Responses to the Pandemic COVID-19 in Primary Health Care in Oman: Muscat Experience.

OBJECTIVES: As coronavirus disease (COVID-19) was pervading different parts of the world, little has been published regarding responses undertaken within primary health care (PHC) facilities in Arabian Gulf countries. This paper describes such responses from January to mid-April 2020 in PHC, including public health measures in Muscat, Oman. METHODS: This is a descriptive study showing the trends of the confirmed positive cases of COVID-19 and the undertaken responses to the evolving epidemiological scenario. These responses were described utilizing the World Health Organizations' building blocks for health care systems: Leadership and governance, Health workforce, Service delivery, Medical products and technologies, and health information management. RESULTS: In mid-April 2020, cases of COVID-19 increased to 685 (particularly among non-nationals). As the cases were surging, the PHC responded by executing all guidelines and policies from the national medical and public health response committees and integrating innovative approaches. These included adapting comprehensive and multi-sectoral strategies, partnering with private establishments, and strengthening technology use (in tracking, testing, managing the cases, and data management). CONCLUSIONS: Facilities in the Muscat governorate, with the support from national teams, seemed to continuously scale-up their preparedness and responses to meet the epidemiological expectations in the management of COVID-19.

The Usefulness of Nap Sleep Recording During Routine Electroencephalography: An Audit Study.

OBJECTIVES: A measure to increase the electroencephalogram (EEG) outcome includes a short period of nap sleep during a routine standard EEG with the aim of increasing its sensitivity to interictal abnormalities or provoking seizures. As part of an ongoing auditing of our EEG data, we aimed to investigate the contribution of nap sleep during routine outpatient department based EEGs requested for a variety of reasons. METHODS: EEG data at the Department of Clinical Physiology at Sultan Qaboos University Hospital, Oman, from July 2006 to December 2007 and from January 2009 to December 2010 (total 42 months) were reviewed. The EEGs were for patients older than 13-years referred for possible epilepsy, blackouts, headache, head trauma, and other non-specified attacks. The recording period was between 20 to 40 minutes. Abnormalities were identified during waking and nap sleep periods. RESULTS: A total of 2 547 EEGs were reviewed and 744 were abnormal (29.2%). Of those abnormal EEGs, nap sleep was obtained in 258 (34.7%) EEGs, and 39 (15.1%) showed abnormalities during nap sleep. Nineteen out of the 39 (48.7%) EEGs were abnormal during awake and nap sleep; and 20 (51.3%) were abnormal during nap sleep, which represented only 2.7% of the total abnormal EEGs (n = 744). CONCLUSIONS: The contribution of the short nap sleep to the pickup rate of interictal abnormalities in EEG was minimal. We recommend the EEG service to include one cycle of spontaneous sleep EEG directed at patients with a history suggestive of epilepsy if their awake EEGs are normal.