Prevalence of anxiety, depression, and post-traumatic stress disorder among Omani children and adolescents diagnosed with cancer: a prospective cross-sectional study.

BACKGROUND: Children and adolescents diagnosed with cancer often experience psychological distress, encompassing anxiety, depression, and post-traumatic stress disorder (PTSD). This study aimed to evaluate the prevalence of these conditions among Omani children and adolescents diagnosed with cancer, alongside identifying contributing factors. METHODS: A prospective cross-sectional study was conducted from October 2021 to June 2023 among a cohort of Omani children and adolescents (6-18 years old) diagnosed with cancer at three primary cancer referral centres in Oman. Validated Arabic-language versions of the Screen for Child Anxiety Related Disorders, the Center for Epidemiologic Studies Depression Scale for Children, and the Impact of Event Scale-Revised instruments were used to assess symptoms of anxiety, depression, and PTSD, respectively. An initial assessment (T1) was undertaken within the first 3 months of diagnosis, followed by a second assessment (T2) 3-6 months later. RESULTS: Of 113 eligible participants, 101 agreed to participate in the study (response rate: 95.6%), with 92 (91.0%) completing both assessments and included in the final analysis. Prevalence rates of anxiety, depression, and PTSD decreased from 43.5%, 56.5%, and 32.6%, respectively, at T1, to 38.0%, 35.9%, and 23.9% at T2. All average scores were below diagnostic cut-off points, except for the depression score at T1. Anxiety and depression scores decreased significantly (p = 0.043 and 0.001, respectively) between T1 and T2, as did the overall prevalence of depression (p = 0.004). At T1, linear regression analysis showed significant correlations between anxiety scores and the child's age and PTSD score (p < 0.05); these variables were also correlated with depression scores (p ≤ 0.001). At T2, significant correlations were observed between anxiety scores and the child's age and PTSD scores (p < 0.001). At both T1 and T2, anxiety, depression, and PTSD scores remained significantly correlated (p < 0.001). CONCLUSIONS: Omani children and adolescents recently diagnosed with cancer exhibit a high prevalence of anxiety, depression, and PTSD over time. Age-appropriate communication, ongoing support, and mental health services are recommended to help this patient group cope with their diagnosis and manage their emotional wellbeing. There is a need for future research to determine the effectiveness of specific psychological interventions in reducing the frequency of these disorders.

Effects of COVID-19 on Pediatric Cancer Care: A Multicenter Study of 11 Middle Eastern Countries.

During the COVID-19 pandemic, major challenges are facing pediatric cancer centers regarding access to cancer centers, continuity of the anti-cancer therapy, hospital admission, and infection protection precautions. Pediatric oncologists actively treating children with cancer from 29 cancer centers at 11 countries were asked to answer a survey from May 2020 to August 2020 either directly or through the internet. COVID-19 pandemic affected the access to pediatric cancer care in the form of difficulty in reaching the center in 22 (75.9%) centers and affection of patients' flow in 21 (72.4%) centers. Health care professionals (HCP) were infected with COVID-19 in 20 (69%) surveyed centers. Eighteen centers (62%) modified the treatment guidelines. Care of follow-up patients was provided in-hospital in 8(27.6%) centers, through telemedicine in 10 (34.5%) centers, and just delayed in 11 (38%) centers. Pediatric oncologists had different expectations about the future effects of COVID-19 on pediatric cancer care. Seventy-six percent of pediatric oncologists think the COVID-19 pandemic will increase the use of telemedicine. Fifty-five percent of pediatric oncologists think if the COVID-19 pandemic persists, we will need to change chemotherapy protocols to less myelosuppressive ones. Collaborative studies are required to prioritize pediatric cancer management during COVID-19 era.

Extrarenal Wilms' Tumour of the Ovary: A case report.

Wilms' tumour (nephroblastoma) is the most common abdominal malignancy in children. Extrarenal Wilms' tumour is rare, with limited reports in the literature. We report a two-year-old girl who presented to a tertiary care hospital in Muscat, Oman, in 2019 with an abdominal mass. The patient was diagnosed with unilateral ovarian Wilms' tumour (initially diagnosed by closed biopsy and confirmed later by histopathology study of the excised tumour). This report highlights the unusual location and presentation of Wilms' tumour and presents the medical challenge in both the initial clinical impression and pathological diagnosis. Furthermore, this report details the therapeutic plan and shows the good outcome achieved by using the classic renal Wilms' tumour therapy protocols.

The prevalence of sickling abnormality in Oman: A review of relevant publications

Sickle cell disease (SCD), caused by a mutation in the ß-globin gene HBB, is widely distributed in malaria endemic regions.  The prevalence of sickle cell trait and disease reaches up to 4.8-6% and 0.2% respectively, which is the highest among the Arab Gulf states.  Omani population represents a variability of HbS genotype combinations with other Hb genotypes modify the clinical severity of the disease. The most prevalent sickling abnormality in Oman is Hb S/S (SCA) followed by Hb S/ß-thalassemia. Omani children with SCD with high Hb F level had less severe disease. More than two-thirds of SCD cases were running a mild course of the disease due to the high prevalence of  a-thalassemia trait. The severity index has been correlated with the early age of presentation, the absence of  a-thalassemia trait and the lower level of HbF as well as to the existence of different ß-globin gene haplotypes.  S/ ß0 presented with the same clinical severity of S/S while those with S/ ß+ had some splenic function into adulthood and were more prone to splenic sequestration. The unique existence of HbS-Oman (a severe variant of sickle hemoglobinopathy) markedly increased the severity of the disease. Compound heterozygotes HbS-Oman resulted in very severe clinical manifestations with transfusion-dependency and hypersplenism early in life. This paper summarizes and reviews ßs gene haplotypes in patients with sickle cell anemia (SCA) in Oman. (www.actabiomedica.it).

Coronavirus Disease 2019 Infection in Children With Sickle Cell Disease: Case Series From Oman.

BACKGROUND: In March 2020, WHO announced Coronavirus Disease 2019 (COVID-19) outbreak a global pandemic. During this pandemic, patients with sickle cell disease (SCD) have been placed in the "high-risk" category of the population. Although there are numerous publications describing COVID-19 in adult patients, pediatric data are still limited. OBSERVATION: Herein, we report case series of 5 sickle cell disease Omani children who got infected with COVID-19; illustrating their different ways of presentation, management and highlighting the outcomes. CONCLUSION: Although SCD patients are considered as a high-risk group, all of the observed patients, and whose cases are reported here, have recovered. A large scale of SCD cases should be studied to reach more conclusive results.

Hepatoblastomas in Oman: Unveiling success.

OBJECTIVES: Primary malignant liver tumours account for more than 1% of all paediatric malignancies, with the most common form being hepatoblastomas (HB). Such malignancies among Arab populations have rarely been addressed in the literature. Using data from Oman's sole national referral centre for childhood solid malignancies, this study aimed to present the nationwide Omani experience with HB over the past 21 years. METHODS: This retrospective study reviewed the medical records of all children with HB who were managed in the Royal Hospital, Muscat, Oman, between January 1991 and April 2012. Clinical, radiological and laboratory characteristics were examined as well as treatments and outcomes. RESULTS: During the study period, 15 patients with HB were treated. Of these, 10 have survived to date. Nine of the survivors were no longer receiving treatment and one patient still had the disease but was in a stable condition. Of the remaining five patients, three did not survive and two were lost to follow-up. The survival rate among patients who completed therapy was 91%. CONCLUSION: HB has an excellent prognosis in Oman. The main obstacle to improving outcomes among Omani patients is non-compliance with therapy.

Renal cell carcinoma with Xp 11.2 translocation as a second tumor in a long-term survivor of advanced neuroblastoma.

Renal cell carcinoma (RCC) is an uncommon tumor in childhood and adolescence, and is exceptionally rare as a secondary neoplasm related to prior anti-neoplastic therapy. We report a case of RCC with Xp11.2 translocation in a 17 year old boy who is a survivor of stage 4 neuroblastoma 13 years earlier.

Brain is not always the last fortress; osteosarcoma with large brain metastasis.

Osteosarcomas are the most common malignant primary bone tumors in children and adolescents. Brain metastases of osteosarcoma are very rare and carry a dismal prognosis. We report a case of chondroblastic osteosarcoma of right humerus presented with right frontal lobe metastasis in a 10-year-old girl with small pulmonary lesions.

Postvaricella thrombosis-report of two cases and literature review.

Varicella (chickenpox) is a common disease of childhood, caused by varicella-zoster virus. Postviral thromboembolism is a rare complication of varicella-zoster virus in childhood. We describe 2 children who developed lower limb deep venous thrombosis shortly after varicella infection, along with a review of 130 previously reported cases.