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Article ; Online: Preoperative Anemia is Associated with Increased Intraoperative Mortality in Patients Undergoing Cardiac Surgery

Arwa Z. Al-Riyami / Balan Baskaran / Sathiya M. Panchatcharam / Hilal Al-Sabti

Oman Medical Journal, Vol 36, Iss 3, Pp e267-e

2021 Volume 267

Abstract: Objectives: We sought to investigate the incidence of preoperative anemia in cardiac surgery and its association with outcomes. Methods: A retrospective review of clinical, laboratory, and transfusion data for all patients who underwent cardiac surgery ... ...

Abstract	Objectives: We sought to investigate the incidence of preoperative anemia in cardiac surgery and its association with outcomes. Methods: A retrospective review of clinical, laboratory, and transfusion data for all patients who underwent cardiac surgery at Sultan Qaboos University Hospital between 2008 and 2014 was performed. Patients were divided into two groups, anemic and non-anemic, with anemia defined as hemoglobin levels < 13 g/dL (males) and < 12 g/dL (females). Clinical variables were compared using chi-square and independent t-test. Factors influencing preoperative mortality were analyzed using multivariate binary logistics regression. Results: A total of 599 patients (69.9% males and 30.1% females) were included in the study; 69.3% underwent coronary artery bypass surgery. Preoperative anemia was found in 76.1% of females and 26.7% of male patients. Rates of intraoperative red blood cell transfusions were higher among anemic patients (75.9% vs. 52.3%, p < 0.001). Anemic patients had a worse risk profile with higher incidence of diabetes mellitus (53.8% vs. 38.9%, p < 0.001), congestive heart failure (51.4% vs. 28.3%, p < 0.001), arrhythmia (16.5% vs. 8.6%, p =0.004), and cerebrovascular disease (10.0% vs. 4.9%, p =0.015). In addition, they had a higher risk of overall mortality (6.4% vs. 2.6%, p =0.023). Preoperative anemia remained a risk factor for intraoperative mortality after logistic regression (odds ratio = 4.08, 95% confidence interval: 1.43–11.66; p= 0.009). Conclusions: Preoperative anemia in cardiac surgery is independently associated with increased intraoperative mortality and early readmission rates post-surgery.
Keywords	retrospective studies ; blood transfusion ; anemia ; cardiac surgical procedures ; Medicine ; R
Language	English
Publishing date	2021-05-01T00:00:00Z
Publisher	Oman Medical Specialty Board
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Preoperative Anemia is Associated with Increased Intraoperative Mortality in Patients Undergoing Cardiac Surgery

Arwa Z. Al-Riyami / Balan Baskaran / Sathiya M. Panchatcharam / Hilal Al-Sabti

Oman Medical Journal, Vol 36, Iss 3, Pp e267-e

2021 Volume 267

Abstract	Objectives: We sought to investigate the incidence of preoperative anemia in cardiac surgery and its association with outcomes. Methods: A retrospective review of clinical, laboratory, and transfusion data for all patients who underwent cardiac surgery at Sultan Qaboos University Hospital between 2008 and 2014 was performed. Patients were divided into two groups, anemic and non-anemic, with anemia defined as hemoglobin levels < 13 g/dL (males) and < 12 g/dL (females). Clinical variables were compared using chi-square and independent t-test. Factors influencing preoperative mortality were analyzed using multivariate binary logistics regression. Results: A total of 599 patients (69.9% males and 30.1% females) were included in the study; 69.3% underwent coronary artery bypass surgery. Preoperative anemia was found in 76.1% of females and 26.7% of male patients. Rates of intraoperative red blood cell transfusions were higher among anemic patients (75.9% vs. 52.3%, p < 0.001). Anemic patients had a worse risk profile with higher incidence of diabetes mellitus (53.8% vs. 38.9%, p < 0.001), congestive heart failure (51.4% vs. 28.3%, p < 0.001), arrhythmia (16.5% vs. 8.6%, p =0.004), and cerebrovascular disease (10.0% vs. 4.9%, p =0.015). In addition, they had a higher risk of overall mortality (6.4% vs. 2.6%, p =0.023). Preoperative anemia remained a risk factor for intraoperative mortality after logistic regression (odds ratio = 4.08, 95% confidence interval: 1.43–11.66; p= 0.009). Conclusions: Preoperative anemia in cardiac surgery is independently associated with increased intraoperative mortality and early readmission rates post-surgery.
Keywords	retrospective studies ; blood transfusion ; anemia ; cardiac surgical procedures ; Medicine ; R
Language	English
Publishing date	2021-05-01T00:00:00Z
Publisher	Oman Medical Specialty Board
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: A promising future for tele-mental health in Oman

Tamadhir Al-Mahrouqi / Kamila Al-Alawi / Mohammed Al-Alawi / Naser Al Balushi / Abdullah Al Ghailani / Hilal Al Sabti / Hamed Al Sinawi

SAGE Open Medicine, Vol

A qualitative exploration of clients and therapists’ experiences

2022 Volume 10

Abstract: Objectives: Tele-mental health services can play an important role in overcoming barriers in mental health services in the Eastern Mediterranean Region. However, despite its potential, tele-mental health has not been widely adopted in Oman. This study is ...

Abstract	Objectives: Tele-mental health services can play an important role in overcoming barriers in mental health services in the Eastern Mediterranean Region. However, despite its potential, tele-mental health has not been widely adopted in Oman. This study is an exploratory investigation into the experiences of therapists and their clients in utilizing video-based tele-mental health care during the COVID-19 pandemic. Methods: A total of 19 semistructured qualitative interviews were individually conducted, it included 13 adult clients with mental health conditions who received video-based tele-mental health care and six clinical psychologists who provided video-based tele-mental health care during the COVID-19 pandemic. Results: The clients reported favorable experiences using tele-mental health, with the primary benefits being convenience, easy accessibility to subspecialized care, reduced absenteeism from work with commuting costs, and alleviated mental health stigma. The therapists also expressed experiencing benefits from tele-mental health, such as reduced risk of intrahospital infection, reduced healthcare costs, and the achievement of work-life balance. Primary concerns were related to the lack of public tele-mental health services, lack of specified tele-mental health guidelines, shortage of trained therapists, limited access to high-speed Internet, electronic devices, privacy, and concerns toward the security of telehealth systems in general. Conclusion: Clients and therapists report that tele-mental health offers new opportunities to improve the quality of mental healthcare services in Oman, and that the challenges could be resolved by establishing governmental tele-mental health services along with developing tele-mental health guidelines and implementing local postgraduate clinical psychology programs in universities in Oman.
Keywords	Medicine (General) ; R5-920
Subject code	360
Language	English
Publishing date	2022-03-01T00:00:00Z
Publisher	SAGE Publishing
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Dyslipidemia in the Arabian Gulf and its Impact on Cardiovascular Risk Outcome

Khalid Al-Rasadi / Hilal Al-Sabti

Oman Medical Journal, Vol 30, Iss 6, Pp 403-

2015 Volume 405

Keywords	Dyslipidemia ; Cardiovascular ; Medicine ; R
Language	English
Publishing date	2015-11-01T00:00:00Z
Publisher	Oman Medical Specialty Board
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Management of Internal Mammary Artery Spasm

Edam Ziadinov / Nasser Al-Kemyani / Hilal Al-Sabti

International Journal of Clinical Medicine, Vol 05, Iss 05, Pp 284-

2014 Volume 291

Abstract: The article is dedicated to the management of internal mammary artery spasm intra- and postoperatively based on the accumulated evidence in the literature. It provides a stepwise decision algorithm for safely resolving the spasm and prevention of relapse. ...

Abstract	The article is dedicated to the management of internal mammary artery spasm intra- and postoperatively based on the accumulated evidence in the literature. It provides a stepwise decision algorithm for safely resolving the spasm and prevention of relapse.
Keywords	Internal Mammary Artery Spasm ; Coronary Artery Bypass Grafting ; Vasodilation ; Medicine (General) ; R5-920 ; Medicine ; R
Language	English
Publishing date	2014-03-01T00:00:00Z
Publisher	Scientific Research Publishing
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Coronary artery bypass grafting in a patient with protein S deficiency

Baskaran Balan / Suresh Chengode / Hilal Al Sabti / Ram Narayan Rao

Annals of Cardiac Anaesthesia, Vol 17, Iss 3, Pp 232-

Perioperative implications

2014 Volume 236

Abstract: Protein S (PS) along with activated protein C plays an important role in the down-regulation of in vivo thrombin generation. Its deficiency can cause abnormal and inappropriate clot formation within the circulation necessitating chronic anticoagulation ... ...

Abstract	Protein S (PS) along with activated protein C plays an important role in the down-regulation of in vivo thrombin generation. Its deficiency can cause abnormal and inappropriate clot formation within the circulation necessitating chronic anticoagulation therapy. The risk of developing thrombotic complications is heightened in the perioperative period in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). Heparin resistance is very rare in these patients, especially when antithrombin levels are near normal. Management of CPB in this scenario is quite challenging. We report the perioperative management, particularly the CPB management, of a patient with type I PS deficiency and incidentally detected heparin resistance, who underwent coronary artery bypass grafting with CPB.
Keywords	Cardiopulmonary bypass; Coronary artery bypass grafting; Heparin resistance; Hypercoagulable states; Protein S deficiency ; Diseases of the circulatory (Cardiovascular) system ; RC666-701 ; Specialties of internal medicine ; RC581-951 ; Internal medicine ; RC31-1245 ; Medicine ; R
Subject code	610
Language	English
Publishing date	2014-01-01T00:00:00Z
Publisher	Medknow Publications
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Clinical and Genetic Characteristics of Familial Hypercholesterolemia at Sultan Qaboos University Hospital in Oman

Khalid Al-Waili / Khalid Al-Rasadi / Fahad Zadjali / Khamis Al-Hashmi / Suad Al-Mukhaini / Mohammed Al-Kindi / Hilal Al-Sabti / Ali Talib Al-Hinai / Hatem Farhan / Ibrahim Al-Zakwani

Oman Medical Journal, Vol 35, Iss 3, Pp e141-e

2020 Volume 141

Abstract: Objectives: We sought to describe the clinical and genetic characteristics of patients with familial hypercholesterolemia (FH) that presented to the lipid clinic at Sultan Qaboos University Hospital, Muscat, Oman. Methods: Patients who presented with ... ...

Abstract	Objectives: We sought to describe the clinical and genetic characteristics of patients with familial hypercholesterolemia (FH) that presented to the lipid clinic at Sultan Qaboos University Hospital, Muscat, Oman. Methods: Patients who presented with high low-density lipoprotein cholesterol (LDL-C) levels (> 189.0 mg/dL or 4.9 mmol/L) were recruited to the study. FH was diagnosed according to the Dutch Lipid Clinic Network criteria. Analyses were performed using univariate statistics. Results: The study enrolled 450 patients with a mean age of 48.0±12.0 years, 56.0% (n = 252) were males and 11.3% (n = 51) were smokers. At admission, the proportion of ‘probable/definite’, ‘possible’, and ‘unlikely’ FH were 27.6% (n = 124), 70.0% (n = 315), and 2.4% (n = 11), respectively. Overall, 26.0% (n = 117) of patients had hypertension, 22.4% (n = 101) had a history of coronary artery disease, and 17.3% (n = 78) had diabetes mellitus. Those with ‘probable/definite’ FH were more likely to be prescribed high-intensity statin therapy (75.8% vs. 54.5%; p < 0.001) and statin ezetimibe combination (50.8% vs. 27.3%; p < 0.001) when compared to the ‘unlikely’ FH cohort. Additionally, those with very high atherosclerotic vascular disease (ASCVD) risk were also associated with high-intensity statin therapy (54.7% vs. 42.7%; p = 0.006) and statin ezetimibe combination (26.4% vs. 17.2%; p = 0.023). Patients with ‘probable/definite’ FH were less likely to achieve their LDL-C goal attainment compared to those with ‘unlikely’ FH (13.0% vs. 57.1%; p < 0.001). Furthermore, those with very high ASCVD risk were less likely to achieve their LDL-C goals compared to the high ASCVD risk cohort (9.6% vs. 32.0%; p < 0.001). Conclusions: FH patients are underdiagnosed, undertreated, and less likely to attain their LDL-C goals in Oman.
Keywords	hypercholesterolemia ; acute coronary syndrome ; cardiovascular abnormalities ; diabetes mellitus ; arabs ; oman ; Medicine ; R
Subject code	610
Language	English
Publishing date	2020-05-01T00:00:00Z
Publisher	Oman Medical Specialty Board
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Pretreatment with Hydroxyurea of the Patient with Essential Thrombocythemia Followed by Coronary Artery Bypass Surgery

Edem Ziadinov / Hilal Al-Sabti / Malik Al-Toubi / Mohammad Salman Siddiqi

Oman Medical Journal, Vol 29, Iss 4, Pp 294-

2014 Volume 295

Abstract: The risk of thrombosis is high in patients with essential thrombocythemia. Special precaution needed for those patients who will undergo Coronary artery bypass grafting. We are reporting a 62 years old patient with ischemic heart disease who was found to ...

Abstract	The risk of thrombosis is high in patients with essential thrombocythemia. Special precaution needed for those patients who will undergo Coronary artery bypass grafting. We are reporting a 62 years old patient with ischemic heart disease who was found to have essential thrombocythemia. This report explains the preoperative management and the postoperative risks anticipated due to the treatment.
Keywords	Coronary Artery Bypass Grafting ; Essential Thrombocythemia ; Hydroxyurea ; Case Report ; Medicine ; R
Language	English
Publishing date	2014-07-01T00:00:00Z
Publisher	Oman Medical Specialty Board
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: The Achievement of Non-high-density Lipoprotein Cholesterol Target in Patients with Very High Atherosclerotic Cardiovascular Disease Risk Stratified by Triglyceride Levels Despite Statin-controlled Low-density Lipoprotein Cholesterol

Hilal Al-Sabti / Ali T. Al-Hinai / Ibrahim Al-Zakwani / Khamis Al-Hashmi / Wael Al Mahmeed / Mohamed Arafah / Abdullah Shehab / Omer Al Tamimi / Mahmoud Al Awadhi / Shorook Al Herz / Faisal Al Anazi / Khalid Al Nemer / Othman Metwally / Akram Alkhadra / Mohammed Fakhry / Hossam Elghetany / Abdel Razak Medani / Afzal Hussein Yusufali / Obaid Al Jassim /

Omar Al Hallaq / Fahad Omar Ahmed S. Baslaib / Haitham Amin / Khalid Al-Waili / Khalid Al-Rasadi

Oman Medical Journal, Vol 37, Iss 2, Pp e367-e

2022 Volume 367

Abstract: Objectives: We sought to estimate the percentage achievements of non-high-density lipoprotein cholesterol (non-HDL-C) target in patients with very high atherosclerotic cardiovascular diseases (ASCVD) risk stratified by triglyceride (TG) levels despite ... ...

Abstract	Objectives: We sought to estimate the percentage achievements of non-high-density lipoprotein cholesterol (non-HDL-C) target in patients with very high atherosclerotic cardiovascular diseases (ASCVD) risk stratified by triglyceride (TG) levels despite statin-controlled low-density lipoprotein cholesterol (LDL-C) in the Centralized Pan-Middle East Survey on the under treatment of hypercholesterolemia. Methods: The non-HDL-C target achievement in patients with diabetes mellites (DM) and patients with established ASCVD was defined according to European Society of Cardiology and European Atherosclerosis Society 2019 guidelines for managing dyslipidemia. Patients were stratified to controlled LDL-C defined as < 70 mg/dL (< 1.8 mmol/L) with normal TG < 150 mg/dL (< 1.7 mmol/L) and high TG between 150–400 mg/dL (1.7–4.5 mmol/L). Results: The mean age of our cohort was 58.0±11.0 years, 6.8% (n = 717) were male, 9.7% (104) were smokers, and 48.4% (n = 518) had body mass index of ≥ 30 kg/m2. Those with high TG levels male (76.5% vs. 63.8%; p < 0.001), smokers (16.1% vs. 7.7%; p < 0.001), have metabolic syndrome (77.6% vs. 17.1%; p < 0.001), and low HDL-C levels (79.2% vs. 49.4%; p < 0.001). The majority (93.9%, n = 1008) were on statins (atorvastatin and rosuvastatin) with only 2.2% (n = 24) on the combined statins plus fenofibrate/gemfibrozil. Only 27.4% (n = 294) of patients had non-HDL-C goal attainment. Goal attainment rates in patients with diabetes (3.1% vs. 34,4%; p < 0.001), coronary artery disease (CAD) (2.4% vs. 37.9%; p < 0.001), diabetes plus CAD (0% vs. 40.0%; p < 0.001), and CVD (0% vs. 30.0%; p =0.048) were significantly lower in those with higher TG levels. Conclusions: A large proportion of statin-controlled LDL-C diabetic patients and patients with established ASCVD with high TGs did not achieve the non-HDL-C target. Our study did not demonstrate an association between ASCVD and high TG levels; and therefore, a follow-up study is highly required to assess long-term ASCVD ...
Keywords	triglycerides ; cholesterol ; ldl ; cardiovascular diseases ; risk factors ; diabetes mellitus ; arabs ; Medicine ; R
Subject code	616 ; 610
Language	English
Publishing date	2022-03-01T00:00:00Z
Publisher	Oman Medical Specialty Board
Document type	Article ; Online
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Article ; Online: First Implementation of Transfusion Consent Policy in Oman

Arwa Z. Al-Riyami / Naif Al-Ghafri / Fehmida Zia / Mohammed Al-Huneini / Abdul-Hakeem Al-Rawas / Salam Al-Kindi / Sachin Jose / Murtadha Al-Khabori / Hilal Al-Sabti / Shahina Daar

Sultan Qaboos University Medical Journal, Vol 16, Iss 3, Pp 293-

Audit of compliance from a tertiary care university hospital

2016 Volume 297

Abstract: Objectives: Transfusions are a common medical intervention. Discussion of the benefits, risks and alternatives with the patient is mandated by many legislations prior to planned transfusions. At the Sultan Qaboos University Hospital (SQUH), Muscat, Oman, ...

Abstract	Objectives: Transfusions are a common medical intervention. Discussion of the benefits, risks and alternatives with the patient is mandated by many legislations prior to planned transfusions. At the Sultan Qaboos University Hospital (SQUH), Muscat, Oman, a written transfusion consent policy was introduced in March 2014. This was the first time such a policy was implemented in Oman. This study therefore aimed to assess adherence to this policy among different specialties within SQUH. Methods: The medical records of patients who underwent elective transfusions between June and August 2014 were reviewed to assess the presence of transfusion consent forms. If present, the consent forms were examined for completeness of patient, physician and witness information. Results: In total, the records of 446 transfused patients (299 adult and 147 paediatric patients) were assessed. Haematology patients accounted for 50% of adult patients and 71% of paediatric patients. Consent was obtained for 75% of adult and 91% of paediatric patients. The highest adherence rate was observed among adult and paediatric haematology specialists (95% and 97%, respectively). Consent forms were correctly filled out with all details provided for 51% and 52% of adult and paediatric patients, respectively. Among inadequately completed forms, the most common error was a lack of witness details (20–25%). Conclusion: In most cases, the pre-transfusion consent policy was successfully adhered to at SQUH. However, further work is required to ensure full compliance with the consent procedure within different specialties. Implementation of transfusion consent in other hospitals in the country is recommended.
Keywords	blood transfusion ; informed consent ; policy compliance ; clinical audit ; oman ; Medicine ; R
Subject code	616
Language	English
Publishing date	2016-08-01T00:00:00Z
Publisher	Sultan Qaboos University
Document type	Article ; Online
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