibiotic concentrations in both breast (H (4) = 54.69, p < 0.05) and liver (H (4) = 44.36, p < 0.05). A follow up of this finding by Bonferroni correction for both breast and liver samples revealed a significant difference for the breast sample between the concentration of ENR residue, and the concentration of residues for of both OTC and TYL (p < 0.05). These data show that not all tissues incorporate antibiotics at the same concentration. The results of this study could support regulatory bodies in adopting, monitoring, and enforcing guidelines pertinent to safety levels of different antibiotic residue concentrations in poultry meat when antibiotics are used for different indications. [ABSTRACT FROM AUTHOR]

• Description of first outbreak of autochthonous dengue fever in two villages in the Seeb District, Muscat Governorate, Oman. • Initial case reported in December 2018; final cases reported in March 2019. • Patient zero had no history of travel out of Oman. Upon report of illness to hospital in Oman, considering no local transmission of dengue was previously recorded in Oman, further epidemiological investigation was required. • Because of speedy notification and early community-wide, extensive vector control activities, the autochthonous dengue fever virus outbreak was successfully controlled. In December 2018, routine surveillance identified an autochthonous outbreak of dengue fever in Muscat Governorate, Oman, a region previously free of dengue fever. Routine surveillance confirmed locally acquired cases in the second week of December, leading to a rapid public health response including case management guidance and epidemiological investigations. The main activity was the vector survey using systematic sampling to assess extent of previously unreported Aedes aegypti presence followed by a campaign aimed to eliminate breeding sites of A. aegypti ". During a 5-month period, 343 suspected cases were reported from Muscat Governorate with 122 from the outbreak affected area. Out of 207 probable cases eligible for laboratory testing as per guidelines issued, 59 cases were confirmed. The vector elimination campaign started on January 8, 2019 after a media advocacy using television and social media and concluded on January 23. By the end of campaign, the case load had decreased significantly in the affected area with no reports of locally acquired cases from adjoining areas of Muscat Governorate, indicating no further spread. Rapid notification and early community-wide, extensive vector control activities effectively contained the autochthonous dengue fever virus outbreak. [ABSTRACT FROM AUTHOR]