Psychological Symptoms of COVID-19 Pandemic Among Community-Dwelling Older People in Oman and Associated Risk Factors.

Introduction: The COVID-19 pandemic has led to a dramatic loss of human lives worldwide. Objective: This study aimed to investigate the psychological factors of the COVID-19 pandemic in the community-dwelling older population. Method: This was a cross-sectional study of older people aged ≥60 years with no mental or psychological illnesses. A total of 193 participants were recruited. The study questionnaire included anxiety- and depression-related questions tailored for the COVID-19 pandemic. The questionnaire was developed through a literature review and expert review. Data was collected from December 2020 to January 2022. Results: The psychological symptoms of COVID-19 were high in this sample (mean 29.18 ± 3.57). Gender (female) was found to have a strong positive relationship with the psychological symptoms of COVID-19 score (p = 0.003). Chronic illnesses (ß = 0.19, p < 0.001), living alone (ß = 0.39, p < 0.001), and having a family member or a friend with COVID-19 (ß = 0.15, p < 0.001) were also found to have a strong positive relationship with the psychological symptoms of COVID-19 score. Conclusion: The negative psychological effects of COVID-19 were high among the older population in Oman. In this study, female gender, chronic illnesses, living alone, and having a family member or a friend with COVID-19 were associated with worse COVID-19 psychological symptoms. Older women were affected by COVID-19 more than older men. In addition, those who had chronic illnesses, lived alone, or had a family member or a friend with COVID-19 were more psychologically burdened by the pandemic than those without those characteristics. Particular attention should be given to older adults who have chronic illnesses, live alone, or have a family member or a friend with COVID-19. Support groups and psychological counseling programs are essential for older people during a pandemic.

Exploring Factors Associated With Depressive Symptoms Among Patients With Chronic Pain: A Cross-Sectional Multicenter Study.

ABSTRACT: This cross-sectional study examined the factors associated with depression among people with chronic pain (PwCP) attending specialized pain clinics in Muscat, Oman. Two-hundred eighty-seven participants were recruited for the study, and univariate analyses were used to investigate the difference between individuals who scored above/below the cutoff points for depressive symptoms. A multiple regression analysis was used to detect the independent predictors. Twenty-six percent of participants scored above the cutoff point. Further analysis indicated that unstable family relationships pre-existing depressive symptoms (odds ratio [OR], 2.86; p = 0.044), a family history of depression (OR, 4.75; p = 0.019), severe pain (OR, 4.21; p < 0.006), having fibromyalgia (OR, 28.29; p = 0.005), and lumbago/truck (OR, 2.41; p = 0.039) were independent predictors of depressive symptoms. This study indicates that one in four patients with chronic pain also presents with depressive symptoms. However, the role of culture needs to be taken into consideration when interpreting these findings and when building on these data.

Awareness of Breast Cancer Risk Factors, Symptoms and Breast Self-Examination Among Omani Female Teachers: A cross-sectional study.

OBJECTIVES: This study aimed to assess knowledge of breast cancer (BC) risk factors, warning signs and symptoms and breast self-examination (BSE) practice among Omani female teachers in Al-Dhahira Governorate. METHODS: A cross-sectional sample of female teachers aged 20-50 years was collected from January to December 2018 from three wilayats (provinces) in Al-Dhahira-Ibri, Dhank and Yunqal. A questionnaire that included the Breast Cancer Awareness Scale and demographic characteristics was administered. Data were analysed using descriptive statistics, regression analysis and Pearson's Chi-square test. RESULTS: A total of 478 female teachers were included in the study (response rate: 72.4%). The majority of participants (60.5%) had good overall knowledge about BC while 19.9% of participants had excellent overall knowledge. Only 9% of participants demonstrating excellent knowledge of BC risk factors. More than half of the participants (56.1%) reported excellent knowledge in screening methods. Unfortunately, only 57% of the female teachers indicated practising BSE. Knowledge of BC symptoms was closely divided between excellent and good levels (45.8 and 42.5%, respectively). BSE practice was significantly (P <0.05) correlated with overall knowledge of BC and its symptoms and screening methods, but not with knowledge of BC risk factors. CONCLUSION: This study revealed unsatisfactory overall knowledge of BC risk factors, symptoms, screening methods and BSE practice among female Omani teachers in Al-Dhahira Governorate. These findings constitute a challenge to healthcare providers to continue developing awareness of BC and providing health information to the public.

Diversity, distribution and conservation of the terrestrial reptiles of Oman (Sauropsida, Squamata).

In the present work, we use an exceptional database including 5,359 records of 101 species of Oman's terrestrial reptiles together with spatial tools to infer the spatial patterns of species richness and endemicity, to infer the habitat preference of each species and to better define conservation priorities, with especial focus on the effectiveness of the protected areas in preserving this unique arid fauna. Our results indicate that the sampling effort is not only remarkable from a taxonomic point of view, with multiple observations for most species, but also for the spatial coverage achieved. The observations are distributed almost continuously across the two-dimensional climatic space of Oman defined by the mean annual temperature and the total annual precipitation and across the Principal Component Analysis (PCA) of the multivariate climatic space and are well represented within 17 out of the 20 climatic clusters grouping 10% of the explained climatic variance defined by PC1 and PC2. Species richness is highest in the Hajar and Dhofar Mountains, two of the most biodiverse areas of the Arabian Peninsula, and endemic species richness is greatest in the Jebel Akhdar, the highest part of the Hajar Mountains. Oman's 22 protected areas cover only 3.91% of the country, including within their limits 63.37% of terrestrial reptiles and 50% of all endemics. Our analyses show that large areas of the climatic space of Oman lie outside protected areas and that seven of the 20 climatic clusters are not protected at all. The results of the gap analysis indicate that most of the species are below the conservation target of 17% or even the less restrictive 12% of their total area within a protected area in order to be considered adequately protected. Therefore, an evaluation of the coverage of the current network of protected areas and the identification of priority protected areas for reptiles using reserve design algorithms are urgently needed. Our study also shows that more than half of the species are still pending of a definitive evaluation by the International Union for Conservation of Nature (IUCN).

Writing a Research Proposal to The Research Council of Oman.

Writing a research proposal can be a challenging task for young researchers. This article explains how to write a strong research proposal to apply for funding, specifically, a proposal for The Research Council (TRC) of Oman. Three different research proposal application forms are currently used in TRC, including Open Research Grant (ORG), Graduate Research Support Program (GRSP), and Faculty-mentored Undergraduate Research Award Program (FURAP). The application forms are filled and submitted electronically on TRC website. Each of the proposals submitted to TRC is selected through a rigorous reviewing and screening process. Novelty and originality of the research idea is the most crucial element in writing a research proposal. Performing an in-depth review of the literature will assist you to compose a good researchable question and generate a strong hypothesis. The development of a good hypothesis will offer insight into the specific objectives of a study. Research objectives should be focused, measurable, and achievable by a specific time using the most appropriate methodology. Moreover, it is essential to select a proper study design in-line with the purpose of the study and the hypothesis. Furthermore, social/economic impact and reasonable budget of proposed research are important criteria in research proposal evaluation by TRC. Finally, ethical principles should be observed before writing a research proposal involving human or animal subjects.

The Role of Inflammatory Mediators in the Pathogenesis of Alzheimer's Disease.

Alzheimer's disease (AD), a neurodegenerative disorder associated with advanced age, is the most common cause of dementia globally. AD is characterised by cognitive dysfunction, deposition of amyloid plaques, neurofibrillary tangles and neuro-inflammation. Inflammation of the brain is a key pathological hallmark of AD. Thus, clinical and immunopathological evidence of AD could be potentially supported by inflammatory mediators, including cytokines, chemokines, the complement system, acute phase proteins and oxidative mediators. In particular, oxidative mediators may actively contribute to the progression of AD and on-going inflammation in the brain. This review provides an overview of the functions and activities of inflammatory mediators in AD. An improved understanding of inflammatory processes and their role in AD is needed to improve therapeutic research aims in the field of AD and similar diseases.

Analysis of inflammatory mediators in type 2 diabetes patients.

The main aim of this study is to assess the inflammatory markers in type 2 diabetes mellitus (T2DM) by measuring some cytokines concentrations and lymphocytes subset and correlate them with other laboratory investigations. Fifty-seven patients with type-2 diabetes and 30 healthy volunteers were enrolled in this study. Data for the C-reactive protein (CRP), haemoglobin, HbA1c, and autoantibody levels were obtained from the patients files. The cytokine concentrations were measured in patient's serum using commercially available ELISA assays. Lymphocytes subsets were measured by flow cytometric methods. The levels of IL-1ß, IL-6, IL-15, and TNF-α were found to be decreased in T2DM patients, whereas the levels of IL-10, IFN-γ, and caspase-1 were increased, compared to normal controls. T2DM patients with hypertension show significantly decreased levels of IL-1ß and caspase-1 compared to patients without hypertension. No significant differences in lymphocytes subset between cases and normal control were observed. Significant correlations were found between HbA1c and IL-6; body mass index (BMI) was significantly correlated with CRP, TNF-α, and phosphate; the weight (Wt) was associated with CRP and IFN-γ. In conclusion, an alteration in the function of the immune system was observed in T2DM patient.

Effect of gum arabic on oxidative stress and inflammation in adenine-induced chronic renal failure in rats.

Inflammation and oxidative stress are known to be involved in the pathogenesis of chronic kidney disease in humans, and in chronic renal failure (CRF) in rats. The aim of this work was to study the role of inflammation and oxidative stress in adenine-induced CRF and the effect thereon of the purported nephroprotective agent gum arabic (GA). Rats were divided into four groups and treated for 4 weeks as follows: control, adenine in feed (0.75%, w/w), GA in drinking water (15%, w/v) and adenine+GA, as before. Urine, blood and kidneys were collected from the rats at the end of the treatment for analysis of conventional renal function tests (plasma creatinine and urea concentration). In addition, the concentrations of the pro-inflammatory cytokine TNF-α and the oxidative stress markers glutathione and superoxide dismutase, renal apoptosis, superoxide formation and DNA double strand break frequency, detected by immunohistochemistry for γ-H2AX, were measured. Adenine significantly increased the concentrations of urea and creatinine in plasma, significantly decreased the creatinine clearance and induced significant increases in the concentration of the measured inflammatory mediators. Further, it caused oxidative stress and DNA damage. Treatment with GA significantly ameliorated these actions. The mechanism of the reported salutary effect of GA in adenine-induced CRF is associated with mitigation of the adenine-induced inflammation and generation of free radicals.

Evaluation of anti-mutated citrullinated vimentin antibodies, anti-cyclic citrullinated Peptide antibodies and rheumatoid factor in omani patients with rheumatoid arthritis.

Rheumatoid factor (RF) is currently used in the diagnosis of rheumatoid arthritis (RA). The discovery of anticitrullinated protein autoantibodies has led to the development of various new tests, such as anti-cyclic citrullinated peptide (anti-CCP) antibodies, and anti-mutated citrullinated vimentin (anti-MCV) antibodies, to diagnose RA. The aims of this study were to determine the sensitivity and specificity of anti-MCV antibodies in comparison with anti-CCP antibodies and RF in Omani Arab patients with RA and compare our findings with published values from different ethnic groups. The sensitivity of anti-MCV antibodies was 72% with 87% specificity. For anti-CCP antibodies the sensitivity was 52% and the specificity was 97%. The sensitivity of RF was 57% with 94% specificity. Anti-CCP antibodies have higher diagnostic specificity and positive predictive value than RF and anti-MCV antibodies. Anti-MCV antibodies have the highest sensitivity when compared to anti-CCP antibodies and RF. Anti-MCV antibodies do not appear to be very useful in the diagnosis of RA. However, long-term study is required to find out whether anti-MCV antibodies can be used as predictive test for incidence of RA.

Pro-inflammatory cytokines in Omani type 2 diabetic patients presenting anxiety and depression.

BACKGROUND: The relationship of inflammatory cytokines with anxiety and depression has been reported, but their role in diabetic patients has not been fully elucidated. OBJECTIVE: We examined whether an association between prevalence of anxiety and depression in Omani type-2 diabetic patients (n=30) and the levels of inflammatory markers such as IL-1ß, TNF-α, IFN-γ and C-reactive protein (CRP) exists. METHODS: Symptoms of anxiety and depression were screened using the Hospital Anxiety and Depression Scale (HADS) through self-rated questionnaires. IL-1ß, TNF-α, IFN-γ, CRP, anti-TPO and anti-GAD65 antibodies were measured in patients' sera using commercially available ELISA assays. RESULTS: In Omani type-2 diabetic patients, high prevalence of anxiety and depression along with high levels of inflammatory markers were detected. However, no correlation was observed between inflammatory markers and anxiety or depression. CONCLUSION: These results indicate that Omani type-2 diabetic patients are at great risk for developing anxiety and depression. Therefore, these complications need more care and attention. There was no association between scores of anxiety and depression with the levels of inflammatory cytokines. This may need to be elucidated in a larger cohort of patients.

Effect of N-acetyl-L-cysteine on Cytokine Production by Human Peripheral Blood Mononuclear Cells.

OBJECTIVES: This study investigates the in vitro effect of the antioxidant drug, N-acetyl-L-cysteine (NAC), on cytokine production by peripheral blood mononuclear cells (PBMC). METHODS: PBMC were isolated by Ficoll-Hypaque, and stimulated with anti-CD3 antibodies, phytohaemagglutinin (PHA), lipopolysaccharide (LPS) for 24 hours in the presence or absence of 5 mM NAC. The cytokines produced were measured by enzyme-linked immunosorbent assay (ELISA). RESULTS: Treatment with NAC significantly up-regulates the secretion of IL-1ß, IL-5 (interleukin) and IFN-γ (interferon) and down regulates IL-10 production, after anti-CD3 or PHA (p<0.05), but not after LPS stimulation. NAC also significantly increased total IL-12 secretion after anti-CD3 (but not PHA or LPS) stimulation and IL-12p40 after anti-CD3, PHA, and LPS stimulation (p <0.05). CONCLUSION: These results indicate that NAC up-regulated the production of pro-inflammatory cytokines, and down regulated anti-inflammatory cytokine production by PBMC, in a process which may be associated with increased levels of glutathione (GSH). Further work is required to determine whether this increase or decrease in cytokine production is due to direct effect of NAC.

Reference ranges for lymphocyte subsets in healthy adult male Omanis.

OBJECTIVE: To determine the reference ranges of lymphocyte subsets in serologically HIV-seronegative healthy male adults in Oman. METHODS: A cohort, of 118 healthy male blood donors ranging in age from 18-51 years, was included in the study. The average age was 25 years. Blood samples collected into tubes containing ethylene-diamine-tetra acetic acid were investigated for lymphocyte subsets using flow cytometer. This study was conducted in the Immunology Laboratory of the Sultan Qaboos University, College of Medicine and Health Sciences, Muscat, Oman during the year 2006. RESULTS: For the 118 males investigated, the mean percentage and absolute values of the lymphocyte subsets were as follows: CD3: 68.53 +/- 7.5%, 1701 +/- 489 cells/microliter; CD4: 40.4 +/- 6.5%, 1006 +/- 319 cells/microliter; CD8: 25.8 +/- 5.9%, 638 +/- 225 cells/microliter; CD19: 13.7 +/- 4.7%, 349 +/- 158 cells/microliter, and CD56: 12.2 +/- 6.7%, 308 +/- 204 cells/microliter. The ratio of CD4/CD8 was 1.6. CONCLUSION: Immunophenotyping has been used to establish reference values of lymphocyte subsets in normal healthy adult males in Oman. The Omani male reference values obtained in this study show wide variations compared with kits values previously used as a reference.

A comparative study of interleukin-1beta production and p2x7 expression after ATP stimulation by peripheral blood mononuclear cells isolated from rheumatoid arthritis patients and normal healthy controls.

Interleukin 1 beta (IL-1beta) is a proinflammatory cytokine that is considered to play an important role in the progression of rheumatoid arthritis (RA). A stimulus such as ATP is necessary to cause the release of mature IL-1beta, via activation of the P2X(7) receptor on monocytes. In this study, the production of IL-1beta in whole blood after ATP stimulation and expression of P2X(7) receptors in RA and healthy subjects were examined. Blood samples from RA patients or healthy controls were stimulated with ATP in the presence of lipopolysaccharide (LPS). Supernatants were harvested and IL-1beta levels were measured by enzyme-linked immunosorbent assay (ELISA). Expression of P2X(7) receptors was measured using flow cytometry. ATP induced significantly higher levels of IL-1beta in LPS-activated RA blood samples compared to controls. A significant up-regulation of P2X(7) receptor expression on mononuclear cells was observed after overnight incubation with ATP without any significant differences between RA patients and normals. These data suggest that RA patient mononuclear cells are more sensitive to ATP stimulation than healthy individuals perhaps due to genetic polymorphism in the P2X(7) gene.

Prognostic value of auto-antibodies in the serum of Omani patients with gastric cancer.

OBJECTIVE: To investigate the prevalence of a group of different autoantibodies, in Omani patients with gastric cancer, and to examine whether their presence correlates with clinical course of the disease. METHODS: Ninety-three Omani patients with gastric cancer, and 100 gender-matched blood donors were investigated for the presence of 15 different auto-antibodies against nuclear antigens (ANA), extractible nuclear antigens (ENA), Scleroderma antigen (Scl-70), Sjogren syndrome antigen A/B (SSA/B), Smith antigen (Sm), ribonucleoprotein (RNP), Jo-1 antigen, double stranded DNA (ds-DNA), parietal cell antibodies (APCA), reticulin antibodies (ARA), smooth muscle antibodies (ASMA), proteinase 3 (PR3), myeloperoxidase (MPO), and mitochondria antibody (AMA). Antinuclear antigen were detected using human epithelial cells-2 (Hep-2 cells). Anti-dsDNA antibodies were measured using Crithidia lucilia slides; APCA, ARA, and ASMA were examined using mouse liver, kidney, and stomach sections. Other autoantibodies were detected using commercially available ELISA kits. Seventy-three out of the 93 patients with gastric cancer were divided into 4 groups (stages I to IV) according to disease severity. This study was conducted in the period of 2001-2005 in the Department of Microbiology and Immunology Laboratories of the College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman. RESULTS: Approximately 40% of the autoantibodies investigated were found to be significantly higher in patients with gastric cancer than in normal controls. These autoantibodies are ANA (57.3 versus 14%, p<0.0001), anti-ENA (38.7 versus 13.9%, p<0.01), anti-Scl-70 (29 versus 5%, p<0.001), ARA (19.8 versus 3.1%, p<0.0001), ASMA (72.9 versus 31.6%, p<0.01), and anti-PR3 (21.5 versus 5.3% p<0.01). Generally, the presence of auto-antibodies was more frequent in stage III and IV compared to stage I and II. However, some autoantibodies (ENA, SSA, Scl-70, and ASMA) were more common in stage II than stage IV. CONCLUSION: Auto-antibodies are more prevalent in the serum of patients with gastric cancer compared to healthy controls. Some of these auto-antibodies may prove to be important markers of prognostic values in patients with gastric cancer.

Rheumatoid arthritis, cytokines and hypoxia. What is the link?

Rheumatoid arthritis (RA) is a chronic systemic inflammatory disorder that affects approximately 1% of the population, in a female to male ratio of 3:1. The disease can occur at any age, but it is most common among those aged 40-70 years. Despite many years of study, the etiology of RA is still undefined. However, with increased understanding of the immune system the pathogenesis of RA has become clearer. A large bulk of data suggests that T lymphocytes and macrophages play a critical role in the initiation and perpetuation of synovial inflammation. Recently, the cytokine profile of T helper cells has been associated with the disease, the cytokine repertoire of inflamed synovia is categorized as that of T helper 1 response. Moreover, in RA elevated levels of pro-inflammatory or inflammatory cytokines such as Tumor Necrosis Factor - alpha (TNF-alpha) and Interleukin -1 beta (IL-1beta) have been detected. Hypoxia up-regulates TNF-alpha and IL-1beta; therefore, considerable research interest has been focused on the biological consequences of the hypoxic nature of the rheumatoid synovium. Hypoxia might underlie the functional polarization of the T cells and cytokine production, and thus may contribute to the progression and persistence of the disease. In this short review, we discuss our current knowledge of the link between cytokines and RA and the role of hypoxia in the pathogenesis of the disease.