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Tobacco use among Omani physicians and dentists has not been studied, so we conducted a cross-sectional survey using a WHO questionnaire to measure prevalence and to learn about smoking practices among this population and about their knowledge and attitudes of the health effects of tobacco use and tobacco control. The 1191 subjects who participated (787 men and 404 women) ranged in age from 24 to 65 years with a mean (SD) of 41.7 (6.8) years for men and 38.1 (6.9) years for women. The prevalence of tobacco use was 16.4% among males and less than 1% among females. Manufactured cigarettes were the most common form of tobacco used (14.7%), followed by smokeless tobacco (2.2%) and waterpipes (1.7%). Tobacco users were significantly less favorable to strict control and policy measures than never tobacco users and had less knowledge of some of the heatlh effects of tobacco use. Tobacco use among physicians and dentists in Oman is lower than in other countries in the region, but remains a cause of concern. Programs and policies should strive to maintain the low level of tobacco use or reduce it further.

Access to glycosylated hemoglobin (HbA1c) assays in clinical practice remains limited. We investigated the relationship of fasting plasma glucose and HbA1c to determine optimal glucose levels for predicting HbA1c.We retrospectively analyzed data on 2888 patients with type 2 diabetes mellitus agedor=20 years using a linear regression of HbA1c against fasting plasma glucose. A receiver-operating characteristic analysis was used to determine optimal cut-points for fasting glucose in relation to HbA1c, area under the curve, sensitivity and specificity, and 95% confidence intervals (CI) for each cut-point.The mean (standard deviation) for the age of patients was 52+/-11.6 years. The average HbA1c was 8.9+/-2.46% and mean fasting plasma glucose was 10.1+/-3.62 mmol/L. The prevalence of HbA1cor=7.0% and6.5% was 76% and 82%, respectively. Overall, fasting plasma glucose and HbA1c were linearly correlated (r=0.62, P=0.001). A fasting plasma glucose of9.0 mmol/L predicted HbA1cor=7.0% with an area under the curve = 0.807 (95% CI, 0. 0.794 to 0.821), while fasting plasma glucose8.2 mmol/L predicted HbA1c6.5%, with an area under the curve = 0.805 (95% CI, 0.791 to 0.818). The sensitivity of both cut-points was 64.5% and 70.7%, the specificity was 82.7% and 76.4%, the positive likelihood ratio was 3.73 and 2.99, and the positive predictive value was 92.2% and 93.2%, respectively.When HbA1c determination is not available, fasting plasma glucose levels may be used to identify patients with uncontrolled type 2 diabetes and initiate timely intensification of therapy to avoid long- term complications of diabetes.

Lung cancer is the most common cancer in the world, with an estimated number of 1.3 million new cases as of 2002. This is the first report from the countries that comprise the Gulf Cooperation Council (GCC).All the primary lung cancer cases registered in the Gulf Center for Cancer Registration during 1998 to 2001 were used to calculate the age-standardized incidence rate (ASR) per 100,000 person-years by the direct standardization method.Overall, there were 1607 (1261 males, 346 females) primary lung cancer cases registered during this period with the male to female ratio of 3.6:1. The highest ASR was in Bahrain (34.3 for males, 12.1 for females) followed by Qatar (18.5 for males, 5.5 for females) and Kuwait (13.8 for males, 4.0 for females); the lowest rate was in Saudi Arabia (4.8 for males, 1.3 for females). The mean age at diagnosis for males ranged from 68.7 years in Bahrain to 59.2 years in Oman. For females it ranged from 68.2 years in Bahrain to 58.0 years in Oman. Squamous cell carcinoma in males (except in Qatar) and adenocarcinoma in females were the predominant histological type.Cancer of the lung is one of the common cancers among males in all the GCC countries and ranks second among Bahraini females. Adenocarcinomas were more common in women than men.

BACKGROUND AND OBJECTIVES: Limited data are available on patients with acute coronary syndromes (ACS) and their long-term outcomes in the Arabian Gulf countries. We evaluated the clinical features, management, in-hospital, and long-term outcomes in such a population. DESIGN AND SETTING: A 9-month prospective, multicenter study conducted in 65 hospitals from 6 countries that also included 30 day and 1-year mortality follow-up. PATIENTS AND METHODS: ACS patients included those with ST-elevation myocardial infarction (STEMI) and non–ST-elevation acute coronary syndrome (NSTEACS), including non-STEMI and unstable angina. The registry collected the data prospectively. RESULTS: Between October 2008 and June 2009, 7930 patients were enrolled. The mean age [standard deviation (SD)], 56 (17) years; 78.8% men; 71.2% Gulf citizens; 50.1% with central obesity; and 45.6% with STEMI. A history of diabetes mellitus was present in 39.5%, hypertension in 47.2%, and hyperlipidemia in 32.7%, and 35.7% were current smokers. The median time from symptom onset to hospital arrival for STEMI patients was 178 minutes (interquartile range, 210 minutes); 22.3% had primary percutaneous coronary intervention (PCI) and 65.7% thrombolytic therapy, with 34% receiving therapy within 30 minutes of arrival. Evidence-based medication rates upon hospital discharge were 68% to 95%. The in-hospital PCI was done in 21% and the coronary artery bypass graft surgery in 2.9%. The in-hospital mortality was 4.6%, at 30 days the mortality was 7.2%, and at 1 year after hospital discharge the mortality was 9.4%; 1-year mortality was higher in STEMI (11.5%) than in NSTEACS patients (7.7%; P

BACKGROUND AND OBJECTIVES: Oman provides comprehensive care for the detection and management of diabetes during pregnancy with the goal of reducing or eliminating adverse outcomes for mothers and newborns. We assessed the outcome of pregnancies complicated with diabetes as compared to healthy controls. SUBJECTS AND METHODS: A 1-year retrospective review of registry records was conducted on pregnant women with gestational diabetes mellitus (GDM) and pre-gestational diabetes mellitus (PGDM). Of the 5394 women registered, 225 had GDM and 56 had PGDM. Fourteen cases of GDM and 2 cases of PGDM were excluded. For each patient recruited, the next healthy control of the same age and parity was selected. RESULTS: Nearly 80% of diabetic women achieved good glycemic control (hemoglobin A1c

Diabetes mellitus (DM) is a major public health problem in Oman. We evaluated the impact of the revised diagnostic criteria for DM adopted by the American Diabetes Association (ADA) on the prevalence of diabetes and impaired glucose tolerance (IGT), and on the classification of individuals among the Omani population.We used the dataset of the National Diabetes Survey, conducted in 1991 and involving 4682 subjects who did not have any missing data on fasting and 2-hour glucose. The subjects comprised 2002 males and 2680 females aged 20 years or above. Data were analyzed using the ADA criteria (diabetes as fasting plasma glucose [FPG]or =7 mmol/L, impaired fasting glucose [IFG] as FPGor =6.1 mmol/L and7 mmol/L), and compared these with the World Health Organization (WHO) criteria (diabetes as FPGor =7.8 mmol/L and/or 2-hour post-glucose loador =11.1 mmol/L, IGT as FPG7.8 mmol/L, and 2-hour post-load 7.8-11.1 mmol/L).Applying the ADA criteria on the Omani population resulted in an overall reduction of diabetes prevalence by 2.2% (95% confidence interval [CI] 1.6% to 2.8%), and a 4.8% reduction of IGT (95% CI 3.8% to 5.8%). Over 29% of diabetics classified by the WHO criteria were reclassified as being normal or having IFG by the ADA criteria. Around 3.6% of those who were normoglycemic by the WHO criteria were classified as having diabetes or IFG by the ADA criteria. In all but one region of Oman, the prevalence of diabetes and IFG using the ADA criteria was lower compared to the prevalence using the WHO criteria. Gender, age and body mass index did not seem to pose an increased risk to the probability of being diagnosed by one criteria or the other or both together.The adoption of the ADA criteria in Oman will significantly reduce the prevalence of diabetes and IGT. In addition, the glycemic status of a substantial number of individuals will be changed from normal to either being diabetic or having IGT.