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Background  Sleep disturbance is a major complaint among individuals with diabetes mellitus and may be augmented by dietary interventions. The objective of this randomized controlled trial was to determine the effectiveness of a Mediterranean diet intervention on daytime sleepiness among individuals with type 2 diabetes mellitus (T2DM) in Oman. Methods  In total, 134 eligible individuals with T2DM (61 and 73 participants in the intervention and control groups, respectively) were recruited. The intervention participants underwent a 6-month Mediterranean diet intervention consisting of individual dietary counseling, cooking classes, phone calls, and social media messages, while the control group continued with standard diabetes care. Daytime sleepiness was assessed using the Epworth Sleepiness Scale. All data was analyzed using IBM SPSS Statistics for Windows, version 26.0 (IBM Corp., Armonk, NY, USA). Results  Daytime sleepiness was evident, with ∼ 30% of the participants experiencing it, with no significant difference between control and intervention participants at baseline. There was a significant reduction in daytime sleepiness in both the intervention and control groups after 6 months, with daytime sleepiness significantly lower in the intervention group, with a modest difference of 42.56% ( p  < 0.001). Conclusion  Adherence to the Mediterranean diet is effective in reducing daytime sleepiness among individuals with T2DM. Clinical Trial  UMIN000041152., Competing Interests: Conflict of Interests The authors have no conflict of interests to declare., (Brazilian Sleep Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ).)

Būt ( Sideroxylon mascatense ) is an indigenous wild blueberry found in Oman. It has a very short season and is commonly preserved by drying. The aims of this study were to determine the physico-chemical characteristics and stability of phytochemicals (i.e., polyphenols and flavonoids) in the berries during drying (i.e., freeze-drying at -40 °C and air-drying at 60 and 90 °C) and the polyphenol stability of the dried berries as a function of storage temperature (i.e., 90, 70, 60, 40, 20, and -20 °C). The moisture content of fresh berry flesh was 64.5 g/100 g sample (wet basis). The crude protein and fat contents were higher in the seeds than in the flesh. Glucose and fructose were the main sugars and their concentrations were highest in the sample air-dried at 60 °C. The initial total polyphenol content (TPC) and total flavonoid content (TFC) of the flesh were 2.009 mg gallic acid equivalent (GAE)/g dry-solids and 0.199 mg catechin equivalent (CE)/g dry-solids, respectively. The samples air-dried at 90 °C and freeze-dried at -40 °C had higher TPC (i.e., 2.638 mg GAE/g dry-solids) and TFC (i.e., 0.395 mg CE/g dry-solids), respectively. There was a significant difference between the TPC and TFC of fresh and dried wild berries ( p < 0.05). The freeze-dried wild berries retained a high TPC compared to the air-dried samples. The polyphenol storage stability of freeze-dried wild berries at different storage temperatures showed two phases: an initial release phase followed by a decay phase. The polyphenol storage stability was modeled using the Peleg model and the kinetic parameters were correlated with the storage temperature.

Introduction: Tobacco smokers are at high risk of developing severe COVID-19. Lockdown was a chosen strategy to deal with the spread of infectious diseases; nonetheless, it influenced people's eating and smoking behaviors. The main objective of this study is to determine the impact of the COVID-19 lockdown on smoking (waterpipe and cigarette) behavior and its associations with sociodemographic characteristics and body mass index., Methods: The data were derived from a large-scale retrospective cross-sectional study using a validated online international survey from 38 countries (n=37207) conducted between 17 April and 25 June 2020. The Eastern Mediterranean Region (WHO-EMR countries) data related to 10 Arabic countries that participated in this survey have been selected for analysis in this study. A total of 12433 participants were included in the analysis of this study, reporting their smoking behavior and their BMI before and during the COVID-19 lockdown. Descriptive and regression analyses were conducted to examine the association between smoking practices and the participant's country of origin, sociodemographic characteristics, and BMI (kg/m 2 )., Results: Overall, the prevalence rate of smoking decreased significantly during the lockdown from 29.8% to 23.5% (p<0.05). The percentage of females who smoke was higher than males among the studied population. The highest smoking prevalence was found in Lebanon (33.2%), and the lowest was in Oman (7.9%). In Egypt, Kuwait, Lebanon, and Saudi Arabia, the data showed a significant difference in the education level of smokers before and during the lockdown (p<0.05). Smokers in Lebanon had lower education levels than those in other countries, where the majority of smokers had a Bachelor's degree. The findings show that the BMI rates in Jordan, Lebanon, Oman, and Saudi Arabia significantly increased during the lockdown (p<0.05). The highest percentages of obesity among smokers before the lockdown were in Oman (33.3%), followed by Bahrain (28.4%) and Qatar (26.4%), whereas, during the lockdown, the percentage of obese smokers was highest in Bahrain (32.1%) followed by Qatar (31.3%) and Oman (25%). According to the logistic regression model, the odds ratio of smoking increased during the pandemic, whereas the odds ratio of TV watching decreased. This finding was statistically significant by age, gender, education level, country of residence, and work status., Conclusions: Although the overall rates of smoking among the studied countries decreased during the lockdown period, we cannot attribute this change in smoking behavior to the lockdown. Smoking cessation services need to anticipate that unexpected disruptions, such as pandemic lockdowns, may be associated with changes in daily tobacco consumption. Public health authorities should promote the adoption of healthy lifestyles to reduce the long-term negative effects of the lockdown., (© 2022 Al Sabbah H. et al.)

Background: The COVID-19 pandemic along with its confinement period boosted lifestyle modifications and impacted women and men differently which exacerbated existing gender inequalities. The main objective of this paper is to assess the gender-based differentials in food consumption patterns, dietary diversity and the determinants favoring weight change before and amid the COVID-19 pandemic among Arab men and women from 10 Arab countries., Methods: A cross-sectional study was conducted based on a convenience sample of 12,447 households' family members (mean age: 33.2 ± 12.9; 50.1% females) and information from participants aged 18 years and above was collected about periods before and during the pandemic., Results: Findings showed that, during the COVID-19 period, the dietary diversity, declined by 1.9% among females compared to males (0.4%) ( p < 0.001) and by 1.5% among overweight participants ( p < 0.001) compared to their counterparts., Conclusions: To conclude, gender-sensitive strategies and policies to address weight gain and dietary diversity during emergent shocks and pandemics are urgently needed in the region., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Tayyem, Ibrahim, Mortada, AlKhalaf, Bookari, Al Sabbah, Qasrawi, Kamel, Dashti, Allehdan, Bawadi, Waly, Abuhijleh, Hammouh, Al-Awwad, Al-Bayyari, Cheikh Ismail, Abu Al-Halawa, Othman, The Regional CORONA COOKING Survey Group and Hoteit.)

Insufficient physical activity is considered a strong risk factor associated with non-communicable diseases. This study aimed to assess the impact of COVID-19 on physical (in)activity behavior in 10 Arab countries before and during the lockdown. A cross-sectional study using a validated online survey was launched originally in 38 different countries. The Eastern Mediterranean regional data related to the 10 Arabic countries that participated in the survey were selected for analysis in this study. A total of 12,433 participants were included in this analysis. The mean age of the participants was 30.3 (SD, 11.7) years. Descriptive and regression analyses were conducted to examine the associations between physical activity levels and the participants' sociodemographic characteristics, watching TV, screen time, and computer usage. Physical activity levels decreased significantly during the lockdown. Participants' country of origin, gender, and education were associated with physical activity before and during the lockdown ( p < 0.050). Older age, watching TV, and using computers had a negative effect on physical activity before and during the lockdown ( p < 0.050). Strategies to improve physical activity and minimize sedentary behavior should be implemented, as well as to reduce unhealthy levels of inactive time, especially during times of crisis. Further research on the influence of a lack of physical activity on overall health status, as well as on the COVID-19 disease effect is recommended.

Objective: Cardiovascular disease (CVD) is the leading cause of disability and death in many countries. Together with CVD, Type 2 diabetes mellitus (T2DM) accounts for more than 80% of all premature non-communicable disease deaths. The protective effect of the Mediterranean diet (MedDiet) on CVD and its risk factors, including T2DM, has been a constant topic of interest. Notwithstanding, despite the large body of evidence, scientists are concerned about the challenges and difficulties of the application of MedDiet. This review aims to explore the motivations and challenges for using MedDiet in patients with CVD and T2DM., Design: An electronic search was conducted for articles about MedDiet published in PubMed, ScienceDirect, Scopus, and Web of Science up to December 2021, particularly on CVD and T2DM patients. From a total of 1536 studies, the final eligible set of 108 studies was selected. Study selection involved three iterations of filtering., Results: Motivation to apply MedDiet was driven by the importance of studying the entire food pattern rather than just one nutrient, the health benefits, and the distinct characteristics of MedDiet. Challenges of the application of MedDiet include lacking universal definition and scoring of MedDiet. Influences of nutritional transition that promote shifting of traditional diets to Westernized diets further complicate the adherence of MedDiet. The challenges also cover the research aspects, including ambiguous and inconsistent findings, the inexistence of positive results, limited evidence, and generalization in previous studies. The review revealed that most of the studies recommended that future studies are needed in terms of health benefits, describing the potential benefits of MedDiet, identifying the barriers, and mainly discussing the effect of MedDiet in different populations., Conclusions: In general, there is consistent and strong evidence that MedDiet is associated inversely with CVD risk factors and directly with glycemic control. MedDiet is the subject of active and diverse research despite the existing challenges. This review informs the health benefits conferred by this centuries-old dietary pattern and highlights MedDiet could possibly be revolutionary, practical, and non-invasive approach for the prevention and treatment CVD and T2DM.

Background & Aims: Previous studies comparing low-carbohydrate ketogenic diet (LCKD) and low caloric fat low diets (LCLF) in obesity management are still controversial. This study evaluated the effect of LCKD in weight reduction compared to the LCLF diet among Omani obese adults., Methods: This prospective cohort study was conducted at the National Diabetes and Endocrine Centre (NDEC), Royal Hospital, Muscat, Oman, between 2015 and 2017. We included 200 (100 in each group) obese patient with Body Mass Index (BMI) more than 30kg/m2, who attended the outpatient department and met the inclusion criteria were enrolled in the study for six months follow-up. Anthropometric, biochemical and clinical data was gathered before starting the diet. Follow-up outcomes included reduction in weight, fat mass and visceral fat, lipid profile and HbA1c. Data were analysed using SPSS-24., Results: The LCKD group showed a significant reduction of 13.0 kg (95% CI: 11.0-15.1) in body weight compared to 4.7 kg (95% CI: 3.4-5.9) in the LCLF group with p-value<0.001. LCKD group showed a significant reduction of 4.0% (95% CI: 3.3-4.7) in fat mass, compared to 1.4% (95% CI: 0.83-1.9) in the LCLF group with p-value<0.001. In addition, LCKD group showed a significant reduction of 2.5L (95% CI: 2.0-2.9, P < 0.001) in visceral fat compared to 1.2L (95% CI: 0.86-1.56) P < 0.001) in the LCLF group with p-value<0.001. Combined with significant reduction in HbA1c with 0.69% (95% CI: 0.5-0.89, P < 0.001) in LCKD and a reduction of 0.74% (95% CI: 0.47-1.2, P < 0.001) in LCLF. Furthermore, this diet has not increased lipid profile with a mean reduction of 0.19 mmol/L (95% CI: 0.003-0.37, P < 0.001) in total cholesterol and mean change of 0.04 mmol/L (95% CI: 0.12-0.21) in LDL level. In addition, it has not increased uric acid with a mean reduction of 20.8 umol/L (95% CI: 4.8-36.7), (P = 0.01)., Conclusion: LCKD seems superior to LCLF in weight, fat mass and visceral fat reduction. In addition, this diet does not increase serum cholesterol and uric acid, which encourage the use of this diet in obesity management., Competing Interests: Declaration of competing interest The authors declare no conflicts of interest., (Copyright © 2022 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.)

The COVID-19 pandemic has revealed the Eastern Mediterranean Region's food system's fragility posing severe challenges to maintaining healthy sustainable lifestyle. The aim of this cross-sectional study ( N = 13,527 household's family members, mean age: 30.3 ±11.6, 80% women) is to examine the impact of the COVID-19 pandemic on food consumption patterns and household's dietary diversity in 10 Eastern Mediterranean countries. A food frequency questionnaire was used to investigate the consumption patterns along with the calculation of the Food Consumption Score (FCS), a proxy indicator of dietary diversity. Data collected on cooking attitudes, shopping and food stock explore the community mitigation measures. In the overall population, before and during the pandemic, most food groups were consumed less or equal to 4 times per week. As evident from our findings and considering that the pandemic may be better, but it's not over, small to moderate changes in food consumption patterns in relatively short time periods can become permanent and lead to substantial poor dietary diversity over time. While it is a priority to mitigate the immediate impact, one area of great concern is the long-term effects of this pandemic on dietary patterns and dietary diversity in Eastern Mediterranean households. To conclude, the COVID-19 crisis revealed the region's unpreparedness to deal with a pandemic. While the aggressive containment strategy was essential for most countries to help prevent the spread, it came at a high nutritional cost, driving poor dietary diversity., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Hoteit, Mortada, Al-Jawaldeh, Mansour, Yazbeck, AlKhalaf, Bookari, Tayyem, Al-Awwad, Al Sabbah, Cheikh Ismail, Qasrawi, Abu Seir, Kamel, Dashti, Allehdan, Al-Mannai, Bawadi, Waly and The Regional CORONA COOKING Survey Group.)

Although cancer is still one of the most significant global challenges facing public health, the world still lacks complementary approaches that would significantly enhance the efficacy of standard anticancer therapies. One of the essential strategies during cancer treatment is following a healthy diet program. The ketogenic diet (KD) has recently emerged as a metabolic therapy in cancer treatment, targeting cancer cell metabolism rather than a conventional dietary approach. The ketogenic diet (KD), a high-fat and very-low-carbohydrate with adequate amounts of protein, has shown antitumor effects by reducing energy supplies to cells. This low energy supply inhibits tumor growth, explaining the ketogenic diet's therapeutic mechanisms in cancer treatment. This review highlights the crucial mechanisms that explain the ketogenic diet's potential antitumor effects, which probably produces an unfavorable metabolic environment for cancer cells and can be used as a promising adjuvant in cancer therapy. Studies discussed in this review provide a solid background for researchers and physicians to design new combination therapies based on KD and conventional therapies.

Purpose: The objective of this study is to expand the understanding of the family influence on children's nutrition and physical activity patterns in Oman., Design and Methods: A cross-sectional research design was used in this study. We recruited 204 dyads (a mother with a child) conveniently. Research data were collected in public cycle one schools, nongovernmental community centers, and home visits from five provinces in Oman. Study measures included a general information survey, anthropometric measurements, electronic children and family nutrition and physical activity questionnaires, and a single-day dietary recall for children. Univariate, bivariate, and multivariate analyses were used., Results: Children's nutrition intake was significantly associated with parental education level, family income, and family nutrition and physical activity patterns, while children's physical activity patterns were significantly associated with maternal BMI and parental education level., Conclusions: Children's nutrition and physical activity patterns are associated with maternal BMI, family's sociodemographic characteristics, and family's nutrition and physical activity pattern., Practice Implications: Family is a key element in shaping and influencing children's lifestyle-related behaviors. School-health programs that actively involve the families hold promise in promoting children's nutrition and physical activity pattern. Future research should be directed toward understanding the moderating and mediating factors., Competing Interests: Declaration of Competing Interest None., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Background: In the past infectious diseases affected the quality of lifestyle during home confinement. The study conducted examines the influence of home confinement during the COVID-19 pandemic outbreak on lifestyle, mental wellbeing, nutritional status, and sleeping pattern., Method: An online multicategorical questionnaire was distributed to collect demographic information combined with the following tools: Food Frequency Questionnaire (FFQ), International Physical Activity Questionnaire (IPAQ), WHO-5 wellbeing score, and Pittsburgh Sleep Quality Index (PSQI). A snowball non-discriminate sampling procedure was conducted to collect data from people attending or working at higher institutions from March 1, 2020 to April 24, 2020. A total of 1723 completed responses (917 males, 37.4 ±13.4 years old and 806 females 32.2 ± 11.5 years old) were collected., Results: The female participants had significantly lower mental health scores than males (53.9% vs. 46.1%). The mental wellbeing scores were higher among participants with medium and high physical activity (PA) levels (p < 0.00). Additionally, the mental wellbeing scores were significantly improved by dietary quality and it's sleeping score (p < 0.001). However, PA was by far the major determinant of the mental health scores., Conclusion: Factors such as PA, diet, and sleeping patterns were associated with mental wellbeing during the COVID-19 confinement among Arab participants., Competing Interests: MH is an employee of Actness. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Purpose: Evidence from industrialized/developed countries showed that colorectal cancer (CRC) incidence rates have significantly dropped due to the widespread use of colonoscopy. In Arab countries, however, the CRC had been reported to have increased. Despite the concerted effort in the primary prevention and widespread use of colonoscopy, to our knowledge, there have been no reports of the prevalence rate of CRC among colonoscopy recipients from Oman. This study aims to explore the CRC prevalence estimates over selected sociodemographic characteristics among colonoscopy-recipients at a tertiary hospital in Oman over five years of follow-up. The regional variations in Oman were also examined in this study., Methods: This hospital-based cross-sectional study reviewed reports of colonoscopies performed over 5-years of retrospective follow-up at a tertiary hospital in Oman. CRC prevalence estimates were calculated over age, gender, governorate, and time of follow-up., Results: A total of 442 CRC cases were enumerated among 3701 colonoscopies, with an overall CRC prevalence estimate of 11.9 per 100 colonoscopies (95% CI: 10.9, 13.0). Gender-specific CRC prevalence was higher among males compared with females (13.3 vs. 10.5). Age-specific CRC prevalence increased with advancing age, from 2.8 among those less than 40 years of age to 26.5 among aged 70 years or more. Regional CRC prevalence was highest among residents in Batinah Governorate. Over the 5-years of follow-up, there was a slow rise in CRC prevalence with an annual increment of 0.59%., Conclusion: The study provides supportive evidence for a steady increase in CRC prevalence over age categories and years of follow-up and depicted the variations of gender-specific CRC prevalence estimates over increasing age categories. The study calls for timely formulation and adoption of national CRC screening programs centered on the colonoscopy use as primary prevention and maximizing its utilization and efficiency., Competing Interests: The authors declare that there are no conflicts of interest regarding the publication of this paper., (Copyright © 2020 Alanoud F. Alsumait et al.)

As a major neurodevelopmental disorder, Autism Spectrum Disorder (ASD) encompasses deficits in communication and repetitive and restricted interests or behaviors in childhood and adolescence. Its etiology may come from either a genetic, epigenetic, neurological, hormonal, or an environmental cause, generating pathways that often altogether play a synergistic role in the development of ASD pathogenesis. Furthermore, the metabolic origin of ASD should be important as well. A balanced diet consisting of the essential and special nutrients, alongside the recommended caloric intake, is highly recommended to promote growth and development that withstand the physiologic and behavioral challenges experienced by ASD children. In this review paper, we evaluated many studies that show a relationship between ASD and diet to develop a better understanding of the specific effects of the overall diet and the individual nutrients required for this population. This review will add a comprehensive update of knowledge in the field and shed light on the possible nutritional deficiencies, metabolic impairments (particularly in the gut microbiome), and malnutrition in individuals with ASD, which should be recognized in order to maintain the improved socio-behavioral habit and physical health., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Background and Objective: Leaves of basil plant (Ocimum basilicum) are often used for medicinal purposes because of their bioactive constituents, yet the antioxidant properties of this plant are not fully studied in the field of diabetes. The present study investigated the antioxidant property and anti-diabetic effect of two basil cultivars of Ocimum basilicum, 'Italian Genovese' and 'Thyrsiflora', in a Streptozotocin (STZ) rat model of diabetes ., Materials and Methods: Sixty adult Sprague Dawley rats (n = 10/group) were divided into 6 groups: Three non-diabetic and three diabetic groups that either did not receive any supplementation or were supplemented with the leaves extract of one or the other cultivar. After 13 weeks of feeding, all rats were sacrificed, pancreatic tissues were homogenized and used for evaluating oxidative DNA damage and dichlorofluorescein fluorescence (DCF) assay. Blood was collected for the measurements of glucose and insulin., Results: The STZ caused oxidative stress in the diabetic group as evidenced by an increase in oxidative DNA damage and also caused DCF production in pancreatic tissues as compared to non-diabetic groups, (p<0.05). The STZ treatment resulted in hyperglycemia and low serum insulin level in diabetic rats. Supplementation with extracts of 'Italian Genovese' and 'Thyrsiflora' to the diabetic groups significantly abrogated the STZ-mediated effects (p<0.05)., Conclusion: The results indicated that the extracts from the leaves of the two examined basil cultivars act as potent antioxidants and combat the STZ-mediated diabetogenic effect.

Vitamin or mineral supplementation is considered to be the most commonly used medical treatment for autism spectrum disorder (ASD), in addition to other interventions such as neurological and psychological interventions. There is not much evidence of therapeutic efficacy between vitamin and mineral supplementation and improvements in ASD. However, several researchers have noted that patients with ASD have various metabolic and nutritional abnormalities including issues with sulfation, methylation, glutathione redox imbalances, oxidative stress, and mitochondrial dysfunction. There is some evidence that vitamin and mineral supplementation may support these basic physiologic processes. Recently, the nutritional status of ASD patients has been gaining focus in this particular area. Pointing out the nutritional status as a potential etiological factor for attention/communication disorders, more importance has been given to this particular point. Moreover, autistic specific considerations like the feature and behavior of ASD might be increased or at least fall in the higher risk due to the sub-optimal nutritional status.

Curcumin has a wide spectrum of biological, pharmaceutical, and antioxidant effects in cancer experimental models. Nitrosamine is commonly used as an experimental oxidizing agent which induces gastric oxidative stress and gastric carcinogenesis in rats. We examined the antioxidant potential effect of curcumin against nitrosamine-induced gastric oxidative stress in rats. Forty Sprague-Dawley rats were randomly divided into 4 groups (10 rats/group). The control group was fed a standard diet and received a single dose of normal saline, the nitrosamine-treated group was fed a standard diet and received an intraperitoneal injection of nitrosamine at a single dose of 100 mg/kg body weight (b.w.). The other two groups received a daily dose of curcumin (200 mg/kg b.w.) via intra-gastric intubation in the presence or absence of nitrosamine injection. After 16 weeks, all rats were sacrificed, and the gastric tissues were dissected for histopathological examination and for biochemical measurements of oxidative stress indices. Our results showed that nitrosamine causes oxidative stress in gastric tissues as evidenced by glutathione depletion, increased level of lipid peroxides, nitric oxide release, impairment of total antioxidant capacity, DNA oxidative damage, and inhibition of antioxidant enzymes (catalase, glutathione peroxidase, glutathione reductase, and superoxide dismutase). Histopathological findings revealed abnormal gastric architecture in association with nitrosamine injection compared to the non-treated control group. Curcumin significantly suppressed the gastric oxidative damage associated with nitrosamine treatment and mitigated its histopathological effect. These results suggest that curcumin, as an antioxidant, has a therapeutic effect against oxidative stress-mediated gastric diseases., Competing Interests: AUTHOR DISCLOSURE STATEMENT The authors declare no conflict of interest.

Background: Colorectal cancer (CRC) represents a heterogeneous group of diseases characterized by uncontrolled growth and spread of abnormal cells in the body. CRC vary on the basis of both the biologic features of the disease and its associated lifestyle characteristics. The risk of CRC increases with several modifiable factors including obesity, physical inactivity, a diet high in red or processed meat, heavy alcohol consumption, and possibly inadequate intake of fruits and vegetables. We aimed to establish a baseline data for dietary and lifestyle characteristics of Omani adults diagnosed with CRC. Methods: A Case control study conducted at Sultan Qaboos University Hospital, a referral hospital for CRC patients in Oman, and included 279 subjects (109 diagnosed CRC cases and 170 matched controls). All study subjects were recruited on volunteer basis and personally interviewed for preset questions related to sociodemographic data, anthropometric assessment, dietary intake and physical activity. Results: There was no significant difference between cases and controls regarding smoking, alcohol intake, physical activity and dietary fiber intake. However the enrolled cases were more overweight (OR =3.27. 95% CI: 1.91, 7.27), and, had a higher caloric (p =0.001) and macronutrient intake (carbohydrate: p = 0.001; protein: p = 0.017; saturated fat: P = 0.034) than the controls. In addition, the dietary pattern of the cases was characterized by a trend towards low vegetables and fruits intake. Conclusion: CRC maybe prevented through dietary management of high risk groups. This primary prevention approach will ultimately reduce the burden of CRC in Oman., (Creative Commons Attribution License)

Purpose: Previous studies in Euro-American populations have shown that women with polycystic ovarian syndrome (PCOS) have increased levels of "psychological burden". While PCOS has been reported in Arab countries such as Oman, there is a dearth of studies of the occurrence of psychological burden among PCOS women in the Arab region. This study aimed to compare sociodemographic and clinical characteristics of PCOS women diagnosed with non-PCOS women and prevalence of severity of depression, anxiety and stress and to explore the association between PCOS and indices of psychological disturbances after adjusting for potential confounding factors., Patients and Methods: This hospital-based case-control study was conducted among women aged 16-49 years. The study included 52 women diagnosed with PCOS (as per Rotterdam 2003 criteria) and 60 control who were PCOS-free. The presence of psychological burden - depression, anxiety and stress - was quantified using Depression, Anxiety and Stress Scale-21 (DASS-21)., Results: The crude odds ratios (ORs) generated by logistic regression models indicated an increased risk of depression, anxiety and stress among women with PCOS compared to controls. The adjusted OR also indicated an increased risk of depression (OR =1.10; 95% confidence interval [CI] 0.50, 2.43), anxiety (OR =1.09; 95% CI 0.47, 2.52) and stress (OR =1.45; 95% CI 0.68, 3.12), However, no statistical differences were observed along the three psychological distresses ( p >0.05) between the two study groups., Conclusion: The study indicates that the presence of PCOS is associated with an increased risk of psychological burden. If this study will withstand further scrutiny, meeting psychological needs of such population would need to be contemplated., Competing Interests: Disclosure The authors report no conflicts of interest in this work.

Background: Azoxymethane (AOM) is a well-known colon cancer-inducing agent in experimental animals via mechanisms that include oxidative stress in rat colon and liver tissue. Few studies have investigated AOM-induced oxidative stress in rat liver tissue. Red seaweeds of the genera Hypnea Bryodies and Melanothamnus Somalensis are rich in polyphenolic compounds that may suppress cancer through antioxidant properties, yet limited research has been carried out to investigate their anti-carcinogenic and antioxidant influence against AOM-induced oxidative stress in rat liver. Objective: This study aims to determine protective effects of red seaweed (Hypnea Bryodies and Melanothamnus Somalensis) extracts against AOM-induced hepatotoxicity and oxidative stress. Materials and Methods: Sprague–Dawley rats received intraperitoneal injections of AOM, 15 mg/kg body weight, once a week for two consecutive weeks and then orally administered red seaweed (100 mg/kg body-weight) extracts for sixteen weeks. At the end of the experiment all animals were overnight fasted then sacrificed and blood and liver tissues were collected. Results: AOM treatment significantly decreased serum liver markers and induced hepatic oxidative stress as evidenced by increased liver tissue homogenate levels of nitric oxide and malondialdehyde, decreased total antioxidant capacity and glutathione, and inhibition of antioxidant enzymes (catalase, glutathione peroxidase, glutathione S-transferase, glutathione reductase and superoxide dismutase). Both red seaweed extracts abolished the AOM-associated oxidative stress and protected against liver injury as evidenced by increased serum levels of liver function markers. In addition, histological findings confirmed protective effects of the two red seaweed extracts against AOM-induced liver injury. Conclusion: Our findings indicate that red seaweed (Hypnea Bryodies and Melanothamnus Somalensis) extracts counteracted oxidative stress-induced hepatotoxicity in a rat model of colon cancer., (Creative Commons Attribution License)

Dysfunction of the serotoninergic and glutamatergic systems is implicated in the pathogenesis of autism spectrum disorder (ASD) together with various neuroinflammatory mediators. As the kynurenine pathway (KP) of tryptophan degradation is activated in neuroinflammatory states, we hypothesized that there may be a link between inflammation in ASD and enhanced KP activation resulting in reduced serotonin synthesis from tryptophan and production of KP metabolites capable of modulating glutamatergic activity. A cross-sectional study of 15 different Omani families with newly diagnosed children with ASD (n = 15) and their age-matched healthy siblings (n = 12) was designed. Immunological profile and the KP metabolic signature were characterized in the study participants. Our data indicated that there were alterations to the KP in ASD. Specifically, increased production of the downstream metabolite, quinolinic acid, which is capable of enhancing glutamatergic neurotransmission was noted. Correlation studies also demonstrated that the presence of inflammation induced KP activation in ASD. Until now, previous studies have failed to establish a link between inflammation, glutamatergic activity, and the KP. Our findings also suggest that increased quinolinic acid may be linked to 16p11.2 mutations leading to abnormal glutamatergic activity associated with ASD pathogenesis and may help rationalize the efficacy of sulforaphane treatment in ASD. Autism Res 2016, 9: 621-631. © 2015 International Society for Autism Research, Wiley Periodicals, Inc., (© 2015 International Society for Autism Research, Wiley Periodicals, Inc.)

Purpose: To study the cosmetic outcome of external dacryocystorhinostomy (Ex-DCR) and to detect the factors affecting it., Patients and Methods: Prospective randomized interventional study included forty patients who were treated by 40 Ex-DCRs. In twenty patients, medial canthal vertical incision was used and in the other twenty cases, subciliary incision was used. The skin was closed using vicryl 6-0 or prolene 6-0 interrupted sutures, and each one was randomly used in twenty patients (10 patients of each incision type). Cosmetic outcome was evaluated 6 months postoperative by the patients and by an oculoplastic surgeon on a four grades scale. Cosmetic results and its correlation to patients' age, sex, skin complexion, type of incision, and type of skin sutures were studied., Results: The mean scar grading was 0.98 ± 1.0 and 1.3 ± 1.0 in patients' and examiner's assessment. About 27.5% described their scars as cosmetically significant. The cosmetic outcome was significantly affected by the type of incision with only 5% significant scars in subciliary incision group. Prolene 6-0 suture was associated with better cosmetic results with 15% significant scars. 50% of dark-skinned patients showed cosmetically significant scars. Although no correlation was found between patients' age and cosmetic outcome, pediatric patients showed higher tendency to scar visibility with mean scar grade 1.2 ± 1.0 and 1.5 ± 0.9 in patients' and examiner's assessment., Conclusion: Dark skinned and pediatric patients are more prone to visible Ex-DCR scar. The use of subciliary approach and prolene 6-0 skin sutures is associated with more favorable cosmetic outcome.

Epidemiological surveys from various countries indicate an increased prevalence of autism spectrum disorders (ASD), leading researchers to debate whether there are now 'more affected' or 'more detected'. The epidemiology of ASD in developing countries, such as Oman, has generally indicated a lower prevalence compared to developed countries in the West. In Oman, the prevalence is low; however, this article highlights some of the factors that could contribute to the appearance of a low ASD rate: cross-cultural variations in the presentation of distress; a lack of reliable biological markers for diagnosing ASD, and a lack of health services for children with ASD, thus limiting the number of participants in epidemiological surveys. While the defining features of ASD have yet to be established, pilot studies in Oman indicate a substantial number of children with these disorders. Therefore, it is important that these discrepancies be addressed and the need for appropriate services for this patient population in Oman be highlighted.

Aluminum (Al) is an environmental toxin that induces oxidative stress in neuronal cells. Mushroom cultivar extract (MCE) acted as a potent antioxidant agent and protects against cellular oxidative stress in human cultured neuronal cells. This study aimed to investigate the neuroprotective effect of MCE against Al-induced neurotoxicity in rat brain. Forty Sprague-Dawley rats were divided into 4 groups (10 rats per group), control group, MCE-fed group, Al-administered group and MCE/Al-treated group. Animals were continuously fed ad-libitum their specific diets for 4 weeks. At the end of the experiment, all rats were sacrificed and the brain tissues were homogenized and examined for biochemical measurements of neurocellular oxidative stress indices [glutathione (GSH), Total Antioxidant Capacity (TAC), antioxidant enzymes and oxidized dichlorofluorescein (DCF)]. Al-administration caused inhibition of antioxidant enzymes and a significant decrease in GSH and TAC levels, meanwhile it positively increased cellular oxidized DCF level, as well as Al concentration in brain tissues. Feeding animals with MCE had completely offset the Al-induced oxidative stress and significantly restrict the Al accumulation in brain tissues of Al-administered rats. The results obtained suggest that MCE acted as a potent dietary antioxidant and protects against Al-mediated neurotoxicity, by abrogating neuronal oxidative stress.

Objectives: We evaluated dietary pattern and lifestyle characteristics of patients with colorectal cancer (CRC) in Jordan., Design: The case-control study included 220 recently diagnosed CRC cases and 220 age and gender matched healthy subjects as a control group., Results: The participating CRC cases had lower dietary intake of fibre, folate, vitamin B12, β-carotene, vitamin C and selenium as compared to controls (P<0.05). The frequency of consumption of fruits and vegetables was also lower among CRC cases, while the frequency of consumption of red meat and saturated fat was higher and positively associated with CRC risk. Furthermore, family history for CRC played a positive role and the majority of CRC cases and controls had a low physical activity level., Conclusions: A sedentary lifestyle and a diet low in fruits and vegetables, and high in animal red meat and saturated fat, appeared associated with CRC among the studied Jordanian subjects. This is consistent with the reported CRC studies in developed nations indicating global causal effects for this tumour type.

Background: Recent case-control studies on breastfeeding and childhood leukemia risk have indicated that longer duration of breast feeding (> 6 months) is associated with decreased risk of the disease., Objective: To investigate the relationship between duration of breastfeeding and risk of childhood leukemia in Oman., Materials and Methods: In a case control study all recently diagnosed and registered cases of childhood leukemia at the National Registry during (1999-2009), a total of 70 cases, were recruited. For each case, a gender and age matched control was selected either from the family relatives or from the neighbors of family siblings., Results: Breastfeeding is culturally favored for longer periods of time (up to 24 months) in Oman. Data of this study revealed that 21% of cases and 12 % of their gender and age matched controls were breastfed for an average duration of 6-12 months. In 75% of the cases and 81% of controls the period of breastfeeding was between 12-24 months. Only 4% of the cases and 7% of controls were breastfed for a period more than 24 months. No significant (P>0.05) differences were observed between the cases and controls with respect to breastfeeding and the risk of childhood leukemia in Oman. Similarly the duration of breast feeding did not have any significant (P>0.05) effect on the risk., Conclusion: This study indicated that duration of breastfeeding was not associated with risk of childhood leukemia in Oman and there may be some other environmental and genetic factors that might be responsible for the occurrence of this disease that must be explored further.