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The quality of life (QoL) of the caregivers of children with autism spectrum disorder and intellectual disabilities has received limited attention in emerging economies such as those of the Arabian Gulf region. The aims of this investigation were threefold and sought to contribute to the gap in the literature by exploring the following issues in Oman: (i) to examine the socio-demographic characteristics of caregivers of children with autism spectrum disorder (ASD), intellectual disabilities (ID) and typical development (TD); (ii) to compare health satisfaction of caregivers of children with ASD, ID, and TD and (iii) to ascertain the relationship between QoL and socio-demographic factors among the families caring for children with ASD. Two-hundred and twenty caregivers seeking consultation for their children with ASD were recruited for this study, in addition to the control group (caregivers of children with ID, n= 109), and caregivers of children with TD (n= 125). The overall number of participants was 454. An Arabic version of the World Health Organization Quality of Life (WHO QOL-BREF) was employed to measure QoL and health satisfaction. Compared to the caregivers of children with ID and TD, the caregivers of children with ASD scored lower on indices of QoL and reported poorer health status. Socio-demographic factors such as higher education were associated with improved QoL, which often entailed steady employment and higher-income. This study suggests that poor QoL appears to be pervasive in caregivers of children with ASD in Oman. Given the increase in the reported prevalence of ASD, QoL should be considered when devising interventions and services for children presenting with these difficulties and their caregivers. This evidence-based research lays the foundation for systemic interventions and future allocation of resources.

Studies conducted in the West countries suggest that sleep habits and disordered sleep are common among children with autism spectrum disorder (ASD). To explore the rates of sleep habits and disord...

Omar A Al-Farsi,1 Yahya M Al-Farsi,1,2 Marwan M Al-Sharbati,3 Samir H Al-Adawi31Department of Family Medicine and Public Health, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Sultanate of Oman; 2Department of Epidemiology, School of Public Health, Boston, MA, USA; 3Department of Behavioural Medicine, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Sultanate of Oman Abstract: Previous studies carried out in Euro-American populations have unequivocally indicated that psychological disorders of the CASD (caregivers of children with autism spectrum disorder) are marked with high levels of stress, anxiety, and depression. This finding has been attributed to the reaction of having to care for a child with neurodevelopmental disorders. While there have been reports on autism spectrum disorder in Arab/Islamic countries such as Oman, there is no study from this region, to our knowledge, reporting the performance of indices of stress, anxiety, and depression among CASD. This study aimed to examine whether there is variation in the performance of indices of stress, depression, and anxiety explored via Depression, Anxiety and Stress Scale 21 among CASD, caregivers of children with intellectual disabilities, and caregivers of typically developing children. All indices of stress, depression, and anxiety were higher in CASD compared to other caregivers in the control group. This study corroborates with other studies carried out in other populations that caring for children impacts the mental health status of caregivers. Therefore, there are strong grounds to contemplate the mechanism to help such a vulnerable group of family caregivers. Keywords: stress, anxiety, depression, caregivers, autism, Oman

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.

To find the growth trends in a sample of schoolchildren in Benghazi (Libya), and to compare it with international and other local growth charts, as a step for setting the national curves.From 25The boys and girls in the lowest age-group had a pattern similar to that of the reference population for both height/age and weight/age, but it dropped sharply from mid-school years. The Benghazi curves were consistently higher than those of Tripoli, particularly for height/age.The nutritional status of these children, which was good before the beginning of schooling, was negatively affected during the school years. This could be attributed either to births in the family and consequent neglect, or to the school's negative effects on the child, such as lack of appetite created by anxiety or other factors. Further studies from different regions of the country are needed to set national growth curves.

Genetic, nutrition, and environmental factors have each been implicated as sources of risk for autism. Oxidative stress, including low plasma levels of the antioxidant glutathione, has been reported by numerous autism studies, which can disrupt methylation-dependent epigenetic regulation of gene expression with neurodevelopmental consequences. We investigated the status of redox and methylation metabolites, as well as the level of protein homocysteinylation and hair mercury levels, in autistic and neurotypical control Omani children, who were previously shown to exhibit significant nutritional deficiencies in serum folate and vitamin B12. The serum level of glutathione in autistic subjects was significantly below control levels, while levels of homocysteine and S-adenosylhomocysteine were elevated, indicative of oxidative stress and decreased methionine synthase activity. Autistic males had lower glutathione and higher homocysteine levels than females, while homocysteinylation of serum proteins was increased in autistic males but not females. Mercury levels were markedly elevated in the hair of autistic subjects vs. control subjects, consistent with the importance of glutathione for its elimination. Thus, autism in Oman is associated with decreased antioxidant resources and decreased methylation capacity, in conjunction with elevated hair levels of mercury.

Children with special needs such as those with autism spectrum disorder have been recorded as ostracized and stigmatized in many parts of the world. Little is known about whether such negative views are present among mainstream teachers in Oman. A cross-sectional study was conducted to evaluate school teachers’ awareness about autism spectrum disorder in an urban region in Oman. A total of 164 teachers were randomly enrolled from five schools. Misconceptions about autism spectrum disorder were found to be common among mainstream teachers in the country. We posit that such lack of awareness was likely to be rooted with sociocultural patterning as well as conflicting views often “spun” by the scientific community and mass media. Enlightened views toward children with autism spectrum disorder should be presented to Omani teachers to overcome misconceptions and negative attitudes toward children with autism spectrum disorder.

Objectives: Autism is a lifelong neurodevelopmental disorder of early childhood. Dietary supplementation of the u-3 fatty acid (docosahexaenoic acid [DHA]) during prenatal and postnatal life is considered a protective dietary intervention strategy to minimize the risk for autism spectrum disorder (ASD). To our knowledge, no relevant studies have been conducted in the Middle East investigating the status of DHA among children with autism during early childhood. The aim of this study was to investigate the serum levels and dietary intake status of DHA among Omani children recently diagnosed with ASD. Methods: The present case–control study involved 80 Omani children (

Accumulating evidence suggests that oxidative stress induced mechanisms are believed to be associated with the pathophysiology of autism. In this study, we recruited 19 Omani autistic children with age-matched controls to analyze their plasma and serum redox status and the levels of ATP, NAD+ and NADH using well established spectrophotometric assays. A significant decrease was observed in the levels of plasma total antioxidants (TA), reduced glutathione (GSH), superoxide and catalase activity in Omani autistic children as compared to their age-matched controls. In contrary, the level of plasma glutathione peroxidase (GSH-Px) was significantly increased in autistic children. Reduced serum NAD+ and ATP levels and lower NAD+:NADH ratio were observedin patients with autism compared to controls. Finally, a significant inverse correlation was observed between plasma GSH, SOD, catalase activity, and serum NAD+ and ATP levels, and autism severity using Childhood Autism Rating Scale (CARS) scores. The levels of plasma GSH-Px and serum NADH correlated strongly with autism severity whilst no significant correlation was observed for plasma TA. Our data suggests that increased vulnerability to oxidative stress in autism may occur as a consequence of alterations in antioxidant enzymes leading to mitochondrial dysfunction.

Objective Arab populations lack data related to nutritional assessment in children with autism spectrum disorders (ASDs), especially micronutrient deficiencies such as folate and vitamin B12. Methods To assess the dietary and serum folate and vitamin B12 statuses, a hospital-based case–control study was conducted in 80 Omani children (40 children with ASDs versus 40 controls). Results The ASD cases showed significantly lower levels of folate, vitamin B12, and related parameters in dietary intake and serum levels. Conclusion These data showed that Omani children with ASDs exhibit significant deficiencies in folate and vitamin B12 and call for increasing efforts to ensure sufficient intakes of essential nutrients by children with ASDs to minimize or reverse any ongoing impact of nutrient deficiencies.

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A cross-sectional study was conducted to investigate whether caregiver's variations in socioeconomic status (SES) has direct bearing on challenges of nurturing children with autism spectrum disorder (ASD) in Oman. A cadre of caregivers (n = 150) from two types of SES (low-income and middle-high income) were compared based on four domains: (1) accessing and perception of remedial services, (2) utilization and perception of psychiatric services, (3) constraints for being a caregiver of children with ASD and (4) financial expenses of taking care of children with ASD. There is little indication that any particular SES fare well on these domains. Factors to mitigate such predicaments are therefore imperative in order to improve quality of life for caregivers among children with ASD.

Objective: To evaluate the association between suboptimal breast-feeding practices and autism spectrum disorders (ASDs). Methods: A case–control study was conducted in 102 ASD cases and 102 matched healthy controls. Results: Based on adjusted odds ratios from logistic regression models, ASD was found to be associated with the late initiation of breast-feeding (odds ratio 1.48, 95% confidence interval 1.01– 3.1), a non-intake of colostrum (odds ratio 1.7, 95% confidence interval 1.03–4.3), prelacteal feeding, and bottle-feeding. The risk of ASD was found to decrease in a dose–response fashion over increasing periods of exclusive breast-feeding (P for trend ¼ 0.04) and continued breast-feeding (P for trend ¼ 0.001). Conclusion: The study indicates that increased ASD risk is generally associated with suboptimal breast-feeding practices.

Introduction: There is a lack of studies examining the effectiveness of some of the commonly used instruments to elicit the presence of social anxiety disorder (SAD) in Arab-speaking populations, such as those in Oman. The aim of this study was to establish the influence of social anxiety and the role of gender among Omani adolescents. Methods: A two-phase protocol was used, entailing the psychometric properties of the Arabic version of the Liebowitz Social Anxiety Scale (LSAS) against the gold standard, the Diagnostic and Statistical Manual of Mental Disorders (DSM). Results: According to DSM and LSAS, the prevalence of social phobia among Omani students was generally higher compared to what has been reported in other parts of the world and the crosstabs analysis showed a significant correlation between gender and SAD. Discussion: The Arabic version of LSAS proved to be an effective tool for assessing and quantifying the presence of SAD. This study discusses the sociocultural factors affecting social phobia in Omani society.

Child maltreatment (CM) is common worldwide, and can take many forms. It may even endanger the child’s life, especially when younger children are the victims. CM affects the child’s quality of life and consequently leads to long term issues to be dealt with by the child, family and community. This case series discusses six children who have been subjected to CM, and diagnosed by the child protection team of the departments of Child Health and Behavioural Medicine at Sultan Qaboos University Hospital (SQUH), Oman. The aim of this case series is to increase the level of awareness of CM among Oman’s medical professionals and to highlight the difficulties encountered in diagnosing and providing optimal care for these children. Although treatment is provided in Oman’s health care system, it is clear that there are gaps in the existing system which affect the quality of child protection services provided to the children and their families.

To assess prevalence of malnutrition indicators among preschool children with autism spectrum disorder (ASD) a cross-sectional study was conducted among 128 Omani autistic children 3–5 years of age. Based on standardized z-scores, the overall prevalence of malnutrition was 9.2 per 100 preschool ASD children (95% CI 4.1, 11.6). The most common type of malnutrition was underweight (3.9; 95% CI 0.5, 7.3), followed by wasting (3.1; 95% CI 0.1, 6.1) and stunting (2.3; 95% CI 0.3, 5.0). Among boys, underweight and stunting were significantly higher than in girls, while wasting was more prevalent among girls. None of the participants showed evidence of overweight or obesity. The study indicates an overall tendency among autistic Omani children towards being malnourished.

With recent rapid progress in technology and advancing lifestyle associated with modernization, individuals are consuming increasing quantities of unhealthy food, a major risk factor for the onset of a variety of diseases. In particular, fried potato chips (FPCs), are the most commonly consumed snack, especially by children. However, research in the field of nutrition demonstrated that FPCs encompass significant quantities of acrylamide, a known carcinogen and neurotoxin. Thus, frequent intake of FPC, especially at younger age, might generate cumulative amounts of acrylamide in the body, thereby silently increasing the risk for various diseases. Although intake of a balanced diet can prevent this scenario, further measures should be set to overcome the oxidative damage from fried food. This review outlines existing scientific evidence suggesting an urgent need for systematic study regarding the health effects of consumption of FPC and French fries in the general population.

There has been a decline in the mortality rate among infants and children under five years of age in the last decade in many developing countries. This has led to a shift in focus to look beyond survival to the prevention or reduction of impairment and promotion of children's health. With the apparent rise in the prevalence of autism spectrum disorders (ASD) in the Arab countries the development of an Arabic tool for early diagnosis and intervention was sought as part of an effort to better understand the prevalence of this disorder. The Modified Checklist for Autism in Toddlers (M-CHAT) was chosen. The study was conducted in nine Arabic speaking countries. The final analysis included 228 children (122 screened positive for ASD). The sensitivity (0.86), the specificity (0.80) and positive predictive value (0.88) were very similar to Robins et al. study (2001). Maternal health problems during pregnancy and labour were found to be more significant for ASD mothers than their control. In addition, child health problems were more evident among ASD subjects as reported by their parents with significant differences from controls. The limitation of the study is that the sample size is not large enough to generalize the results to all countries of the region. The strength of the study is that it is the first known study where Arab countries undertook a collaborative mental health study using the same tool for screening for a specific disorder.

Background Among developing countries, there is dearth of information related to sleep problems among children with autism spectrum disorder (ASD) and their sequel on parents health. Objective To e...

Objectives: To determine the frequency of the VNTR alleles in the human dopamine transporter gene (DAT1) in the Omani population and to investigate association of the VNTR alleles with attention-deficit hyperactivity disorder (ADHD). Design and methods: 92 Omani children with ADHD and 110 healthy Omani subjects were genotyped for the DAT1-VNTR polymorphism in a case-control study using two independent PCR tests (one developed in our laboratory) followed by agarose gel electrophoresis. Results and conclusions: We determined the DAT1-VNTR alleles in 202 Omani subjects. There were two common alleles (DAT1*9 and *10) and five rare ones. The DAT1*10 allele distribution was essentially the same both in the control (60.9%) and the patient group (64.6%). There was, however, a relatively higher occurrence of the DAT1*10 allele in ADHD males (69.4%) than females (55%), but this gender difference was not present in the control group (males 60%, females 62%). D 2005 The Canadian Society of Clinical Chemists. All rights reserved.

To determine the genetic variability at the human DAT1 VNTR locus, we screened 110 healthy Omani blood donors using the polymerase chain reaction (PCR) and agarose gel electrophoresis. Two common alleles (DAT1*9 and DAT1*10) were observed with a frequency of 0.332 and 0.609, respectively. There were also five rare alleles (*3, *6, *7, *8, and *11). The frequency of the observed genotypes was not significantly different from the expected Hardy-Weinberg distribution. We compared the Omani DAT1 alleles with similar data from other populations.

OBJECTIVE To describe the demographics, precipitating factors, substances and methods used for deliberate self-harm in Oman. METHODS Data were extracted from the Accident and Emergency (A & E) records of patients treated at the A & E units in Muscat from 1993 to 1998. Data were obtained form the history, and clinical findings resulting form deliberate self-harm. RESULTS During the 5-year study period, 123 persons presented to various hospitals in the Muscat area with injuries that resulted form deliberate self-harm. Most of these cases were women, students and unemployed. There was a high incidence of family, marital and psychiatric or social problems. The methods of self-harm were most often analgesics (such as paracetamol) and non-pharmaceutical chemicals. CONCLUSIONS The rate of self-injurious behaviour is low in Oman, compared with other countries, including other Islamic countries. The data illustrate a rising rate and a tendency to ingest toxic doses of analgesics or non-pharmaceutical chemicals.

Research about bullying among school pupils in the Arab/Muslim population is scarce. This study evaluates the characteristics of bullying and its impact among school pupils in Oman via cross-sectional survey among eighth grade school pupils (n= 1,229) during the academic year 2006-2007. The participants were selected using stratified random selection among 6 administrative divisions of one the governorates in the country. Data were collected using self-completed structured questionnaires. This study found similar percentages of males and females (76%) have experienced one form of bullying, and the majority of the incidents (80%) occurred in the vicinity of the school. In almost half of the cases, the bullying was initiated by a student of the same age or older than the victim. The most common type of bullying encountered in this study was verbal (47.7%), followed by misuse (45.9%), physical (43.9%), and, finally, social isolation/exclusion (22.5%). Although the failure of an academic year was uncommon among victims of bullying, the number of pupils who missed 4–6 and ≥7 school days was higher among bullied pupils. If this study will withstand further research, educational initiatives are needed to mitigate the rate of bullying in Oman.

BACKGROUND: Many developing countries such as Oman are marred with the rising tide of children with autism and the lack of specialized services for these children. Within existing compartmentalized and centralized health care organizations, the general practitioners (GPs) are likely to serve as the first level of contact relevant for diagnosis and referral for remedial services. This study aims to explore the awareness of autism among GPs in Oman on issue pertinent to etiology, signs and symptoms, perceived correlates, as well as the consequence of having autism. Related to this is to examine whether years of medical practice would invariably influence GPs’ awareness. METHODS: This cross-sectional study was conducted among GPs (n=113) working at primary healthcare centers (PHC) during September 2013 to February 2014 in Muscat, the capital of Oman.RESULTS: The GPs appear to have suboptimal awareness of etiological factors relevant for the development of autism, its common signs and symptoms, perceived correlates, as well as the social dimension. Number of years in practice has little bearing on awareness.CONCLUSION: Empirical evidence has unequivocally indicated that although there is no known ‘cure’ for autism, early identification and early intervention tend to better the quality of life for children with autism. This means GPs in Oman should be fitted with adequate awareness of such population.

Toxic levels of heavy metals and low levels of essential minerals have been suggested to play a critical role in the pathogenesis of autism spectrum disorders (ASD). This study documents the levels of heavy metals and essential minerals in hair samples of children with ASD in Muscat, the urbanized capital of Oman, Muscat. The study included 27 children with ASD and 27 matched non-ASD controls. Parental interviews were held and dietary intake questionnaires completed in conjunction with the collection of hair samples. Analysis of heavy metals and essential minerals was carried out by inductively coupled plasma mass spectrometry. Chi-square analysis and non-parametric Fisher’s exact tests were used to assess statistical significance. Children with ASD had significantly higher levels of all 11 analyzed heavy metals in their hair samples (P

Objectives: There is significant evidence that psychotherapy is a pivotal treatment for persons diagnosed with Axis I clinical psychiatric conditions; however, a psychotherapy service has only recently been established in the Omani health care system. This study aimed to investigate the sociodemographic and clinical characteristics of attendees at a psychotherapy clinic at a tertiary care hospital. Methods: An analysis was carried out of 133 new referrals to the Psychotherapy Service at Sultan Qaboos University Hospital, a tertiary care hospital. Results: The majority of referrals were females (59%), aged 18–34 years, employed (38%), had ≤12 years of formal education (51%), and were single (54%). A total of 43% were treated for anxiety disorders (including obsessive compulsive disorder), while 22% were treated for depression. A total of 65% were prescribed psychotropic medications. The utilisation of the Psychotherapy Service and its user characteristics are discussed within the context of a culturally diverse Omani community which has unique personal belief systems such as in supernatural powers (Jinn), contemptuous envy (Hassad), evil eye (Ain) and sorcery (Sihr) which are often used to explain the aetiology of mental illness and influence personal decisions on utilising medical and psychological treatments. Conclusion: Despite the low number of referrals to the Psychotherapy Service, there is reason to believe that psychotherapy would be an essential tool to come to grips with the increasing number of mental disorders in Oman.

Autism spectrum disorder (ASD) is a neurodevelopmental disorder of early childhood, and an enumeration about its etiology and consequences is still limited. Oxidative stress-induced mechanisms are believed to be the major cause for ASD. In this study 19 autistic and 19 age-matched normal Omani children were recruited to analyze their degree of redox status and a prewritten consent was obtained. Blood was withdrawn from subjects in heparin-coated tube, and plasma was separated. Plasma oxidative stress indicators such as nitric oxide (NO), malondialdehyde (MDA), protein carbonyl, and lactate to pyruvate ratio were quantified using commercially available kits. A significant elevation was observed in the levels of NO, MDA, protein carbonyl, and lactate to pyruvate ratio in the plasma of Omani autistic children as compared to their age-matched controls. These oxidative stress markers are strongly associated with major cellular injury and manifest severe mitochondrial dysfunction in autistic pathology. Our results also suggest that oxidative stress might be involved in the pathogenesis of ASD, and these parameters could be considered as diagnostic markers to ensure the prevalence of ASD in Omani children. However, the oxidative stress-induced molecular mechanisms in ASD should be studied in detail.

High serum homocysteine (Hcy) level is regarded as an indicator for impairment of folate-dependent methionine cycle and is associated with oxidative stress. In a case control study, we evaluated eighty 3-5 years old Omani children (40 diagnosed with Autism Spectrum Disorder and 40 their age and gender matched controls) for their fasting serum homocysteine levels as a biomarker of Autism Spectrum Disorder (ASD). Serum folate and vitamin B(12) status were also evaluated. The serum homocysteine was measured using an enzyme immunoassay (EIA) technique whereas folate and vitamin B(12) were measured using an automated random access immune-assay system. The results indicated that mean serum Hcy levels were significantly (P0.05) higher in autistic children (20.1 ± 3.3 µmol/L) as compared to controls (9.64 ± 2.1 µmol/L). Significantly (P0.05) lower serum folate (1.8 ± 0.4 µg/L) and vitamin B(12) (191.1 ± 0.9 pg/mL) levels were observed in autistic children as compared to controls (6.1 ± 0.6 µg/L and 288.9 ± 1.3 pg/mL, respectively). The levels of homocysteine in autistic children were also much higher as compared to normal reference values (5-15 µmol/L). The results suggest that high fasting serum homocysteine and low folate and vitamin B(12) levels could be used as clinical biomarkers for an early diagnosis and management of ASD.

Prevalence of autistic spectrum disorders (ASD) in Oman is unknown. We conducted a cross-sectional study to estimate the prevalence of ASD among 0-14 year old children. Diagnoses were made as per DSM-IV-TR criteria and supplemented with information collected with the standard Childhood Autism Rating Scale (CARS) questionnaire. A total 113 cases of ASD were enumerated nationwide, indicating an overall prevalence of 1.4 (95% CI 1.2, 1.7) cases per 10,000 children aged 0-14 years. More prevalent cases were among boys (75%) and among low-income families. Ritualistic interests were more common among girls as an onset-symptom compared to boys (p = 0.03). The reported low prevalence of ASD in Oman is likely due to under-diagnosis and under-reporting.

Background: There is a dearth of studies describing the characteristics of ADHD among schoolchildren attending child psychiatry clinics in the Arab world. Most of the previous quests have focused on community surveys or themes that hampered international comparison. Aim: This study screened for the presence of ADHD as well as investigates the psychosocial and educational history relevant for the diagnosis of ADHD among children. Method: Consecutive schoolchildren attending child psychiatric consultations were screened for the presence of ADHD according to the Diagnostic and Statistical Manual for Mental disorders ( DSM) criteria. Result: A total of 221 schoolchildren suffering from ADHD were identified according to the DSM. The year incidence was 0.16. Males constituted the majority presenting with ADHD. The contribution of consanguinity and a history of acquired brain injury were common features. The majority were attending mainstream education as pharmacotherapy is the only option available for managing ADHD. Conclusion: This study is one of the few from this part of the world using DSM criteria to diagnose ADHD. The implications of the present findings are discussed in the context of the available literature and the specific situation in Oman. ( J. of Att. Dis. 2011; 15(2) 139-146)

Objective: There is a dearth of cross-cultural research on hyperactivity. This article aims to quantify the prevalence of hyperactivity in schoolboys residing in an Arab/Islamic country, Oman. Method: 1,502 Omani schoolboys from eight randomly selected schools representing the urban population of Oman were screened for various indices of hyperactivity and psychosocial and academic functioning using the short version of Conners' Teacher Rating Scale and other ecologically valid assessment measures. Results: 7.8 % of the sample exhibited hyperactivity, which was strongly associated with indices of conduct disorder, poor school performance, and behavioral disorders (such as aggression, stealing, and lying). Sociodemographic variables such as child's rank, number of siblings, and parental education were not significant. Conclusion: To our knowledge, this is one of the few quantifications of the prevalence of hyperactivity in the Arabian Gulf region. The high prevalence of hyperactivity found by this study suggests that it is increasingly becoming a global challenge. (J. of Att. Dis. 2008; 12(3) 264-269)

The human dopamine transporter (DAT1) gene contains a variable number tandem repeat (VNTR) in its 3′- untranslated region because of repetition of a 40-bp core sequence. Methods available for the diagnosis of this polymorphism are limited in number. We have developed a new polymerase chain reaction (PCR) test, which is similar to that described originally by Vandenbergh's group, but provides a better detection of the VNTR alleles in the human DAT1 gene. Using two independent PCR methods, we have determined the distribution of VNTR alleles in 110 healthy Omani subjects, and in 92 children with attention-deficit hyperactivity disorder (ADHD). The frequency of the risk allele (DAT1*10) was similar in the healthy subjects and ADHD cases, indicating absence of association of this allele with ADHD in Oman.

Journal of the American Academy of Child & Adolescent Psychiatry - Vol. 43 - N° 2 - p. 132-133

To find the common behavioral problems in youth, their co-morbidity, treatment, and other variables in Oman.All patients who attended the child psychiatric clinic in Sultan Qaboos University Hospital (SQUH), Muscat, (the only child psychiatry clinic in Sultanate of Oman) for a 3-month period were investigated for behavioral problems, particularly hyperactivity (by Conners' Questionnaire). The diagnosis was based on the Diagnostic and Statistical Manual of Mental Disorders, 4th edition.Of the total 212 cases, Omani nationals constituted 89% and the rest were expatriates. Sixty five percent were boys, 57% were of school age, 26% were adolescents, 9% were preschoolers and 5% were toddlers. Consanguinity among their parents was high at 52%. The majority (60%) of the patients exhibited hyperactivity. Aggression was found in 49%, while stealing and lying were found in 25% and 22%. Approximately one-third suffered from headache and abdominal pain. The majority (62%) were of below-normal intelligence. Anxiety affected 14%, depression 4%, and conduct disorders 8%. One-third of the patients were taking psychostimulants and another one-third were taking tricyclics. The results were compared with those from other developing countries.Behavioral problems among children and adolescents are high in Oman, same as other developing countries, though the type of disorders is different here. This calls for the attention of the health policy makers for diagnosing and treating such disorders in Oman as well as in the other developing countries.

To find the prevalence of sleep problems among pupils, its possible causes and associated behaviors.This study was carried out during 3-24 February 1996. We randomly selected a sample of (277) 5th graders (181 boys and 96 girls), from 3 public primary schools in 3 different socio-economic areas in Benghazi, Libya. We interviewed the pupils and the teachers by a pretested questionnaire concerning sleep, school achievement and other behaviors. Those pupils who sleep after 10:00 pm, or those having bad sleep characters, or both, twice or more a week in the last month, were considered suffering from sleep problems. According to their performance in the first semester in both Arabic and Mathematics, pupils were classified in to 3 groups (70% in both the good group, 50-70% in both subjects or in one provided that the other was above 70% the average group,50% in one or both subjects the poorly achieving group).This study shows high prevalence of sleep problems among pupils (28.9%), especially in a high-density area, with non-significant gender difference. Associated behaviors are bad school achievement, sleepiness and mood fluctuation.Parental ignorance, unawareness and bad child rearing and follow-up are evident, and considered to be the main cause of these problems, that needs intensive education towards better sleep hygiene.

We report a case of a 14-year-old girl who presented, following a sudden onset, with bilateral ptosis, gait disturbance, difficulty swallowing and loss of appetite, right hypochondriacal pain, and frontal headache. Protracted neurological and medical examinations were unremarkable; neither was precipitating psychological stresses evident. The condition, which manifest as typical conversion disorder, lasted for one year. “Treatment” involving electrical stimulation of both eyes muscles and legs with positive reassurance resolved the symptom. This case supports the view that conversion disorder, not only involves a strong element of suggestion, but also incorporates socio-cultural sanctioned prescription.

Introduction Trichobezoars are an infrequent form of bezoar found in the stomach or intestine, created from ingested hair. This condition has been well described in the surgical literature, but less reported in psychiatry. Case presentation We describe the case of an 18-year-old Middle Eastern Caucasian woman with trichotillomania who presented to our emergency department with a history of central abdominal pain associated with vomiting and constipation for five days. An examination showed a trichobezoar requiring emergent surgical intervention, and indicating the need for psychiatric treatment. The trichobezoar was treated successfully by laparotomy. Conclusion The medical and psychiatric sequelae of trichotillomania should not be underestimated, and early diagnosis and treatment is of utmost importance to save the patient’s life and prevent recurrence. Although laparotomy is still considered an excellent option, pharmacotherapy and behavioral assessment play a useful role in patient management. Our case highlights the fundamental concept of a holistic approach rather than only treating the symptoms, by considering factors such as genetic influences to understand the disease.

Background: Autism spectrum disorder (ASD) is a severe neuro-developmental disorder with poorly understood etiology. Numerous studies evidenced that oxidative stress and altered antioxidant status could be involved in the pathophysiology of ASD. It is also reported that the altered levels of antioxidant proteins such as ceruloplasmin (copper-binding protein) and transferrin (iron-binding protein) could enhance the oxidative stress directly or indirectly and it can considerably retard acquired language skills in autistic children. But these types of studies in children with autism in Oman were not available. Materials and Methods: To reveal this paradigm, in this study, we evaluated the plasma levels of ceruloplasmin and transferrin in Omani autistic children and compared the results with age matched control children (n = 20). Results: In accordance with the previous reports, significantly lower plasma levels of ceruloplasmin and of transferrin were observed in Omani autistic children as compared to normal children. Conclusion: This suggests that such changes may lead to abnormalities of iron and copper metabolism, resulting in the enhancement of the oxidative stress and contributing to the pathogenesis of ASD. However, the underlying mechanism is still unclear and further extensive studies are warranted.