Original Articles
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Perception and Usage of Point of Care Devices: A Cross-sectional Study Targeting Residents and Trainers in Oman
Amna Al Harrasi, Laila Mohammed Al Mbeihsi, Abdulhakeem Al Rawahi, Mohammed Al Shafaee
Objectives: The use of mobile technologies and handheld computers by physicians has increased worldwide. However, there are limited studies globally regarding training physicians on the use of such devices in clinical practice. In addition, no studies have been conducted previously in Oman addressing this issue among postgraduate medical trainees and trainers. The present study explores the practice and perception of resident doctors and trainers towards the use of mobile technologies and handheld devices in healthcare settings in Oman. Methods: This cross-sectional study was conducted using a validated questionnaire disseminated via email to all residents and trainers in five major training programs of the Oman Medical Specialty Board (OMSB). The questionnaire explored three main areas; perception, usage, and perceived barriers of handheld devices. Results: Overall, 61.4% of the residents and 28.3% of the trainers responded to the questionnaire. Both types of participants agreed that the use of such devices positively affects clinical decision-making. In total, 98.8% of the participating residents and 86.7% of the trainers frequently used handheld devices. Both OMSB residents and trainers agreed that lack of time, training, and applications were the most common factors limiting the use of these devices. Participants emphasized the need for constructive training regarding the use of handheld devices as healthcare resources. Conclusions: Point-of-care devices are positively perceived and frequently used by OMSB trainees and trainers. However, constructive training on the effective usage of these devices in clinical decision-making is needed. Further future studies to evaluate the impact of using such devices in patient care should be conducted.
Keywords: Internship and Residency; Point-of-Care Systems; Cross-Sectional Studies; Clinical Decision-Making; Oman; Computers, Handheld; Training Support.
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Neutrophil-to-Lymphocyte Ratio as an Alternative Marker of Neonatal Sepsis in Developing Countries
Khadijah Rizky Sumitro, Martono Tri Utomo, Agung Dwi Wahyu Widodo
Objectives: We sought to analyze the neutrophil-to-lymphocyte ratio (NLR) as an alternative marker of neonatal sepsis. Methods: In this cross-sectional study, we undertook consecutive sampling in all inborn neonates admitted to the Neonatal Intensive Care Unit with clinical manifestations of neonatal sepsis. Neonates with congenital anomalies and referred neonates were excluded. Complete blood count, C-reactive protein (CRP), and blood culture were carried out as the septic workup examinations based on the local Clinical Practical Guidelines. NLR is obtained by dividing the absolute count of neutrophils from lymphocytes manually. A cut-off value of NLR is obtained using a receiver operating characteristic curve. Results: The median NLR value of the 104 neonates who met the inclusion and exclusion criteria was 3.63 (2.39–6.12). Neonates with NLR of 2.12 have the area under the curve of 0.630 (95% confidence interval (CI): 0.528–0.741) and 0.725 (95% CI: 0.636–0.814) when combined with CRP = 2.70 mg/dL. Neonates with NLR ≥ 2.12 in clinical neotnatal sepsis had almost double the risk of providing positive blood culture results (relative risk = 1.867, 95% CI: 1.077–3.235; p = 0.011). Conclusions: NLR, calculated from complete blood count, can be used as an alternative marker of easy and relatively inexpensive neonatal sepsis, especially in developing countries, and detection of proven neonatal sepsis to be better when combined with CRP.
Keywords: Infant, Newborn; Neonatal Sepsis; Neutrophils; Lymphocytes; Intensive Care Units, Neonatal; C-Reactive Protein.
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Prevalence of Gestational Diabetes Mellitus Using the Latest World Health Organization Diagnostic Criteria among Omani Women in Muscat, Oman
Saada K. Al Subhi, Rahma M. Al Kindi, Abdul Hakim Al Rawahi, Iman S. Al Seyabi, Ameena Al Mukhaini
Objectives: In 2013, the World Health Organization (WHO) recommended new criteria for diagnosing gestational diabetes mellitus (GDM). Our study aimed to compare the incidence of GDM and its complications among Omani pregnant women using the new diagnostic criteria compared to previous criteria published in 1999. Methods: This retrospective cohort study was conducted between January and December 2016 at the Bawshar Specialized Polyclinic in Muscat, Oman. A total of 613 Omani women were included in the study. Baseline maternal characteristics such as age, body mass index, parity, and socioeconomic status were recorded in addition to maternal and neonatal outcomes. Results: Based on the current diagnostic criteria, the incidence of GDM was 48.5% (n = 297); however, this dropped to 26.4% (n = 162) when applying the old criteria. Moreover, rates of maternal complications including polyhydramnios (5.6% vs. 4.6%), pregnancy-induced hypertension (3.2% vs. 1.5%), and preterm delivery (3.2% vs. 1.5%) were slightly higher among women with GDM diagnosed using the latest criteria. However, these differences were not statistically significant. Neonatal complications were also slightly more frequent among the first group, without any significant differences. Conclusions: The incidence of GDM among Omani women rose dramatically when utilizing the latest WHO diagnostic criteria, owing to a lower fasting blood glucose cut-off value. In addition, a comparison of the frequencies of maternal and neonatal complications supports the validity of the new criteria. These findings should be taken into consideration by decision-makers in Oman when planning antenatal and postnatal services.
Keywords: Diabetes, Gestational; Incidence; World Health Organization; Oman.