Annual Report 2010-2011

ACADEMIC &PATIENT CAREDEPARTMENTS OVERVIEW EXECUTIVE SUMMARY DEAN’S MESSAGE Contents Research 26 Clinical &DiagnosticServices Training Courses &CMEActivities Teaching Programmes Highlights oftheYear 2010-2011 Staff 23 Overview 22 Behavioural Medicine Research Clinical &DiagnosticServices Training Courses &CMEActivities Teaching Programmes Highlights oftheYear 2010-2011 Staff 15 Overview 14 Anaesthesia, ICU&PainManagement Sultan QaboosUniversityHopsital College ofMedicine&HealthSciences Research 36 Clinical &DiagnosticServices Teaching Programmes Highlights oftheYears 2010-2011 Staff 33 Overview 32 Biochemistry 24 34 23 25 25 16 33 33 18 3 2 15 17 17 9 5

academic and patient care departments Emergency Child Health Overview 44 Staff 45 Highlights of the Year 2010-2011 46 Teaching Programmes 47 Research 50 Emergency Medicine Overview 56 Staff 57 Highlights of the Year 2010-2011 58 Teaching Programmes 60 Training Courses & CME Activities 61 Research 63 Family Medicine & Public Health Overview 66 Staff 67 Highlights of the Year 2010-2011 67 Teaching Programmes 67 Training Courses & CME Activities 69 Clinical & Diagnostic Services 69 Research 70 Genetics Overview 76 Staff 77 Highlights of the Year 2010-2011 77 Teaching Programmes 77 Training Courses & CME Activities 78 Clinical & Diagnostic Services 79 Research 83 Haematology Overview 86 Staff 87 Highlights of the Year 2010-2011 88 Teaching Programmes 88 Clinical & Diagnostic Services 89 Research 92 Human & Clinical Anatomy Overview 104 Staff 105 Highlights of the Year 2010-2011 105 Teaching Programmes 105 Research 106 Medicine Overview 110 Staff 111 Highlights of the Year 2010-2011 112 Teaching Programmes 113 Clinical & Diagnostic Services 114 Research 116 Microbiology & Immunology Overview 126 Staff 127 Highlights of the Year 2010-2011 127 Teaching Programmes 128 Clinical & Diagnostic Services 129 Research 130 Nursing Services Directorate Overview 136 Staff 137 Highlights of the Year 2010-2011 137 Nutrition & Dietetics Overview 144 Staff 145 Highlights of the Year 2010-2011 145 Obstetrics & Gynaecology Overview 150 Staff 151 Highlights of the Year 2010-2011 151 Teaching Programmes 152 Training Courses & CME Activities 153 Clinical & Diagnostic Services 153 Research 154 Ophthalmology Overview 164 Staff 165 Highlights of the Year 2010-2011 165 Teaching Programmes 166 Training Courses & CME Activities 167 Clinical & Diagnostic Services 168 Research 170 Oral Health Overview 174 Staff 175 Highlights of the Year 2010-2011 175 Teaching Programmes 176 Clinical & Diagnostic Services 176 Research 176 Pathology Overview 180 Staff 181 Highlights of the Year 2010-2011 181 Teaching Programmes 182 Training Courses & CME Activities 183 Clinical & Diagnostic Servies 184 Research 185 Pharmacology & Clinical Pharmacy Overview 190 Staff 191 Highlights of the Year 2010-2011 191 Teaching Programmes 191 Clinical Programme 192 Research 193 Pharmacy Overview 200 Staff 201 Highlights of the Year 2010-2011 201 Teaching Programmes 203 Training Courses & CME Activities 203 Clinical & Diagnostic Services 203 Research 236 Clinical &DiagnosticServices Training Courses &CMEActivities Teaching Programmes Highlights oftheYear 2010-2011 Staff 233 Overview 232 Surgery Research 230 Clinical &DiagnosticServices Teaching Programmes Highlights oftheYear 2010-2011 Staff 227 Overview 226 Radiology &MolecularImaging Research 225 Clinical &DiagnosticServices Training Courses &CMEActivities Teaching Programmes Highlights oftheYear 2010-2011 Staff 221 Overview 220 Physiotherapy Research 215 Clinical &DiagnosticServices Training Courses &CMEActivities Teaching Programmes Highlights oftheYear 2010-2011 Staff 211 Overview 210 Physiology Research 205 229 236 228 228 224 234 234 222 223 223 235 212 213 211 211

academic and patient care departments Emergency SUPPORT DEPARTMENTS

College Medical Library 242 Medical Education Unit 244 Sultan Qaboos University Medical Journal 249 Hospital Development & Quality Directorate 252 Information System Directorate 259 Medical Supply Directorate 263 Patient Services Directorate 265 Public Relations & Information Directorate 268 Technical Affairs Directorate 271 Training & Continuing Professional Development Directorate 282 Finance Department 285 Housing Department 287 Medical Records Department 289 Transport Department 291 APPENDICES

Appendix I Conferences & workshops organised by COMHS & SQUH in 2010-2011 292

Annual Report 2010-2011 Dean’s Message

Dean's Message

t is my pleasure to present to you the report of the College of Medicine & Health Sciences for the aca- demic year 2010-2011 and of Sultan Qaboos University Hospital for the calendar year 2011. IThe College of Medicine was founded in 1986 and became the College of Medicine & Health Sciences (CoMHS) in 2002 when the Nursing Program was added. From the beginning, the College and the Sultan Qaboos University Hospital (SQUH) have recognised teaching, research, training and clinical and community services as their core responsibilities. They aim for the highest standards of achievement in the quality of their medical and health education and services, in research and in their contribution to Omani society. They also aspire to become a role model for other medical and health science colleges and health care institutions in Oman and abroad.

In 2011, the College had a total of 75 faculty members including 17 Professors, 22 Associate Professors and 27 Assistant Professors. The CoMHS has grown and diversified, with well established programmes in the preclinical and clinical departments. Student intake is around 125 per year and the total student numbers around 1,100. The College runs an M.S.c programme in Biomedical Sciences and Ph.D. programmes are now approved in eight study areas.

In 2011 the SQUH had 53 senior consultants and 68 consultants. It has had ISO 9001/2000 certification since 2005 and has introduced an electronic patient records system. SQUH and the CoMHS have state of the art laboratories and equipment.

Prof Omar Al-Rawas

Dean College of Medicine & Health Sciences Sultan Qaboos University

2 Executive Summary

he College of Medicine & Health Sciences (COM&HS) and the University Hospital (SQUH) continue to expand and develop their educational and clinical mission. This report documents their activities and achievements during the period September 2010 to December 2011 and the clinical calendar year T2011.

Education In 2010, the COM&HS admitted into the B.Sc. Health Sciences a total of 122 students of which 61% were fe- male. Following successful completion of the BSc Health Sciences degree, 129 students joined the clinical MD programme in September 2010. A major contribution towards the training of B.Sc. Medical Laboratory Sci- ences students is also among the responsibilities of the COM&HS and SQUH, of whom 22 graduated in 2011 all of them female.

The College of Medicine and the University Hospital graduated a total of 127 medical doctors in 2010-2011. A total of 41 students have now graduated from the College’s Masters programme in Biomedical Sciences. There are currently 12 Ph.D. students. The number of SQU trained medical doctors joining the Oman Medi- cal Specialty Board (OMSB) for postgraduate training, under the academic supervision of the COM&HS and SQUH, was 88 in 2010-2011. In this year the University also sponsored 3? MD graduates for a 5–7 year resi- dency and fellowship training programme abroad (locations are Canada, USA, UK and Australia) and a total of 7? returned to Oman after such training.

The College has continued to expand its e-learning system, with many departments making their teaching and course materials available on-line.

Research In 2010-2011, the College saw a major increase in research activity. Itundertook 179 research projects (com- pared to 53 in 2009-10) to a total value of OR 1,342,795 (65% increase). In 2010-2011, staff of the College pub- lished a total of 371 research articles (compared to 234 in 2009-10), 2 books and 11 book chapters. In the same period, College staff made a total of 280 conference and seminar presentations. Of these, 65 were interna- tional conference platform presentations and 100 international poster presentations (compared to 55 and 47 respectively in 2009-10). Also 4 Ph.D. and 12 master’s theses were supervised. The College and SQU Hospital organised 9 major conferences and 5 seminars or workshops in 2010-2011, some of them in cooperation with the Ministry of Health (see Annexe 1). Dean’s Message & Executive Summary Dean’s 3 Annual Report 2010-2011 Executive Summary

Clinical Activity By the end of 2011, the SQU Hospital was opened at full capacity. The hospital has continued to maintain ISO by bi-annual external review. It decided to go ahead for accreditation by inviting Canadian Accreditation In- ternational to assess and implement the Canadian accreditation system. New developments were the open- ings of the Genetic and Developmental Medicine clinic, of the “one-stop clinic” for the Breast Cancer Surgery unit, and of an Ophthalmology Electrodiagnosis unit. A pneumatic system for the transport of blood samples to the laboratory area was also successfully installed as well as other major new items of equipment.

By the end of 2011, the Hospital staff had increased to 2,408 employees including 418 doctors, 1,041 nurses and 438 technicians and 511 administrative/support staff. This is a major increase compared to 2010.

Clinical activity at SQUH expanded in all areas. Outpatient visits were 118,454 and SQUH had 30,745 inpatient admissions compared to 28,524 in 2010. The average length of stay increased to 6.5 days compared to 5.0 days in 2010. The number of day care patients was 12,999 compared to a lower figure of 8,907 recorded in the preceding year. Finally, newborn live deliveries showed a slight decrease from 3,427 in 2010 to 3,337 in 2011.

Dr. Kamlesh Bhargava Chairperson, Annual Report Committee & Senior Consultant, Department of Family Medicine & Public Health

Thanks are due for the preparation of this report to the following College staff: Meriel Carboni, Vice-Chairperson & Editor Annual Report,, Editorial Office, College of Medicine Dr. Jumana Saleh, Committee member, Department of Biochemistry Asma Al-Siyabi, Coordinator, Office of Postgraduate Studies & Research Amir Hussain, Technical Consultant, Editorial Office, College of Medicine Sheherajoy Biruar, Technical Editor, Editorial Office, College of Medicine

4 Overview College of Medicine & Health Sciences COLLEGE ADMINISTRATION The College Administration is the focal point of activities between the various departments and the main University Administration. It consists of the Office of the Dean, four Assistant Deans (Preclinical, Clinical, Postgraduate Studies & Research and Training & COmmunity Service) and the Director of Administration, .

The College Board met 12 times during the period September 2010 to December 2011. The following key deci- sions and actions were taken:

[1] Criteria for Selection of Students from College of Science for Admission to BSc-MLS Course host- ed by the CoMHS for the Academic Year 2012-11 [2] Criteria for admission into BSc-MLS Program from the Academic Year 2011-12 [3] Transfer Criteria to BSc-MLS Program from other Colleges [4] Renaming of Department of Accident and Emergency to “Department of Emergency Medicine” [5] Upgradation of CSSD Technicians Certificate to Central Sterile Processing Technologists Diploma at the Directorate of Training and Continuing Professional Development, SQUH [6] Apporval of additional Hospitals for training Interns [7] Proposal for PhD Programs Clinical Departments [8] Draft Organisation Chart sciences [9] Form for external participation in regular activities outside SQU organisations for CoMHS & SQUH Staff

[10] Establishing Allied Health Sciences Department in the College health

[11] M.Sc. Program in Human Genetics & medicine

of

college Overview 5 Annual Report 2010-2011 Overview

STAFF Dean Dr Mansour Al-Moundhri (to 15 June 2011) Dr Yayha Al-Farsi, Acting Dean (from 16 June 2011) Assitants Deans Dr. Omar Habbal, Preclinical Affairs Dr. Arunodaya Gujjar, Clincal Affairs Prof. Badreldin Ali, Research & Postgraduate Studies College Administration Administration Office Badriyah Al-Hashar, Director of Administration Mahmoud Al-Abri, Deputy Director Safaa Al-Harasy, Administrative Assistant Zakiya Al-Omairi, Follow-up & Communications Officer Ahmed Al-Saadi, Clerk Bakar Al-Hinai, Storekeeper Dean’s Office Sagar Hussain, Executive Assistant to the Dean Aisha Al-Senaidi, Clerk Aisha Al-Wardi, Clerk Amal Al-Jassasi, Coordinator for Follow-up Examinations Office Alphonsus Okoro, Examinations Officer Nasser Al-Mufarji, Coordinator

6 Preclinical Affairs Zulfa Al-Busaidi, Student Affairs Officer Muna Al-Alawi, Student Services Officer Shabbir Patel, Coordinator, Clinical Affairs Glorio Almeida, Coordinator, Clinical Affairs Clinical Electives & Internship Programme Office Ahmed Al-Wahaibi, Administrator Salem Al-Khaldi, Administrator Research & Postgraduate Studies Asma Al-Siyabi, Coordinator Fauzia Al-Abrawi, Staff Support Staff Salem Al-Salhi, Photocopy Technician Qassim Al-Salhi, Messenger Khalid Al-Hinai, Messenger Hamed Bani Auraba, Driver Education Programmes Preclinical Programme – B.Sc. Health Sciences This is a four-year programme in general and basic medical sciences. The B.Sc. Health Sciences degree is awarded to students after successful completion of 120 credit hours at the end of semester 8 (see Appendi- sciences ces). Students who wish to obtain the MD have to complete all course requirements for the B.Sc. Health Sci- ences before entering the clinical years. The student intake is around 125 per year. See http://www.squ.edu. om/medicine-health/tabid/2455/language/en- US/Default.aspx for details of the curriculum. health

Clinical Programme & This is a three-year clinical programme during which the knowledge acquired during the B.Sc. in Health Sci- ences degree is applied to the clinical practice of medicine. An MD degree is awarded upon completion of this programme. See http://www.squ.edu.om/medicine-health/tabid/2455/language/en-US/Default.aspx for an medicine overview of the MD programme. of

Clinical Elective Programme college Overview 7 Annual Report 2010-2011 Overview

An 8-week Elective Placement Programme is part of the second year of the Clinical Programme and is es- sential as one of the requirements to qualify for the MD degree. The programme provides students with an opportunity to gain more experience and skills through working in a different environment mainly in a foreign country. This programme is sponsored by the University and different organisations locally and internationally.

Internship training Programme This consists of 3 rotations of 4 months each in General Medicine, Surgery and either Child Health or Obstet- rics/Gynaecology in hospitals approved for the purpose by the College of Medicine & Health Sciences. The programme involves not only SQU graduates but those of other medical programmes in Oman, and Omani medical graduates from institute abroad. Approximately 230 graduates take part in this programme each year.

Postgraduate Studies The College introduced a two-year Masters Programme in Biomedical Sciences in 2001. It has the following eight specialisations: Biochemistry and Molecular Biology; Clinical Biochemistry; Clinical Pharmacy; Medical Microbiology; Epidemiology and Medical Statistics; Physiology; Radiology and Molecular Imaging, and Hu- man and Clinical Anatomy.

The College now offers the following 8 Ph.D. programmes: Biochemistry & Molecular Biology;

Medical Microbiology & Immunology; Epidemiology & Medical Statistics; Genetics; Pharmacology & Clinical

Pharmacy; Physiology; Human & Clinical Anatomy; Radiology & Molecular Imaging.

The Oman Medical Specialty Board (OMSB) was established in June 1994 and became an independent entity in November 2006. Its role is to train high calibre and internationally recognised Omani medical specialists in diverse disciplines. These specialists are to provide leadership in clinical, research and service endeavours and also boost the manpower resources of the Sultanate thus making an important contribution towards translating national health policies into reality.

The OMSB has representatives from the University, the Ministry of Health and the medical services of the Sultan’s Armed Forces and the Royal Omani Police. It supervises and coordinates postgraduate training pro- grammes as well as providing guidelines to ensure that the training meets international standards. Spe- cialty committees staffed by highly experienced professionals run these programmes on a day-to-day basis.

The OMSB Office sources overseas postgraduate residency placements, particularly in North American uni- versities, Australia and the UK. Residents who have received residency and postgraduate training abroad are required to return to Oman to strengthen the country’s manpower development efforts by focusing on the training of junior colleagues and students.

8 Sultan Qaboos University Hospital OVERVIEW Sultan Qaboos University Hospital (SQUH), with a total of 675 beds is the only teaching hospital in Oman. It currently has 470 of its beds in use with 89 beds in ambulatory areas such as day care and Emergency. The goals of SQUH are to provide teaching, research and high quality patient-centered care in an environment that supports continuous improvement.

During the year 2011, a number of developmental activities took place in the Hospital. It is worthy of note that the renal transplantation service continued to provide the patients with quality service. A total of 5 kidney transplants were done in 2011. A total of 118,454 outpatients and 30,745 in-patients were seen in the course of 2011. A total of 28 bone marrow transplants were also done. The staff numbers in December 2011 stood at 2,408 comprising of 418 doctors, 1,041 nurses, 438 technical staff and 511 administrative/support staff.

HOSPITAL MANAGEMENT The Hospital Management embraces the senior leadership of all the units in the hospital administration. The Hospital Director-General, Deputy Director-General (Clinical Affairs), and Deputy Director-General (Nursing Affairs) together with the Heads of Clinical Departments hold a monthly Medical Advisory Com- mittee (MAC) meeting. The MAC, with representatives from all clinical departments, serves as a focal point for continued improvement of care, and makes a report at every meeting of the Hospital Board.

Similarly, the Hospital Board, comprising the top management team of the hospital and some senior doctors in the hospital and chaired by the Dean of College of Medicine & Health Sciences, also meets monthly dur- ing the academic year. Through the recurrent agenda items from the Hospital Director-General’s office, the members are kept informed about important matters in hospital management and developments in patient related activities.

During the year under review, much discussion was devoted to accommodating the significant increase in hospital patient flow and maintaining standards of research, teaching and service in the face of continued budget constraints.

Staff university

Dr. Ahmed Al-Mandhari, Hospital Director-General Dr. Hilal Al-Sabti, Deputy Director-General (Clinical Affairs) Mr. Ahmed Al-Kindi, Deputy Director-General (Admin. & Finance) qaboos

Ms. Yusriya Al-Akbari, Deputy Director-General (Nursing Affairs) sultan Overview 9 Annual Report 2010-2011 Overview

HIGHLIGHTS OF 2011 DEVELOPMENTAL ACTIVITIES Sultan Qaboos University Hospital is continuing the process of development and growth in order to fulfill its main aims which are health education, researches and clinical services. Furthermore, the Hospital plays a significant role in the community and the Hospital Management is committed to providing high quality care services in collaboration with the College of Medicine & Health Sciences with the continued support of the University Administration.

PIONEER IN HEALTH CARE SERVICES By the end of 2011, the Hospital was opened at full capacity after the following developments:

- Significant development and increase in the different clinical specialties and services. - Three highly specialised doctors returned from abroad while 7 scholars have proceeded abroad for their studies in 2011. - Continuous professional development policy for doctors in fellowship and training. - Successful installation of a Pneumatic System for the transport of blood samples to the laboratory area. - Purchase, commissioning, and installation of different types of new equipment such as: - High Performance Liquid Chromatography - Haemofiltration Machine - Complete Neuroendoscope System - NNL Screening System - Broncho Videoscope - LC-MS/MS Tandem Mass Spectrometry - Biometry Machine - EMG Unit MEDICAL SERVICES DEVELOPMENT The following developments are worth highlighting. The opening of the Genetic and Developmental Medi- cine clinic, of the “one-stop clinic” for the Breast Cancer Surgery unit, and of an Ophthalmology Electrodiag- nosis unit.

10 QUALIFIED HUMAN RESOURCES The Hospital Management believes in the training of Omani professionals abroad in order to achieve the goals of the hospital. Therefore a total of 5–10 physicians are sent abroad yearly for higher education and fellowship training with above 100 doctors having been sent to Canada, USA, Australia, and UK. A total of 14 of these returned in 2010 and 3 in 2011. Also, we have established and completed the CPD system for continuous professional development.

RECOGNITION The Hospital continued to be recognised as a centre of excellence by visiting experts and through receiving invitations from other health organisations in the community to conduct symposia and lectures in order to enhance the level of education services in other institutions. The hospital has continued to maintain ISO by bi-annual external review. Striving for better quality, the hospital decided to go ahead for accredita- tion by inviting Canadian Accreditation International to assess and implement the Canadian accreditation system.

WORK IN PROGRESS Based on the Hospital’s aims and vision, the Hospital Development Committee plans to develop/update the current services through the following projects already approved by the Hospital Board:

- Theatres/Radiology Extension - Haematology Centre – 6 floors - Emergency Department Extension - Administration Building - ICU/CCU/PICU (20-40 Beds) plus CSSD Extension. - Renal Dialysis Unit hospital

- OPD Building plus Day Care Unit - Seminar Rooms, Offices and On-call Rooms-Complex - Staff Residential Building - Multi-storey Car Park. university FUTURE DEVELOPMENT

- New Wards Extension

- Laboratory Building Extension qaboos

- Postgraduate Centre sultan Overview 11 Annual Report 2010-2011 Overview

CLINICAL ACTIVITIES The increase in patient activities over the years has relied on strong commitment by all the medical, nursing, technical and administrative staff. The Hospital Management would like to acknowledge all their efforts to- wards continuous improvement. Such developments are unattainable without proper in-house and external training. This has witnessed yet further improvement during the year 2011.

The role of SQUH as a major Omani health service provider continued in this period with a total of 118,454 outpatients and over 30,745 inpatients seen during the year. A total of 28 bone marrow transplants were also done as against 23 in the preceding year.

The number of day care patients was 12,999 compared to a lower figure of 8,907 recorded in the preceding year. This high use of day care reflects a healthy trend as the encouragement of ambulatory care results in considerable savings in the cost of delivery as well as improved quality.

Inpatient admissions increased still further to 30,745 surpassing the previous year’s figure of 28,524. The aver- age length of stay increased to 6.5 days compared to 5.0 days in 2010.

Finally, newborn live deliveries showed a slight decrease from 3,427 in 2010 to 3,337 in 2011.

12 hospital

university

qaboos

sultan Overview 13 Annual Report 2010-2011 Anaesthesia. ICU & Pain Management

Anaesthesia, ICU & Pain Management

he Department of Anaesthesia, Intensive Care & Pain Management is a dynamic and very productive department of Sultan Qaboos University Hospital (SQUH). Our key roles are in the operating theatre, anaesthetising patients for all surgical spe- cialties and subspecialties and in the Intensive Care Unit, managing critically ill patients. The Department provides 24-hour Telective and emergency anaesthesia services to the entire hospital, including referrals from other health institutions. We manage a 25-bed Intensive Care Unit. We are also involved in inserting venous access devices, both implantable and percutaneous, to patients from various clinical departments. Pain management is also part of departmental functions with acute and chronic pain manage- ment services. Cardiopulmonary resuscitation is a significant function of this Department and now cardiothoracic anaesthesia has also been added. The Department forms a solid part of SQUH Trauma and Disaster management services.

The pre-Anaesthesia Assessment Clinic (PAC) has been fully functional since March 2009. Patients who have to undergo surgery are assessed here for surgical fitness at the Out Patient Department (OPD) level. This was initiated with the main aim of reducing in- patient cancellations—a key factor in improving hospital efficiency. The clinic is being run Saturday to Wednesday from 8 am to 2 pm.

14 Staff Mohammed Al-Badi, Technician Maheswariamma, Technician Acting Head of Department Bipin Aravind, Respiratory Therapist Amarnath Shetty, Consultant Kingsly Prabhkaran, Respiratory Therapist Faculty Karin Nollain, Senior Consultant Highlights of the Year Suresh Chengode, Senior Consultant Ram Narayan Rao, Consultant 2010-2011 Sinnakirouchenan, Consultant The annual Scientific Session of the Oman Soci- Rajini Kausalya, Consultant ety of Anaesthesia and Critical Care was held in Ali Al-Abady, Consultant March 2011 at Sultan Qaboos University. Dr. Rajini Nasser Al-Kemyani, Consultant Kausalya, Dr. Satyajit Karanth and Dr. Jyoti Burad Mohammed Al-Ismaili, Consultant were speakers in this scientific meeting. It was a Jaswinder Sharma, Senior Registrar ‘PRO-CON’ debate on the latest topics in Anaesthe- Binoy Zachariah, Senior Registrar sia & ICU. Pradipta Bhakta, Senior Registrar The Department organised a workshop on Ultra- Pradeep K. Sharma, Senior Registrar sound in Anaesthesia in March 2011 It was facili- Shahid Ahmed, Senior Registrar tated entirely by the Anaesthesia faculty of SQUH. Jyoti Burad, Registrar The response was very positive and the workshop Devaraj N. Dyamanna, Registrar was very successful. Hatem Abd El Ghany, Registrar Sanath Kumar, Registrar The Department also participated in the Quality Rohit Date, Registrar Day, which was held in SQUH in March 2011, pre- Qutaiba Tawfiq, Registrar senting posters related to the Pain Management P. Madhanagopal, Registrar and Pre-anaesthesia clinic. Ahmed Khamis, Registrar departments

We are proud of the achievements of the following Chander Lal, Registrar doctors who attained further qualifications. Dr. Ra- Hussein Hamdan, Registrar jini Kausalya and Dr. Devaraj Dyamanna obtained a care

Nisha John, Registrar European Diploma in Regional Anaesthesia and Dr. Babji Kalapati, Registrar Jyoti Burad a European Diploma in Critical Care. Dr. Ajai K. Arora, Registrar Rajini Kausalya, Dr. Sinnakirouchenan, Dr. Qutaiba Zahra G. Ahmed, Senior House Officer patient

Tawfic, Dr.Hussein Sadkhan and Dr. Zahra Ghanim Support Staff gained a Diploma in Regional Anaesthesia and and Leena Chacko, Coordinator Chronic Pain from Montpellier University, France. Ibrahim Al-Farsi, Coordinator academic Anaesthesia, ICU & Pain Management 15 Annual Report 2010-2011 Anaesthesia. ICU & Pain Management

NEW SERVICES The service of ultrasound guided peripheral nerve blocks is functioning very well and we have performed more than 500 blocks in the past one year. This has revolutionised the practise of regional anaesthesia.

The Department is proud to have introduced the new service of performing peripheral nerve blocks and vascular access under ultrasound guidance. The new ultrasound machine, which corporates the latest in portable ultrasound technology for clinical applications, has been a boon for the Department and has made it possible for this latest service to be initiated in the department. This machine is also going to be effectively put to use in the Intensive Care Unit for haemodynamic measurements and transthoracic echocardiogram.

NEW SUB-SPECIALTY The sub specialty of Neuro anaesthesia and Paediatric Anaesthesia are functioning well. In Paediatric anaes- thesia, we are doing several procedures which are done for first time in Oman.

Teaching Programmes UNDERGRADUATE CLINICAL PROGRAMME – OLD CURRICULUM The sixth year medical students have a compulsory two week rotation in the Department participating in the clinical activities. Students are given ‘hands-on’ experience, on both manikins as well as patients, un- der the close supervision of anaesthesiologists. This is in order to witness and learn airway management, endotracheal intubation, intravenous cannulation, fluid management and monitoring of the anaesthetised patient. The tutorials are aimed at making the student understand the use of airway adjuncts, respiratory equipment, central venous and arterial cannulation, regional blocks, and drugs used in anaesthesia and car- diopulmonary resuscitation. The main topics of these lectures are pre-anaesthetic evaluation; management of patients under anaesthesia; postoperative pain relief; the pharmacology of anaesthetic drugs; acid base and electrolyte disorders, and hypovolemic shock. The lecture is given by senior doctors in the department on a rotation basis followed by a 30-minute case discussion.

UNDERGRADUATE CLINICAL PROGRAMME – NEW CURRICULUM The department is involved in Pre-Clerkship teaching as well as in Junior Clerkship teaching.

POSTGRADUATE PROGRAMME Oman Medical Specialty Board (OMSB) A 4-year residency programme in anaesthesia was started in September 2007 under the OMSB. Two resi- dents were enrolled in this programme. An exit examination is planned at the end of 4 years; after the suc-

16 cessful completion, the residents would do a further year of specialised training. The Department is actively involved in developing the curriculum, accreditation and examination processes for this programme

Training Courses & CME Activities The Department is actively involved in the teaching of training courses organised by the SQUH Training Directorate. These include the Advanced Cardiac Life Support (ACLS) provider course, ACLS recertification course, Basic Life support (BLS) provider course, BLS recertification course, AED (Accident & Emergency Dept) course and the Pain Management course. Every Saturday there is a CME session in the Department covering topics of recent interest in anaesthesia and intensive care. Doctors of the Department present interesting topics beneficial to the staff. Residents are encouraged to attend. Members of the Department are also part of OSAAC which is involved in regular CME activities and scientific sessions. Dr. Rajini Kausalya from the department is now part of the faculty of ATLS in Oman.

Clinical & Diagnostic Services A total of 5,591 anaesthetic procedures were carried out in 2011 compared to 4,761 in 2010 and 4,056 in 2009.

800

700 590 698 631 600 589 584 553 567 530 541 515 500 502 484 473 487 446 442 423 420 421 400 399 369 No. of Patients No. 337 326 300 252 200 190 161 163 172 143 145 144 136 100 106 103 116 110 departments

0 Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec care Emergency Elective Total Figure 1: Anaesthesia Statistics 2011 patient

and

academic Anaesthesia, ICU & Pain Management 17 Annual Report 2010-2011 Anaesthesia. ICU & Pain Management

Research RESEARCH PROJECTS Sickle Cell Disease in Adult Patients and Intensive Care Management- A 5 Year Retrospective Study in the ICU of SQUH Project Code: MREC# 348; Dates: 2010 Value: Unfunded; Project approval: Sultan Qaboos University Investigators: Dr. Qutaibah Tawfic, Dept. Anaesthesia, SQU RESEARCH PUBLICATIONS & BOOKS Journal Publications 1. Dyamanna DN, Bhakta P, Chouhan RS, Al Azri F. Anaesthetic management of a patient with pituitary adenoma for caesarean section. Int J Obstet Anaesth 2010; 19:460-1. 2. Bhakta P, Mishra P, Bakshi A, Langer V. Case report and mini literature review: Anesthetic management for severe peripartum cardiomyopathy complicated with preeclampsia using sufentanil in combined spinal epidural anesthe- sia. Yonsei Med J 2011; 52:1-12. 3. Tawfic QA, Bhakta P, Kausalya .R Unexpected cause of oesophageal obstruction due to accidental use of traditional medicine in a critically ill patient fed through naso-gastric tube. Indian J Crit Care Med 2010; 14:160-1. 4. Tawfiq QA, Bhakta P, Khamis A, Sharma J. Subclavian vein injury and massive haemothorax requiring thoracotomy following insertion of tunneled dialysis catheter: a case report and review of literature. Middle East J Anaesthesiol 2010; 20:861. 5. Bhakta P, Mady HA, Burad J, Tawfic QA. Anaesthetic management of a patient with Weill-Marchesani syndrome complicated with mitral regurgitation. Indian J Anaesth 2011; 55:428-30. 6. Tawfic QA, Bhakta P, Mishra P, Burad J, Kausalya R. Central Venous catheterization in a patient With sickle cell dis- ease: a mishap and explanation. Sultan Qaboos Univ Med J 2011; 11:519-21. 7. Tawfic QA, Bhakta P,Mishra P, Ahmed MA. Glidescope for assessment of recurrent laryngeal nerve integrity after thyroid surgery. Sultan Qaboos Univ Med J 2011; 11:527-8. 8. Mishra P, Bhakta P, Kumar S, Al Abri R, Burad J. Sudden near-fatal tracheal aspiration of an undiagnosed nasal for- eign body in a small child. Emerg Med Australas 2011; 23:776-8. 9. Tawfic QA, Bhakta P,Mohammed AK, Sharma J. Subclavian vein injury and massive hemothorax requiring thora- cotomy following insertion of tunneled dialysis catheter--a case report and review of literature. Middle East J Anes- thesiol 2010; 20:861-4. 10. Kuba PK, Sharma J, Sharma AK. Complication of warfarin therapy presenting as empyema. J Thoracic Dis 2011; 3:74- 6.

18 11. Al Asmi A, John R, Nandhagopal R, Jacob PC, Nollain K, Jain R. Spinal cord infarction following abdominal surgery and post operative epidural anaesthesia. Sultan Qaboos University Med J 2010; 10:396-400. 12. Bhakta P, Mady HA, Burad J, Tawfic QA. Anaesthetic management of a patient with Weill-Marchesani syndrome complicated with mitral regurgitation. Indian J Anaesth 2011; 55:428-30. 13. Bhakta P, Mishra P, Bakshi A, Langer V. Anaesthetic management of a patient with severe peripartum cardiomyopa- thy complicated with preeclampsia scheduled for cesarean section, use of sufentanil in combined spinal epidural anaesthesia: a case report along with review of literature. Yonsei Med J 2011; 52:1–12. CONFERENCE & SEMINAR PRESENTATIONS Conference presentations International 1. Chengode S. GUCH - Grown up Congenital Heart disease. 14th National Conference Indian Association of Cardiovas- cular Thoracic Anaesthesiologists (IACTA). Bangalore, India, 18–20 Feb 2011. 2. Kausalya R. Regional anaesthesia and anticoagulation. 8th U.A.E. International Conference on Anaesthesia and Pain Medicine (with European Society of Anaesthesiolog).University of Sharjah, U.A.E., December 2010. 3. Kausalya R. Quality in Anaesthesia. 8th U.A.E. International Conference on Anaesthesia and Pain Medicine (with European Society of Anaesthesiolog).University of Sharjah, U.A.E., December 2010. 4. Kausalya R. Types of hospital hazards and risk management in anaesthesia. 8th U.A.E. International Conference on Anaesthesia and Pain Medicine (with European Society of Anaesthesiolog).University of Sharjah, U.A.E., December 2010. National 1. Kausalya R. Is ultrasound the future of regional anaesthesia? Pro-Con Debate, 4th Annual Scientific Meet, Oman Society of Anaesthesia and Critical Care (OSACC). Sultan Qaboos University, 24-25 March 2011. 2. Kausalya R. Tight perioperative Glycemic Control. Pro-Con Debate, 4th Annual Scientific Meet, Oman Society of An- aesthesia and Critical Care (OSACC). Sultan Qaboos University, 24-25 March 2011. departments Poster Presentations International care

1. Bhakta P. Ilioinguinal nerve blocks improve the success of low dose spinal anaesthesia for cesarean section in criti- cal obstetric cases: Our experience of two cases. E-poster. European Society of Regional Anaesthesia & Pain Medi- cine Medical Congress. Dresden, Germany, 7-10 September, 2011. patient 2. Bhakta P. Ambulatory labour analgesia using epidural analgesia (EA): our experience from developing country. E- poster. European Society of Regional Anaesthesia & Pain Medicine Medical Congress. Dresden, Germany, 7-10 Sep- and

tember, 2011. 3. Dyamanna D. Ambulatory labour analgesia using combined spinal epidural technique, 29th European Society of academic Anaesthesia, ICU & Pain Management 19 Annual Report 2010-2011 Anaesthesia. ICU & Pain Management

Regional Anaesthesia & Pain Medicine Medical Congress. Porto, Portugal, 8-10 September 2011. 4. Burad J. Ventilator associated pneumonia. Canadian Critical Care Forum. Toronto, Canada 25–28th October 2010. 5. Kausalya R. Adult Sickle Cell Disease: A five year experience in the critical care unit of a university hospital in Oman. Canadian Critical Care Forum. Toronto, Canada, 25–28th October 2010. Seminar Presentations International 1. Bhakta P. Peripartum Cardiomyopathy. National Conference of Association of Obstetricians of India. Shillong, India, September 2010. 2. Bhakta P. Ultrasound Guided Regional Anaesthesia. Eastern Zonal Conference of Indian Society of Anaesthesiolo- gists. Kolkata, India, October, 2010. 5. Chengode S. TEE assessment of Right Ventricular function & dysfunction. Pre conference TEE workshop. 14th Na- tional Conference Indian Association of Cardiovascular Thoracic Anaesthesiologists (IACTA). Bangalore, India, 18–20 Feb 2011. 6. Chengode S. TEE assessment of mitral valve. 5th National Workshop on Intraoperative Transoesophageal Echocar- diography. Bangalore, India August 2011. 7. Chengode S. Porcine heart dissection - Wet lab (Lead Demonstrator). 5th National Workshop on Intraop- erative Transoesophageal Echocardiography. Bangalore, India August 2011. National 1. Bhakta P. Workshop on Ultrasound Guided Regional Anaesthesia organized by Oman Society of Anaesthesia and Critical Care (OSACC), Muscat, March, 2011. 2. Kausalya R. Types of hospital hazards. Risk Management Workshop. Directorates of Quality & Development and Training & CPD, Sultan Qaboos University Hospital, Oman, October 2010 3. Burad J. Use of Albumin in Intensive care. Oman Society of Anaesthesia and Critical Care (OSACC) meeting. Muscat, December 2010. 4. Kausalya R. Workshop on ultrasound guided peripheral Nerve Blocks – hands-on with live models and the latest ultrasound machines. Sultan Qaboos University Hospital, Muscat, March 2011.

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academic Anaesthesia, ICU & Pain Management 21 Annual Report 2010-2011 Behavioural Medicine

Behavioural Medicine

he Department of Behavioural Medicine strives, as an academic and clinical department, for excellence in learning, teaching and research and to be the flagship department in the country and the region. ‘Behavioural’ in the contex¬t of medicine is de- fined here as all the disciplines that explore ‘behaviour’. Therefore, behavioural medicine is a scientific discipline, such as soci- Tology, anthropology, or psychology, in which the actions and reactions of humans (and animals) are studied in order to appreciate the biological, social and cultural aspects of illness and wellbeing in the context of Oman. There is ample evidence to suggest that most illnesses, whether physical or psychiatric, are invariably influenced by biology, psychological and social factors and so the necessity of this biopsychosocial approach. In this context, in the approach to learning, teaching and research, efforts are made to determine how biopsychosocial factors are central to the predisposition, onset, course and outcome of most disorders.

Whilst communicable diseases continue to be a source of attrition in a country like Oman, there is also the ‘silent epidemic’ of non- communicable diseases, often precipitated and exacerbated by an individual’s behavior and life style which can result in serious distress and often fatal diseases. Research in the Department has specifically focused on the psychosocial determinants of health and ill-health since biological sciences alone are not sufficient in the prevention of and intervention in matters related to disease. This has led Department researchers to establish cultural variations as a pillar of establishing psychological services in Oman. Research com- ing from this Department indicates that the incidence of psychological distress in Oman is common, with some minor differences in

22 the incidence of the types of reaction. Samira Al-Hamdan, Psychologist Salwa Al-Redha, Psychologist We have come a long way since the time when the Abdullah Al-Sulaimani, Social Worker relevance of behavioural input in medical science Ahmed Al-Salmi, Social Worker was considered to be a ‘luxury’ only affordable in Khamis Al-Balushi, Social Worker the industrialized part of the world. Now the ques- Khoula Al-Wahaibi, Social Worker tion is not how relevant behavioural science is for Younis Al-Hashim, Social Worker Oman, but how Oman is implementing behavioural Support Staff sciences in its health care infrastructure. Bearing the rising magnitude of non-communicable diseas- Ravindran Kozhapatil, Coordinator es, the prospect and relevancy of embracing a sci- Govindan Mundayadan, Coordinator entific approach to the study of human behaviour knows no boundaries. Highlights of the Year 2010-2011 As in previous years, 2010-2011 witnessed enor- Staff mous growth and expansion in the Department. Head of Department The psychiatric residency programme witnessed Samir Al-Adawi, Professor yet another of substantial development. In line Faculty with changes in medical education, the Depart- ment has been instrumental in embracing the new Ala’Aldin Al-Hussaini, Professor curriculum with its integrated approach to teach- Ziad AJ Zaidan, Associate Professor ing. This approach has been shown to be in the Marwan Al-Sharbati, Associate Professor vanguard for the much needed holistic approach Harith Ghassany, Assistant Professor in learning medical skills. Rodger Martin, Senior Consultant Amre El Guenedi, Consultant The Department was involved in local and inter- departments Hamed Al-Sinawi, Consultant national research collaborations and published Ahmed S. Amer, Senior Registrar a number of papers on various aspects of behav-

Yousif A. Obeid, Senior Registrar ioural medicine, psychiatry, psychology and allied care

Aziz Al-Naamani, Registrar fields, for example: cross-cultural differences in Nonna Viernes, Registrar morbid body preference; hazardous and harming Amaal Ambusaidi, Registrar drinking patterns in Oman; medical education and patient Amira Al-Hosni, Registrar child psychiatry. In the Departmental database, Ibrahim Elzein, Senior House Officer much research has been amassed on topics such as and Basma Al-Said, Mental Health Counsellor how distress is experienced in Oman; psychologi- Zena M. Al-Sharbati, Clinical Psychologist cal aspects of cardio-thoracic disease and surgery; academic Behavioural Medicine 23 Annual Report 2010-2011 Behavioural Medicine

cognitive functions of schizophrenic patients; genetics of schizophrenia and obsessive-compulsive disorders and adjustment difficulties and developmental disorders among infants, children and adolescents.

Teaching Programmes The main thrust of the Department’s teaching approach is to equip future Omani doctors with the ability to prevent, diagnose and treat various mental illnesses in the community at large and to expose our students to empirical evidence that distress, disease and treatment are experienced in the context of cultural and social processes, as well as to introduce the idea of integrating mental health in primary care. The academic component includes a regular seminar in therapeutic skills of teaching and consultation; teaching on cur- rent issues in psychiatry; developmental psychology; psychological assessments; personality; bereavement; cross-cultural psychiatry; eclectic approaches to psychological intervention, and behavioural medicine. To keep abreast with the development of psychiatry elsewhere, a regular Journal Club is held. External speakers are also part and parcel of this endeavour.

DEVELOPMENT OF THE NEW MEDICAL CURRICULUM The Department has been active in developing its new curriculum for the new medical degree programme. Behavioural medicine lectures, tutorials and seminars are now fully integrated into the pre-clinical system modules of Phases 1 and 2 and the integrated modules. The Phase 3 clinical curriculum for behavioural medi- cine is being developed which has its primary focus within the pre-clerkship and junior clerkship training although it will be a contributing theme throughout the senior clerkship and junior internship phases. The Department will be contributing specific lectures, case studies and training in the pre-clerkship stage on the topics of clinical assessment (young people, working adults and older adults); vulnerability for mental health (genetic versus environmental influences); models of stress and coping, and health psychology and chronic illness management. In liaison with other College departments, teaching is provided on specific clinical com- munication skills (e.g. working with psychotic patients) and clinical ethics (e.g. confidentiality and suicide management). The junior clerkship stage will focus on the advanced training of medical students in the clinical application of the basic skills learned within the pre-clerkship stage giving them clinical exposure to a wide range of psychiatric conditions and their medical and psychotherapeutic treatment.

POSTGRADUATE PROGRAMME The Department continued in this period to train Family and Community Medicine residents and contribut- ed to revising programmes for the examination for Membership of the Royal College of General Practitioners (MRCGP), the Arab Board of Psychiatry and the Oman Medical Specialty Board (OMSB) residency training programme (including writing the curriculum, preparing for examinations and writing their programmes).

24 18000 OUTPATIENTS 16144 IN-PATIENTS 16000 14605 14000 12783 12000

10000

8000

6000

4000

2000 350 552 305 0 2009 2010 2011 Figure 1: Statistics In & Outpatients Clinic 2009-2011

Training Courses & CME Activities The Department conducted a number of workshops on various aspects of stress and coping; the psychology of chronic disease management; research methodology, and issues pertinent to social medicine.

Clinical & Diagnostic Services On the hospital side, the combination of referrals from all part of Oman and prompt service delivery put the Department in the vanguard of psychiatric services in the country. The Department is one of the few in Oman which provides for specialist tertiary referrals. It has a multidisciplinary team approach designed for optimum treatment of patients and training of medical students. The Department has a support staff of departments

psychologists, nurses, social workers and other clinicians.

The Department strives to offer comprehensive liaison psychiatry with other branches of medicine as well care as psychosocial intervention and various social work services with its fully functioning team of psychia- trists, psychologists and social workers. The Department offers unique clinical and diagnostic services. A wide range of assessments relevant for diagnosis of cognitive disorder, personality testing. The assessments

provided by our staff employ specialised testing procedures to integrate medical, neurological, and behav- patient ioural data with findings in order to answer any of a number of referral questions. Referrals to our services typically consist of, but are not limited to, questions concerning: a) differential diagnoses between functional and and organic syndromes (e.g. depression versus dementia); b) delineation of spared and impaired cognitive functions secondary to central nervous system dysfunction; c) establishment of behavioural baseline mea- academic Behavioural Medicine 25 Annual Report 2010-2011 Behavioural Medicine

sures to monitor recovery or progression of central nervous system dysfunction; d) comparison of pre- and post-pharmacological states, surgical, and behavioural interventions; e) assessment of cognitive/behavioural functions for the formulation of rehabilitation, management strategies, and/or educational or employment placement, and f) evaluation of neurocognitive status for the purpose of tests for disability, compensation and liability determinations. One of the new developments in this regard was the establishment of an Old Age Psychiatry service from September 2010. It provides services for the increasing ageing population in Oman. The major undertaking is to develop cognitive testing for the elderly population in Oman as well as to liaise with nuclear medicine and radiology to obtain neuro-imaging data.

Research RESEARCH PROJECTS Attitudes towards Mobile Phones among Adolescents/Young Adults in Second and Third-cycle schools in Oman Project Code: CR/SCI/MATH/08/01; Dates: October 2010 Value: Funded; Project Approval: Sultan Qaboos University Investigators: Atsu SS Dorvlo, Dept. Mathematics, SQU; Dr. Samir Al-Adawi, Dept. Behav- ioural Medicine, SQU.

Effect of Dietary Supplementation of Fruits Grown in Oman on Cognitive Decline in Alzheimer’s Demen- tia, Mild Cognitive Impairment, Vascular Cognitive Impairment and Traumatic Brain Injury Project Code: RC/AGR/FOOD/11/01; Dates: May 2011 Value: Funded; Project Approval: Research Council Investigators: Dr. Mohamed Essa, Department of Food Science & Human Nutrition, SQU; Dr. Samir Al Adawi, Dept. Behavioural Medicine, SQU.

The Ethics of Veracity in Health Care Project Code: MREC # 350; Dates: 2010 Value: Unfunded; Project Approval: Sultan Qaboos University Investigators: Dr. Ahmed Amer, Dept. Behavioural Medicine, SQU.

26 Anxiety and Depression among Children with Chronic Illnesses in a Tertiary Health Care Hospital Project Code: MREC# 400; Dates: 2011 Value: Unfunded; Project Approval: Sultan Qaboos University Investigators: Dr. Marwan Al Sharbati, Dept. Behavioural Medicine, SQU.

Prevalence of Depression and Anxiety among mixed oncology patients within a tertiary care hospital Project Code: MREC# 443; Dates: 2011 Value: Unfunded; Project Approval: Sultan Qaboos University Investigators: Dr. Zena Al Sharbati, Dept. Behavioural Medicine, SQU. RESEARCH PUBLICATIONS & BOOKS 1. Al-Adawi S, Jaju SS, Al-Zakwani I, Dorvlo, ASS. Culture to Culture Fatphobia and somatization. In: V. R. Preedy, R. R. Watson, C. R. Martin, Eds. International Handbook of Behavior, Diet, and Nutrition. New York: Springer, 2011. Pp. 1457- 73. 2. Al-Sinawi H, Al-Adawi S. Sultanate of Oman. In: Ghodse H, Editor. International Perspectives on Mental Health. London: Royal College of Psychiatry Publications 2011; Pp.167-72, Journal Publications 1. Al-Shafaee M, Bhargava K, Al-Farsi YM, Mcllvenny S, Al-Mandhari A, Al-Adawi S, Al Maniri A. Prevalence of pre- diabetes and associated risk factors in an adult Omani population. Int J Diabetes Dev C 2011; 31:166-73. 2. El Shafie K, Al Farsi Y, Al Zadjali N, Al Adawi S, Al Busaidi Z, Al Shafaee M. Menopausal symptoms among healthy, middle-aged Omani women as assessed with the Menopause Rating Scale. Menopause 2011; 18:1113-9. 3. Al-Maskari MY Petrini K, Al-Zakwani I, Al-Adawi SSH, Dorvlo ASS, Al-Adawi S. Mood dysfunction and health-related quality of life among type 2 diabetic patients in Oman: Preliminary study. Int J Nutr Pharmacol Neurol Dis 2011; 1:56- 3. departments 4. Al-Asmi A, Dorvlo AS, Burke DT, Al-Adawi S, Al-Zaabi A, Al-Zadjali HA, Al-Sharbati Z, Al-Adawi S. The detection of mood and anxiety in people with epilepsy using two phase designs: Experiences from a tertiary care centre in

Oman. Epilepsy Res 2011; 11:9-12. care

5. El Shafie K, Al-Shaqsi A, Al-Mahrouqi B, Al Lawati H, Ganguly SS, Al-Adawi S, Al Shafaee M. The diagnostic yield of thyroid function tests and their cost-effectiveness in the student clinic at Sultan Qaboos University: Retrospective chart review. Sultan Qaboos University Med J 2010; 10:215-20. patient 6. Al-Adawi S, Al-Zakwani I, Obeid YA, Zaidan Z. Neurocognitive functioning in women presenting with undifferenti- ated somatoform disorders in Oman. Psychiat Clin Neuros 2010; 64:555-64. and

7. Al-Adawi SH, Ali BH. West is West, East is East. The divide in science. Saudi Med J 2010; 31:1093-4. 8. Al-Sharbati M, Al-Zaidi R, Al-Naamani R, Al-Futaisi A, Jain R. A rare presentation of attention deficit/hyperactivity academic Behavioural Medicine 27 Annual Report 2010-2011 Behavioural Medicine

disorder: A recommendation to be more alert! Sultan Qaboos Univ Med J 2010; 10: 84-8. 9. Al-Sharbati MM, Zaidan ZA, Dorvlo AS, Al-Adawi S. Characteristics of ADHD disorder among Omani schoolchildren using DSM-IV: Descriptive study. J Atten Disord 2011; 15:139-46. 10. Al-Farsi Y, Al-Sharbati M, et al. Prevalence of autism in Oman. J Autism Dev Disord 2011; 41:821-5. 11. Essa MM, Al-Sharbati MM, Al-Farsi YM, Ali A, Waly MI, Al-Shaffae MA, Gilles GJ. Altered activities of monoamine oxidase A in Omani autistic children – A brief report. Int J Biol Med Res 2011; 2:811-13. 12. Essa MM, Al-Sharbati MM, Al-Farsi YM, Ali A, Waly MI, Al-Shaffae MA, Gilles GJ. Reduced levels of adiponectin in Omani Autistic Children – A brief report. Int J Biol Med Res 2011; 2:793-5. 13. Essa MM, Braidy N, Al-Sharbati MM, Al-Farsi YM, Ali A, Waly MI, Al-Shaffae MA, Gilles GJ. Elevated plasma leptin levels in autistic children of Sultanate of Oman. Int J Biol Med Res 2011; 2: 803-5. 14. Al-Farsi YM, Al-Sharbati MM, Waly MI, Al-Farsi OA, Al Shafaee MA, Deth RC. Malnutrition among preschool-aged children with autism in Oman. Res Autism Spectr Disord 2011; 5:1549–52. CONFERENCE & SEMINAR PRESENTATIONS Conference Presentations National 1. Al-Adawi S. Personality Types in Occupational Setting for Health and Wealth. Al-Dakhliyaha Laboratory Open Day. Nizwa University, Oman, 3 March 2011. 2. Al-Adawi S. No health without mental health. 1st World Mental Health Day Nursing Conference. Sultan Qaboos University, 13 October 2010. 3. Hallas CN. The Mask of Perfectionism: Is it a cultural fear of failure? 1st World Mental Health Day Nursing Confer- ence. Sultan Qaboos University, Oman, 13 October 2010. 4. Al-Adawi S, Hallas CN, Sharbati Z, Al-Zajdali H, Said B, et al. The psychology and psychotherapy service at Sultan Qaboos University Hospital (SQUH). 1st World Mental Health Day Nursing Conference. Sultan Qaboos University, Oman, 13 October 2010. Poster Presentations International 1. Al-Sharbati M, Ali Al-Jabri. The experience of the committee dealing with students under probation in the College of Medicine at SQU. 6th Congress of the Asian Medical Education Association, Kuala Lumpur, Malaysia, 26-30 March 2011. 2. Al-Sharbati M, Al-Attabi K. Atomoxetine treatment of ADHD cases in SQUH: an open trial study. 6th World Confer- ence International Iraqi Medical Association (IIMA), Sharjah, UAE, 26-30 March 2011. 3. Mohamed-Musthafa ME, Guillemin GJ, Waly MI, Ali A, Al-Farsi YY, Al-Sharbati MM, Braidy N Al-Shafaee M. Elevated Leptin and Reduced Adiponectin Levels In Omani Autistic Children. International Meeting for Autism Research. San

28 Diego, USA, 12-14 May 2011. 4. Ali A, Waly MI, Al-Farsi YY, Al-Sharbati MM. High Serum Level of Homocysteine is Associated with Increased Risk of Autism in Oman. International Meeting for Autism Research. San Diego, USA, 12-14 May 2011. 5. Al-Farsi YY, Al-Sharbati M. Waly MI, Al-Farsi OA, Al-Shafaee M Al-Khaduri MM. Effect of Suboptimal Breastfeeding on Occurrence of Autism: A Case Control Study. International Meeting for Autism Research. San Diego, USA, 12-14 May 2011. 6. Waly MI, Al-Sharbati MM, Al-Farsi Y, Ali A. Dietray Antioxidants Vitamins Status in Omani Autistic Children. Inter- national Meeting for Autism Research. San Diego, USA, 12-14 May 2011. 7. Al-Sadoon M, Al-Sharbati M, Rizvi S. School bullying in Muscat. AACAP/CACAP Joint Annual Meeting. Toronto, Can- ada, 18-23 October 2011. 8. Carboni M, Al-Adawi S, Al-Lamki L. Survey of Peer Review in WHO EMRO Region. 5th Regional Conference of Eastern Mediterranean Medical Journals: Medical Journalism: Opportunities and Challenges in the Eastern Mediterranean Region. Karachi, Pakistan, 2-5 Dec 2010. Seminar Presentations International 1. Al-Adawi S. Classification of Mental and Behavioral Disorders in Arab Countries. Department of Psychiatry, Ameri- can University of Beirut Medical Center. Beirut Lebanon 21June 2011. 2. Al-Adawi S. Journal of Medical Sciences. Sheikh Hamdan Bin Rashid Al Maktoum Award for Medical Sciences. Dubai, United Arab Emirates 9th October, 2010. THESIS SUPERVISION Omar Al-Farsi Qualification: M.Sc.

Title: The prevalence of Autistic Spectrum Disorders in Oman. departments

Supervisor Dr. Marwan Al-Sharbati care Date of completion: August 2010

Maha Al-Khalili patient Qualification: M.Sc. and

Title: Nutritional Factors in Autism

Supervisor Dr. Marwan Al-Sharbati academic Behavioural Medicine 29 Annual Report 2010-2011 Behavioural Medicine

Date of completion: On going

Samia Al-Fahdi Qualification: M.Sc. Title: The clinical correlate of autism in Oman Supervisor Dr. Marwan Al-Sharbati Date of completion: On going

Dr. Aziz Al-Naamani Qualification: PhD Title: Neuropsychiatric syndrome in Oman among the victim of acquired brain injury, Supervisor: Dr. Samir Al-Adawi Date of completion: On going

Tayyiba Almarri Qualification: PhD

Title: Investigating alcohol consumption patterns, associated cognitions & behaviors of Arab Nationals living in the Arabian Gulf countries

Supervisor: Dr. Samir Al-Adawi

Date of completion: On going

30 departments

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academic Behavioural Medicine 31 Annual Report 2010-2011 Biochemistry

Biochemistry

he Department of Biochemistry is involved in both pre-clinical and clinical teaching. In the pre-clinical years, teaching con- centrates mainly on basic principles of biochemistry and metabolism. Teaching in the clinical years is devoted to clinical chemistry, including interpretation of biochemical data on patients. The Department is also engaged in teaching medical Tlaboratory science to undergraduates; biochemistry to nursing students, and offers a graduate program leading to an M.Sc. degree in Biomedical Sciences and/or Clinical Biochemistry. A Ph.D. programme by research has also been offered since 2009. The Department has also been recognised by the Royal College of Pathologists, London, in relation to postgraduate education through the Oman Medi- cal Specialty Board (OMSB).

The major research activities are focused around the development of molecular tests for detecting and mapping mutations associ- ated with various genetic disorders including hypertension, diabetes, deafness and hyperlipidaemias. The Department has a total of eight academic staff in addition to four consultants at SQUH who are also involved in the teaching programmes. There are seven biomedical research scientists in the College who are involved in research run by the Department.

The Department also provides a clinical biochemistry service to Sultan Qaboos University Hospital (SQUH) on a 24-hour basis and serves as a referral laboratory for hospitals all over the Sultanate. Twenty one biomedical scientists serve the Department at SQUH.

32 Staff Mohammed Al-Kindi, Chief Biomedical Scientist (College) Head of Department Hameeda Al-Barwani, Senior Biomedical Scientist Riad Bayoumi, Professor (College) Faculty Mohammed Al-Toubi, Biomedical Scientist (Col- lege) Jumana Saleh, Associate Professor Abdulrahim Al-Abri, Biomedical Scientist (College) Nadia Al-Wardy, Associate Professor Sana Hasari, Biomedical Scientist (College) Hamza Babiker, Associate Professor Taruna Dutt, Coordinator (College) Clifford Abiaka, Assistant Professor Marina Bendecio, Coordinator (Clinical) Marit Delghandi, Assistant Professor Yahya Tamimi, Assistant Professor Yajnavalka Banerjee, Assistant Professor Highlights of the Year David Nkansa-Dwamena, Senior Consultant Khalid Al-Rassadi, Consultant 2010-2011 Nafila Al-Riyami, Consultant H.E. Dr. Nadia Al-Wardy was promoted to Associ- Khalid Al-Waili, Consultant ate Professor and continues as a member of the Maha Al-Riyami, Lecturer State Council. Dr. Jumana Saleh was awarded the Amani Al-Khaifi, Lecturer University Best Teacher award. Ms. Arwa Al-Kindi Arwa Al-Kindi, Demonstrator joined the Department as a Demonstrator. Dr. Yaj Banerjee was appointed as Coordinator of the B.Sc. Support Staff Medical Laboratory Sciences Programme.Dr. David George Khaukha, Superintendent (College) Nkansa Dwamena left the Department in this pe- Halima Adnan, Superintendent (Clinical) riod. Mater Al-Maney, Chief Biomedical Scientist (Clini- cal) Adil Al-Wahaibi, Chief Biomedical Scientist (Clinical) Teaching Programmes departments

Younis Al-Musafir, Senior Biomedical Scientist (Clinical) UNDERGRADUATE MEDICAL Romulo Cipriano, Senior Biomedical Scientist (Clini- PROGRAMME care cal) The Department is teaching Biochemistry in both Suleiman Al-Riyami, Senior Biomedical Scientist the old and new MD curricula on the following (Clinical) courses: Molecular Biology & Introductory Genet- patient Hamed Al-Riyami, Senior Biomedical Scientist ics; Metabolism; Foundation Biochemistry; Enzy- (Clinical) mology and Metabolism; Alimentary System, and and Sameera Al-Harrasy, Senior Biomedical Scientist Applied Medical Sciences. The Department also (Clinical) participates in various system courses like Hemo- academic Biochemistry 33 Annual Report 2010-2011 BiochemistryAnnual Report 2010-2011 Biochemistry

poietic System, Endocrine System, Respiratory System, Tissues, Urinary System, 7th year clinical rotations, the Integrated Lecture Series, and the student Research Project.

B.Sc . MEDICAL LABORATORY SCIENCES (MLS) The Department is teaching on the MLS degree in Semesters 6 through 10. It also offers courses in Molecular Diagnostics and in Clinical Chemistry - Specialization I, II and III.

NURSING DEGREE The Department of Biochemistry is teaching Biochemistry for Nursing students.

POSTGRADUATE PROGRAMMES In the postgraduate programme, the Department offers the following courses: Biochemical basis of Disease; Instrumentation and Biochemical Techniques; Molecular Biology, and

Methodology in Clinical Biochemistry. In this period, the Department had 11 students registered for an M.Sc. degree and 4 students studying for their Ph.D.

Clinical & Diagnostic Services SERVICE PROVISION The Department of Clinical Biochemistry provides a wide range of routine and specialised investigations. Some of the specialised tests are unique in Oman and hence the Department offers a referral laboratory service for such investigations. Service is provided to the SQU hospital on 24-hour basis. The number of tests performed from January to December 2011 was 1,493,199.

Clinical Biochemistry Department manages the Commercial Laboratory Services offered to some selected hospitals within the private sector, e.g. Muscat Private Hospital, Badar Al Samaa Polyclinic and Hatat Poly- clinic.

NEW TESTS The Serum Tobramycin and Urine Metanephrines assays have been introduced in the laboratory.

EXPANSION OF THE METABOLIC SERVICES The Department has acquired the following new equipment in order to improve the metabolic service and provide the associated tests locally: 1) High performance liquid chromatography (HPLC) for plasma/urine

34 amino acids analysis; 2) Tandem mass spectrometry (TMS) for screening for acylcarnitine and amino acids on dried blood spots and 3) DELFIA system for the assay of some metabolic disorders; this includes bioteni- dase, total galactose, GALT and 17-OH progesterone assays.

POINT OF CARE TESTING (POCT) The Department maintains quality assurance of the blood gas analyser outside the laboratory, i.e. in the Emergency Medicine Department, the operating theatre, and Intensive Care and Neonatal units.

TEACHING Teaching is conducted by Senior Biomedical Scientists staff (superintendent, chief and seniors) and clinical staff (professor and chemical pathologist). The mode of instruction includes lectures, seminars and practical demonstration of methods, techniques and instrument operation.

PRE-ANALYTICAL PHASE The Department has introduced regular sessions to emphasise the importance of the pre-analytical phase to nurses. This session is also included in the I.V. Therapy course for nurses during the induction programme.

EXTERNAL QUALITY ASSURANCE The Department continues to participate in the Royal College of Pathology of Australia External Quality As- surance programme.

1500

1250

1000 departments

750

No. of tests x 1000 No. 500 care

250

0 patient

2005 2006 2007 2008 2009 2010 2011 Year

and Figure 1: Diagnostic Services 2005-2011 academic Biochemistry 35 Annual Report 2010-2011 Biochemistry

RESEARCH RESEARCH PROJECTS The Clinical and genetic characterization of type 2 diabetes mellitus in Omanis Project code: RC/MED/BIOC/10/01; Dates: 2010 Value: OR 87,300; Project Funder: The Research Council, Oman Investigators: Prof. Riad Bayoumi, Dept. Biochemistry, SQU; Prof. Mohammed Hassan, Dept. Physiology, SQU; Dr. Sulayma Albarwani, Dept. Physiology, SQU; Prof. Nicolas Woodhouse, Dept. Medicine, SQU; Dr. Omayma El-Shafie, Dept. Med- icine, SQUH; Dr. Mohammed Al Shafaee, Dept. Family Medicine & Public Health, SQU.

Searching for the origin of human lactase persistence in the Southern part of the Arabian Peninsula Project code: IG/MED/BIOC/10/02; Dates: 2010–2011 Value: OR 13,100; Project Funder: Sultan Qaboos University Investigators: Prof. Riad Bayoumi, Dept. Biochemistry, SQU; Abdulrahim Al-Abri, Dept. Biochemistry, SQU.

The brunt of mutations conferring drug resistance on the fitness of malaria parasites Project code: IG/MED/BIOC/09/02; Dates: 2009-2011 Value: OR 18,500; Project Funder: Sultan Qaboos University, Oman Investigators: Dr. Hamza Babiker, Dept. Biochemistry, SQU; Dr. Petra Schneider, Institute of Infection & Immunology Research, Edinburgh University; Dr. Gote Swed- berg, Department of Medical Biochemistry & Microbiology, Uppsala Univer- sity, Sweden.

Evaluation of the status and prevalence of deficiency of vitamin D in Omani adults with particular focus on pregnant Omani women Project code: IG/MED/BIOC/09/01; Dates: 2009-2011 Value: OR 9,000; Project funder: Sultan Qaboos University Investigators: Dr. Clifford Abiaka, Dept. of Biochemistry, SQU; Dr. Lovina Machado, Dept. of Obstetrics & Gynaecology, SQU.

36 A study of the effect of pregnancy-related thyroid autoimmunity and oxidative stress in Omani women from conception to parturition Project code: IG/MED/BIOC/10/04; Dates: 2010-2012 Value: OR 7,000; Project funder: Sultan Qaboos University Investigators: Dr. Clifford Abiaka, Dept. of Biochemistry, SQU; Dr. Lovina Machado, Dept. of Obstetrics & Gynaecology, SQU.

Physiological Lipids as Modulators of Thrombin generation Project Code: IG/MED/BIOC/11/01; Dates: 2011-2013 Value: OR 10,000; Project Funder: Sultan Qaboos University Investigators: Dr. Yaj Banerjee, Dept. of Biochemistry, SQU; Dr. Jumana Saleh, Dept. of Biochemistry, SQU; Prof. Riad Bayoumi, Dept. of Biochemistry, SQU; Dr. Khalid Al-Rassadi, Dept. of Biochemistry, SQU.

Identifying Candidate Genes for Heart Pacemaker Control in Oman Family Study Project code: IG/MED/BIOC/10/03; Dates: 2009-2010 Value: OR 3,353; Project funder: Sultan Qaboos University Investigators: Dr. Marit P. Delghandi, Dept. Biochemistry, SQU; Prof. Riad Bayoumi, Dept. Biochemistry, SQU; Prof. Mohammed O. Hassan, Dept. Physiology, SQU; Dr. Sulayma Albarwani, Dept. Physiology, SQU.

A Study of the Highly Polymorphic Vitamin D binding Protein in a healthy Omani Population Project code: MREC # 328; Dates: 2010-2011 Value: OR 1,893; Project funder: Sultan Qaboos University departments Investigators: Dr. Marit P. Delghandi, Dept. Biochemistry, SQU; Dr. Clifford Abiaka, Dept. Biochemistry, SQU. care

Retrospect Analysis of incidence of Failure to Mature of Arterio- Venous Fistula (AVF) performed at SQUH Project Code: MREC# 381; Dates: 2010 patient Value: Unfunded

Investigator: Dr. Dawood Al-Riyami, Dept. Biochemistry, SQU. and

academic Biochemistry 37 Annual Report 2010-2011 Biochemistry

Validity of Serum Free Light Chain Assay in the Diagnosis and Monitoring of Patients with Monoclonal Gammopathy Project Code: MREC# 398; Dates: 2011 Value: Unfunded; Project Approval: Sultan Qaboos University Investigators: Dr. Moza Al Nabhani, Dept. Biochemistry, SQU.

Maternal Predictors of Fetal Birth Weight in non-diabetic Omani Women Project Code: MREC# 427; Dates: 2011 Value: Unfunded; Project Approval: Sultan Qaboos University Investigators: Dr. Jumana Saleh, Dept. Biochemistry, SQU.

HLA-DRB1 Shared Epitope Analysis and Single Nucleotide polymorphism Screening of the PTPN22 Gene in Omani Patients affected with Rheumatoid Arthritis Project Code: MREC# 458; Dates: 2011 Value: Unfunded; Project Approval: Sultan Qaboos University Investigators: Dr. Yahya Tamimi, Dept. Biochemistry, SQU. RESEARCH PUBLICATIONS & BOOKS Journal Publications 1. Joshi SN, Fathalla M, Koul R, Maney MA, Bayoumi RA. Biotin responsive seizures and encephalopathy due to biotini- dase deficiency. Neurol India 2010; 58:323-4. 2. Banerjee Y, Bayoumi R, Farook SM. Could deadly snake venom save lives? Sultan Qaboos University Med J 2010; 10:142-3. 3. Al-Amri MS, Alrasadi K, Bayoumi RA, Banerjee Y. In silico design of novel anticoagulant peptided targeting blood coagulation factor VIIa. Sultan Qaboos University Med J 2011; 11:83-94. 4. Hassan MO, Jaju D, Voruganti VS, Bayoumi RA, Albarwani S, et al. Genome-wide linkage analysis of hemodynamic parameters under mental and physical stress in extended Omani Arab pedigrees: the Oman Family Study. Twin Res Hum Genet 2011; 14:257-67. 5. Al-Tobi M, Kashoob M, Joshi S, Bayoumi R. A novel splice-site allelic variant is responsible for Wilson Disease in an Omani Family. Sultan Qaboos Univ Med J 2011; 11:357-62. 6. Saleh J, Al Wardy N, Farhan H, Al Khanbashi M, Cianflone K. Acylation Stimulating Protein: A Female Lipogenic Fac- tor? Obes Rev 2011; 12:440-8. 7. Saleh J. Maternal Triglycerides: Underestimated predictors of neonatal birth weight. Sultan Qaboos University Med

38 J 2011; 11:417. 8. Saleh J, Rabab A. Acylation stimulating protein plasma levels are strongly predicted by waist /hip ratio and correlate with atherogenic risk factors in Omani males. XVII International Symposium on Drugs Affecting Lipid Metabolism: DALM XVII. Abstract book, P. 35. March 2011. 9. Sutherland C, Babiker HA, Mackinnon MJ, Ranford-Cartwright L, El Sayed B. Rational deployment of antimalarial drugs in Africa: should first-line combination drugs be reserved for paediatric malaria cases? Parasitology 138:1459- 68. 10. Babiker HA. The role of crossing and recombination in dissemination of drug resistance in Plamodium falciparum: filed observation. Revista CENIC. Lencias Biologicas, Vol. 41, INF001. 11. Reece S, Ali E, Schneider P, Babiker HA. Stress, drugs and evolution of reproductive restraint in malaria parasites. Proc Roy Soc Lond B 22; 277:3123-9. 12. Kheir A, Nwakanma D, Akbarov Y, Al-Saai S, Al-Gazali A, Swedberg G, Babiker HA. Transmission and cross-mating of high-level resistance Plasmodium falciparum dhfr haplotypes in the Gambia. Am J Trop Med Hyg 2010; 82:535-41. 13. Taranikanti V, Banerjee Y. Antihypertensive treatment of patients with cardiovascular disease but without hyper- tension. JAMA 2011; 305:2170. 14. Taranikanti V, AlRiyami M, Banerjee Y. Initial combination therapy for treatment of hypertension. Lancet 2011; 377:1490-1. 15. Banerjee, Y, Taranikanti V, AlRiyami M. Can antihypertensive drugs raise the risk of cancer? Trends Mol Med 2011; 17:175-6. 16. Banerjee Y, Taranikanti V, Bayoumi R. Assays for multi-drug resistant (MDR) and extremely drug resistant (XDR) tuberculosis in high burden countries. Lancet Infect Dis 2011; 11:161-2. 17. Banerjee Y. Pakistan: the brain drain dilemma. Nature 2010; 467:378-9. 18. Banerjee Y, Taranikanti, V, Bayoumi R. Triglyceride-mediated pathways and coronary heart disease. Lancet 2011; 376:956-8. 19. Vesterlund M, Zadjali F, Persson T, Nielsen ML, Kessler BM, et al. The SOCS2 Ubiquitin Ligase Complex Regulates

Growth Hormone Receptor Levels. PLoS One 2011; 6:e25358. departments

20. Zadjali F, Pike AC, Vesterlund M, Sun J, Wu C, Li SS, et al. Structural basis for c-KIT inhibition by the suppressor of cytokine signaling 6 (SOCS6) ubiquitin ligase. J Biol Chem 2011; 286:480-90. care

CONFERENCE & SEMINAR PRESENTATIONS Conference Presentations patient

International and

1. Bayoumi RA. Prediabetes in Oman. 4th International Congress on Prediabetes and the Metabolic Syndrome. Madrid, Spain, 7-11 April 2011. 2. Bayoumi RA. The Genomics of Common Diseases, Wellcome Trust Genome Campus. Cambridge, UK, 30 August – 2 academic Biochemistry 39 Annual Report 2010-2011 Biochemistry

September 2011. 3. Al Wardy NM, Keynote Speech. Curricula Transformation in Medical Faculties Conference. Damascus University, Syria, October 2010. 4. Al-Wardy NM, Al-Kindi M, Al-Khabouri M, Alasti F, van Camp G, del Castillo I, Bayoumi R. Otoferlin [OTOF] gene vari- ants responsible for hearing loss in two Omani families. 3rd Pan Arab Human Genetics Conference. Abstracts P.34. Dubai, UAE, March 2010. 5. Al Wardy NM. The Five Questions on Assessment Answered. AMEE, International Association for Medical Education Conference. Abstracts 4U1. Glasgow, UK, September 2010. Seminar Presentations National 1. Al Wardy NM. Preparation for Examinations. CoM&HS, Sultan Qaboos University, Muscat, Oman, December 2010. 2. Al Wardy NM, Keynote speech. White Coat Ceremony, Oman Medical College, Sohar Campus, Oman, January 2011. 3. Al Wardy NM. Assessment of Competence. Al Nahdha Hospital, Ministry of Health, Oman, April 2011. 4. Saleh J. Acylation stimulating protein plasma levels are strongly predicted by waist/hip ratio and correlate with atherogenic risk factors in Omani males. XVII International Symposium on Drugs Affecting Lipid Metabolism XVII. Qatar, March 2011. 5. Babiker HA, Can imported malaria jeopardize the success of malaria control in Oman? Lucca (Barga), Italy, 31 July 31 – 5 August 2011. THESIS SUPERVISION Sawsan Al-Sinani Qualification: Ph.D. Title of Thesis: The clinical and genetic characterization of type 2 diabetes mellitus in Omanis Supervisor: Prof. Riad Bayoumi Date of Completion: In Progress

Amal Gadalla Qualification: Ph.D. Title of Thesis: Factors influencing malaria parasites Plasmodium falciparum transmission strategies Supervisor: Dr. Hamza Babiker

40 Date of Completion: In Progress

Amani Ahmed Qualification: Ph.D. Title of Thesis: Genetic mapping of drug resistant Plasmodium falciparum in Sudan. Supervisor: Dr. Hamza Babiker Date of Completion: In Progress

Student Name: Bashair Al-Riyami Qualification: Ph.D. Title of Thesis: Hormonal regulation of acylation stimulating protein production and receptor expression in rodent regional adipose tissue. Supervisor: Dr. Jumana Saleh Date of Completion: In Progress

Najma Al-Kharusi Qualification: M.Sc. Title of Thesis: Effect of elagic acid on cisplatin-induced nephorotoxicity in rats Supervisor: Dr. Hamza Babiker Date of Completion: August 2011

Zeinab Al-Hashmi Qualification: M.Sc. departments

Title of Thesis: Population structure of Plasmodium falciparum and spread of chloroquine resistance in Saudi Arabia care Supervisor: Dr. Hamza Babiker Date of Completion: December 2010 patient Sheikha Al-Harthy

Qualification: M.Sc. and

Title of Thesis: Screening for p53 mutations using archive al material in an Omani cohort with diffuse large B-cell lymphoma academic Biochemistry 41 Annual Report 2010-2011 Biochemistry

Supervisor: Dr. Yahya Tamimi Date of Completion: March 2011

Aisha Al-Busaidi Qualification: M.Sc. Title of Thesis: The putative regulation of K-Ras/B-Raf pathway by Sos ½ protein in colon cancer cell lines Supervisor: Dr. Yahya Tamimi Date of Completion: September 2011

Suad Nasib Al-Mustaheil Qualification: M.Sc. Title: TG/HDL ratio as a surrogate predictor of LDL size and oxidizability in Omani subjects. Student Supervisor: Supervisor: Dr. Jumana Saleh Date: In Progress

42 departments

care

patient

and

academic Biochemistry 43 Annual Report 2010-2011 Child Health

Child Health

he Department of Child Health is one of the most active departments of the College of Medicine & Health Sciences (COMHS) and SQU Hospital (SQUH). The Department accounts for more than a third of total SQUH admissions and provides the best of Tpatient care from birth to adolescence, encompassing all sub-specialties including Developmental Paediatrics and Cardiology. It has well-developed undergraduate teaching and training programmes collaborating with other institutions locally and interna- tionally. Department members are actively involved in almost all of the College educational activities and committees including the Curriculum and Examination committees. Department members have contributed significantly to the development and implemen- tation of the new curriculum. The Department trains many foreign undergraduate medical students during their elective rotations.

The Department has also a highly integrated postgraduate training programme and is equipped with excellent Clinical Teaching Units (CTUs) run by experienced teachers. Our Department started the first CTU in Oman and has been complimented on this by international medical educationists. Various departments have followed suite, thereafter. The Department teaches and trains junior doctors, preparing them for various examinations affiliated to the Royal College of Paediatrics and Child Health (UK), Royal College of Physicians and Surgeons of Glasgow and the Arab Board. The Department is the only centre in Oman offering subspecialty train- ing of pediatric residents in metabolic diseases, neurology, immunology and haemato-oncology. It also serves as the national refer-

44 ral centre for polio surveillance and various benign of renovation work has been done, and new duty haematological conditions and leukaemia. The Ge- rooms, isolation rooms and procedure rooms have netic-Metabolic Unit has expanded and moved to been built at various paediatric wards. It is a long a dedicated building, in order to cater for the over- cherished dream of the Department to establish whelming numbers and this is well supported by a world class Institute of Child Health with great the Development Progress Clinic, introduced by Dr. emphasis on research as a joint venture between Watfa Al-Mamari. The Cardiology services offered SQUH and the College of Medicine. by Dr. Khalfan Al-Senadi have been a great blessing to patients, who earlier had long waits to be seen at the Royal Hospital. The long term follow-up clinics, Staff including the Post BMT clinic and the Cancer Sur- vival Clinic are in full swing, along with the Chemo- Head of Department therapy Clinic. The Haemophilia Comprehensive Yasser Wali, Associate Professor Care Clinic and the Haemostasis Follow-up Clinic Faculty will soon be started. Zakia Al-Lamki, Professor Finally, the Department conducts high quality re- Muna Al-Saadoon, Assistant Professor search with state-of-the-art support from the ge- Hussein Al-Kindy, Senior Consultant netic laboratories producing publications in high Amna Al-Futaisi, Senior Consultant impact peer reviewed indexed journals. Collabo- Saif Al-Yaarubi, Senior Consultant ration with international centres of excellence in Ibtisam B. Elnour, Senior Consultant paediatrics has benefited a large number of sick Salem Al-Tamemi, Senior Consultant children, especially those with haematological dis- S.N. Joshi, Senior Consultant eases. Roshan L. Koul, Senior Consultant P.C. Alexander, Senior Consultant The Department also takes great pride in continu- Khalfan Al Senadi, Consultant ing to serve the community, raising funds to serve Matthew Zachariah, Consultant departments children with all kinds of special needs in various Siham Al-Sinani, Consultant ways. The School Health Education Programme Reem Abdwani, Consultant care has been an innovative initiative by the Depart- Mohamed Abdellatif, Consultant ment addressing issues of healthy life style, alcohol Abdulhakim Al-Rawas, Consultant and drug abuse, obesity/ healthy diet for children Dana Al-Nabhani, Consultant Anas Al-Wogud, Consultant studying in various schools. patient Hashim Javad, Consultant Watfa Al Mamari, Consultant Lack of space, technological support and person- and nel have limited performance in both academic Azza Al Sidhani, Senior Registrar and clinical areas. Within the existing space, lots Irfan Ullah, Senior Registrar academic Child Health 45 Annual Report 2010-2011 Child Health

Masood Ahmed, Senior Registrar Highlights of the Year Mohamed Elshinawy, Senior Registrar Wafa Bashir, Senior Registrar 2010-2011 Kripail Mathew, Senior Registrar Syed R. Haider, Senior Registrar COMMUNITY & CLINICAL SER- Zenaida Reyes, Senior Registrar VICE Aamir Qais MH, Registrar A public information and knowledge article about the Maria F. Bataclan, Registrar metabolic diseases services at SQUH was published Mohammed Fazalullah, Registrar in the Times of Oman on 20 February 2011. An aware- Naga Ram Dhande, Registrar ness article on the same topic was written by Dr. S. N. Surekha Tony, Registrar Joshi and published in issue 211 of Horizon, the maga- Renjit Mani, Registrar zine of the SQU Department of Public Relations & In- Rana Abelrahim, Registrar formation. We also initiated a PICU registry with The Ismail Beshlawi, Registrar Australian and New Zealand Paediatric Intensive Care Mohammed A. El Naggari, Registrar Registry. We were able to initiate new ventilation mo- Ashfaq Khan, Senior House Officer dalities, such as high-frequency oscillation, in both the Ashraf A. Saad, Senior House Officer PICU and the NICU. We started a policy of plasmapha- Eiman Abdalla, Senior House Officer resis in babies under 10 kg. and ventilating babies un- Hilal Al-Mandhari, Senior House Officer der 3 kg. We are now accepting postoperational surgi- Joseph Manji, Senior House Officer cal cases, a service which was not available before in Laila Al-Yazdi, Senior House Officer SQUH. Mazen A.M. Abuanza, Senior House Officer Shafiq U. Rehman, Senior House Officer INTERNATIONAL VISITORS Sharef W.Sharef, Senior House Officer Prof. George F. Hoffman, Professor of Metabolic Dis- Yusriya Al Rawahi, Senior House Officer ease at Ruprecht-Karls University, Heidelberg, Ger- Support Staff many, and Prof. Sue Bennett, Child & Youth Protection Aisha Al-Maskary, Coordinator (College) Director, University of Ottawa Children’s Hospital, On- Jolina Balasta-Pogoy, Coordinator (Hospital) tario, Canada, visited our Department and interacted Aisha Al Rawahi, Social Worker with all the Departmental members. Fatma Al-Farsi, Play Therapist Amna Al Alawi, Play Therapist SCHOLARLY & ACADEMIC AC- Kawther Al-Khusaibi, Play Therapist TIVITIES Fathiya Al Zadjali, Play Therapist Dr. S. N. Joshi and Dr. Hussein Al-Kindy collaborated in an international molecular epidemiology and diagno- sis study of common inborn errors of metabolism dis- orders in Oman and the UAE. The research was funded

46 by UAE University and the SQU Cooperative Research Grant Participants fund.

In this period, Dr. Yasser Wali, Dr. Muna Al-Sadoon and Dr. Zakia Al-Lamki served on the Editorial Board of the SQU Medical Journal. Dr. Amna Al-Futaisi, Dr. Saif Al-Yaarubi and Dr. Reem Abdwani served on the Editorial Board of the Oman Medical Journal. Dr. Roshan Koul was a member of the International Advisory Board of the Journal of Pediatric Neurology. Dr. Yasser Wali was a reviewer for the Journal of Pediatric Hematology/ Oncology, the Postgraduate Medical Journal, Sultan Qaboos University Medical Journal, Oman Medical Jour- nal, and the Alexandria Journal of Pediatrics. Dr. Roshan Koul was a reviewer for the Oman Medical Journal, SQU Medical Journal, Saudi Medical Journal, Neurosciences, Neurology India and the Journal of Pediatric Neurology.

The Department organised four conferences during this period. In January 2011, Dr. S. N. Joshi organised a conference on the Metabolic Disease Services at SQUH: Past Present and Future, along with the first Oman Metabolic Awareness Day. A Nutrition Workshop for Metabolic Diseases was held on the same day. A semi- nar on Medical Awareness of Hemophilia was organised on Hemophilia Day, 7th July 2011, by Dr. Yasser Wali. A lecture from an invited speaker from Canada about child protection was organised by Dr. Ibtisam Elnour and Dr. Muna Al-Saadoon. Lastly, a symposium was organised by Dr. Zakia Al-Lamki at the Crowne Plaza Hotel on 29 September 2011. This was a joint educational event together with the World Federation of Hemophilia.

Teaching Programmes The Department is actively involved in undergraduate and postgraduate teaching.

UNDERGRADUATE PRECLINICAL PROGRAMME The Department is committed to the process of delivering to undergraduate students the main concepts and principles of child health that will help them to undertake their internship duties safely and also decide on departments their future postgraduate studies.

The Department has structured teaching activities for students under the responsibility of the clinical year care coordinators and the Education Committee of the Department. The students have different components of assessment during the rotations and at the end of the rotation, organised by the clinical coordinators and monitored by the Department’s Examination Committee patient

NEW CURRICULUM and The new curriculum has been successfully implemented, starting with the pre-clerkship, followed by junior clerkship. During the junior clerkship the students are posted to the Clinical Teaching Units, so that they get academic Child Health 47 Annual Report 2010-2011 Child Health

hands-on experience in patient management. They are allotted cases for which they are responsible, with adequate supervision by consultants and residents.

OLD CURRICULUM 7th Year Teaching At any time, the Department has about 15 students. The teaching of the 7th year students is divided into theoretical, clinical elements and self-learning with guidance. In addition, there are other teaching modali- ties implemented in the last 3 years that require one to one interaction between the students and tutors. In the HOPE Evaluation process, each student presents 2 cases to a tutor. At the end of the 1 hour session, stu- dents receive feedback with a grade. In total, the Department provides 1,540 contact hours of teaching and academic activities for 7th year students.

PRECLINICAL TEACHING Members of the Department are involved in the following courses in the preclinical programmes of the Col- lege: Clinical Communications and Clinical Skills.

POSTGRADUATE TEACHING The morning meetings provide an hour of clinical teaching every day in the form of clinical meetings, case presentations, grand rounds, histopathology meetings and clinical radiological meetings. In addition to this, there are weekly presentations for interns, and monthly journal club / mortality meetings.

The Department has 10-14 interns on average for training. The Department is involved in teaching Oman Medical Specialty Board (OMSB) residents as follows. At any time of the year, the Department has around 3-4 child health residents for training. Three Department members are invited yearly to give presentations to Family Medicine & Public Health residents on common childhood diseases. One Department member is invited yearly to deliver a clinical presentation to the A&E residents.

Dr. Yasser Wali is the convener of the Clinical Ph.D. Program, a new degree programme of College of Medicine and Health Sciences

The Department conducts the examination towards Membership of the Royal College of Paediatrics & Child Health (MRCPCH) and is the centre for Diploma of Child Health (DCH) examination every year, in collabora- tion with the concerned international bodies.

The Department runs the following training courses: Neonatal Advance Resuscitation Course (3 times a year); Paediatric Advance Life Support (twice a year); MRCPCH Course (once a year), and contributes towards other courses offered by hospitals such as Basic Life Support (BLS) and Pain Management.

48 Table 1: Paediatric Inpatients 2010-2011 Year No. of Admissions Average Bed Occupancy Average Length of Stay (Days) 2011 4,179 66 4.1 2010 4,753 70.1 3.3 Table 2: Paediatric Day Care Unit Year No. of Admissions Average Bed Occupancy Average Length of Stay (Days) 2011 3,820 3,702 5 2010 2,576 2,486 4−6 Table 3: Paediatric Outpatients Year Booked Total Seen Admitted Discharged 2011 14,370 11,690 323 959 2010 13,534 10,970 301 924 Table 4: Neonatal Intensive Care Unit Year No. of Admissions Average Bed Occupancy Average Length of Stay (Days) 2011 526 77 11.2 2010 444 85 14 departments Table 5: Postnatal Ward Year No. of Admissions Average Bed Occupancy Average Length of Stay care (Days) 2011 2,320 85 2.2 patient

2010 2,490 80 2.3 and

academic Child Health 49 Annual Report 2010-2011 Child Health

Table 6: Paediatric Intensive Care unit Year No. of Admissions Average Bed Occupancy Average Length of Stay (Days) 2011 194 81 7.51 2010 158 80 8 Table 7: Paediatric services provided to the Department of Clinical Physiology: electroen- cephalogram (EEG); brainstem auditory evoked response (BAER); visual evoked potential (VEP); somatosensory evoked potential (SSEP); Video EEG; electromyography (EMG); nerve conduction velocity (NCV); echocardiography; 24-hour oesophageal Ph monitoring; new- born audiometric sreening 2011 4,735 2010 1,081

Research RESEARCH PROJECTS Integrative investigation and applied molecular epidemiology of cystic fibrosis in Oman Project Code: IG/MED/CHILD/09/01; Dates: 2010–2011 Value: OR 19,900; Project Funder: Sultan Qaboos University Investigators: Dr. Hussein Al-Kindi, Dept. Child Health, SQU; Dr. Said Al-Yahyaee, Dept. Genetics, SQU; Dr. Allal Ouhtit, Dept. Genetics, SQU; Dr. Uwe Fass, Dept. Bio- chemistry, Oman Medical College; Qaseem Al-Salmi, Dept. Child Health, Royal Hospital, Oman.

Genetic causes of congenital neutropenia Project Code: IG/MED/CHILD/10/01; Dates: 2010–2012 Value: OR 9,600; Project Funder: Sultan Qaboos University Investigators: Dr. Yasser Wali, Dept. Child Health, SQU; Dr. Christoph Klein, Dept. Pediatric Hematology-Oncology, Hannover Medical School, Germany; M. Al-Zalabany, Dept. Pediatric Immunology, Alexandria University, Egypt; Dr. Said Al-Yahy- aee, Dept. Genetics, SQU; Dr. Ismail El-Beshlawi, Dept. Child Health, SQU;

50 Dr. Naglaa Fawaz, Dept. Hematology, SQU; Dr. Aisha Alkhayat, Dept. Biology, College of Science, SQU; Dr. Salem Al-Tamemi, Dept. Child Health, SQU; Ms Khalsa Al-Kharousi, Department of Genetics, SQU; Dr. Shahina Daar, Dept. Haematology, SQU; Dr. Martin Zimmermann, Dept. Statistics, Hannover Medical School, Germany.

Assessment of Aortic and carotid intima media thickness and arterial stiffness indices in Omani children with type 1 diabetes mellitus Project Code: IG/MED/CHILD/11/01; Dates: 2011 Value: OR 7,500; Project Funder: Sultan Qaboos University Investigators: Dr. Saif Al Yaarubi, Dept. Child Health, SQU; Dr. Khalid Alrasadi, Dept. Clini- cal Biochemistry, SQU; Dr. Khamis Al-Hashmi, Dept. Clinical Physiology, SQU; Dr. Humood Al-Dhuhli, Dept. Radiology & Molecular Imaging, SQU; Dr. Faisal Al-Azri, Dept. of Radiology & Molecular Imaging, SQU; Dr. Ibrahim Al- Zakwani, Dept. Clinical Pharmacy, SQU.

A Prospective Observational Study on the Home Treatment with of rFVIIa (active recombinant factor VII) of Haemarthrosis in Haemophilia A and B Patient with Inhibitors Project Code: MREC # 377; Dates: 2010 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. Yasser Wali, Dept. Child Health, SQU.

Choledochal Cysts in Oman, How Different Project Code: MREC # 378; Dates: 2010 Value: Unfunded; Project Approval: Sultan Qaboos University departments Investigator: Dr. Siham Al-Sinani, Dept. Child Health, SQU.

Active Drug Surveillance Program of Ferriprox Use care

Project Code: MREC # 395; Dates: 2010 Value: Unfunded; Project Approval: Sultan Qaboos University patient Investigator: Dr. Yasser Wali, Dept. Child Health, SQU. and

academic Child Health 51 Annual Report 2010-2011 Child Health

Experience with early vs. late TPN in very low birth weight babies in SQUH in Oman Project Code: MREC # 434; Dates: 2011 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. Amitha Rao Aroor, Dept. Child Health, SQU

Pattern of Childhood Mortality in SQUH Project Code: MREC # 477; Dates: 2011 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. Anas Alwogud, Dept. Child Health, RESEARCH PUBLICATIONS & BOOKS Book Chapters 1. Al Sadoon MA, Elnour IB, Al Abduwani J, Yasmeen A Jaffar. Child Abuse & Neglect prevention in Oman. In: Preven- tion of Child Abuse & Neglect in Arabian Peninsula. International Society for Prevention of Child Abuse & Neglect (ISPCAN). ISPCAN: Aurora, CO, USA, 2011. Journal Publications 1. Wali Y, Mohib H. Effect of hydroxyurea on physical fitness indices in older children with sickle cell disease. Pediatr Hematol Oncol 2011; 28:43-50. 2. Wali Y, Almaskari S. Avascular Necrosis of the Hip in Sickle Cell Disease in Oman: Is it a serious enough to warrant bone marrow transplantation? Sultan Qaboos Univ Med J 2011; 11:127-8. 3. Wali Y, Zadjali SA, Elshinawy M, Beshlawi I, Fawaz N, et al. Severity ranking of non-deletional alpha thalassemic al- leles: insights from an Omani family study. Eur J Haematol 2011; 86:507-11. 4. Al Yaarubi S, Diabetes Care in Oman. Sultan Qaboos Univ Med J 2011; 11:343-8. 5. Al Yaarubi S, Accuracy of ultrasound-guided fine-needle aspiration cytology for diagnosis of carcinoma in patients with multinodular goiter. Indian J Endocr Metab 2011; 35:132-5. 6. Al Sadoon M, Elnour IB, Ganesh A. Shaken baby syndrome as a form of abusive head trauma. Sultan Qaboos Univ Med J 2011; 11:322-27. 7. Koul R, Al Futasi A, Al Sadoon MA, Elnour IB, et al. Vehicle entrapment and heat stroke in 3 children, is it a form of child neglect? Oman Med J 2010; 25:222-4.

52 CONFERENCE & SEMINAR PRESENTATIONS Conference Presentations International 1. Wali Y. Comprehensive management of Hemophilia In Oman. Saudi Hematology Society Meeting, Damam, Saudi Arabia, 22-23 December 2010. 2. Wali Y. Home therapy in Hemophilia: Oman Experience. Middle East and Arabian Gulf Hemophilia Advisory Board Meeting, Dubai, UAE, 10 December 2010. 3. Wali Y. Iron Chelation on areas of Ethnic Neutropenia. Iron Overload Workshop, Dubai, UAE , 20-21 November 2010. 4. Wali Y. Familial Hemophagocytic Lymphohistiocytosis. 23rd Annual Conference of the American Society of Pediat- ric Hematology/Oncology (ASPHO), Montreal, Canada, 7-10 April 2010. 5. Wali Y. T2^ MRI in Management of Children with Thalassemia Major. 8th Egyptian Society of Pediatric Hematol- ogy/Oncology (ESPHO) Conference, Alexandria, Egypt, 25-26 March 2010. 6. Wali Y. Pitfalls in Management of Anemia in Childhood. 9th International Congress ESPHO. Cairo, Egypt, 24-25 March 2011. 7. Hussein AK. CF in the Omani population. 2nd Congress of Arab pediatric Pulmonology Association (APPA). Beirut, Lebanon, 24-26 Nov 2010. 8. Tamemi S. Management of asthma and allergic rhinitis – a regional perspective, World Allergy Organization Confer- ence. Dubai, UAE, December 2010. 9. Tamemi S. C1 esterase inhibitor deficiency and angioedema. Allergy, Asthma & Clinical Immunology Symposium King Faisal Specialist Hospital & Research Centre. April 2011. Riyadh, Saudi Arabia. 10. Tamemi S. Primary immunodeficiency. International Conference on Laboratory Medicine. Sultan Qaboos Univer- sity, Muscat, Oman, November 2010. 11. Alsadoon MA, Elnour IB. Shaken Baby Syndrome, how can we approach. Cases when there is no child protection policy. XVIII ISPCAN International Congress. Hawaii, USA, 26-29 September 2010. departments

12. Elnour IB, Al Sadoon MA. Can we help when we do not have child protection services? The experience in Oman. XVIII ISPCAN International Congress. Hawaii, USA, 26-29 September 2010.

13. Mevada ST, Wali Y. EARLY detection of cardiac and hepatic iron overload by T2* magnetic resonance in very young care

patients with thalassemia major in Oman. 52nd American Society of Hematology Meeting. Orlando, Florida, USA, 5-7 December 2010. 14. Wali Y. Comparison of activated factor VII and activated prothrombin complex in children with hemophilia a and patient

inhibitors, Oman Experience. Hemophilia Advisory Board Meeting. Dubai, UAE, 10 December 2010. 15. Wali Y. Update on iron chelation therapy in thalassemia major, Oman Experience. Saudi Hematology Society Meet- and ing. Damam Saudi Arabia, 22-23 December 2010. 16. Rawas A, Wali Y, Beshlawi I. Thimane responsive megaloblastic anemia in Oman: novel deletional phenotype asso- academic Child Health 53 Annual Report 2010-2011 Child Health

ciated with variable phenotypic severity. 24th Annual Conference of the American Society of Pediatric Hematology/ Oncology (ASPHO). Baltimore, USA, 7-10 April 2011. 17. Shinawy M, Wali Y, Fawaz N. Novel combinations of rare mutations reveal more insightson genotype-phenotype correlation of alpha thalassemia. 24th Annual Conference of the American Society of Pediatric Hematology/Oncol- ogy (ASPHO). Baltimore, USA, 7-10 April 2011. 18 Zacharia M, Hashami H, Wali Y. Efficacy of adding IV paracetamol to morphine in the management of vasocclus- sive crisis in children with sickle cell disease. 24th Annual Conference of the American Society of Pediatric Hematol- ogy/Oncology (ASPHO). Baltimore, USA, 7-10 April 2011. 19. Wali Y. Comprehensive management of hemophilia in Oman. The Best of St. Judith International Outreach Program. Dammam, Saudi Arabia, 16-17 April, 2011. 8. Al Sadoon M, Elnour IB. Shaken Baby Syndrome, The experience in Oman. 9th ISPCAN Asia Pacific Regional Conference on Child Abuse and Neglect. New Delhi, India, 6-9 October 2011. National 1. Wali Y. Management of immune thrombocytopaenic purpura (ITP) in childhood: A dilemma. 17th International Child Health Conference, Muscat, Oman, 13−15 October 2009. 2. Zakia Z, Al Sadoon M. Impact of living with thalassaemia major on the affected child, parents and siblings. 17th International Child Health Conference, Muscat, Oman, 13−15 October 2009. Poster Presentations International 1. Wali Y, Mevada ST. T2* magnetic resonance in pediatric patients with thalassemia major in Oman. 52nd ASH Annual Meeting. Orlando, Florida, 4-7 December 2011. 2. Elnour IB, Nabhani D, Naggari MA, Sankhla D. Renal malformations and scarring of children with UTI referred to SQU Hospital. 15th International Pediatric Nephrology Association Congress. New York, USA, 29 Aug–2 Sept 2010. 3. Tamemi S. Primary immunodeficiency deficiency in Oman, 1st report of the national registry at Sultan Qaboos Uni- versity Hospital. European Society for Immunodeficiency Conference. Istanbul, Turkey, October 2010. Abstract pub- lished in Clinical & Experimental Immunology. 4. Tamemi S. Inhalant allergens sensitization in patients with asthma and allergic rhinitis; review of skin test results over two years period at Sultan Qaboos University Hospital, Muscat, Oman. World Allergy Organization Conference. Dubai, UAE, December 2010. 5. Tamemi S. Management of asthma and allergic rhinitis - Regional prospective. World Allergy Organization Confer- ence. Dubai, UAE, December 2010. 6. Tamemi S. C1 esterase inhibitor deficiency and angioedema. King Faisal Specialist Hospital & Research Centre Meet- ing. Saudi Arabia, April 2011. 7. Tamemi S. Management of asthma and allergic rhinitis, regional prospective, 2nd Middle Eastern-Asian Congress of Allergy, Asthma & Immunology. Dubai UAE, April 2011. 8. Tamemi S. Diagnostic Approach in Primary Immunodeficiency. 2nd Middle Eastern-Asian Congress of Allergy, Asth-

54 ma & Immunology. Dubai UAE, April 2011. Seminar Presentations National 1. Tamemi S. Allergic disease. TV program on Health. Oman TV, Oct 2010. 2. Tamemi S. Anaphylaxis. CME activity. Al-Nahda Hospital, Muscat ,Oman, October 2010. 3. Tamemi S. Primary immunodeficiency in Oman. International Conference on Laboratory Medicine. Sultan Qaboos University, November 2010. 4. Tamemi S. Diagnostic testing for primary immunodeficiency. International Conference on Laboratory Medicine. Sultan Qaboos University, November 2010. 5. Hussein AK. Cystic fibrosis in the Omani population. University Day. Sultan Qaboos University, Muscat, Oman, May 2011. THESIS SUPERVISION Fatma Al-Harami Qualification: M.Sc. Title of thesis: Parameters of anerobic power and motor abilities in grade 3-7 female students in the Sultanate of Oman Supervisor: Dr. Yasser Wali Date of Completion: 2011 departments

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Emergency Medicine

ver since its establishment in 1986, the Department has been the leader in Emergency Medicine in Oman. We have set such high standards of care that we are an inspiration for other hospitals in the country. The Emergency Medical Services (EMS) in Oman is based on Anglo-American system of EMS. EMS brings almost all accident and most of the medical cases to our De- Epartment from Wilayat Seeb, which is one of the most densely populated wilayats (districts) of the whole Muscat region. Patients are managed with the highest possible care. The trauma team comprises emergency physicians, surgeons, anaesthetists and orthopedic surgeons. Patients have very good survival rates in our Department.

Our highly skilled and energetic team of emergency care physicians and nurses provide round the clock treatment, seven days a week, 365 days a year. At present, our department has 29 beds with a fully equipped triage desk with one doctor and two nurses to ensure prompt medical attention to all patients.

The Department has the most modern equipment, including different types of ventilators, conventional and non-invasive, sono- graphic machines and arterial blood gas (ABG) machines. There are separate Dental, ENT and Ophthalmologic examination rooms, equipped with a slit lamp and necessary ENT and dental equipment.

56 Our department is visited by approximately Staff 60,000 patients annually and is one of the major tertiary care facilities in the Governorate of Muscat Acting Head of Department having its own helipad used by different national Khalfan Al-Amrani, Consultant agencies in the event of disaster or any specific urgent medical situation. We also receive patients Medical Staff from different parts of the Sultanate, from as far as Nabil Al-Zadjali, Senior Consultant Salalah in the far south of the country. Daniel O. Ogunjumo, Senior Consultant Abdullah Al-Reesi, Consultant In an effort to fulfill the vision of the Department to Marwan Al-Raisi, (Paediatric) Consultant be a national model for the development of emer- Yousef Al-Weshahi, Senior Registrar gency medicine with the integration of interna- Magdy Shehata, Acting Consultant (left November tional standards, diversified training and learning 2010) activities are organised for different strata of health Moustafa Ashoor, Senior Registrar (left April 2011) care personnel involved in the department. Teodorico T. Diputado, Registrar (moved to Family A wide range of health care professionals are at- Medicine & Public Health, Nov. 2010) tached to the Department including undergradu- Remanand Sudhir, Registrar ate and postgraduate medical and nursing stu- Sabah Awad, Registrar dents from the University’s Colleges of Medicine Ashraf Ali, Registrar & Health Sciences and Nursing, the Oman Medical Mohammed F. Khilji, Registrar Specialty Board (OMSB), medical staff of the Royal Mohammed O. Mubashir, Registrar Court and Royal Affairs, the Ministry of Health, the Asma Al-Balushi, Registrar Health Institute, the Royal Oman Police and interns Awatif Al-Alawi, Registrar of the private Oman Medical College in Sohar. Amal Al-Shibli, Registrar Suad Al-Abri, Registrar The Department also actively participates in the Hilal Al-Barwani, Registrar (in training abroad) departments hospital and national planning of disaster manage- Sabina Naz, Registrar (Pediatric) ment and clinical research. Our department also Umar Shahzad, Registrar

Rasha Abdulhadi, Senior House Officer care regularly participates in all disaster drills organised by concerned government agencies for different Mohammed Awais, Senior House Officer government departments. The main aim of these Vinod Abraham, Senior House Officer drills is to familiarise with real time disasters and Aisha Al-Buraiki, Senior House Officer patient to eradicate any weaknesses in the disaster plan. Aisha Al-Khamisi, Senior House Officer (left for training abroad) and Nafisah Al-Borhan, Senior House Officer Nowfal Al-Sabri, Senior House Officer academic Emergency 57 Annual Report 2010-2011 Emergency

Reem Gaafar, Senior House Officer Magnus J. Rodrigues, Senior House Officer (left October 2011) Mohammad S. Khan, Senior House Officer Bader Al-Amri, Senior House Officer Amal Al-Rashdi, Senior House Officer Niranjan Lal, (Pediatric) Registrar

Nursing Staff (total 57) CN1- - 3 CN2 - 1 CN3 - 3 CN4 - 2 Staff Nurse 1 (SN1) - 9 Staff Nurse 2 (SN2) - 9

Support Staff (total 20) Ayida Al-Hadhrami, Coordinator Mercy Gandhirajan, Coordinator Sabeel Al-Zadjali, Ambulance Attendant Florenda Sicat, Emergency Medical Technician (Ambulance) Ahmad Al-Shaqsi, Emergency Medical Technician Fahad Al-Abri, Emergency Medical Technician Medical Record Clerks – 2 Medical Orderlies – 12 Highlights of the Year 2010-2011 HISTORIC VISIT OF HIS MAJESTY SULTAN QABOOS BIN SAID During the last year we were honoured by the opportunity to establish a “Mobile Emergency Clinic” during the historic visit of His Majesty Sultan Qaboos Bin Said for the opening ceremony of the new Cultural Center of the University. We also established one clinic in the Cultural Center with full time doctors and nurses.

THE SECOND ASIAN BEACH GAMES: As the relationship between Omani people and sea is legendary, it was fitting that Oman was chosen to host an international sporting event, the 2nd Asian Beach Games. This took place on the occasion of the 40th An- niversary of the Sultan’s accession. About 43 nations and 1,131 athletes took part in the event held from 8th to

58 16th December 2010.

The Department was honoured to have the task of providing 24 hour emergency medical care to all the teams and associated staff during the event. Our dedicated team of doctors and nurses provided on spot medical care during the competitions. If required, patients were moved to the hospital immediately accom- panied by our doctor for further care and management.

GULF COOPERATION COUNCIL UNIVERSITY GAMES WEEK: Our Department provided full emergency coverage to the GCC University games held from 20-27 January 2010. On the spot care was also provided to the players during the events. About 1,000 athletes took part in the Games.

RENAMING OF THE DEPARTMENT In order to align with internationally and widely accepted practice the name of the department was changed from Accident and Emergency Department to the Department of Emergency Medicine.

3 RD INTERNATIONAL EMERGENCY & TRAUMA CONFERENCE 2011 We organised the 3rd International Trauma Conference in Muscat from 11th to 13thOctober 2011 along with the Emergency Medicine Service of the Armed Forces Hospital, and the Ministry of Health, EMS. The confer- ence was a great success attracting around 500 participants. Lectures were delivered by specialists from Oman, other GCC countries, Canada, UK, USA, Italy and Australia.

Dr Al-Reesi received the Young Investigator Award at the American College of Emergency Physicians’ Scien- tific Assembly held in October 2011 in San Francisco, USA.

ADDITION OF NEW AMBULANCE departments

Department added one new fully equipped ambulance to its fleet of ambulances.

INTERNATIONAL VISITOR care

Visitors from Germany visited the Emergency Department during their visit to the hospital in order build collaboration between SQUH and centers in Germany. patient MEDIA PRESENCE

We are actively participating in public awareness TV programmes on national television. Our live program and on “Child emergencies in the summer” was a great success. academic Emergency 59 Annual Report 2010-2011 Emergency

Teaching Programmes UNDERGRADUATE CLINICAL PROGRAMMES Clinical Skills Course for 5th year medical students: For many years, we have been holding Clinical Skills courses for 5th year medical students. These are held in the Training and Staff Development (TSD) center of the hospital. Courses involve hands on practice in basic life support, intravenous techniques, aseptic techniques, monitoring patients, electrical therapy with man- ual and automated defibrillators. Different staff members from our department participate in these courses and they were periodically evaluated by the course director.

Emergency Medicine for 6th year Medical Students: Our Department actively participates in the training and teaching of the 6th year medical students. We receive 8 batches every year on a monthly rotation from August to May. Each batch is divided into 4 groups. Teaching sessions were held by consultants and include lectures along with bedside teaching. The areas of teaching includes basic life support, wound care, recognition and treatment of dynamic arrhythmias and use of defibrillators. In addition to these, problem-based tutorials were also held regularly by consultants on important clinical emergencies like chest pain, shortness of breath polytrauma, poisoning etc. Student’s per- formance is assessed at the end of the rotation by a one-hour multiple choice question examination based on the contents of the core curriculum.

Addition of new tutorials During the last year we have completely updated our syllabus of tutorials and the following important new tutorials have been added in the teaching schedule: bites and Anaphylaxis; approach to the sick child; altered mental status.

POSTGRADUATE PROGRAMME Teaching and Training of Interns Interns rotate through our Department on a one-month elective rotation during General Surgery posting. Interns are given handouts and a one day tour of the department at the start of their rotation. During their rotation interns were exposed to real emergency cases like chest pain, polytrauma, poisoning, etc. They were taught procedures like different types of suturing, foreign body removals, use of ABG machine, basic know how on intubations and central lines placement, etc. Bedside teaching and CME sessions were also held regu- larly. All interns were assessed by the shift supervisor at the end of every call and the final assessment was made on the basis of performance on all shifts. Apart from knowledge, punctuality and overall behaviour as part of team facing busy shifts were also taken into account.

60 Teaching and Training of Residents and OMSB Residency Programme The residents participating in the OMSB (Oman Medical Specialty Board) programme of Emergency Medi- cine, Family and Community Medicine and Surgery rotate through our Department at various stages of their training.

They are exposed to real emergencies and given full chance to handle patients independently as an active member under the supervision of the shift supervisor. They are given the chance to perfect skills already learnt like suturing, other simple procedures and are taught new skills like intubations, central line place- ments, basic bedside ultrasound, etc. Senior residents handle more critical patients in the bay area under supervision of the shift in charge. Apart from clinical activities, academic activities of minimum 4 hours per week are mandatory. These activities include case or topic presentations, Journal clubs, workshops etc.

Clinical Electives The Department welcomes international medical students doing electives in emergency medicine. This year we received 11 students from 4 different countries.

Clinical Attachments Our Department regularly receives foreign medical graduates for clinical attachments. This year 8 graduates of 3 different countries joined us for clinical attachment.

Training Courses & CME Activities ADVANCED CARDIAC LIFE SUPPORT (ACLS) AND BASIC LIFE SUPPORT COURSES Our Department holds different life support courses every year in collaboration with Anaesthesia depart-

ment. Courses were held regularly at the TSD on BLS and ACLS. Participants include SQUH, Ministry of Health departments and Royal Court staff. Re-certification courses are conducted twice a year. care IN HOUSE CME ACTIVITIES This year our CME activities have been accredited by OMSB with CPD points for the presenter and partici- pants. Recently, we have also upgraded our CME sessions from a fortnightly to weekly basis. They include patient case discussions, mortality and morbidity reviews, journal club sessions and presentation and discussion of various topics relevant to the practice of emergency medicine. Formulation of protocols with regards to the and treatment of various life threatening diseases presenting to the ED are also discussed. All doctors working in the department actively participates in these activities. academic Emergency 61 Annual Report 2010-2011 Emergency

TCN COURSE FOR NURSES The Department regularly receives trauma cases in different scale and degree. To better equip our staff, the Department launched its Trauma Course tailored mainly for nurses with the goal of enhancing staff knowl- edge and refining trauma management skills thus improving patient care outcomes.This course not only educated nurses but it sustained the Department’s quality improvement initiative. About 30-35 participants attended the course from the Department of Emergency Medicine, wards, and other hospitals. This course received positive feedback and will likely be conducted again in the near future. It was an interactive 3 day course covering both theory and practical aspects. The trainers were high caliber nurses and physicians from Sultan Qaboos University and the Armed Forces Hospital. The course was accredited by the Oman Medical Specialty Board (OMSB) and integrated three courses into one (ATLS, ITLS & ATCN) in order to boost nurses’ competence.

Emergency Department monthly statistic January to december 2011 Category Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Total B 24 15 18 18 16 22 25 22 14 19 22 30 245 R 94 86 76 69 74 66 65 83 86 89 79 112 979 Y 2837 2488 2945 2724 2695 2528 2518 2726 2979 3081 2981 3098 33600 G 1639 1439 1524 1372 1363 1259 1188 1253 1236 1379 1558 1435 16645 W 1173 983 1088 1191 939 818 850 727 998 1156 1002 1007 11932 F/U 359 273 278 277 255 271 198 226 246 225 252 233 3093 Total 6126 5284 5929 5651 5342 4964 4844 5037 5559 5949 5894 5915 66494 SSU 334 260 256 231 156 171 115 69 128 134 92 116 2062 DEF 890 756 843 865 660 567 666 674 725 795 655 715 8811 LWBS 209 93 136 117 107 89 62 83 128 100 126 176 1426 ADM 800 756 823 793 794 682 697 726 881 704 792 762 9210 TRANS 19 14 25 16 17 11 19 11 19 19 20 25 215 DOA 15 10 13 11 8 23 14 16 10 12 169 21 169 DAA 6 2 1 1 3 1 2 2 3 6 0 1 28 SCD 490 413 460 541 476 428 498 410 479 558 460 505 5718 RTA 154 164 160 180 159 198 144 166 158 173 208 292 2156

62 ADULTS 4303 3783 4364 4138 4031 3776 3700 3806 4176 4225 4200 4102 48604 PEDS 1823 1501 1565 1513 1311 1188 1144 1231 1383 1724 1694 1813 17890 Amb. Activities Ward 20 21 38 22 20 28 53 29 36 30 21 27 345 ED 10 14 25 9 14 12 47 16 14 16 12 26 215 Airport 6 6 3 5 8 4 2 4 3 8 7 6 62 Campus 9 2 5 11 8 3 5 2 8 12 6 25 96 Total 45 43 71 47 50 47 107 51 61 66 46 84 718 Total Patient in 2011 = 66,494 (over 9% rise compared to 2010 number of 60,795)

Legend: B = Blue category patients; R = Red category patients; Y = Yellow category patients; G = Green category patients; W = White category patients; F/U = Follow-up patients; FT = Fast track; SSU = Short stay unit; DEF = Deferred cases; LWBS = Left without being seen; ADM = Admission cases; TRANS = Transferred to other wards/hospitals; DOA = Dead on arrival; DAA = Died after arrival; SCD = Sickle cell disease cases; RTA = Road traffic accident cases.

Research SQU Medical students have done research on the following two topics in Emergency Medicine: Trauma clini- cal presentation, outcome and Management at SQUH; Urine Dipstick visual comparison with machine read- ing.

The Department is also doing ongoing research on the following topics: Safety of rapid assessment and dis- charge from the ED; Characteristics of patients with H1N1 at SQUH; Comparison of transcutaneous bilirubin check and laboratory bilirubin check; Assessment of time interval of Emergency Medical Services in Seeb departments

Area; Procalcitonin in SCD patients; Comparison between serum billirubin and transcutaneous billirubin in neonates; Braselow tape validation in Omani population; Comparison of ABG electrolytes and serum elec- trolytes. care

RESEARCH PROJECTS

Accuracy of Masimo total Hemoglobin Measurement in Comparison to invasive Hb Measurement patient

Project Code: MREC# 428; Dates: 2011 and Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr Khalfan Al-Amrani, Dept. Accident & Emergency, SQU. academic Emergency 63 Annual Report 2010-2011 Emergency

Accuracy of Triage and Agreement between Nurses and Physicians using Canadian Triage and Acuity Scale (CTAS) Project Code: MREC# 432; Dates: 2011 Value: Unfunded: Project Approval: Sultan Qaboos University Investigator: Dr Khalfan Al-Amrani, Dept. Accident & Emergency, SQU.

The reliability of Point-of-Care (POC) capillary Blood International Normalized Ratio (INR) in comparison to Standard Laboratory Values Project Code: MREC# 419; Dates: 2011 Value: Unfunded; Project Approval: Sultan Qaboos University Investigators: Dr Abdullah Al Reesi, Dept. Accident & Emergency, SQU.

RESEARCH PUBLICATIONS & BOOKS Journal Publications 1. Al-Reesi A, Stiell IG, Al-Zadjali N, Cwinn AA.Comparison of CT head interpretation between emergency physicians and neuroradiologists. Eur J Emer Med 2010; 17s:280-2. 2. Thiruganasambandamoorthy V, Hess EP, Alreesi A, Perry JJ, Wells GA, Stiell IG. External validation of the San Fran- cisco Syncope rule. Ann Emerg Med 2010; 55:464-72. 3. Al-Aghbari S, Al-Harthy A, Ahmed M, Al-Reesi A, Al-Wahaibi K, Al-Qadhi H. Laproscopic repair of traumatic intra- peritoneal bladder rupture. Sultan Qaboos Univ Med J 2011; 11:515-8. Research Presentations 1. Al-Reesi A. Predictors of adverse outcomes for SCD patients in ED. Scientific Assembly, American College of Emer- gency Physicians. San Francisco, USA, Oct 2011.

64 departments

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Family Medicine & Public Health

stablished in 1986, the Department of Family Medicine & Public Health is one of the major clinical teaching and research de- partments in College of Medicine & Health Sciences. The clinical services are provided through the University Health Center and the Student Clinic. The Department is involved extensively in teaching medical students at different levels and phases of Ethe old curriculum and the new curriculum. The postgraduate programmes include the Masters in Epidemiology and Medical Statis- tics, the PhD in Epidemiology & Public Health and the Family Medicine Residency Program which has 46 postgraduate students. The Department conducts the MRCGP [INT] (Membership of the Royal College of General Practitioners - International) examination. The Department is also actively involved in research both independently and also in collaboration with other departments and external bodies.

66 Staff Head of Department Mohammed Al-Shafaee, Associate Professor Faculty Shyam S. Ganguly, Associate Professor Randa Youssef, Associate Professor Syed Rizvi, Assistant Professor Yahya Al-Farsi, Assistant Professor (Acting Dean & Assitant Dean for Training & Community Service) Abdullah Al-Muniri, Assistant Professor Kamlesh Bhargava, Senior Consultant Thord Theodorson, Senior Consultant Abdulaziz Al-Mahrezi, Senior Consultant, Deputy Head, Clinical Services Mohammed Al-Azri, Senior Consultant Ahmed Al-Waily, Consultant/Dermatologist Zakiya Al-Busaidy, Consultant Hamdan Al-Habsi, Consultant Mustafa Al Hinai, Consultant Kawther El-Shafie, Consultant Ana Maria Anido, Senior Registrar/Dermatologist Rahma Al-Kindi, Senior Registrar Laila Ali Ramadhan, Registrar Aisha Al-Hinai, Registrar Vrunda Pimpalkhute, Registrar departments Nafisa Samir, Registrar Imran Saad, Registrar care

Teodorico Diputado, Registrar Hanaa Sumari, Senior House Officer Wahida Al-Maskeri, Senior Chief Dietician patient

Support Staff Perpetua Gabor, Coordinator and

Zulfa Al-Tobi, Coordinator Bahiya Al-Siyabi, Coordinator academic Family Medicine & Public Health 67 Annual Report 2010-2011 Family Medicine & Public Health

Highlights of the Year 2010–2011 The Department offered the 10th diet of the MRCGP (INT) examination in October 2011. The examination was taken by 15 doctors including 1 doctor from Saudi Arabia and 1 Indian doctor working in Oman. The Royal College of General Practitioners has appreciated and recognised the progress made in the development of this examination. The examination was reaccredited by the RCGP for three further years (until 2013) after the accreditation process.

Teaching Programmes UNDERGRADUATE PROGRAMMES The Department offers courses in Epidemiology & Statistics: EPISTAT-2; Data Analysis using SPSS as an uni- versity elective; Epidemiology and Medical Statistics for MLS; Biostatistics for College of Nursing; Principles of Epidemiology; Special Epidemiology and Health Management for Health Statistics students from the Col- lege of Science; Nutrition & Health Education for the College of Agriculture; Research Project-1 for Phase II and Hospital & Community Attachment course for MD students in the new curriculum.

NEW CURRICULUM The Department is involved in Phase II and Phase III of the new curriculum. In addition, the Department is involved in teaching of students from the intercalated phase. In Phase III, the Department is currently involved in Pre-clerkship and Junior Clerkship.

PRE-CLERKSHIP The Department participated in the Pre Clerkship by conducting 9 general assessment weeks and partici- pated in the pre-clerkship final exam. About 120 students, 15 students per group, get the chance to obtain a focussed history and conduct a focussed physical exam on real patients or simulated patients. The aim of this course is to prepare the student for their clinical years.

JUNIOR CLERKSHIP About 120 students, in groups of 20, have a 5-week clinical rotation in the SQU Health Center and in 5 of the accredited MOH Health Centres. The aim of the rotation is that the students get the opportunity to practise focused history taking and physical examinations, besides differential diagnoses and defining management

68 plans. The emphasis is on the acquisition of knowledge that is required to manage a wide variety of health conditions (physical, social and psychological) in the context of family, culture, work and community. The rotation explores further the principles of patient-centered care.

SENIOR CLERKSHIP IN THE OLD CURRICULUM In the final year of the MD programme, the students come for a 7 week rotation. The emphasis is on com- prehensive management of the patient in the context of his/her family, culture, work and community. Daily clinical teaching takes place in the SQU Heath Centre as well as in a number of accredited MOH health cen- tres. The course also includes a full week of lectures on public health programmes (communicable and non- communicable diseases) in the Ministry of Health. Students have afternoon presentations on various topics commonly seen in family medicine. Students are assessed daily for their performance in the health centre and for their afternoon presentation. At the end of the rotation, all students are additionally evaluated by MCQs and an OSCE.

POSTGRADUATE PROGRAMME Family Medicine Residency training program The Department, along with the Oman Medical Specialities Board (OMSB), is actively involved in the teach- ing, training and examination of the Family Medicine residents. There were 46 Residents in the programme in this period at various levels of training. The exit examination MRCGP (INT) is accredited by the Royal Col- lege of General Practitioners, UK.

M.Sc . PROGRAMME The following postgraduate courses were conducted by the Epidemiology and Medical Statistics Unit for the Master’s Programme: Statistics and Computers; Advanced Principles of Epidemiology; Advanced Statis- tical Methods; Categorical Data Analysis; Applied Epidemiology; Statistical Methods in Quality Control. A

Research Methodology course was also offered and supervision of master’s thesis research projects. departments

2009 2010 2011 care

Total Patients seen 43,073 42,273 42,077 Seen with appointments 23,539 21,165 18,393 patient

Walk-in patients 1,518 9,736 16,552 and

Vaccinations 9,481 7,078 8,744 Antenatal Clinics 1,467 1,111 1,336 academic Family Medicine & Public Health 69 Annual Report 2010-2011 Family Medicine & Public Health

Postnatal 126 30 32 Birth Spacing 161 47 66 Dermatology 4,092 4,704 5,414 Diabetic 311 253 301 Respiratory Therapist 89 95 129 Dietician 260 248 233 Treatment Room Services 1,817 2,005 1,885

PH.D. PROGRAMME Two candidates have been selected to join Ph.D. programme in Epidemiology & Public Health

Training Courses & CME Activities The Department arranged continuing medical education through journal clubs, seminars and workshops. These activities are open to doctors, nurses and paramedics from the Department, the MOH and also Univer- sity Hospital personnel.

Clinical & Diagnostic Services The SQU Health Center is a pioneer primary care institution in Oman. It is the first health centre in the country which received international accreditation as a “model health centre” by the Arab Board and by the Royal College of General Practitioners (RCGP), UK, for clinical services and the teaching of family medicine. Our Health Center is the leading star in primary health care (PHC) in Oman as regards PHC ideology, quality, comprehensiveness of care and prevention.

Patient services are provided at the SQU Health Center and Students Clinic. A total of 42,077 patients were seen at the Health Center. The Department has separate diabetes, antenatal & postnatal clinics besides the birth spacing and MOH infertility programmes and the extended programme of immunisation for mother & child health. The dermatology clinic gets referrals from all departments in SQU Hospital and different parts of the country for various procedures besides laser treatment. The Students Clinic serves all the University students for all of their primary health needs. The following clinics are offered: General Appointments, Walk- in, Diabetes, Antenatal & Postnatal, Immunisation/well baby, Birth spacing, Dermatology, Counselling.

Clinical workload 2009-2011 in the Health centre

70 Clinical Workload 2009-2011 in the Student Clinic

2009 2010 2011 Total Patients seen 11,308 14,873 14,885

Research RESEARCH PROJECTS Autism in Oman: Epidemiology and Etiology Project Code: SR/MED/FMCO /11 /01; Dates: 2011-2013 Value: OR 90,000; Project Funder: His Majesty’s Strategic Research Fund Investigators: Dr Yahya Al-Farsi, Dept. Family Medicine & Public Health, SQU; Dr. Marwan Al Sharbati, Dept. Behavioural Medicine, SQU; Dr. Mansour Al-Moundhri, Dept. Medicine, SQU; Dr. Said Al-Yahyaee, Dept. Genetics, SQU; Prof. Mad- hwa HG Raj, Dept. Oncology, USA; Prof. Herlyn Meenhard, Wistar Institute, USA.

Screening Novel Biomarkers for Early Detection of Autism in Omani Children Project Code: IG/AGR/FOOD/11/03; Dates: 2011 Value: Project Funder: Sultan Qaboos University Investigators: Dr. Yahya Al-Farsi and Dr. Mohammed Al-Shafaee, Dept. Family Medicine & Public Health, SQU; Dr. Mohammed Issa and Dr. Mustafa Waly, College of Agriculture, SQU. departments

Incidence of Familial Hypertension in Patients attending a Single Health Center: A Pilot Study care

Project Code: MREC# 371; Dates: 2010 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. Yousef Al-Farsi, Dept. Family Medicine & Public Health, SQU. patient

Prevalence and Significance of inter Arm Difference in Blood Pressure in Diabetes and Project Code: MREC# 374; Dates: 2010 Value: Unfunded; Project Approval: Sultan Qaboos University academic Family Medicine & Public Health 71 Annual Report 2010-2011 Family Medicine & Public Health

Investigator: Dr. Kamlesh Bhargava, Dept. Family Medicine & Public Health, SQU.

Residents Experience and Perception of Mistreatment during Internship Project Code: MREC# 382; Dates: 2010 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr Mohammed Al Shafaee, Dept. Family Medicine & Public Health, SQU.

Physical Activity, overweight and perceived barriers among Omani Adolescent Project Code: MREC# 386; Dates: 2010 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. Randa Yousef, Dept. of Family Medicine & Public Health, SQU.

The Epidemiology of Road Traffic Crashes in the Sultanate of Oman: Evaluating the Role of Risky Driver Behavior Project Code: MREC# 387; Dates: 2010 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. Abdullah Al-Muniri, Dept. Family Medicine & Public Health, SQU.

Human Errors as Cause for Road Traffic Crashes (RTCs) in the Sultanate of Oman under Consideration of Road Construction Designs Project Code: MREC# 404; Dates: 2011 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. Abdullah Al-Muniri, Dept. Family Medicine & Public Health, SQU.

Knowledge and Attitudes of Sultan Qaboos University Students to Premarital Testing Project Code: MREC# 405; Dates: 2011 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. Rahma Al Kindi, Dept. Family Medicine & Public Health, SQU.

Keloids: Epidemiology and Genetics Studies Project Code: MREC# 414; Dates: 2011 Value: Unfunded; Project Approval: Sultan Qaboos University

72 Investigator: Dr. Ahmed Al-Waily, Dept. Family Medicine & Public Health, SQU; Arthur Paul Kelly, Dept. Genetics, SQU; Dr. Ana Maria Serrano, Dept. Family Medi- cine & Public Health, SQU; Dr. Allal Ouhtit, Dept. Genetics, SQU; Dr. C. Thom- as, Dept. of Plastic Surgery, Khoula Hospital; Mohammed Mustafa and Dr. Fatma Al-Balushi. Dept. Dermatology, Al Nahdha Hospital, Oman.

Prevalence and Risk Factors of Diabetic Nephropathy in type 2 Diabetic Omani Population in Al-Dakhili- ya Region Project Code: MREC# 422; Dates: 2011 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. Seyed Rizvi, Dept. Family Medicine & Public Health, SQU.

Prevalence of borderline gestational diabetes and its association with adverse maternal and fetal out- comes Project Code: MREC# 449; Dates: 2011 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. Kamlesh Bhargava, Dept. Family Medicine & Public Health, SQU.

Prevalence and Characteristics of Patient with Chronic Pain attending Staff Clinic at SQUH Project Code: MREC# 453; Dates: 2011 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr Abdulaziz Al-Mahrezi, Dept. Family Medicine & Public Health, SQU. departments

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Patient-doctor relationship and its impact on care outcomes Project Code: MREC# 476; Dates: 2011 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. Mohammed Al-Azri, Dept. Family Medicine & Public Health, SQU. RESEARCH PUBLICATIONS & BOOKS Research Publications 1. Al-Kindi R, Al-Bulushi A. Prevalence and Impact of Dysmenorrhea among Omani High School Students. Sultan Qa- boos University Med J 2011; 11:373-9. 2. Al-Kindi RM, Al-Mushraf M, Al-Rabaani M, Al-Zakwani I. Complementary and alternative medicine use among adults with diabetes in Muscat Region, Oman. Sultan Qaboos Univ Med J 2011; 11:62-8. 3. Theodorsson T, El Shafie K, Al Wardy N, Khan A, Al Mahrezi A, Al Shafaee M. Assessment of aamily doctors in Oman: getting the questions right. Preliminary findings of a performance analysis of multiple choice questions. Internet J Med Educ 2010. 4. Gowri V, Mathew M, Gravell D, Alfalahi K, Zakwani I, Ganguly SS, Pathare AV. Protein Z levels in pregnant Omani women: correlation with pregnancy outcome. J Thromb Thrombolysis 2011; 32:453-8. 5. Maddali MM, Mathew M, Chandwani J, Alsajwani MJ, Ganguly SS. Outcomes after rigid bronchoscopy in chil- dren with suspected or confirmed foreign body aspiration: A retrospective study. J Cardiothorac Vasc Anesth 2011; 25:1005-8. 6. Al-Shafaee M, Shenoy R, Bialasiewicz AA, Ganguly SS, Bhargava K. Macular function in prediabetic and diabetic Omani adults: a microperimetric evaluation. Eur J Opthalmol 2011; 21:771-6. 7. Al- Saadi R, Al-Shukaili S, Al Mahrazi S, Al- Busaidi Z. Prevalance of uncontrolled hypertension in primary care set- tings in AlSeeb Wilayat, Oman. Sultan Qaboos University Med J 2011; 11:349-56. 8. Al Azri M, Al Azri H, Al-Rasbi S, El Shafie K, Al Maniri A Factors affecting quality of diabetic care at primary care settings in Oman - a qualitative study on patient’s perspectives. Sultan Qaboos University Med J 2011; 11:207-13. 9. Al-Shafaee M, Al-Farsi Y, Mcllvenny S, Al-Mandhari A, Al Adawi S, Bhargava K, Al Maniri A. Prevalence of pre- diabetes and associated risk factors in Omani adult population. Int J Diab Dev Ctries 2011; 31:166-74. 10. Al-Farsi YM, Brooks DR, Werler MM, Cabral HJ, Al-Shafaee MA, Wallenburg HC. Effect of high parity on occurrence of anemia in pregnancy: a cohort study. BMC Pregnancy Childbirth 2011; 20;11:7. 11. Essa MM, Guillemin GJ, Waly MI, Al-Sharbati MM, Al-Farsi YM, Hakkim FL, Ali A, Al-Shafaee MS. Increased markers of oxidative stress in autistic children of the sultanate of oman. Biol Trace Elem Res 2012; 147:25-7. 12. El Shafie K, Al-Shaqsi A, Al-Mahrouqi B, Al Lawati H, Ganguly S, Al Adawi S, Al Shafaee M. The diagnostic yield of thyroid function testing and its cost-effectiveness in the student’s clinic in Sultan Qaboos University: a retrospective chart review. Sultan Qaboos University Med J 2010; 10:215-20.

74 13. Al-Farsi YM, Al-Sharbati MM, Al-Farsi OA, Al-Shafaee MA, Brooks DR, Waly MI. Prevalence of autistic spectrum dis- orders in Oman (brief report). J Autism Dev Disord 2010; 1094-8. 14. Al-Farsi YM, Brooks DR, Werler MM, Cabral HJ, Al-Shafaee MA, Wallenburg HC. Effect of high parity on the occur- rence of prediabetes: a cohort study. Acta Obstet Gynecol Scand 2010; 89:1182-6. 15. Al Rabei F, Al Maniri A. Work related injuries in an oil field in Oman. Oman Med J 2011; 26:315-8. 16. Al-Mujaini A, Al-Farsi Y, Al-Maniri A, Ganesh A Satisfaction and perceived quality of an electronic medical record system in a tertiary hospital in Oman. Oman Med J 2011; 5:324-8. 17. Al-Busaidi Z, Bhargava K, Al-Ismaily A, Al-Lawati H, Al-Kindi R, Al-Shafaee M, Al-Maniri A. Prevalence of depression among university students in Oman. Oman Med J 2011: 235-9. 18. Al-Azri N, Al-Maniri A. Re: Improving Road Safety through Deterrence-Based Initiatives. Letter to the Editor. Sultan Qaboos University Med J 2011; 11:420-3, 19. Al-Shidhani TA, Bhargava K, Rizvi S. An Audit of Hypertension at University Health Center in Oman. Oman Med J 2011; 248-52. 20. Bhargava K. Book Review. Symptom Sorter. Keith Hopcroft and Vincent Forte, Radcliffe Publications Book Review, 4th Edition. Sultan Qaboos University Med J 2011; 11:293-4 21. El Shafie K, Al Farsi Y, Al Zadjali N, Al Adawi S, Al Busaidi Z, Al Shafaee M. Menopausal symptoms among healthy middle-aged Omani women as assessed with the Menopause Rating Scale. Menopause 2011; 18:1113-9. 22. Jaju D, Dikshit MB, Balaji J, George J, Rizvi S, Al-Rawas O. Effect of pranayam breathing on respiratory pressures and sympathovagal balance of patients with chronic airflow limitation and in control subjects. Sultan Qaboos Univer- sity Med J 2011; 11:221-9. 23. Samir N, Al-Mahrezi A. Congenital fusion of the trapezium and trapezoid. Sultan Qaboos University Med J 2010; 10:405-6. 24. Baddar SA, Al-Ismaili AI, Al-Taie MA, Al-Mahrezi AM, Al-Rawas OA. Documentation of the management of asthma exacerbation in adults by primary health care physicians in a teaching hospital in Oman. Sultan Qaboos University Med J 2010; 10:335-40.

25. Samir N, Al-Mahrezi A, Al-Sudairy S. Odontogenic cutaneous fistula: Report of two cases. Sultan Qaboos University departments Med J 2011; 11:115-8. 26. Gowri V, Rizvi S, Shabnam S. High sensitivity C-reactive protein, is a marker of obesity and not of polycystic ovarian care syndrome per se. Fertil Steril 2010; 94:2832-4. CONFERENCE & SEMINAR PRESENTATIONS patient

Conference Presentations

International and

1. Al Azri-M, Al-Rawahi N, Al-Ramadhani R, Al-Maniri A. Continuity of care in Primary Care Setting in Oman. World Or- ganization of Family Doctors East Mediterranean Region (WONCA EMR) Congress: Provision of Primary Healthcare academic Family Medicine & Public Health 75 Annual Report 2010-2011 Family Medicine & Public Health

& Family Medicine in the Twenty First Century. Dubai, United Arab Emirates, 7-19 December 2011. 2. Theodorson T, El Shafie K, Al Mahrezi A, Khan A, Al Shafaee .M What makes a good question? Developing the MCQ/Written paper in post graduate examination in Oman. A presentation at the AMEE Conference. Glasgow, UK, 5−8 September 2010. 3. Ganguly SS. Use of ordinal logistic regression model in the study of endometrial cancer. Mathematics (FIM) on In- terdisciplinary Mathematical and Statistical Techniques. Patna University, India, 18-20 December 2010. Poster Presentations International 1. Al-Saadoon M, Al-Sharbati M, Rizvi S. School Bullying Among Omani Children in Muscat. AACAP/CACAP Joint An- nual Meeting. Toronto, Canada, 18-23 October 2011.

76 departments

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Genetics

enetics is at the heart of health sciences in Oman and the Arab World where genetic and congenital disorders are a serious health issue for many reasons: customary consanguineous marriage; high prevalence of haemoglobinopathies; high fre- quency of advanced parental age, and lack of public awareness and education about genetic disorders. Certain cultural tradi- Gtions also restrict the efforts for the prevention and control of genetic disorders. Genetics is a young department, with ample resources and potential, providing scientists and clinicians with unprecedented oppor- tunities to make a difference to society. The mission of the Department is to provide state-of-the-art diagnostic services for patient care, education, research as well as public awareness rising in the field of genetics. While serving as a focal point for routine clinical services, the Department is committed to updating the ongoing routine diagnostic tests in cytogenetics and immunogenetics, and in addition to developing new molecular diagnostic tests for various genetic diseases, including cancer, cardiovascular and neurological diseases.

The Department has four specialised sections: Clinical Genetics; Cytogenetics; Molecular Genetics and Immunogenetics. The research in the Department is currently focused on inborn errors of metabolism, rare genetic diseases, cystic fibrosis and cancer.T

78 Staff Support staff Ghadeer Al-Zadjali, Coordinator Head of Department Muna M. Al-Bimani, Research Assistant Allal Ouhtit, Associate Professor Lina N. Al-Mashhadani, Research Assistant Faculty Pravrutha Raman, Research Assistant Aisha Al-Abri, Research Assistant Cytogenetics Udayakumar, Associate Professor Robert Sigmani, Biomedical Scientist HIighlights of the Year Lamya Al-Anbouri, Biomedical Scientist Shoma S. Raj, Biomedical Scientist 2010-2011 Sami Al-Kalbani, Biomedical Scientist In this period, cell culture was established as a core Balaji Krishnan, Biomedical Scientist facility for the College of Medicine & Health Sci- Sultan S. Al-Salhi, Biomedical Scientist ences. The ichthyosis molecular genetics test was Immunogenetics introduced for routine molecular diagnostics. It is Hamad Al-Riyami, Chief Biomedical Scientist currently being cross-validated in collaboration Varghese CM, Senior Biomedical Scientist with an accredited laboratory in the Netherlands. Faiza Al-Yahyai, Biomedical Scientist Dr. Allal Ouhtit was the winner of the 14th John M. Suriyan Mani, Biomedical Scientist Kinney Award in Pediatric Nutrition as a senior au- Iman H. Al-Hadhili, Biomedical Scientist thor of the following paper: “Effects of fried potato Molecular Genetics chip supplementation on mouse pregnancy and Rayhanah Al-Mjeni, Ph.D. Student fetal development” was published in Nutrition in Manal Al-Khanbashi, Ph.D. Student 2010. Mariam Al Nabhani, Biomedical Scientist Khalsa Al-Kharousi, Biomedical Scientist In this period, the following Staff members joined Aisha Al-Naamani, Biomedical Scientist the Department: Balaji Krishnan, Sultan Al-Salhi Feisal Al-Mahrizi, Biomedical Scientist and Iman Al-Hadhili as biomedical scientists; Sara departments Samia Al-Rashdi, Biomedical Scientist Al-Alawi as a social worker, and Farida Al-Maamari Clinical Genetics as a research assistant. care

Fathiya Al-Murshedi, Consultant Adila AlKindy, Consultant Khalid Al-Thihli, Registrar Teaching Programmes Maha Al-Awadi, Registrar (on a study leave) The Department of Genetics participates in teach- patient

Rahma Al-Jashmi, Biomedical Scientist ing and training clinicians and medical science stu-

Sara Said Al-Alawi, Social Worker and

dents. academic Genetics 79 Annual Report 2010-2011 Genetics

UNDERGRADUATE PRECLINICAL PROGRAMME The Department is involved in a significant amount of teaching and training in the College of Medicine & Health Science. It contributes to the Molecular Biology and Principles of Genetics undergraduate preclinical courses with lectures on molecular genetics, cytogenetics, as well as participating in the annual teaching rotations and training of doctors and students proceeding to their 2nd or 3rd year of their degree. This is done through laboratory based workshops as follows: 1) a biannual workshop for training in standard laboratory techniques in molecular genetics, and 2) rotation of students and doctors in our laboratories (Cytogenetics, Immunogenetics and Molecular genetics). This includes training and an observation course on genetic tech- niques organised in January and June of each academic year.

UNDERGRADUATE CLINICAL PROGRAMME The Department was involved in the following clinical teaching activities: 1) Clinical (bedside and outpatient) teaching for residents, senior house officers and registrars; 2) 7th year MD student seminar on metabolic diseases, August 2010; 3) Man nursing institute, a two hours lecture in June 2010, and 4) Genetics lecture for 7th year medical Obstetrics & Gynaecology rotation students, repeated every 6 weeks with 25–28 students in each batch.

The Department participates in the teaching of the following courses in the Medical Laboratory Sciences (MLS) programme: Molecular Diagnosis and Biology of Disease, and provides lectures on cancer genetics and genethics.

Finally, the Department contributes to the teaching in the College of Nursing with lectures on genetics.

POSTGRADUATE PROGRAMME The Department takes part in senior house officer in-house training, and the Oman Medical Specialties Board residents training programme in Haematology/Biochemistry with lectures on cytogenetics, molecular ge- netics and immunogenetics. The Department is actively involved in training rotating residents in the field of medical genetics and biochemical genetics (inborn errors of metabolism).

Training Courses & CME Activities The Omani staff members of the Department are sent abroad for regular training in genetics (residency training, Ph.Ds. and short training courses in genetics). There are regular in-house training activities for the staff and in genetics for Omani graduates from SQU and abroad.

80 Clinical & Diagnostic Services CLINICAL GENETICS The main objectives of the Clinical Genetics section is to provide a standard of care service for patients and families with genetic disorders including diagnosis, genetic counselling, management and social support in addition to teaching and research. During the period September 2010 to August 2011, the clinical genet- ics team was involved in the management of hundreds of patients including inpatients consultations and outpatient clinics referrals.

The month of August 2011 witnessed a breakthrough in the evolution of the clinical genetics service at SQUH, as the first patient was seen in the new building assigned for the Genetic and Developmental Medicine Clin- ic. Currently this is a very active clinic receiving all outpatient medical genetic, biochemical genetic, and can- cer genetic consultations. The genetic counselling sessions arranged for different families are also held there.

The clinical genetics team also contributed to the care of metabolic patients and in teaching MD and post- graduate students. Although no active grant proposals are linked to the clinical genetics section at present, current hypotheses are being explored for this potential. The clinical unit is actively involved in liaison with other clinical services in designing, arranging and facilitating clinical research that may have direct or indi- rect genetic implications. The clinical genetic services naturally imply dealing with rare disorders, and these are typically associated with ongoing research questions that are being explored on family or individual basis as clinical needs merit. So far, there are a few families that have been involved in clinical research or are currently considering such an involvement

CYTOGENETICS This section provides routine cytogenetic investigations (karyotyping) to clinical departments of SQUH us- ing conventional and fluorescence in situ hybridisation (FISH) techniques. A prenatal diagnostic service was started in 2010. The total number of samples received for conventional karyotyping was 487 (prenatal cyto- departments genetics [amniotic fluid] 9); and 123 for FISH. The total number between January and end of October 2011 was 610. Figure 1 below shows major referrals from clinical departments. care

IMMUNOGENETICS The Immunogenetics Laboratory continued to provide diagnostic services to SQUH, and the Ministry of

Health and Armed Forces hospitals. Compared to previous years, there was a significant increase in the patient number of samples received by the Laboratory. The Tissue Typing Laboratory, run by 4 members of staff, is

the only laboratory in Oman. Due to service expansion, the laboratory has been under extreme pressure. As and

SQUH is going to expand the Bone Marrow Transplantation Unit and reactivate it renal transplantation pro- gramme, this will lead to a further increased in workload. The laboratory is also in process of establishing a academic Genetics 81 Annual Report 2010-2011 Genetics

Section Type Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Total Clinical Internal 3 1 1 2 10 3 23 8 49 84 60 94 338 Genetics External 1 0 1 0 0 4 9 9 24 33 22 24 127 Total 4 1 2 2 10 7 32 17 73 117 82 118 465 Immuno- Internal 215 161 138 176 306 142 145 253 154 96 71 308 2165 genetics External 116 168 206 110 74 45 161 108 74 46 39 103 1250 (HLA) Total 331 329 344 286 380 187 306 361 228 142 110 411 3415 Cytoge- Internal 73 52 58 63 65 65 62 46 57 89 37 96 763 netics External 0 0 1 0 0 1 0 0 0 0 0 0 2 Total 73 52 59 63 65 66 62 46 57 89 37 96 765 Molecular Internal 0 3 0 0 0 0 0 0 0 1 0 0 4 External 12 6 6 15 5 6 10 5 7 9 1 12 94 Total 12 9 6 15 5 6 10 5 7 10 1 12 98 Grand Total 420 391 411 366 460 266 410 429 365 358 230 637 4743 Figure 1: Genetics Statistics 2011

national bone marrow registry, an important development in the search for unrelated bone marrow donors.

In 2010, the Laboratory introduced three more techniques as part of its service for a trial period and valida- tion: 1) Flow cytometry cross match for renal transplantation (FCXM); 2) Sequencer based tissue typing (SBT) i.e. high resolution technique. This is necessary for unrelated bone marrow transplantation and for the bone marrow registry; 3) Luminex technique, this will help for (PRA) lymphoscreening and post-transplant moni- toring. In 2011, these tests are expected to be available as part of the laboratory diagnostic service.

The tissue typing laboratory is hoping to provide a high quality service and attain international standards. We are therefore in the process of establishing relationships with international laboratories which will sup- port our effort for quality assurance, certification and accreditation.

MOLECULAR GENETICS The Molecular Genetics section has been recently established to provide routine molecular diagnosis in ad- dition to banking DNA samples collected from the patients attending our recently set up genetics clinic.

82 Our aim is to develop new molecular tests for the most common genetic diseases observed at SQU Hos- pital. Pursuant to this goal, we are adopting the following strategy: 1) Identify the most common genetic diseases observed at SQUH; 2) Identify technical and equipment needs to develop tests for these diseases; 3) Provide in–house or external specialised training of staff; 4) Develop tests (diagnostics development), and cross-validate them in collaboration with accredited diagnostic laboratories. Our molecular tests are divided into the following categories: 1) routine molecular diagnostic tests; 2) ichthyosis, and 3) acute lymphoblastic leukaemia. The following test has been introduced for routine diagnosis while cross-validated through an accredited laboratory: cystic fibrosis. Other tests are still at the research and development stage: inborn er- rors of metabolism; spinal muscular atrophy (SMA); fragile X (FRAX); myotonic dystrophy (DM); Feingold syndrome, and colorectal cancer.

In 2011, 339 samples were received for both diagnosis and research and development towards establishment of diagnostics. In the same period, 179 samples were received for diagnosis (65 internal and 114 external). A total of 160 samples were received for research and development for different genetic disorders (SMA, FRAX, DM, Feingold syndrome and others), and for DNA banking.

The following tables summarise the number of tests performed by the National Tissue Typing Laboratory in 2011.

Table 1: Type of tissue typing tests performed in each month Tests Serological Method Extracted Molecular Method Total DNA AB X/M PRA A B C DR DQ Jan 79 19 9 49 48 48 48 44 44 339 Feb 72 7 2 64 49 53 50 48 48 329 departments

Mar 55 15 10 48 56 54 54 50 50 344 Apr 57 6 6 47 43 45 43 43 43 286 care May 91 22 18 55 51 51 51 48 48 380 Jun 48 5 3 23 29 29 26 29 28 197

Jul 84 14 17 47 43 43 39 35 31 306 patient

Aug 56 8 11 47 58 57 57 57 57 361 and

Sep 54 8 9 39 35 37 12 38 35 228 academic Genetics 83 Annual Report 2010-2011 Genetics

Oct 86 5 10 49 3 7 0 16 15 142 Nov 26 3 3 26 17 15 16 15 15 110 Dec 54 11 12 29 67 70 69 66 62 411 Total 762 123 110 523 499 509 465 489 476 3433

Legend: X/M: Renal crossmatch. PRA (LYM-SCR): Lymphoscreen.

Table 2: Tissue typing tests according patient’s category/donors BMP BMD RP RD DIS TOTAL January 14 52 11 12 1 90 February 16 70 6 7 4 103 March 7 29 11 15 7 69 April 13 34 6 7 3 63 May 15 52 19 23 3 112 June 9 42 4 4 2 61 July 13 55 15 13 3 99 August 14 39 7 7 7 70 September 8 42 9 7 3 69 October 14 65 12 6 1 98 November 3 18 3 3 1 28 December 10 36 11 7 2 66 Total 136 534 114 111 37 928

Legend: BMP: Bone Marrow Patient. BMD: Bone Marrow Donor. RP: Renal Patient. RD: Renal Donor. Dis: Disease association.

84 Research RESEARCH PROJECTS From Gene Expression Analysis of Omani Breast Tumours to Biomarkers/Candidate Gene Discovery Project Code: SR/MED/GENT/10/01; Dates: 2010-2013 Value: OR 120,000; Project Funder: His Majesty’s Strategic Research Fund, Oman Investigators: Dr. Allal Ouhtit, Dept. Genetics, SQU; Dr. Yahya Al-Tamimi, Dept. Biochem- istry, SQU; Dr. Mansour Al-Moundhri, Dept. Medicine, SQU; Dr. Said Al-Yahy- aee, Dept. Genetics, SQU; Prof. Madhwa HG Raj, LSU Health Sciences Center, New Orleans, USA; Prof. Herlyn Meenhard, Dept. Dermatology, Wistar Insti- tute, Pennsylvania, USA.

Family and Genetic Understanding of Autosomal Recessive Disorders: A Clinical Genetic, Cytogenetic, Molecular and Linkage Study in Oman Project Code: SR/MED/GENT /06 /01; Dates: 2006-2010 Value: OR 168,850; Project Funder: His Majesty’s Strategic Research Fund, Oman Investigators: Prof. John Raeburn, Dept. Genetics, SQU; Dr. Aisha Al-Khayat, Dept. Biol- ogy, SQU; Dr. Ahmed Al-Mandhari, Dept. Family Medicine & Public Health, SQU; Ms. Rayhana Al-Mjeni, Dept. Genetics, SQU; Dr. Shyam Ganguly, Dept. Family Medicine & Public Health, Epidemiology & Statistics Unit, SQU; Dr. Mohamed Al-Shafaee, Dept. Family Medicine & Public Health, SQU; Dr. Anu- radha Ganesh, Dept. Ophthalmology, SQUH; Prof. Riad Bayoumi, Dept. Bio- chemistry, SQU; Dr. Yasser Wali, Dept. Child Health, SQU; Dr. AM Udayaku- mar, Dept. Genetics, SQU; Dr. David Dennison, Dept. Haematology, SQU

Molecular Epidemiology and Diagnosis Study of Common Inborn Errors of Metabolism Disorders in departments Oman and UAE Project Code: CL-SQU/UAE/10/01; Dates: 2010–2011 care

Value: OR 20,000; Funder: Sultan Qaboos University and UAE University Investigators: Dr. Said Al-Yahyaee, Dept. Genetics SQU; Dr. Bassam R. Ali, Dept. Pathology,

UAE University; Dr. Allal Ouhtit, Dept. Genetics, SQU; Prof. Yousef Abdulraz- patient

zaq, Dept. Paediatrics, UAE University; Dr. Jozef Hertecant, Dept. Paediatrics,

Tawam Hospital, UAE; Dr. Mahera Abdulrahman, Dubai Genetics Center, and

UAE; Dr. Hussein Al-Kindi, Dept. Child Health, SQU; Dr. S. N. Joshi, Dept. Child Health, SQU. academic Genetics 85 Annual Report 2010-2011 Genetics

Novel Bardet-Biedl syndrome (BBS) locus in Omani patients: identification of novel (BBS) genes Project Code: IG/MED/GENT/11/01; Dates: 2011-2012 Value: OR 8,000; Project Funder: Sultan Qaboos University Investigators: Dr. Allal Ouhtit, Dept. Genetics; Dr. Aisha Al-Shehi, Dept. Biology, SQU; Dr. Anuradha Ganesh, Dept. Ophthalmology, SQU; Sana AlZuhaimi, Dept. of Ophthalmology, SQU; Dr. Said Al-Yahyaee, Dept. of Genetics, SQU; Ms. Ray- hanah Al-Mjeni, Dept.of Genetics, SQU.

Cytogenetics and Molecular Characterization of Chronic Myeloid Leukaemia Project Code: IG/MED/GENE /08/01; Dates: 2008–2010 Value: OR 5,500; Project Funder: Sultan Qaboos University Investigators: Dr. A. M. Udayakumar, Dept. Genetics, SQU; Dr. Salam Al-Kindi, Dept. Hae- matology, SQU.

Assessment of the Role of Consanguinity & Cytogenetic Abnormalities in Individuals with Recurrent Miscarriage among Omani population Project Code: MREC# 345; Dates: 2010 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. A. M. Udayakumar, Dept. Genetics, SQU; 6th & 7th year students of Ge- netics Dept., SQU.

Establishment of Molecular Genetics Diagnostics Project Code: MREC# 356; Dates: 2010 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. Allal Ouhtit, Dept. Genetics, SQU.

Signal Transduction Mechanisms of CD146 receptor in Breast Cancer in Oman Project Code: MREC#334; Dates: 2010 Value: Unfunded; Project approval: Sultan Qaboos University Investigator: Dr. Allal Ouhtit, Dept. Genetics, SQU.

86 Cytogenetic and Clinical Profile of Down Syndrome Children in Oman Project Code: MREC# 450; Dates: 2011 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr A. M. Udayakumar, Dept. Genetics, SQU. RESEARCH PUBLICATIONS & BOOKS Journal Publications 1. Trappey A, Fernando A, Gaur R, Raj M, Ouhtit A. The shady side of sunlight: current understanding of the mecha- nisms underlying UV-induction of skin cancers. Front Biosci (Schol Ed) 2010; 2:11-7. 2. El-Sayyad HI, Abou-Egla MH, El-Sayyad FI, El-Ghawet HA, Gaur RL, Fernando A, Raj MH, Ouhtit A. Effects of fried potato chip supplementation on mouse pregnancy and fetal development. Nutrition 2011; 27:343-50. 3. Abdeen SH, Reda ES, El-Shabasy EA, Ouhtit A. Ultrastructural changes of adult Schistosoma mansoni worms recov- ered from C57BL/6 mice passively immunized with normal and vaccinated rabbit sera in vivo. Parasitol Res 2011; 109:2448-7 4. Abdraboh ME, Gaur RL, Hollenbach AD, Sandquist D, Raj MH, Ouhtit A. Survivin is a novel target of CD44-promoted breast tumor invasion. Am J Pathol 2011; 179:555-63. 5. Reda ES, Ouhtit A, Abdeen SH, El-Shabasy EA. Structural changes of Schistosoma mansoni adult worms recovered from C57BL/6 mice treated with radiation-attenuated vaccine and/or praziquantel against infection. Parasitol Res 2012; 110:979-92. Epub 9 Aug 2011. 6. El-Sayyad HI, El-Gammal HL, Habak LA, Abdel-Galil HM, Fernando A, Gaur RL, Ouhtit A. Structural and ultrastruc- tural evidence of neurotoxic effects of fried potato chips on rat postnatal development. Nutrition 2011; 27: 1066-75. 7. Al-Mayouf SM, Sunker A, Abdwani R, Abrawi SA, Almurshedi F, Alhashmi N, et al. Loss-of-function variant in DNAS- E1L3 causes a familial form of systemic lupus erythematosus. Nat Genet 2011 Oct 23. doi: 10.1038/ng.975. Epub ahead of print. 8. Valente EM, Logan CV, Mougou-Zerelli S, Lee JH, Alkindy A, et al. Mutations in TMEM216 perturb ciliogenesis and departments cause Joubert, Meckel and related syndromes. Nat Genet 2010; 42:619-25. 9. Pilozzi-Edmonds L, Maher TA, Basran RK, Milunsky A, Al-Thihli K, Braverman NE, Alfares A. Fraternal twins with care

Aarskog-Scott syndrome due to maternal germline mosaicism. Am J Med Genet A 2011; 155A:1987-90. 10. Gowri V, Udayakumar AM, Bsiso W, Al Farsi Y, Rao K. Recurrent early pregnancy loss and consanguinity in Omani couples. Acta Obstet Gynecol Scand 2011; 90:1167-9. patient

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academic Genetics 87 Annual Report 2010-2011 Haematology

Haematology

he Department of Haematology functions both as a major clinical and laboratory medicine department. It plays a pivotal role in the teaching of haematology to undergraduate medical students (MD), postgraduate students of medicine who have opted to specialise in medicine, and haematology Oman Medical Specialty Board (OMSB) residents, as well as medical labora- Ttory technicians in the B.Sc. Medical Laboratory Sciences course. The laboratory provides state of the art haematology testing for the University Hospital (SQUH) and referral services to other private hospitals, like Muscat Private Hospital, as well as highly specialised testing such as flowcytometric and molecular haematological analysis for the diagnosis of haematological conditions for the whole of Oman.

88 Staff Hamood Al-Haddabi, Senior Biomedical Scientist Rodrigo Villacrusis, Senior Biomedical Scientist Head of Department Maria Cicillia, Senior Biomedical Scientist Salam Alkindi, Associate Professor & Consultant Abdulrehman N Rashid, Senior Biomedical Scientist Haematologist Bushra Al-Said, Senior Biomedical Scientist Faculty Sahima Al-Mamari, Senior Biomedical Scientist Karima Al-Falahi, Senior Biomedical Scientist Chao Hung Ho, Professor Deuel M Labrador, Senior Biomedical Scientist Shahina Daar, Associate Professor Enrique O Pedojan, Senior Biomedical Scientist Muna Al-Maskari, Lecturer Hamed Al-Gheithi, Senior Biomedical Scientist David Dennison, Senior Consultant Sabah Al-Mahrooqi, Senior Biomedical Scientist Anil Pathare, Senior Consultant Sumaya Al-Hinani, Senior Biomedical Scientist Naglaa Fawaz, Senior Consultant Qamariya Al-Abri, Biomedical Scientist Mohammad Huneini, Consultant Mariyam Al-Brashdi, Biomedical Scientist Khalil Al-Farsi, Consultant Saif Al-Hosni, Biomedical Scientist Murtadha Al-Kabori, Consultant Shoaib Al-Zadjali, Biomedical Scientist Arwa Al-Riyami, Consultant Asma A Musleh, Biomedical Scientist Zeba Zabeen, Senior Registrar Badriya Al-Belushi, Biomedical Scientist Hammad Khan, Senior Registrar Mohammed Al-Rawahi, Biomedical Scientist Fehmida Zia, Registrar Ishaq Al-Salmi, Biomedical Scientist Fauzia Wasim, Registrar Eufrosina Alverez, Biomedical Scientist Abdulmanan Adulgafoor, Registrar Julian Neson, Biomedical Scientist Nausheeen Kamran, Registrar Mohan Doraiswamy, Biomedical Scientist Vinodh Panjwani, Senior House Officer Nestor Naniong, Biomedical Scientist Najwa Abdulhameed, Senior House Officer Rene Gabucay, Biomedical Scientist Ghasan Ageed, Senior House Officer Allan S Aurelio, Biomedical Scientist Mohamed Rehan, Senior House Officer Adela Angeles, Biomedical Scientist departments Moez HA Rhim, Senior House Officer Melani Tauro, Biomedical Scientist Mariyam Al Bakri, Senior House Officer Malvin J Wee Li, Biomedical Scientist care

Rana Ibrahim El Fadil, Senior House Officer Vardarajan Nelvoy, Biomedical Scientist Support Staff Lancy Henry, Biomedical Scientist Stuart Donaldson, Superintendent Jerry Macni, Biomedical Scientist patient

David Gravell, Chief Biomedical Scientist Rhea Misquith, Biomedical Scientist Heidi M. Davis, Chief Biomedical Scientist, Binny Sam, Head Staff Nurse -1 and

Ali Al-Marhoobi, Chief Biomedical Scientist Rose Saly, Staff Nurse -2 Shakila Ashraf, Senior Biomedical Scientist Mary Kurian, Staff Nurse - ICH3 academic Haematology 89 Annual Report 2010-2011 Haematology

Victoria Gladwin Menezes, Staff Nurse 2 Shiney Thomas, Staff Nurse 2 Silva Kumari, Staff Nurse 2 Bindu Shiby, Staff Nurse 2 Shobha Sujith, Staff Nurse 2 Eman Al-Homaidi, Coordinator Tomichan Varghese, Coordinator Highlights of the Year 2010-2011 In 2010-2011, the Haematology Clinical Unit treated patients with a vast range of haematological disorders, both as inpatients and outpatients. In addition, the Department runs a Thalassaemia Day Care Unit. In 2011, it offered comprehensive care for about 150 patients with transfusion dependent thalassaemia. Of national interest is the successful bone marrow transplant programme, run by this Department. By the end of De- cember 2011, a total of 209 bone marrow transplants had been performed in this centre, with results as good as those from the best centres around the world.

Teaching Programmes UNDERGRADUATE The Department has participated in teaching the Haemato-Lymph-Vascular course to the third year stu- dents. It developed and taught a new module, Hemato-lymphatic-Immunology, in phase 2 of the undergrad- uate curriculum. It participated and coordinated the various courses in phase 2 in the new curriculum, in the particular Integrated modules I, II, III. The Department ran a 5-week course on case-based learning, in hae- matology for the fifth year students in the Integrated Lecture Series; participated in bedside clinical teaching in Medicine. It also ran a laboratory rotation for 6 groups of 7th year students. Each rotation is of 5 days dura- tion. Finally, it runs a B.Sc MLS degree course for training undergraduate biomedical scientists.

POSTGRADUATE PROGRAMME The Department has developed and taught the Haematopathology course along with the Royal Hospital, MOH, which is affiliated with the Oman Medical Specialty Board. There are 6 residents at various stages of training in the programme.

90 Clinical & Diagnostic Services The clinical services are provided in the following major areas; adult outpatients, adult inpatients; bone mar- row transplantation, sickle cell anaemia programe; the leukaemia, lymphoma and myeloma programme, and the thalassaemia day care programme. The laboratory services likewise cover specialised areas incud- ing: haemostasis, flowcytometry, haemoglobinopathy, molecular diagnostics, general laboratory haematol- ogy and the blood transfusion service which includes blood donation, storage, irradiation, plasmapheresis and exchange and apheresis facilities as well as the blood grouping and cross matching laboratory.

BONE MARROW TRANSPLANTATION PROGRAMME The bone marrow transplant programme, established in 1995 in the Department, serves the entire coun- try and continues to provide curative treatment for patients with haematologic malignancy, bone marrow failure and potentially fatal genetic diseases. In the year January to December 2011, 28 transplants were per- formed, (20 allogeneic; 2- haplo-identical; 6 autologous) making a total of 209 transplants since 1995. The results of this transplant centre are comparable with those of the best centres worldwide. Importantly, the cost per transplant is a fraction of what is charged in other countries. Additionally, we have also collected 16 bone marrows and cryopreserved them in our liquid nitrogen storage facility for future use (5 bone marrow harvests for allogeneic use and 11 peripheral blood stem cell collections for autologous use).

SICKLE CELL PROGRAMME The Department looks after a large number of patients with sickle cell disease (SCD) providing acute medical care, as well as genetic counselling and preventive programmes (e.g. cord blood testing), and organising and guiding the patients and the medical community in the care of SCD. Recently the role of the Department has been highlighted through our community outreach programmes via the Hereditary Blood Disorders Society. Furthermore, several cases with severe sickle cell disease have now benefited from the department’s active role in transplanting these patients from sibling donors with good success. departments LEUKAEMIA LYMPHOMA AND MYELOMA PROGRAMME The Department is now an important tertiary care centre for most referrals for adult haematological malig- care nancies particularly leukaemias, lymphomas and myeloma. The patients are able to receive state-of-the-art care both in terms of diagnostic and therapeutic modalities, including bone marrow transplant (BMT) and the advanced molecular diagnostics needed for proper workup and follow-up. patient

THALASSAEMIA PROGRAMME and The Department has been looking after about 150 patients with thalassaemia, delivering comprehensive care including blood transfusions, chelation therapy, and regular meticulous monitoring for the side effects academic Haematology 91 Annual Report 2010-2011 Haematology

and complications of the disease and its treatment. The unit is a centre of excellence in the region with heavy involvement in care and research including participation in an international drug trial (Exjade). The availability of the latest state of art MRI T2* equipment in the Radiology department has helped in monitor- ing the cardiac and liver iron overload status of these patients with improved monitoring of iron overload in these patients.

HAEMATOLOGY CLINICS AT THE NEW SOHAR HOSPITAL The Department conducts a monthly haematology clinic at the new Sohar Hospital. The clinic is run on rotation basis by one of the Department’s haematology consultants. They are assisted locally by Dr Ali Al- Madhani, from the Department of Medicine, Sohar Hospital.

GENERAL LABORATORY SERVICES The Haematology Laboratory caters to the entire hospital and additionally receives referral samples from all over Oman for routine and advanced haematology laboratory testing. The laboratory is subdivided into various sections including general haematology, haemoglobinopathy, haemostasis and special haematol- ogy, blood banking and donor room services, and the molecular division.

MOLECULAR RESEARCH AND DIAGNOSTIC LABORATORY The Department now offers DNA diagnostic facilities for several thrombophilic disorders, haemoglobin dis- orders, immune deficiency syndromes and malignant haematology, especially for acute and chronic leu- kaemia. The section is also involved in the monitoring of the transplant progress by chimerism studies in post-transplant patients.

CORD BLOOD BANK The Department, in collaboration with Obstetrics & Gynaecology, has now set up a Cord Blood Bank. We have standardised the collection and storage of cord blood samples. Collection of cord blood is currently done under two programs; a) sibling cord blood (SCB) and b) unrelated cord blood (UCB). Up to December 2011, we had collected a total of 93 SCB units and 50 UCB units. We have so far used 3 SCB units for sibling cord blood transplantation.

APHERESIS UNIT OF THE BLOOD BANK The Department has now installed the Baxter Amicus and Cobe Spectra apheresis systems and our apheresis nurses and technicians are trained in their use. Both of these systems are now in routine use for harvesting stem cells from donors in the Department’s Bone Marrow Transplantation program and platelet apheresis. We have performed bone marrow harvest for autologous backup of patients undergoing transplantation in

92 9 cases. Additionally, in 15 cases, we have done peripheral blood stem cell cryopreservation for patients un- dergoing autologous transplantations. Moreover, apheresis services are now made available, in consultation with the attending haematologist on duty, to the SQUH wards and ICU units whenever the need for plasma- pheresis or plasma exchange arises.

BUSULPHAN PHARMAKOKINETICS Optimisation of busulphan dosage in patients undergoing bone marrow transplantation is recommended in order to reduce the toxic effects associated with high drug levels. The API 150 EX LCMS system which has been installed for the research project on intravenous versus oral busulphan in BMT for thalassaemia is now fully operational. The section looks after the busulphan pharmakokinetics in patients undergoing BMT to assess the blood levels of the drug in order to optimise the treatment protocols. We have thus far performed pharmacokinetic studies on 14 patients for this purpose.

Table 1: Laboratory Activities Year Patients % increase Tests & % increase on previous year Procedures on previous year 2007 11,7631 -12.1% 48,5060 -2.5% 2008 14,7799 +25.6% 59,8309 +23.3% 2009 17,7568 +20.1% 71,2520 +19.1% 2010 19,8109 +11.6% 77,8662 +9.3% 2011 21,3406 +7.7% 84,0309 +7.9%

Table 2: Clinical Workload departments

Year Haematology % Change Haematology % Change on Haematology % Change In-Patients on previous day care previous year Out-Patients on Previous care year Year 2007 1,416 +5.3% 3,078 -10.5% 2,826 +6.2% patient 2008 1,409 -0.5% 3,035 -1.4% 3,428 +21.3%

2009 1,887 +33.9% 3,127 +3.0% 4,181 +22.0% and

2010 1,869 -1.0% 3,271 +4.6% 4,407 +5.4% 2011 1,630 -12.8% 3,773 +15.3% 5,336 +21.1% academic Haematology 93 Annual Report 2010-2011 Haematology

Research RESEARCH PROJECTS Establishment of a national facility in stem cell translation research for novel cellular-based therapies and tissue repair Project Code: SR/MED/ HAEM/09 /01; Dates: 2009–2011 Value: OR 165,000; Project Funder: His Majesty’s Strategic Fund, Oman Investigators: Dr. David Dennison, Dept. Haematology, SQU; Dr. Sultan Al-Maskari Dept. Surgery, SQU; Dr. Anil Pathare, Dept. Haematology, SQU; Dr. Salam Al-Kin- di, Dept. Haematology, SQU; Dr. Khalil Al-Farsi, Dept. Haematology, SQU; Dr. Mohammed Al-Hunieni, Dept. Haematology, SQU; Dr. Nagla Fawaz, Dept. Haematology, SQU; Ms. Qamariya Al-Abri, Dept. Haematology, SQU; Ms. Sahima Al-Maamaari, Dept. Haematology, SQU; Ms. Sabah Al-Mah- rooqi, Dept. Haematology, SQU; Ali Al-Mahroobi, Dept. Haematology, SQU; Hamed Al-Gheiti, Dept. Haematology, SQU; Shoaib Al-Zadjali, Dept. Hae- matology, SQU; Melanie Tauro, Dept. Haematology, SQU; Dr. Yasser Wali, Dept. Child Health, SQU; Dr. Abdulhakeem Rawas, Dept. Child Health, SQU; Dr. Muhanna Al-Muslahi, Dept. Haematology, Royal Hospital, Oman ; Dr. Hamoud Al-Dhuli, Dept. Radiology, SQU; Dr. Rashid Al- Sukaiti, Dept. Radiol- ogy & Molecular Imaging, SQU; Dr. Shyam Ganguly, Dept. Family Medicine & Public Health, SQU; Dr. Helmut Schuster, Dept. Microbiology & Immunol- ogy, SQU; Dr. Adeeb Al-Zoubi, Jordan University, Jordan.

Molecular Genetics of alpha globin gene expression in native Omani Population: Towards understanding the molecular basis of alpha thalassaemia and impact on clinical expression of beta thalassaemia and sickle cell disease Project Code: RC/MED/HAEM/10/01; Dates: 2010-2012 Value: OR 68,300; Project Funder: The Research Council, Oman Investigators: Dr. Salam Al-Kindi, Dept. Haematology, SQU; Dr. Muhammed Al-Hu- naini, Dept. Haematology, SQU; Dr. Khalil Al-Farsi, Dept. Haematology, SQU; Dr. Anil Pathare, Dept. Haematology, SQU; Dr. Nagla Fawaaz, Dept. Haematology, SQU; Shoaib Al-Zadjali, Dept. Haematology, SQU; Hamood Al-Haddabi, Dept. Haematology, SQU; Dr. R. Krishnamoorthy, INSERM U 763, Paris, France.

94 Pharmacogenetic factors affecting warfarin dosing: Rationale for prospective genetic screening before anticoagulation therapy Project Code: IG/MED/HAEM/09/01; Dates: 2009–2011 Value: OR 5,400; Project Funder: Sultan Qaboos University Investigators: Dr. Anil Pathare, Dept. Haematology, SQU; Dr. Salam Al-Kindi, Dept. Hae- matology, SQU; David Gravell, Dept. Haematology, SQU; Shoaib Al-Zadjali, Dept. Haematology, SQU; Hamood Al-Haddabi, Dept. Haematology, SQU; Dr. R. Krishnamoorthy, INSERM U 763, Paris, France.

Genetic basis of variable expression of fetal hemoglobin in sickle cell disease and beta thalassaemia patients from Oman Project Code: IG/MED/HAEM/10/01; Dates: 2010–2011 Value: OR 4,700; Project Funder: Sultan Qaboos University Investigators: Dr. Anil Pathare, Dept. Haematology, SQU; Dr. Salam Al-Kindi, Dept. Hae- matology, SQU; Dr. Mohammed Al-Hunieni, Dept. Haematology, SQU; Dr. Khalil Al-Farsi, Dept. Haematology, SQU; Dr. Shahina Daar, Dept. Haema- tology, SQU; Shoaib Al-Zadjali, Dept. Haematology, SQU; Sahima Al-Maa- mari, Dept. Haematology, SQU; Dr. R. Krishnamoorthy, INSERM U 763, Paris, France.

Role of von Willebrand factor on the occurrence of vaso-occlusive crisis in patients with sickle cell dis- ease. Project Code: IG/MED/ HAEM/10/02; Dates: 2010–2012 Value: OR 11,500; Project Funder: Sultan Qaboos University Investigators: Dr. Mohammed Al-Hunieni, Dept. Haematology, SQU; Dr. Anil Pathare, departments Dept. Haematology, SQU; Prof. Chao-Hung Ho, Dept. Haematology, SQU; David Gravell, Dept. Haematology, SQU; Shoaib Al-Zadjali, Dept. Haema-

tology, SQU; Qamariya Al-Abri, Dept. Haematology, SQU; Vinod Panjwani, care

Dept. Haematology, SQU; Hamed Khan, Dept. Haematology, SQU.

Rhesus [RH] and Kell [KEL] alleles in Sickle cell patients with alloimmunization patient Project Code: IG/MED/HAEM/11/01; Dates: 2011–2013

Value: OR 13,000; Project Funder: Sultan Qaboos University and

Investigators: Dr. Anil Pathare, Dept. Haematology, SQU; Dr. Salam Al-Kindi, Dept. Hae- matology, SQU; Dr. Nagalaa Fawaz, Dept. Haematology, SQU; Shoaib Al- academic Haematology 95 Annual Report 2010-2011 Haematology

Zadjali, Dept. Haematology, SQU; Ali Mahroobi, Dept. Haematology, SQU; Saba Mahrooqi, Dept. Haematology.

Evaluation of serum procalcitonin as a marker of sepsis in febrile sickle cell disease patients presenting to the Emergency Department at the SQUH. Project Code: IG/MED/HAEM/11/03; Dates: 2011–2013 Value: OR 2,000; Project Funder: Sultan Qaboos University Investigators: Dr. Mohammed Al-Hunieni, Dept. Haematology, SQU; Dr. Salam Al-Kindi, Dept. Haematology, SQU; Dr. Anil Pathare, Dept. Haematology, SQU; Dr Ab- dulla Al-Reesi, Emergency Department, SQU, Dr. Ali Al-Busaidi, Emergency Department, SQU, Dr. Mustafa Al-Hinai, Emergency Department, SQU, Dr. Khalil Al-Farsi, Dept. Haematology, SQU; Murtadha AlKhabori, Dept. Hae- matology, SQU.

Towards understanding the environmental and inherited basis of Iron Deficiency and Iron Deficiency Anemia in native Omani population: Molecular Genetics of Iron Metabolism. Project Code: IG/MED/HAEM/11/02; Dates: 2011–2013 Value: OR 16,700; Project Funder: Sultan Qaboos University Investigators: Dr. Nagala Fawaz, Dept. Haematology, SQU; Dr. Anil Pathare, Dept. Hae- matology, SQU; Dr. Salam Al-Kindi, Dept. Haematology, SQU; Shoaib Al- Zadjali, Dept. Haematology, SQU; Dr. R. Krishnamoorthy, INSERM U 763, Paris, France

Prevalence of abnormal bone densitometry findings in individuals with homozygous beta thalassaemia Project Code: MREC #325; Dates: 2010–11 Investigators: Dr. Shahina Daar, Dept. Haematology, SQU, Dr. Samir Hussein, Dept. Radiol- ogy & Molecular Imaging, SQU, Dr. Mohammed Al-Hunieni, Dept. Haema- tology, SQU.

Prevalence of delta globin chain variant in Omani population Project Code: MREC #326 Dates: 2010-11 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. Shahina Daar, Department of Haematology, SQU.

96 Prevalence of optimal monitoring of kidney function in relation to patients with thalassaemia. Project Code: MREC #351 Dates: 2010–2011 Value: Unfunded; Project Approval: Sultan Qaboos University Investigators: Dr. Shahina Daar, Dept. Haematology, SQU; Dr. Sunil Bhandari, Hull York Medical School, UK; Dr. Khalid Al-Rasadi, Dept. Biochemistry, SQU; Dr. Hu- moud Al-Dhuhli, Dept. Radiology & Molecular Imaging, SQU; Surekha Mev- ada, Dept. Child Health, SQU; Dr. Hammad Khan, Dept. Haematology, SQU.

Evaluation of cardiac and liver iron load by MRI T2* Project Code: MREC #361; Dates: 2010–2011 Value: Unfunded; Project Approval: Sultan Qaboos University Investigators: Dr. Shahina Daar, Dept. Haematology, SQU; Dr. Humoud Al-Dhuhli, Dept. Radiology & Molecular Imaging, SQU.

Prevalence of endocrinopathies in thalassaemia major patients, correlation with total body iron load and cardiac iron load Project Code: MREC #344; Dates: 2010–2011 Value: Unfunded; Project Approval: Sultan Qaboos University Investigators: Dr. Shahina Daar, Dept. Haematology, SQU; Dr. Khalil Al-Farsi, Dept. Hae- matology, SQU; Dr. David Dennison, Dept. Haematology, SQU; Dr. Fehmida Zia, Dept. Haematology, SQU; Dr. Moez HA Rhim, Dept. Haematology, SQU.

Clinical effects of Nicosan TM to reduce the occurrence vasoocclusive crisis patients with sickle cell dis- ease

Project Code: MREC# 352; Dates: 2010-11 departments

Value: Unfunded; Project Approval: Sultan Qaboos University care

Investigator: Dr. Salam Al-Kindi, Dept. Haematology, SQU

Retrospective analysis of Sickle cell patient with PORT-A-CATH insertion to analyze complications of PORT-A-CATH in patients with Sickle cell Disease patient

Project Code: MREC# 357; Dates: 2010-11 and

Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. Salam Al-Kindi, Dept. Haematology, SQU academic Haematology 97 Annual Report 2010-2011 Haematology

Evaluation of Cardiac and Liver Iron Load by Cardiac MRI (T2*) Project Code: MREC# 361; Dates: 2010-11 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. Shahina Daar, Dept. Haematology, SQU

Causes and Outcome of Fever in patients with Sickle cell Disease Project Code: MREC# 362; Dates: 2010-11 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. Khalil Al-Farsi, Dept. Haematology, SQU

Acute Chest Syndrome in Sickle Cell Patients during Pregnancy: Risk Factors and Outcome Project Code: MREC# 363; Dates: 2010-11 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. Khalil Al-Farsi, Dept. Haematology, SQU

Causes of Prolonged Prothrombin Time and Activated Partial Thromboplastin Time Project Code: MREC# 364; Dates: 2010-11 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. Khalil Al-Farsi, Dept. Haematology, SQU

Prevalence of delta globin chain variant in Omani population Project Code: MREC# 326; Dates: 2010-11 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. Shahina Daar, Dept. Haematology, SQU.

Worldwide Evaluation of Cardiac T2 Project Code: MREC# 335; Dates: 2009-11 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. Shahina Daar, Dept. Haematology, SQU.

98 Thrombophilia in patients with recurrent pregnancy loss Project Code: MREC# 375; Dates: 2010 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr Khalil Al-Farsi, Dept. Haematology, SQU.

Prevalence of Hepatitis B and C infection in individuals with homozygous beta thalassemia Project Code: MREC# 402; Dates: 2011 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. Shahina Daar, Dept. Haematology, SQU.

Achievement of Target international normalized ratio (INR) in patients taking warfarin- A study in Oman Project Code: MREC# 406; Dates: 2011 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Prof. Chao Hung Ho, Dept. Haematology, SQU.

Prevalence, Spectrum and Correlation of Lupus Anticoagulant Positively with Clinical Outcome: Retro- spective Data Analysis Project Code: MREC# 418; Dates: 2011 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr Anil Pathare, Dept. Haematology, SQU.

Variation of Lymphocytes subset in HIV patients on HAART departments

Project Code: MREC# 431; Dates: 2011 Value: Unfunded; Project Approval: Sultan Qaboos University care Investigator: Dr. Salam Al-Kindi, Dept. Haematology, SQU

Study of Efficacy of Tyrosine Kinase Inhibitors in the Treatment of CML patient

Project Code: MREC# 457; Dates: 2011 Value: Unfunded; Project Approval: Sultan Qaboos University and

Investigator: Dr. Salam Al-Kindi, Dept. Haematology, SQU academic Haematology 99 Annual Report 2010-2011 Haematology

Extending molecular responses with Nilotinib in newly diagnosed chronic myeloid leukemia (CML) pa- tients in chronic phase (ENESTxtnd study) Project Code: MREC# 461; Dates: 2011 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. Salam Al-Kindi, Dept. Haematology, SQU RESEARCH PUBLICATIONS & BOOKS Journal Publications 1. Daar S, Ahmed S, Berdoukas V. Rapid iron loading in heart and liver in a patient with transfusion dependent thal- assaemia after brief poor compliance with iron chelation therapy. Sultan Qaboos University Med J 2010; 10:401-4. 2. Suliman MA, Juma AA, Almadhani AA, Pathare AV, Alkindi SS, Werner UF. Predictive value of neutrophil to lympho- cyte ratio in outcomes of patients with acute coronary syndrome. Arch Med Res 2010; 41:618-22 3. Puig N, Pintilie M, Seshadri T, Al-Farsi K, Nagy T, et al. Different response to salvage chemotherapy but similar post- transplant outcomes in patients with relapsed and refractory Hodgkin’s lymphoma. Haematologica 2010; 95:1496- 502. 4. Aljurf M, Zaidi SZ, Hussain F, Ghavamzadeh A, Jahani, Dennison D, et al. Status of hematopoietic stem cell transplan- tation in the WHO Eastern Mediterranean Region (EMRO). Transfus Apher Sci 2010; 42:169-75. 5. Dalal B, Al Riyami A, Yenson P.Microangiopathic haemolytic anaemia and hyposplenism in angiosarcoma. Br J Hae- matol 2010; 151:413. 6. Mousa SA, Al Momen A, Al Sayegh F, Al Jaouni S, Nasrullah Z, Al Saeed H, Alabdullatif A, Al Sayegh M, Al Zahrani H, Hegazi M, Al Mohamadi A, Alsulaiman A, Omer A, Al Kindi S, et al. Management of painful vaso-occlusive crisis of sickle-cell anemia: consensus opinion. Clin Appl Thromb Hemost. 2010; 16:365-76. 7. Khabori MA, El-Emary M, W Xu, Guyatt G, et al. Impact of intensity of the conditioning therapy in patients aged 40 to 60 years with acute myeloid leukemia/ myelodysplastic syndrome undergoing allogeneic transplantation. bone marrow transplantation 2011; 46:516-22. 8. Al Khabori M, de Almeida JR, Guyatt GH, Kuruvilla J, Crump M. Autologous stem cell transplantation in follicular lymphoma: a systematic review and meta-analysis. J Natl Cancer Inst 2011; 104:18-28. 9. Alkaabi JK, Pathare A. Pattern and outcome of vascular involvement of Omani patients with Behcet’s disease. Rheumatol Int 2011; 31:731-5. 10. Gowri V, Mathew M, Gravell D, Al Falahi K, Al Zakwani I, Ganguly SS, Pathare AV. Protein Z levels in pregnant Omani women: Correlation with pregnancy outcome. J Thromb Thrombolysis 2011; 32:453-8. 11. Alkindi S, Arafa N, Al Okbi M, Pathare A. Complete recovery following sudden sensorineural hearing loss in a pa- tient with sickle cell disease. Hematol Oncol Stem Cell Ther 2011; 4:97-9. 12. Al Okbi MH, Alkindi S, Al Abri RK, Mathew J, Nagwa AA, Pathare AV. Sensorineural hearing loss in sickle cell disease-

100 -a prospective study from Oman. Laryngoscope 2011; 121:392-6. 13. Alkindi S, Machado N, Chopra P, Al-Huneini M, Mohamed K, Alfarsi K, Pathare A. Acute massive splenic infarction with complete liquefaction of the spleen in sickle cell disease. Hematol Oncol Stem Cell Ther 2011; 4:142-3. 14. Krishnan L, Pathare A. Necrotizing enterocolitis in a term neonate following intravenous immunoglobulin therapy. Indian J Pediatr 2011; 78:743-4. 15. Alkindi S, Pathare A, Al-Madhani A, Al-Zadjali S, Al-Haddabi H, Al-Abri Q, Gravell D, Mathew M, Krishnamoorthy R. Neonatal Screening: Mean haemoglobin and red cell indices in cord blood from Omani neonates. Sultan Qaboos University Med J 2011; 11:462-9. 16. Al Zadjali S, Wali Y, Al Lawatiya F, Gravell D, Alkindi S, Al Falahi K, Krishnamoorthy R, Daar S. The β-globin promoter -71 C>T mutation is a β + thalassemic allele. Eur J Haematol. doi: 10.1111/j.1600-0609.2011.01687.x. Epub ahead of print. 17. Daar S, Al Zadjali S, Gravell D, Al Haddabi H, Al Riyami M, et al. Hb A2’ (Hb B2) in the Omani population and diagnos- tic significance. Hemoglobin 2011; 35:117-24. 18. Al Zadjali S, Daar S, AlKindi S, Gravell D, Al Haddabi H, et al. Hb Sheffieldβ [ 58(E2)ProβHis] in Oman: potential pitfall in genetic counseling. Hemoglobin 2011; 35:111-6. 19. Wali Y, Zadjali SA, Elshinawy M, Beshlawi I, Fawaz N, Alkindi S, Rawas A, Alsinani S, Daar S, et al. Severity ranking of non-deletional alpha thalassemic alleles: insights from an Omani family study. Eur J Haematol 2011; 86:507-11. 20. Taher A, Elalfy MS, Al Zir K, Daar S, Al Jefri A, Habr D, et al. Importance of optimal dosing β30 mg/kg/d during de- ferasirox treatment: 2.7-yr follow-up from the ESCALATOR study in patients with β-thalassaemia. Eur J Haematol 2011 87: 355-65. 21. Taher A, Elalfy MS, Al Zir K, Daar S, Al Jefri A, , et al. Achieving treatment goals of reducing or maintaining body iron burden with deferasirox in patients with β-thalassaemia: results from the ESCALATOR study. Eur J Haematol 2011; 87:349-54. 22. Wali Y, Zadjali SA, Elshinawy M, Fawaz N, Alkindi S, Rawas A, Alsinani S, Daar S, Krishnamoorthy R. Severity ranking of non-deletional alpha thalassemic alleles: insights from an Omani family study. Eur J Haematol 2011; 86:507-11. 23. Al-Farsi K, Al-Haddabi I, Al-Riyami N, Al-Sukaiti R, Al-Kindi S. Myelomatous Pleural Effusion: Case report and re- view of the literature. Sultan Qaboos University Med J 2011; 11:259-64. departments 24. Puig N, Pintilie M, Seshadri T, Al-Farsi K, Franke N, et al. High-dose chemotherapy and ASCT in elderly patients with Hodgkin’s lymphoma. Bone Marrow Transplant 2011; 46:1339-44. care 25. Ho CH. Can very high level of D-dimer exclusively predict the presence of thromboembolic diseases? J Chin Med As- soc 2011; 74:151-4. 26. Mohamed SY, Fadhil I, Hamladji RM, Hamidieh AA, Fahmy O, Ladeb S, Dennison D, et al. Hematopoietic stem cell

transplantation in the Eastern Mediterranean Region (EMRO) 2008-2009: report on behalf of the Eastern Mediter- patient

ranean Bone Marrow Transplantation (EMBMT) Group. Hematol Oncol Stem Cell Ther 2011; 4:81-93. and

27. Ahmed SO, Ghavamzadeh A, Zaidi SZ, Baldomero H, Alkindi S, et al. Trends of hematopoietic stem cell transplanta- tion in the Eastern Mediterranean region,. Biol Blood Marrow Transplant 2011; 17:1352-61. academic Haematology 101 Annual Report 2010-2011 Haematology

28. Alkindi S, Dennison D. Umbilical cord blood banking and transplantation: A short review. Sultan Qaboos University Med J 2011;11:455-61. 29. Alkindi S, Smith OP, Enright H. Successful use of alternative anticoagulants in the management of heparin-induced thrombocytopenia with thrombotic complications: Report of 5 cases and review of literature. Sultan Qaboos Uni- versity Med J 2011; 11:391-8 30. Al-Riyami AZ, Tsang PW, Hudoba M. Extreme eosinophilia in a setting of metastatic leiomyosarcoma: An unusual case report. Ann Hematol 2011; Dec 23 Epub ahead of print. 31. Al-Riyami AZ, Lee J, Connolly M, Shereck E. Cerebral sinus thrombosis following IV immunoglobulin therapy of im- mune thrombocytopenia purpura. Pediatr Blood Cancer 2011; 57:157-9. 32. El-Emary M, Khabori MA, Buitron N, et al. Long term outcomes of allogeneic stem cell transplantation for chronic lymphocytic leukemia. Biol Blood Marrow Transplant 2010; 16:S275-6. 33. Al-Khabori M, Al-Rawas A, Al-Kindi S, et al. Long term outcomes of allogeneic transplant using non-radiation based preparative regimens for acute lymphoblastic leukemia. Biol Blood Marrow Transplant 2011; 2:S313. CONFERENCE & SEMINAR PRESENTATIONS Posters Presentations International 1. Farsi KA, Zadjali SA, Falahi KA, Al-Khabori MK, Pathare A, Alkindi S. Inherited thrombophilia in Omani women with recurrent pregnancy loss. 52nd ASH Annual Meeting. Orlando, FL, USA, 4-7 December 2010. Blood (ASH Annual Meeting) Abstracts 2011; 116:5124. 2. Al-Khabori MK, Guyatt G, Minden MD, et al. A prognostic score of overall survival in adults with acute myeloid leu- kemia. 52nd ASH Annual Meeting. Orlando, FL, USA, 4-7 December 2010. Blood (ASH Annual Meeting Abstracts) 2011; 116:2730. 3. Al-Khabori MK, Yee K, Gupta V, et al. Validation of monosomal karyotype based model in the risk stratification of acute myeloid leukemia. 52nd ASH Annual Meeting. Orlando, FL, USA, 4-7 December 2010. Blood (ASH Annual Meet- ing Abstracts) 2011; 116:2745. 4. Al-Khabori MK, Pathare A, Al Farsi K, Al Huneini M, Alkindi S. Prevalence of thrombophilia in patients with sickle cell disease and osteonecrosis. 52nd ASH Annual Meeting. Orlando, FL, USA, 4-7 December 2010. Blood (ASH Annual Meeting Abstracts) 2011; 116:3184. 5. Al Riyami AZ, Roland K, Chipperfield K. Octaplex usage one year after implementation at a tertiary care hospital. Canadian Society of Transfusion Medicine, 2010, and University of British Columbia, Pathology Day, 2010. 6. Panjwani V, Alkindi SS, Fawaz N, Pathare AV. Prevalence, spectrum and correlation of lupus anticoagulant positiv- ity with clinical outcome: experience from a single tertiary centre in Oman. 16th Congress European Hematology Association. London, United Kingdom, 9-12 June 2011. Haematologica 2011; 96:663. Abstract 1709. 7. Pathare AV, Al Zadjali S, Alkindi SS, Panjwani V, Misquith R, AlKhabori M, Ganguly SS, et al. Contribution of age, gender, body weight, CYP2C9, CYP4F2 and VKORC1 genotype to the warfarin anticoagulant response in Omani pa-

102 tients. 16th Congress European Hematology Association. London, United Kingdom, 9-12 June 2011. Haematologica 2011; 96:677. Abstract 1751. 8. Alkindi S, AlZadjali S, Pathare A, Krishnamoorthy R. Strategy for Molecular Characterization of Alpha Thalassaemia in Omani Population. 16th Congress European Hematology Association. London, United Kingdom, 9-12 June 2011. Haematologica 2011; 96:615. Abstract 1564. 9. AlFarsi S, AlZadjali S, Kumar V, AlFalahi K, Gravell D, PathareA, Alkindi S. inherited thrombophilia in women with recurrent pregnancy loss. 16th Congress European Hematology Association. London, United Kingdom, 9-12 June 2011. Haematologica 2011; 96:670. Abstract 1730. 10. Ho CH, Gravell D. Setting a target international normalized ratio range doesn’t guarantee good achievement of that range—A study in Omani patients taking warfarin. 16th Congress European Hematology Association. London, United Kingdom, 9-12 June 2011. Haematologica 2011; 96:662. Abstract 1704. 11. Pathare AV, AlZadjali S, Misquith R, Alkindi S, Lapoumeroulie C, A Paldi, R. Krishnamoorthy. Atypical VKORC1 hap- lotypes in the Omani population: Implications for dose variability of vitamin K antagonist”. 4th International Con- gress of Molecular Medicine. Istanbul, Turkey, 27-30 June 2011. In Vivo 2011; 25:552-3. Abstract 227. 12. Pathare AV, Alkindi S, Al Maskari M, Al Zadjali S, Krishnamoorthy R. Fetal hemoglobin expression in sickle cell dis- ease patients from Oman: Correlation with BCL11A, HBSIL-MYB, HBG2 SNPs. 4th International Congress of Molecular Medicine. Istanbul, Turkey, 27-30 June 2011. In Vivo 2011; 25:553. Abstract 228. 13. Gowri V, Mathew M, Gravell D, Al Falahi K, Al Zakwani I, Pathare AV. Protein Z levels in pregnant Omani women: Correlation with pregnancy outcomes. 23rd Congress International Society of Thrombosis & Hemostasis, Kyoto, Japan, 23-28 July 2011. Abstract 153. 14. Ho CH, Gravell D. Low achievement of target international normalized ratio in patients taking warfarin even in a specialist clinic: A study in Omani patients and review of literature. 23rd Congress International Society of Throm- bosis & Hemostasis, Kyoto, Japan, 23-28 July 2011. Abstract 433. 15. V Gowrie, D Dennison, Pathare AV. Etiological profile of women presenting with premature ovarian failure to Sul- tan Qaboos University hospital, in the Sultanate of Oman”. North American Menopause Society (NAMS), 22nd An- nual Meeting. Washington DC, USA, 21-24 September 2011. Abstract 1165079. 16. Alkindi S, AlMahrooqi S, AlHinai S, Al Marhoobi A, Daar S, Fawaz N, Pathare AV. Alloimmunization among pa- departments

tients with sickle cell disease and thalassaemia: experience of single centre in Oman. San Diego, CA, USA, 22-25 October 2011.

17. Al Zadjali S, Abdulhameed S, AlMahrooqi S, Alkindi S, Pathare AV. Molecular basis of Pk phenotype in a sickle cell care

anemia patient from Oman. San Diego, CA, USA, 22-25 October 2011. 18. Al Farsi K, Al-Khabori M, et al. Gonadal function in patients with beta-thalassemia major following bone marrow transplantation. 52nd ASH Annual Meeting. Orlando, FL, USA, 4-7 December 2010. Blood (ASH Annual Meeting Ab- patient stracts) 2011; 118:4105. 19. Tony S, Murtadha K, Al-Khabori M, et al. Dose optimization of deferasirox in chelation naive children with thalas- and semia major. 52nd ASH Annual Meeting. Orlando, FL, USA, 4-7 December 2010. Blood (ASH Annual Meeting Ab- stracts) 2011; 118:5294. academic Haematology 103 Annual Report 2010-2011 Haematology

20. Tony S, Daar S, Al Zadjali S, Murtadha K, Al-Khabori M, et al. T2* MRI in hypertransfused children with thalassemia intermedia: serum ferritin does not reflect the reality. 52nd ASH Annual Meeting. Orlando, FL, USA, 4-7 December 2010. Blood (ASH Annual Meeting Abstracts) 2011; 118:5304. 21. Al-Habsi K, Murtadha K, Al-Khabori M, et al. Long term follow up of patients with immune thrombocytopenia receiving rituximab. 52nd ASH Annual Meeting. Orlando, FL, USA, 4-7 December 2010. Blood (ASH Annual Meeting Abstracts) 2011; 118:4675. Seminar Presentations International 1. Daar S. Iron chelation in beta thalasaemia. 1st Haematology Update Conference. Manama, Bahrain, May 2010. 2. Daar S. Myocardial T2* MRI for diagnosis & follow-up of cardiac siderosis in thalassaemia. 1st Haematology Update Conference. Manama, Bahrain, May 2010. 3. Daar S. Exjade – The Oman Experience, Gulf Thalassaemia Workshop. Dubai, UAE, February 2010. 4 Daar S. Exjade in Oman- case presentations. Middle East Hematology Oncology Summit, Dubai, UAE, February 2011. National 1. Daar S. Unusual Hb variants in Oman- Pitfalls in diagnosis. Oman International Conference on Laboratory Medicine. Sultan Qaboos University, Muscat, Oman, November 2010. 2. Daar S. 6 year clinical experience with Exjade in Oman. Novartis Symposium, Muscat, Oman, April 2011. 3. AlKindi S. Indications for platelet transfusions. Liwa First National Symposium, Oman. October 2010. 4. AlKindi S. Platelet transfusion. Annual National Laboratory Symposium (Transfusion Medicine), Nizwa, Oman, Oc- tober 2010. 5. AlKindi S. Research in Sickle Cell Disease - From bench to bedside. Oman International Conference in Laboratory Medicine. Sultan Qaboos University, Muscat, Oman, November 2010. 6. AlFarsi K. Clinical Cases with Thrombophilia. Oman Hematology Forum, Blood Club. Al Sawadi Beach, Muscat, Oman, January 2010.

104 departments

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academic Haematology 105 Annual Report 2010-2011 Human & Clinical Anatomy

Human & Clinical Anatomy

he Department is concerned with the science of human anatomy, especially the relationship between structure and function, clinical applications and its use in interpreting images produced by modern radiographic techniques. The Department’s main teaching load is in the pre-clinical programme (B.Sc. Health Sciences). It shares this with other basic medical sciences depart- Tments in the delivery of integrated system courses. However, it also teaches a few department-based courses. Teaching focuses on gross anatomy, developmental anatomy and the study of the microstructure of tissues and cytogenetics. In addition to radiological anatomy, students study gross and topographical anatomy using prosections and anatomical models, histology, and embryology. Living and surface anatomy is an important component of the course. Students taught include medical undergraduates and post- graduates preparing for higher examinations, e.g. Fellowship of the Royal Colleges of Surgeons (FRCS), and students from the College of Nursing.

In addition, the Department’s input includes teaching clinical and applied anatomy and applied cytogentics to Oman Medical Spe- cialty Board candidates. Postgraduate teaching involves the teaching of advanced histology and embryology to candidates specialis- ing in histopathology and obstetrics & gynaecology. Candidates preparing for their FRCS examinations enjoy the teaching facilities provided by the Department. The Department also provides services to other clinical departments and students of the Institute of Health Sciences in Muscat. The Department makes modest contributions to the College’s Master’s Programme.

106 Research continued to be pivotal to the academic ment in September 2010 as Assistant Professor. Dr. activities of the Department. This embraces hyper- Halima Al-Balushi and Dr. Ruqaya Khalfan Al Jabri tension, immune response to pregnancy, calcifica- joined the Department as Clinical Instructors in tion and bone resorption, bone marrow cells and December 2010 and November 2011 respectively. blood cells, medical education, medical informatics Dr. Adhari Al-Zaabi, Senior House Officer, left in and curriculum development. July 2011 on a 4 year Ph.D. scholarship at Brigham Young University, Utah, USA. Dr. Aida Al-Wahaibi resigned as Superintendent and left the depart- Staff ment in October 2010. Sulaiman Al-Khiyari was promoted as Acting Superintendent in November Head of Department 2010. The University of Dundee, UK, conferred a Ibrahim Inuwa, Associate Professor Postgraduate Diploma in Medical Education on Dr. Faculty Ibrahim Inuwa in June 2011. Omar Habbal, Associate Professor Luben Tchakarov, Assistant Professor Varna Taranikanti, Assistant Professor Teaching Programmes Sadhana Roychoudhury, Assistant Professor PRE-CLINICAL PROGRAMME Maimouna Al-Rawahi, Senior Registrar The Department offered several courses in the B.Sc. Adhari Abdullah Al-Zaabi, Senior House Officer (Health Sciences) programme and contributed to Halima Al-Balushi, Clinical Instructor most system-based courses in old as well as in the Ruqaya Al-Jabri, Clinical Instructor new curriculum. Support Staff Courses offered in the old curriculum were: Ali- Sulaiman Al-Khiyari, Acting Superintendent mentary System; Locomotor System; Urinary Sys- Abdulgaffar El-Hag, College Superintendent tem; Respiratory System; Cardiovascular System; Nasser Al-Hashmi, Biomedical Scientist Haematopoetic-Lymphoid-Vascular System; Head

Nawal Al-Mukheini, Biomedical Scientist departments and Neck; Human Nervous System; Applied Basic Talal Al-Hassani, Biomedical Scientist Medical Sciences; Endocrine & Reproductive Sys- Prem Tilaka, Biomedical Scientist care

tem; Clinical Skills Course. Indrani Arambewela, Biomedical Scientist Alexander George, Coordinator Courses offered in the new curriculum were: Intro- duction to Anatomy; Structure-Function Relation- patient Highlights of the Year ship; Growth & Development; The Integrated Mod- ule I; Cardiovascular System; Respiratory System; and 2010-2011 Haemo, Lymph, Immune Systems; The Integrated Dr. Sadhana Roychoudhury joined the Depart- Module II; Alimentary System; Uro-reproductive academic Human & Clinical Anatomy 107 Annual Report 2010-2011 Human & Clinical Anatomy

System; Integrated Module III; Locomotor System; Nervous System & Special Senses.

B.Sc . NURSING PROGRAMME The Department offered Anatomy and Physiology courses in the B.Sc. Nursing program in College of Nursing.

CLINICAL PROGRAMME The Department provided teaching during the clinical program and contributed to cytogenetics and the 5th Year Integrated Lecture Series (ILS).

POSTGRADUATE TEACHING The Department was involved in postgraduate teaching. The teaching of cytogenetics contributed to the Core Program of the Oman Medical Specialty Board (OMSB). The Department also contributed to the post- graduate programme (histopathology) and took part in the SCRAPS medical seminar programme in the Col- lege of Medicine & Health Sciences.

Research RESEARCH PROJECTS Effectiveness of Flexible Digital Media Platform in Anatomy Education Project Code: ORG/SQU/HER/09/007; Dates: 2010–2013 Value: OR 16,900; Project Funder: Sultan Qaboos University Investigators: Dr. Ibrahim Inuwa, Dept. Human & Clinical Anatomy, SQU; Mr. Abdullah Al-Sadi, College of Science, SQU RESEARCH PUBLICATIONS & BOOKS Books 1. Bhatnagar SM, Roychoudhury S, Mehta L, Kothari ML. Essentials of Human Genetics, 5th Ed., Orient Longman (Black- swan) Pvt. Ltd., 2010. 2. Bhatnagar SM, Roychoudhury S. Multiple Choice Questions in Anatomoy, 3rd Ed. Elsevier Reed India Pvt. Ltd., 2010. Journal Publications 1. Taranikanti V, Banerjee Y. Antihypertensive treatment in pre-hypertensive patients JAMA 2011; 305: 2170-71. 2. Taranikanti V, AlRiyami M, Banerjee Y. Initial combination therapy for treatment of hypertension. Lancet 2011 30;

108 377:1490-1. 3. Banerjee Y, Taranikanti V, Bayoumi R. Triglyceride-mediated pathways and coronary heart disease. Lancet; 376:956- 8. 4. BanerjeeY, Taranikanti V, AlRiyamiM. Can antihypertensive drugs raise the risk of cancer? Trends Mol Med 2011; 17:175-6 5. Banerjee Y, Taranikanti V, Bayoumi R. Assays for multi-drug resistant (MDR) and extremely drug resistant (XDR) tuberculosis in high burden countries. Lancet Infect Dis 2011; 11:161-2. 6. Inuwa IM, Rawahy MA, Taranikanti V, Habbal O. Anatomy ‘steeplechase’ online- necessity sometimes is the cata- lyst for innovation. Anat Sci Educ 2011; 4:115-8. 7. Inuwa IM, Taranikanti V, Al-Rawahy M, Habbal O. Anatomy practical examinations: How does student perfor- mance on computerized evaluation compare with the traditional format? Anat Sci Educ 2012; 5:27-32. 8. Inuwa IM, Taranikanti V, Al-Rawahy M, Habbal O. Perceptions and attitudes of medical students towards two methods of assessing anatomy practical knowledge. Sultan Qaboos University Med J 2011; 11:383-90. CONFERENCE & SEMINAR PRESENTATIONS Conference Presentations International 1. Sadhana R. Incorporating team based learning into a traditional medical curriculum for enhanced learning. Na- tional Conference Anatomical Society of India. Pune, India, December 2010. National 1. Inuwa IM. Anatomy of salivary glands. 1st International Sialendoscopy Symposium. Sultan Qaboos University, Mus- cat, Oman, October 2010 Poster presentations International departments 1. Inuwa IM. Is virtual reality undermining “REAL” anatomy learning? – The E-learning debate amongst basic scien- tists in Sultan Qaboos University, Oman. Academy of Medical Educators of England, UK, January 2011. care

2. Varna T. Correlation of lymphangiogenesis and lymphnode involvement in breast cancer. American Association of Cancer Research (AACR) 102nd Annual Meeting. Orlando, Florida, USA, April 2011. 3. Sadhana R. Congenital Diaphragmatic Hernia: Born to Die. National Conference Anatomical Society of India, Pune,

India, December 2010. patient

4. Adhari AZ. PBL (Problem Based Learning) vs Conventional Learning in Sultan Qaboos University Medical College. and

International Journal of Arts & Sciences. Germany, December 2010. academic Human & Clinical Anatomy 109 Annual Report 2010-2011 Human & Clinical Anatomy

110 departments

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academic Human & Clinical Anatomy 111 Annual Report 2010-2011 Medicine

Medicine

he Department of Medicine endeavours to create an environment conducive for achieving excellence in learning for under- graduate and postgraduate students, to provide opportunities to conduct clinical research relevant to the region, and to be a Tcentre of excellence providing specialised, state-of-the-art clinical care in a tertiary care pattern. The major research themes include asthma, breast cancer, gastric cancer, HIV, Hodgkin’s lymphoma, non-Hodgkin’s lymphoma, and cerebrovascular disease. Research areas include epidemiology, molecular characterisation, study of genetic polymorphisms, and study of novel mechanisms of the aetiology of various diseases. Members of the Department are principal or co-investigators of several funded research projects.

The Department provides clinical services through a specialty-based system, and takes pride in providing continuous, comprehen- sive care to the patients in the area required. Consultants are on-call daily from ten different sub-specialties: cardiology, endocrinol- ogy, gastrointestinal and liver disease, general internal medicine, infectious disease, nephrology, neurology, oncology, respiratory and rheumatology. These subspecialties offer medical services to patients in the capital area and accept complicated referrals from all over the country

112 Staff Saif Khan, Senior Registrar Abdulmannan Kaskheli, Senior Registrar Head of Department Shiyam Kumar, Senior Registrar Omar A. Al-Rawas, Professor Ammar Abdulrahman, Senior Registrar Faculty Khalfan Al Zeedy, Senior Registrar Wasif Rasool, Senior Registrar Bazdawi Al-Riyami, Professor, Dean of Nursing Mohammed Misbah, Registrar Nicholas Woodhouse, Professor Fatma B Abid, Registrar Mansour Al-Moundhri, Dean Kowthar Hassan, Registrar Arunodaya Gujjar, Associate Professor, Asst. Dean Osama Hassan, Registrar Clinical Affairs Mohammed A Shah, Registrar Jamal Sallam, Assistant Professor Osama Tariq, Registrar P.C. Jacob, Assistant Professor Saja Mahmoud Mohd, Registrar Batool Hassan, Assistant Professor Ali Al-Shemmari, Senior House Officer Ali Al-Mamari, Senior Consultant, Deputy Head, Abdullah Al-Alawi, Senior House Officer Hospital Affairs Ahmed Al-Qassabi, Senior House Officer Masoud Kashoob, Senior Consultant Haifa Al-Abri, Senior House Officer William Johnston, Senior Consultant Noon Abdulghaffar, Senior House Officer Mehar Ali, Senior Consultant Jamal Al-Aghbari, Senior House Officer Abdullah Al-Asmi, Senior Consultant Yasser Waadallah, Senior House Officer Ikram Burney, Senior Consultant Leena Bella, Senior House Officer Abdullah Balkhair, Senior Consultant Nesreen Siddiq, Senior House Officer Hafidh Al-Hadi, Senior Consultant Sara Aziz, Senior House Officer Juma K Al-Kaabi, Senior Consultant Anjum Hassan, Senior House Officer B. N. Jayakrishnan, Consultant Fathima Aamer, Senior House Officer Dawood Al-Riyami, Consultant Waiel Mekki, Senior House Officer Omayma T Elshafie, Consultant Hashim BaTaher, Senior House Officer departments Jojy George, Consultant Zaheer Siddiqui, Senior House Officer Adil Al-Riyami, Consultant

Technologists care Mansour Sallam, Consultant Aftab Siddiqui, Consultant Sawsan Baddar, Respiratory Therapist R. Nandhagopal, Consultant Saphia Al-Ajmi, Podiatrist Abdulhakim Al-Hashim, Consultant patient

Support Staff Ahmed Farqani, Consultant Rose Natividad, Coordinator

Hatem Farhan, Consultant and Ibrahim Al-Shoaibi, Coordinator Issa Al Qarshoubi, Consultant Ghaniya Al-Siyabi, Coordinator Mohammed Al-Ghailani, Senior Registrar academic Medicine 113 Annual Report 2010-2011 Medicine

Hihglights of the Year 2010-2011 In this period, a number of departmental staff received awards for their achievements. Professor Nicholas Woodhouse was awarded an OBE (Order of British Empire) from Her Majesty Queen Elizabeth II. The Inves- titure took place at Windsor Castle, England. Dr. Omar Al Rawas was promoted from Associate Professor to Professor. Dr. Ali Al-Hinai was appointed as Undersecretary for Planning in the Ministry of Health. Dr. Wil- liam Johnston received an award for Best Trainer from the Oman Medical Specialty Board (OMSB). Dr. Ali Al-Shirawi achieved M.Sc. Specialization in Biomedical Ethics from McGill University, Canada. The following two staff returned from scholarship study: Dr. Issa Al-Qarshoubi and Dr. Wasif Rasool.

The Department welcomed the following new staff: Dr. Zeid Gaifer, Consultant; Dr. Khawaja Zahid, Senior Registrar; Dr. Dawar Rizavi, Senior Registrar; Dr. Saja Mohammed, Registrar; Dr. Zaheer Siddiq, Senior House Officer. It said goodbye to four staff members: Dr. Masoud Al-Maskari, Assistant Professor and three regis- trars: Dr. Hassan Ali, Dr. Nagi Hashim and Dr. Saeed Ahmad.

The 11th Advanced General Medicine Conference was organised by the Department of Medicine from 23–24 February 2011. The lectures, given by expert international speakers, covered a wide range of general medical topics, disease mechanisms and cutting edge advances in clinical practice. It was attended by more than 400 physicians and allied health professionals from Oman and different parts of the country.

The Department‘s Annual Research Retreat, in which most all staff participated, was held on 14 April 2011 at the Grand Hyatt Hotel, Muscat. Following an overview of departmental research activities in the preceding year, ten research papers were presented.

The Department continues to attract undergraduate and postgraduate students from local and international universities to spend their electives here. This year there were 18 students from various universities in Oman as well as other countries including Bahrain, India, New Zealand, Norway, Pakistan, the UK and the USA. We also received 7 junior doctors as clinical attachments for further training and development.

The MRCP (UK) PACES examination is held twice a year for two days each in SQUH and the Royal Hospital. Members of staff are much involved in the preparation for this and in examination.

The staff of the department participated in a number of courses and workshop organised by the Medical Edu- cation Unit (MEU) of the College of Medicine & Health Sciences (CoMHS) in order to improve teaching and as- sessment skills for undergraduate and postgraduate level courses. These included: Appraisal Skills Workshop; Certificate in Health Professional Education (CHPE); Student Assessment Workshop; Continuous Assessment of Clinical Skills and Professional Behaviour workshop, and Designing Integrated Questions Workshop.

114 Teaching Programme UNDERGRADUATE CLINICAL PROGRAMME The Department started teaching students in Phase III of the new curriculum.

PRE-CLERKSHIP Most staff members have contributed to the 9 weeks course of the pre-clerkship in both teaching and assess- ment. In particular the Department was leading in the neurology and cardiology modules.

JUNIOR CLERKSHIP Junior Clerkship started on 26 November 2011. It has a total of 115 students, divided into 6 groups with more or less 20 students per group. Each group is divided into 3 subgroups and designated to the SQUH, Royal Hospital (RH) and Armed Forces Hospital for 7 weeks. One or 2 students join the clinical units from 9 am to 12 noon on weekdays. Each unit schedules activities for the student according to their schedule for rounds, clin- ics and procedures. Then the whole group in each hospital meets at noon for one hour’s bedside teaching. In the afternoon, the students meet again 90 minute presentations usually led by the students with the tutors acting as facilitators. The bedside teaching and the seminar are based on the clinical presentations which are outlined in their curriculum. The students also meet weekly with the coordinator for feedback. Dr. Issa Al-Qarshoubi is the Coordinator of the Junior Clerkship in Medicine.

7 TH YEAR (OLD CURRICULUM) As part of the old curriculum, approximately 25–27 final year students (7th year) are posted for clinical rota- tion in the Department for a period of 7 weeks, divided between the RH and SQUH (total of 5 rotations). Stu- dents are posted to Internal Medicine unit teams as pre-interns. They are attached to the team throughout their daily activities. By the end of their rotation, they are assessed by the team in clinical skills, data inter- pretation and management of a variety of diseases. Students are fully integrated with the team and given departments responsibility for patient care under direct supervision of the seniors. Also the new curriculum’s “common clinical presentations” were incorporated in their teaching with students expected to present on these topics care in tutorials. More emphasis was given to continuous assessment in their overall assessment of the rotation. There is a formal end of rotation examination using short cases and an objective structured clinical exami- nation (OSCE). The overall assessment is based on performance throughout rotation in both the in-course

assessment and end of rotation examination which is conducted both in SQUH and the RH. The Department patient continued to develop the curriculum for the final year medical students to meet with the objectives of the

rotation and better prepare them for the internship. Students are divided into three groups and are attached and to the general medicine units. Members of the department are heavily involved in research projects both as supervisors and examiners. academic Medicine 115 Annual Report 2010-2011 Medicine

POSTGRADUATE PROGRAMME Interns About 10-20 interns are posted for 4 month rotations in the Department. Every intern rotates in one subspe- cialty for one month with a one month mandatory rotation in the Haematology Department. Interns have supervised training by senior staff. By the end of their rotation, all interns are formally assessed on issues such as knowledge, clinical skills, attitude and professionalism.

OMSB Residency Program The Department is continuously receiving OMSB residents for training in internal medicine. Undergraduates and postgraduates are involved in many educational activities including the morning case report (morn- ing meeting), grand rounds, radiology meetings and journal clubs, as well as the monthly mortality review meeting. CME sessions are held every alternate Monday morning and Wednesday lunch-time is used for presentations by outside guest speakers.

Members of the Department actively participate in postgraduate teaching of interns, house officers and the OMSB residents in internal medicine as well as residents from other subspecialties (such as Family Medicine and Public Health, dermatology, laboratory sciences and Accident and Emergency) rotating through Medi- cine. Residents receive supervised training on ward rotations and during electives to different sub-specialties of Medicine. Members of the Department participate in organised teaching activities, such as lectures (twice weekly), radiology rounds (weekly) and grand rounds (weekly). In addition, members of the Department of Medicine are invited to deliver lectures to other sub-specialty residency programs, such as those in the Emer- gency Medicine and Family Medicine and Public Health departments.

NURSING DEGREE Dr Mansour Al-Moundhri delivers lectures regularly at the Pain Management Course organised by the Train- ing Directorate in conjunction with the Directorate of Nursing SQUH. Drs. Ikram Burney and Muhammad Furrukh deliver lectures regularly at the Chemotherapy Administration Course organised by the Training Directorate in conjunction with the Directorate of Nursing SQUH.

Clinical & Diagnostic Services In 2011, there were 2,166 dialysis sessions. The respiratory statistics in 2011 were as follows. The total number of bronchoscopies in 2011 was 54 (39 males and 15 females); the total full lung function tests was 448 and total spirometries 446.

116 In and outpatients numbers were as shown in the table below

Table 1: In and Outpatient numbers 2011 Specialty In Patients Out Patients Total Cardiology 1009 9650 10659 CPH Cardiology 0 4650 4650 CPH Neurophysiology 1 4102 4103 Diabetic 22 5434 5456 Endocrinology 217 1029 1246 Gastroenterology 800 7052 7852 Infectious Diseases 113 1071 1184 Lipid Clinic 0 1432 1432 Medicine 1634 935 2569 Nephrology 374 1895 2269 Neurology 467 7430 7897 Oncology 1803 2214 4017 Pulmonology Clinic 250 5417 5667 Rheumatology 210 4231 4441 Thyroid 139 4593 4732

Total 7039 61135 68174 departments

Table 2: Catheter Laboratory care CAG 697 Emergency CAG 27

PCI 237 patient

Emergency PCI 13 and

IABP 13 academic Medicine 117 Annual Report 2010-2011 Medicine

Aspiration 12 FFR 37 TPI 11 PPI 17 Pericardialcenthesis 1 Total 1,065

Table 3: Gastrointestinal Unit Table 4: Cardiology Procedures Esophagogastroduode- 943 Procedure name Total noscopy (EGD) ECG 4,169 Colonoscopy 370 24 hr ECG holter 421 Percutanuos endo- 13 24 hr BP monitoring 105 scopic gastric (PEG) tube insertion Cardiac stress test (ETT) 318 Endoscopic retrograde 82 Stress thallium 710 cholangiopancreati- Echocardiography (adult) 3,847 cography (ERCP) Toe 54 Esophageal varices 6 stenting Entric metal stenting 1 Total 1415

Research RESEARCH PROJECTS Relationship of Hemodynamic Profile in Acute Stroke with Stroke Location, Severity and Outcome: Pro- spective Study with Thoracic Electrical Bioimpedance Project Code: IG/MED/MEDI/11/01; Dates: 2011

118 Value: OR 12,000; Project Funder: Sultan Qaboos University Investigators: Dr. Arunodaya Gujjar, Dept. Medicine, SQU; Dr. Abdullah Al-Asmi, Dept Medicine, Neurology Unit, SQU; Prof. Mohan Dikshit, Dept. Physiology, SQU; Dr. Deepali Jaju, Dept. Physiology, SQU; Dr. Shyam Ganguly, Dept. Family Medicine & Community Health, SQU; Dr. P.C. Jacob, Department of Medi- cine, SQU, Dr. R. Nandagopal, Department of Medicine, SQU.

Prognostic and predictive biomarkers in Diffuse Large B Cell Lymphoma Project Code: IG/MED/MEDI/11/02; Dates: 2011-12 Value: OR 10,000 ; Project Funder: Sultan Qaboos University Investigators: Dr. Ikram Burney, Dept. Medicine, SQU; Dr. Hamza Babiker, Dept. Biochem- istry SQU; Dr. Mansour Al-Moundhri, Dept. Medicine, SQU; Dr Khalil Al- Farsi, Dept. Haematology, SQU; Dr. Shiyam Kumar, Dept. Medicine, SQU; Dr Crystal Koh, Dept. Microbiology & Immunology, SQU; Dr Ahmed Al-Shukaily, Dept. Microbiology & Immunology, SQ;. Dr Aisha Al-Hamdani, Dept. Pathol- ogy, SQU.

Incidence of dialysis tunneled catheter related bacteremia at SQUH Project Code: MREC# 379; Dates: 2010 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. Dawood Al-Riyami, Dept. Medicine, SQU.

Retrospect Analysis of incidence of Failure to Mature of Arterio- Venous Fistula (AVF) performed at SQUH Project Code: MREC# 381; Dates: 2010 Value: Unfunded; Project Approval: Sultan Qaboos University departments

Investigator: Dr. Dawood Al-Riyami, Dept. Medicine, SQU. care

Retrospect analysis of the incidence spectrum and incidence of the kidney biopsy at SQUH Project Code: MREC# 390; Dates: 2010 Value: Unfunded; Project Approval: Sultan Qaboos University patient

Investigator: Dr Dawood Al-Riyami, Dept. Medicine, SQU. and

academic Medicine 119 Annual Report 2010-2011 Medicine

Retrospect analysis of the data of patient with diabetic nephropathy (DNP) attending the nephrology clinic at SQUH to determine the rate of progression of diabetic nephropathy Project Code: MREC# 391; Dates: 2010 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. Dawood Al-Riyami, Dept. Medicine, SQU.

Effect of Feeding Omani Traditional and Diet Halwa on Patients with Pre-diabetes and Type-2 Diabetes Project Code: MREC# 392; Dates: 2010 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. Masoud Al-Maskari, Dept. Medicine, SQU.

Global Investigation of Therapeutic Decision in Hepatocellular Carcinoma and of its treatment Project Code: MREC# 393; Dates: 2010 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. Ikram Burney, Dept. Medicine, SQU.

Characterization of Immune Response and HLA Genotype in Antipilptic Drug-Induce Hypersensitivity Project Code: MREC# 394; Dates: 2010 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. Abdullah Al-Asmi, Dept. Medicine, SQU.

Pulse Wave Velocity as a Predictor of Failure to Mature of Arterio-Venous Fistula (AVF) Project Code: MREC# 415a; Dates: 2011 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. Dawood Al-Riyami, Dept. Medicine, SQU.

Validation of Predictive and Prognostic Biomarkers, and the Development of Novel Technologies to aid in Customizing Treatment Decisions: A Biomarker Analysis in Omani Patients with Lung Cancer Project Code: MREC# 415b; Dates: 2011 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. Muhammed Furrukh, Dept. Medicine, SQU.

120 The Prognostic Role of Tissue, Serum, and whole Blood Global and Site-Specific Promoter DNA Methyla- tion and miRNA Gene Expression Profile in Locally Advanced Breast Cancer During neo-adjuvant Chemo- therapy Treatment Project Code: MREC# 420; Dates: 2011 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. Mansour Al-Moundhri, Dept. Medicine, SQU.

An Open Label, randomized, phase IIIb trail evaluating the efficacy and safety of standard of care +/- con- tinuous bevacizumab treatment beyond progression of disease (PD) in patients with advanced non- seqamous non-small cell lung cancer (NSCLC) after first (1st)- line treatment with bevacizumab plus a platinum doublet-containing chemotherapy Project Code: MREC# 421; Dates: 2011 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. Mansour Al-Moundhri, Dept. Medicine, SQU.

Clinical and Genetics Study of Huntington’s Disease in Oman Project Code: MREC# 425; Dates: 2011 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. Ramachandiran Nandhagopal, Dept. Medicine, SQU.

Prognostic Value of EEG Abnormalities in Critically Ill Adult Patients Project Code: MREC# 433; Dates: 2011 Value: Unfunded; Project Approval: Sultan Qaboos University

Investigator: Dr. Abdullah Al-Asmi, Dept. Medicine, SQU. departments

Use of Honey for Chemotherapy and Radiotherapy-Induced Oral Mucositis care Project Code: MREC# 435; Dates: 2010 Value: Unfunded; Project Approval: Sultan Qaboos University

Investigator: Dr. Ikram Burney, Dept. Medicine, SQU. patient

Bone Mineral Density Measurement in Healthy Young Omanis, a Pilot Study to Establish Local Reference and Values Project Code: MREC# 393; Dates: 2010 academic Medicine 121 Annual Report 2010-2011 Medicine

Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Prof. Nicholas Woodhouse, Dept. Medicine, SQU.

Clinical Profile of Wilson’s Disease in Oman Project Code: MREC# 451; Dates: 2011 Value:Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. Ramachandiran Nandhagopal, Dept. Medicine, SQU.

Nosocomial Candidemia: Incidence, Risk Factors and Outcome Project Code: MREC# 454; Dates: 2011 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. Abdullah Balkhair, Dept. Medicine, SQU.

Prevalence of Anxiety and Depression in Patients with Multiple Sclerosis (MS) Project Code: MREC# 464; Dates: 2011 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. Abdullah Al-Asmi, Dept. Medicine, SQU

The Etiology of Carpal Tunnel Syndrome in its Frequency in Newly Diagnosed Diabetic among Omani Patients Project Code: MREC# 465; Dates: 2011 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. Abdullah Al-Asmi, Dept. Medicine, SQU

Bone Health in Ambulatory Omani Patient with Parkinson Disease Project Code: MREC# 472; Dates: 2011 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. Ramachandiran Nandhagopal, Dept. Medicine, SQU. RESEARCH PUBLICATIONS & BOOKS Journal Publications 1. Gujjar AR, Ranjan William, Jacob PC, Rajeev Jain, Al-Asmi AR. Transcranial doppler ultrasonography in acute isch-

122 emic stroke predicts stroke subtype and clinical outcome: A study in Omani population. Journal of Clinical Monitor- ing and Computing. 2011; 24:155-9. 2. Gujjar AR, Jacob PC, Al-Asmi AR, Nandhagopal R, Obaidi A, Jain R. Reversible MRI changes in prolonged status epi- lepticus: A case report. International Journal of Neuroscience. 2011; 121:341-5 3. Gujjar AR, Al-Mamari A, Jacob PC, Jain, Balkhair A, Al-Asmi AR. Extrapontine myelinolysis as presenting manifesta- tion of adrenal failure: a case report. J Neurol Sci 2010; 290:169-71. 4. Nandhagopal R, Al-Asmi AR, Gujjar AR, Jacob PC, Al-Azri F, Harper C. Necrotizing vacuolar myopathy presenting with recurrent myoglobinuria. Int J Neurosci 2010; 20:784-6. 5. Nandhagopal R, Al-Asmi AR, Gujjar AR. Neuromyelitis optica: an overview. Postgraduate Med J 2010: 86:153-9. 6. Gujjar AR, Muralidhar K, Bhandopadhyaya A, Sathyaprabha TN, Janaki P, Mahalla BK, et al. Transthoracic electrical bioimpedence cardiac output: comparison with multigated equillibrium radionuclide cardiography. J Clin Monit Comput 2010; 24:155-9. 7. Jacob PC, Al-Asmi AR, Gujjar AR, Al-Mamari A, Balkhair A, William R. Lower Cranial nerve palsies. Oman Med J 2010; 25:239-41. 8. Nandhagopal R, Al-Asmi AR, Gujjar AR, Jacob PC, Faisal Al-Azri. Recurrent episodes of hemiparesis and aphasia: Picture Quiz. BMJ. 2010; 341:c4674. 9. Nandhagopal R, Al-Asmi AR, Al-Azri F, Jacob PC, Gujjar AR, Alobaidy A. Vestibular schwannomas in neurofibroma- tosis type 2: Teaching Neuro Images. Neurology 2010; 75:e60. 10. Nandhagopal R, Al-Asmi AR, Gujjar AR, Jacob PC, Al-Azri F, Burney IA. Gliomatosis Cerebri: Clinical picture. Q J Med 2010; 104:619-20. 11. El Shafie O, Woodhouse NJY. The diagnosis and management of severe hypercalcaemia: A simplified approach. Sultan Qaboos University Med J 2010; 10:388-95. 12. El Shafie O, Grant C, Hamdani A, Jain R, Woodhouse NJY. VIPoma crisis: Immediate and life saving reduction of mas- sive stool volumes on starting treatment with octreotide. Sultan Qaboos University Med J 2011; 11:104-8 13. Al Kalbani M, El Shafie ,O Al Rawahi M, Al Mamari A, Al Zakwani A, Woodhouse NJY. Vitamin D status in pregnant

Omanis. Sultan Qaboos University Med J 2011; 11:52-5. departments

14. Baddar SA, Al-Ismaili A, Al-Tai M, Al-Muhrazi A, Al Rawas OA. Documentation of asthma exacerbation management by primary care physicians in a tertiary teaching hospital in Oman. Sultan Qaboos University Med J 2010; 10:345-40. care

15. Jayakrishnan B, Al-Rawas OA. Asthma inhalers and colour coding: Universal dots. Brit J Gen Pract 2010; 578:854-5. 16. Jaju DS, Dikshit MB, Balaji J, George J, Rizvi S, Al-Rawas OA. Effects of pranayam breathing on respiratory pressures and sympathovagal balance of patients with chronic airflow limitation and in control subjects. Sultan Qaboos Uni- patient versity Med J 2011; 11:221-9.

17. Al-Abri M, Al Hashmi K, Jaju D, Al-Rawas OA, Al Riyami BM, Hassan MO. Gender difference in relationship of ap- and noea/hypopnoea index with BMI and age in Omani population. Sultan Qaboos University Med J 2011; 11:363-8. 18. Beasley RW, Clayton TO, Crane J, Lai CK, Montefort SR, Mutius E, Stewart AW; ISAAC Phase Three Study Group (in- academic Medicine 123 Annual Report 2010-2011 Medicine

cludes Al-Rawas OA). Acetaminophen use and risk of asthma, rhinoconjunctivitis, and eczema in adolescents: Inter- national Study of Asthma and Allergies in Childhood Phase Three. Am J Respir Crit Care Med 2011; 183:171-8. 19. Quanjer PH, Stocks J, Cole TJ, Hall GL, Stanojevic S; on behalf of the Global Lungs Initiative (includes Al-Rawas OA). Influence of secular trends and sample size on reference equations for lung function tests. Eur Respir J 2011; 37:658- 64. 20. Al-Moundhri MS, Al-Khanbashi M, Al-Kindi M, Al-Nabhani M, Burney IA, Al-Farsi A, et al. Association of E-cadherin (CDH1) gene polymorphisms and gastric cancer risk. World J Gastroenterol 2010; 16:3432-6. 21. Kumar S, Burney IA, Al-Ajmi A, Al-Moundhri MS. Changing trends of breast cancer survival in a developing coun- try-Oman. J Oncol 2011; 2011:316243. 22. Al-Moundhri MS, Al-Nabhani M, Tarantini L, Baccarelli A, Rusiecki JA. The prognostic significance of whole blood global and specific DNA methylation levels in gastric adenocarcinoma. PLoS One 2010; 5:e15585. 23. Waly MI, Al Moundhri MS, Ali BH. Effect of curcumin on cisplatin- and oxaliplatin-induced oxidative stress in hu- man embryonic kidney (HEK) 293 cells. Ren Fail 2011; 33:518-23. 24. Ali BH, Abdelrahman AM, Al-Salam S, Sudhadevi M, Almahruqi AS, Al-Husseni IS, Beegam S, Dhanasekaran S, Nem- mar A, Al-Moundhri M. The effect of sildenafil on cisplatin nephrotoxicity in rats. Basic Clin Pharmacol Toxicol 2011; 109:300-8. 25. Rusiecki JA, Al-Nabhani M, Tarantini L, Chen L, Baccarelli A, Al-Moundhri MS. Global DNA methylation and tumor suppressor gene promoter methylation in whole blood and gastric cancer risk in an Omani Arab population. Epig- enomics 2011; 3;417-29. 26. Al Asmi AR, Nandhagopal R, Jain R, Burney IA. Full blown picture of Wernicke’s encephalopathy. QJM 2010; 103:891- 2. 27. Burney IA. Author’s response Re: The trend to seek a second opinion abroad among cancer patients in Oman. Sultan Qaboos University Med J 2010; 10:277. 28. Nandhagopal R, Al Asmi AR. Magnetic resonance angiogram of the brain. BMJ 2011; 343:d6276. 29. Nandhagopal R, Al Asmi AR. A young adult with seizure and visual field defect. Neurosciences (Riyadh) 2011; 16:389-90. 30. Nandhagopal R. CADASIL. Sultan Qaboos University Med J 2011; 11:284-5. 31. Nandhagopal R. Acquired crossed aphasia in a dextral. Sultan Qaboos University Med J 2011; 11:122-3. 32. Nandhagopal R. Solitary cerebral cysticercus granuloma. Sultan Qaboos University Med J 2011; 11:119-21. 33. Al-Asmi AR, John R, Nandhagopal R, Jacob PC, Nollain K, Jain R. Spinal cord infarction following abdominal surgery and postoperative epidural analgaesia. Sultan Qaboos University Med J 2010; 10:396-400. 34. De la Fuente-Fernandez R, Schulzer M, Kuramoto L, Cragg J, Nandhagopal R, Au WL, Mak E, et al. Age-specific progres- sion of nigrostriatal dysfunction in Parkinson’s disease. Ann Neurol 2011; 69:803-10. 35. Sossi V, de la Fuente-Fernández R, Nandhagopal R, Schulzer M, McKenzie J, Ruth TJ, et al. Dopamine turnover in- creases in asymptomatic LRRK2 mutations carriers. Mov Disord 2010; 25:2717-23.

124 36. Nandhagopal R. Coexistence of cerebral tubers with neurocysticercosis. South Med J 2010; 103:953-5. 37. Nandhagopal R, Troiano AR, Mak E, Schulzer M, Bushnell MC, Stoessl AJ. Response to heat pain stimulation in idio- pathic Parkinson’s disease. Pain Med 2010; 11:834-40. 38. Kumar S, Shaikh AJ, Khalid S, Masood N. Influence of patient’s perceptions, beliefs and knowledge about cancer on treatment decision making in Pakistan. Asian Pacific J Cancer Prev 2010; 11:251-5. 39. Shaikh AJ, Bawany SA, Masood N, Khan AA, Abbasi AN, Niamutullah SN, Zaidi A, Adil S, Kumar S. Incidence and im- pact of baseline electrolyte abnormalities in patients admitted with chemotherapy induced febrile neutropenia. J Cancer 2011; 2:62-6. 40. Mathew M, Saquib S, Kumar S, Lokuhetty D, Jain R. Successful management of a case of gestational trophoblastic neoplasia in young woman. Proceedings of the Sultan Qaboos University Clinico-Pathological Conference. Sultan Qaboos University Med J 2010; 10:297. 41. Sallam M, Ali M, Al-Sekaiti R. Management of radial artery perforation complicating coronary intervention: A step- wise approach. Journal Interv Cardiol 2011; 24:401-6. 42. Al-Sekaiti, Ali M, Sallam M. Radial artery perforation after coronary intervention: Is there a role for covered coronary stent? Catheter Cardiovasc Interv 2011; 78:632-5. 43. Sallam M. Book review. Cardiovascular interventions in clinical practice. Sultan Qaboos University Med J 2011; 11:134- 5. 44. Farhan HL, Hassan KS, Al Belushi A, Sallam M, Al Zakwani I. Diagnostic value of electrocardiographic T-wave inver- sion in lead aVL in diagnosing coronary artery disease in patients with chronic stable angina. Oman Med J 2010; 25:123-6. 45. Farhan HL, Al Hasani M, Misbah M, Sallam M. Comparative study of ambulatory blood pressure monitoring and clinic blood pressure measurement in the risk assessment and management of hypertension. Sultan Qaboos Uni- versity Med J 2010; 10:370-6. 46. Balkhair AA, Al Muharrmi Z, Darwish L, Farhan HL, Sallam M. Treatment of vancomycin-intermediate Staphylococ- cus aureus (VISA) endocarditis with linezolid. Int J Inf Dis 2010; 14:227-9. 47. Pathare A, Al Kindi S, Khan S, Al Riyami D, Farooqui M. Coexistence of immune thrombocytopenic purpura and departments

idiopathic membranous glomerulonephritis successfully treated with rituximab. Platelets 2010; 21(7):575-7. 48. Baluchi F, Khan S, Al Riyami D, Ghailani M, Farooqui M. Incidence, etiology and outcome of acute kdiney injury at a

teaching hospital in Oman. Saudi J Kidney Dis Transpl 2011; 22:825-8. care

49. Al Shukaili, Al Kaabi J, Hassan B, Al Araimi T, Al Tobi M, Al Kindi M, Al Maniri A. P2X7 receptor gene polymorphism analysis in rheumatoid arthritis. Int J Immunogenet 2011; 38:389-96.

50. Siddiqui AA, Mahboob A, Ansari M, Alam I, Bashir B, Ahmed S. Effect of pregnancy on the disease activity in Ulcer- patient

ative Colitis. J Postgrad Med Inst 2011; 25:314-7. and

academic Medicine 125 Annual Report 2010-2011 Medicine

CONFERENCE & SEMINAR PRESENTATIONS Conference Presentations International 1. Al Rawas OA. Spirometry: Factors Affecting Spirometry Interpretation. The World Allergy Organization Interna- tional Scientific Conference, 5-8 Dec. 2010, Dubai, UAE (Invited speaker). 2. Al Rawas OA. Inhalation Devices in Asthma. Second Middle East – Asia Allergy Asthma Immunology Congress, 28- 30 April 2011, Dubai, UAE (Invited speaker). 3. Kumar S, Burney IA, Al Moundhri MS. Renal cell carcinoma, survival trends in Oman: A single center experience. Dubai, UAE, March 2011 4. Jayakrishnan BN. Management options in sarcoidosis. 12th NAPCON 2009. Jodhpur, India, November 2010. 5. Mohammed SM. Pre-emptive use of immunosuppression in renal transplantation. Mumbai, India, 13-14 May 2011. National 1. Kumar S. Discrepancies in breast cancer. 3rd National Cancer Conference, Muscat, Oman. Muscat, Oman, February 2011. 2. Jayakrishnan BN. Management of stable COPD. 2nd National COPD Symposium, Oman Respiratory Society. Sultan Qaboos University, Muscat, Oman, 14 October 2010. 3. Al Rawas OA. Lung function in COPD. 2nd National COPD Symposium, Oman Respiratory Society. Sultan Qaboos University, Muscat, Oman, 14 October 2010. 4. Jayakirshnan BN. Non-invasive ventilation. 2nd National Symposium on Sleep Medicine, Oman Respiratory Society. Sultan Qaboos University, Muscat, Oman, 4-5 May 2011. Poster presentations International 1. Kumar S. Renal cell carcinoma, survival trends in Oman: A single center experience. Arab Afro Cancer Conference, April 2011, Istanbul, Turkey. 2. Al Kaabi J. Thrombosis in Behcet’s disease. Mafraq Hospital, UAE, 23 February 2011. 3. Nandhagopal R. Are there gender-related differences in the progression of Parkinson’s disease. 63rd Annual Meet- ing American Academy of Neurology. Honolulu, Hawaii, USA, 9-16 April 2011. National 1. Al Kaabi J. Vasculitis, OMSB, Muscat, Oman. 22 November 2011. 2. Jayakrishnan BN, Al Rawas OA. Quality Management. Dept. of Medicine, SQUH Quality Day. 10 November 2010.

126 Seminar Presentations International 1. Kumar S. Renal cell carcinoma, survival trends in Oman: A single center experience. Dubai, UAE. National 1. Al Mamari AS. Management of diabetes in the new millennium. 9th Endocrine Club. Sur Hospital, 4 January 2011. 2. Kumar S. Adjuvant therapy in lung cancer. Oman Tumor Board, Muscat, Oman, May 2011. 3. Al Qarshoubi I. The use of proton pump inhibitors in gastrointestinal disorders. Gastroenterology Workshop, Armed Forces Hospital, Muscat, Oman. 4. Al Qarshoubi I. Advances in management of chronic hepatitis B infection. Oncology Forum, Muscat, Oman 5. Al Qarshoubi I. 1) Introduction to esophagogastroduodenoscopy procedures; 2) How to perform esophagogastrodu- odenoscopy; 3) Technical aspects of performing colonoscopy. Surgical Skills Workshop, SQU Hospital, Muscat, Oman, 9-11 October 2010. 6. Nandhagopal R. Clinical case illustrations in epilepsy. Oman Neurological Society, 26 May 2011. 7. Jayakrishnan BN. Management of Asthma. Update for general practitioners. ORS Continuing Education. Muscat, February 2011. 8. Jayakrishnan BN. Asthma treatment protocols. Asthma Clinic Establishment Seminar. MOH, Oman, Dept. of Health Services, Seeb Wilayat, 1 December 2011. 9. Baddar S. Asthma Management Workshops. Various private clinics, 2011. THESIS SUPERVISION Samira Al-Mahruqui Qualification: M.Sc. Title: Correlation between Human Leukocyte Antigens and response to departments

Antiretroviral Treatment amongst Omani AIDS Patients Co-Supervisor: Dr. Abdullah Balkhair care Date of Completion: 2011

Ruwaida patient

Qualification: M.Sc. Title: Utilization Patterns of AEDs among Epileptic Patient in SQUH and

Co-Supervisor: Dr. Abdullah Al-Asmi Date of Completion: 2010 academic Medicine 127 Annual Report 2010-2011 Microbiology & Immunology

Microbiology & Immunology

he Department of Microbiology and Immunology contributes significantly to teaching, research and community service. The Department takes part in the B.Sc. Health Sciences, MD (the old and new curriculum), the BSc MLS, Nursing, MSc, PhD, and TOMSB residents teaching and training programmes. The microbiology research interests include basic molecular virology and microbiology and epidemiology of parasitic infections. The immunology research focuses on autoimmunity and immunodeficiency, both primary and acquired including HIV and AIDS. There is active international research cooperation between the Department and scientists in the UAE, Britain, Germany, France and the USA. The Department’s clinical divisions offer diagnostic services to SQU Hospital and other hospitals in Oman in bacteriology, virology, parasitology, mycology, serology and immunology.

128 Staff Khuloud Al-Rahbi, Senior Biomedical Scientist Zamzam Al-Bimani, Senior Biomedical Scientist Head of Department Juma Al-Busaidi, Senior Biomedical Scientist Mohammed Ahmed Idris, Professor Fatma Saeed, Senior Biomedical Scientist Faculty Ruwaida Al-Lamki, Senior Biomedical Scientist Fathiya Al-Maskery, Senior Biomedical Scientist Sharanjit Thukral, Professor Safiya Al-Harthy, Senior Biomedical Scientist Ali Al-Jabri, Professor Nasra Al-Harrasi, Senior Biomedical Scientist Muhannad Al-Kobaisi, Assistant Professor Sabaz Ali Khan, Senior Biomedical Scientist Basil Nzeako, Assistant Professor Amna Al-Balushi, Senior Biomedical Scientist Crystal Koh, Assistant Professor Sada Al Harthy, Senior Biomedical Scientist Elias A. Said, Assistant Professor Sumayya Al-Hosni, Senior Biomedical Scientist Akbar Rafay, Senior Consultant Sam George, Senior Biomedical Scientist Zakariya Al-Muharrmi, Consultant Faiza Al-Naamani, Biomedical Scientist Munira Al-Siddiqui, Registrar Ibrahim Kutty, Biomedical Scientist Mohammed Al-Balushi, Research Associate Kiran Ali, Biomedical Scientist Ghada Al-Rawahi, Registrar* Sahim Al-Ghafri, Biomedical Scientist Jalila Al-Shukaily, Registrar* Issa Al-Samsami, Biomedical Scientist Mahmood Al-Kindi, Registrar* Manawar Al-Quraini, Biomedical Scientist Khuloud Al-Ma’mari, Registrar* Amal Al-Hinai, Biomedical Scientist Badriya Al-Adawi, Registrar* Faiza Al-Mujaizi, Biomedical Scientist Fatma Ba’Alawi, Registrar* Marwa Al-Hinai, Biomedical Scientist Turkiya Al-Siyabi, Registrar* Zia-ul Qamar Al Qureshi, Coordinator, College Zaaima Al-Jabri, Clinical Instructor Yousuf Al-Sabty, Coordinator, Hospital *On study leave Mohammed Al-Wahaibi, Clerk, Hospital Support Staff departments Sidqi Hassan, Superintendent - College Highlights of the Year Jameel Nograles, Superintendent - Hospital

2010-2011 care Robert Toki, Chief Biomedical Scientist During the academic year 2010-2011, the Depart- Frank Serebour, Chief Biomedical Scientist ment continued to support its faculty members Intesar Al-Balushi, Chief Biomedical Scientist (immunologists, bacteriologists, a virologist, and

Jacob George, Chief Biomedical Scientist patient a parasitologist) and a number of biomedical sci- Said Al-Hinai, Chief Biomedical Scientist entists to study for B.Sc., M.Sc. and Ph.D. qualifica-

Masoud Al-Khayari, Senior Biomedical Scientist and tions. However, three staff members, Dr. Yaseen Khazina Al-Harthy, Senior Biomedical Scientist Al-Lawatia, Assistant Professor; Dr. Ashok Shenoy, academic Microbiology & Immunology 129 Annual Report 2010-2011 Microbiology & Immunology

Consultant; and Dr. Ahmed Al-Shukaily, Research Associate left the Department and Mr. Ahmed Al-Badawi, Chief Biomedical Scientist, was seconded to the National Ethical Committee. Three new biomedical scien- tists, Amal A-Hinai, Faiza Al-Mujaizi and Marwa Al-Hinai joined the Department. During the past year Pro- fessor Tibor Pal, from the Microbiology & Immunology Department, UAE University, Al Ain, served his final year as external examiner in microbiology.

Teaching Programmes PRE-CLINICAL PROGRAMME (OLD CURRICULUM) The Department kept offering its two main courses in the BSc Health Sciences programme, namely Immu- nology and Microbiology to the 3rd and 4th year medical students respectively.

PRE-CLINICAL PROGRAMME (NEW CURRICULUM) The Department continued to contribute and play a vital role in the new curriculum that was initially imple- mented in 2009-2010. The Department extended its participation to all semesters of Phase II that includes 10 different modules of core and system courses.

B.Sc . MEDICAL LABORATORY SCIENCE PROGRAMME As in the previous years the Department also contributed substantially to the B.Sc. MLS programme. Seven different courses were offered during 2010-2011.

B.Sc . NURSING The Department continued to offer a 3 credit Microbiology course that is taught to second year B.Sc. nursing students during the spring semester.

CLINICAL PROGRAMMES (MD PROGRAMME) The 5th year clinical students attended the integrated lecture series and case-oriented learning offered by the Department and 5 groups of 7th year medical students each undertook a one week laboratory rotation that covered all the clinical microbiology and immunology laboratory sections. The students were assessed on the final day of each rotation.

POSTGRADUATE PROGRAMME There were two microbiology first/second year residents who did various rotations in clinical microbiology and immunology. The Department also participated in the training of some of the Oman Medical Specialty Board (OMSB) residents.

130 M.Sc . PROGRAMME The Department continued to offer the Medical Microbiology programme for the M.Sc. students in 2010-2011. Four courses were taught in the M.Sc. programme.

PH.D. PROGRAMME The PhD programme at the Department kept progressing with the student who was enrolled during 2009.

Clinical & Diagnostic Services 2001 2002 2003 500000 2004 400000 2005 300000 2006 200000 2007 100000 2008 0 2009 Specimens Tests 2010

Figure 1: Microbiology & Immunology specimens/tests 2001-2011. 2011 departments

The Department, with its two major units, continued to offer diagnostic services primarily to SQUH, as well

as other government and private hospitals. The yearly expansion in the diagnostic services in molecular care microbiology and immunology services runs in parallel with the increased patient activity within SQUH. There was an increase in the number of samples (specimens) sent to our laboratories in 2011. The decrease in the number of tests during 2011 could be explained by the merging of some old tests and the decrease in patient the number of requested influenza virus tests in comparison to the H1N1 requests during the outbreak. The number of tests and samples received for microbiology and immunology diagnostic services is shown in the and diagram. academic Microbiology & Immunology 131 Annual Report 2010-2011 Microbiology & Immunology

EXTERNAL QUALITY ASSURANCE The Department continue to participate in the Royal College of Pathology of Australia External Quality As- surance program. According to these international standards, the diagnostic laboratories of the Department scored reasonably well.

Research In 2010-2011, the Department had one jointly funded research project and a number of internally funded ones with a total value of around OR 200,000. The main projects are genetic determinates of AIDS patients on HAART and the epidemiology of hepatitis A and molecular and functional characterization of gene poly- morphisms associated with inflammatory diseases. Fourteen articles were published in different journals in addition to two book chapters. A workshop was held by the Department and two Masters Degrees were awarded.

RESEARCH PROJECTS Genetic determinants of patients’ different responses to HAART: insight into CCL3L1/CCR5 genotype & HLA antigens Project Code: RC/MED/MICR/11/01; Dates: 2011- Value: OR 145,000; Project Funder: The Research Council Oman Investigators: Prof. Ali Al-Jabri; Dr. Sidgi Hasson; Dr. Crystal Koh; Dr. Mohammed Al- Balushi; Dr. Zakaria Al-Muharrmi; Dr. Muhannad Al-Kobaisi, Dept. Mi- crobiology & Immunology, SQU; Dr. Abdullah Balkhair, Dept. Medicine, SQU; Dr. Hamad Al-Riyami, Dept. Genetics.

Epidemiology of hepatitis A in United Arab Emirates and Sultanate of Oman: a study to assess the need for vaccination programmes. Project Code: CL/ SQU-UAE/07/01; Dates: 2011-12 Value: OR 22,500 + OR 23,365; Project Funders: SQU & UAE Universities Investigators: Dr. Youssef Abou-Zeid, Dept. Biology, College of Science, UAE University; Dr. Muhannad Al-Kobaisi, Dept. Microbiology & Immunology, SQU; Salem Awad, Gastroenterology Medical Consultant, UAE; Dr. Taoufik A. Zoubeidi, College of Business & Economics, UAE University.

132 Bio-behavioural survey among injecting drug users in Muscat Project Code: Not applicable; Dates: 2010 Value: OR 32,000; Project Funder: Ministry of Health Investigators: Prof. Ali Al-Jabri, Dept. Microbiology & Immunology, SQU; Dr. Ali Baomar, Dr. S. Samir, etc, Ministry of Health.

The anti-snake venom activity of the date Palm - [Phoenix dactylifera] Plant– Ajwa Extract. Project Code: IG/MED/MICR/11/01; Dates: 2011-12 Value: OR 9,000; Project Funder: Sultan Qaboos University Investigators: Prof. Ali Al Jabri, Dr. Sidgi Hasson, Dr. Crystal Koh, Dr. Mohammed Al- Balushi, Dr. Elias Said, Dr. Munira Al-Rahman, Dept. Microbiology & Im- munology, SQU.

HIV/AIDS in Oman: Awareness and attitudes of Omani pregnant women of HIV/AIDS. Project Code: IG/MED/MICR/10/01; Dates: 2010 Value: OR 2,500; Project Funder: Sultan Qaboos University Investigators: Prof. Ali Al-Jabri, Dept. Microbiology & Immunology, SQU; Dr. Muna Al-Sa- doon, Dept. Child Health, SQU; Prof. Mohamed Idris, Dept. Microbiology & Immunology, SQU; Dr. Abdullah Balkhair, Dept. Medicine; Dr. Shyam Gangu- ly, Dept. Family Medicine & Public Health, SQU; Dr. Zakaryia Al-Muharrmy, Dept. Microbiology & Immunology, SQU; Dr Mariam Mathew, Dept. Obstet- rics & Gynaecology, SQU.

The Role of Toll-Like Receptors in Progression and Severity of Systemic Lupus Erythematosus (SLE) in Omani Population. departments

Project Code: IG/MED/MICR/11/02; Dates: 2011

Value: OR 11,000; Project Funder: Sultan Qaboos University care

Investigators: Dr. Crystal Koh, Dept. Microbiology & Immunology, SQU; Prof. Ali Al-Jabri, Dept. Microbiology & Immunology, SQU; Dr. Juma Al-Kaabi, Dept. Medicine, SQU; Dr. Yahya Al-Farsi, Dept. Family Medicine & Public Health, SQU. Mu- patient nira Al-Rahman, Dept. Microbiology & Immunology, SQU; and

academic Microbiology & Immunology 133 Annual Report 2010-2011 Microbiology & Immunology

Detection and Characterization of AmpC beta lactamases in Clinical Isolates of Escherichia coli and Kleb- siella spp” Project Code: IG/MED/MICR/09/01; Dates: 2009-11 Value: OR 6,100; Project Funder: Sultan Qaboos University Investigators: Prof. Sharanjit Thukral, Dr. Akbar Rafay, Dr. Ashok Shenoy, Dept. Micro- biology & Immunology, SQU.

Clinical and Immunological Manifestations of Systemic Lupus Erythematosus (SEL) among Omani Popu- lation Project Code: MREC# 384; Dates: 2010 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr Crystal Koh, Department of Microbiology & Immunology, SQU.

Vitamin D Deficiency among a Cohort of Omani HIV/AIDS Patients. Project Code: MREC# 455; Dates: 2011 Value: Unfunded; Project Approval: Sultan Qaboos University Investigators: Prof. Ali Al-Jabri, Maha Alkalbani, Dr. Mohammed Al-Balushi, Dr. Sidgi Hasson, Dept. Microbiology & Immunology, SQU.

Detection and characterization of metallo-beta lactamases in clinical isolates of Pseudomonas aerugi- nosa, Escherichai coli and Klebsiella spp. collected from Sultan Qaboos Universiy Hospital Project Code: MREC# 416; Dates: 2011 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Prof. Sharanjit Thukral, Dr. Akbar Rafay, Dr. Muhannad Al-Kobasi, Dept. Microbiology & Immunology, SQU.

Role of the Microbial translocation and inflammatory cytokines in the immunological non-responsive- ness in Omani HIV-infected patients on HAART Project Code: MREC# 430; Dates: 2011 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. Elias Said, Dept. Microbiology & Immunology, SQU.

134 Prevalence of Anti-Cardiolipin, Anti-Glycoprotein and other auto-antibodies during pregnancy in Omani Women Project Code: MREC# 452; Dates: 2011 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. Mohammed Al-Balushi, Dept. Microbiology & Immunology, SQU.

Survey of Antibiotics Resistance (SOAR) Project Code: MREC# 468; Dates: 2011 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr Akbar Rafay, Department of Microbiology & Immunology, SQU

The Normal Levels of Vitamin D and Vitamin D Deficiency among Healthy Adult Omanis from Sultan Qaboos University. Project Code: MREC# 470; Dates: 2011 Value: Unfunded; Project Approval: Sultan Qaboos University Investigators: Prof. Ali Al-Jabri, Bishara Al-Harrasi, Dr. Mohammed Al-Balushi, Dr. Sid- gi Hasson, Dept. Microbiology & Immunology, SQU.

Knowledge about HIV/AIDS and Attitudes towards Routine HIV Testing among Laboratory Workers in Oman Project Code: MREC# 471; Dates: 2011 Value: Unfunded; Project Approval: Sultan Qaboos University Investigators: Prof. Ali Al-Jabri, Dr. Mohammed Al-Balushi, Dr. Sidqi Hasson, Ahmed

Al-Saidi, Dept. Microbiology & Immunology, SQU. departments

RESEARCH PUBLICATIONS & BOOKS care Books & Book Chapters Book Chapter

, Balkhair AA, Al-Belushi MS, . Antenatal Screening and HIV-Pregnancy: strategies for patient Al-Jabri AA Hasson SS treatment. In: Fyson Hanania Kasenga, Eds. Understanding HIV/AIDS Management and Care - Pandemic and

Approaches in the 21st Century. InTech, 2011. ISBN: 978-953-307-603-4. Chapter 5, Pp.77-86. From: http://www. intechopen.com/ articles/ show/title/antenatal-screening-and-hiv-pregnancy-strategies-for-treatment academic Microbiology & Immunology 135 Annual Report 2010-2011 Microbiology & Immunology

Handbook Rafay A. Laboratory Rotations and Quiz - for OMSB Microbiology Residents, 2011. Journal Publications 1. Hasson SS, Al-Balushi MS, Sallam TA, Idris M.A, Habbal O, Al-Jabri AA. In vitro antibacterial activity of three medici- nal plants-Boswellia (Luban) Species. Asian Pac J Trop Biomed 2011; S176-S180. 2. Habbal O, Hasson SS, El-Hag AH, Al-Mahrooqi Z, Al-Hashmi N, Al-Bimani Z, MS Al-Balushi, Al-Jabri AA. Antibac- terial activity of Lawsonia Inermis Linn (Henna) against Pseudomonas aeruginosa. Asian Pac J Trop Biomed 2011; 173-176. 3. Al-Jabri AA, Al-Muharrami Z, Balkhair AA, Al-enzi FQ, BaOmar AA. Overview of factors affecting AIDS progression. Int J Med Biol Frontiers 2010; 16:211-236. 4. Mouahid G, Nguema RM, Idris MA, Shaban MA, Al Yafae S, Langand J, et al. High phenotypic frequencies of complete albinism in wild populations of Biomphalraia pfeifferi (Gastropoda: Pulmonata). Malacologia 2010; 53:161-6. 5. Nzeako BC, Al Sumri SH. The disinfecting potential of some contact lens solutions used by some Sultan Qaboos University students. Sultan Qaboos University Med J 2011; 11:252-8. 6. Nzeako B.C., Al Lawati H, Elsafie A,Al Jabri M, Al Balkhair A. Correlation between sedimentation plate and surface swabs in the isolation of Fungi from the Hospital wards Int J Microbiol Res 2011; 2:129-34. 7. Monteiro P, Gosselin A, Sue Wacleche V, El-Far M, Said EA, Kared H, et al. Memory CCR6+CD4+ T Cells are preferential targets for productive hiv type 1 infection regardless of their expression of integrin β7. J Immunol 2011; 4618-30. 8. Van Grevenynghe J, Cubas RA, Noto A, Dafonseca S, He Z, Peretz Y, Filali-Mouhim A, Dupuy FP, Procopio FA, Chomont N, Balderas RS, Said EA, et al. Loss of memory B cells during chronic HIV infection is driven by Foxo3a- and TRAIL- mediated apoptosis. J Clin Invest 2011; 121:3877-88. National Publications 1. Idris MA. Usage of Praziquantel in the treatment of Schistosmiasis mansoni in Dhofar Province, Sultanate of Oman. Al Watan Newspaper, 13 November 2010. 2. Idris MA. Treatment of intestinal Bilharzia in Dhofar. Oman Observer, 13 November 2010, P. 26 3. Idris MA. Transmission of Schistosomiasis. SQU Horizon, 2010. Issue 210, P. 4. 4. Al-Jabri AA. Happiness is renewed by a promised that has been fulfilled. Al-Wattan, Special Issue, 18 December 2010, P. 11. 5. Al-Jabri AA. Antimicrobial Activity of Honey. SQU Horizon 2010. Issue 202, P.4 6. Al-Jabri AA. Our immune system and the effects of fasting. (Arabic). Al-Masar, 30 August 2010. Issue 197, P.10.

136 CONFERENCE & SEMINAR PRESENTATIONS Poster Presentations International 1. Al-Sharbati MM, Al-Jabri AA. The experience of the committee for students under probation in the College of Medi- cine and Health Sciences, Sultan Qaboos University (Oman). Innovations in Healthcare Management and Informat- ics. Kuala Lumpur, Malaysia, 16-17 March 2011. 2. Al-Jabri AA, Al-Mahrooqi S, Al-Muharrami Z, Balkhair A. Prevalence of HIV-1 & 2 among pregnant women attending Sultan Qaboos University Hospital, Oman. 18th International AIDS Conference. Vienna, Austria, 18-23 July 2010. 3. Al-Mahrooqi SH, Al-Mundhari S, Al-Jabri AA. Knowledge and attitudes of Omani pregnant women towards HIV/ AIDS. 18th International AIDS Conference. Vienna, Austria, 18-23 July 2010. National 1. Al-Rahman M, Kutty I, Al-Belushi M, Al-Shukaili A, Al-Harthi S, Ali K, Sidgi H, Al-Jabri AA. ANCA Detection and Strat- egy. University Day. Sultan Qaboos University, Muscat, Oman, May 2010. 2. Hasson S. Al-Jabri A.A., Idris MA. (2010). Autoimmunity: When the good turns bad-II. University Day. Sultan Qaboos University, Muscat, Oman, May 2011. 3. Balkhair A, Al-Muharrami Z, Ganguly S, Al-Jabri AA. Spectrum of opportunistic infections in a series of 77 hospital- ized HIV-1 infected Omani patients. University Day. Sultan Qaboos University, Muscat, Oman, May 2011. 4. Al-Muharrami Z, Balkhair A, Ganguly S, Al-Jabri AA. Effect of gender on HIV presentation and progression in Omani AIDS patients. University Day. Sultan Qaboos University, Muscat, Oman, May 2011. THESIS SUPERVISION Muna Al-Rubkhi Qualification: M.Sc. Medical Microbiology Title: Molecular detection and identification of Theilaria species in sheep in Oman, departments

Supervisors: Dr. Hamza Babiker, Prof. Mohamed Idris, Dr. M. H. Tageldin care

Hissa Al-Farsi Qualification: M.Sc. Title: Genetics of Plasmodium falciparum Resistance to SP in Saudi Arabia patient

Supervisor: Dr. Hamza Babiker and

Ms Wafaa S. Al-Areimi Qualification: M.Sc. Title: Viral Respiratory Infections among Omani Infants and Young Children at

Sultan Qaboos University Hospital (SQUH) academic Microbiology & Immunology Supervisor: Dr. Muhannad Kobaisi 137 Annual Report 2010-2011 Nursing Services Directorate

Nursing Services Directorate

he Nursing Services Directorate, being the hub of SQUH, provides a 24 hour service dedicated to providing outstanding, safe and quality patient care which includes performance improvement methodologies and indicators, quality control, assess- Tment, peer review, teaching strategies to ensure nursing related processes are continuously improved. The Directorate plays a pivotal role in SQUH health care system which consistently strives for a safe, caring, innovative, scientific and empowering nursing practice based on a solid foundation of transformational leadership. The Directorate seeks to be a model of excellence for all nursing services in the country. Through its practice models, it promotes evidence-based practice and aims for a higher standard of care, teaching and training for the nursing adn medical students and the continuous professional development of all nurses.

Committed to an environment that fosters evidence-based practice, critical thinking and innovations that enhance delivery of quality patient care and teaching, The Directorate coordinates health care delivery across the continuum to international standards; pro- motes patient advocacy while providing comprehensive, mutually defined care; empowers nurses to exercise sound judgment which will promote their professional development, and supports and complements teaching and training activities.

138 Staff Megawati Nor, Head Nurse, Ward 3 Red Bader Head Nurse, Ward 3 Yellow The Directorate has a multinational team provid- Lau Pek Hoon, Head Nurse, Ward 3 Blue ing nursing services to SQUH. There were a total of Koh Choy Fong, Head Nurse, Ward 3 Purple 1,147 posts as of December 2011 of which 1,039 were Janet Ogonjumo, Head Nurse, Ward 4 Blue filled. This is compared to 908 staff in post at the Vijayarani Reddy, Head Nurse, Ward 4 Yellow end of 2010. Suliaman Mahmoudi, Head Nurse, Ward 4 Red Yusriya Al-Akbary, Deputy Hospital Director for Umi K. Head Nurse, Ward 1 Purple Nursing Affairs Zairiyah Zainol, Head Nurse 4 Purple Shinuna Al-Harthy, Assistant Director, Maternal Sarala Kodamala, Head Nurse, Family Medicine & and Child Health Public Health Clinic Ayna Al-Riyamy, Assistant Director, Inpatient Area Haseena Saib, Head Nurse, Operating Theatres Catherine Lausa, Assistant Director, Supplementary Sapiah Abbas, Head Nurse, Day Care Unit Services Zayana Al-Maskary, Head Nurse, A&E Yousuf Al-Hasani, Assistant Director, Ambulatory Parvi Ponambalam, Head Nurse, Neonatal Ward Services Barbara Swales, Head Midwife, Delivery Ward Roseliyah Shamsudin, Nursing Quality & Special Michael Lee, Head Nurse, Psychiatry Ward Projects Nooraini Yadi, Head Nurse, Intensive Care Unit/ Daniel Birru, Assistant Director, Training and Staff CICU/Paediatric ICU Development Asila Al-Busaidy, Head Nurse OPD Fatma Al-Dhabari, Nursing Quality & Special Proj- Rabia Al-Saadi, Out Patients Coordinator ects Yacoub Al-Maharazi, Director for Support Services Lucia Pelser, Nursing Coordinator Hafidh Al Hashmi, Head Central Sterile Supply Phang Ah Looi, Nursing Coordinator Dept. Rose George, Nursing Coordinator Support staff like coordinators, medical orderlies Robert Dimaiwat, Nursing Coordinator (145) and ward clerks provide support in all areas. departments

Ranbindra Singh, Nursing Coordinator Moey Pheng, Nursing Coordinator Samira Al-Rasbi, Bed Flow Manager Highlights of the Year care Nancy V. Reyes, Head Nurse, Ward 1 Blue Norah Ngcamu, Head Nurse, Ward 2 Blue 2011 Thavamony Saravanan, Head Nurse, Ward 2 Red The Directorate is committed to delivering the

highest quality of patient care and to advance patient Sotinah Tariono, Head Nurse, Ward 2 Yellow Zita Montesclaros, Head Nurse, Ward 2 Purple nursing practice—a hallmark of professional com- and Rahma Al-Mahrazi, Head Nurse, Ward Bone Mar- mitment. row Transplant academic Nursing Services Directorate 139 Annual Report 2010-2011 Nursing Services Directorate

EVENTS AND ACTIVITIES The year 2011 has been a great year for nursing in SQUH as the hospital navigates the pathway of change and improvements.

The existing orientation and induction programme for new staff/employees was reviewed and thoroughly revised. This included the complete revision of the Orientation Guideline for new staff.

High Dependency units on specific wards were opened after the implementation of training plans for HD Staff.

Collaboration between SQUH and the University of Malaya for Omani nurses career development took place.

A total of 50 Omani Nursing graduates (Cohort 5/6) joined Nursing Directorate between December 2010 and August 2011.

The year started with an Open Day organised by the Professional Code of Conduct with the goal of making each staff aware of the scope of their duties as defined by the Oman Midwifery and Nursing Council. The Support Group actively participated in the Open Day.

The current staff self appraisal form was reviewed and amended in order to improve this self appraisal tool.

24 staff members participated in the Arabian Gulf Sports event.

International Nurses Day was celebrated on 12 May 2011 with the theme of “Closing the Gap: Increasing Ac- cess and Equity”. The programme included both scientific and social activities.

The International Nursing Conference held in November 2011 was judged to have been a very successful conference.

All Head Nurses attended the Accreditation presentation from a Canadian Consultant on Accreditation which focused on” Driving Quality Health Success”

QUALITY IMPROVEMENT Hospital wide audits like Nursing Documentation (January 2011); Call bell (March); Inpatient Satisfaction with Nursing Courtesy and Patient’s Perceptions of Safety (June); and ID Band (July) audits were done. The results were presented in the Nursing Management Meeting

A Documentation Awareness Day was held to raise staff awareness about the effect of nursing assessment and documentation on patient care. The day was highlighted by other activities such as a quiz, poster pre- sentations, slide show on documentation and awards to deserving wards and staff.

140 The Psychiatry Ward launched their Best Practice Initiative which consists of identifying the following: Most Innovative Nurse; Best in Documentation, and Best in Bedside Care.

The adaptation of the Key Performance Indicators as one of the pilllars of Quality Improvement has taken place in the different wards. Existing KPIs are still utilised with new clinical indicators identified by the Nurs- ing Directorate

The BSI audits took place on 22 February and June 25 2011 with a positive outcome and recertification.

A Patient Classification study was conducted to review the existing patient/staffing ratio which includes studying the skills mix and standardising the requirements for staffing ratios across the hospital.

The Best Practice Audit is an annual quality initiative held in November which aims to benchmark nursing practices between wards. It promotes, recognises and rewards the ward with the highest compliance to stan- dards. Winners were presented their awards during the Year end Debate. Around 300 nurses attended the debate on “Informed consent: Is it Practical?” held in the College of Nursing in both May and December 2011.

The ongoing revision and updating of the nursing manual/guidelines were undertaken by all wards.

“Our News”, a nursing newsletter, is published twice a year by the nurses for the nurses.

Regular meetings with all Omani staff are held to discuss their career path and provide individual guidance on meeting their professional developmental needs based on their interests and future plans.

An annual meeting between the top management and different levels of staff provided a forum for open dialogue issues related to employment etc.

Infection Link Nurses participated actively in the International Hand Hygiene Initiative launched in May by the Infection Control Unit. departments

Early Warning Score Charts for paediatric and adult patients were introduced as a standard monitoring and triggering tool in the general wards. This chart is part of the procedure to the assessment and reassessment of patients with acute problems who might deteriorate. care

A Quality Assurance Committee was set up in preparation for the future plans of obtaining international accreditation. patient

EDUCATIONAL ACTIVITIES and

A video conference on Pathways to Excellence & Nursing Analytics was held with the Methodist Hospital in Houston, Texas, USA, in March 2011. academic Nursing Services Directorate 141 Annual Report 2010-2011 Nursing Services Directorate

In March, three Omani nurses left for Malaysia (University Malaya Medical Center) to study for their Ad- vanced Diploma in Critical and Diabetic Nursing.

Departmental Studies, CNE and Patients Bedside stories were amongst 2011’s Quality & Educational Projects in which different wards participated on a monthly basis.

Patient’s Bedside Story is a new initiative for inpatient areas where patient’s actual hospital experiences are portrayed. This promotes staff confidence in presenting talks and increases empathy towards patients.

A survey of Nurses Awareness in Disaster Management Preparedness was undertaken to assess the knowl- edge and readiness of all staff in the event of a disaster. This was done in conjunction with the new Disaster Plan introduced by the Disaster Planning Committee.

Representatives from Bone Marrow Transplant and the Delivery ward participated in the Health and Safety Conferences; the Annual Meeting of the European Group for Blood and Marrow Transplantation in Paris in April 2011, and the Midwifery Today conference in Oregon, USA, in April 2011. Two of our Haematology nurses attended the American Society of Haematology Annual Meeting in Texas, USA, in December 2011

The nursing staff attended the Workshop on Strategic Planning of Frontline Managers held in December 2011.

RESEARCH PROJECTS AND SURVEYS The 10 member Research Group initiated research studies between June and December 2011.

The staff participated in the following studies: 1) Nurses perception of collaboration between Doctors and Nurses in SQUH; 2) GFR Study by DCU; 3) Research on Colon Cancer by DCU; 4) School Health Program for Paediatrics with Child Health Department, and 5) Pain Score for premature babies by NNL.

Departmental Studies were organised as a whole year activity for the ambulatory areas which facilitates the orientation, preparation and exposure of staff to research study, surveys and data analysis. This also aimed to develop staff public speaking skills through interview. The activity is a competitive activity focused on Patient Satisfaction and Safety.

Senior Nurses were requested to be examiners in the recently concluded final examination of the nursing students of SQU College of Nursing held on 22 and 23 May.

IN-HOUSE TRAINING All Head Nurses attended the Key Performance Indicators Course organised by the Directorate for Training & CPD (DTCPD) in June which aimed to educate nurses on the concept of KPIs.

142 The Nursing Assessment and Documentation Course commenced on 31 May. This is part of the Patient’s Safety and Quality Initiative which educates and train nurses to be competent in patient assessment and writing acceptable patient notes.

A series of educational updates, organised by the DTCPD, were attended by various staff such as: Problem Solving & Decision Making; Customers Service; Paediatric Surgical Workshop; VAC Workshop; Identifying Learning needs; Emotional Intelligence, and a Leadership Course.

A Dysphagia Workshop was conducted on 27 September and attended by 12 nurses.

A Preceptor Workshop was conducted on 20 October for senior nurses. It aimed to enhance the knowledge of head nurses and their deputies on mentoring the nursing students affiliated to the Hospital.

A CBPA Workshop for head nurses was held after approval by the Board. It aimed to strengthen and enhance the nursing leaders’ objectivity when assessing their staff through the appropriate utilisation of the tool.

A Nursing Administration Workshop was conducted for head nurses on 14 November to guide each head nurse in the different aspects of ward management.

The High Dependency training course ran from July to October. High dependency nurses completed their training, both theoretical and clinical, in 2 weeks. This was in conjunction with the plans to open high depen- dency beds on all paediatric, medical, surgical and obstetrics and gynaecology wards.

The Directorate is continuously engaged in teaching and training both medical and nursing students at the ward and departmental level. Nursing students came from OSNI, Oman Nursing Institute, Muscat Nursing Institute and SQUH College of Nursing.

An E-Learning Tutorial Workshop was held in April in the College of Nursing. Five nurses attended to learn about this new learning strategy. departments Continuing Nursing Education activities at ward level are held monthly with selected nursing topics pre- sented by invited speakers from the medical team. care

EXTERNAL VISITS & TRAINING The Nursing Team from the Psychiatric Unit visited the Ibn Sina Hospital on 17 August to network with the

other institution and gain a better insight into the management and care of mental health patients in Oman. patient

SQUH Delegates (DTCPD, Directorate of Nursing and the top management team) visited the University Ma- and laya Medical Centre to explore training opportunities in October. academic Nursing Services Directorate 143 Annual Report 2010-2011 Nursing Services Directorate

CONFERENCES Collaborative conference was organised by the SQUH Directorate of Nursing and the College of Nursing with the theme of “Delivering Quality, Serving Community - Nurses leading Chronic Care” with participation from nurses all over Oman.

May 12, 2011 marked the International Nurses Day and was held in Majan Hotel, Bowshar. The event was high- lighted by both scientific and social programs. 350 Nurses attended the event. Scientific Programs’ theme is “Closing the Gap. Increasing access and equity”

February 1, 2011 3rd Day of International Patient Safety Conference was supported by nursing staff partici- pants.

9thGCC Symposium held in Crown Plaza on February 7 to 8, 2011 was attended by several Omani nurses.

VISITORS A Patient Flow Management resource person from Adelaide, Australia visited SQUH from 5-17 December to advice on bed utilisation strategies. She also conducted a KPI Workshop for the Head Nurses on 11 December. Visitors from Pennsylvania, USA, came and discussed the clinical practices of nurses

Visitors from the Ministry of Health (MOH) Committee on Strategic Planning came to SQUH. A MOH DGNE visitor came to explore and seek guidance on nursing assessment and documentation.

144 departments

care

patient

and

academic Nursing Services Directorate 145 Annual Report 2010-2011 Nutrition & Dietetics

Nutrition & Dietetics

he Department has responsibilities in a range of areas including dietetic counselling to inpatients and outpatients, adminis- tration, health education and promotion through activities related to preventative medicine, and training. Several clinics are covered for both adult and pediatric patients. Adult clinics include diabetic, renal, lipid, obesity and gynecology, whereas pe- Tdiatric clinics include pre-term, haematology, metabolic, neurology, respiratory, general, endocrine and nephrology. The Department consists of two main divisions: Nutrition & Dietetics and Catering Administration

NUTRITION & DIETETICS Nutrition is the study of nutrients in food, how nutrients are used by the body, and the relationship between diet, health and disease. Nutritionists work mostly in food industries, media, health promotions, schools, sports or education. Dieticians, on the other hand, work mostly in hospitals; however, they can also work in the community as health promoters, educators, as well as in sports or media. They assess nutritional needs, diet restrictions and current health plans to develop and implement dietary management plans for pa- tients mainly in the Hospital, and educate them on special diets as part of their medical treatment in several areas such as: Diabetes; Oncology; Renal conditions; Liver conditions; Gastroenterology; Paediatrics; Food Allergies; Obesity, and Nutrition Support.

146 CATERING ADMINISTRATION Highlights of the Year The purpose of the catering administration service is to ensure a supply of safe, nutritious, well pre- 2011 sented food and to protect patients from contami- NUTRITION & DIETETICS nated, decomposed or injurious food. Continuous monitoring prevents the use of misleading labels. SECTION Further monitoring activities encourage healthier The Section provided dietetic consultations to 363 and safer food by better standards of quality con- adult and 462 paediatric outpatients in 2011. trol in receiving food products from suppliers, cor- A major achievement this year was conducting rect storage, food preparation, cooking and finally the first Oman Metabolic workshop. It was a full serving food to patients. day metabolic workshop under the patronage of H.H. Sayedah Dr. Mona Bint Fahad Al-Saeed. The aim was to boost the awareness of the mothers of Staff children diagnosed with inborn errors of metabo- Head of Department lism. It was organised by Mr. Salah Al-Shukaili, Mrs. Salah Al-Shukaili Ayda Al-Nabhani, and Ms. Salma Al-Mahrouqi of the Department. Dietetics staff Majda Al-Maamary, Deputy Head of Department The Nutrition Day at SQU Hospital was a one day Shadya Al-Harthy, Senior Dietitian international cross-sectional audit in all types of A’Shaima Al-Kindi, Senior Dietitian wards, in association with Medical University of Ayda Al-Ghadhee, Dietitian Vienna. The aim of this worldwide cross-sectional Fatma Al-Hashmi, Dietitian multicentre audit is to generate a risk and level of Salma Al-Mahrouqi, Dietitian nutritional intervention profile for an individual Catering Staff unit/ward based on case-mix, structures and the social environment.

Razeen Hameed, Catering Administration Superin- departments tendent The Dar Al-Hanan Nutrition & Food safety Manual Matar R. Al-Ruqaishim, Catering Supervisor was developed by joint cooperation between the care Thuraya Al-Abadi, Asst. Catering Supervisor SQUH and Dar Al-Hanan (Patients & Family On- Coordinator cology Centre). It aims to improve the nutritional status of the centre’s residents and patients, under Ali S. Al-Farai patient

professional food safety practices.

The Department provided speakers for different and

national events: Nutrition and Dietetics Education academic Nutrition & Dietetics 147 Annual Report 2010-2011 Nutrition & Dietetics

for medical staff at SQUH; the Physiotherapy & Rehabilitation Week at SQUH; Diagnostic Day at special care centre in Al Khoud; Nutritional Chronic Diseases Management at the Sharqyia Nutrition Conference, and training for non-SQUH dieticians on Renal Management.

The Department is very active in developing, designing and teaching nutrition and dietetics training pro- grammes tailored and delivered to different national organisations in Oman such as the Ministry of Health.

Dieticians worked from the beginning of the year on updating the different policies and procedures which are related to patient care and management. The department also successfully updated different education- al materials, mainly used as part of nutritional clinical management plan especially for outpatients

The Department introduced two new machines: an anthropometrics measurement machine for more ac- curate body composition analysis and a machine to measure muscle strength which is used particularly for oncology adult patients.

CATERING SECTION The Section provided a total of 853,452 meals in 2011: 365,204 for patients; 253,114 for staff and students and 235,134 for attendants.

The introduction of new food safety trolleys for patients was a major achievement. SQUH is the first hospital in Oman to introduce state of the art technology in patient meal services. This kind of meal delivery services comply with food safety regulation and fulfills hazard analysis and critical control points (HACCP) require- ments.

Ten new catering policies were introduced to ensure that the catering operation is monitored even at docu- mented policy level. New patient meal recipes were introduced and updated to focus on meals prepared entirely according to special patient meal menus

The Section conducted training for SQU food science and nutrition students and graduates. In addition, it conducted ongoing training for Tawoos staff. The objective was to upgrade their knowledge and hence en- sure better patient care.

The Section improving general catering services as evidenced by the increased reduction in meal service complaints with only 11 minor complaints in 2011 (compared to 13 in 2010 and 35 in 2009). Statistics were collected by the Patient Services Directorate. A patient satisfaction survey is conducted annually to identify patient needs and receive patients’ suggestions, comments and remarks in order to improve our catering services. A study during the month of October 2011 showed a significant improvement in our patient meal services. Improvements were achieved by the innovation of colour-coding and continuous monitoring; im- proved disinfection of vegetables and fruits; monitoring that the process of meal production complies with

148 HACCP and food safety regulations; the regular audit of supplier to ensure the food is supplied in accordance with food safety regulation; continuous monitoring of HACCP records, and continuous on the job staff train- ing

97 97 100 96 96 95 93 89 87 90 85 80 78 71 70 60 50 40 30 20 10 0 1 2 3 4 5 6 7 8 9 10 11

Figure 1: Results of patient satisfaction survey 2011

Q1. The taste /flavor of the food was - good Q2. The overall appearance of the meal tray was - good Q3. The variety of foods you received was - good Q4. The temperature of your meals received was - good Q5. Friendliness and service from staff was – Satisfactory departments

Q6. The size of the portions were – excellent Q7. Have you received the meals you order – Yes care

Q8. Dose a diet clerk visit you daily to take your menu selection – Yes Q9. Do you receive enough assistance with filling out the menu - Yes patient

Q10. Were your cutleries, crockery and tray clean when delivered – Yes Q11. Have we met your culture food preferences – Yes and

academic Nutrition & Dietetics 149 Annual Report 2010-2011 Nutrition & Dietetics

Long awaited new equipment was received for catering operations. The objective is to provide the best pos- sible patient care within the boundaries of food safety that comply with ISO 22000: HACCP requirements.

Training material was received from Highfield Company, UK, covering almost all areas and levels of food safety and all HACCP training modules. These training materials will be used to update food safety aware- ness and knowledge of students, in-house hospital catering staff and catering contract staff.

In liaison with the SQUH Engineering Department, the Section organized the services of professionally quali- fied and internationally recognised design consultants to redesign our catering unit according to the food safety standards of ISO 22000:HACCP.

CONFERENCE & SEMINAR PRESENTATIONS Seminar Presentations National 1. Al-Harthy S. Series of workshops on infant feeding for students. College of Medicine & Health Sciences, SQU. 2011. 2. Al-Harthy S. Series of workshops and demonstration of food testing on infant feeding for nursing staff. Sultan Qa- boos University Hospital, SQU. 2011. 3. Al-Shukaili S. Sport Nutrition.Sultan Qaboos Sport Complex, 8 March 2011. 4. Al-Shukaili S. Sport Nutrition. Sultan Qaboos University Hospital, 9 March 2011. 5. Al-Harthy S. Nutrition for fitness. Seeb Sports Complex, Oman, 8 March 2011. 6. Al-Shukaili S, Al-Mahrouqi S, Hameed R, Al-Ruqaishi M. Healthy Eating and Food Safety. Diagnostic Day. Special Care Centre, Alkhoud, Oman 18 May 2011. 7. Al-Harthy S. Medical Nutrition therapy for Kidney diseases. SQUH, 10-12 October 2011. 8. Al-Mahrouqi S. Eating guide for cancer patients - for nursing staff. SQUH, 10 April 2011. 9. Al-Mahrouqi S. Approach to nutritional support using hospital food. Sharqiya Region National Gathering of Nutri- tion. Ministry of Health, Sharqiya, Oman 18-19 October 2011. 10. Al-Hashmi F. Diet and chronic kidney diseases in adult. Sharqiya Region National Gathering of Nutrition. Ministry of Health, Sharqiya, Oman 18-19 October 2011. Poster Presentations National 1. Al-Mahrouqi S. Infant Feeding. 1st National Breastfeeding Symposium. Ministry of Health, Directorate of General of Health Affairs, Department of Nutrition, Nov 2010.

150 departments

care

patient

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academic Nutrition & Dietetics 151 Annual Report 2010-2011 Obstetrics & Gynaecology

Obstetrics & Gynaecology

he Department of Obstetrics and Gynaecology is one of the major departments involved in teaching undergraduates, post- graduates and other allied professionals. It produces trained leaders in women’s health whether as an academic subspecialty, community practice or research. We take care of women of all age groups and believe that women are the nucleus of the Tfamily, the community and the nation. The goal of the Department is to provide excellent women’s health care through the academic subspecialties in the Department like uro-gynaecology, infertility, endoscopic surgery, maternal fetal medicine and gynae-oncology. We value team work, intellectual curiosity, compassion and academic excellence. Our mission is to provide a structured educational environment in which dedicated teaching is integrated with graduated clinical responsibilities that promote intellectual growth in the operation room, delivery room inpatient and outpatient settings. Our undergraduate and postgraduate programmes train the students to provide comprehensive health care for women by applying an evidence-based approach to clinical management with a view to providing the best possible care to all our patients.

152 Staff Support Staff Philomena Sangameshwar, Coordinator Head of Department Samson Packianathan, Coordinator Dr. Vaidyanathan Gowri, Acting Head of Depart- ment & Asst. Professor Highlights of the Year Faculty Dr. Lamya Al-Kharusi, Consultant, & Deputy Head 2010-2011 of Department The Department started the Recurrent Pregnancy Dr. Mariam Mathew, Senior Consultant Clinic & Adolescent Gynaecology Clinic in the Out Dr. Saniya El Tayeb, Asst. Professor/Consultant Patient Department in addition to the existing spe- Dr. Lovina Machado, Consultant cialty clinics of Urogynecology, Oncology, Maternal Dr. Maha Al-Khaduri, Consultant Fetal Medicine, IUGR, Infertility, Gestational Diabe- Dr. Wadha Al-Ghafri, Consultant tes and Endoscopic Surgery. Dr. Tamima Al-Dughaishi, Consultant The Advanced Life Support in Obstetrics (ALSO) Dr. Nihal Al-Riyami, Consultant course was organised by Dr. Moza Al-Kalbani, Dr. Dr. Mariam Al-Shukri, Acting Consultant Lamya Al-Kharusi and conducted twice this year Dr. Moza Al-Kalbani, Consultant under the Oman Medical Specialty Board. This Dr. Rahma Al-Haddabi, Acting Consultant course is very important in training all medical Dr. Asma Al-Ojaili, Acting Senior Registrar personnel involved in the management of a deliv- Dr. Evelyn Moral, Senior Registrar ery ward. The aim is to improve the management Dr. Shahila Tazneem, Senior Registrar of obstetric emergencies thus decreasing morbidi- Dr. Majeda Al-Bash, Registrar ty and litigation. Dr. Silja Pillai, Registrar Dr. Hazel Gonsalves, Registrar A Cochrane Systematic Review Workshop was held Dr. Asha Nair, Registrar from 2 to 5 February 2011. It was organised by Dr. Dr. Hana Al-Sayed, Senior House Officer Maha Al-Khaduri and conducted by P J Wiffen and departments Dr. Sarya Bella, Senior House Officer Khadra Galaal from the UK. Dr. Farah Fathih, Senior House Officer

The following new equipment was obtained: GE care

Dr. Seema Zulfikar, Senior House Officer Dr. Musarrat Musarrat, Senior House Officer Ultrasound machine in the OPD for Obstetrics and Dr. Ayesha Salahuddin, Senior House Officer Gynaecology Ultrasound routine scanning; new Dr. Mayesa Al Din, Senior House Officer colposcopy equipment with television monitor; patient Dr. Sara Abu Zaid, Senior House Officer Karl Storz laparoscopy and hysteroscopy machines with tower; diagnostic hysteroscopy machine for

Dr. Nooren Ishrat, Senior House Officer and the outpatient department; equipment for I.U.I (sperm preparation). academic Obstetrics & Gynaecology 153 Annual Report 2010-2011 Obstetrics & Gynaecology

In the new curriculum, the Phase II Department representative/coordinator was Dr. Mariam Mathew; the Phase III Pre-clerkship representative/coordinator was Dr. Lovina Machado, and the Senior-clerkship repre- sentative/coordinator was Dr. Mariam Al-Shukri.

During this period, the Department said goodbye to the following staff: Dr. Kuntal Rao, Acting Head of De- partment and Senior Consultant; Dr. Shabnam Saquib, Senior Registrar, and Dr. Sadaf Ayoob, Dr. Maya Sree- kumari, and Dr. Soha Gadir Senior House Officers. Dr. Sheikha Al-Jabri, Acting Consultant, and Dr. Zamzam Al-Bimani, Senior House Officer are now both working for the Ministry of Health.

Teaching Programmes UNDERGRADUATE PRECLINICAL PROGRAMME-OLD CURRICULUM In the 4th year, the Department is involved in the clinical methods and communication skills programme. The clinical methods course in obstetrics and gynaecology necessitates that 3 staff members spend 2 hours for each of 3 days. The communication skills programme is conducted by spending 2 hours in lectures and student exposure to the wards for 2 hours per week for 16 weeks. One lecture is given as an interdisciplinary activity to 5th year students.

UNDERGRADUATE CLINICAL PROGRAMME – 6TH AND 7TH YEAR (OLD CURRICULUM) In 2010 and 2011, 115 and 127 students presented for the MD examination in obstetrics and gynaecology re- spectively.

For 6th year students, we have 8 groups of students, with each group rotating for 4 weeks in the Department. Each student has to do 2 case write-ups and present one case bedside for formative assessment. Students are exposed to didactic lectures, outpatients, bedside teaching and operative procedures in the Obstetrics and Gynaecology department.

The 7th year students spend 7 weeks on placement: 3 weeks at SQUH, 2 weeks at the Royal Hospital and 2 weeks at Khoula Hospital. They are exposed to problem solving seminars and ward rounds with consultants. They also rotate to the operating theatre, outpatient clinics and wards. In the OPD, they are exposed to a wide spectrum of obstetrics and gynaecology patients, attend the high risk pregnancy clinic and are exposed to ultrasound procedures.

154 NEW CURRICULUM The Department takes part in lectures, tutorials and examinations in 4 modules in Phase II as follows: 1 lec- ture in growth & development; 1 lecture & 1 tutorial in clinical nutrition; 3 tutorials in the uroreproductive module; 2 weeks vomiting Integrated module.

For the Pre-clerkship course, about 120 students were taught (in 9 groups) basic clinical skills like history tak- ing and examination of a patient in obstetrics & gynaecology. Common symptoms and science in obstetrics & gynaecology were taught in the clinical skills laboratory from September to November 2011 over 9 weeks. A formative assessment in the form of a mini-CEX was conducted for all the students at the end each week for a group of 12 to 15 students.

POSTGRADUATE PROGRAMME The Oman Medical Speciality Board (OMSB) programme started in September 2007; 6-7 Residents are posted at a time in the Department where they are actively involved in patient care, on call rota and presentations such as in the Journal Club. Dr. Lamya Al-Kharusi was Chairperson, of the Obstetrics & Gynaecology Scientific Committee; Dr. Wadha Al-Ghafri was Programme Director of the Scientific Committee. Active Members of the Scientific Committee were: Dr. Maha Al-Khaduri, Dr. Lovina Machado, Dr. Tamima Al-Dughaishi, Dr. Nihal Al-Riyami and Dr. Mariam Al-Shukri.

Training Courses & CME Activities CME activities include the daily morning meeting that includes handover and important announcements. The CME programme consists of a monthly Journal Club, monthly pathology rounds, monthly fetal anomaly group meetings (multidisciplinary with NICU, genetics, paediatric surgeons), weekly resident presentation, weekly intern presentation, weekly CME aimed at SHOs and registrars. There is also a weekly inter-depart- mental meeting between Obstetrics & Gynaecology and the NICU. The monthly departmental meeting

includes all obstetrics & gynaecology staff, midwives, and OPD nurses as needed. departments

care Clinical & Diagnostic Services In 2011 in the Gynaecology OPD, 16,131 patients were seen in general OPD. There were 8,711 antenatal patients, 6,196 gynaecological patients and 42 postnatal patients. Besides these, the following patients were seen: patient

Infertility Clinic - 1,182; Diabetics Clinic (pregnancy with diabetes) - 581; Uro-Gynaecology Clinic - 344; Colpos- copy Clinic - 35; Intra Uterine Growth Restriction (IUGR) Clinic - 38; Fetal-Maternal Clinic - 374; Amniocentesis and

Clinic - 12 patients; Recurrent Abortion - 113 patients; Oncology - 171 patients; Adolescents - 25, Combined In- fertility - 97 patients. In addition to the patients seen, the following numbers of procedures were performed: Ultrasound Scans (abdominal & vaginal) - 3,698; Mirena insertion (intra uterine device) - 41; Phlebotomy academic Obstetrics & Gynaecology 155 Annual Report 2010-2011 Obstetrics & Gynaecology

-10,795; Hydrosonography - 24; Endometrial Biopsy - 121; Bartholin Abscess incision - 2; NST - 1,823; Bladder scans - 53; Uro-flowmetry - 44.

In the Labour ward from January to December 2011, a total of 5,131 (day cases 1,237 and admissions 3,894) pa- tients were seen. Total deliveries were 3,328 of which 2,668 were normal vaginal deliveries, 477 emergency cesarean sections, and 283 elective cesarean sections.

We had a total of 3,346 admissions in Red 2, the mainly postnatal ward. Of these, 1,766 patients who delivered were booked via the antenatal clinic and 1,580 (47%) were unbooked cases. There were 660 patients who underwent cesarean sections out of 3,346 admissions.

We had 2,965 patients admitted in the Yellow 2 ward, mainly with gynaecological problems. Of these, 1,309 were new cases and 1,520 were old cases and antenatal problems. The total number of antenatal patients admitted to this ward was 1,345 and 394 with postnatal problems.

Research RESEARCH PROJECTS The Relationship between Birth Weight and Shoulder Dystocia at Sultan Qaboos University Hospital. Project Code: MREC #347; Dates: 2010 Value: Unfunded; Project Approval: Sultan Qaboos University Investigators: Dr. Maha Al-Khaduri, Dept. Obstetrics & Gynecology, SQU; Dr Yahya Al- Farsi, Dept. Family Medicine & Public Health.

An Analysis of the Indications for increase in the Rate of Primary Cesarean Sections in Parous Women Project Code: MREC# 372; Dates: 2010 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. V. Gowri, Dept. Obstetrics & Gynaecology, SQU.

Clinical Profile and Histology of Patients Surgically Managed for Benign Ovarian Tumors Project Code: MREC# 373; Dates: 2010 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. V. Gowri, Dept. Obstetrics & Gynaecology, SQU.

156 Analysis of the Diagnostic Value Hystosalpingogram (HSG) and compare it with laparoscopy in the as- sessment of fallopian tube patency in infertile women Project Code: MREC# 388; Dates: 2010 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. V. Gowri, Dept. Obstetrics & Gynaecology, SQU.

Maternal and Perinatal Outcome in Pregnancies Complicated with Diabetes Project Code: MREC# 397; Dates: 2011 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. Mariam Mathew, Dept. Obstetrics & Gynaecology, SQU.

Hemoglobin S Level in Sickle Cell Disease and Fetal Outcome Project Code: MREC# 389; Dates: 2010 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. Nihal Al-Riyami, Dept. Obstetrics & Gynaecology, SQU.

Myomectomy during Cesarean Section- A Retrospective Review from 1998-2010 Project Code: MREC# 399; Dates: 2011 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. Lovina Machado, Dept. Obstetrics & Gynaecology, SQU.

Thrombophilia and Adverse Pregnancy Outcome: A Prospective Study Project Code: MREC# 403; Dates: 2011 departments Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. V. Gowri, Dept. Obstetrics & Gynaecology, SQU. care

Effects of Pre-Pregnancy BMI on Obstetrical and Neonatal Outcomes Project Code: MREC# 407; Dates: 2011 patient Value: Unfunded; Project Approval: Sultan Qaboos University and

Investigator: Dr. V. Gowri, Dept. Obstetrics & Gynaecology, SQU. academic Obstetrics & Gynaecology 157 Annual Report 2010-2011 Obstetrics & Gynaecology

Pregnancy outcome in homozygous beta thalassemia: maternal and fetal outcome Project Code: MREC# 426; Dates: 2011 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. Nihal Al-Riyami, Dept. Obstetrics & Gynaecology, SQU.

Extreme Preterm Premature Rupture of Membrane; Maternal and Fetal outcomes Project Code: MREC# 439; Dates: 2011 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. Nihal Al-Riyami, Dept. Obstetrics & Gynaecology, SQU.

Pregnancy outcome monochromic monoamniotic twins (MCMA) Project Code: MREC# 440; Dates: 2011 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. Nihal Al-Riyami, Dept. Obstetrics & Gynaecology, SQU.

Hospital-based prevalence of polycystic ovarian syndrome among Omani women Project Code: MREC# 444; Dates: 2011 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. Maha Al-Khaduri, Dept. Obstetrics & Gynaecology, SQU.

Incidence of Endometriosis and the Genetic base Project Code: MREC# 445; Dates: 2011 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. Maha Al-Khaduri, Dept. Obstetrics & Gynaecology, SQU.

Technicity as a Quality Indicator of Excellence in Gynecology Project Code: MREC# 446; Dates: 2011 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. Maha Al-Khaduri, Dept. Obstetrics & Gynaecology, SQU.

158 Postmenopausal Bleeding among Omani Women: Descriptive Analysis and Risk Factors Evaluation Project Code: MREC# 447; Dates: 2011 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. Maha Al-Khaduri, Dept. Obstetrics & Gynaecology, SQU.

Age of menarche in Omani girls and their relationship to body mass index and socioeconomic status Project Code: MREC# 448; Dates: 2011 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr V. Gowri, Dept. Obstetrics & Gynaecology, SQU.

HBA1C levels and pregnancy outcome in diabetic pregnancies Project Code: MREC # 478; Dates: 2011 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr Mariam Mathew, Dept. Obstetrics & Gynaecology, SQU. JOURNAL PUBLICATIONS 1. Mathew M, Gowri V, Rizvi G. Saline infusion sonohysterography – an effective tool for evaluation of the endometrial cavity in women with abnormal uterine bleeding. Acta Obstet Gynecol Scand 2010; 89:140-2. 2. Gowri V, Al Hamdani A, Ikram B, Jain R. Sertoli Leydig cell tumor - A rare ovarian tumour. Sultan Qaboos University Med J 2010; 10:296-8. 3. Gowri V, Rizvi G, Shabnam S, Futaisi A. High sensitivity CRP is a marker of obesity and not of polycystic ovarian syndrome per se. Fertil Steril 2010; 94:2832-4. 4. Gowri V, Jain R, Rizvi R. Magnetic resonance pelvimetry for trial of labour after previous caesarean section. Sultan Qaboos University Med J 2010;10:210-14. departments

5. Gowri V, Venkiteswaran KP, Zakwani IL, Mathew J, Abdul Rahman K, Al Marhoon A. Comparison of the demograph- ics, semen parameters and hormone profiles in men with primary and secondary infertility. Sultan Qaboos Univer- care

sity Med J 2010;10: 350-3. 6. Gowri V, Al Mabslai R. Book Review. Woman-centered care in Pregnancy and Childbirth. Sultan Qaboos University Med J 2011; 11:291. patient

7. Gowri V. Radiation exposure from medical imaging CT scan. Sultan Qaboos University Med J 2011; 11:290. 8. Al Kharusi L, Gowri V, Ghafri W, Suketi R, Rao K. Submyomatous cornual pregnancy – managed surgically after and failed medical management. Sultan Qaboos University Med J 2011; 11:399-402. 9. Gowri V, Udayakumar A, Bsiso W, Farsi Y, Rao K. Recurrent early pregnancy loss and consanguinity in Omani cou- academic Obstetrics & Gynaecology 159 Annual Report 2010-2011 Obstetrics & Gynaecology

ples. Acta Obstet Gynecol Scand 2011; 90: 1167-9. 10. Mathew M, Saquib S, Kumar S, Lokuhetty D, Jain R. Successful management of a case of gestational trophoblastic neoplasia in a young woman. Sultan Qaboos University Medical Journal 2010; 10:297-8. 11. Al Hashami H, Bataclan MF, Mathew M, Krishnan L. Caudal regression syndrome with partial agenesis of corpus callosum and partial lobar holoprosencephaly: a case report. Sultan Qaboos University Med J 2010; 10:89-93. 12. Mathew M, Mohan AK, Al Kalbani, Al Aamari S. Cornual Pregnancy – successful management with multiple dose methotrexate. J Arab Board Med Specializ 2011; 12:49-51. 13. Mathew M, Bella SM, Al Ojaili A, Jacob PC. Sudden aphonia following caesarean section under GA for twin preg- nancy. Neurosci 2011; 16:84. 14. Machado L. Emergency peripartum hysterectomy: Incidence, indications, risk factors and outcome. Review. N Am J Med Sci 2011; 3:358-61. 15. Machado N, Machado L, Al Ghafri W. Laparoscopic resection of a larger ovarian cyst herniating into the inguinal canal - a rare presentation. SLEPT (Surg Laparos Endosc Percut Tech) 2011; 21:e215-8. 16. Al-Khaduri M, Shawki O. hysteroscopy and resection of submucous fibroids with an intramural component. Gyne- col Surg 2011; 8:S1- S225. 17. Al-Khaduri M, Al- Farsi Y, Ouhtit A.Endometriosis in Oman: Experience in a Tertiary Hospital. Gynecol Surg 2011; 8:S1- S225. 18. Al-Riyami N, Hui D, Herer E, Nevo O. Uterine compression sutures in patients with postpartum hemorrhage: case series, Am J Perinatol Rep 2011; 1:47-52. 19. Al-Riyami N, Walker MG, Proctor LK, Yinon Y, Windrim RC. Utility of head/abdomen circumference ratio in the eval- uation of severe early onset intrauterine growth restriction, J Obstet Gynaecol Can 2011; 33:715-19. 20. Al Kalbani M, Elshafie O, Rawahi M, Al Mamari A, Al-Zakwani A, Woodhouse N. Vitamin D status in pregnant Oma- nis: A disturbingly high proportion of patients with low vitamin D stores. Sultan Qaboos University Med J 2011; 11:52-5. 21. Al Kharusi L, Waly MI, Othman H.M, Guizani N, Naabi F, Ali A. depression and low serum levels of docohexaenoic acid (DHA) are associated with increasing number of pregnancies among postpartum Omani Women. Can J App Sci 2011; 1:144-52. 22. Gowri V, Al Dughaishi T, Arumugam S, Mathew M. Misdiagnosed cervical pregnancy following a pregnancy with cotyledonoid leiomyoma. Letter to Editor. Eur J Obstet Gynecol Reprod Biol 2011; 159:242-3. 23. Gowri V, Mathew M, Gravell D, Al Falahi K, Zakwani I, Ganguly S, Pathare AV. Protein Z levels in pregnant Omani women: correlation with pregnancy Outcome. J Thromb Thrombolysis 2011; 32: 453-8. 24. Al Riyami N, Al Harthy A, Zia F. Atypical case of acute fatty liver of pregnancy. Sultan Qaboos University Med J 2011; 11:507-10. 25. Al Riyami N. Book Review. De Swiet’s Medical Disorders in Obstetric Practice, Sultan Qaboos University Med J 2011; 11:136-7.

160 26. Al Khaduri M, Al Farsi Y. Technicity as a quality indicator of excellence in gynaecology. M Al Khaduri, Y Al Farsi. Technicity as a Quality Indicator of Excellence in Gynaecology. J Minim Invasive Gynecol 2010; 17:S73. 27. Al Kindy S, Pathare A, Al-Mandhari A, Gravell D, Mathew M, Krishnamurthy R. Neonatal Screening: Mean haemoglo- bin and red cell indices in cord blood from Omani neonates. Sultan Qaboos University M Journal 2011; 11:462-9. CONFERENCE & SEMINAR PRESENTATIONS Conference Presentations International 1. Al Riyami N. Fetal soft Markers - what a dilemma. Pan Arab OBGYN Conference. Dubai, UAE, April 2011. Poster Presentations International 1. Al Khaduri M, Daar S. Successful pregnancy following iron chelation and ovulation induction for hypogonadotropic hypogonadism associated with beta thalassemia major: a case report and literature review. 20th World Congress on Fertility and Sterility (IFFS). Munich, Germany, 12-16 September 2010. 2. Machado L, Gowri V, Al Kharusi L, Al Riyami N. Myomectomy in pregnancy – experience of 8 cases. 13th World Congress Controversies in Obstetrics & Gynaecology. Berlin, Germany, 4-7 November 2010. 3. Mathew M, Saquib S, Kumar S, Lokuhetty D, Jain R. Through the “vine (vein) yard” – Successful management of a case of gestational trophoblastic neoplasia in a young woman. 13th World Congress Controversies in Obstetrics, Gynaecology & Infertility. Berlin, Germany, 4-7 November 2010. 4. Mathew M, Bella SM, Al-Ojaily A, Jacob P. Sudden aphonia following cesarean section under General Anesthesia. 13th World Congress on Controversies in Obstetrics, Gynecology & Infertility. Berlin, Germany, 4-7 November 2010. 5. Mathew M, Abreo M, Rajeev Jain. Advanced endometriosis – A diagnostic dilemma. 13th World Congress on Contro- versies in Obstetrics, Gynecology & Infertility. Berlin, Germany, 4-7 November 2010. 6. Machado L, Al-Ismaili M. A morbidly obese pregnant woman at her 4th Cesarean section – an obstetric and anes- thetic challenge. 13th World Congress Controversies in Obstetrics & Gynaecology. Berlin, Germany, 4-7 November departments 2010. 7. Sheik S, Machado L. Peripartum cardiomyopathy in a 19 year old girl. 13th World Congress Controversies in Obstet- care

rics & Gynaecology. Berlin, Germany, 4-7 November 2010. 8. Mathew M, Silja A O, Saquib S, George M. Sight threatening proliferative retinopathy in a young Type 2 Diabetic mother-a challenging case. 6th International Symposium Diabetes in Pregnancy. Salzburg, Austria, 24-27 March

2011. patient

9. Saquib S, Mathew M, Sheik S, Al Kharousi L. Acute fatty liver of pregnancy in a Type 2 Diabetic mother. 6th In-

ternational symposium on Diabetes in Pregnancy. 6th International Symposium Diabetes in Pregnancy. Salzburg, and

Austria, 24-27 March 2011. 10. Mathew M, Al Hashmi H, Flordeliz M, Krishnan L. Caudal regression syndrome with partial agenesis of corpus cal- academic Obstetrics & Gynaecology 161 Annual Report 2010-2011 Obstetrics & Gynaecology

losum and partial lobar holoprosencephaly in a diabetic baby. 6th International Symposium Diabetes in Pregnancy. Salzburg, Austria, 24-27 March 2011. 11. Machado L, Al-Ismaili M. A morbidly obese pregnant woman at her 4th Cesarean section – an obstetric and anes- thetic challenge. 13th World Congress Controversies in Obstetrics & Gynaecology. Berlin, Germany, 4-7 November 2010. 12. Mathew M, Saquib S. Sight threatening proliferative retinopathy in a young Type 2 Diabetic mother-a challenging case. 6th International Symposium Diabetes in Pregnancy. Salzburg, Austria, 24-27 March 2011. 13. Mathew M, Saquib S. Acute fatty liver of pregnancy in a Type 2 Diabetic mother. 6th International symposium on Diabetes in Pregnancy. 6th International Symposium Diabetes in Pregnancy. Salzburg, Austria, 24-27 March 2011. 14. Mathew M. Caudal regression syndrome with partial agenesis of corpus callosum and partial lobar holoprosen- cephaly in a diabetic baby. 6th International Symposium Diabetes in Pregnancy. Salzburg, Austria, 24-27 March 2011. 15. Mathew M. Maternal and Prenatal outcome in pregnancies complicated with diabetes in a tertiary hospital in Oman. 6th International Symposium Diabetes in Pregnancy. Salzburg, Austria, 24-27 March 2011. 16. Al Riyami N. Fetal Amelia – a case report. 10th World Congress Fetal Foundation Medicine. Malta, June 2011. 17. Gowri V, Mathew M, Pathare AV. Protein Z levels in Omani pregnant women and correlation with pregnancy out- come. 23rd Congress International Society Thrombosis and Haemostasis (ISTH). Kyoto, Japan, 23-28 July 2011. 18. Dughaishi T. Echogenic amniotic fluid presented in 10th World congress on Fetal Foundation medicine, Malta, June 2011. 19. Al Kalbani M, Price J, Thompson G, Nagar H. Does Cervical screening in young women (20-25 years) in Northern Ire- land lead to unnecessary and harmful intervention? 9th International Scientific Meeting. Greece, September 2011. 20. Al Kalbani M, McCluggage WG, McVeigh G, Nagar H. FIGO Stage 1A and small (<2cm) 1B1 Cervical Adenocarcinomas have an extremely good prognosis and may warrant less radical surgery IGCS Regional Meeting on Gynaecologic Cancers. India April 2011. 21. Gowri V, Dennison D and Pathare AV. Aetiological profile of women presenting premature ovarian failure in Oman, Experience in Sultan Qaboos University Hospital. 22nd Annual Meeting North American Menopause Society. Wash- ington DC, USA, 21-24 September 2011. 22. Mathew M, Machado L, Al Mandhari H, Krishnan L. A case of non immune hydrops with Blueberry muffin baby. 4th Asia Pacific COGI-BCGIP Congress. Bangkok, Thailand, 24-27 November 2011. 23. Mathew M, Machado L, Arumugham S, Bella Sm. Supraventricular Tachycardia in pregnancy. 4th Asia Pacific COGI- BCGIP Congress. Bangkok, Thailand, 24-27 November 2011. 24. Mathew M, Machado L, Al-Busaidi Q. Ectopia Cordis: prenatal sonographic diagnosis at 12 weeks and perinatal out- come. 4th Asia Pacific COGI-BCGIP Congress. Bangkok, Thailand, 24-27 November 2011. 25. Mathew M, Machado L, Sheik S. Isolated unilateral micromelia: A rare birth defect. 4th Asia Pacific COGI-BCGIP Congress. Bangkok, Thailand, 24-27 November 2011. 26. Saquib S, Mathew M, Sreekumari M, Rizvi SG. Maternal and Prenatal outcome in pregnancies complicated with

162 diabetes in a tertiary hospital in Oman. 6th International Symposium Diabetes in Pregnancy. Salzburg, Austria, 24- 27 March 2011. Poster Presentations National 1. Al Kharusi L, Gowri V, Ghafri W, Suketi R, Rao K. Submyomatous cornual pregnancy managed surgically after failed medical treatment. University Day. Sultan Qaboos University, Muscat, Oman, May 2011. 2. Gowri V, Udayakumar A. Aetiological factors for recurrent miscarriage in Omani couples – A university hospital experience. University Day. Sultan Qaboos University, Muscat, Oman, May 2011. 3. Gowri V, Shabnam S, Rizvi S. Correlation of hs CRP and other biochemical markers in women with polycystic ovar- ian syndrome and age and BMI matched controls. University Day. Sultan Qaboos University, Muscat, Oman, May 2011. 4. Gowri V, Busaidi Q. An analysis of indications for primary caesarean sections in multiparous and nulliparous women. NWCCP Workshop. Salalah, Oman, 14-15 December 2010. 5. Busaidi I, Gowri V. Obstetric and non-obstetric risk factors for caesarean section case controlled study in |Oman. NWCCP Workshop. Salalah, Oman, 14-15 December 2010. Seminar Presentations National 1. Al Khaduri M. Challenges Facing Research at SQUH. College of Medicine & Health Sciences, Research and Post- graduate Studies Retreat. Muscat, Oman, 6th May 2010. 2. Al Khaduri M. Cornual Ectopic Pregnancy. ULSTER O&G Society CME IV, 11th Muscat, Oman, March 2010. 3. Al Khaduri M. Ovulation Induction, Update on Subfertilty. OBGYN Club, Oman. 28 October 2010. 4. Al Riyami N. Rh isoimmunization. OBGYN Club Oman. March 2011, 5. Al Riyami N. First trimester scan. Basic obstetrical ultrasound and medical disorders in pregnancy. Sultan Qaboos University Hospital, Oman, January 2012. departments

6. Al Riyami N. Fetal soft markers and their clinic significance. Basic Obstetrical Ultrasound and Medical Disorders in Pregnancy. Sultan Qaboos University Hospital, Oman, January 2012. care 7. Machado L, Woodhouse N, et al. The Milky Way - Polypeptide with molecular mass 21,500 KDa. Two patients with macroadenomas complicating surgery, one managed medically, one has transsphenoidal surgery during pregnan- cy. SCRAPS, College of Medicine & Health Sciences, Sultan Qaboos University, 2nd March 2011. patient THESIS SUPERVISION and

Dr. Fikra Al-Busaidi Qualification: Arab Board Examination academic Obstetrics & Gynaecology 163 Annual Report 2010-2011 Obstetrics & Gynaecology

Title: Comparison of efficacy, tolerability and adverse effects of Iron Polymaltose complex with Ferrous Sulphate in the treatment of Iron deficiency anemia in pregnant women Supervisors: Dr. Mariam Mathew

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Ophthalmology

he Department of Ophthalmology at the Sultan Qaboos University Hospital (SQUH) has long been recognised as a leader in patient care, research and education in the country. The Department’s staff of doctors, optometrists, orthoptists, and ophthal- mic technicians is committed to advancing the treatment and understanding of ocular disorders in Oman. Our subspecialties Tare general ophthalmology; cornea and external diseases; uveitis; medical retina; paediatric ophthalmology; ophthalmo-genetics, and vitreoretina surgery The Department is proud to have the first electrophysiology diagnostic clinic unit in the country. As part of an academic health care system, the Department provides clinical experience for medical students and residents under the auspices of the Oman Medical Specialty Board (OMSB). The Department conducts a number of CME activities, participates in various confer- ences and meetings, and conducts research with ensuing publications.

Overall, the Department is an active department in all aspects and will continue to improve as we strive to achieve the best.

166 Staff Raya Al-Mughery, Senior Technician Sadika Al-Ajmi, Senior Technician Head of Department Harith Al-Hasani, Technician Nadiya Al-Kharousi, Senior Consultant Hanan Al-Harty, Technician Faculty Eman Al-Hasmi, Technician Iman Al Harthy, Technician Sana Al-Zuhaibi, Senior Consultant Melinda Manegdeg, Coordinator (Hospital) Abdullah Al-Mujaini, Senior Consultant Laila Al-Kindi, Coordinator (College) Anuradha Ganesh, Consultant Ahmed Al-Hinai, Consultant Mohammed Al-Abri, Consultant Highlights of the Year George Manayath, Senior Registrar Upender Wali, Senior Registrar 2010-2011 Archana Thakral, Senior Registrar NEW CLINICS AND THERAPIES Nawal Al-Fadhil, Senior Registrar The Department has introduced intravitreal anti Buthaina Sabt, Senior Registrar VGEF therapy for age related macular degeneration Carolina Montana, Registrar run by retinal team. It has also established a state Shahab Agha, Registrar of the art Retina Unit with two vitroretinal consul- Sitara Azeem, Registrar tants, (Dr. Ahmed Al-Hinai and Dr. Mohammed Al- Rana Al-Senawi, Senior House Officer Abri) equipped with up to date investigative, ther- Samia Al-Jabri, Registrar apeutic and pharmaceutical items. Laser-assisted Beena Harikrisna, Registrar surgical procedures in oculoplasty have been in- Tysser A. Basi, Senior House Officer troduced, run by Dr. Abdullah Al-Mujaini. The Elec- Dalal Al- Zahra, Senior House Officer troretino Physiology Clinic has been opened and Nouf Al-Farsi, Senior House Officer is run by Dr. Sana Al-Zuhaibi and Mrs. Habiba Al- Support Staff Belushi. It is the only one in Oman which can run

investigative tests for the diagnosis of hereditary departments

Janet Ogunjumo, Superintendent Kuan Yok Leng, Assistant Head Nurse and other retinal diseases. Finally, a Genetic Clinic Jessy Jose, Senior Staff Nurse has been opened in collaboration with the Depart- care Mangu Thomas, Staff Nurse ment of Genetics. It is run by Dr. Sana Al-Zuhaibi Habiba Al-Belushi, Chief Technician Dr. Nadiya Alkharousi and Dr. Anuradha Ganesh. Bushra Al-Jabri, Optometrist patient

Sreelatha OK, Optometrist RESEARCH Edgardo Go, Optometrist Work on a Glaucoma project with the postgradu- and Pascale Cooymans, Orthoptist ate student, Ms. Rayhana Al-Mujaini, is continuing Salim Al-Abri, Senior Technician as well as another research project on central cor- academic Ophthalmology 167 Annual Report 2010-2011 Ophthalmology

neal thickness. Members of the Department have published five book chapters and nine journal articles this year and made nine conference presentations.

Dr. Sana Al-Zuhaibi was awarded a prize on University Day in May 2010 in recognition of her excellent ser- vice to the University.

Teaching Programmes UNDERGRADUATE CLINICAL PROGRAMME The main objective of the course is to introduce students to ophthalmology as a branch of surgery and to provide them with core information which will allow them to recognise, diagnose and manage common diseases of the eye and the adnexa. Particular emphasis is laid on awareness of the most frequent blinding diseases and the largely preventable and curable maladies of the eye such as cataract, glaucoma, trachoma, diabetic retinopathy, trauma and congenital anomalies.

The Department conducts a 4 week course in ophthalmology for 6th year medical students throughout the year. They spend 2 weeks in the University Hospital and 2 weeks at the Ministry of Health Al-Nadha Hospital. Students have a series of didactic lectures, clinical sessions on problem-oriented approaches to important eye conditions by dedicated clinical teaching faculty of SQUH and Al-Nahda hospital. Students are also at- tached to general and subspecialty ophthalmology clinics, wards and the operating theatre to give them ex- posure to the common and important eye conditions to improve their clinical skills, following which they sit for an end of posting examination at the University Hospital. Each student is expected to maintain a logbook of all patients and surgeries seen by them during their posting.

The students are exposed to the following 11 lectures to cover the important topics in ophthalmology: Intro- ductory lecture – Anatomy and Physiology; Red Eye; Acute and chronic Visual Loss PNAG and POAG; Lens; Ocular Trauma; Uveitis; Neuro-ophthalmology; Systemic Diseases of the Eye; Amblyopia and Strabismus; Optics & Refraction, and Pediatric Ophthalmology

Students also maintain a logbook of the patients they have seen are given a model case write-up to enable them to submit case reports for evaluation. After their 2 week rotation in MOH hospitals, they returned to SQUH for an end of posting examination

The residency programme in ophthalmology was launched in 2009 under the umbrella of OMSB. A total of 7 residents are accepted in the Department. The most important courses given to residents are: Pediatric ophthalmology; Corneal external Disease; Retina diseases, and Optics and refraction.

168 NEW TEACHING PROGRAMMES Pre-clerkship teaching (new modules) has been started with 12-14 students per session, 2 days per week for 9 weeks per year followed by a clinical examination. Students are exposed to different clinical cases in the eye clinic. They are encouraged to examine and present the case. And to keep a record of clinical and practical skills learned during rotation, in the log books and in the student’s electronic patient record.

Junior clerkship students are divided in two groups, spending 7 days in SQUH and 8 days at Al-Nahda Hospi- tal. During the first half of the rotation either at Al-Nahda or SQUH they are exposed to the all the 5 presen- tations (red eye, trauma, visual loss, diplopia, pupillary reaction - as per the guidelines from the curriculum committee). In the second half students rotate and by then should have completed 5 modules and only nec- essary revision will be made.

POSTGRADUATE PROGRAMME The Department had one Phd. student, Ms Rayhana Al-Mjeni, doing research on clinical and genetics studies of glaucoma in Oman.

CLINICAL ATTACHMENTS Seven ophthalmologists came to the Department for clinical attachments: Dr. Haider Al-Tamimi from Nizwa Hospital and Dr. Nouf Al-Farsi (who was also an intern from January 2010). Dr. Huda Al Farsi came from the Ministry of Health, and Dr. Harth Al-Harthi and Dr. Sabrina Al-Mahrooqi from the Armed Forces Hospital. Dr. Safa Othman and Ms. Khawla Rashid Al-Saidi had attachements as optometrists.

Training Courses & CME Activities The Department established two structured teaching course in two subspecialties: 1) Cornea and External Diseases, composed of 14 lectures covering all aspects of this field based on the American Academy of Oph- departments thalmology (AAO) guidelines; 2) Pediatric Ophthalmology, composed of 16 lectures covering all aspects of this, again based on AAO guidelines. Both courses were followed by an examination of 50 A type multiple

choice questions. A third course on Vitreoretina Diseases is currently in preparation. A three-day ERG train- care ing course was conducted for staff by an external expert. Internal CME programmes were held two to three times a week after the Department daily morning meeting. Discussions are held on difficult and interesting cases seen in the clinics or on current departmental research. A total of 50 CME sessions were conducted patient during 2010-2011. and

academic Ophthalmology 169 Annual Report 2010-2011 Ophthalmology

Clinical & Diagnostics Services Table 1: Ophthalmology Outpatient Department 2011 Patients booked 14,038 Patients seen 15,792 Patients admitted 509 Patients DNA 2,500 Patients discharged 149 Patients for RX 2,417 Total 21,367

Table 2: Minor Operating Theatre Procedures Minor operation 366 Blood Extraction 513 Sedation 101 Cannulation 135 Dilatation 6,031 Other 356 Total 7,502

Table 3: Laser Procedures Argon 180 Yag 44 Photodynamic therapy 51 Avastin & Lucent Injections 205 Fundus fluorescein angiography 138 Diabetic screening 163

170 Contact Lens 39 Low Vision Service 2 ERG & VEP 82 Orthoptic 337 Total 1,241

Table 4: Technical Procedures Refraction 308 Ultrasound 329 Pachymetry 260 Visual Field 729 Optical coherence tomography 2,559 Confoscan 116 Orbscan 95 Microperimetry 0 Photo 551 Total 4,947

Table 5: Patient Ward Statistics 2011 departments

Month Patient Census January Adult: 59, Pediatric: 6 care February Adult: 47, Pediatric: 8 March Adult: 54, Pediatric: 13 patient

April Adult: 68, Pediatric: 2 May Adult: 58, Pediatric: 11 and

June Adult: 43, Pediatric: 11 academic Ophthalmology 171 Annual Report 2010-2011 Ophthalmology

July Adult: 38, Pediatric: 4 August Adult: 12, Pediatric: 4 September Adult: 40, Pediatric: 3 October Adult: 40, Pediatric: 9 November Adult: 58, Pediatric: 7 December Adult: 34, Pediatric: 16

Table 6: Main Theatre Total no. of surgeries 371

RESEARCH RESEARCH PROJECTS Correlation of central corneal thickness (CCT) with intraocular pressure (IOP) in Omani children: The importance of CCT in pediatric aphakic and pseudophakic glaucoma Project Code: IG/MED/OPTH/10/01; Dates: 2010-2012 Value: OR 6,600; Project Funder: Sultan Qaboos University Investigators: Dr. Sana Al-Zuhaibi, Dept. Ophthamology, SQU; Dr Anuradha Ganesh, Dept. Ophthamology, SQU; Dr. Rana N Senawi, Dept. Ophthamology, SQU; Dr Seyed Rizvi, Dept. Family Medicine & Public Health, SQU; Mrs Raya Al- Mugheiry, Dept. Ophthamology, SQU; Mr Harith Al-Hasani, Dept. Oph- thamology, SQU.

Clinical and genetic studies of glaucoma in Oman Project Code: IG/MED/GENT/10/01; Dates: 2010–2012 Value: OR 13,500; Funder: Sultan Qaboos University Investigators: Dr. Nadiya Al-Kharousi, Dept. Ophthamology, SQU; Dr. Said Al-Yahyaee, Dept. Genetics, SQU; Dr. Anuradha Ganesh, Dept. Ophthamology, SQU; Dr. Upender Wali, Dept. Ophthamology, SQU; Ms. Rayhanah Al Mejeni, Dept. Genetics, SQU.

172 RESEARCH PUBLICATIONS & BOOKS Books & Book Chapters 1. Ganesh A, Levin AV. Astroctyic hamartoma. In: Nelson LB, ed. Wills Eye Institute Pediatric Ophthalmology and Stra- bismus Atlas. Lippincott Williams & Wilkins, Philadelphia, 2011. 2. Ganesh A, Levin AV: Familial exudative vitreoretinopathy. In: Nelson LB, ed. Wills Eye Institute Pediatric Ophthal- mology and Strabismus Atlas. Lippincott Williams & Wilkins, Philadelphia, 2011. 3. Ganesh A, Levin AV: Congenital hypertrophy of the pigmented epithelium. In: Nelson LB, ed. Wills Eye Institute Pe- diatric Ophthalmology and Strabismus Atlas. Lippincott Williams & Wilkins, Philadelphia, 2011. 4. Ganesh A, Levin AV: Incontinentia pigmenti. In: Nelson LB, ed. Wills Eye Institute Pediatric Ophthalmology and Stra- bismus Atlas. Lippincott Williams & Wilkins, Philadelphia, 2011. 5. Wali UK, Al Kharousi N. Clinical applications of optical coherence tomography in Ophthalmology. In: Gangjun Liu, Ed. Selected Topics in Optical Coherence Tomography, In Tech publications, Croatia, 2011. ISBN: 978-953-51-0034-8. Journal Publications 1. Diab F, Al-Sabah K, Al-Mujaini A. Successful surgical management of optic disc pit maculopathy without internal membrane peeling. Middle East Afr J Ophthalmol 2010; 17:278-80. 2 Harikrishna B, Cooymans P, Ganesh A, Al-Zuhaibi S. A 22-year-old lady with squint. Oman J Ophthalmol 2010; 3:41-2. 3. Cooymans P, Al-Zuhaibi S, Al-Senawi R, Ganesh A. Congenital fibrosis of the extraocular muscles. Oman J Ophthal- mol 2010; 3:70-4. 4. Haider AS, Al-Hinai A, Ganesh A. Six-year-old girl with decreased vision. Oman J Ophthalmol 2010; 3:98. 5. Levin AV, Ganesh A, Al-Busaidi A. Fee-Splitting in Ophthalmology. Can J Ophthalmol 2011; 46:21-7. 6. Khetan V, Al-Kharousi N, Ganesh A, Al-Futaisi A, Biswas J, Kumar K, Raja T. Diffuse infiltrating retinoblastoma with CNS metastasis at presentation. Arch Ophthalmol 2011; 129:375-7. 7. Ganesh A, Manayath GJ, Al-Senawi R, Sreelatha OK, Al-Zuhaibi S. Cystic macular lesions in patients with retinitis pigmentosa. Arch Ophthalmol 2011; 129:817. departments

8. Ganesh A, Stroh E, Manayath GJ, Al-Zuhaibi S, Levin AV. Macular cysts in retinal dystrophy. Curr Opin Ophthalmol 2011; 22:332-9. care 9. Al-Mujaini A, Al-Farsi Y, Al-Maniri A, Al-Rawahi Z, Anuradha G. Satisfaction and perceived quality of an electronic medical record system in a tertiary hospital in Oman. Oman Med J 2011; 26:324-8.

CONFERENCE & SEMINAR PRESENTATIONS patient

Conference Presentations and International 1. Ganesh A, Stroh E, Levin AV. Infantle nystagmus: a diagnostic dilemma. 28th Annual Pediatric Ophthalmology Fo- academic Ophthalmology 173 Annual Report 2010-2011 Ophthalmology

rum (Joe’s Meeting). Wills Eye Institute, Philadelphia, USA, 12 Nov 2010. 2. Ganesh A, Stroh E, Al-Zuhaibi S, Manayath GJ, Al-Abri M, Al-Hinai A, Al-Hosni A, Levin AV. Macular cysts in retinal dystrophy. Annual Meeting International Society of Genetic Eye Diseases and Retinoblastoma. Bangalore, India, 14- 16 January 2011 3. Ganesh A, Stroh E, Alvi R, Al-Zuhaibi S, Al-Abri M, Al-Hinai A, Al-Hosni A, Levin AV. Characterization of macular cysts in patients with retinal dystrophy. Wills 63rd Annual Alumni Conference. Wills Eye Institute, Philadelphia, USA, March 10-12 2011. 4. Levin AV, Ganesh A. Genetics of Craniosynostosis. Annual Meeting of the American Association of Pediatric Oph- thalmology and Strabismus. San Diego, California, USA, 1 April 2011. 5. Ganesh A, Stroh E, Levin AV. CRB1 mutation – Preserved para-arteriolar RPE. Oncology Conference. Wills Eye Institute, Philadelphia, USA, 6 Dec 2010. 6. Ganesh A, Stroh E, Levin AV. Schwartz-Jampel syndrome. Neuroophthalmology Conference. Wills Eye Institute, Philadelphia, USA, 2 February 2011. 7. Ganesh A, Stroh E, Levin AV. CPEO - Mitochondrial disorder. Neuroophthalmology Conference. Wills Eye Institute, Philadelphia, USA, 2 February 2011. 8. Ganesh A. common eye ailments in the pediatric age group. Faculty Guest Lecture. Pondicherry Institute of Medical Sciences (PIMS). Pondicherry, India, 11 May 2011. 9. Ganesh A. Retinopathy of prematurity: Review and recent trends. Faculty Guest Lecture. Pondicherry Institute of Medical Sciences (PIMS). Pondicherry, India, 11 May 2011.

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academic Ophthalmology 175 Annual Report 2010-2011 Oral Health

Oral Health

he Oral Health Department provides dental, oral and maxillofacial services for the University community, hospital inpatients and referred outpatients. It also acts as a tertiary centre of referrals for oral and maxillofacial surgery and paediatric dentistry. The Department provides dental services including basic primary dental care, oral hygiene therapy, restorative, endodontic, as Twell as comprehensive paediatric dentistry and oral and maxillofacial surgery treatments. The Department is also a member of the trauma team of the Hospital, and is therefore actively involved in the treatment of patients with facial injuries including the repair of facial bone fractures. In addition, the Department is also heavily involved in the diagnosis and treatment of a wide range of medically compromised patients including those with haematological malignancies, sickle cell anaemias and bleeding disorders. The dental services are provided at the Department’s outpatient clinical setting or in the operating theatre for the inpatients or day care visitors.

176 Staff Highlights of the Year Head of Department 2010-2011 Salim Al-Sudairy, Consultant Oral & Maxillofacial The Department maintained a high standard of Surgeon dental care to patients and continued to improve Faculty and expand its services. One of the main events of 2011 was the return of Khamis Al-Mufargi, Dental Abdulaziz Bakathir, Deputy Head of Department, Laboratory Technician, after successfully gaining Consultant Oral & Maxillofacial Surgeon a BSc. Degree in Dental Laboratory Technology in Amur Al-Hajri, Consultant the UK . The Department continued to provide a Ali Al-Mullahi, Consultant Paediatric Dentist highly specialised consultancy service, diagnosis Awatif Al-Maskery, Senior Registrar and treatment in the subspecialty of paediatric Sameera Al-Anqoodi, Registrar in Restorative Den- dentistry, as well as the existing oral and maxillo- tistry facial surgery services. In addition, the Department Hana Al-Raisi, Senior House Officer provided continuous support to the expanding Rasha Ahmed, Senior House Officer and specialised medical and surgical units of the Madelin Hernandaz, Senior House Officer University Hospital (SQUH) and continued to play Mahboob Pasha, Senior House Officer an important role in the holistic multidisciplinary Other Staff care of patients at SQUH. Nasriya Al-Harthy, Dental Hygienist/ Therapist Zahra Al-Ghafri, Dental Hygienist The Department’s clinical staff were actively in- Judy Mathew, Senior Nurse volved in local scientific events and dental confer- Lorena Mendoza, Senior Nurse ences conducted by the Oman Dental Society dur- Lovely Kuriakose, Senior Nurse ing 2009-2010. Dr. Abdulaziz Bakathir continued to Ibrahim Al-Shizawi, Medical Nurse. hold the position of Deputy Chairman of the Oman Marcedes Estimada, Senior Nurse Dental Society. Furthermore, our clinical staff par-

ticipated in many dental conferences and work- departments

Afrah Abdulbaqi, Dental Surgery Assistant Sulaiman Al-Maqimi, Dental Surgery Assistant shops conducted in Oman, United Arab Emirates, Mohammed Al-Alawi, Dental Surgery Assistant Turkey, the Philippines and Switzerland. Dr. Ab- care Khamis Al-Mufargi, Dental Laboratory Technician. dulaziz Bakathir and Dr. Ali Al-Mullahi presented scientific papers and poster presentations at inter- Support Staff national dental conferences in the Philippines. In

Fatma Al-Siyabi, Central Sterile Supplies Dept. Tech- addition, Dr. Abdulaziz Bakathir attended the 15th patient nician International Sialendoscopy Hands-on Course at

Khamis Al-Jabri, Medical Records Clerk the European Sialendoscopy Training Centre in Ge- and

Nadia Al-Ghafri, Coordinator neva, Switzerland, from 2 to 4 July 2010. Dr. Awatif academic Oral Health 177 Annual Report 2010-2011 Oral Health

Al-Maskary attended courses related to oral and maxillofacial surgery in the UAE and in Oman. Dr. Samira Al-Anqoodi attended workshops related to endodontics and also presented lectures at national level confer- ences.

In 2010 and 2011, Department produced a series of educational leaflets for patients covering a range of dental and oral surgery conditions. This work was done by the Department’s dental hygienist, Zahra Al-Ghafri.

Teaching Programmes The Oral Health Department continues to provide teaching support to MD degree students in the University College of Medicine and Health Sciences and the Institute of Health Sciences of the Ministry of Health. This included: 1) Regular teaching seminars during the Oral Health Rotation for 5th year MD students; 2) Exami- nation of oral cavity in clinical skills laboratory teaching for 4th year MD students; 3) Daily clinical teaching to the Dental Surgery Assistance (DSA) students during their oral health rotation on room preparation and aseptic technique for surgical patients and infection control; 4) Teaching of DSA students at the Institute of Health Sciences, Ministry of Health, and 5) Training doctors (intern dentists) from the Ministry of Health.

Clinical & Diagnostic Services The Oral Health Department continued to provide primary dental treatment as well as specialised compre- hensive paediatric dentistry and oral & maxillofacial surgical treatments. The number of patients treated at the Oral Health Department increased by more than 1,000 patients in 2011compared to 2010, a reflection of the good quality and standard of health care offered. The Department had a 5% increase in the number of pa- tients attending the Outpatient Clinic in 2011 compared to 2010. This rise is a reflection of the increase in the number of referrals for specialised paediatric and maxillofacial care from various hospital departments as well as from other regional hospitals and local health centres. The Department has also recorded an increase in the number of complex medically compromised patients admitted for oral maxillofacial surgery and den- tal treatment, especially in the paediatric group in 2010. The Department continued to be actively involved in a 24-hour on-call service in collaboration with the Emergency Department of SQUH.

Research Dr. Awatif Al-Maskary has been investigating three topics: the knowledge, attitude, behaviour, and source of information of Omani type 2 diabetic patients regarding their oral health; knowledge, attitude, behaviour, and source of information of Omani university students regarding their oral health, and the essential oil composition, antimicrobial and antioxidant activities of unexplored Omani basil.

178 1400 1200 1000 800 600 400 200 0 1 2 3 4 5 6 7 8 9 10 11 Month

Figure 1: Number of patients treated in the Oral Health Department in 2011 RESEARCH PROJECTS Dental health indices in Omani patients with Beta thalassaemia Major Project Code: MREC #336; Dates: 2010–11 Value: Unfunded; Project Approval: Sultan Qaboos University Investigators: Dr. Ali Al-Mullahi, Dept. Oral Health, SQU; Dr. Abdulaziz Bakathir, Dept. Oral Health, SQU; Dr. Shahina Daar, Dept. Haematology, SQU; Dr. Yasser Wali, Child Health, SQU; Dr. Salahuldeen Al Bulushi, MOH; Dr. Surekha Mev- ada, Child Health, SQU. departments Impaction Status and Reason for Removal of Mandibular Third Molars in Omani Population: Retrospec- tive radiographic analysis care Project Code: MREC #385; Dates: 2010–11 Value: Unfunded; Project Approval: Sultan Qaboos University

Investigators: Dr. Salim Al-Sudairy, Dr. Samira Al-Anqoodi, Dept. Oral Health patient

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academic Oral Health 179 Annual Report 2010-2011 Oral Health

RESEARCH PUBLICATIONS & BOOKS Journal Publications 1. Hanif MA, Al-Maskari MY, Al-Maskari A, Al-Shukaili A, Al-Maskari AY, Al-Sabahi JN. Essential oil composition, anti- microbial and antioxidant activities of unexplored Omani basil. J Med Plant Res 2011; 5:751-7. 2. Al-MaskeryAY, Al-Sudairy SA, Al-Hamadani AS. Dendritic myxofibrolipoma: often misdiagnosed as sarcoma. Cra- nial Maxillofac Traum Reconstruct 2011; 4:171-4. 3. Al-Maskari AY, Al-Maskari MY, Al-Sudairy S. Oral manifestations and complications of diabetes mellitus: A review. Sultan Qaboos University Med J 2011; 11:179-186 CONFERENCE & SEMINAR PRESENTATIONS Poster presentations International 1. Al-Mullahi A. Dental Management of a Child with Hermansky-Pudlak Syndrome. 23rd Congress International As- sociation of Paediatric Dentistry. Athens, Greece, 15-18 June 2011. National 1. Bakathir A. Neonatal TMJ Ankylosis as a Complication of Septic arthritis Infection. 7th Gulf Dental Association Con- ference. Muscat, Oman, 3-4 November 2010. 2. Al-Mullahi A. Crown, crown-root and root fracture. 7th Gulf Dental Association Conference, Pre-Conference Oral Traumatology Workshop. Muscat, Oman, 2 November 2010. Seminar Presentations National 1. Al-Anqoodi S. Role of mineral trioxiode aggregate (MTA) in endodontics. 7th Gulf Dental Association Conference. Muscat, Oman, 3-4 November 2010.

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academic Oral Health 181 Annual Report 2010-2011 Pathology

Pathology

he Department provides specialist diagnostic services in histopathology, cytopathology, enzyme and immunohistochemistry and electron microscopy to Sultan Qaboos University Hospital. With a total of 7 senior pathologists, including both academic and clinical staff and 23 biomedical scientists, it functions as a major referral centre for many of the Ministry of Health hospi- Ttals, Armed Forces Hospital, Royal Oman Police Hospital as well as some of the private hospitals in the country. There are also 4 junior pathologists currently in rotation with other Oman Medical Specialty Board residents or completing their training abroad.

The Department takes part in the B.Sc. Health Sciences, MD, and the B.Sc. Medical Laboratory Sciences teaching and training pro- grammes. It also participates in the Oman Medical Specialty Board (OMSB) postgraduate medical training programmes in pathology and other medical specialties.

The Department is also actively engaged in research in collaboration with other clinical departments. The electron microscopy unit, in particular, undertakes many research projects with other colleges within SQU as well as other institutions.

The Department is registered and subscribes to international external quality assurance programmes (EQA) in cytopathology, immu- nohistochemistry and anatomical pathology including both diagnostic and technical modules. The postgraduate training programme

182 is approved for Part I (FRCPath) of the Fellowship of Shadia Al Sinawi, Senior Biomedical Scientist (Clini- the Royal College of Pathologists examination. cal) Samira Al Rawahi, Senior Biomedical Scientist (Clinical) Staff Usha R. Bai, Chief Biomedical Scientist, Cytopathology(Clinical) Head of Department Amal Al Mashari, Senior Biomedical Scientist, Cyto- Anand Date, Professor pathology (Clinical) Faculty James S. Vijayan, Biomedical Scientist (Clinical) Ahmed Al-Hinai, Mortuary Technician (Clinical) Chandu De Silva, Professor Edna B. Ranada, Coordinator (College) Ritu Lakhtakia, Associate Professor Nadeera K. Ammu, Coordinator (Clinical) Aisha Al-Hamdani, Senior Consultant Shamla Mohammed, Coordinator (Clinical) Anna Saparamadu, Consultant Badriya Al-Hinaai, Coordinator (Clinical) Ibrahim Al-Haddabi, Consultant, Deputy HoD, Clini- cal Affairs Marwa Al-Riyami, Consultant Highlights of the Year Maiya Al-Bahri, Senior House Officer Radiya Al-Ajmi, Senior House Officer 2010-2011 Asmaa Al-Shihi, Senior House Officer 2010-2011 has been an exciting year for the Depart- Nasar Al-Wahaibi, Researcher & Lecturer ment. Prof. Chandu De Silva joined the department as Professor of Pathology and Dr. Ritu Lakhtakia as Support Staff Associate Professor. Dr Marwa re-joined the de- Emmanuel Odor, Superintendent (SQUH) partment after completion of her FRCPath training Issa Sulaiman Al Amri, Superintendent (College) in the UK followed by a fellowship attachment in Joseph Ogunfiditimi, Chief Biomedical Scientist, renal pathology at the Hammersmith Hospital. Ms Histopathology (Clinical) Muna Al-Sarkhi joined the department in January

Ishmael Nwabuebo, Chief Biomedical Scientist (Col- departments 2011 as a biomedical scientist. lege) Kamla Al-Mawali, Chief Biomedical Scientist, Immu- The Department also witnessed an expansion of care nohistochemistry (Clinical) its diagnostic facilities with the addition of in situ Johannes Selva Kumar, Chief Biomedical Scientist hybridization and the use of automated immuno- (Clinical) histochemistry staining for improved performance

in keeping with the exponential rise in the number patient Virginia Uy, Chief Biomedical Scientist (Clinical) Virgilio Cruz, Chief Biomedical Scientist (Clinical) of tests being done. and

Kawther Al Adawi, SeniorBiomedical Scientist A new high resolution field emission transmission (Clinical) electron microscope (JEOL 2100F) was introduced academic Pathology 183 Annual Report 2010-2011 Pathology

to the Electron Microscopy Unit for nanotechnology, structural and molecular biomedical applications and clinical research. The JEOL 2100F was commissioned in August 2010. The features of this microscope are the first of their kind in the Arab Region and include: Field Emission Analytical TEM (FETEM) 200kV achiev- ing magnifications of X1 6,000,000 and a resolution of 0.1 nm with TEM, ASID achieving magnifications of X90,000,000, a Tomography System for 3D reconstruction, a Holography System for magnetic field studies and sample preparation equipment. This unit was inaugurated under the auspices of H.E. the Minister of Health.

Dr. Ritu Lakhtakia was Chairperson in the session on ‘Predictive and Prognostic factors in breast cancer’ at the Conference on Controversies in Breast Cancer held in Muscat from 12 to 14 Feb 2011.

Teaching Programmes PRECLINICAL PROGRAMME This year the Department has been involved in the full implementation of the new curriculum with the fol- lowing modules: Response to Infection and Pathobiology; Cardiovascular systems; Respiratory systems; Uro- reproductive systems; Alimentary; Locomotor systems; Endocrine systems, and Human Nervous systems. In addition, the old curriculum courses, the Integrated Lecture Series and problem-based learning, were still being taught. Dr. Ritu Lakhtakia was appointed module coordinator for the Locomotor Systems module.

CLINICAL PROGRAMME For the 5th year medical students, the Department took part in teaching in the integrated lecture series: Cardiovascular System, Nervous System, Respiratory System, Endocrinology, Gastrointestinal Tract System, and Urinary System. For the 7th year medical students, a one week lab rotation was organised to give them an insight into the daily work in the histopathology and cytopathology laboratories and an introduction to specialized techniques namely immunofluorescence, immunohistochemistry and electron microscopy.

B.Sc . MEDICAL LABORATORY SCIENCES (MLS) COURSES In the B.Sc. Medical Laboratory Sciences (MLS) programme, the following courses were taught: Introduction to MLS, Biology of Disease, Applied MDLS, Cellular Pathology I, Cellular Pathology II, Biology of Cancer, Ad- vanced Instrumentation in Cellular pathology and the Pathology Projects. Dr. Nasar Al-Wahaibi conducted two workshops in microtomy for the B.Sc. MLS students in April 2011.

INTERCALATED MD A new degree in Health Sciences was introduced this year for the students who either obtain less than 2.5 in the total GPA or obtain higher than 2.5 but do not want to continue with the MD programme. As part of this

184 degree, a new course on histopathology was taught.

POSTGRADUATE TEACHING The Pathology Department is a training centre for the Oman Medical Specialty Board (OMSB) and is an ap- proved centre for the Part I examination of the British Fellowship of the Royal College of Pathologists (FRC- Path), UK. There are up to 3 residents posted at any one time for general pathology training. The Department also offers an elective rotation (4 weeks) for Dermatology, Haematology and Obstetrics and Gynaecology residents. This provides them with an opportunity to develop an understanding about dermatopathology and gynaecological pathology, respectively. In addition to OMSB residents, there are 3 senior house officers employed by SQUH who rotate between surgical pathology and cytopathology and acquire basic training before they travel abroad for further studies. The training programme for postgraduate residents in Pathol- ogy is 5 years. At present, there are 11 OMSB trainees who rotate between the Royal Hospital, Khoula Hospital, the Armed Forces Hospital and SQUH. The end of year practical assessment of all Pathology OMSB residents was conducted in COM&HS in June 2011.

Training Courses & CME Activities Dr. Ibrahim Al-Haddabi attended a workshop on Her-2 FISH in Breast Cancer, Graz University, Austria, in July 2011 and a Thin Prep Morphology workshop in the UK in June 2011. He was officially selected to visit Ger- many in September 2011 to investigate the feasibility of developing a heart transplant programme at SQUH. Ms Samira Al-Rawahi attended a training course in Austria, Salzburg on KRAS mutation and immunohisto- chemistry on 1 July to 15 August 2011. Ms Yusra Al-Bulushi attended a training programme in the Immunohis- tochemistry and molecular pathology of lymphoma in Glasgow, UK, from May to 3 July 2011. Mr. Mohamed Al-Kindi attended a training course on TEM and SEM in the JEOL Training Center, in Tokyo, Japan, in January 2011. Mr. Issa Al-Amri attended a training course on high resolution field emission TEM in the JEOL Training Center, in Tokyo, Japan, in September 2011. departments Consultant pathologists participated in monthly inter-departmental presentations with the departments of paediatrics, surgery, haematology and obstetrics and gynaecology. Consultant pathologists provided input care for the College in the SCRAPS CME presentations.

The Department of Pathology offers clinical attachments in laboratory medicine. The technical staff under- took the training of three Omani students from various hospitals and schools who are studying medical patient laboratory techniques. The Department also welcomed staff from other laboratories of the MoH and AFH who came to train in special techniques in cytology, immunohistochemistry and electron microscopy. and

academic Pathology 185 Annual Report 2010-2011 Pathology

Clinical & Diagnostic Services With the expansion of clinical and surgical services offered by SQUH, the department of pathology wit- nessed a surge in the number of biopsies and resection specimens received. This not only reflected the num- ber but also the complexity of these specimens. The Department is also a centre for subspecialist reporting, particularly haematopathology and renal pathology. It acts as a referral centre for the Ministry of Health Hospitals, the Royal Oman Police Hospital, the Armed Forces Hospital, Royal Palace Hospital and clinics, Royal Diwan clinics, and private hospitals within Oman.

Clinicopathological conferences are also playing an increasingly important role in patient management. The pathologists contribute to such meetings as core members, particularly in the breast and oncology MDTs held on a weekly basis. This year the Department started a rapid cytologic diagnosis of breast fine needle aspirates for the weekly “one-stop” breast clinic.

Table 1: Histopathology Laboratory Tests done in 2011 Type of Test Requests Tests Histology 6,397 40,628 Immuno Histochemistry 1,584 14,103 Immuno Fluorescence 251 1,742 Enzyme Histochemistry 11 146 Molecular Pathology 39 105 Cytology-Gynaecology 1,506 1,684 Cytology-Non-Gynaecol 1,117 4,584 Electron Microscopy 303 1,975 TOTAL 11,208 64,967

In 2011 with 64,967 tests and 11,208 requests handled in the Department, there was an increase of 14.9% over the 2010 figures. The diagnostic service activities of the Department are evaluated by departmental internal quality assurance programmes. The Department is also registered with and subscribes to international ex- ternal quality assurance programmes in histopathology, cytopathology and immuocytochemistry. We also subscribe to a technical module.

186 Research RESEARCH PROJECTS Expression and Localization of Cancer –Testis Associated Antigens MAGE – 1 Family in Relation to CD8 +T Lymphocyte in Breast Cancer Project Code: G/MED/PATH/11/01; Dates: 2006-2010 Value: OR 2,800; Project Funder: Sultan Qaboos University Investigators: Prof. Anand Date, Dept. Pathology, SQU; Dr. Jamal Sallam, Dept. Medicine SQU; Dr. Ibrahim Al-Haddabi, Dept. Pathology, SQU; Dr. Anna Saparama- du, Dept. Pathology, SQU; Prof. Chandu De Silva, Dept. Pathology, SQU. Dr. Issa Al-Amri, Electron Microscope Division, Dept. Pathology, SQU.

Using Paraffin Blocks for Lung Cancer Cases Project Code: MREC #341; Dates: 2010 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. Nasar Al-Wahaibi, Dept. Pathology, SQU.

The role of Perl’s method in bone marrow diagnosis Project Code: MREC #408; Dates: 2011 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. Nasar Al-Wahaibi, Dept. Pathology, SQU.

Correlation between cervical smear and cervical biopsy - retrospective study Project Code: MREC #409; Dates: 2011 departments

Value: Unfunded; Project Approval: Sultan Qaboos University

Investigator: , Dept. Pathology, SQU. care

Dr. Nasar Al-Wahaibi

The expression of S100, serotonin and somatostatin in gastric carcinoma

Project Code: MREC #410; Dates: 2011 patient

Value: Unfunded; Project Approval: Sultan Qaboos University and Investigator: Dr. Nasar Al-Wahaibi, Dept. Pathology, SQU. academic Pathology 187 Annual Report 2010-2011 Pathology

Glomerular diseases in Oman: Light and immunoflourescent microscopy investigations Project Code: MREC #411; Dates: 2011 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. Nasar Al-Wahaibi, Dept. Pathology, SQU

Comparative study of Thin Prep 5000 with conventional Pap smear Project Code: MREC #412; Dates: 2011 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. Nasar Al-Wahaibi, Dept. Pathology, SQU

Collaraborative Research Projects using Electron Microscopy Projects done in 2010: Total number of projects in 2010 = 81 projects Total samples carried on above projects using TEM, SEM, STEM, FETEM and EDX = 511 samples Total tests on above samples = 2,607

Projects done in 2011: Total number of projects to 20 November 2011 = 63 projects Total samples carried on above projects using TEM, SEM, STEM, FETEM and EDX = 299 samples Total tests on above samples = 1,503 RESEARCH PUBLICATIONS & BOOKS Journal Publications 1. Date A. Someday a very interesting story to tell - William Osler and the tomb of Avicenna. In: Barondess JA, Bryan CS. The Persisting Osler IV, Selected Transactions of the American Osler Society 2001-2010. 2011, Pp. 169-180. 2. Lokuhetti MDS, Saparamadu PAM, Al Sajee DMA. Gigantomastia in pregnancy with axillary mass masquerading as inflammatory carcinoma. Diagn Cytopathol 2011; 39:141-3. 3. Al Abri R, Kumar S, Chopra P, Saparamadu PAM. Schwannoma of the cervical sympathetic chain. Sultan Qaboos University Med J 2011; 1:403-6. 4. Ahmed MA, Saparamadu PAM, et al. Bilateral elastofibroma dorsi. Sultan Qaboos University Med J 2011; 1:415-6. 5. Elhadi ZM, Melghit K, Al-Amri I, Al-Kindi MA. Soft chemistry preparation of layered Al0.3V2O5_5H2O. Ceram Int

188 2010; 36:807-9. 6. Al-Harthi S, Al-Saadi M, Al-Omari I, Sitepu H, Melghit K, Al-Amri I, et al. Structural analysis and band gap tailoring of Fe3+-doped Zn–TiO2 nanoparticles. Appl Phys A 2010; 99:237-44. 7. Al-Harthi SH, Al-Barwani M, Elzain M, Al-Hinai AT, Al-Naamani N, Al-Amri I. Self-assembly of CuSO4 nanoparticles and bending multi-wall carbon nanotubes on few-layer graphene surfaces. Appl Phys A 2011; 105:469-77. 8. Alwahaibi N, Budin SB, Mohamed J. Absence of p53 gene expression in selenium molecular prevention of chemically induced hepatocarcinogenesis in rats. Saudi J Gastroenterol 2011; 17:328-34. 9. Alwahaibi N. Re: “I found it on the Internet” : Preparing for the e-patient in Oman. Letter to Editor. Sultan Qaboos University Med J 2011; 11:129-31. 10. Alwahaibi N, Algharibi JS, Alshukaili AS, Alshukaili AK. Tissue Carcinoembryonic Antigen, Calcium, Copper and Iron Levels in Cancerous Lung Patients. Chin J Lung Cancer 2011; 14:28-32. 11. Alwahaibi N, Budin SB, Mohamed J. Biochemical profile of sodium selenite on chemically induced hepatocarcino- genesis in male Sprague-Dawley rats. African J Biochemistry Rese 2010; 4:163-6. 12. Alwahaibi N, Mohamed J, Alhamadani A. Supplementation of selenium reduces chemical hepatocarcinogenesis in male Sprague-Dawley rats. J Trace Elem Med Biol 2010; 24:119-23. 13. Alwahaibi N, Mohamed J, Budin SB, Alhamadani A. NF-κB as a promising target for selenium chemoprevention in rat hepatocarcinogenesis. J Gastroenterol Hepatol 2010; 25:786-91. 14. Lakhtakia R. Difficulties in Hirschsprung’s disease Pathology. SQU Med J 2011; 11:138-45. 15. Lakhtakia R. The mind is for seeing, the heart is for hearing (Saudi Arabian proverb). J Cancer Educ 2011; 26:202-3. 16. de Silva KRD, Silva R, de Silva C, Gunasekera WSL, Jayasekera RW. Comparison of the configuration of the posterior bifurcation of the posterior communicating artery between fetal and adult brains: A study of a Sri Lankan popula- tion. Ann Indian Acad Neuro 2010; 13:198-201. 17. Madarasingha NP, Sathgurunathan K, de Silva MVC. A rare type of primary cutaneous amyloidosis: amyloidosis cutis dyschromica. Int J Dermatol 2010; 49:1416-18. 18. Ranasinghe W, Sibanda S, de Silva MVC, Persad R, Ranasinghe T. Incidence of prostate cancer in Sri Lanka using the departments

cancer registry data and comparisons with incidence in South Asian men in England. B J Urol Int 2011: 108:E184-9. 19. Al-Bahry SN, Mahmoud IY, Melghit K, Al-Amri I. Analysis of elemental composition of the eggshell before and after

incubation in the loggerhead turtle (Caretta caretta) in Oman. Microsc Microanal 2011; 17:452-60. care

20. Nemmar A, Melghit K, Al-Salam S, Dhanasekaran S, Yasin J, Attoub S, Al-Amri I, et al. Acute respiratory and systemic toxicity of pulmonary exposure to doped TiO2. Toxicol 2011; 279:167-75.

21. Sharbati A, Choopani S, Ghasemi A, Al-Amri I, Cerqueira Machado CF, Paesano Jr A. Synthesis and magnetic proper- patient

ties of nanocrystalline Ba3Co2 (0.8-ᵪ) Mn 0.4 Ni 2 ᵪ Fe24 O41 prepared by citrate sol gel method. Dig J Nanomat Bio-

struct 2011; 6:187-198. and

22. Macho N, Chopra P, Al Haddabi I, Al Qadhi H. Large duodenal gastrointestinal stromal tumor presenting with acute bleeding managed by a whipple resection, a review of surgical options and the prognostic indicators of outcome. J O P 2011; 12:194-9. academic Pathology 189 Annual Report 2010-2011 Pathology

23. Al Farsi K, Al Haddabi I, Al Riyami N, Al Shukaiti, R, Al Kindi S. Myelomatous pleural effusion. Case report and review of the literature. Sultan Qaboos University Med J 2011; 11:259-64. CONFERENCES & SEMINAR PRESENTATIONS Conference Presentations International 1. Opatha OKDST, Lokuhetty MDS, Jayawickrama MMA, de Silva MVC. Histological characterization of cutaneous leish- maniasis demonstrating parasitized histiocytes. International Conference Dermato and Uro Pathology. Sri Lanka College of Pathologists and British Division of the International Academy of Pathologists. Colombo, Sri Lanka, 18-20 August 2011. 2. Opatha OKDST, Lokuhetty MDS, Jayawickrama MMA, de Silva MVC. Clinico-pathological agreement in the diagnosis of leprosy and its subtypes. International Conference Dermato and Uro Pathology. Sri Lanka College of Pathologists and British Division of the International Academy of Pathologists. Colombo, Sri Lanka, 18-20 August 2011. 3. Bartholameu NAZ, Lokuhetty MDS, Wijesinghe HD, Smarasinghe UC, de Silva MVC. Diagnostic utility of digital rec- tal examination, prostate specific antigen level and transrectal ultrasound scan in diagnosis of prostate carcinoma in transrectal ultrasound guided biopsies in a local setting. International Conference Dermato and Uro Pathology. Sri Lanka College of Pathologists and British Division of the International Academy of Pathologists. Colombo, Sri Lanka, 18-20 August 2011. 4. Priyani AAH, Fernando CS, Wijesinghe HD, Prabath API, de Silva MVC, Goonewardena SAS. Mucinous tubular and spindle cell carcinoma of kidney. International Conference Dermato and Uro Pathology. Sri Lanka College of Patholo- gists and British Division of the International Academy of Pathologists. Colombo, Sri Lanka, 18-20 August 2011. 5. Al Wahaibi N, Jamuldin M, Budin SB. Selenium approach for hepatocellular carcinoma in experimental rats. Asian Pacific Association for the Study of the Liver (APASL) - Enlightening the future. Bangkok, Thailand, 17-18 February 2011. 6. Al Riyami M. The role of EM in repeat biopsies in the management of persistent proteinuria in class V lupus ne- phritis, treated with Rituximab, MMF and no oral steroids. Renal Week Meeting American Society of Nephrology. Denver, Colorado, USA, 16-21 November 2010 7. Al Amri S, Mahmoud IY, Waring CP, AlKindi AY, Khan T, Bakheit C, Al-Mawali KM, et al. The ovarian cycle of the house gecko H. flaviviridis in Oman in relation to steroid hormonal levels, ultrastructural steroidogenic features and pro- gesterone receptors. World Congress on Reproductive Biology. Cairns, Australia, 9-12 October 2011. Abstracts P. 383 8. AlKindi Y, Al Amri IS, Mahmoud IY, Waring CP, Bacheit C, Al Nabhani A, et al. The testicular cycle of the house gecko H. flaviviridis in Oman in relation to steroid hormonal levels, ultrastructural steroidogenic features and progester- one receptors. World Congress on Reproductive Biology. Cairns, Australia, 9-12 October 2011. Abstracts P. 492 9. Mahmoud Y, Al-Farsi B., Al-Bahry SN, Al Amri IS, Al-Sumri B, Al-Kindi MA, Al Rawahi S. The Relationship Between Steroidogenic Ultrastructural Features and Progsterone Receptors in the Green Sea Turtle Chelonia mydas. The World Congress on Reproductive Biology, Cairns, Australia, 9 -12 Oct, p. 469

190 National 1. Lakhtakia R. Difficulties in HSCR Pathology. Updates in HSCR. Muscat, Oman, 25 Oct 2010. 2. Lakhtakia R. Non-alcoholic steatohepatitis (NASH). 1st International Oman Hepatology Symposium. Muscat, Oman, 12-13 January 2011. POSTER PRESENTATIONS International 1. Saparamadu PAM, Al-Marhoon, MS. Prasad K. Squamous cell carcinoma arising in Keratinizing Desquamative Squa- mous Metaplasia of the renal pelvis. International Conference Dermato and Uro Pathology. Sri Lanka College of Pa- thologists and British Division of the International Academy of Pathologists. Colombo, Sri Lanka, 18-20 August 2011. 2. Saparamadu PAM, Al Waily A, Khashoob M, Ikram B, de Silva MVC. Widespread kaposi sarcoma occurring in an asthmatic on long term steroid therapy. International Conference Dermato and Uro Pathology. Sri Lanka College of Pathologists and British Division of the International Academy of Pathologists. Colombo, Sri Lanka, 18-20 August 2011. 3. de Silva MVC, Saparamadu PAM, Al Ajmi A, Furrukh, M, Joseph KM. Metastatic lobular carcinoma of the breast masquerading as a primary renal cell carcinoma. International Conference Dermato and Uro Pathology. Sri Lanka College of Pathologists and British Division of the International Academy of Pathologists. Colombo, Sri Lanka, 18-20 August 2011. departments

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academic Pathology 191 Annual Report 2010-2011 Pharmacology & Clinical Pharmacy

Pharmacology & Clinical Pharmacy

he Department of Pharmacology & Clinical Pharmacy plays an active teaching role in both the College’s old and new cur- ricula as well as in the College of Nursing’s educational programme. The Department also offers a Master’s degree in Clinical Pharmacy, Doctoral degree in Clinical Pharmacy and contributes to the teaching of other Master’s courses. The Department Tcoordinates the Research Method and Critical Analysis of Scientific Information course. In addition, the Department coordinates the Cellular Communication and Introduction to Drug Action and Alimentary System courses in the new curriculum, and offers two elec- tive courses (in Arabic) entitled: Drugs, Nutrients and Narcotics and History of Medicine.

Research activities embrace different areas of experimental and clinical pharmacology and therapeutics. The areas under investiga- tion encompass: study of toxicity and composition of Omani traditional remedies and plants; the effect of several agents on experi- mental acute and chronic renal failure; the elucidation of cardiovascular and behavioural effects of some medicinal plants.

192 Staff blood count machine, homogenizer, Commet as- say equipment for measuring DNA damage, digi- Head of Department tal balance, isoflurane vaporizer machine for small Mohammed Al Za’abi, Assistant Professor animal anesthesia, weighing balances, Barners Faculty Maze for rats and mice. These are used for research activities and teaching. Musbah Tanira, Professor Badreldin Ali, Professor The research output for 2010-2011 consisted of 4 Ragini Vaishnav, Assistant Professor research projects, 6 international poster presenta- Ibrahim Al-Zakwani, Assistant Professor tions, 8 seminar presentations, 1 book chapter and Khalid Al-Balushi, Assistant Professor 40 publications in peer-reviewed journals. Our as- Support Staff sociate researchers were involved in some of these activities and featured as first and co-authors. The Ikhlas Ahmed, Associate Researcher Department also contributed to the world of medi- Mercy Calma, Coordinator cal science through its review and editorial activi- ties in various medical journals. Staff members Highlights of the Year were involved in different research activities and participated in national and international confer- 2010-2011 ences. The Department serves in several commit- In the old curriculum, the Department continued to tees in the College, SQUH and University and other teach in the pre-clinical B.Sc. (Health Sciences) pro- institutions. Internationally, the Department has gramme as well as in the MD programme. With the representation on the Executive Council of the In- implementation of the new curriculum in the Col- ternational Union of Basic and Clinical Pharmacol- lege, the Department was given the responsibility ogy (IUPHAR) Education Section. to coordinate two courses, Cellular Communication and Introduction to Drug Action and Alimentary System, and participate in many system module

Teaching Programmes departments courses. PRECLINICAL PROGRAMME Mr. Yousuf Al-Suleimani continued his study at care

The Department contributes to undergraduate University of Cambridge, UK. Ms. Ikhlas Ahmed re- teaching in the B.Sc. (Health Sciences), MD and turned from her study leave in October 2010, after B.Sc. Medical Laboratory Sciences degrees as well obtaining her Ph.D. degree from the University of as in Phase I and Phase II of the new curriculum. patient

Kentucky, USA. The Department offers several courses in the B.Sc.

During the year, the Department has acquired the Health Sciences programme and contributes to all and following equipment; platelet aggregometer, Gen- system-based courses. The courses for B.Sc. Health tle MACS dissociator, fluorescence reader, complete Sciences are: Alimentary System, Respiratory Sys- academic Pharmacology & Clinical Pharmacy 193 Annual Report 2010-2011 Pharmacology & Clinical Pharmacy

tem, Cardiovascular System, Urinary System, Haematopoietic, Lymphoid & Vascular System, Human Ner- vous System, Endocrine & Reproductive System and Applied Pharmacology for Medical Students. The cours- es for B.Sc. MLS are Biology of Disease, Diagnostic Toxicology and Therapeutic Drug Monitoring.

At the preclinical level, the teaching concentrated on mechanisms by which drugs affect various biological systems and functions, as well as the actions of drugs on pathological processes.

The pharmacology contribution is also designed to teach the students the basic concepts of the mechanism of action, pharmacological effects and interactions of drugs and to apply this knowledge through case stud- ies. Applied Pharmacology for Medical Students (offered in the Spring and Summer semesters) is fully deliv- ered by the Department. The course is composed of lectures and case-based discussions.

The Department continues to contribute to the College of Nursing courses. Basic Pharmacology and Dosage Calculations and Pharmacology for Nurses are delivered in both semesters.

The Department also delivers the University elective courses, Nutrients, Medicines and Narcotics, during the Spring semester and History of Medicine in the Fall semester.

With the implementation of the new curriculum in the College, the Department was given the responsibility to coordinate Cellular Communication and Introduction to Drug Action in Phase I. This module introduces the physiological, biochemical and pathophysiological processes and control of cellular communication. The Department delivers lectures and tutorials for the following courses: Cellular Communication and Introduc- tion to Drug Action; Response to Infection and Pathobiology; Alimentary System, Respiratory System; Hae- mopoetic Lymphoid Immune System ; Cardiovascular System, Uro-reproductive System, Endocrine System, Locomotor System, Nervous System and Research Project I & II.

Clinical Programme The Department is involved in teaching in the clinical programme. Pharmacology contributed to the Inte- grated Lecture Series (ILS) with courses on Gastroenterology, Nephrology, Neurology, and to clinical rotations in different clinical specialties.

The Department, solely, coordinates the Therapeutics Course which is provided for the 6th year medical stu- dents. Most of this teaching was based on the concept of case-based learning. The Department also contrib- uted to the interdisciplinary activities of 5th and 6th year medical students in Medical Ethics and Gerontol- ogy.

POSTGRADUATE PROGRAMME The Department plays an active role in the teaching in the Master’s in Biomedical Sciences. The Department

194 also offers a Master’s degree in Clinical Pharmacy. Major courses delivered by the Department are: Clinical Pharmacokinetics and Therapeutic Drug Monitoring; Clinical Pharmacy I; Clinical Pharmacy II; Pharmaco- therapeutics I and II. The Department introduced a new elective course ‘Introduction to Pharmacoeconomics.’

The Department was given the responsibility of coordinating the Master’s Degree core course, Research Method and Critical Analysis for Scientific Information. The Master’s student numbers continuously in- creased so the course had to be offered in both semesters.

The Department is involved in the Pharmacy Working Group to establish a Pharmacy specialty for the Oman Medical Specialty Board (OMSB).

Research RESEARCH PROJECTS Effect of Gum Arabic on an Animal Model Chronic Renal Failure Effect Project Code: RC/MED/PHAR/10/01; Dates: 2010–2011 Value: OR 50,000; Project Funder: The Research Council Investigator: Prof. Badreldin Ali, Dept. Pharmacology & Clinical Pharmacy, SQU.

The effect of water extract and anthocyanins of the medicinal plant Hibiscus sabdariffa L on cisplatin- induced nephrotoxicity in rats Project Code: G/MED/PHAR/11/01; Dates: 2006-2010 Value: OR 16,000; Project Funder: Sultan Qaboos University Investigators: Prof. Badreldin Ali, Dept. Pharmacology & Clinical Pharmacy, SQU; Dr.

Mansour Al-Moundhri, Dept. Medicine SQU; Dr. Ahmed Al-Shukaili, Dept. departments Microbiology & Immunology, SQU; Dr Allal Ouhtit, Dept. Genetics, SQU. care

The Effect of Different Classes of Antidepressant drugs on Thiamine status in Rats Project Code: MREC #330; Dates: 2010 Value: OR 2,000; Project Funder: Sultan Qaboos University patient

Investigators: Prof. Badreldin Ali, Dept. Pharmacology & Clinical Pharmacy, SQU; Dr.

Mohammed Al-Zaabi, Dept. Pharmacology & Clinical Pharmacy, SQU; Dr. and Samir Al-Adawi, Dept. Behavioral Medicine, SQU. academic Pharmacology & Clinical Pharmacy 195 Annual Report 2010-2011 Pharmacology & Clinical Pharmacy

Bone Mineral Density Measurement in Healthy Young Omanis, a Pilot Study to Establish Local Reference Values Project Code: MREC# 437; Dates: 2011 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. Mohammed Al Zaabi, Dept. Pharmacology & Clinical Pharmacy, SQU.

Prescribing Pattern of Tazocin and Vancomycin in the Accident Emergency Department at Sultan Qaboos University Hospital ( SQUH ): a prospective study Project Code: MREC# 467; Dates: 2011 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. Ragini Vaishnav, Dept. Pharmacology & Clinical Pharmacy, SQU.

Blood Sugar Control in Omani Diabetic Patients at a Primary Health Center Project Code: MREC# 473; Dates: 2011 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. Khalid Al Balushi, Dept. Pharmacology & Clinical Pharmacy, SQU.

Blood Sugar Control in Omani Diabetic Patients at SQUH Project Code: MREC# 474; Dates: 2011 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. Khalid Al Balushi, Dept. Pharmacology & Clinical Pharmacy, SQU. RESEARCH PUBLICATIONS & BOOKS Book Chapters 1. Al Adawi S, Jaju SS, Al Zakwani I, Dorvlo ASS. Culture to Culture Fat Phobia and Somatization. In: Preedy VR, Watson RR, Martin CR, Eds. International Handbook of Behaviour, Diet, and Nutrition. New York: Springer, 2011. Journal Publications 1. Abdwani R, Hira M, Al-Nabhani D, Al-Zakwani I. Juvenile systemic lupus erythematosus in the Sultanate of Oman: clinical and immunological comparison between familial and non-familial cases. Lupus 2011; 20:315-9. 2. Abusham AA, Mohammed AH, Al-Kindi S, Hassan MM, Al-Zakwani I. Sub-optimal serum gentamicin concentra- tions in sickle cell disease patients utilising the Hartford protocol. J Clinical Pharm Therapeut 2011; 37:212-16. 3. Albarwani SA, Tanira MO. A call for a quiet debate on the future of genetics research. Oman Med J 2011; 26:153-4.

196 4. Ali BH, Al Husseini I, Kayed R, AlMasroori N, Al Harthi T, Al Zaabi M, Nemmar A. Effects of gum arabic in rats with adenine-induced chronic renal failure. Exp Biol Med (Maywood). 2010; 235:373-82. 5. Ali BH, Abdelrahman AM, Al-Salam S, Sudhadevi M, Almahruqi AS, Al-Husseni IS, et al. The effect of sildenafil on cisplatin nephrotoxicity in rats. Basic Clin Pharmacol Toxicol 2011; 109:300-8. 6. Ali BH, Al Za’abi M, Blunden G, Nemmar A. Experimental gentamicin nephrotoxicity and agents that modify it: A mini-review of recent research. Basic Clin Pharmacol Toxicol 2011; 109:225-32. 7. Ali BH, Ziada A, Al Husseni I, Beegam S, Nemmar A. Motor and behavioral changes in rats with adenine-induced chronic renal failure: influence of acacia gum treatment. Exp Biol Med (Maywood) 2011; 236:107-12. 8. Ali BH, Ziada A, Al Husseni I, Beegam S, Al-Ruqaishi B, Nemmar A. Effect of acacia gum on blood pressure in rats with adenine-induced chronic renal failure. Phytomed 2011; 18:1176-80. 9. Al-Kindi R, Al-Mushrafi M, Al-Rabaani M,Al-Zakwani I. Complementary and alternative medicine use among adults with diabetes in the Muscat region, Sultanate of Oman. Sultan Qaboos University Med J 2011; 11:62-6. 10. Al-Mandhari A, Al-Zakwani I, Al-Hasni A, Al-Sumri A. Assessment of self-perceived health status in hypertensive and diabetes mellitus patients at primary health centers in Oman. Int J Prevent Med 2011; 2:256-63. 11. Al-Maskari M, Petrini K, Al-Zakwani I, Al-Adawi SS, Dorvlo AS, Al-Adawi S. Mood dysfunction and health-related quality of life among type-2 diabetes in Oman: Preliminary study. Int J Nutrit Pharmacol Neurol Dis 2011; 1:55-61. 12. Al-Rasadi K, Al-Zakwani I, Ali A, Bahnacy Y, Zubaid M, Sulaiman K, et al. Prevalence of low high-density lipoprotein cholesterol (HDL-C) as a marker of residual cardiovascular risk among acute coronary syndrome patients in the Middle East. Open Cardiovasc Med J. 2011; 5:203-9. 13. Al-Rasadi K, Sulaiman K, Panduranga P, Al-Zakwani I. Prevalence, characteristics, and in-hospital outcomes of meta- bolic syndromes in acute coronary syndrome patients in Oman. Angiology 2011; 62:381-9. 14. Al-Riyami IM, Al-Busaidi IQ, Al-Zakwani I. Medication use during pregnancy in Omani women. Int J Clin Pharm 2011; 33:634-41. 15. Al-Siyabi K, Farhan H, Al-Rasadi K, Al-Salhi A, Al-Hinai AT, Al-Zakwani I. Safety of simvastatin and goal attainment for low-density lipoprotein cholesterol in Sultan Qaboos University Hospital, Oman. Oman M J 2010; 25:264-8.

16. Al-Yaarubi S, Farhan H, Al-Futaisi A, Al-Qassabi S, Al-Rasadi K, Al-Riyami S, Al-Zakwani I. Accuracy of ultrasound departments guided fine-needle aspiration cytology for diagnosis of carcinoma in patients with multinodular goiter. Indian J Endocrinol Metabol 2011; 15:S132-5. care 17. Al-Zakwani I, Suleiman K, Al-Rasadi, Mikhailidis DP. Prevalence of low high-density lipoprotein (HDL-C) as a mark- er of residual cardiovascular risk among acute coronary syndrome patients from Oman. Curr Med Res Opin 2011; 27:879-85.

18. Al-Zakwani I, Zubaid M, Panduranga P, Al Suwaidi J, Al Mahmeed W, Rashed W, et al. Medication use pattern and patient

predictors of optimal therapy at discharge in 8176 acute coronary syndrome patients from six Middle Eastern coun- tries: data from the Gulf Registry of Acute Coronary Events (Gulf RACE). Angiology 2011; 62:447-54. and

19. Artigas Ms, Loth Dw, Wain Lv, Gharib Sa, Al Balushi KA, et al. Genome-wide association and large-scale follow up identifies 16 new loci influencing lung function. Nat Genet 2011; 43:1082-90. academic Pharmacology & Clinical Pharmacy 197 Annual Report 2010-2011 Pharmacology & Clinical Pharmacy

20. Gowri V, Krishnaprasad V, Al-Zakwani I, Joseph KM, Abdul Rahman K, Al-Marhoon M. Comparison of the demo- graphics, semen parameters and hormone profiles in men with primary and secondary infertility. Sultan Qaboos University Med J 2010; 10:350-3. 21. Gowri V, Mathew M, Gravell D, AlFalahiK, Zakwani I, Ganguly SS, Pathare AV. Protein Z levels in pregnant Omani women: correlation with pregnancy outcome. J Thromb Thrombolysis 2011; 32:453-8. 22. Hardy A D, Barss P, Rollinson G, Vaishnav R. The chemical composition of traditional eye cosmetics in Sudan. House- hold Pers Care Today (Analyt Technol) 2011; 3:38-42. 23. Hardy AD, Rollinson G, Vaishnav R. The chemical composition of traditional eye cosmetics in Syria. Household Pers Care Today (Analyt Technol) 2010; 4:24-28. 24. Mir SU, Ahmed IS, Arnold S, Craven RJ. Elevated progesterone receptor membrane component 1/sigma-2 receptor levels in lung tumors and plasma from lung cancer patients. Int J Cancer 2011; 131:E1-9. 25. Nemmar A, Al-Salam S, Zia S, Marzouqi F, Al-Dhaheri A, Subramaniyan D, Dhanasekaran S, Yasin J, Ali BH, et al. Con- trasting actions of diesel exhaust particles on the pulmonary and cardiovascular systems, and the effect of thymo- quinone thereon. Br J Pharmacol 2011; 164:1871-82. 26. Nemmar A, Melghit K, Al-Salam S, Zia S, Dhanasekaran S, Attoub S, Al-Amri I, Ali BH. Acute respiratory and systemic toxicity of pulmonary exposure to rutile Fe-doped TiO(2) nanorods. Toxicology 2011; 279:167-75. 27. Nemmar A, Zia S, Subramaniyan D, Fahim MA, Ali BH. Exacerbation of thrombotic events by diesel exhaust particle in mouse model of hypertension. Toxicology 2011; 285:39-45. 28. Panduranga P, Sulaiman K, Al-Lawati J, Al-Zakwani I. Relationship between admitting (non-fasting) blood sugar and in-hospital mortality among acute coronary syndrome (ACS) patients in Oman with and without diabetes mellitus. Heart Views 2011; ¬12:12-7. 29. Panduranga P, Sulaiman K, Al-Zakwani I. Acute coronary syndrome in Oman. Results from Gulf Registry of Acute Coronary Events. Sultan Qaboos University Med J 2011; 11:338-42. 30. Panduranga P, Sulaiman K, Al-Zakwani I. Acute coronary syndrome in young adults from Oman: Results from the Gulf Registry of Acute Coronary Events (Gulf RACE). Heart Views 2010; 11:93-8. 31. Panduranga P, Sulaiman K, Al-Zakwani I. Gender-related differences in the presentation, management, and out- comes among patients with acute coronary syndrome from Oman. J Saudi Heart Assoc 2010; 23:17-22. 32. Tanira M, Al-Barwani S, Al-Moharby D, Soussi B, Balachandran S. International experience in university strategic planning: Options for SQU. Proceedings International workshop Towards a Long-Term Strategic Plan for Sultan Qa- boos University, 9-10 November 2010. Pp. 108-118. 33. Tanira MO. Medical education is on the move once more. Sultan Qaboos University Med J 2010; 10:310-1. 34. Waly MI, Al Moundhri MS, Ali BH. Effect of curcumin on cisplatin- and oxaliplatin-induced oxidative stress in hu- man embryonic kidney (HEK) 293 cells. Ren Fail 2011; 33:518-23. 35. Yusufali A, Zubaid M, Al-Zakwani I, Alsheikh-Ali AA, Al-Mallah MH, Al Suwaidi J, et al. Validation of the GRACE risk score for hospital mortality in patients with acute coronary syndrome in the Arab Middle East. Angiology 2011; 62:390-6.

198 36. Zubaid M, Rashed W, Alsheikh-Ali AA, Al Mahmeed W, Shehab A, Sulaiman K, Al-Zakwani I, et al. Gulf Survey of Atrial Fibrillation Events (Gulf SAFE): design and baseline characteristics of patients with atrial fibrillation in the Arab Middle East. Circulation: Cardiovasc Qual Outcome 2011; 4:477-82. 37. Al Za’abi MA, Ali BH. A rapid HPLC method for determination of indoxyl sulfate in rat plasma. Abstract. Ther Drug Monit 2011; 33:554. 38. Al Za’abi MA, Shafiq S,Ali BH. Prescribing pattern and therapeutic drug monitoring of Vancomycin at a tertiary hospital in Oman. Abstract. Ther Drug Monit 2011; 33:514. 39. Al Balushi KA, Balkhair AA, Ali BH, Al Rawas NO. Prescribing Pattern of Antimicrobial Agents to patients with Che- motherapy-induced febrile Neutropenia at SQU Hospital. Abstract. Basic Clinical Pharmacol Toxicol 2011; 109:157. 40. Vaishnav R, Jassim G, Al Zakwani I. Omeprazole prescribing and its cost impact in outpatient clinics at SQU. Basic Clinical Pharmacol Toxicol 2011; 109:137. CONFERENCE & SEMINAR PRESENTATIONS Poster Presentations International 1. Al Balushi KA, Balkhair AA, Ali BH, Al Rawas NO. Prescribing pattern of antimicrobial agents to patients with che- motherapy-induced febrile neutropenia at SQU Hospital. 10th Congress of European Association for Clinical Phar- macology & Therapeutics. Budapest, Hungary, 26-29 June 2011. 2. Vaishnav R, Jassim GA, Al Zakwani I. Omeprazole prescribing and its cost impact in outpatient clinics at Sultan Qaboos University Hospital. 10th Congress of European Association for Clinical Pharmacology & Therapeutics. Bu- dapest, Hungary, 26-29 June 2011. 3. Al-Rasadi K, Al-Zakwani I, Sulaiman K, Mikhailidis DP. Prevalence of low high-density lipoprotein cholesterol (HDL- C) as a marker of residual cardiovascular risk among acute coronary syndrome patients from Oman. 4th Internation- al Congress on Prediabetes and the Metabolic Syndrome. Epidemiology, Management and Prevention of Diabetes and Cardiovascular Disease. Madrid, Spain, 6-9 April 2011. 4. Al-Waili K, Al-Rasadi K, Al-Habsi, K, Al-Zakwani I. Comparison of Low-Density Lipoprotein Cholesterol and Apolipo- departments

protein B as targets for lipid lowering treatment in high risk patients in Oman. 4th International Congress on Pre- diabetes and the Metabolic Syndrome. Epidemiology, Management and Prevention of Diabetes and Cardiovascular Disease. Madrid, Spain, 6-9 April 2011. care 5. Al-Rashdi I, Victoria M, Susan S, Al-Zakwani I. Analysis of pharmacists’ interventions of electronic prescriptions at Sultan Qaboos University Hospital in Oman. International Society for Pharmacoeconomics and Outcomes Research (ISPOR), 13th Annual European Congress. Prague, Czech Republic, 6-9 November 2010. patient

6. Al-Zakwani I, Al-Rasadi K, Sulaiman K, Panduranga P. Prevalence, characteristics, and in-hospital outcomes of meta- bolic syndromes in acute coronary syndrome patients in Oman. International Society for Pharmacoeconomics and

Outcomes Research (ISPOR), 13th Annual European Congress. Prague, Czech Republic, 6-9 November 2010. and

academic Pharmacology & Clinical Pharmacy 199 Annual Report 2010-2011 Pharmacology & Clinical Pharmacy

Seminar Presentations International 1. Al Zakwani I. Introduction to Pharmacoeconomics. Ministry of Health, Continuing Professional Development (CPD), Doha, Qatar, June 4, 2011. 2. Al Zakwani I. Which univariate statistical test should I choose? African and Gulf Region Cardiologists, 2-Day Clinical Trial Program. Sofitel Hotel, Dubai, UAE, 29 May 2011. National 1. Tanira MO. International Experience In University Strategic Planning: Options For SQU. International Workshop On Towards A Long-Term Strategic Plan For Sultan Qaboos University. SQU, Oman, 9-10 November 2010. 2. Ahmed IA. Pgrmc1 promotes tumorigenesis, associates with EGFR and is inhibited by a specific ligand. College of Medicine & Health Sciences, SQU, Oman, 1 May 2011. 3. Al Zakwani I. Introduction to Pharmacoeconomics. Sultan Qaboos University Hospital, Continuing Professional De- velopment (CPD). Muscat, Oman, 3 November 2010. 4. Al Zakwani I. Pharmacoeconomics: From Theory to Practice. Oman Pharmaceutical Society, Muscat, Oman, 10 March 2011. 5. Al Zakwani I. Which univariate statistical test should I choose for my research? Armed Forces Hospital, Continuing Professional Development (CPD). Muscat, Oman. 22 September 2010. 6. Al Zakwani I. Introduction to Pharmacoeconomics. Sultan Qaboos University Hospital, Continuing Professional De- velopment (CPD). Muscat, Oman 13 October 2010. THESIS SUPERVISION Student name: Gheith A. Jassim Qualification: M.Sc. Clinical Pharmacy Title: Omeprazole Prescribing and Its Cost Impact in Outpatient Clinics at Sultan Qaboos University Hospital: A Retrospective Study Supervisors: Dr. Ragini Vaishnav, Dr. Ibrahim Al-Zakwani Date of Completion: October 2010

Jannat Q. Al-Lawati Qualification: M.Sc. Clinical Pharmacy Title: Comparative Effectiveness between Valsartan (plus hydrochlorthiazide) and Irbesartan (plus hydrochlorthiazide) with Respect to Blood Pressure Control at Sultan Qaboos University Hospital in Oman

200 Supervisors: Dr. Khalid Al-Balushi, Dr. Ibrahim Al-Zakwani Date of Completion: Completed April 2011

Mohsin M. Maqbool Qualification: M.Sc. Clinical Pharmacy Title: Analysis of pharmacists’ interventions of prescriptions and its impact on pharmaceutical care provision at Sultan Qaboos University Hospital in Oman Supervisors: Professor Musbah Tanira, Dr. Ibrahim Al-Zakwani Date of Completion: Completed June 2011 departments

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academic Pharmacology & Clinical Pharmacy 201 Annual Report 2010-2011 Pharmacy

Pharmacy

he Pharmacy Department at SQU Hospital is considered the centre of excellence within the country for the provision of gen- eral and specialised pharmaceutical services, and the promotion of pharmaceutical research and teaching. The Department’s mission is to dispense the correct, most effective, safe and most economic medication to a properly identified patient at the Tappropriate time with sufficient written and verbal patient information and to disseminate appropriate and unbiased drug, poison and disease related information to patients, medical, pharmacy, nursing and allied health care professionals.

The Department is divided into 6 major sections: Pharmacy Administration and Training; Outpatient Pharmacy; Inpatient Clinical Pharmacy; Manufacturing/Aseptic Preparations; Medicine Information and the Pharmacy Sub-Store.

There has been a significant increase in the number of clinical services and patients in the last 5 years, however, the Department has maintained its high quality services and the outpatient waiting time has also been maintained below 30 minutes even in the busiest months.

The Department is recognised nationally and regionally as a training centre that supports a range of quality programmes. It is respon- sible for teaching health care providers and students from the colleges of Medicine and Pharmacy and for the provision of in-service

202 training for pharmacy staff. It also provides individ- Maryam Al-Riyami, Assistant Pharmacist ualised work experience placements for graduate Medicine Information pharmacy personnel. Intisar Al-Busaidi, Senior Pharmacist The Department has carried out a number of re- Nibu Nair, Pharmacist search projects with the aim of further improving Manufacturing/ Aseptic Preparations its services and the effectiveness of certain drug Felicidad Dizon, Pharmacist therapies. Dawood Al-Salhi, Pharmacist Ali Al-Jabri, Assistant Pharmacist Pharmacy Sub-Store Staff Khalid Al-Zadjali, Pharmacist Head of Department Pharmacy Computer System Management Dr. Ibrahim Al-Zakwani, Assistant Professor Dr. Bruno Louis, Senior Pharmacist Deputy Head & Training Coordinator Technical Services Amna Al-Hashar, Clinical Pharmacist Ahmed Al-Mahruqi, Pharmacist Assistant Head Coordinators Aqeela Taqi, Clinicat Pharmacist Mahfoudh Al-Rawahi Inpatient Clinical Pharmacy Faiza Al-Zadjali Badriya Al-Zadjali, Clinical Pharmacist Asmahan Al-Barram, Clinical Pharmacist Highlights of the Year Maryam Al-Kindi, Pharmacist Samiya Al-Ajmi, Pharmacist 2010-2011 Amal Al-Rahbi, Pharmacist Continuous Professional Development Structured Mafiana Rose, Pharmacist Courses departments Anwar Al-Mahrizi, Pharmacist The Department has organised a number of cours- Outpatient Pharmacy es to improve the skills of pharmacists and assis- care Issa Al-Rashdi, Pharmacist tant pharmacists in the retrieval and evaluation Soud Al-Shabibi, Pharmacist of medicine information. This has been almost an Janardhanan Nair, Senior Pharmacist annual event where every year a number of par- patient Family Medicine Clinic and Emergency ticipants from SQUH and other government and private institutions attend these courses. This year,

Dept. Pharmacy and three courses were organised: Introduction to In- Nagwa Mohammed, Pharmacist formation Mastery and Medicines Information, Is- academic Pharmacy 203 Annual Report 2010-2011 Pharmacy

sues in Medicines Formulations Workshop, and Principles of Evidence Based Medicine and Critical Appraisal. An online course on Laboratory Values Interpretation was also organised in November 2010 over a period of 8 weeks with 20 pharmacists enrolled from SQUH and other MOH institutions. The course was coordinated by a pharmacy consultant from the Best Practice Advocacy Centre in New Zealand. It enabled pharmacists to have a comprehensive understanding of common and important laboratory results. All courses were ac- credited by the Oman Medical Specialty Board (OMSB).

CHEMOTHERAPY SAFETY Chemotherapy safety was enhanced by the appointment of a Chemotherapy Verification Pharmacist, whose responsibility is to verify all chemotherapy prescriptions prior to processing for preparation. This is an addi- tional precaution to detect any potential prescribing errors or justify any deviation from the standard man- agement protocol.

MEDICINE INFORMATION DATABANK A new programme was installed at the Medicine Information Services (MIS). This databank will save and retrieve all queries handled by the service and enable the generation of various statistical reports on the nature, number and outcome of queries. It will improve MIS efficiency by the quick retrieval of old enquiries with their formulated responses.

SMS SERVICE FOR UNCOLLECTED PRESCRIPTIONS In July 2011, an SMS service was introduced to remind patients to collect their Prescriptions. This has resulted in a reduction in the number of cancelled prescriptions and in the time previously wasted in preparation and cancellation. It has also improved patient satisfaction as observed from patient feedback.

EXTEMPORANEOUS PREPARATIONS STATION This is a specially designed workbench in compliance with Good Manufacturing Practice (GMP) guidelines to facilitate proper clean preparation for syrups and oral solutions. It is located in the Manufacturing Section.

CHEMOTHERAPY PREPARATION SOFTWARE A smart software was developed in-house by a pharmacy staff member and tailor made to facilitate order entry, calculation, label generation, etc. to cover the whole chemotherapy preparation process. It also gener- ates useful statistics that facilitate costing and forecasting the requirements of chemotherapy items.

204 Teaching Programmes UNDERGRADUATE CLINICAL PROGRAMME During the year, four courses, attended by twelve 5th year medical students, were held on Prescription Writ- ing and Asthma Inhaler Devices.

Postgraduate Programme A lecture on ‘Medication Errors and Safe Prescribing’ was given to 20 OMSB residents on their orientation program

Training Courses & CME Activities In this year, the Pharmacy staff contributed to CME activities by teaching the following topics/ courses: Pain Management course - Pharmacotherapy and Pain Management; Chemotherapy course; CSSD course - Chem- ical Agents and Antiseptics.

Training has been provided for students from Nizwa University, Dubai School of Pharmacy, Oman Assistant Pharmacist Institute and the Higher College of Technology as well as others.

Additionally, 16 CPD/CME sessions were organised in the department and delivered by pharmacy staff.

Clinical & Diagnostic Services OUTPATIENT PHARMACY (OP) Dispensing prescriptions to ambulatory patients is the major activity of this section. This service is offered at four different locations: the main hospital pharmacy, the Family Medicine & Public Health clinic, the Emer- departments gency Department Pharmacy (which offers a 24 hour service) and the Student Clinic Pharmacy. At the main Hospital Pharmacy, one room is dedicated for counselling patients. During 2011, the OP pharmacies dis-

pensed a total of 226,365 prescriptions, which accounted for 551,915 items [Figure 1]. care

IN-PATIENT CLINICAL PHARMACY Clinical pharmacy is a service provided by qualified clinical pharmacists to promote rational drug therapy patient that is safe, appropriate, and cost effective. Clinical pharmacists work in teams with other health care pro-

viders to achieve this goal. The review of discharge prescriptions by the clinical pharmacists continues to be and an important and major requirement before dispensing of medications to the patients. Clinical pharmacists perform a number of clinical activities and interventions in their day-to-day work. academic Pharmacy 205 Annual Report 2010-2011 Pharmacy

600000 Rx 551915 Items

500000 489471 454654

400000

300000

226365 200252 200000 186353

100000

0 2009 2010 2011 Figure 1: Total number of prescriptions and items dispensed from all Outpatient pharmacies (2009- 2011).

The development of clinical treatment guidelines and patient educational material is a major activity of clin- ical pharmacists. In this year, the following guidelines were produced or updated: Patient information leaflet on Extravasation; updating TDM guidelines in paediatric patients; Information on electrolytes available in SQU pharmacy; updating prescribing for CF patients (clinicians guide); analgesics dosing guidelines in Pae- diatrics; Guidelines on the treatment of Hypokalaemia in Paediatric Oncology Patients; Rituximab protocol for myasthenia gravis in children.

MANUFACTURING (ASEPTIC PREPARATIONS) This section is responsible for the preparation of TPN, chemotherapy preparations, sterile & non-sterile prod- ucts and repacking of medicines. The following table shows details of manufacturing activities (2009-2011)

Table 1: Manufacturing activities (2009-2011) Activity 2009 2010 2011 TPN Bags 1,484 3,030 3,388 Cytotoxic doses 6,633 9,928 10,659 Sterile and non-sterile preparations 1,653 2,740 2,886 Repacked Items 298 322 238

206 MEDICINE INFORMATION SERVICES (MIS) MIS provides unbiased evidence-based and critically evaluated information about medicines, poisons and diseases in order to improve patient care. The following table shows the number of documented enquiries, adverse drug reaction (ADR) and poisoning reports from 2009 to 2011.

Table 2: Medicine Information Services activities (2009-2011) Year/Number 2009 2010 2011 Enquiries 736 621 681 Adverse drug reaction reports 526 603 549 Poisoning reports 78 118 128

MIS also provides essential medicine information for the Hospital’s Pharmacy & Therapeutics Committee meetings. Information was provided on more than 12 drugs, which led to the addition of 8 drugs to the for- mulary.

PHARMACY SUB-STORE The Pharmacy Sub-store is the link between the hospital main stores and the Pharmacy Department. It plays an important role in ensuring the availability and smooth distribution of general pharmaceuticals, IV fluids, narcotics and psychotropic drugs to hospital wards and units. It facilitates the control of expiries and helps in the estimation of the quantities of pharmaceuticals to be purchased. The Pharmacy Sub-store aims to ensure the availability of all critical items as soon as possible in co-operation with the main store and the Procurement Department. The Pharmacy Sub-store is responsible for the supply of medicines on requisi- tions for other satellite pharmacies and different clinics and units in the Hospital. In 2011, there was 0% non- departments availability of emergency items (CRR & antidotes) in pharmacy store. care Research RESEARCH PUBLICATIONS & BOOKS patient Books & Book Chapters

1. Al-Adawi S, Jaju SS, Al-Zakwani I, Dorvlo ASS. Culture to Culture Fat Phobia and Somatization. In: Preedy VR, Watson and

RR, Martin CR, Eds. Handbook of Behaviour, Food and Nutrition. 1st Edition, New York: Springer, 2011. academic Pharmacy 207 Annual Report 2010-2011 Pharmacy

40000 35532 35000 34882

30000 No. of requisitions 25000 No. of Items 20000

15000

10000

5000 1830 2125 0 2010 2011 Figure 2: Number of items and requisitions issued by the Pharmacy Sub-store from 2010-2011.

Journal Publications 1. Al-Mandhari A, Al-Zakwani I, Al-Hasni A, Al-Sumri A. Assessment of self-perceived health status in hypertensive and diabetes mellitus patients at primary health centers in Oman. Int J Prevent Med 2011; 2:256-63. 2. Panduranga P, Sulaiman K, Al-Zakwani I. Acute coronary syndrome in Oman - Results from Gulf Registry of Acute Coronary Events. Sultan Qaboos University Medical Journal 2011; 11 (3): 338-42. 3. Al-Rasadi K, Al-Zakwani I, Ali A, Bahnacy Y, Zubaid M, Sulaiman K, et al. Prevalence of low high-density lipoprotein cholesterol (HDL-C) as a marker of residual cardiovascular risk among acute coronary syndrome patients in the Middle East. Open Cardiovasc M J 2011; 5:203-9. 4. Al-Yaarubi S, Farhan H, Al-Futaisi A, Al-Qassabi S, Al-Rasadi K, Al-Riyami S, Al-Zakwani I. Accuracy of ultrasound guided fine-needle aspiration cytology for diagnosis of carcinoma in patients with multinodular goiter. Indian J Endocrinol Metab 2011; 15:S132-5. 5. Gowri V, Mathew M, Gravell D, AlFalahiK, Al-Zakwani I, Ganguly SS, Pathare AV. Protein Z levels in pregnant Omani women: correlation with pregnancy outcome. J Thromb Thrombolysis 2011; 32:453-8. 6. Zubaid M, Rashed W, Alsheikh-Ali AA, Al Mahmeed W, Shehab A, Sulaiman K, Al-Zakwani I, et al. Gulf Survey of Atrial Fibrillation Events (Gulf SAFE): design and baseline characteristics of patients with atrial fibrillation in the Arab Middle East. Circulation: Cardiovasc Qual Outcomes 2011; 4:477-82. 7. Al-Riyami IM, Al-Busaidi IQ, Al-Zakwani I. Medication use during pregnancy in Omani women. Int J Clin Pharm 2011; 33:634-41. 8. Panduranga P, Sulaiman K, Al-Lawati J, Al-Zakwani I. Relationship between admitting (non-fasting) blood sugar and in-hospital mortality among acute coronary syndrome (ACS) patients in Oman with and without diabetes mel- litus. Heart Views 2011; ¬12:12-7. 9. Al-Rasadi K, Sulaiman K, Panduranga P, Al-Zakwani I. Prevalence, characteristics, and in-hospital outcomes of meta- bolic syndromes in acute coronary syndrome patients in Oman. Angiology 2011; 62:381-9.

208 10. Al-Zakwani I, Suleiman K, Al-Rasadi, Mikhailidis DP. Prevalence of low high-density lipoprotein (HDL-C) as a mark- er of residual cardiovascular risk among acute coronary syndrome patients from Oman. Curr Med Res Opin 2011; 27:879-85. 11. Al-Zakwani I, Zubaid M, Panduranga P, Al Suwaidi J, Al Mahmeed W, Rashed W, et al. Medication use pattern and predictors of optimal therapy at discharge in 8176 acute coronary syndrome patients from six Middle Eastern coun- tries: data from the Gulf Registry of Acute Coronary Events (Gulf RACE). Angiology 2011; 62:447-54. 12. Al-Kindi R, Al-Mushrafi M, Al-Rabaani M,Al-Zakwani I. Complementary and alternative medicine use among adults with diabetes in the Muscat region, Sultanate of Oman. Sultan Qaboos University Med J 2011; 11:62-6. 13. Yusufali A, Zubaid M, Al-Zakwani I, Alsheikh-Ali AA, Al-Mallah MH, Al Suwaidi J, et al. Validation of the GRACE risk score for hospital mortality in patients with acute coronary syndrome in the Arab Middle East. Angiology 2011; 62:390-6. 14. Abdwani R, Hira M, Al-Nabhani D, Al-Zakwani I. Juvenile systemic lupus erythematosus in the Sultanate of Oman: clinical and immunological comparison between familial and non-familial cases. Lupus 2011; 20:315-9. 15. Panduranga P, Sulaiman K, Al-Zakwani I. Acute coronary syndrome in young adults from Oman: Results from the Gulf Registry of Acute Coronary Events (Gulf RACE). Heart Views 2010; 11:93-8. 16. Gowri V, Krishnaprasad V, Al-Zakwani I, Joseph KM, Abdul Rahman K, Al-Marhoon M. Comparison of the demo- graphics, semen parameters and hormone profiles in men with primary and secondary infertility. Sultan Qaboos University Med J 2010; 10:350-3. 17. Al-Maskari M, Petrini K, Al-Zakwani I, Al-Adawi SS, Dorvlo AS, Al-Adawi S. Mood dysfunction and health-related quality of life among type-2 diabetes in Oman: Preliminary study. Int J Nutr Pharmacol Neurol Dis 2011; 1:55-61. 18. Panduranga P, Sulaiman K, Al-Zakwani I. Gender-related differences in the presentation, management, and out- comes among patients with acute coronary syndrome from Oman. J Saudi Heart Assoc 2011; 23:17-22. 19. Al Alawi K, Al Shinawy M, Taqi A, Wali Y. Vancomycin induced acute flaccid paralysis in a child with acute Leukemia: an overlooked complication: a case report. Oman Med J 2011; 26:282-3. CONFERENCE & SEMINAR PRESENTATIONS departments

Conference Presentations National care

1. Al-Zadjali B. Pharmacy initiatives in optimizing patient care: SQUP experience. 5th Regional Pharmacy Symposium. Nizwa, Oman, 5 May 2011. 2. Al-Salhi D. Update of pharmacotherapy of Osteoporosis. Osteoporosis Update Conference. Sohar Hospital, Oman, 5

May 2011. patient

3. Al-Barram A. Optimizing patient’s safety - SQU pharmacy initiatives. 1st Al Nahdha Pharmacy Conference - Phar- and

macy & patient safety conference. Muscat, Oman. 9 June 2011. 4. Taqi A. Use of factor concentrates in hemophilia. Haemophilia Awareness Day. SQUH, Muscat, Oman, 9 June 2011. academic Pharmacy 209 Annual Report 2010-2011 Pharmacy

Poster Presentations International 1. Al-Riyami I, Taqi A. Pharmaceutical care in bone marrow transplantation (BMT) at Sultan Qaboos University Hospi- tal (SQUH). 16th Congress European Association Hospital Pharmacists. Vienna, Austria, 30 March - 1 April 2011.

210 departments

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academic Pharmacy 211 Annual Report 2010-2011 Physiology

Physiology

he Department of Physiology has two divisions: Basic Physiology and Clinical Physiology located in the College of Medicine and the University Hospital (SQUH), respectively. The Department teaches basic and clinical physiology, and also familiarises medical students with various clinical physiological procedures. Physiology teaching is coordinated with other basic science Tdepartments in an integrated and multidisciplinary fashion. The curriculum is further fortified by live models as well as simulated ba- sic and clinical case demonstrations at different levels of medical training. Clinical students are taught hands-on as well as diagnostic skills of the most common clinical measurements that they are like to encounter after graduation.

The Department of Clinical Physiology provides advanced clinical diagnostic services for SQUH and also for the whole of Oman. It is the only Department of its kind in the country where such procedures are carried out under one roof, with fully digital equipment, good quality assurance, and cost effectiveness.

The Department lays major emphasis on cardiovascular research and has strong links with the universities of McMaster and Toronto in Canada; Oxford, UK; Wisconsin, USA; Graz, Austria and Groningen in the Netherlands as well as with the US National Heart & Lung Institute and the Southwest Foundation for Biomedical Research, San Antonio, USA. Researchers from the Department interact regu- larly with these universities through exchange programmes. Technical and medical staff members receive regular training and are

212 audited to meet international standards. Highlights of the Year 2010–2011 Staff Cardiovascular research is the high point of depart- mental research expertise and activity. It spans Head of Department topics from membrane and vascular physiology Mohan B. Dikshit, Associate Professor to genetics and clinical research. Two strategic re- Faculty search projects on the genetics and epidemiology Mohammed Hassan, Professor of hypertension, and metabolic syndrome and life- Sulayma Al-Barwani, Associate Professor style interventions are underway. Both projects Abdul A. Khan, Assistant Professor receive SQU His Majesty’s Research Trust funds as Khamis Al-Hashmi, Assistant Professor well as National Institutes of Health grants. Sami Al-Rawas, Consultant Apart from the addition of new diagnostic proce- Mohammed Al-Abri, Consultant dures, the number of existing clinical tests has in- Hajer Al-Rujeibi, Senior Registrar creased in all specialties, with some having shown Deepali Jaju, Senior Registrar a substantial increase. Medical research has also Amira Al-Kharusi, Clinical Lecturer (left for higher increased and results from various projects have training leave) been published. Support Staff Adila Al-Tooqi, Acting Superintendent (CPH) Mariam Al-Hooti, Senior Technologist Teaching Programmes Susan Al-Nabhani, Senior Technologist UNDERGRADUATE PRECLINI- Hajer Ba Omar, Research Assistant Sultan Al-Siyabi, Research Assistant CAL PROGRAMME Isehaq Hussaini, Biomedical Scientist The Department of Physiology offers one depart-

Farid Al-Dhuhli, Biomedical Scientist mental course and makes major contributions to departments

Jessy George, Coordinator system-based courses in: Early development Tis- Iluminada Calupig, Coordinator sues and Integuments; Alimentary System; Respi- care ratory System; Cardiovascular System; Urinary Sys- tem; Nervous System & Special Senses; Endocrine In addition, there are 25 technicians (of which 15 are & Reproductive System; Applied Medical Sciences.

Omanis) in the support staff team working in the Each of these courses has approximately 140 stu- patient sections of Cardiology, Pulmonology, and Neuro- dents. The Department also teaches the following

physiology, and in the Sleep Disorders laboratories. and

courses in the Nursing degree programme: Anato- my & Physiology courses I & II and Pathophysiol- academic Physiology 213 Annual Report 2010-2011 Physiology

ogy for Nursing. The Applied Medical Science course is a problem-based course shared with the departments of Anatomy and Biochemistry.

The old teaching curriculum has now been almost completely replaced with the new curriculum. The first cohort of students in the new curriculum has now progressed to phase III (Clinical phase). The Department has contributed extensively to the development and delivery of various systems modules which have been incorporated into the new curriculum. Seven academic staff of the department are now involved as module coordinators in the new curriculum.

Most of the above courses have relevant clinical applications. Case presentations and the appropriate clinical procedures are taught to the students during these courses and elaborated upon during the clinical years. Students are evaluated in their theoretical and practical components as well as in their basic clinical skills.

UNDERGRADUATE CLINICAL PROGRAMME In the clinical program, the Department is heavily involved in the Integrated Lecture Series teaching in the Cardiovascular System; Alimentary System; Respiratory System; Family and Community Medicine courses as well as providing Clinical Physiology rotations for 5th and 7th year students of the MD program.

POSTGRADUATE TEACHING The Department contributes to the core programme of the Oman Medical Specialty Board (OMSB) and to the preparation of trainees for the Membership of the Royal College of Physiologists (MRCP) and Fellowship of the Royal College of Surgeons (FRCS) examinations. Clinical Physiology senior house officers spend one year rotating in two units of Medicine of their choice and one year training in clinical physiology before going abroad for further training and higher qualifications.

Training Courses & CME Activities Regular in-house training is conducted for newly recruited technicians. As a part of this course, the techni- cians attend the Anatomy & Physiology course for nursing students. Continuing medical education sessions are held on a monthly basis. Support staff members are all actively involved in the training, teaching and research activities of the Department in both College and Hospital programmes. Cardiology technicians of the department have been accepted for specialised training courses at Texas Heart Institute under a memo- randum of understanding between SQU and THI. The first batch of technicians is expected to proceed to the USA for this training from the start of the academic year 2011-2012.

214 Clinical & Diagnostic Services The Department of Clinical Physiology offer its diagnostic services which cover most of the spectrum of neu- rophysiology, cardiology, pulmonology, sleep medicine and other discrete tests. All CPH diagnostic services, along with the newly added sleep laboratory, cardiac catheterization laboratory and the screening of new borns for hearing deficiencies, are fully functional to date.

The total number of patients attending Clinical Physiology clinics in 2011 was 21,592. This is 12% more than last year (18,789). The monthly distribution of procedures is shown in Figure 1. Maximum patient attendance was in May followed by January and April.

Cardiology showed the largest number of procedures (11,532), followed by neurology (8,230) and pulmonary function tests (1,829) [Figure 2]. CPH Procedures maximally attended were non-invasive cardiology (5,768), invasive cardiology (1,208), skin tests (804), audiometry and new born screening (4,269), polysomnography (578) and ECHO (4,556). Out of the total procedures (21,592) during the year 2011, outpatients were 10,375 (18% more compared to 2010) and inpatients were 8054 (12% more compared to 2010). A total of 3,142 patients were referred from non-governmental hospitals (4% more compared to 2010) and private practitioners

This increase was managed due to the efficient continuation of available services and improved patient scheduling. Figure 3 depicts the total number of patients investigated in CPH in each section since 2009. There has been significant and consistent increase in number of patients investigated in CPH in all sections.

2500 2096 2071 2063 2067 2007 2000 1740 1725 1837 1660 1552

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Figure 1: Patients attending the Department of Clinical Physiology in the year 2011 academic Physiology 215 Annual Report 2010-2011 Physiology

1200 Pulmonary Cardiology Neurology

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Figure 2: Types and number of procedures in the Department of Clinical Physiology in 2011

2009 12000 2010 11532

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Figure 3: Total number of patients by section 2009 to 2011.

216 Research RESEARCH PROJECTS The impacts on structural and functional characteristics of blood vessels in dyslipidaemic patients; a randomized clinical trail comparing Simvastatin alone versus Simvastatin plus Ezetimibe. Project Code: IG/MED/PHYS/10/01; Dates: 2010–2011 Value: OR 16,250; Project Funder: Sultan Qaboos University Investigators: Dr. Khamis Al-Hashmi, Dept. Physiology, SQU; Dr. Mohammed Al-Abri, Dept. Clinical Physiology, SQU; Dr. Deepali Jaju, Dept. Clinical Physiology, SQU; Dr. Omar Al-Rawas, Dept. Medicine, SQU; Prof. Mohammed Hassan, Dept. Physiology, SQU.

Assessment of the beneficial effect of gum Arabic with or without treadmill exercise in experimental osteoporosis in rats: Comparison with the standard drug residronate Project Code: IG/MED/PHYS/10/02; Dates: 2010–2011 Value: OR 19,000; Project Funder: Sultan Qaboos University Investigators: Late Dr. Amal Ziada, Dept. of Clinical Physiology, SQU; Prof. Badreldin Ali, Dept. of Pharmacology & Clinical Pharmacy, SQU; Dr. Haddia Berehi, Dept. Radiology & Molecular Imaging, Medical Physics Unit, SQU. Ms Maymouna Al-Rawahi, Dept. Human & Clinical Anatomy, SQU.

Estimation of reference values for arterial stiffness indices in normotensive adult subjects and assess- ment of lifestyle effect Project Code: IG/MED/PHYS/10/03; Dates: 2010–2011

Value: OR 2,000; Project Funder: Sultan Qaboos University departments

Investigators: Prof. Mohammed Hassan, Dept. Physiology, SQU; Dr. Khamis Al-Hashmi, Dept. of Physiology, SQU. care

An investigation into lethal ischaemia / reperfusion injury and anti-apoptotic therapies (caspase inhibi- tors) in the human myocardium patient Project Code: IG/MED/PHYS/10/04; Dates: 2010–2011

Value: OR 14,600; Project Funder: Sultan Qaboos University and

Investigators: Dr. Hajar Al-Rajaibi, Dept. Clinical Physiology, SQU; Dr Hilal Al-Sabti, Dept. Surgery, SQU; Dr Sulayma Al-Barwani, Dept. Physiology, SQU; Ms Kamla Al-Maawali, Dept. Pathology, SQU. academic Physiology 217 Annual Report 2010-2011 Physiology

Interaction between ageing and exercise training in the regulation of coronary vascular tone: Role of intracellular calcium signaling and BKCa channels Project Code: IG/MED/PHYS/11/01; Dates: 2011–2013 Value: OR 16,000; Project Funder: Sultan Qaboos University Investigators: Dr. Sulayma Al-Barwani, Dept. Physiology, SQU; Prof. Mohammed Has- san, Dept. Physiology SQU; Ph.D. student, Dept. Physiology, SQU; Ms. Hajer Ba-Omar, Dept. Physiology ,SQU. Mr. Sultan Al-Siyabi, Dept. Physiology ,SQU.

Effect of 10 Weeks Lisinopril Administration on EDHF-Mediated Relaxation on Mesenteric Arteries of Spontaneously Hypertensive Rats Project Code: MREC #314; Dates: 2010–2011 Value: OR 600; Project Funder: Sultan Qaboos University Investigators: Dr. Sulayma Al-Barwani, Dept. Physiology, SQU.

Obstructive sleep apnea: Its prevalence and pathophysiology in patient with acute coronary syndrome Project Code: MREC #380 Dates: 2010 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. Mohammed Al Abri, Dept. Clinical Physiology, SQUH.

Correlation between Exercise Tolerance Test (ETT), Myocardial Perfusion Imaging (MOI) and Coronary Angiography (CAG) at SQUH Project Code: MREC #441; Dates: 2011 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. Khamis Al-Hashmi, Dept. Physiology, SQU.

Assessment of Autonomic Neuropathy in Omani patients with type II Diabetes Mellitus Project Code: MREC #466; Dates: 2011 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. Sami Al- Rawas, Dept. Physiology, SQU.

218 CPAP Compliance for randomized OSAHS patients Project Code: MREC #469; Dates: 2011 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. Mohammed Al-Abri, Dept. Physiology, SQU. RESEARCH PUBLICATIONS & BOOKS Journal Publications 1. Hassan MO, Aslani A, Bayoumi RA, Albarwani S, Al-Yahyaee S, Jaju D, et al Genome-wide linkage analysis of blood pressure and hemodynamic parameters under mental and physical stress in extended Omani arab pedigrees; The Oman Family Study. Twin Res Hum Genet 2011; 14:257-67. 2. Albarwani S, Al-Siyabi, S, Baomar H, Hassan MO. Exercise training attenuates ageing-Induced BKCa channel down- regulation in rat coronary arteries. Exper Physiol 2010; 95:746-55. 3. Al-Abri MA, Al-Hashmi KM, Jaju D, Al-Rawas OA, Al-Riyami BM, Hassan MO. Gender difference in relationship of apnoea/hypopnoea index with body mass index and age in Omani population. Sultan Qaboos University Med J 2011; 11:363-8. 4. Albarwani SA, Tanira O. A Call for a Quiet Debate on the Future of Genetic Research. Oman Med J 2011; 26:153-4. 5. Jaju DS, Dikshit MB, Balaji Jothi, Jyoji G, Rizvi S, Al Rawas O. Effects of Pranayam breathing on respiratory pressures and sympathovagal balance of patients with chronic airflow limitation and in normal subjects. Sultan Qaboos Uni- versity Med J 2011; 11:221-9. 6. Parthasaraty HK, Alhashmi K, McMahon AD, Struthers AD, McInnes GT, Ford I, et al. Does the ratio of serum aldoste- rone to plasma renin activity predict the efficiency of diuretics in hypertension? Results of RENALDO. J Hypertens 2010; 28:170-7. 7. Albarwani S, Jaju DS, Al-Yahyaee S, Bayoumi RA, Lopez Alvaranga JC, Commuzie AG, Hassan MO. Cardiovascular re- activity to mental and physical stress in offspring of hypertensive parents from large Omani Arab families. Abstract FASEB J 2011; 25:1099.4. departments 8. Hassan MO, Albarwani S, Al Yahyee S, Jaju D, Lopez-Alvarenga JC, Commuzie AG, Bayoumi R. Mental Stress Exposed Novel Quantitative Trait Loci for Haemodynamics in Large Arabs Pedigrees. of “Oman Family Study”. Abstract. FASEB

J 2011; 25:1099.3. care

9. Al-Husseini AS, Albarwani S, Badreldin HA, Tanira MO. The effect of 28 days administration of betaine on blood pres- sure and arteriolar contractility in normal and spontaneously hypertensive rats. Abstract. FASEB J 2010; 24:786.23. patient

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academic Physiology 219 Annual Report 2010-2011 Physiology

CONFERENCE & SEMINAR PRESENTATIONS Conference Presentations International 1. Hassan MO, Albarwani S, Al Yahyee S, Juan C Lopez-Alvarenga, Antony G Commuzie, Bayoumi R. Mental Stress and sleep expose novel quantitative trait loci for haemodynamics in large Arab pedigrees of “Oman Family Study”. Ex- perimental Biology. Washington DC, USA, April 2011. 2. Hassan MO, Albarwani S, Al Yahyee S, Al–Haddabi S, Comuzzie AG, Bayoumi R. Sharing genetic results of large Arab pedigrees achievements and challenges. UCLA Center for Society and Genetics. Denver, USA, 22-25 July 2010. 3. Hassan MO. Recent Advances in Sleep and Respiratory Medicine. 2nd Regional Conference on Sleep & Respiratory Medicine. Sharm el Sheikh, Egypt, 12-14 October 2010. 4. Al-Hashmi K, Jaju D, Al-Abri M, Albarwani S, Bayoumi R, Al-Yahyaee S, Hassan MO. Ambulatory arterial stiffness index in pre-diabetic and normoglycaemic subjects of “Oman Family Study”. 4th International Congress Pre-diabetic and Metabolic syndrome. Madrid, Spain, 14-17 April 2011. 5. Jaju DS, Albarwani S, Al Abri M, Al Hashmi K, Bayoumi R, Al Yahyee S, Hassan M. Young obese subjects do not react differently to mental stress than lean ones: Oman Family Study (OFS). The Obesity Society 2010 Annual Scientific Meeting. San Diego, California, USA, 8-12 October 2010. Poster Presentations International 1. Al-Abri M, Al-Hamhami A, Al-Nabhani H, Al-Zakwani I. Validity of the Arabic Epworth Sleepiness Scale (ESS) in Omani Population. Associated Professional Sleep Societies Meeting (APSSM 2010).San Antonio, TX, USA, 5-9th June 2010. 2. Al-Hooti M, Al-Abri M. Continue positive airway pressure usage and compliance among Omani sleep apnea pa- tients. Associated Professional Sleep Societies Meeting (APSSM 2010).San Antonio, TX, USA, 5-9th June 2010.

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academic Physiology 221 Annual Report 2010-2011 Physiotherapy

Physiotherapy

he Department covers three different disciplines: physiotherapy, occupational therapy, and speech and language therapy. Physiotherapy views human movement as central to the health and well-being of individuals. Physiotherapists identify and maximise movement potential through health promotion, preventive healthcare, treatment and rehabilitation. Occupational Ttherapy helps clients who have orthopaedic, neurological and psychiatric handicaps in their daily living to live a normal life. Surgical and chronically ill patients can also benefit from it. Speech and language therapy is concerned with improving clients’ communica- tion skills.

Physiotherapy Services cover in-patients, outpatients, Emergency and Day Care patients. They are available seven days a week in all the hospital wards including cardio-rehabilitation. Treatment modalities include electrotherapy, manual therapy, hydrotherapy, acu- puncture, reflexology, neuro-rehabilitation, respiratory, paediatric rehabilitation, cupping, women’s health, (pre- and postnatal, and female urinary incontinence), sports injury, public health education and splinting. Physiotherapists are involved in clinical teaching of physiotherapy and medical students.

Occupational Therapy (OT) services include home modifications, adaptive devices, splinting, and help to improve oral motility, cogni- tive skills and to overcome learning disabilities. Adaptive devices are advised or provided to compensate any disability and improve

222 their functional ability. OT aims to enable clients to Therapists reach their maximum level of functional indepen- Saif Al-Riyami, Deputy Head dence in all their activities of daily living (ADL) so as Kauther Al-Busaidi, Senior Chief Physiotherapist B to enable them to become independent members Omar Al-Tamimi, Chief Physiotherapist B of society. In paediatrics, problems such as posture Nasser Al-Hajri, Chief Physiotherapist B (proper seating), mobility (wheelchair and mobility Said Al-Balushi, Chief Physiotherapist B devices), activities of daily living (adaptive devices), Zuwaina Al-Bahri, Senior Physiotherapist deformities (splinting), hyperactivity and sensory Ahlaam Al-Mazrui, Senior Physiotherapist concentration and coordination integration dys- Hilal Al-Rashdi, Senior Physiotherapist function and dysphagia (feeding and eating trou- Najma Al-Mahruqi, Senior Physiotherapist bles) are tackled to bring the child’s development Huda Al-Saadi, Senior Physiotherapist to as normal a level as possible. Treatment includes Moza Al-Amri, Senior Physiotherapist family counselling and home programmes. Sabah Al-Touqi, Senior Physiotherapist Safiya Al-Hashmi, Senior Physiotherapist Speech and Language Therapy services provide as- Aisha Al-Talei, Physiotherapist sessments, management and treatment for a wide Madiha Al-Kindi, Senior Physiotherapist range of cases related to hearing impairment; cog- Hasna Al-Rashdy, Senior Physiotherapist nitive, or other developmental delays; birth defects Shaima Al-Saidi, Physiotherapist such as cleft lip and/or palate; motor planning Hammad Al- Subhi, Physiotherapist problems; dysphagia; traumatic brain injury; neuro- Mahmoud Al-Hinai, Physiotherapist logical problems affecting communication, or voice Inas I. Ali, Physiotherapist disorders. In addition, speech and language thera- Halima Al-Mahrooqi, Physiotherapist pists supervise speech and language therapy stu- Hilal Al-Balushi, Physiotherapist dents during their training in SQUH. Furthermore, Fathiya Al-Harthy, Physiotherapist great efforts are made to educate other profession- Mohamed Al-Shamli, Physiotherapist als (e.g., physicians, dieticians and nurses) about Mohamed Al-Hinai, Physiotherapist

speech and language therapy. We also receive other departments

Kamla Al-Qasmi, Physiotherapist trainee medical students and educate them on the Sumaiya Al-Mahrizi, Physiotherapist role of speech and language therapists. Said Al-Yaarobi, Physiotherapist care Senthikumar Ravindran, Physiotherapist Basma Al-Araimi, Occupational Therapist Staff Ibtisam Al-Wardi, Speech & Language Therapist patient

Fathiya Al-Amri, Speech & Language Therapist Head of Department and

Suleiman Al-Alawi academic Physiotherapy 223 Annual Report 2010-2011 Physiotherapy

Support Staff Laureana P. Valderama, Coordinator Fathiya Al-Akhzami, Receptionist Hamood Al-Amri, Messenger Highlights of the Year 2010–2011 The Department was able to provide pre- and post cardio-rehabilitation to both in and outpatients.

The Speech and Language Therapy service was focused on both adult and pediatric patients (both in- and outpatients) who presented with hearing impairments; cognitive, or other developmental delays; motor planning problems; dysphagia; traumatic brain injury; neurological problems affecting communication or voice disorders. Caregivers also received training as necessary. A variety of therapeutic techniques are em- ployed, including speech and language stimulation, voice exercises e.g., Lee Silverman Voice Treatment (LSVT program) and dysphagia management. In addition, the speech and language therapist supervised newly graduated speech and language therapists during their training in SQUH. Furthermore, great efforts were made to educate other professionals (e.g. physicians, dieticians and nurses) about the speech and language therapist’s role by providing an introduction to the profession, making brochures and handouts and organis- ing a workshop on dysphagia. A child development progress clinic is run in the hospital by a team consisting of a speech therapist, an occupational therapist and a paediatrician.

Occupational therapy services focused both paediatric and adult cases with physical, cognitive and sensory issues as well as splinting. The oral motor programme is the most important aspect of treatment for neo- nates having sucking difficulties and children with feeding and eating problems. An introduction to occu- pational therapy was provided to medical, nursing, physiotherapy, dieticians, education and speech and lan- guage therapy students.

The Department provided physiotherapy services to the 2nd Asian Beach Games held in Muscat in 2010, and the GCC Universities Games. It also regularly provides services to the Oman Football Association. The Depart- ment published a Rehabilitation Newsletter in both April and October. The Department held its annual Reha- bilitation Day with the theme Sports Injuries. This year it was done over five days with activities in different areas: lectures on the prevention of sports injuries to SQU athletes at SQU Conference Hall, at Sultan Qaboos Sports Complex in Bowsher, and at Seeb Sports Stadium, then distribution of leaflets at Qurum beach, a pre- sentation to school children, and a workshop done in Physiotherapy Department at SQUH.

Departmental staff attended various national and international conferences, courses and workshops. Three international conferences were attended: 16th International Congress of the World Confederation for Physi- cal Therapy in Amsterdam; Laryngectomy, Rehabilitation and Surgical Voice Restoration at Imperial College, London, UK, and 3rd Physical Medicine Symposium - Global Osteopathic Approach, Egypt. Staff attended

224 courses on: Spinal, Pelvic & Scapular Stabilisation; Spring Board; Cardiac Rehabilitation; Emotional Intelli- gence, and workshops on Medical Error Disclosure; Key Performance Indicators; Dysphagia; 4th Clinical Au- dit; Management of Common Musculoskeletal Disorders; Analysing the Training & Evaluating the Training Outcome; Problem Solving and Decision Making, and Clinical Hands-on Treatment in Neurodevelopment Therapy in India.

Teaching Programmes UNDERGRADUATE CLINICAL PROGRAMME Physiotherapists teach physiotherapy students in the Institute of Health Sciences twice a week. The Depart- ment is involved in clinical teaching, practical hands-on training, and in supervising of students and interns from both inside and outside Oman. This ranges from undergraduates in physiotherapy, speech therapy and occupational therapy to qualified doctors. In 2011, 45 students from the Institute of Health Sciences in Muscat had an 8 week full-time clinical placement, three Omani physiotherapists had 3 month internships and one student from Australia had a one week placement. Tutorial sessions were provided on Introduction to Joint Assessment and Alternative Medicine for 5th year medical students; Locomotors Skills for 4th year medical students, and teaching sessions for trainee dieticians. Six students from the College of Education, SQU, took part in clinical observations in physiotherapy, occupational therapy and speech therapy for two weeks in each area.

POSTGRADUATE PROGRAMME One physiotherapist from the Royal Court Affairs is still on attachment with us.

Training & CME Activities

On a rotation basis, each therapist conducts in-service lectures and speaks at the journal club. We also invite departments visitors, i.e. doctors, nurses and other paramedics, to give lectures. Therapists write articles for the bi-annual Physiotherapy Newsletter on a rotation basis. Articles included in the October and April issue were: Review care of Evidence on Mobility and Exercise Therapy Effect on Back Pain; Sacroiliac Joint Dysfunction; Spondylosis/ Osteoarthritis of the Cervical Spine; Physiotherapy Management of Total Hip Replacement; A Systematic Review of Closed Kinetic Chain Exercises versus Open Kinetic Chain Exercises and its Importance in Reha- patient

bilitation of Post Anterior Cruciate Ligament Repair Patients, and Related Back Pain Issues in School Children. Therapists also conduct a weekly lifting and handling lecture for nurses, paramedics, medical orderlies and and other hospital staff. Therapists gave lectures to doctors and nurses in Purple 4 Ward on -evidence-based phys- iotherapy in the intensive care unit. academic Physiotherapy 225 Annual Report 2010-2011 Physiotherapy

For its own staff, the Department conducted a three day course on Clinical Reasoning in December 2010; three topics were covered: understanding the factors that influence decision making in practice; recognising the different models of clinical reasoning used in healthcare; the application of a range reflective and meta- cognitive tools for the development of critical evaluation and clinical reasoning skills. A one day workshop on Medical Taping was held in March 2011.

The Department also ran a weekly in-service training session for its own staff as well as other Sultan Qaboos University Hospital (SQUH) staff including nurses. The topics covered were: physiotherapy and postpartum physiotherapy; knee joint athroplasty; cervical spondylosis and osteoarthritis of the spine, dry needling, sensory integration disease in children; the basis of massage is touch; dysphagia in adults; neuro mobilisa- tion; obstetric brachial plexus injury - physiotherapy management; women’s health; brain aneurysm; groin pain; strengthening exercises for treating low back pain; lifting techniques; evaluating a clinical research paper; lifting techniques – practical; how to read a chest X-ray; homeopathy for autistic children; mechanical ventilation implications for physiotherapy; stroke rehabilitation; plantar fasciitis; incontinence in females; cardiac tumours; strengthening exercises in children with cerebral palsy; mobilisation after hip fracture; physiotherapy management after total hip replacement; physiotherapy approach in transverse millets; head injury, and work stress.

Lectures were given in the Training Directorate programme on Other Modalities of Pain Management, and the Department participated in the Clinical Methods Course and the Interdisciplinary Activity Week in col- laboration with the College of Medicine & Health Sciences.

Clinical Services Table 1: Patient statistics 2011 Service Total no. of Patients No. of new Patients Physiotherapy 13,775 5,032 Occupational Therapy 498 196 Speech & Language Therapy 717 400

226 Research CONFERENCE & SEMINAR PRESENTATIONS Conference Presentations International 1. Al-Busaidi K. The Prevalence of Urinary Incontinence in Women in Oman. 16th International Congress of the World Confederation for Physical Therapy. Amsterdam, Netherlands, 20 June 2011. Seminar Presentations National 1. Al-Hajry N. Dry Needling. 1st Physiotherapy & Neurological Rehabilitation Conference. Buraimi Hospital, Oman, 11 November 2010. 2. Al-Riyami S, Back Pain. Physiotherapy Symposium 2011. Nizwa Hospital, Oman, 28 April 2011. 3. Al-Tamimi O. The Benefit of Early Physiotherapy Management of Back Pain. Physiotherapy Symposium 2011. Nizwa Hospital, Oman, 28 April 2011. 4. Al-Riyami S, Al-Hajry N, Al-Balushi S, Al-Tamimi O. Shoulder Management, Physiotherapy Workshop. Physiother- apy Dept., SQUH, Oman, 9 March 2011. departments

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academic Physiotherapy 227 Annual Report 2010-2011 Radiology & Molecular Imaging

Radiology & Molecular Imaging

he Department offers specialised diagnostic services which include Magnetic Resonance Imaging (MRI), Digital Subtraction Angiography (DSA), Nuclear Medicine (NM), Computed Tomography (CT), Ultrasound (US) and Medical Physics (Calibration of TRadiation Equipment, Research, etc.) as well as routine Radiological Imaging. The Department became fully digitised in May 2002 after installation of a complete PACS (Picture and Archiving Communication Sys- tem). Radiological examinations can be viewed by all doctors from any computer outlet at SQUH on an internal web system together with the radiological report. The old PACS/RIS system was replaced with a new system - Philips PACS/RIS: iSite/XIRIS - in May 2011. The new system has improved functionality, storage and accessibility compared to the previous system. The most notable features are: integration with the hospital information system (HIS) - MedTrack, a modern web base archiving system which ensures availability of all studies 24 hours a day.

The clinical services offered by the Department are increasing rapidly with the expansion of the clinical services in the Hospital. We are currently performing 86,500 studies a year in the Radiology & Nuclear Medicine Section alone and the number is rapidly rising. This does not include the services offered by the Medical Physics Section which performs 19,000 tests for various departments and colleges of SQU as well as the community at large. The Medical Physics services include TLD Radiation Protection for many insti-

228 tutions in Oman, as well as teaching and checking Nader Atari, Associate Professor radio-activity in other places. Nuclear Medicine Ranjan William, Assistant Professor Services, besides the Diagnostic Services, also deliv- Humoud Al-Dhuhli, Senior Consultant ers four therapeutic procedures mainly radioiodine Rashid Al-Sukaiti, Consultant therapy for thyroid cancer and hyper-thyroidism. Anupam Kakaria, Senior Registrar Sinan Al-Azawi, Senior Registrar Research, teaching and training at both undergrad- Technical Staff uate and postgraduate level involve all 13 members Mohammed El-Gindy, Departmental Superinten- of faculty, from both college and hospital staff, dent who are also involved in the training of radiogra- Per Rude, Deputy Superintendent, Senior Chief phers. Radiology technicians are also involved in Radiographer (A) the teaching of radiographers from the Institute of Bernardo Ramos, Chief Technologist (A) Health Sciences. We have been successful as a De- Salvador De Vera, Chief Technologist (A) partment in sending our young Omani technolo- Virginia Ablen, Chief Technologist (A) gists abroad to get university degrees. The teach- Antonio Velarde, Chief Technologist (A) ing and training of Oman Medical Specialty Board Merlie Vanderlipe, Chief Technologist (A) (OMSB) radiology residents started in 2005. We Editha San Diego, Chief Technologist (B) have now trained 32 residents10 of whom gradu- Manuel Gaerlan, Chief Technologist (B) ated this year as radiology specialists. In addition, Meda Bersaba, Senior Technologist (A) we train about 20 residents a year from other clini- Ahmed Abdou, Senior Technologist (A) cal services who rotate through the Department. Mohammed Al-Abri, Senior Technologist (B) We are also actively involved in teaching of medical Abdullah Al-Siyabi, Senior Technologist (A) students (4th, 5th, 6th and 7th year in old and new Adnan Al-Kharousi, Senior Technologist (A) curricula as detailed below). Matheo Dilao, Senior Technologist (B) Mahmood Al-Abri, Senior Technologist (B) Faiza Al-Salmi, Senior Technologist (A)

Umaima Al-Ajmi, Senior Technologist (A) departments Staff Aziza Al-Jabri, Senior Technologist (A) Head of Department Mohammed Al-Saqri, Senior Technologist (B) care Prof. Lamk Lamki, Professor Nabila Al-Hesani, Senior Technologist (B) Faculty Ahmed Al-Shuhaimi, Senior Technologist (B) Faisal Al-Azri, Deputy Head, Consultant Sultan Al-Naamani, Senior Technologist (B) patient Dilip Sankhla, Senior Consultant Hamoud Al Ghafri, Senior Technologist (B) Samir Hussein, Senior Consultant Aida Al-Rahbi, Technologist (A) and Sukhpal Sawhney, Senior Consultant Rania El Tigani, Senior Technologist (B) Haddia Bererhi, Senior Consultant Hanan Al-Qassabi, Technologist (A) academic Radiology & Molecular Imaging 229 Annual Report 2010-2011 Radiology & Molecular Imaging

Khitam Al-Hijri, Technologist (A) Sonya Dominic, Radiology Nurse Ruqaya Al-Rawahi, Senior Technologist (B) Aleyamma Lalu, Radiology Nurse Lubna Al-Esry, Technologist (A) Administrative and Clerical Staff Mathew George, Technologist (A) Rhodora Campo, Coordinator Kalthoom Al-Shesawi, Technologist (A) Laddie Lara, Coordinator Victor Arulnathan, Technologist (A) Jeraldine Arante, Coordinator Kuriakose KP, Technologist (A) Sharifa Moh’d Al-Tobi, IT & Network Support Unnikrishnan Nair, Technologist (A) Mohammed Al-Farai, Clerk Wesley Asirvatham, Senior Technologist (A) Khamis Al-Farsi, Clerk Luz Solo-Esguerra, Senior Technologist (B) Ahmed Al-Badawi, Clerk Joji Mathew, Technologist (A) Sultan Al-Busaidi, Medical Orderly Ahmed Al-Anqoodi, Technologist (B) Mohammed Al-Subhi, Coordinator Faisal Al-Ghusaini, Technologist (B) Shurooq Al-Alawi, Technologist (A) Lourdes Hernandez, Technologist (A) Highlights of the Year Paul Martinez, Technologist (A) Arthur De Guzman, Chief Technologist (B) 2010-2011 Marievic De Guzman, Senior Technologist (A) We have started developing sections in our Depart- Lovella Parfina, Senior Technologist (B) ment to better serve our patients and Clinical Staff, Thomas Jefferson B., Senior Technologist (B) and also develop research in those fields. Those re- Ravichandran V. K., Senior Technologist (B) sponsible for the sections are as follows: David Devaraj, Technologist (A) Moath Al-Jabri, Technologist (B) Alya Al-Julandani, Technologist (B) Teaching Programmes Nawal Al-Kharusi, Senior Technologist (B) UNDERGRADUATE Dalal Al-Shabibi, Technologist (A) Rabiya Al-Mahrouqi, Senior Technologist (B) PRECLINICAL PROGRAMME Amaal Al-Rasbi, Biomedical Scientist The Department teaches more than 100 4th stu- Ibtissam Al-Maskery, Biomedical Scientist dents in the Integrated Lecture Series (ILS) Anatomy Hilal Al-Zeheimi, Biomedical Scientist Lecture Series in coordination with the Anatomy Department. There is also a Clinical Skills Exam Radiology Nurses with over 100 students. Warda Sajjad Al-Lawati, Radiology Nurse Bindu V.P., Radiology Nurse The Department teaches about forty 5th year stu- Kunnappillil Ranipol, Radiology Nurse dents in the ILS on the following topics: Respiratory Marichu Lorica, Radiology Nurse System; Cardiovascular System; Gastro-Intestinal Bini Prathapan, Radiology Nurse System; Neurology; Infectious Disease, and Uro/Ne- Lenny Netto, Radiology Nurse phrology.

230 Section Section Chief Deputy Chief Neuro-Radiology Dr. Faisal Al-Azri Interventional Dr. Rashid Al-Sukaiti Body Imaging Dr. Humoud Al-Dhuhli Dr. Rashid Al-Sukaiti Emergency Radiology & General Dr. Rashid Al-Sukaiti Dr. Sinan Al-Azawi Pediatrics Dr. Dilip Sankhla Mammography Dr. Sukhpal Sawhney Dr. Anupam Kakaria Nuclear Medicine Dr. Samir Hussein Dr. Haddia Bererhi Medical Physics Dr. Haddia Bererhi Dr. Nader Atari

UNDERGRADUATE CLINICAL PROGRAMME Approximately 180 students in the 6th Year rotate through the Department in groups of 6 to 7 students per group every two weeks. In the 7th year there are approximately 30 students and they also receive an Obstet- rics & Gynaecology lecture.

POSTGRADUATE PROGRAMME The Department is involved in the training of 37 OMSB radiology residents. Groups of 5-7 residents rotate through the Radiology Department for a 4 week rotation.

Clinical & Diagnostic Services Table 1: Examination Workload 2011 departments

Services Total care

General X-Ray (Plain X-Ray & IVU) 44,692 Special Procedures (Fluoro Guided Procedures) 958 Ultrasound (Incl. US guided Intervention) 17,081 patient

CT Scanning (Incl. CT guided Intervention) 11371 and Vascular & Intervention (Including OR Procedures) 820 Nuclear Medicine 2,883 Bone Densitometry 873 academic Radiology & Molecular Imaging 231 Annual Report 2010-2011 Radiology & Molecular Imaging

MR Scanning 3,828 Mammography 614 Oral Health 2454 Lithotripsy 166 Total 85,740 Research RESEARCH PROJECTS Safety profile and therapeutic use of back ink from Omani fishes in two experimental models of osteopo- rosis in rats Project Code: IG/MED/RADI/09/01; Dates: 2009-2011 Value: OR 9,000; Project Funder: Sultan Qaboos University Investigators: Dr. Haddia Berehi, Dept. Medical Physics, SQU; Prof. Badreldin Ali, Dept. Pharmacology & Clinical Pharmacy, SQU; Dr. Kamran Malik, Dept. Surgery, SQU; Dr. Khaled Malgat, Dept. Chemistry, SQU; Dr Aisha Al-Hamadani, Dept. Pathology, SQU. RESEARCH PUBLICATIONS & BOOKS Books & Book Chapters 1. Atari NA. Radiobiology, Radiotherapy and Radiation Protection. Muscat: Sultan Qaboos University Press, 2010. Journal Publications 1. Balkhair A, Ahamed S, Sankhla D. Unmasking immune reconstitution inflammatory syndrome (IRIS): A report of five cases and review of literature. Sultan Qaboos University Med J 2011; 11:95-103. 2. Sankhla D. Hirschprung’s Disease Scientific Update Proceedings. Radiological findings of Hirschsprung’s disease. Abstract. Sultan Qaboos University Med J 2011; 11:143. 3. Al-Wahaibi K, Acquil S, Al Sukaiti R, Al Busaidi Q. Transplant renal artery false aneurysm: Case report and literature review. Oman Med J 2010; 25:306-10. 4. Al Sukaiti R, Stein L, Christou N, Mesurolle B. Imaging of small bowel obstruction following gastric bypass surgery for morbid obesity - Retrospective review. Sultan Qaboos University Med J 2010; 10:354-60. 5. AlSukaiti R, Robinson K, Menias C. Retrospective review of cross sectional imaging findings of pancreatic non func-

232 tional islet cell tumor (NFICT) and its hepatic metastases. Oman Med J 2010; 26:39-42 6. Al Farsi K, Al Hadabi I, Al Riyami N, Al Sukaiti R. Myelomatous pleural effusion: Case report and review of literature. Sultan Qaboos University Med J 2011; 1:259-64. 7. Al Ghafri A, Al Sukaiti R. Cystic pelvic lesions. Oman Med J 2011; 26:208-9 8. Al Kharusi L, Gowri V, Al Sukaiti R, Al Ghafri W, Rao K. Submyomatous cornual pregnany managed surgically after failed medical treatment. Sultan Qaboos University Med J 2011; 11:399-402. 9. Sallam MM, Ali M, Al Sukaiti R. Management of radial artery perforation complicating coronary intervention: a stepwise approach. J Interv Cardiol 2011; 24:401-6. 10. Al Sukaiti R, Ali M, Sallam M. Radial artery perforation after coronary intervention: is there a role for covered coro- nary stent. Catheter Cardiovasc Interv 2011; 78:632-5. CONFERENCE & SEMINAR PRESENTATIONS Conference Presentations National 1. Sankhla D. Imaging Hirschsprung’s Disease. Update on Hirschsprung’s Disease. Pediatric Surgery and GI Depts., Sultan Qaboos University and Royal Hospitals, and Oman Surgical Society. Muscat, Oman, 25 October 2010. Conference Posters International 1. Atari NA. High performance imaging system for characterization of radiotherapeutic beams in cancer radiothera- py”. Conference on Biomedical Imaging Science, Vanderbilt University, USA, 2-5 June 2011. 2. Atari NA. Recent advances in cancer radiotherapy. International Conference for Health care Professionals & Physi- cians. Alexandria, Egypt, 7-8 April 2010. National 1. Al Shabibi S, . Percutaneous Image-guided drainage of iliopsoas abscess: Midterm results. 1st OMSB An- Al Sukaiti R departments nual Research Day. Muscat, Oman, 27 September 2010. 2. Al Hadhrami S, Al Sulaimi J, Al Kindi D, Elshafie O,Hussein S, Al Zakwani A, et al. Osteoporosis and osteopenia are care

overdiagnosed in Oman. Our therapeutic strategies must be changed. Research Day. Department of Medicine, SQU, Oman, 2011. Seminar Presentations patient National

1. Sankhla D. Neuronal migrational disorder: Retrospective analysis. Radiology Club Day. ORMIS and OMSB, Sultan and

Qaboos University Hospital, Muscat, Oman. 27 October 2010. 2. Sukaiti R. Role of interventional radiology in traumatic solid organ injury. Khowla Hospital, Muscat, Oman, 18 Octo- ber 2010. academic Radiology & Molecular Imaging 233 Annual Report 2010-2011 Surgery

Surgery

he Department’s mission is to teach and train students and doctors, conduct research, and provide specialised clinical services Tand patient care.

234 Staff Naveed Khatib, Senior Registrar, (General) Suresh Kannan, Senior Registrar (General) Head of Department Syed Ali, Senior Registrar (General) Christopher Grant, Professor Sudesh Kumar, Senior Registrar (ENT) Faculty Khalid Rahman, Senior Registrar (Urology) Shahid Aquil, Senior Registrar (Urology) Hani Al-Qadhi, Consultant, Deputy HOD for Clinical Mirdavron Mukaddirov, Senior Registrar (Cardio- Affairs (Trauma) thoracic) Nayil Al-Kindy, Senior Consultant (General) Mohammed Siddiqi, Senior Registrar (Cardiotho- Norman Machado, Senior Consultant (General) racic) John Mathew, Senior Consultant (ENT) Paresh Kuba, Senior Registrar (Cardiothoracic) Rashid Al-Abri, Senior Consultant (ENT) Venkatesh G, Senior Registrar (Neurosurgery) Krishna Prasad, Senior Consultant (Urology) Intisar Al-Hashmi, Registrar (General Surgery) Qassim Al-Busaidi, Senior Consultant (Urology) Najib Draz, Registrar (General) Ashok Sharma, Senior Consultant (Cardiothoracic) Mohammed Al-Hosni, Registrar (General) Hilal Al-Sabti, Senior Consultant (Cardiothoracic) Mooayad Ahmed, Registrar (General) Rajeeva Pieris, Senior Consultant (Cardiothoracic) Sareyah Al-Sibai, Registrar (General) Tarek Alameddine, Senior Consultant (Cardiotho- Shahzad Younas, Registrar (General) racic) Zaid Raouf, Registrar (General) Sultan Al-Maskari, Senior Consultant (Orthopaedic) Wameed Al-Bassam, Registrar (ENT) Parkash Mandhan, Senior Consultant (Paediatric) Omar Sharef, Registrar (Urology) Rajeev Kariyattil, Senior Consultant (Neurosurgery) Ehab Rajab, Registrar (Cardiothoracic) Unnikrishnan M, Senior Consultant (Neurosurgery) Adham Said, Registrar (Orthopaedics) Khalifa Al-Wahaibi, Senior Consultant (Vascular) Ahmed Yaseen, Registrar (Orthopaedic) Adil Al-Ajmi, Consultant (General) Ayman Al-Amri, Registrar (Orthopaedic) Pradeep Chopra, Consultant (General) Madni AbdulAziz, Registrar (Orthopaedic) Sreedharan VK, Consultant (General) Mohammed Al-Mutani, Registrar (Orthopaedics) departments Mohammed Al-Hashmi, Consultant (Endocrine) Mohammed Toufique, Registrar (Paediatric) Abdullah Al-Harthy, Consultant (Trauma) Koshy Kochumen, Registrar (Neurosurgery) care

Deepa Bhargava, Consultant (ENT) Charles Okoro, Senior House Officer (General) Mohammed Okbi, Consultant (ENT) Ghassan Elshafie, Senior House Officer (General) Yahya Al-Badaai, Consultant (ENT) Laila Al-Masaoudi, Senior House Officer (ENT) Joseph Mathew, Consultant (Urology) patient

Nesrin Qader, Senior House Officer (ENT) Mohammed Al-Marhoon, Consultant (Urology) Shaza Idris, Senior House Officer (ENT)

Zainab Al-Balushi, Consultant (Paediatric) and

Wafaa Abdul Qader, Senior House Officer (Ortho- Kamran Malik, Senior Registrar, (General) paedic) Muhammad Baloch, Senior Registrar (General) academic Sugery 235 Annual Report 2010-2011 Surgery

Support Staff Balan Baskaran, Perfusionists Sayed Rizvi, Perfusionist Zainab Al-Hashmi, Perfusionist Saif M Al-Kharusi, Technician Badar Al-Mazidi, Technician Maria T Ablen, Coordinator Ruel Natividad, Coordinator Highlights of the Year 2010-2011 The Department hosted an international conference on Controversies in Breast Cancer at the Al Bustan Ho- tel, Muscat, Oman, from 12 to 14 February 2011. Dr. Adil Al-Ajmi, was the chief organiser. Nineteen eminent international surgical oncologists, pathologists and medical oncologists participated in the presentations.

Teaching Programmes UNDERGRADUATE CLINICAL PROGRAMME The Department participated in the teaching of the Clinical Methods and Communication Skills course for 4th year MD Students. In the 5th Year junior rotation, the Department catered for 86 students in 2010–2011. The students rotated in groups of 21–23, each group spending half of the 11-week rotation at Sultan Qaboos University Hospital (SQUH) and half at the Royal Hospital. In problem-based learning, the annual six-week clinical course on the gastrointestinal tract, liver and pancreas for 5th year students was organised by the Department. For the 6th year ENT rotation, the ENT Division, in collaboration with the ENT Department in Al Nahda Hospital, delivered the course for 82 students. The students rotated in groups of 11-12, spending 1 week each at SQUH and Al Nahda Hospital. For the 7th Year senior rotation, the Department received final year students in groups of 24–27 in rotation for seven week courses. Altogether, there were 129 students. The 7th year students had their Final MD examination in June 2011. The Department was also involved in the fol- lowing courses in Phase II of the new curriculum: the Locomotor System, Uro-Reproductive System and the Alimentary Module.

POSTGRADUATE PROGRAMME Internship A total of 64 interns undertook their surgical rotations in the Department in the year 2010–2011.

236 Oman Medical Speciality Board (OMSB) Residents For the OMSB Residency Programme, 28 residents undertook their rotations in general surgery in the Depart- ment in the academic year 2010–2011. A total of 19 weekly lectures for the senior residents and 15 weekly lectures for junior residents were delivered.

Training Courses & CME Activities Dr. Pradeep Chopra delivered a talk on Physiology of Wound Healing and which Dressing to choose at all five Wound Study Days for nurses in October and December 2010, and in May June and September 2011, all at SQUH.

Sixteen surgical trainees attended the annual two-day Basic Surgical Skills Course (BSSC) conducted by the Department in the Skills Laboratory, College of Medicine & Health Sciences, on 9 and 10 October 2010 and coordinated by Dr. Norman Machado. This was followed by a one-day course on Basic Endoscopy attended by 15 surgical residents on 11 October 2010.

The Department conducted a course on “Hirschsprung’s Disease” at SQUH on 25 October 2010 which was coordinated by Dr. Prakash Mandhan.

The Department hosted the Bariatric Surgery Workshop at SQUH on 19 and 20 March 2011.

Dr. Jon Krinstinsson from Oslo, Norway conducted the workshop.

Dr. Abdullah Al-Harthy conducted the Advanced Trauma Life Support (ATLS) Provider and Instructor course, held at the OMSB Simulation Centre, Muscat from 1 to 3 April 2011.

Dr. Deepa Bhargava delivered a talk on Evidence Based Protocol at the Evidence-Based Medicine Workshop held at OMSB in 2011. departments

care

patient

and

academic Sugery 237 Annual Report 2010-2011 Surgery

Clinical & Diagnostic Services

25,000 Outpatients Admissions Procedures 20,000

15,000

10,000

5,000

0 2010 2011 Outpatients 17,307 19,137 Admissions 4,372 4,956 3,339 3,812 Procedures Figure 1: Surgical Clinical Statistics for 2010 and 2011

Research RESEARCH PROJECTS The relationship of Helicobacter pylori infection with prostatic and bladder diseases Project Code: IG/MED/SURG/11/01; Dates: 2010-2012 Value: OR 16,.000; Project Funder: Sultan Qaboos University Investigators: Dr. Mohammed Al-Marhoon, Dept. Surgery (Urology); Dr. Allal Ouhtit, Dept. Genetics, SQU; Dr. Qassim Al-Busaidi, Dept. Surgery, Royal Hospital; Dr. Krishna Prasad, Dept. Surgery, SQU; Dr. Josephkunju Mathew, Dept. Surgery, SQU; Dr. Ibrahim Al-Haddabi, Dept. Pathology, SQU; Dr. Shyam Gan- guly, Dept. Family Medicine & Public Health, SQU.

238 Patterns of Care for Paediatric Appendectomy- Overview from University Hospital Project Code: MREC# 366; Dates: 2010 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. Prakash Mandhan, Dept. Surgery, SQU.

Splenectomy and/or Cholecystectomy for Omani Children with Sickle Cell Disease Project Code: MREC# 367; Dates: 2010 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. Prakash Mandhan, Dept. Surgery, SQU.

Three Hundred Sixty-Five Days of a Sub-Specialty in a University Hospital Project Code: MREC# 368; Dates: 2010 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. Prakash Mandhan, Dept. Surgery, SQU.

Routine Pre-Operative Blood Testing in Children undergoing Ambulatory Surgery: Is it Necessary? Project Code: MREC# 369; Dates: 2010 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. Prakash Mandhan, Dept. Surgery, SQU.

Laparoscopic Splenectomy: is it the ideal approach for sickle cell disease children Project Code: MREC# 396; Dates: 2011 Unfunded; Project Approval: Sultan Qaboos University

Value: departments

Investigator: Dr. Zainab Al-Balushi, Dept. Surgery, SQU. care Bactibilia and Surgical Site Infection after Laparoscopic Cholecystectomy Project Code: MREC# 429; Dates: 2011

Value: Unfunded; Project Approval: Sultan Qaboos University patient

Investigator: Dr. Kamran Malik, Dept. Surgery, SQU. and

academic Sugery 239 Annual Report 2010-2011 Surgery

Effectiveness in our Hands Project Code: MREC# 442; Dates: 2011 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. Shahzad Younes, Dept. Surgery, SQU.

Does Delay to operate a child with acute appendicitis affect the outcome - Experience from Sultanate of Oman Project Code: MREC# 459; Dates: 2011 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. Prakash Mandhan, Dept. Surgery, SQU.

Types and Trends of Hypospadias as seen in Sultanate of Oman Project Code: MREC# 460; Dates: 2011 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. Prakash Mandhan, Dept. Surgery, SQU.

Short term follow up clicky hips in newborns at Sultan Qaboos University Hospital Project Code: MREC# 462; Dates: 2011 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. Sultan Al-Maskari, Dept. Surgery, SQU.

The Incidence of clicky hips among newborn at Sultan Qaboos University Hospital Project Code: MREC# 463; Dates: 2011 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. Sultan Al-Maskari, Dept. Surgery, SQU.

Peri-operative blood transfusion in Total Knee Replacement (TKR) in patients among Omani population Project Code: MREC# 475; Dates: 2011 Value: Unfunded; Project Approval: Sultan Qaboos University Investigator: Dr. Sultan Al-Maskari, Dept. Surgery, SQU.

240 RESEARCH PUBLICATIONS & BOOKS Journal Publications 1. Kumar S, Gupta A. Submandibular gland hemangioma: Clinicopathological features and review of literature. ENT J 2010; 89:14-7. 2. Kumar S, Al-Abri R. Management of paediatric tracheobronchial foreign body aspiration. Oman Med J 2010; 24:4. 3. Kumar S, Mathew J, Al-Abri R, Osama A, Saparamadu P. Laryngeal mass: Clinical quiz. Oman Med J 2011; 4:293-4. 4. Al-Abri R, Kumar S, Chopra P, Saparamadu P. Schwannoma of cervical sympathetic chain: First case report from Oman. Sultan Qaboos University Med J 2011; 11:403–6. 5. Ahmed M, Subramanian S, Al-Hashmi I, Koliyadan S, Al-Kindi N, Saparamadu P. Bilateral elastofibroma dorsi. Sul- tan Qaboos University Med J 2011; 3:415-6. 6. Machado N, Chopra P, Al-Qadhi H, Al-Haddabi I. Large duodenal gastrointestinal stromal tumor presenting with acute bleeding managed by whipple resection: a review of surgical options and the prognostic indicators of out- come. J Pancreas 2011; 12:194-9. 7. Machado N. Biliary complications post laparoscopic cholecystectomy. Review of mechanism, preventive measures and management. Diagn Ther Endos 2011:967017. 8. Machado N. Thyroidectomy for massive goiter weighing more than 500 grams - Technical difficulties and approach, complications and management. Surg Sci 2011; 2:278-84. 9. Machado N, Machado L, Al-Ghafri W. Laparoscopic excision of a large ovarian cyst herniating into the inguinal ca- nal: A rare presentation. Surg Laparos Endos Percut Tech 2011; 21:215-8. 10. Machado N. Unusual contents of inguinal hernia. Surg Sci 2011; 2:322-5. 11. Machado N. Necrotizing fasciitis: The importance of early diagnosis, prompt surgical debridement and adjuvant therapy. N Am J Med Sci 2011; 3:107-18. 12. Machado N, Grant C, Sharma A, Al-Sabti H, Koliyadan S. Large posterior mediastinal retrosternal goiter managed by transcervical and lateral thorocotomy approach. Gen Thorac Cardiovasc Surg 2011; 57:471-8. departments

13. Machado N. Pancreatic metastasis from colon carcinoma treated with radiotheraphy with palliative benefit. J Pan- creas (JOP) 2010; 11:650.

14. Machado N, Al-Kindy N, Chopra P. Laparoscopic splenectomy using LigaSure. J Soc Laparoendos Surg (JSLS) 2010; care 14:547-52. 15. Al-Wahaibi K, Aquil S, Al-Sukaiti R, Al-Riyami, Al-Busaidi Q. Transplant renal artery false aneurysm: Case report and literature review. Oman Med J 2010; 25:306-10. patient 16. Al-Wahaibi K, Al-Azri F. Syncopal attacks and severe abdominal pain. Oman Med J 2010; 25:318-9.

17. , Mosbah A, Kamal M, Shokeir A. Incidental versus symptomatic renal tumors: Survival outcomes. and Al-Marhoon M Arab J Urol 2011; 9:17-21. 18. Al-Marhoon M. The role of biopsy in incidental renal tumors. Arab J Urol 2011; 9:11-5. academic Sugery 241 Annual Report 2010-2011 Surgery

19. Al-Marhoon M. Small incidental renal masses in adults: review of literature. Sultan Qaboos University Med J 2010; 10:196-202. 20. Mishra P, Bhakta P, Kumar S, Al-Abri R, Burad J. Accidental tracheal aspiration of an undiagnosed nasal foreign body. Emerg Med Australas 2011; 23:776-8. 21. Bhargava D, Bhargava K, Al-Abri A, Al-Bassam W, Al-Abri R. Non allergic rhinitis in Oman: prevalence, clinical profile and knowledge gaps in literature. Oman Med J 2011; 26:416-20. 22. Bhargava D, Al-Saidi Y, Bhargava K, Al-Abri R. Information mastery, effective health care, evidence-based practice and the otolaryngologist. Sultan Qaboos University Med J 2011; 11:492-6. 23. Al-Abri R, Kumar S, Chopra P, Saparamadu P. Schwannoma of the cervical sympathetic chain : first case report from Oman. Sultan Qaboos University Med J 2011; 11:403-6. 24. Kumar S, Mathew J, Al-Abri R, Ahmed O, Sapramadu P. Laryngeal Mass. Oman Med J 2011; 26:293-4. 25. Al Okbi MH, Alkindi S, Al Abri R, Mathew J, Nagwa AA, Pathare AV. Sensorineural hearing loss in sickle cell disease - A prospective study from Oman. Laryngoscope 2011; 121:392–6. 26. Al-Abri R, Marchal F. New era of endoscopic approach for sialolithiasis: Sialendoscopy. Sultan Qaboos University Med J 2010; 10:382–7. 27. Al-Abri R, Marchal F. Sialendoscopy in the old patients: A new tool or a revolution? Eur Geriatr Med 2010; 1:95-8. 28. Al Okbi MH , Jain R, Al-Abri R. Sphenochoanal polyp—surgical review. Int J Pediatr Otorhinolaryngol 2010; 5:99-101. 29. Bhargava D, Al-Abri R, Bhargava K. Evolving trends in evidence based practice: Use of internet to retrieve evidence at point of care. Oman Med J 2010; 25:145-7. 30. Al-Abri R, Kumar S, Salim Al-Sudairi S. A Palatal Mass. Oman Med J 2010; 25:55-6. 31. Al-Abduwani JA, Bhargava D, Sawhney S, Al-Abri R. Bimanual, intra-operative, fluoroscopy-guided removal of naso- pharyngeal migratory fish bone from carotid space. J Laryngol Otol 2010; 124:786-9. 32. Kumar S, Al-Abri R, Sharma A, Al-Kindi H, Mishra P. Management of pediatric tracheobronchial foreign body aspira- tion. Oman Med J 2010; 25. CONFERENCE & SEMINAR PRESENTATIONS Conference Presentations International 1. Machado N. Large duodenal GIST tumour presenting with acute bleeding managed by Whipple resection. 20th World Congress International Association of Surgeons, Gastroentrologists and Oncologists. Cairo, Egypt, 20-23 Octo- ber 2010. 2. Machado N. Neutropaenic enteroclotis post chemotherapy for breast cancer. 20th World Congress of International Association of Surgeons, Gastroentrologists and Oncologists. Cairo, Egypt, 20-23 October 2010. 3. Al-Wahaibi K. Vascular Intervention for Diabetic Foot. 2nd International Diabetic Foot Conference. Dubai, UAE, 24-25

242 September 2011. 4. Al-Wahaibi K. Debate: Carotid Endarterectomy versus Carotid Artery Stenting in Symptomatic Carotid Artery sy- enosis. 1st Pan Arab Angiology Congress. Dubai, UAE, 27-29 May 2011. 5. Al-Wahaibi K. Lost limbs and future steps: Review of causes of amputations in two major hospitals in Muscat, Sul- tanate of Oman. 5th Gulf Vascular Society Meeting. Dubai, UAE, 2-3 March 2011. 6. Bhargava D, Al-Abri R. A Model for change to Evidence Based Practice by Implementing and Auditing Evidence Based Protocols. 12th Asia-Oceania Otolaryngology Congress. Auckland, New Zealand, 1-4 March 2011. 7. Bhargava D. Quality of Evidence Based Practice in ORLHNS; Has the base expanded enough in the last 8 years? 12th Asia-Oceania Otolaryngology Congress. Auckland, New Zealand, 1-4 March 2011. National 1. Al-Wahaibi K. Trauma Initial Assessment and Management -Primary and Secondary Survey. Trauma Care for Nurs- es. Sultan Qaboos University Hospital, Muscat, Oman. 19 September 2011. 2. Al-Wahaibi K. Thoracic Trauma. Trauma Care for Nurses. Sultan Qaboos University Hospital, Muscat, Oman, 19 Sep- tember 2011. 3. Al-Wahaibi K. Thromboprophylaxix in Surgical Patients - Current Recommendations and Results. Oman Medical Specialty Board, Muscat, Oman. 18 September 2011. 4. Al-Wahaibi K. Abdominal Aortic Aneurysm. Sultan Qaboos University Hospital, Muscat, 28 August 2011. POSTER PRESENTATIONS International 1. Malik K. Micriobiology of gall bladder bile in symptomatic cholelithiasis. International Surgical Week, ISW 2011. Yokohama, Japan. 28 August - 1 September 2011. 2. Bhargava D, Al-Saldi Y. Information Mastery and Information seeking behaviour of Otolaryngologist of Oman. 12th Asia-Oceania Otolaryngology Congress. Auckland, New Zealand, 1-4 March 2011. 3. Al-Badaai Y, Endam M, Platt M, Stankovic K, Metson R, Filali A, et al. Reduced Mucosal Production of MUC7 in Chronic departments

Rhinosinusitis. Head and Neck Surgery Annual Meeting. Boston, USA, September 2010. care

patient

and

academic Sugery 243 Annual Report 2010-2011 Medical Library

Medical Library Overview The main thrust of our library policy has always been towards developing, evaluating library resources and providing services more effectively. A major achievement in this respect was online searching to support the programmes of the College of Medicine & Health Sciences, University Hospital and College of Nursing especially in research activities.

Staff Director Mohammed Al-Wardi Librarians Mariam Al-Sinani, Librarian A Mohammed Al-Higgi, Chief Librarian C Huda Al-Farsi, Chief Librarian C Huda Al-Haddabi, Chief Librarian C Suad Al-Busaidi, Senior Librarian A Salim Al-Farei, Senior Librarian A Saif Al-Muharbi, Senior Librarian B Mohammed Al-Yahmadi, Senior Librarian B Abdulla Al-Hinai, Assistant Librarian Jassim Al-Hasani, Assistant Librarian Saif Al-Abri, Assistant Librarian Qassim Al-Harrasi, Senior Programmer B Support Staff Luthgarda Bongsalo, Clerk/Coordinator Amal Al-Hashami, Clerk Hanan Al-Jashami, Clerk Said Al-Alawi, Clerk Ahmed Al-Ghafri, Graphic Camera Operator

244 Highlights of the Year 2010-2011 CIRCULATION In this period, the total number of checked out materials was 3,929. The number of registered library mem- bers was 300.

ACQUISITIONS In this period, 360 new book titles were added to the library collection. This number was made up of 105 titles from Dawson, UK, and 255 monographs received gratis from the Ministry of Health, Oman, World Health Organization and other sources. The total cost for the subscription of journals was $393,302.31. The amount was made up of 75 print journals at $83,995.86, 183 electronic journals at $264,809.45 and 4 databases at $44,497.00. A total of 39 journals from the Gulf Cooperation Council Region were received gratis.

INTERLIBRARY LOANS The requests for journal articles not available in our collection totaled 85. A total of 11 articles at the cost of ₤100.05 were procured from BLDSC, London and 74 articles from the different Gulf Biomedical Libraries were received gratis. The price for printed articles increased from £10.75 to £11.30.

IT SERVICES A total of 2,162 e-journals can be accessed through our website (http://www.squ.edu.om/med-Lib/index. htm), Science Direct and BMJ Journals. 2 book databases (e-brary and e-books) can also be accessed through our website.

TRAINING OF LIBRARY USERS The Library staff trained 18 students from the Sultan Qaboos University College of Arts, Department of Li- brary Science and Information, 20 from Sultan Qaboos University, College of Nursing, 20 from College of Agriculture, Nutrition Department, 20 from Language Centre and 14 graduate students.

A total of 175 external students were also trained to use the Library. There were 65 from Institute of Health Sciences and 50 from Oman Nursing Institute, 50 from Muscat Nursing Institute and 10 BSc students from the Ministry of Health. departments

support Medical Library 245 Annual Report 2010-2011 Medical Education Unit

Medical Education Unit Overview The Medical Education Unit (MEU) was established in 2006 under the Dean’s Office with a mission to raise the standards of medical education in the College. The Unit has a full-time staff, but draws mainly on the vol- untary participation of staff, from the different departments of the College and from the Ministry of Health, with either a formal qualification or a strong interest in the field of medical education.

The Unit is very active in providing educational support to College, Hospital and affiliated staff and other health professionals through faculty development workshops in the areas of teaching and learning, assess- ment, and e-learning. The Unit has also established the IDEAL (International Databank for Enhancement of Assessment and Learning) office which houses the IDEAL secure assessment databank, liaises with the IDEAL Consortium Office, and offers the service of item analysis.

The Clinical skills laboratory is playing a very active role in the College as it is equipped with a variety of instruments, simulators and manikins to support the training of clinical skills. It has evolved into a learning environment that supports a wide range of skills across the spectrum of the curriculum and facilitates the acquisition of theoretical and clinical knowledge. The facility provides medical students with the opportu- nity to develop and maintain competence within the clinical skills area and allow them to practice physical assessment and procedural skills safely, and to demonstrate these skills under simulated conditions prior to attempting them on a patient.

The Medical Informatics Section of the Unit strengthens the integration of medical informatics technologies in teaching, research and service; increases the competency of faculty in the use of medical informatics tools; conducts effective telemedicine conferences and workshops with international institutes; evaluates the ef- fectiveness of various medical informatics technology products in teaching and learning medicine; analy- ses and specifies the College requirements for medical informatics equipment and infrastructure; supports hardware maintenance and provides a troubleshooting service.

Staff Head of Unit Nadia Al-Wardy, Associate Professor, Dept. Biochemistry Members Zahra Al-Rawahi, Assistant Professor, Medical Informatics, MEU Ken Masters, Assistant Professor, Medical Informatics, MEU

246 Ibrahim Inuwa, Associate Professor, Head, Dept. Anatomy Muna Al-Saadoon, Assistant Professor, Dept. Child Health Syed Rizvi, Assistant Professor, Dept. Family Medicine and Public Health Abdullah Al-Asmi, Senior Consultant, Dept. Medicine Samir Hussein, Senior Consultant, Dept. Radiology & Molecular Imaging Adil Al-Ajmi, Consultant, Dept.Surgery Khalil Al-Farsi, Consultant, Dept. Haematology Omar Al-Hussaini, Dept. Medicine, Royal Hospital, Ministry of Health Laila Al-Zadjali, Director, Training & Scholarships, Ministry of Health Kamila Al-Alawi, Director, Education & Training, Royal Hospital, Ministry of Health Support Staff Hisham A. Hadi, College IDEAL Administrator Moosa Al-Rawahi, e-Learning / e-assessment and Multimedia Designer Salim Al-Harthi, Programmer Bader Al-Ismaili, Computer Technician Talal Al-Kindi, Computer Technician Almaqdad Al-Lawati, System Analyst Taha M. El-Sayed, Chief Technician, Clinical Skills Lab Ahmed Al-Hadhrami, Technician, Clinical Skills Lab Rahima Al Maashari, Technician, Clinical Skills Lab Asila Al-Harthy, Coordinator Musab Masood, Coordinator Highlights of the Year 2010–2011 The Clinical Skills Laboratory was officially inaugurated by His Excellency, Dr. Ahmed Al-Saidi, Minister of Health.

One new staff member was recruited to the Unit, Rahima Al-Maashari, Technician in the Clinical Skills Labo- ratory.

Several new workshops were conducted by the Unit. These were attended by staff members from the Col- lege, SQU Hospital and Ministry of Health.

A new activity in the form of a “Lecture Series in Medical Education” was introduced by the Unit. Several topics in Medical Education were presented by MEU members and were attended by a good number of audi- departments ences from the College and Hospital. support Medical Education Unit 247 Annual Report 2010-2011 Medical Education Unit

Dr. Nadia Al-Wardy was awarded the TWAS-ARO (Arab Regional Office) Regional Prize 2011 in the subject area of “The Development of Scientific Educational Material”. The prize was to acknowledge her exceptional contributions to scientific educational material in the Arab Region, through publications, lectures and other means. The ceremony was hosted at the Bibliotheca Alexandrina, Alexandria, Egypt.

Teaching Programmes UNDERGRADUATE PRECLINICAL PROGRAMME The Medical Informatics section of the MEU was involved in teaching the following core and elective courses to undergraduate medical and nursing students: Medical Informatics I and II; Creative Thinking, and Health Informatics

Training Courses & CME Activities WORKSHOPS Several educational workshops conducted by internationally renowned faculty and local staff in medical education were offered by the Unit.

The CHPE (Certificate Course in Health Professions Education), a three-day course in February in 2011, ws conducted by Professor Hamdy, University of Sharjah, UAE, Professor Bandaranayake, Sydney, Australia, and Professor Gibbs, Scotland, UK. A total of 35 College, Hospital, affiliated staff and other health professionals participated in the course.

A three-day Student Assessment Workshop was also held in February in 2011, conducted by Professor Ban- daranayake, Sydney, Australia, and Professor Gibbs, Scotland, UK. A total of 23 College, Hospital, and affiliated staff participated in the workshop.

Five different Team-based Learning (TBL) workshops were conducted by Professor Dean Parmelee, Associate Dean for Academic Affairs, Boonshoft School of Medicine, Wright State University, Ohio, USA, from 9-13 Octo- ber 2010. A total of 86 College and Hospital staff participated in these workshops.

A full-day workshop on Using Aspects of Medical Informatics to Assist Research was conducted twice, De- cember 2010 and May 2011 by Dr. Ken Masters.. The workshop involved Systematic Literature Reviews, Data Encryption and Measuring Levels of English. It was a great success and was attended by a large number of staff.

A workshop on running the (IDEAL 4.1 PC version) software was conducted in February2011. Participants

248 were staff members at the College of Medicine and the University Hospital. The workshop focused on train- ing the participants on retrieving questions from the IDEAL secured database and saving them in Word files for later use in final examinations.

Workshops on Configuration MS Outlook2007 and Gmail were held 10 and 11 April 2011. Several Moodle work- shops conducted on a weekly basis in October 2010. The Basic surgical & endoscopic skills course was held from 9-11October 2010. A Family Medicine faculty development workshop, OSCE group, was held on 18th December 2010. An Evidence-based Medicine workshop was held from 25 to 26 January 2011. Finally, the In- ternational Ear, Nose and Throat (ENT) Surgical Workshop was held from 22 to 25 March 2011.

LECTURE SERIES IN MEDICAL EDUCATION The lecture “How Good ‘Is Good Enough’? was presented by Dr. Ibrahim Inuwa, Associate Professor and Head, Department of Anatomy, in December 2010. A lecture on Team-Based Learning (TBL) was presented by Dr. Muna Al-Saadoon, Assistant Professor, Department of Child Health in April 2011. Finally, a lecture on “Open Access Publishing’ was presented by Dr. Ken Masters, Assistant Professor, Medical Education Unit, in May 2011.

Research RESEARCH PROJECTS The Use of M-Learning Technology by 6th year Medical Students in a Minimally-Supported Environment Project Code: MREC# 365; Dates: 2010 Value: Unfunded; Project Approval: Sultan Qaboos University Investigators: Dr. Ken Masters, Medical Education Unit, SQU; Dr. Zahra Al-Rawahi, Medical Informatics Group, SQU.

Team-Based Learning in undergraduate medical informatics Project Code: MREC# 417; Dates: 2010 Value: Unfunded; ProjectApproval: SultanQaboosUniversity Investigators: Dr. Ken Masters, Medical Education Unit, SQU departments

support Medical Education Unit 249 Annual Report 2010-2011 Medical Education Unit

RESEARCH PUBLICATIONS & BOOKS Journal Publications 1. Saleh J, Al Wardy N, Farhan H, Al Khanbashi M and Cianflone K. Acylation stimulating protein: a female lipogenic factor? Obesity Reviews 2011; 1:9. 2. Masters K. A brief guide to understanding MOOCs. Internet J Med Educ 2011; 1:2. 3. Masters K. Book Review. The Doctors’ Communication Handbook. Sultan Qaboos University Med J, 2011; 11:295-6. 4. Masters K. Re: “I found it on the Internet”: preparing for the e-patient in Oman. [Letter response] Sultan Qaboos University Med J 2011; 11:130. 5. Masters K. Re: To err is human: case report of two military aircraft accidents. [Letter] Sultan Qaboos University Med J 2011; 10:278-9. 6. Masters K. The relationship between IT support and medical education in the 21st century. Surgery 2011; 61:21-3. CONFERENCE & SEMINAR PRESENTATIONS Conference Presentation International 1. Al-Wardy NM. Assessment Mapping. 1st Conference on Curricula Transformation in Medical Faculties. Damascus University, Syria, October 2010. 2. Masters K. Developing an ICT learning platform to facilitate student education. 1st Conference on Curricula Trans- formation in Medical Faculties. Damascus University, Syria, October 2010. Poster Presentations International 1. Al-Wardy NM, Al-Kindi M, Al-Khabouri M, Alasti F, van Camp G, del Castillo I, et al. Otoferlin [OTOF] gene variants responsible for hearing loss in two Omani families. 3rd Pan Arab Human Genetics Conference Abstracts P34. Dubai, UAE, 2010. 2. Al Wardy NM. The Five Questions on Assessment Answered. AMEE Conference Abstracts 4U1. Glasgow, Scotland, UK, September 2010. Seminar Presentations National 1. Al-Wardy NM. Preparation for Examinations. CoM&HS, Sultan Qaboos University, December 2010. 2. Al-Wardy NM. Keynote Speech. White Coat Ceremony. Oman Medical College, Sohar Campus, January 2011. 3. Al-Wardy NM. Assessment of Competence. Al Nahdha Hospital, Ministry of Health, Oman, April 2011.

250 Sultan Qaboos University Medical Journal Overview The Journal was officially launched in 1997 with 7 issues published up to 2005. The Journal was relaunched in 2006 and renamed Sultan Qaboos University Medical Journal, SQUMJ. Up to December 2011 a total of 17 issues with 366 articles had been published and the Editorial Board had grown from 15 to 35 members, 34 of them staff of either the College of Medicine & Health Sciences or Sultan Qaboos University Hospital and one from the Armed Forces Hospital.

The vision of the SQUMJ is be a leading regional medium of medical and scientific communication covering both clinical and basic science research and other medically relevant observations that will be recognised and accepted internationally. Its objectives are as follows:

- To promote a culture of scientific publications in the medical and related disciplines at SQU. - To provide a medium for dissemination of research results and reviews of important clinical and basic science topics. - To attract a wide variety of peer reviewed articles including original research and review articles, editorials, case reports, interesting medical images, special contributions, continuing medical education articles, brief communica- tions, book reviews and abstracts. - To attract quality scientific contributions from SQU staff, the region and the wider international community. - To build capacity in all aspects of scientific publishing at SQU and to enhance its research profile. - To be indexed with the US National Library of Medicine and with the Community of Science (COS); thus it will ap- pear in major online databases of health related citations and abstracts. - To be published both online as well as in print and be fully electronic with online submission and review.

Staff – Members of the Editorial Board Editor-in-Chief Lamk Al-Lamki, Professor Radiology & Molecular Imaging Editor Samir Al-Adawi, Associate Professor Behavioural Medicine & Editor Associate Editors departments Rashid Al-Abri, Consultant, Surgery Badreldin Ali, Professor, Pharmacology support Sultan Qaboos University Medical Journal 251 Annual Report 2010-2011 Sultan Qaboos University Medical Journal

Abdullah Al-Asmi, Senior Consultant, Medicine (Neurology) Sulayma Al-Barwani, Associate Professor, Physiology Ikram Burney, Senior Consultant, Medicine Shyam Ganguly, Associate Professor, Epidemiology & Statistics Vaidyanathan Gowri, Assistant Professor, Obstetrics & Gynaecology Omar Habbal, Associate Professor, Human & Clinical Anatomy Ali Al-Jabri, Professor, Microbiology & Immunology Nadia Al-Kharousi, Consultant, Ophthalmology Salam Al-Kindy, Assistant Professor, Haematology Neela Al-Lamki, Professor, Radiology & Molecular Imaging Zakia Al-Lamki, Professor, Child Health Norman Machado, Consultant, Surgery Prakash Mandhan, Senior Consultant, Surgery (Paediatric) Khalid Al-Naamani, Senior Consultant, Gastroenterology, AFH Allal Ouhtit, Associate Professor, Genetics Hani Al-Qadhi, Senior Consultant, Surgery (Trauma) Omar Al-Rawas, Professor, Medicine (Respirology) Muna Al-Sadoon, Assistant Professor, Child Health Jumana Saleh, Associate Professor, Biochemistry Mansour Sallam, Senior Consultant, Cardiology Sukhpal Sawhney, Senior Consultant, Radiology & Molecular Imaging Marwan Al-Sharbati, Associate Professor, Behavioural Medicine Ashok Sharma, Senior Consultant, Surgery (Cardiac) Thord Theodorson, Senior Consultant, Family Medicine & Public Health Yasser Wali, Professor, Child Health Nicholas Woodhouse, Professor, Medicine (Endocrinology) Meriel Carboni, Managing Editor Amar Hussein, Technical Editor Sheherajoy Biruar, Assistant Editor Jacqueline Rispel, Assistant Editor Highlights of the Year 2011 In 2011, there was a 44% increase in the number of articles compared to 2010. The rejection rate was up to 50% from 43% in 2010. SQUMJ began quarterly publication and the four issues had a total of 100 articles. Over 350 experts, 73% of them from outside Oman, reviewed SQUMJ manuscripts. SQUMJ, which had been indexed in the WHO’s Index Medicus for the EMRO region from 2007, was indexed in 2011 Scopus. SQUMJ was also ar-

252 chived with PubMed Central. This meant that the full text of all SQUMJ articles (going back to 1998) became accessible through PubMed, the internationally known online medical database.

The SQUMJ website also provided full access to all content and online submission. Preparations were made to move in 2012 to Editorial Manager, the fully online submission and review system from Aries Systems, which is used by 3,000 journals worldwide.

SQUMJ had a print run of 2,000 copies in order to reach local, regional and international medical and other scientific audiences. It was distributed free of charge to all staff of the College and SQUH and senior staff in the University. It was also distributed in multiple copies to the Ministry of Health, and all hospitals and medi- cal training establishments in Oman. In addition, it was sent to medical libraries in the region; all Gulf area medical colleges, and selected medical colleges in the Middle East, North Africa, India and Pakistan, the UK, USA, Canada and Australia.

Numbers and Sources of Articles Sources of Papers Received 2009 % 2010 % 2011 % SQU – College & Hospital 50 50 56 41 61 38 Ministry of Health & Hospitals in Oman 9 9 24 17 23 11.5 Gulf & Middle East 29 28 33 24 39 19.5 Other countries 13 13 25 18 61 31 Totals 101 100 138 100 199 100 departments

support Sultan Qaboos University Medical Journal 253 Annual Report 2010-2011 Hospital Directorate of Development & Quality

Hospital Directorate of Development & Quality Overview The Directorate of Development and Quality (DDQ) of Sultan Qaboos University Hospital (SQUH) is respon- sible for improving the quality assurance in the hospital through establishing an efficient Quality Manage- ment System (QMS). Continually working towards improving SQUH quality is made possible by having been awarded the ISO 9001-2000 certificate in May 2005 and achieving re-certification with ISO 9001-2008 in May 2008 and again in June 2011.

The DDQ is committed to providing SQUH with support in structuring and maintaining quality standards in all clinical, educational and support services. Achievements are through the main sections of quality assur- ance, development, documentation and studies, and risk management by providing support and encourage- ment to hospital-wide quality activities through teamwork and best practice and coordinating the ongoing hospital-wide education on quality and conducting similar activities in other organisations. Furthermore, the DDQ seeks to promote excellence through continual improvement in teaching, research, patient ser- vices and staff development. This is supported by effective process delivery and efficient resource utilisation throughout the hospital. The DDQ works on enabling the following outcomes:

- Identify objectives and focus on needs and expectations of customers. - Facilitate establishing a baseline for improving performance and outcomes. - Provide a basis for certification and accreditation conformance and ensure applicability to Omani laws, legislation and regulations. - Provide and practise internationally recognised standards of care. - Monitor hospital activities and coordinate the implementation of corrective and preventive actions through audit- ing and site visits. - Monitor healthcare service outcomes through key performance indicators. - Identify and mitigate the risk and hazards of the hospital environment. - Provide a common framework for effective internal communication though controlled policies, protocols and proce- dures documents. The DDQ organises the Hospital Knowledge Forum presented on a weekly basis, with the objective of shar- ing knowledge on various topics of interest and concern. This activity is carries on throughout the year.

Quality Rounds are conducted on a regular basis throughout the year, depending on the need. Sources of need include: Incident Reports, Audit Reports, Risk Assessment Reports, Departmental correspondence, Top Management Directives, Customer Voice (Patient & Staff), DDQ Initiatives for improvement, and any other

254 means of identifying the need. Rounds are conducted with the cooperation of nurses, technicians and other health care professionals where deemed necessary.

Staff Rashid Al-Abri, Director Yasmeen Al-Hatmi, Deputy Director Support Staff Hamdan Al-Siyabi, Lead Auditor Sultan Al-Marhoobi, Document Controller Sumaiya Al-Busaidi, Risk Facilitate Fatma Al-Sharji, Clerk Jamal Al-Busaidi, Sr. Technician Carolina Vacalares, Coordinator Highlights of the Year 2010–2011 The 2011 Quality Day was celebrated on 21 November with the presentation of outstanding departmental achievements and the sharing of scientific improvement studies. Participating departments included Nurs- ing Directorate, Nursing Services, Pharmacy, Child Health, Medicine, Anaesthesia, Ophthalmology, Infection Control, Paediatric Daycare Unit, Dietetics & Nutrition, Catering, Physiotherapy, and H&S Committee/Task Force. The DDQ is expected to expand this celebration to a full “Quality Week” for 2012, following a positive, interesting and highly successful event.

The month of January 2011 led to a full document review of Hospital Wide Policies/ Guidelines/Protocols/Pro- cedures. This activity was carried out in collaboration with the Director General’s Office. Policy owners were advised on review and amendment when necessary and revised documents were uploaded to the hospital intranet through the DDQ. The Internal Audit Policy & Procedure was reviewed and revised as a DDQ-owned policy.

January 24th marked the presentation of the 13th Management Review to the Top Management, HODs and 86 hospital staff with information on the input and outcome management of the hospitals’ service provi- sion.

The DDQ contributed to the Organizing Committee for 1st International Patient Safety Conference held from 31st January to 2nd February. This grand event was attended by over 550 participants. International and departments regional speakers from Switzerland, Ireland, Egypt, Pakistan, Australia and Oman had a great impact on in- creasing the awareness of patient safety issues for health care professionals in Oman. support Hospital Directorate of Development & Quality 255 AnnualAnnual Report Report 2010-2011 2010-2011 Hospital Directorate of Development & Quality Hospital Directorate of Development & Quality

A Quality Round 2-month study conducted during April and May, using a patient record checklist created by the DDQ, identified non-compliance to documentation requirements and mapped patient record documen- tation trends.

An Internal Quality Audit was conducted on 26th April and included the following departments: Cardiac Care Unit/Cardio Thoracic Care Unit, Radiology, Surgical OPD, Ophthalmology OPD, Clinical Physiology, Pedi- atric Day Care Unit, Cardiothoracic & Cardiology Ward, Orthopedic Ward, Training Directorate, Biochemistry Laboratory, Patient Services, Incident Reporting System and Top Management (DG Office).

May saw the introduction and uploading of DDQ-owned new policy documentation: Quality Round Policy & Guidelines, Incident Reporting Procedure, Patient Safety Goal Patient Identification, and Patient Safety Goal of Communication.

In May, the DDQ also sent 2 staff members to attend a Risk Management Week in Doha, Qatar, while 1 staff contributed as a speaker at the conference.

The Department hosted educational international lectures through the Methodist International Hospital, USA, on the topic of ‘Quality in Healthcare’ by video-conferencing on 17th May. There were 25 SQUH staff attendees for this event.

The 14th Management Review was presented on June 20 as a continuation of communicating the achieve- ments of the hospital over the past 6 months.

Strategic Review Audit was conducted by the external auditor from BSI from 25-27th June. Hospital depart- ments covered included: Directorate of Development & Quality, Patient Services, Anesthesia, Neonatal ICU, Clinical Physiology (Respiratory), Environmental services/Occupational Health & Safety/Fire Safety/Waste Management/Infection Control, Nursing Administration, Maintenance, Physiotherapy, Bone Marrow Trans- plant Unit, Hematology Laboratory, Medical Supplies.

In October, in collaboration with the Planning and Statistics Department SQU, a Survey, Incident Reporting System (IRS) End Users Satisfaction Survey was electronically distributed to determine the perception of SQU staff on hospital service provision in SQUH.

A Management Review Meeting was held on 17th December with a presentation of the past 6 month review of quality activities and a look into strategies for improvement.

256 Training Courses & CME Activities No. Course Title Date Description 1. Risk Management Work- 2-4 October Organized for second time by DDQ shop and delivered to SQUH staff. 2. Knowledge Forum: Help- 22 November One-hour lecture describing the op- ful Quality Improvement tions of internationally used quality Tools tools. 3. WHO-EMRO/MOH Patient 5-6 December 2-day workshop for Risk Assessment Safety Initiative Workshop for 26 MOH participants - part of 6-month Patient Safety Initiative. 4. Risk Management Work- 28-29 December 2-day course for 71 MOH participants shop at Wilayat Seeb facility. 5. 1st International Patient 31 January – 2 February DDQ staff contributed in Scientific Safety Conference SQU Committee, registration, transpor- tation, and speaker delegation and correspondence. Two staff made oral presentations, and one poster was presented. 6. WHO/MOH Patient Safety 23-24 February 2 staff conducted practical audit Workshop for MOH participants as part of a 6-month Patient Safety Initiative. 7. MOH Patient Safety Work- 15-16 March 2-day workshop for 60 MOH partici- shop, Rustaq, South Bati- pants. Topics inlcuded Patient Safety, nah Region Standard Compliancy, Documenta- tion and Risk. 8. OMSB Development Work- 16 March 1-hour lecture by DDQ staff for admin- shop istrative skills development. 9. Quality Audit Refresher 25 April Course for hospital auditor skills re- Theory & Practical Work- freshment and covered areas of audit shop planning, audit report writing, audi- departments

tor skills and clause revision. 100% at- tendance of 21 participants. support Hospital Directorate of Development & Quality 257 AnnualAnnual Report Report 2010-2011 2010-2011 Hospital Directorate of Development & Quality Hospital Directorate of Development & Quality

10. OMSB Quality & Patient 28 April DDQ staff gave lectures on Leader- Safety Symposium ship, Setting Objectives, Documenta- tion and Audit. 11. Risk Management Week in 8-12 May 1 staff spoke on future of improving Doha Qatar work safety culture and risk. 12. International Nurses Day 12 May 1 staff took part in Scientific Program Event with theme of ‘Closing the Gap: In- creasing Access and Equity’. 13. Patient Safety Symposium, 19 May 2 staff gave lectures to contribute to Nizwa the theme ’Collaborating to Make a Difference’. 14. Departmental Quality 12 June Event reviewed Roles and Responsi- Representative (DQR) Re- bilities of DQRs. Attendance at 55% fresher Day capacity - 33 of 60 designated staff at- tending. 15. Patient & Family Health 14 July DDQ staff representing Health Educa- Education Workshop, tion Committee presented a lecture. SQUH 16. Nizwa Lecture 28 December Staff from SQUH were invited to de- liver a talk on Patient Safety & Culture Research RESEARCH PUBLICATIONS & BOOKS Journal Publications 1. Al Hatmi YS. Safety as a hospital organizational priority: A case study. Clin Govern: Int J (UK) 2011; 16:203-19. 2. Al Hatmi YS. Quality Audit Experience for Excellence in Healthcare. Clin Govern: Int J (UK) 2011; 15:2. 3. Al Hatmi YS. Improving the quality of care through building quality culture; is it relevant? Abstract. 1st International Nursing Conference. Sultan Qaboos University, Muscat, Oman, November 2011. Abstract Book, p. 157. 4. Al Abri RK. Disclosure in healthcare. Abstract. 1st International Conference on Patient Safety. Sultan Qaboos Univer- sity Hospital, Muscat, Oman, February 2011. Sultan Qaboos University Med J 2011; 11:428. 5. Al Hatmi YS. Integrating patient safety indicators with quality performance measures. Abstract. 1st International

258 Conference on Patient Safety. Sultan Qaboos University Hospital, Muscat, Oman, February 2011. Sultan Qaboos Uni- versity Med J 2011; 11:430. 6. Al Abri RK. Patient safety is it important for post-graduate training in healthcare? Abstract. 2nd International Con- ference Quality Management in Health Care. Sultan Qaboos University, Muscat, Oman, 1-3 February 2010. Oman Med J 2010; 24:152. 7. Al Hatmi YS. SQUH framework for quality improvement. Abstract. 2nd International Conference Quality Manage- ment in Health Care, Sultan Qaboos University, Muscat, Oman, 1-3 February 2010. Oman Med J 2010; 24:154. 8. Al Hatmi YS. The ABCs of quality culture. Abstract. 2nd International Conference Quality Management in Health Care, Sultan Qaboos University, Muscat, Oman, 1-3 February 2010. Oman Med J 2010; 24:156. 9. Al Hatmi YS. An Open Door to Quality. SQUH Quality News 2010; Volume 5, Issue 3, November 2010. CONFERENCE & SEMINAR PRESENTATIONS Conference Presentations International 1. Al Hatmi YS. Safety as a hospital organizational priority: A case study in Oman. 2nd Canadian Quality Congress. Toronto, Canada, September 2010. 2. Al Hatmi YS. Quality tools for improving patients future. Risk Management Week. Doha, Qatar 8-12 May 2011. 3. Al Hatmi YS. A quality improvement approach to sharps management and injury prevention at Sultan Qaboos University Hospital. 28th International ISQua Quality Conference. Hong Kong, China, September 2011. 4. Al Abri RK. Risk management in healthcare. GCC ORL Symposium. Kuwait, March 2011. National 1. Al Abri RK. Disclosure in Healthcare. 1st International Conference on Patient Safety. Sultan Qaboos University Hos- pital, Muscat, Oman, February 2011. 2. Al Abri RK. Quality and Safety. Regional Symposium on Quality and Safety in Healthcare. Sur Hospital, Oman, 20 October 2011. 3. Al Hatmi YS. Integrating Patient Safety Indicators with Quality Performance Measures. 1st International Conference on Patient Safety. Sultan Qaboos University Hospital, Muscat, Oman, February 2011. 4. Al Hatmi YS. Safety Walk Rounds for Patient Safety. Patient Safety Summit. Nizwa Hospital, Oman, May 2011. 5. Al Hatmi YS. Triangulating Quality, Clinical Care & Patient Safety. ultan Qaboos University Hospital Nurses Day, Intercontinental Hotel, Muscat, Oman, May 2011. 6. Al Hatmi YS. Occupational Hazards in healthcare. 5th National Infection Control Awareness in Primary Health Care. Ministry of Health, Oman, October 2011. departments

support Hospital Directorate of Development & Quality 259 Annual Report 2010-2011 Hospital Directorate of Development & Quality

Poster Presentations National 1. Al Hatmi YS, Neilson F, Henderson J. A Practice Development and Cost Effectiveness Program to Reduce Ventilator Associated Pneumonia (VAP) in ICU. 1st International Conference on Patient Safety. Sultan Qaboos University Hos- pital, Muscat, Oman, February 2011. Seminar Presentations National 1. Al Abri RK. Patient Focus on Patient Safety. Nizwa Hospital, 28 December 2011. 2. Al Abri RK. Risk Management. Dept. Obstetrics & Gynecology, SQUH. 1 September 2011. 3. Al Hatmi YS. Ethical Aspects of Patient Family Health Education and its Impact on Quality of Care. Patient & Family Health Education, SQUH. July 2011.

260 Hospital Directorate of Information Systems Overview The Directorate of Hospital Information Systems (HIS) primarily provides information technology (IT) servic- es to SQUH which greatly aids SQUH’s mission of providing the highest degree of health care to the patients. To achieve this goal, HIS uses comprehensive state-of-the-art information technology (IT) services in Health Care Systems and constantly upgrades the systems with the latest updates. HIS has a dedicated team of qualified and specialised personnel in the various fields of information technology to provide these services and who constantly develop new systems and maintain the systems to provide round the clock services to SQUH.

In addition to providing network access (wired and wireless) throughout the Hospital, HIS’s two flagship projects are the Medical Systems and the Edges.

The Medical Systems software is maintained by HIS in state of the art servers using high speed networks. Failover mechanism is implemented in the system so that if one server goes down, another one takes over without affecting the end users. This provides high availability of the system to patient caregivers.

Moreover, HIS is developing in-house Enterprise Resource Planning (ERP) software called the Edges. The soft- ware includes many modules. Some of the modules have already been commissioned and are used by the administration in the management of the hospital.

Services offered by the HIS include:

- Planning information system software needs and related budgetary requirements. - Project management for large-scale computer system implementations. - Evaluation and development of enterprise and departmental software solutions (Edges). - Analysis of business needs and information system requirements. - Design of business workflow, databases, interfaces, documents, reports and processes. - Development and installation of application software. - Testing of computer software to validate performance against design specifications. - Documentation, including preparation of user manuals/procedures and system documentation. - Maintenance of applications software, programs and data files to provide enhanced functionalities. departments - Support for users of HIS applications including support for Help Desk issues. - Security administration for HIS user accounts and permissions. support Hospital Directorate of Information Systems 261 Annual Report 2010-2011 Hospital Directorate of Information Systems

The Hospital Information Systems staff works closely with the SQUH user community to provide compre- hensive 24/7 support for the Hospital’s mission-critical health care computer applications.

Staff Dr. Amer H. Alhabsi, Director Abdullah Al-Mahrouqi, Head, Research & Development Network Section Bader Al-Kiyumi, Head Ghalib Al-Mahrooqi, Technician Said Al-Harassi, Sr. Network Engineer Ahmed Al-Kiyumi, Technician Fahad Al-Shukaily, Technician Mohammed Khalid, Sr. Network Engineer Moosa Al-Rawahi, Network Engineer System Admininistration & Security Nasser Al-Azwani, Head Nakia Al-Riyami, System Security Specialist Users Support Mustafa Al-Hadhrami, Head Younis Al-Mandhari, Technician Ahmed Al-Hoqani, Technician Fatima Al-Masoudi, Technician Hamed Al-Muslhi, Technician Ibraheem Al-Balushi, Technician Moosa Al-Khanbshi, Technician Nasra Al-Mahrouqi, Clerk Rashid Al-Mudalwi, Clerk Abdullah Al-Rashdi, Sr. Programmer Al Marwah Al-Kharoosi, Technician Naima K. Al-Naamani, Technician Younis Al-Harthy, Technician Amur Al-Mamari, Technician Medical Systems Jokha Al-Kalbani, Head

262 Vishnu Mampatta, Technician Yahya Al-Salmi, Programmer Widad Al-Mamary, Sr. Programmer Taheya Al-Habsi, Programmer Admininistration & Finance Systems Akinyemi Koyi, Head Suad Al-Bimani, Programmer Fatema Al-Faliti, Programmer Salma Al-Mayahi, Programmer Application Section Ahmed Al-Shaibani, Head, Mohsin Al-Zadjali, Sr. Systems Analyst Data & Systems Integration Nasser Al-Mandhari, Head Ahmed Al-Yamani, Programmer Maryam Al-Balushi, Technician Dorothy Paul, Coordinator Yaqoub S. Al-Harthy, Messenger Highlights of the Year 2011 - PACS integration with Medical System. - Creating a training environment for Medical Application for colleges of Medicine and Nursing. - Go-Live with Phase 1 of blood bank system. - Completion of Penetration Test for all IT related systems in HIS. - Connecting Genetics department network to the SQUH LAN. - Replacing model 920 blade server with model 960. - Completion of phase one of installation of CCTV around hospital in coordination with Technical Affairs Directorate. - Implementation of new active network equipment (switches and routers). - Upgrade of the HIS data centre. - Re-engineering of stores module in Edges. departments

- Enhancement of Procurement module in Edges. - Reconfiguration of the application to stabilise the HIS System. support Hospital Directorate of Information Systems 263 Annual Report 2010-2011 Hospital Directorate of Information Systems

- Wireless expansion. - Improving the quality of services provided by the HIS Directorate. - Installing 220 PCs, 13 laptops and other peripherals at various departments in the Hospital. - More than 3,600 calls have been attended to by HIS Operation and Development Divisions during 2010. - Training of TRAKCARE System for doctors, interns, nurses, laboratory staff and clerks. - Conducting summer training programmes for College of Medicine students. STUDIES CONDUCTED - Business Intelligence integration with the medical system - External website development for SQUH - Upgrade to T2011 for Medical Systems - Health share with Ministry of Health - Wi-Fi IP Telephony (replacing Pager system) - Disaster Recovery for SQUH environment - E-Tendering and E-Recruitment - Queuing System - Radio Frequency Identification (RFID) - Information security at SQUH - Medical System Reengineering - Inventory/Asset Management/Biomedical/Maintenance/Housing/Budget modules required at SQUH - Security requirements for SQUH - Upgrade Independent Distribution Frame room from 110 to RJ 45 patch panel - Replacing of DNA Helpdesk system with a new one - Changing the fire suppression of Data Centre - Mobile Asset Tracker with RFID

264 Hospital Directorate of Medical Supply Overview The Medical Supply Directorate (MSD) is one of the key departments in the hospital as it has the responsibil- ity to keep the hospital continuously supplied with commodities for health care use. The MSD carries out the procurement of health commodities such as pharmaceutical, medical, surgical and laboratory items.

The MSD is looking forward to improving its performance and achieve its aims. Despite the difficulties faced by MSD to ensure the availability of items, all staff in each section of MSD does their best to cut costs; procure cost effective items; deliver items on time; improve the logistics system, and to be a competitive directorate with a modern supply system.

Sections of MSD There are seven main sections in the Medical Supply Directorate:

1. Pharmacy 2. Medical Surgical 3. Laboratory 4. Stationary 5. Biomedical & Hospital Maintenance 6. Stock Control

7. Linen

Activities Medical Supply Directorate is the key department in the logistics cycle of the hospital. The figure below shows the important activities that are processed by MSD in coordination with other key department like the Procurement and Finance department.

PRODUCT SELECTION The MSD coordinates with committees in the hospital to select the right product that meet the needs of the hospital. Quality, effectiveness and affordability are the most important selection criteria considered by the departments departments

MSD staff and committee members. support support Hospital Directorate of Medical Supply Hospital Directorate of Medical Supply 265 Annual Report 2009-2010 HospitalAnnual Directorate ofReport Medical Supply 2010-2011 Hospital Directorate of Medical Supply

FORECASTING AND PROCUREMENT After the selection of items, the list of selected items is created and the required quantities are estimated (forecasted) taking in to consideration number of patients who will benefit from the item. Thereafter the consumption rate and the movement are used to forecast the future quantities to be ordered to ensure ad- equate stock levels and buffer stocks.

The MSD then issues tenders for the selected items and the quantities needed. Once the quotations are re- ceived from suppliers they are evaluated and items selected by committees. The MSD issues a purchasing order to the selected supplier.

INVENTORY MANAGEMENT Once the item arrives in MSD the inventory management activity takes place. This includes the checking of the delivered items and tallying them with the specifications mentioned in the purchase order. Then the storage process starts making sure that each item is stored in an appropriate climate. Distribution to various sections throughout the hospital then begins at the request of the department concerned.

Procurement of health commodities is a complex process that involves coordination with the directorates of the MOH, funding sources, suppliers, and manufacturers. Any delay or lack of coordination throughout the process or miscommunication throughout the logistics cycle may lead to non-availability of items.

266 Hospital Directorate of Patient Services Overview The Patient Services Department’s role is to provide a 24 hrs, compassionate, accessible and high quality serThe Directorate of Patient Services’ role is to provide a 24 hour, compassionate, accessible and high quality service to SQUH clients and visitors. The Directorate also works to resolve any misunderstandings that might arise between staff and clients so that the hospital runs with minimal interruptions. Directorate staff liaises with other internal/external departments so that clients receive maximum help.

The Directorate’s responsibilities include the following:

- Looking into the different problems that may occur between staff and SQUH clients and finding ap propriate solutions.

- Attesting sick leaves and certificates.

- Coordinating with doctors when medical reports are requested.

- Translating medical reports and administrative work when required.

- Coordinating with the Royal Oman Police regarding accidents and providing accident reports.

- Releasing oxygen concentration machines to patients who fulfill specific conditions.

- Supervising the Hospital security guards.

- Providing health education.

- Receiving complaints/suggestions and following them up with the concerned departments.

- Providing psychological counselling for patients.

In the unfortunate event of a patient dying, the Directorate has the following responsibilities:

- Informing the relatives.

- Making sure that all documents such as death notification and dead body release forms are properly done. departments

- Helping the relatives to find appropriate transportation to transfer the dead person. support Hospital Directorate of Patient Services 267 Annual Report 2010-2011 Hospital Directorate of Patient Services

- If the deceased patient is a non-Omani, the Directorate guides the relatives through the required procedure to transfer the body abroad.

Staff Ahmed Al-Khayari, Director Ahmed Al-Barwani, Deputy Director Younis Al-Farsi, Secretary Khalsa Al-Salmi, Translator Ghosen Al-Ghaafri, Counseling Psychologist Fakhria Al-Amri, Health Education Specialist Saleh Al-Hinai, Duty Administrator Said Al-Harthy, Duty Administrator Masoud Al-Harthy, Duty Administrator Mansoor Al-Hinai, Duty Administrator Muneer Al-Belushi, Duty Administrator Ali Al-Belushi, Duty Administrator Juma Al-Ghafri, Clerks Ibrahim Al-Ghafri, Clerks Yousif Al-Habsi, Receptionist Sultan Al-Sadi, Receptionist Juma Al-Muharbi, Receptionist Salim Al-Mamari, Receptionist All staff members are Omanis.

Activities in 2011 - In cooperation with doctors approximately 3,429 medical reports were issued.

- Approximately 5,022 visiting passes have been issued and 5,544 attendants’ passes were given.

- 108 materials were translated within the department including medical reports and leaflets.

- 48 Lectures for inpatients were conducted on various topics attended by 361 patients besides 65 private visits for patients.

- 36 SQU & other colleges’ students were trained within the Directorate.

268 - Conducting meetings with inpatients and attendants.

- Adding more security guards to the Emergency Dept and OPDs.

- Extending working hours for duty administrators to be 24 hours and will be given 4 days off instead of 3 days.

- A new staff member, Mrs. Alia Al-Habsi, joined the Directorate as a clerk. departments

support Hospital Directorate of Patient Services 269 Annual Report 2010-2011 Hospital Directorate of Public Relations & Information

Hospital Directorate of Public Relations & Information Overview An organisation’s success and reputation is dependent on its image in the customer’s eye. The Public Re- lations & Information Directorate, therefore, works relentlessly on building and maintaining the positive image that Sultan Qaboos University Hospital (SQUH) deserves. The Directorate also provides top quality services to SQUH staff through its contacts with different governmental and private agencies. The vision of the Directorate is that the public associates the terms ‘top quality’ and ‘excellence’ with the Public Relations & Information Directorate and associates ‘excellent reputation and image’ with SQUH. The mission of the Directorate is to provide top quality public relations services to SQUH staff and clients, and to work continu- ously on producing an excellent, realistic image of SQUH.

Staff Sultan H. Al-Abri, Director Khamis S. Al-Farsi, Head of Department Yahya E.K. Al-Hasani, Head of Deparment Salim M. Al-Hinai, Acting Head of Department Mohameed A. Al-Zidi, Clerk Talib A. Al-Abri, Clerk Abdullah J. Al-Owaisi, Clerk Maryam M. Al-Qureshi, Clerk Mohammed A.Al-Salmi, Clerk Ahmed S. Al-Hinai, Clerk Saif M. Al-Ghaithi, Clerk Yahya N. Al-Aamri, Clerk Hashim A. Al-Balushi, Yonis A. Al-Habsi, Clerk Ali K. Al-Hatmi, Clerk Activities in 2010 The Public Relations & Information Directorate serves the hospital through its four different departments.

270 JOURNALISM & INFORMATION DEPARTMENT AND PRINTING & PUBLISHING DEPARTMENT

Activities Number of Activities during 2011 Covering all SQUH events in national media 51 Designing event invitation cards 8 Designing certificates of appreciation 17 Designing patient educational materials (leaflets, posters) 9 Announcement of vacancies, tenders and training programmes 22 Providing banners for hospital events 24 Coordinating with media agencies regarding interviews with hospital staff (doc- 43 tors) Designing annual calendar 1 Producing educational and awareness films 2 Designing pop-up materials 486

CULTURAL & SOCIAL ACTIVITIES DEPARTMENT

Series Activities Number of Activities during 2011 A Supporting all SQUH departments in organising conferences, sympo- 63 sia and workshops B Arranging all the needs for training programmes in coordination with 371 Training Directorate C Organising the graduation ceremony (SQU) 2 D Organising the SQUH Annual Exhibition Day 1 E Arranging all the needs for Patient visits and gift distribution & Fun 33 departments activities for children. F Official visits 27 support Hospital Directorate of Public Relations & Information 271 Annual Report 2010-2011 Hospital Directorate of Public Relations & Information

G Opening ceremony (new department) 2 H Others 19

EMPLOYEE SERVICES DEPARTMENT Activities Number of Activities during 2011 Police station visits 2 Court visits 0 Receiving employees from airport 375 Farewells 75 Visas issued 1350 Visas deposited 223 ID cards issued 3250 Road passes issued 275 Others 198

TRAINING & SCHOLARSHIPS Mr. Khamis Al-Farsi attended short training courses in the year 2010 in Malaysia; Mr. Yahya Al-Hasani, Head of Depatment, is completing a Bachelor’s Degree in Business Administration in 2011, and Mr Abdullah Al- Owaisi has completed a Bachelor’s Degree in Business Administration.

272 Hospital Directorate of Technical Affairs Overview Technical Affairs Directorate is responsible for the operation and maintenance of all buildings, services, plants, equipment and infrastructure in the Hospital to ensure they are available for the smooth running of the Hospital. The Department is also responsible for planning and execution of new buildings to cater for the new hospital development.

The Directorate has four departments: Projects, Bio-Medical Engineering, Hospital Engineering and Mainte- nance, and Health, Safety and Fire Prevention.

PROJECTS DEPARTMENT This Department is responsible for carrying out feasibility studies with land surveys and field orientations according to the requests received from various departments. It compiles preliminary data to suit the facili- ties, and compiles briefs of requirements and preliminary sketches in consultation with user departments. It also compiles tender documents for consultancy services for design and supervision for major projects, while minor projects are dealt with in-house. It reviews designs and documentation produced by consul- tants and liaises for the processing of various statutory approvals. It then reviews the tenders with analysis and recommendations. Finally, it carries out contract administration works with supervision of sites and monitoring the progress of projects to ensure quality work is produced within the time schedules.

HEALTH, SAFETY AND FIRE PREVENTION DEPARTMENT This Department, in coordination with the Health and Safety Committee, formulates health, safety and fire policies; monitors and ensures strict adherence to the policies; investigates any incident that may have an impact on health and safety, and trains hospital staff in health, safety and fire prevention.

BIOMEDICAL ENGINEERING DEPARTMENT This Department is responsible for the procurement and maintenance of biomedical equipment, such as MRI machines, CT Scanners, X-Ray machines, Vital Sign Monitoring and all diagnostic and life saving equipment.

HOSPITAL MAINTENANCE DEPARTMENT This Department is responsible for all Hospital buildings and all equipment except bio-medical equipment. The Department is sub-divided into three sections: departments

support Affairs Hospital Directorate of Technical 273 Annual Report 2010-2011 Hospital Directorate of Technical Affairs

MECHANICAL SECTION Responsible for water services; kitchen equipment; medical gases; disinfection and sterilisation equipment; the natural gas system; sewage; lifting stations; hospital beds; fire fighting equipment, and safety cabinets

HVAC SECTION Responsible for heating, ventilation and air conditioning (HVAC) systems and refrigeration equipment.

ELECTRICAL SECTION Responsible for the power distribution system; lifts; lighting; the paging and telephone systems; HVAC con- trols; uninterruptible power supplies; nurse call systems; intercom systems; public address systems; road barriers, and the audio-visual distribution system.

CIVIL SECTION Responsible for buildings maintenance; soft landscaping maintenance; keys; sign posting; minor modifica- tions and upgrading; renovation of all facilities, and the infrastructure system.

LAUNDRY & HOUSE KEEPING DEPARTMENT This Department is responsible for cleaning services of the buildings and washing of Linen of the Hospital wards and Clinical Staff Uniforms.

Staff Juma S. Al-Jabri, Director Dr. Fahad Al-Hosni, Deputy Director Muhammed Mustafa, Coordinator Projects Mohan Rao Kailas, Civil Subhash Sule, Mechanical Engineer Benjamin George, Mechanical Engineer Arun K. Singh, Electrical Engineer Muthuraj, Civil Engineer Mabruka Al Siyabi, Sr. Civil Engineer Mohammed Kunhi, Draughtsman

274 Health, Safety & Fire Prevention Vaseem A. M. Mirza, Health & Safety Ahmed Al-Mahruqui, Fire Officer Mazin A. H. Al-Zadjali, Fire Assistant Nasser Al-Manai, Fireman Biomedical Engineering Abdullah M. Al-Hashmi, Head, Biomedical Engineering Khalid M. Al Mahrizi, Senior Engineer Shuwaina N. Al-Harrasi, Clerk Zuwaina A. Al-Tooqi, Coordinator Edgar K. Sanz, Senior Engineer Dominador De Guzman, Senior Engineer Santiago O Buniag, Engineer Khamis H. Al-Lamki, Engineer Ravindra Inamdar, Senior Engineer Madhan G, Engineer Amur Al-Sindi, Engineer Hamid Moh’d Al-Mayahi, Engineer Ghassan S. Al-Ghassani, Engineer Saif K. Al-Hinai, Engineer Adil M. Al-Harthy, Engineer Mohsin S. Al-Naamani, Engineer Sultan H. Al-Qalhaty, Technician Taha I. Al-Husseini, Technician Jassim S. Al-Rusheidi, Technician Hospital Engineering & Maintenance Abdullah S. Al-Hinai, Chief Engineer Manikonda V. Rao, Coordinator Salem Al-Hadhrami, Electrical Engineer Venkatesh Prasad, Electrical Engineer Tariq Al-Lawati, Mechanical Engineer Prabu D. Singh, Mechanical Engineer Jamal Al-Belushi, Civil Engineer Ahmed Al-Busaidi, Maintenance Technician

Adel Al-Ghafri, Technician departments

Fahad, Technician support Affairs Hospital Directorate of Technical 275 Annual Report 2010-2011 Hospital Directorate of Technical Affairs

Murad Al-Saadi, Clerk Maniha Q. Al-Shanfari, Clerk Support Services Maintenance Sulaiman Al Farei, Head, Laundry & Housekeeping Ayub Al Hadhabi, Housekeeping Supervisor Sateesh T. N., Housekeeping Supervisor Nasser Al Shargi, Store In-charge Sultan Al Busaidi, Laundry Supervisor Maryam, Tailor Activities in 2011 EQUIPMENT During this period, we acquired many new items of equipments to improve patient care and to support re- search. Some of the major equipment items are:

Biomedical Equipment for 2011 Sl. No Name of the Equipment Value (OR) 1. Infusion Stand 31,338.350 2. Infant Warmer with Resuscitator 50,617.000 3. Transport Incubator 5,020.000 4. Non Invasive Bilirubinometer 9,280.000 5. Neuroendoscope - Complete System 96,971.250 6. Haemofiltration Machine 39,315.300 7. CPAP System Nasal 8,315.000 8. Monitor Vital Signs with Trolley 92,580.000 9. Physiotherapy Light 11,520.000 10. Syringe Driver 6,900.000 11. Digital Diaper Scale 7,756.900 12. Suction Machine 6,360.000

276 13. Video System for Paediatric Surgery + 48,111.000 Telescope 14. Microscope Operating 173,894.500 15. Puncher Dried Blood Spot Puncher 13,300.000 16. Plate Washer 7,590.000 17. Plate Reader 25,585.000 18. Examination Chair/Hydraulic Chair 8,920.000 19. Broncho Videoscope 59,583.000 20. Humidifier 11,025.000 21. Colposcope 18,835.000 22. Endoscope to be used for Lucera System in 9,022.000 Minor OT 23. Thermometer - Digital 26,650.000 24. Air Oxygen Blender 9,360.000 25. Intra Compartmental Pressure Monitor 5,960.000 System 26. High Performance Liquid Chromatography 67,376.000 27. CPAP System Nasal 11,850.000 28. Opthalmic Laser Unit for DCR 24,000.000 29. Fluid Warmer 5,445.000 30. Electro-Surgical Unit 26,808.000 31. Recorder ECG 15,913.000 32. LC-MS/MS TANDEM Mass Spectrometry 138,587.000 33. Ventilator Adult (Non invasive) 19,500.000 34. Biometry Machine 22,100.000 departments

35. Light Source 16,980.000 36. CR Long Length Imaging System 9,775.000 support Affairs Hospital Directorate of Technical 277 Annual Report 2010-2011 Hospital Directorate of Technical Affairs

37. Hysteriscope 26,878.000 38. Laparoscope 57,415.000 39. EEG Recorder 23,636.295 40. CISH and Fish Autostainer 67,464.000 41. Monitor Vital Sign 21,870.000 42. Infusion Pump Ambulatory 29,494.250 43. Immunoflourescence Microscopy 12,950.000 44. Ventilator Neonatal 75,768.000 Total OR 1,457,618.845

HMD Equipment for 2011

Sl.No Name of the Equipment Value (OR) 1. Cart Anaesthesia Aluminium 6 Drawers 6,890.000 2. Hot & Cold Motorized Food Trolleys 243,000.000 3. Operation Tables 44,451.000 4. Bed Examination Couch 5,894.000 5. Gas Boiling Pan 15,600.000 6. Ultra Low Freezer 5,696.500 7. Bed Electric for ICU 87,000.000 8. Bed Trolleys 36,440.000 9. Ironer Industrial 72,100.000 10. Trolley – Cold Room Storing 7,875.000 11. Deioniser Output 5 to 6 Ltr P/H 8,193.750 12. Bed – Electric 87,000.000 13. Ambulance Stretcher with Accessories 6,859.000 14. Work Top Sinks 4,320.000

278 15. AC Split + Window Type 9,851.000 16. Accessories for Anaesthesia Cots 5,054.550 17. Mobile Bain Marie 6,150.000 18. Refrigerator – 1500 Ltrs 5,250.000 19. Steam Sterilizer with Dual Door 50,180.000 20. Refrigerators/Freezers 17,243.000 Total 725,047.800

Projects To meet the hospital expansion plans the following projects are under taken:

Project under Design S. No. Description Value (OR) 1. Modifications in Block-13 Building for cre- 120,000.000 ating Kidney Dialysis Facilities 2. Shaded Car park at Medical Store Annexe 12,000.000 Building 3. Modification works in Paediatric OPD 50,000.000 4. Conversion of Postmortem room to Mortu- 20,000.000 ary 5. Covered passage between Block 3 & 4 (Lev- 16,000.000 el 1) 7. Modifications works in Day Care Unit 15,000.000 8. Expansion of Kitchen 300,000.000 9. Replacement of Generator Sets 269,339.000 Sub-Total 802,339.000 departments

support Affairs Hospital Directorate of Technical 279 Annual Report 2010-2011 Hospital Directorate of Technical Affairs

Project under Execution/Construction S. No. Description Value (OR) 1. UPS in IDF (Switch Rooms) 6,000.000 2. Public Address System 38,381.120 3. MDF Installation in PABX Room 4,500.000 4. Additional CCTV System 35,000.000 5. Construction of Medical Store Annexe 1,715,641.300 Building 6. Multi-Tier Heavy Duty Racking in Medical 175,670.000 Store Building 7. Modification works in Neonatal Clinic in 4,000.000 Block-3 Level-2 8. Additional Works in Family Medicine & 3,000.000 Public Health Clinic 9. AHU’s replacement in laboratories in 231,378.000 Block-9 10. Rented Chillers for 2012 128,667.000 11. AC System for HIS Server Room in Block-9 53,812.000 12. Modification Works in several locations for 144,728.100 creating On Call Rooms and Modifications in the Toilets in Block-11 13. HVAC Modification Works in Paediatric 7,560.000 OPD 14. PMG works in neonatal 4,400.000 15. Modification works in Delivery 15,000.000 Sub-Total 2,567,737.520

280 Projects Completed S.No. Description Value (OR) 1. Grading and Levelling the area of North 97,000.000 East Sector for Construction of Haematol- ogy & BMT Centre Building 2. Modification in Linen Store in Block-17 for 71,064.814 conversion to Genetic Clinic in SQUH (Civil & Electrical) 3. HVAC works in Genetics Clinic in Block-17 65,886.000 4. Vinyl Flooring in New Genetic Clinic in 4,301.000 Block-17 5. Renovation works in Bio-Chemistry Labs 1,700.000 6. Modifications in Wards for creating High 11,666.000 Dependency Bays (Civil & Elec.) 7. Modifications in Family Medicine & Pub- 9,600.000 lic Health Clinic and Oral Health (Civil and Electrical) 8. MDF in PABX Room 4,200.000 9. Modification in A&E Pharmacy (Civil & 4,895.000 Electrical) 10. Public Address System in SQUH 35,851.000 11. Folding partition in Physiotherapy Dept. 2,650.000 12. Raised Access Floor in PABX Room 856.000 13. Supply and Installation of 4 FCU in Admin- 4,965.000 istration 14. Supply and Installation of four new pack- 14,800.000 age units in Block-10 A 15. Improvement of AC in Block-10A 14,430.000 departments 16. Extract System for CICU Isolation Room 4,750.000 17. PMG Works in Clinical Physiology Dept. 6,500.00 support Affairs Hospital Directorate of Technical 281 Annual Report 2010-2011 Hospital Directorate of Technical Affairs

18. PMG Works in High Dependency 4,500.000 19. Installation of Pneumatic System 245,000.00 20. Consultancy Services for Design of Haema- 189,648.000 tology and BMT Centre 21. Expansion of Operating Theatres (8 new) 48,400.000 and Expansion of Radiology 22. Supply & Fix Laboratory Benches and Cori- 10,970.000 an Top for the Microbiology and Pathology 23. Planter Boxes (Behind Block-3) 13,260.000 24. Supply & Fix Base Units & Wall Units in 8,900.000 Staff Base Areas at Wards and Delivery Total 875,792.814

Expenditure 2009 2010 2011 Amount (OR) Amount (OR) Amount (OR) Projects 2,681,159.000 7,061,394.718 4,245,869.334 Engineering Equip- 158,500.000 365,294.450 733,947.800 ment Replacement Biomedical Equipment 425,431.898 1,225,041.600 1,457,618.845 Building Modifications 28,667.593 22,703.255 33,130.000 Maintenance of Plant 649,118.439 729,249.437 720,415.374 and Equipment Maintenance of Bio- 25,988.000 462,302.031 489,434.819 medical Equipment Cleaning & Pest Control - 461,497.805 487,168.800 Services Laundry Services - 120,675.440 123,952.224 Grand Total 3,968,864.930 10,448,158.736 8,291,537.196

282 Energy Consumption Year 2009 Year 2010 Year 2011 Amount (OR) Amount (OR) Amount (OR) Electricity (kwh) 1,199,166.000 1,130,487.990 1,055,688.495 Water (ltrs.) 80,120.000 82,606,259 71,922.245 Gas (M3) 2,849.000 4,124.805 7,303.261 Total 1,282,135.000 1,217,219.054 1,134,914.001 departments

support Affairs Hospital Directorate of Technical 283 Annual Report 2010-2011 Hospital Directorate of Training & Continuing professional Development

Hospital Directorate of Training & Continuing Professional Development Overview The vision of the Directorate is to be a training centre of excellence in Oman assuming a leadership role in continuing education, research and providing the highest standard of programmes to meet the educational and competency-based training needs of Sultan Qaboos University Hospital staff. The mission of the Direc- torate is to offer excellence in providing opportunities for training, professional development, continuing education, and in-house training for all Sultan Qaboos University Hospital staff, thereby promoting the de- livery of highest quality patient/client care.

Staff Khalsa M. Al-Maawali, Acting Director Kirsten Rude, Teaching Staff Barbara Hall, Teaching Staff Esther H. Bonam, Teaching Staff Huda Al-Hosni, Teaching Staff Salha Al-Alawi, Head, Scholarships Samson Pakalapati, Administrator Rashid Al-Hajri, Administrator Ali Al-Owaisi, Administrator Najla Al-Rashidi, Administrator Hind Al-Ghailani, Administrator Amal Al-Mayahi, CPD Administrator Yahya Al-Rawahi, Messenger Activities in 2011 - Conducted courses and programmes as published in the bi-annual course schedules. - 2011- Event Reflection – DTCPD and data submitted to Hospital Director General with the following attachments: conducted attachment programmes and processed attachment requests from institutions/individuals. - Conducted teaching and consultations as per requests - Admission process for CSSD Technician course

284 - Revised old policies, procedures and processes - Participated as member of various SQUH committees - Revised and published course curricula - Revised and published course books - Developed/revised Directorate documentation to meet ISO 9001-2000 requirements - Prepared and submitted Equipment Budget - Departmental training needs assessed for all categories of courses from departments - Updated Departmental Training Committee members list - Worked on and implemented various proposals for Unscheduled In-house Development courses - Identified external short-term courses for departments and processed the applications - Conducted typing tests for prospective candidates for Personnel Affairs - Scrutinised scholarship applications and forwarded to Hospital Training Committee (HTC) - Developed a proposal for reimbursing instructors coming from clinical areas of SQUH - Updated all forms used in DTCPD - Introduced Chemotherapy Administration course in 2-day format - Developed & revised KPI plan on new format and submitted quarterly progress report on KPI to Directorate of De- velopment and Quality - Implemented new Neonatal Resuscitation course to replace the Neonatal Resuscitation Provider & Recertification courses - Revised BLS, ACLS, PALS courses to reflect the 2010 AHA/ILCOR guidelines and timetable changes - Revised ACLS & BLS courses to follow the AHA course format - Applied and obtained accreditation and credit points for Scheduled and Unscheduled In-house development pro- grams from Oman Medical Specialty Board (OMSB) - Amended Database to document individual training credits of staff - Participated as a member of IV Therapy Policy Working Group DEVELOPMENTS UNDERTAKEN - Updated guidelines for smooth processing of training requests - Developed action plan for Risk Management departments

- Updated colour-coded Bi-annual Course Programme Schedule indicating eligibility requirements - Implemented IV Instructor Program support & Continuing Professional Development Hospital Directorate of Training 285 Annual Report 2010-2011 Hospital Directorate of Training & Continuing professional Development

- Changed the certificates/cards and other relevant forms/policies etc. incorporating the new name of the directorate “Directorate of Training & Continuing Professional Development (DTPCD) - Published DTCPD Newsletter - Implemented ACLS Instructor course DEVELOPMENT OF DTCPD STAFF - Emergency First Responder course - Student Assessment Workshop, SQU - 11th Medical Update Conference, SQU - 3rd International Congress Infectious/Tropical Diseases OMANISATION Appointed new Omani clerical/coordinator staff member.

286 Hospital Finance Departrment Overview The responsibilities of the Hospital Finance Department involve:

1. Preparation of the Hospital annual budget for approval by the Ministry of Finance, monitoring the approved funds for effective utilisation, monitoring of the staff induction against staff budget approval, the maintenance of various statistics pertaining to staff, etc. 2. Processing staff salaries on a monthly basis and ensuring timely payments; processing leave salaries; timely settle- ment of terminal benefits of staff leaving the hospital permanently, etc. 3. Processing supplier’s and contractor’s bills for payments in coordination with supplies and stores departments. 4. Maintaining the petty cash account. 5. Collection of revenue from paying patients, private hospitals, insurance companies, etc. 6. Liaising with the Ministry of Finance and other government agencies. 7. Providing various statistics and other information requested by the University Administration and other Ministries. 8. Undertaking specific assignments desired by the Hospital Management.

Staff Nasser S.M. Al-Salmi, Director, Financial Affairs Ahmed S.A. Al-Farsi, Acting Deputy Director, Financial Affairs M.S. Subba Rao, Senior Technician/Statistician Adnan J. Al-Mosawi, Head, Treasury section Suleiman S. Al-Abri, Head, Revenue Section Khamis M. Al-Muzaini, Head, Contracts Section Salim H.H. Al-Sinawi, Accountant Hamoud S. Al-Farsi, Accountant Hilal A. Al-Daghaishi, Head, Salary section Sulaiman D.O. Al-Bulushi, Accountant Salah S.S. Al-Nadabi, Head, Expenditure Section Zakiya S.A. Al-Husni, Accountant Zuweina A.M. Al-Habsi, Accountant Suroor M.K. Al-Rubaiey, Accountant departments Naeema J.R. Al-Saadi, Accountant Azhar S.S. Al-Dhugaishi, Accountant support Hospital Finance 287 Annual Report 2009-2010 HospitalAnnual Finance Department Report 2010-2011 Hospital Finance Department

Mohammed J.S. Al-Ramadhani, Accountant Hamad S.H. Al-Sabti, Accountant Khalfan S. Al-Farei, Accountant Ibtisam J.J. Al-Malki, Accountant Mr.Younis K. Al-Siyabi, Accountant Ms.Saada H. K. Al-Maamri, Accountant Ms.Fakriya S. R. Al-Hajri, Accountant Nadia S.S. Al-Ramadhani, Coordinator Sulaiman H.S. Al-Talei, Messenger Activities in 2011 1. During the year ending 2011, the number of staff being paid salaries was 2,438. 2. The Hospital budget for the year 2012 was prepared and submitted on time to the Ministry of Finance for approval. 3. The Department also processed 4,592 vouchers of suppliers and contractors for payment during the year ending 2011. 4. The Hospital revenue collection for the years ending 2011 was OR 1,237,359.375 which accounted for an increase of around 200% over 2010 revenue generation. 5. Constant monitoring of the budgetary allocation and timely intervention has resulted in the utilization of budget to the extent of 100 % for the year ending 2011. 6. The petty cash disbursement for purchase of some day to day urgent items for the year 2011 was OR 27,830.744.

288 Hospital Housing Department Overview The Housing Department is responsible for arranging accommodation for all the SQU Hospital employees. Assignment of residences is allocated as per housing rules and policy according to provisions of employment contracts.

Residences on-campus are available in different types of categories such as family, single and sharing for senior and junior staff. In addition, the Department hires/rents accommodation units, in order to cover the shortage in the number of residences available on-campus.

The Housing Department plays a vital role in the preparation of residential premises, ensuring they are fit for occupancy. Inspections and housekeeping are carried out by Housing Department staff and any required work is referred to the appropriate hospital department.

Staff Bader Al-Hasni, Head of Department Bader Al-Habsi, Deputy Head Naeema Al-Jufaili, Coordinator Mahboob Al-Belushi, Residence Furnishing Officer Abullah Al-Jaradi, Residence Furnishing Suleiman Al-Esmaily, Inspection & Maintenance Inspection Follow-up Officer Mohammed Al-Wahaibi, Development Assistant Khalifa Al-Hinai, Offices Furnishing Officer Mohammed Al-Malki, Housekeeping Bader Al-Hadabi, Housekeeping

The Department has ten employees and four workers. The Department is fully Omanised.

Activities in 2011 - Follow-up to the request of providing training for housing staff with the Training Services Directorate. departments

- New purchase for residential requirements. - Renewal of lease contracts for one more year. support Hospital Housing 289 Annual Report 2010-2011 Hospital Housing Department

- Increasing the number of hired accommodation to cover the shortage on campus for hospital expansion. - Contribute quality management activities for ISO 9001:2000. BSI

- Preparation of obsolete items for auction.

- Follow-up of administration top management re Housing request for supply of extra vehicles.

- Follow up the request to appoint more staff to the department due to increasing job responsibilities.

- New store for Housing Department and new extension to existing medical store.

HOUSING ALLOWANCE In order to cover residential accommodation shortages, there has been provision of housing allowances for newly recruited employee nurses after they vacated their junior nurse accommodation.

MAINTENANCE Most maintenance requests and other requirements have been successfully met through appropriate liai- son.

RESIDENCE CLEANING The cleaning and preparation of residential units have successfully been completed before occupancy.

290 Hospital Medical Records Department Overview The goal of the Medical Records Service is to create and maintain systems which support health care pro- viders, public studies, financial organisations and, most important of all, the needs of the patient. The hos- pital currently has a hybrid records system that involves most information being held in the new Hospital Information System, TrakCare, which have been recently updated with new version P9. A small amount of information is still held on paper records. The goal is to have a full electronic health record functioning by the end of 2012.

The Department operates with a sincere and highly committed staff team, consisting of 53 young Omanis, in its six sections. An Omani head leads the Department.

The Filing & Retrieval Section retrieves records for treatment and provides services for medical students, doc- tors, nurses and other paramedical staff who need to perform retrospective research or study.

The Processing & Assembling Section ensures that all records have a complete discharge summary and all other notes and reports are present. In addition, they ensure that records are assembled in an orderly and timely manner and signed-in in the system. Also, they scan all the important documents in the new elec- tronic patient record which are not entered directly, such as consent forms. A fax and referrals office has been added to this section.

The Admission & Registration section is the largest section with all the clerks and receptionists of all the clin- ics: OPDs, X-ray, Physiology, Oral health, Family & Community Health and the Student Clinic. Registration of patients in the Emergency Department is an important part of our activity as it is a crucial and critical area in the Hospital, which runs 24 hours a day.

The Statistics Section prepares statistics for the administration, hospital departments, and outside agencies such as the Ministry of Health. It also provides health information for physicians, nurses and students for medical research purposes.

The Coding Section analyses all inpatient discharge records and assigns a numeric code to diagnostic data based on (ICD-10) the International Classification of Diseases classification system and (ICD-9-CM) for pro- cedures.

The Births & Deaths Section issues electronic birth notifications for new born babies, and death notification departments

for those who died in SQUH, in both the Arabic and English languages. The Royal Oman Police, Directorate of Civil Services issues the certificates. A copy of the register is send to the Ministry of Health every single month. support Hospital Medical Records Department 291 Annual Report 2010-2011 Hospital Medical Records Department

14849 15544 12066

42077 118454

12999

21592

85740

Out-patient clinics Radiology Clinical Physiology Day Care Unit Famco Oral Health Student Clinic Physiotherapy

Staff Activities 2011 Salim K. Al-Wahaibi, Head of Department The volume of our activity in the Medical Records Ahmed Al-Farsi, Deputy Head of Department Services for 2011 is shown in the table below: Saif Al-Raqadi, Supervisor Activity 2011 Mubarak Al-Habsi, Supervisor Abdullah Al-Wahaibi, Supervisor Patients registered in Emergency 66,494 Yousif Al-Falahi, Supervisor Dept. Huda Al-Suwaidi, Supervisor Inpatient coded records 25,589 Mahfoudhah Al-Zadjali, Supervisor Salim Al-Hadi, Acting Supervisor Birth notifications issued 3,393 Naji S. Azzan, Acting Supervisor Death notifications issued 565 Khamis S. Al-Farsi, Acting Supervisor

292 Hospital Transport Department Overview The Department provides the following services:

- Transport services for SQUH staff. - Transfer of patients either by car or ambulance to another hospital or the airport. - Delivery and collection of mail and medical reports to and from other governmental institutions. - Transport for female students and patients between their residential complex and the Hospital.

Staff Nassir H. Al- Gaffari, Head of Department Essa K. Al-Raisi, Staff member Drivers: 28 departments

support Hospital Transport 293 Annual Report 2010-2011 Annexes

Appendices Appendix I CONFERENCES SEMINARS & WORKSHOPS ORGANISED BY THE COLLEGE OF MEDICINE & HEALTH SCIENCES AND SULTAN QABOOS UNIVERSITY HOSPITAL 2010–2011

Conference Title Dates Oman International Conference on Laboratory Medicine 9-11 November 2010 1st International Patient Safety Conference 31 January to 2 February 2011 Metabolic Disease Services at SQUH: Past Present and Future, and 1st January 2011 Oman Metabolic Awareness Day International Conference on Controversies in Breast Cancer Manage- 12-14 February 2011 ment – with Oman Medical Specialty Board 11th Advanced General Medicine Conference - with Royal College of 23–24 February 2011 Physicians (UK) and the Ministry of Health, Oman 2nd National Symposium on Sleep Medicine – with Oman Respiratory 4-5 May 2011 Society Symposium on Haemophilia – with World Federation of Hemophilia 29 September 2011 2nd National Update on Chronic Obstructive Pulmonary Disease - with 14 October 2011 Oman Respiratory Society 3rd International Congress on Infectious Diseases and 6th GCC Confer- 4- 8 December 2011 ence on Infection Control – with Ministry of Health Seminar or Workshop Title Dates Hirschsprung’s Disease Scientific Update 25 October 2010 Advanced Laparoscopic Gastrointestinal Course 15-19 January 2011 Nutrition Workshop for Metabolic Diseases January 2011 Curriculum, Postgraduate Studies & Research Retreat 3 March 2011 Medical Awareness of Hemophilia 7 July 2011 Workshop on Medical Research Methodology 12-15 November 2011 294 SURGERY, CLINICAL DISCIPLINES, RADIOLOGY, ANATOMY, PSY- CHIATRY AND LABORATORY SCIENCES Throughout the academic year, the College of Medicine & Health Sciences conducts weekly Surgical Patho- logical Conferences (SCRAPS) where multidisciplinary cases are presented to medical students, residents, clinicians and academics in the University as part of continuing medical education.

SCRAPS is the oldest and only regular academic activity that brings all the students and staff of the Col- lege and Sultan Qaboos University Hospital together. SCRAPS started in the late 1980s during the term of the College’s first Dean, Prof. Gilbert Heseltine, and was initiated by Prof. William Jeans. Responsibility was passed on to Prof. Christopher Grant, Prof. Gordon Reeves, Prof. Keith Whaley, Prof. Mansour Al- Moundhri, Prof. Anand Date, Dr. Aisha Al-Hamadani and now to Dr. Maha Al- Khaduri of the Department of Obstetrics & Gynaecology.

On average there are about 30 scheduled SCRAPS sessions in each academic year. The presentations are made by all the departments in the college and hospital in turn with contribution from other departments depend- ing on the nature of the case. The content includes basic sciences, clinical updates and research conducted at SQU. The presentation lasts 45 minutes followed by open discussion. The discussions at SCRAPS have been a forum in which suggestions for policies in health care at an institutional and national level have been made and this has been a basis for constructive contributions to community service. The target audience includes medical students, postgraduate residents, Masters and Ph.D. students, junior and senior doctors.

The objectives of SCRAPS are to:

1. Learn how to conduct multidisciplinary clinical case presentations. 2. Increase the knowledge of undergraduate and postgraduate students in different fields of medicine. 3. Be updated on advancements in different fields of laboratory and clinical medicine. hospital 4. Gain knowledge of research conducted in different medical specialties. and

5. Improve presentation skills of undergraduate and postgraduate students.

The SCRAPS Committee was formed in 2010. It consists of ten members whose role is to attend and evaluate the SCRAPS presentations and submit a report at the end of the academic year ranking these presentations university in order of content and clinical relevance. The Committee uses two evaluation forms: one to evaluate the SCRAPS presentation overall and one to evaluate medical student presentations. There are also 3 prizes for the best SCRAPS every year. qaboos

Annexes sultan 295 Annual Report 2010-2011 Annexes

There were a total of 19 SCRAPS presentations in 2010-2011. New this year was the introduction of the best student SCRAPS presentation award in order to encourage student involvement and attendance in SCRAPS.

Chairperson of SCRAPS Dr. Maha Al-Khaduri Assistant organizer Mr. Ahmed Al-Wahaibi

PRIZES FOR 2010- 2011 WERE AS FOLLOWS: Best Student Presentation Sadiq Al-Khaboori

Best SCRAPS First place ‘Back from Darkness’ Dr. Amna Al- Futaisi, Department of Child Health

Second place ‘One Lucky Guy’ Dr. Hani Al-Qadhi, Department of Surgery

Third place ‘I Deserve Better Care’ Dr. Muna Al-Saadoon, Department of Child Health

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