Perceived control attitude among heart failure patients in Oman: a multicenter study.

Heart failure (HF) is a global epidemic with a prevalence of over 64.3 million cases worldwide. Several factors account for the increase in the prevalence of HF. The most significant factor is the growing population of older adults. Other factors include improved treatment and survival after myocardial infarction, poorly controlled hypertension (HTN), and diabetes mellitus (DM). As a modifiable construct, perceived control can be improved to promote healthier lifestyle choices, such as self-care, and consequently better health outcomes. A person's perception of control is their conviction that they have the power to deal with adverse circumstances, like receiving an HF diagnosis, and produce favorable results, such as an improvement in symptom status. The objective of this study was to evaluate the factors influencing perceived control attitudes among patients with heart failure in Oman. In this sample of HF patients (N = 180), the mean perceived control attitude was 16.97 ± 2.25. Certain factors had higher effects than others. For example, females (p = 0.006), old age (p < 0.001), those who smoke (p < 0.001), current health compared to one year back (p < 0.001), higher ejection fraction (p = 0.008), and comorbidities (p = 0.026) have significant relationships with perceived control attitude. The perceived control attitude in this sample was found to be adequate. Female gender, old age, smoking, current health, higher EF, and comorbidities were the associated factors of a perceived control attitude. Thus, interventions targeting attitudes, barriers, and social support may improve perceived control. Clinicians should assess and manage perceived control to maintain or improve quality of life.

Human papillomavirus prevalence and genotypes in Gulf Cooperation Council countries: A scoping review 2017-2024.

Background: Cervical cancer remains a global health challenge, claiming the lives of millions annually and having a significant impact on Gulf Cooperation Council (GCC) countries. Human papillomavirus (HPV), the primary causative agent, plays a central role, with regional variations in prevalence.1 The process from HPV infection to neoplastic changes takes 5-25 years to occur, hence, knowing its prevalence in our community is vital.2. Methods: PubMed and SCOPUS were searched to identify articles related to cervical and anogenital HPV prevalence and genotypes in Qatar, Kuwait, Bahrain, Oman, the United Arab Emirates (UAE), and the Kingdom of Saudi Arabia (KSA) published between 2017 and 2024. Results: A total of 19 articles were included in this review. Eight studies were from KSA, four were from Kuwait, three were from the UAE, one was from Qatar, Oman, and Bahrain, and one presented data collectively from the KSA, UAE, Qatar, and Bahrain. The prevalence of HPV ranged between 4.7% and 77% in studies from the KSA, between 15% and 54.3% in studies from Kuwait, between 14.7% and 88% in studies from the UAE, was 8.1% and 31.3% in the two studies from Qatar, and was 17.8% and 20% in the studies from Oman and Bahrain, respectively. HPV 16 was the most prevalent high-risk genotype found in studies conducted in the KSA, UAE, Kuwait, and Qatar. In Oman, HPV 82 predominated. In Bahrain, the majority had other non-HPV 16/18/45 genotypes. In the UAE and Kuwait, HPV 11 was the predominant low-risk type, followed by HPV 6. In Qatar, HPV 81 was the most common low-risk type, followed by HPV 11. In Oman, HPV 54 was the most common low-risk type, followed by HPV 42. Conclusion: There are no studies with data on HPV prevalence and genotypes among women who have been vaccinated against HPV in GCC countries.

Prevalence of Career Indecision and Factors Influencing It Among Medical Students and Interns in Oman: A Cross-Sectional Questionnaire Study.

AIM AND OBJECTIVES: Career indecision is a broad term that refers to the uncertainty and difficulty of decision-making regarding future careers among junior professionals. This study aims primarily to estimate the prevalence of career indecisiveness among senior medical students and medical interns in Oman. Secondly, it assesses the association of sociodemographic factors influencing it. Finally, it examines the association between participation in career development activities and career indecision among them during the academic year of 2022-2023. METHODS: A cross-sectional study was conducted using an anonymous self-administered questionnaire in the English language. Unpaired t-test and ANOVA test were used to compare means between groups. A 21-item Career Factors Inventory (CFI) was used to determine the career indecision score. These scores were further classified as low-level (score 27-71) and high-level (score 72-105).  Results: The total number of participants was 161. The minimum sample size calculated was 153 participants for 95% confidence intervals. The prevalence of high-level career indecision was 63.4% (95%CI 55.4%-70.8%) among the participants. Participants with one of their parents in healthcare professions and those who did not participate in career development activities had high career indecision scores with P-values of 0.002 and 0.022, respectively. Moreover, participants younger than 25 years of age in comparison to older participants had higher need-for-self-knowledge (NSK) scores (p-value 0.018). CONCLUSION: A high prevalence of high-level career indecision was seen among senior medical students and medical interns in Oman. Few factors were found to be statistically associated with career indecision, especially participation in career development activities. Further studies are recommended to investigate the causality of high-level career indecision among junior professionals in Oman and the contributing factors. Curricular and extra-curricular career development activities and counseling may reduce career indecision.

Suspended particulate matter in the Gulf of Oman: Spatial variations in concentration, bulk composition, and particulate metals controlled by physical and biogeochemical processes.

The present work aims to assess the biogeochemical and physical sources of variation in the spatial distribution of suspended particulate matter (SPM), its major biotic and abiotic components, particulate metals, and the Redfield (N:P) stoichiometry of particles in a poorly understood basin of the Gulf of Oman. Particulate samples were collected in February 2022 from the Gulf of Oman aboard the R/V Persian Gulf Explorer, revealing surface SPM concentrations ranging from 140 to 1145 µg/l. The elemental composition of crustal-type elements in the surface offshore region confirmed the input of lithogenic components by aeolian dust from the surrounding deserts. The highest mid-depth SPM levels, with remarkable contribution from CaCO3, were observed at the western shelf edge at 100-300 m depth, supported by the Persian Gulf outflow. Conversely, mid-depth maxima with elevated concentrations of terrigenous elements were observed in the eastern edge, emanating from sediment resuspension and lateral transport under eddy-topography interaction. Organic matter is the most important phase, followed by biogenic silica from the basin-wide winter bloom of diatoms. While signs of CaCO3 dissolution are evident at depths >500 m, the oxidative precipitation of Mn (II) in the upper boundary of the oxygen minimum zone leads to the appearance of perceptible maxima in the vertical profile of particulate MnO2. Seasonal variations in the organic N:P ratio, from summer to winter, at the western station were linked to shifts in phytoplankton assemblage structure, transitioning from cyanobacteria dominance in summer to chain-forming diatoms in winter. The particulate pool of biologically important trace metals was dominated by a non-crustal fraction with enrichment factor followed a descending order: Cd > Mo > Pb > Zn > Ni in surface offshore samples. Metal/P ratios comparison with some previous data from the open ocean SPM and lab cultures of phytoplankton reveals that the Zn/P ratio is significantly exceeded in cultured communities, whereas the Cd/P ratio reflected the consistent demand in the Gulf of Oman compared to reported lab culture requirements.

Investigating Trace and Macro-element Composition of Herbal and Nutraceutical Dietary Supplements Marketed in Oman: Insights into Safety and Labeling.

With the global increase in the use of dietary supplements to provide nutrients in one's regular diet, these supplements' potential health risks and benefits have become a topic of significant interest. Interestingly, as dietary supplements, the Food and Drug Administration (FDA) in the United States (USA), Europe, and most countries do not require manufacturers and distributors to obtain approval or provide safety assessments before marketing those products. This research explores for the first time 16 heavy, trace and macro-elemental contents, namely, As, Ni, Cd, Pb, Cu, Co, Mn, Cr, Zn, V, Fe, Al, K, Na, Mg, and Ca, within 24 nutraceutical and herbal supplements marketed in Oman. The research is focusing on ensuring their compositions, concentrations, and freedom of toxic elements. ICP-OES was utilized, preceded by a microwave digestion technique to digest the samples in concentrated HNO3 and HCl (3:1, v/v). The method was validated within linear ranges of 0.03-5.00 ppm and 1.0-200.0 ppm for micro- and macro-elements, respectively, with %recoveries ranging from 90 to 104%. The limits of detection ranged from 0.01 to 0.09 and 0.14 to 0.30 ppm, while the limits of quantification ranged from 0.03 to 0.28 and 0.46 to 0.91 ppm for micro- and macro-elements, respectively. The detected levels were compared to online databases for risk assessment. Although As and Cd were not detected in all samples, Pb was found in nine samples, with some exceeding regulated limits of exposure. About 80% of the samples contained Al, of which two samples were susceptible to serious health risks of exceeding exposure limits in their compiled doses. The locally harvested Omani herbal supplements revealed significant amounts of Zn, Mg, Mn, and Cu. The results highlighted the potential risks associated with both dosage compliance and labeling discrepancies.

Physical activity policies in Saudi Arabia and Oman: a qualitative study using stakeholder interviews.

BACKGROUND: Countries in the Middle East have some of the lowest rates of physical activity and some of the highest rates of obesity in the world. Policies can influence population levels of physical activity. However, there is a dearth of research on physical activity policies in the Gulf region. This qualitative study analyses cross-sectoral barriers and facilitators for the development, implementation and evaluation of physical activity policies in Saudi Arabia and Oman, two of the largest countries in the region. METHODS: Semi-structured interviews were conducted with 19 senior policymakers from the Ministries of Health, Education, and Sport in Saudi Arabia and Oman, and were examined using thematic analysis. RESULTS: We identified seven themes related to physical activity policies in Saudi Arabia and Oman: leadership; existing policies; physical activity programs related to policies; private sector policies; challenges; data/monitoring; and future opportunities. Both countries have a central document that guides policy-makers in promoting physical activity, and the available policies in both countries are implemented via multiple programs and initiatives to increase physical activity. Compared with Oman, in Saudi Arabia, programs from the non-profit sector, represented by community groups, play a more significant role in promoting physical activity outside the government framework. The private sector has contributed to promoting physical activity in both countries, but interviewees stated that more financial support is required. Policy limitations differ between Saudi Arabia and Oman: intersectoral collaboration in Oman is limited and mainly based on individuals' own initiative, while the health transformation in Saudi Arabia tends to slow down policy implementation in relevant areas. Physical education in Saudi Arabia and Oman is similar; however, increased support and collaboration between government agencies and the private sector for out-of-school sports academies are needed. CONCLUSIONS: This study addresses key gaps in analysing physical activity policies in Gulf Cooperation Council countries. Our study highlights the importance of increasing financial support, improving collaboration between governmental agencies and between them and the private sector and consolidating efforts to back physical activity policies and dismantle cross-sectoral barriers in Saudi Arabia and Oman. Educational institutions in Saudi Arabia and Oman play a crucial role in promoting physical activity from early childhood to young adults. Our insights assist policy-makers, public health officials and stakeholders in shaping effective physical activity-promoting policies, programs and interventions to prevent non-communicable diseases. Challenges identified in Saudi Arabia and Oman's policies will inform their future development.

Melioidosis in a returned traveler: Case report and review of the imported cases in Oman.

Melioidosis is an emerging tropical infectious disease in travelers. We present a case of travel related melioidosis in a 65-year-old man with chronic obstructive pulmonary disease and end stage renal disease following a two-week business trip to Thailand and attendance of the Songkran festival. This case emphasizes that vigilance, heightened clinical suspicion, and use of appropriate microbiology diagnostic tools are of paramount importance for a timely diagnosis and successful management. With the ever-increasing global travel, infectious diseases specialists, microbiologists, and public health professionals are constantly challenged by unfamiliar infections in returned travelers.

Health-related Quality of Life of Omani Adult Patients with ß-Thalassemia Major at Sultan Qaboos University Hospital.

Objectives: The impact of beta-thalassemia major (ß-TM) on health-related quality of life (HRQoL) in Oman is not yet known. Affected individuals suffer from a wide range of physical, mental, and social consequences due to the need for regular hospital visits for blood transfusions and complications related to iron overload. This study aimed to assess the HRQoL of adult patients with ß-TM attending a single tertiary care center in Muscat, Oman, to identify factors influencing Omani patients' QoL for improved management and counseling. Methods: A cross-sectional study was conducted among adult patients (≥ 18 years) with ß-TM at Sultan Qaboos University Hospital between September and November 2022. A validated Arabic version of the self-reported 36-item short-form health survey was used to determine HRQoL. Results: A total of 78 patients with ß-TM were enrolled in the study; 53.8% were male and the mean age was 26.0±0.8 years, ranging from 21-53 years. Most patients were from Al Batinah North governorate (n = 21; 26.9%) and Muscat (n = 20; 25.6%), unmarried (n = 44; 56.4%), did not have university-level education (n = 45; 57.7%), and were unemployed (n = 44; 56.4%). The HRQoL domain with the highest score was role limitations due to emotional problems (median score = 100), while general health and vitality received the lowest scores (mean scores were 60.2±15.9 and 59.1±20.5, respectively). Several variables were associated with better HRQoL in certain domains, including being married, having a high level of education, being employed, exercising regularly, and receiving family support (p < 0.05). However, iron overload and having ≥ 3 ß-TM-related disease complications were associated with poorer general health scores (p = 0.031 and 0.038, respectively), while a history of mental issues was associated with poorer scores in six out of eight HRQoL domains (p < 0.05). Moreover, negative perceptions regarding the social impact of the disease including delayed marriage, workplace difficulties, and reduced academic achievement were associated with poorer HRQoL in various domains (p < 0.05). Conclusions: Although the studied sample reported generally good QoL, several factors were found to affect HRQoL in various domains. Healthcare providers should prioritize maintaining acceptable iron overload levels in Omani patients with ß-TM to help avoid the development of disease-related complications, thereby ensuring better control of their clinical conditions and consequently improving their HRQoL.

Performance of Modification of Diet in Renal Disease and Chronic Kidney Disease Epidemiology Collaboration Equations Versus 99Tc-DTPA-Renogram in Assessing Kidney Function.

Objectives: To evaluate the performance of measurement of glomerular filtration rate (GFR) using Modification of Diet in Renal Disease equations (MDRD186, MDRD175) and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations, in comparison with technetium-99m diethylenetriaminepentaacetic acid (99Tc-DTPA) renogram method, the gold standard. A related aim was to correlate the three equations to estimate GFR and their impact on reclassifying the stages of CKD in adult Omani patients. Methods: This cross-sectional study recruited two groups of patients diagnosed with CKD during a 10-month period from January to October 2021. The first group comprised 48 patients who underwent a 99Tc-DTPA renogram procedure for GFR measurement, and the second group comprised 30 348 adult patients who did not undergo the same procedure; estimated GFR was calculated using the three equations. Results: The median of the reference GFR was 106.0 mL/min/1.73 m2, whereas the median estimated GFR for the MDRD175, MDRD186, and CKD-EPI equations were 92.5, 98.3, and 102.1, respectively. All three equations correlated moderately with the reference GFR (0.428, 0.428, 0.523, respectively; p < 0.010). The CKD-EPI showed lesser bias (3.7 vs. 12.9 and 7.5 for MDRD175 and MDRD186, respectively) and more accuracy (95.8% vs. 91.7% and 93.8%); however, it was the least precise (25.1 vs. 22.3 and 23.8). The MDRD186 performed similarly to the CKD-EPI equation at CKD stages 3a-5 and differed significantly at stages 1-2. Whereas the MDRD175 differed significantly with both equations at stages 1-3b and was similar to them at stages 4-5. Conclusions: The CKD-EPI equation had the highest accuracy and the least bias and precision in the general population. The MDRD186 CKD classification differed significantly from the CKD-EPI equation at CKD-stages 1-2 only. The CKD-EPI equation is preferred to MDRD for the detection and classification of early CKD stages.

Venous Thromboembolism Risk and Prophylaxis in the Acute Hospital Care Settings in Oman: A National Multicenter Cross-sectional Study.

Objectives: To evaluate the prevalence of risk for venous thromboembolism (VTE) and the proportion of at-risk patients who receive appropriate thromboprophylaxis among inpatients in acute hospital care settings in Oman. A related objective was to evaluate the type and time of initiation of VTE prophylaxis. Methods: This multicenter, cross-sectional study was conducted in three tertiary hospitals in Oman. The study included acutely ill medical and surgical inpatients admitted from August to September 2022. VTE risk assessment and prophylaxis were assessed based on the 2012 recommendations of the American College of Chest Physicians (ACCP). Results: A total of 384 patients were enrolled, 240 were medical patients and 144 were surgical patients. As per the ACCP criteria, 179 (74.6%) of medical and 92 (63.9%) of surgical patients were at risk for VTE and required prophylaxis. Appropriate prophylaxis was received by 142 (79.3%) at-risk medical and 70 (76.1%) at-risk surgical patients. In cases where pharmacological prophylaxis was contraindicated, mechanical prophylaxis was markedly underused. For medical patients, the median day of initiating VTE prophylaxis was day one of admission. For surgical patients, the median day of initiating VTE prophylaxis was postoperative day one. Conclusions: The majority of hospitalized patients in Oman are at risk of VTE. However, a significant minority of patients do not receive the required pharmacological or mechanical prophylaxis. We recommend the development of a national VTE risk assessment and guiding tool with a facility for monitoring compliance.

Cost-Minimization Analysis for Subcutaneous Daratumumab in the Treatment of Newly Diagnosed Multiple Myeloma in Three Gulf Countries.

Background: The second most common hematologic cancer worldwide is multiple myeloma (MM), with incidence and mortality rates that have more than doubled over the past 30 years. The safety and efficacy of daratumumab regimens in the treatment of newly diagnosed MM (NDMM) is demonstrated in clinical trials. Objective: To assess the financial effects of the adoption of subcutaneous daratumumab (dara-SC) rather than intravenous daratumumab (dara-IV) for the treatment of NDMM in three Gulf countries (Qatar, Oman and the United Arab Emirates; UAE), a cost-minimization model was constructed. Methods: We performed static cost minimization analyses from a societal perspective to evaluate the costs and possible reductions in resource utilization associated with a shift from dara-IV infusion to dara-SC injection for NDMM patients over a 5-year time horizon. The model included 2 scenarios: the current scenario in which 100% of patients with NDMM are treated with dara-IV infusion and a future scenario in which dara-SC injection is gradually adopted over the modeled time horizon. The model differentiated precisely between autologous stem cell transplantation (ASCT)-eligible and ASCT-ineligible NDMM patients in terms of their number in each group and the associated therapeutic regimens. One-way sensitivity analyses were also conducted. Results: The model showed that the use of dara-SC in NDMM patients who were eligible or ineligible for ASCT resulted in lower non-drug costs, including premedication drug costs, adverse-effect costs, administration costs, medical staff costs, and indirect costs. The resulting total savings over the 5-year time horizon of the model for Hamad Medical Corporation, Sultan Qaboos University Hospital/Royal Hospital, Sheikh Shakhbout Medical City (SSMC), and Tawam Hospital were QAR -2 522 686, OMR -143 214, AED -30 010 627, and AED -5 003 471, respectively. Conclusion: The introduction of dara-SC as a front-line treatment for NDMM patients in Qatar (Hamad Medical Corporation), Oman (Sultan Qaboos University Hospital, Royal Hospital-MOH), and the UAE (SSMC and Tawam Hospital) can help save resources and minimize constraints on the healthcare system.

Simultaneous Pancreatic and Kidney Transplant in Adult with Autosomal Dominant Polycystic Kidney Disease and Type I Diabetes Mellitus: Post Surgical Events and Genetic Review.

Autosomal dominant polycystic kidney disease (ADPKD) is a common inherited condition characterized by the growth of multiple bilateral cysts in the kidneys. We describe the case of a 35-year-old male with combined ADPKD and type 1 diabetes mellitus with a strong family history of both. At the age of 32, he developed end-stage kidney disease for which he underwent preemptive simultaneous pancreatic and kidney transplant, which in turn led to multiple perioperative complications. Evaluation of familial clustering of genetic disease is critical in genetic epidemiology and precision medicine as it enables estimation of lifetime disease risk and early assessment as well as detection of the disease among one's siblings.

Kikuchi Disease "A Lupus Mimicker": A Case Report.

Kikuchi disease, also called, Kikuchi-Fujimoto disease or histiocytic necrotizing lymphadenitis, is a rare self-limiting illness with an unknown etiology and pathogenesis. It is predominantly seen among young females. The cardinal clinical features include fever and cervical lymphadenopathy. Skin eruptions have also been reported. In Oman, two cases have been reported to date, in 2005 and 2020, with only one case exhibiting skin manifestations. There is a paucity of disease in our country and worldwide. In this case report, we discuss the diagnosis of Kikuchi disease in a previously healthy 17-year-old Omani female who presented with fever, cervical lymphadenopathy, and malar rash. The clinical picture in this case resembled that of systemic lupus erythematosus. Due to the rarity of Kikuchi disease, particularly in our region, it is crucial to consider it as a differential diagnosis when a patient exhibits the aforementioned symptoms to prevent misdiagnosis and inappropriate treatment, as it can easily be misdiagnosed as systemic lupus erythematosus.

Sustainability in the Public Healthcare Sector: Insights From an Analytical Hierarchy Process Analysis.

Background This study aimed to identify sustainability priorities within Oman's healthcare sector using the analytical hierarchy process (AHP) methodology. Mainly, it focused on assessing the relative importance of economic, environmental, and social factors and their sub-elements in sustaining Oman's healthcare system. Methodology A semi-quantitative, cross-sectional design was employed to collect data from 23 Omani healthcare experts with at least 10 years of experience in five different public hospitals in Oman. The AHP methodology was used to analyze pairwise comparisons of sustainability factors and derive their priorities. The consistency ratio was calculated to ensure the reliability of the analysis, and the transitivity rule was applied to address inconsistencies in pairwise comparisons. Results The findings revealed a strong emphasis on environmental and social sustainability, with economic considerations ranking comparatively lower. Circular practices emerged as a key priority within the environmental domain, while patient satisfaction stood out within the social domain. The analysis showed the integration between healthcare, environmental health, and societal well-being, emphasizing the need for holistic approaches to sustainability. Conclusions This study contributes to the understanding of healthcare sustainability by providing empirical evidence of stakeholder preferences within Oman's healthcare system. By quantitatively assessing the relative importance of economic, environmental, and social factors, it informs decision-making and resource allocation toward sustainable healthcare development. The findings also support the argument for integrated approaches to healthcare sustainability that balance economic efficiency with environmental protection and social inclusion.

Attitudes of community pharmacists towards extending their professional roles in Oman.

Background: Over the last few decades, the pharmacy profession has witnessed a substantial evolution accompanied by the developing role of community pharmacists (CPs). Evidence indicates that extending the role of CPs contributes to fostering public health outcomes. However, in many countries, their role is still underused. To extend the role of CPs in Oman, it is crucial to understand their perception and determine the influences. Aim: This study determines the willingness of CPs in Oman to extend their role and assess their perception towards barriers. Method: A cross-sectional study was conducted across Oman using an online self-administered survey targeting CPs working in the private sector. Result: Generally, respondents welcomed broadening their professional role. However, among the top perceived barriers were shortage of staff, insufficient training, lack of interconnection between CPs and physicians, and regulation constraints. Different socio-demographic characteristics of respondents showed a noticeable impact on their responses. Conclusion: CPs welcomed extending their role. However, several obstacles were raised that need to be tackled to enable CPs to advance their role.

Levels of polycyclic aromatic hydrocarbons and organochlorine pesticides in sea snakes (Elapidae: Hydrophiinae) from Sharjah, United Arab Emirates.

This study reports OCP and PAH concentrations in the tissues of stranded sea snakes from Sharjah, UAE. Samples from 10 Hydrophis lapemoides, 2 Hydrophis ornatus and 1 Hydrophis curtus were analyzed. Muscle, liver and fat tissues were extracted using micro-QuEChERs, followed by d-SPE and analyzed using GC/MS. Higher concentrations of OCPs were detected, while PAHs were more frequently detected. Significant correlations suggest that OCPs and PAHs do bioaccumulate in the tissues of sea snakes. Additionally, OCPs with lower log Kow (octanol-water partition coefficient) values were mainly detected in the muscle samples of H. lapemoides, whereas OCPs with higher log Kow values were more commonly present in the liver and fat samples. The concentrations of OCPs reported in this study were higher than those previously documented in other marine reptiles in the UAE or sea snakes from different geographical regions.

Perception about telemedicine services among parents of children with neurodevelopmental disorders in a specialised tertiary centre in Oman.

ABSTRACTWhile telemedicine has shown promise for diagnosis and treatment, its integration into specialised clinics and mainstream healthcare is slow. A study at Sultan Qaboos University Hospital, Oman, investigated parental perceptions of virtual clinics and telemedicine experiences among parents of children with neurodevelopmental disorders (NDD) conducted from January 2021 to January 2022; the cross-sectional study involved 130 participants. The study revealed that 70% of participants were male, and the mean age of the children was 6.1 ± 0.26 years. Regarding telemedicine awareness, 53% of respondents were informed, yet encountered obstacles such as poor internet service and lack of awareness. Despite challenges, 46% of respondents viewed telemedicine positively. Parents showed significant differences in their perception of virtual interviews based on interview purpose (P = 0.034), clinic type (P < 0.001), internet service quality (P = 0.029), timing conflicts (P = 0.001), lack of technology experience (P = 0.041), and awareness gaps (P = 0.012). Our study identified challenges for parents of children with NDD in utilising telehealth, primarily stemming from limited awareness and internet connectivity issues. To enhance telemedicine quality, we suggest improving internet infrastructure and promoting telemedicine awareness. Further research is needed to optimise telemedicine implementation for both diagnosis and intervention in children with NDD.

Effects of World War II on Infectious Diseases in the Persian Gulf.

With the allied invasion, the southern half of Iran became the scene of a large presence of British and American occupation forces. The negative consequences of the styling of foreign elements during all the years of war and even afterward affected these areas in various dimensions of their health. The negative consequences of the occupation of southern Iran, the health and healthcare system of this part of Iran suffered problems in various forms of shortage of medicines, equipment, and treatment staff, especially the spread of various infectious and communicable diseases. The article aims to examine the effects of World War II on the southern, southwestern, and eastern regions of Iran from 1939 to 1945 and its consequences in the spread of infectious diseases in these regions. The research with an analytical-historical method relies on the library method and is based on the study of the data of unpublished documents from the archives of the National Archives and Library Organization, medical and economic social publications, and various local and public newspapers of Iran during this period. The study of documents and publications shows that due to Allied restrictive policies and successive waves of famine and widespread malnutrition, epidemic diseases, and drug monopoly, these areas experienced a period of severe decline in public health and spread of various infectious diseases.

Risk assessment of heavy metals and total petroleum hydrocarbons (TPHs) in coastal sediments of commercial and industrial areas of Hormozgan province, Iran.

The significant increase in the pollution of heavy metals and organic pollutants, their stable nature, and their high toxicity are gradually becoming a global crisis. In a recent study, a comprehensive assessment of the spatial distribution of heavy metals and total petroleum hydrocarbons (TPHs), as well as an assessment of their ecological risks in the sediments of 32 stations located in commercial and industrial areas (Mainly focusing on petrochemical and power industries, desalination plants and transit Ports) of Hormozgan province (East and West of Jask, Bandar Abbas, Qeshm, and Bandar Lengeh) was performed during 2021-2022. The sediment samples were digested with HNO3, HCl and HF solvents. The concentration of heavy metals was determined with furnace and flame systems of atomic absorption spectrometer. The concentration of heavy metals showed significant spatial changes between stations. The ecological assessment indices between the regions indicated that the stations located in Shahid Bahonar Port, Suru Beach, and Khor gorsouzuan had a higher intensity of pollution than other places and significant risks of pollution, especially in terms of Cr and Ni. The average contamination degree (CD) (14.89), modified contamination degree (MCD) (2.48), pollution load index (PLI) (2.32), and potential ecological risk index (PERI) (100.30) showed the sediments in the area of Shahid Bahonar Port, Suru beach and Khor gorsouzuan, experience significant to high levels of pollution, especially Cr and Ni. Using contamination factor (CF) and Geoaccumulation index (Igeo), Cr was considered the most dangerous metal in the studied areas. Based on the global classification of marine sediment quality for the concentrations of TPHs, the sediments of the studied stations were classified as non-polluted to low pollution. In all regions, indices of the PELq (General toxicity) and CF (Contamination factor) were much lower than 0.1 and 1 respectively, showing the absence of adverse biological effects caused by TPHs in sediments. It is necessary to consider comprehensive and impressive strategies to control and reduce pollution of heavy metals, especially in the areas of Shahid Bahonar Port, Suru Beach, and Khor gorsouzuan, so that the sources of this pollution are required to be identified and managed.

Global View of Domain-Specific O-Linked Mannose Glycosylation in Glycoengineered Cells.

Protein O-linked mannose (O-Man) glycosylation is an evolutionary conserved posttranslational modification that fulfills important biological roles during embryonic development. Three nonredundant enzyme families, POMT1/POMT2, TMTC1-4, and TMEM260, selectively coordinate the initiation of protein O-Man glycosylation on distinct classes of transmembrane proteins, including α-dystroglycan, cadherins, and plexin receptors. However, a systematic investigation of their substrate specificities is lacking, in part due to the ubiquitous expression of O-Man glycosyltransferases in cells, which precludes analysis of pathway-specific O-Man glycosylation on a proteome-wide scale. Here, we apply a targeted workflow for membrane glycoproteomics across five human cell lines to extensively map O-Man substrates and genetically deconstruct O-Man initiation by individual and combinatorial knockout of O-Man glycosyltransferase genes. We established a human cell library for the analysis of substrate specificities of individual O-Man initiation pathways by quantitative glycoproteomics. Our results identify 180 O-Man glycoproteins, demonstrate new protein targets for the POMT1/POMT2 pathway, and show that TMTC1-4 and TMEM260 pathways widely target distinct Ig-like protein domains of plasma membrane proteins involved in cell-cell and cell-extracellular matrix interactions. The identification of O-Man on Ig-like folds adds further knowledge on the emerging concept of domain-specific O-Man glycosylation which opens for functional studies of O-Man-glycosylated adhesion molecules and receptors.