Contents. Introduction 2. Accident and Emergency 20. Overview 8. Staff 21 Teaching Programmes 23 Training Courses & CME Activities

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3 Contents Introduction 2 Executive Summary 4 Overview 8 Academic and Patient Care Departments 18 Accident and Emergency 20 Overview 21 Staff 21 Teaching Programmes 23 Training Courses & CME Activities C 24 Clinical and Diagnostic Services 25 Research 27 Anaesthesia and Intensive Care Unit 30 Overview 31 Staff 31 Highlights of the Year Teaching Programmes 33 Training Courses & CME Activities 34 Clinical & Diagnostic Services 34 Research 34 a n n u a l re p o r t Contents Behavioural Medicine 36 Overview 37 Staff 37 Highlights of the Year Teaching Programmes 39 Training Courses & CME Activities 41 Clinical & Diagnostic Services 41 Research 42 Conference and Seminar Presentations 44

4 Biochemistry 46 Overview 47 Staff 47 Teaching Programmes 50 Research 53 Child Health 60 Overview 61 Staff 62 Highlights of the Year Teaching Programmes 67 Training Courses & CME Activities 69 Research 72 Research Projects 72 Thesis Supervision 80 Family Medicine and Public Health 82 C Overview 83 Staff 83 Highlight of the Years Teaching Programmes 85 Training Courses & CME Activities 87 Clinical & Diagnostic Services 87 Research 88 Genetics 92 Overview 93 Staff 93 Teaching Programmes 94 Training Courses & CME Activities 94 Clinical & Diagnostic Services 95 Research 98 Haematology 100 Overview 101 Staff 101 Highlights of the Year Teaching Programmes 103 Clinical & Diagnostic Services 104 Research 107 Human and Clinical Anatomy 112 Overview 113

5 Staff 114 Highlights of the Year Teaching Programmes 115 Research 116 Medicine 118 Overview 119 Staff 119 Teaching Programmes 121 Clinical & Diagnostic Services 123 Research Projects 124 Thesis Supervision 133 Microbiology and Immunology 134 Overview 135 Staff 135 Highlights of the Year C Teaching Programmes 138 Clinical & Diagnostic Services 140 Research 140 Thesis Supervision 143 Nursing Program 144 Overview 145 Staff 145 Highlights of the Year Teaching Programmes 150 Training Courses & CME Activities 150 Research 151 a n n u a l re p o r t Contents Nursing Services Directorate 154 Overview 155 Staff 155 Highlights of the Year Teaching Programmes 159 Nutrition and Dietetics 162 Overview 163 Staff 164 Highlights of the Year Training Programmes & CME Activities 165

6 Obtetrics and Gynaecology 168 Overview 169 Staff 169 Highlights of the Year Teaching Programmes 170 Training Courses & CME Activities 171 Clinincal & Diagnostic Services 172 Research 172 Ophthalmology 174 Overview 175 Staff 175 Highlights of the Year Teaching Programmes 178 Training Courses & CME Activities 179 Clinical and Diagnostic Services 180 Research 182 C Oral Health 186 Overview 187 Staff 187 Highlights of the Year Teaching Programmes 189 Clinical and Diagnostic Services 189 Research 189 Pathology 192 Overview 193 Staff 193 Teaching Programmes 194 Training Courses & CME Activities 195 Clinical and Diagnostic Services 196 Conference and Seminar Presentations 197 Pharmacology and Clinical Pharmacy 198 Overview 199 Staff 199 Highlights of the Year Teaching Programmes 201 Clinical & Diagnosatic Services 204 Research 204

7 Pharmacy 208 Overview 209 Staff 209 Highlights of the Year Teaching Programmes 213 Clinical & Diagnostic Services 213 Research 216 Physiology 218 Overview 219 Staff 220 Teaching Programmes 221 Training Courses & CME Activities 223 Clinical and Diagnostic Services 223 Research 225 Physiotheraphy 230 Overview C 231 Staff 232 Highlights of the Year Teaching Programmes 234 Training Courses & CME Activities 234 Clinical and Diagnostic Services 235 Conference and Seminar Presentations 235 Radiology 236 Overview 237 Staff 237 Highlights of the Year Teaching Programmes 240 Clinical & Diagnostic Services 241 Research 242 a n n u a l re p o r t Contents Sugery 248 Overview 249 Staff 249 Highlights of the Year Teaching Programmes 251 Training Courses & CME Activities 252 Clinical and Diagnostic Services 253 Research 254 Overview 260 Staff 260

8 Support Departments 258 Medical Library 260 Highlights of the Year Overview 264 Medical Education Unit 264 Staff 265 Highlights of the Year Teaching Programmes 267 Training Courses & CME Activities 267 Research 268 Overview 270 Sultan Qaboos University Medical Journal 270 Staff 271 Higlights of the Year Overview C 274 Staff 274 Hospital Finance 274 Highlights of the Year Overview 276 Staff 276 Hospital Housing 276 Highlights of the Year Overview 280 Staff 280 Hospital Informations System 280 Highlights of the Year Overview 284 Hospital Medical Records 284 Staff 285 Overview 286 Hospital Medical Stores 286 Staff 287 Highlights of the Year Overview 290

9 Hospital Patient Services 290 Staff 291 Highlights of the Year Overview 294 Staff 294 Hospital Public Relations and Information Directorate 294 Highlights of the Year Overview 298 Hospital Quality Management 298 Staff 299 Highlights of the Year Overview 304 Hospital Support Services 304 Staff 305 Highlights of the Year C 305 Overview 306 Hospital Training Directorate 306 Staff 308 Highlights of the Year Overview 314 Staff 314 Hospital Technical Affairs Directorate 314 Highlights of the Year Training Directoriate, SQUH 317 Overview 322 Staff 322 Highlights of the Year a n n u a l re p o r t Contents Hospital Transport 322

10 Sultan Qaboos Univerity It is amazing how complete is the delusion that beauty is goodness - Leo Tolstoy

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12 I Introduction 2

13 The College of Medicine was founded in 1986 and became the College of Medicine and 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. The College has a total of 70 faculty members including 15 Professors, 22 Associate Professors and 38 Assistant Professors. The CoMHS has grown and diversified, with well established programmes in the preclinical and clinical departments. Student intake is around 200 (medical and nursing) per year and the total student numbers around I1,200. The College runs an MSc programme in Biomedical Sciences and doctoral programmes are now approved in eight study areas. The SQUH has 26 senior consultants and 40 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. s u l t a n qa b o o s un i v e r s i t y an d ho s p i t a l Introduction 3

14 E Executive Summary 4

15 The 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 year academic year and the clinical calendar year Education In , the COM&HS admitted into the BSc Health Sciences a total of 115 students of which 56% were female. In the same period, 65 students were admitted into the Nursing Program, 58% of whom were female. Following successful completion of the BSc Health Sciences degree, 107 students joined the MD programme in September A major contribution towards the training of BSc Medical Laboratory Sciences Estudents is also among the responsibilities of the COM&HS and SQUH, of whom 23 graduated in this year all of them female. The College of Medicine and the University Hospital graduated a total of 108 medical doctors in A total of 23 students have now graduated from the College s Masters programme in Biomedical Sciences. The number of SQU trained medical doctors joining the Oman Medical Specialty Board (OMSB) for postgraduate training, under the academic supervision of the COM&HS and SQUH, was 60 in The College has continued to expand its e-learning system, with many departments making their teaching and course materials available on-line. Research In , The College undertook 72 research projects to a total value of OR 867, 712. Three Strategic Research projects were running in that period to a value of OR 530,081. They were led by the departments of Family Medicine & Public Health, Genetics, and Physiology. In , staff of the College published a total of 261 research articles, 4 books and 15 book chapters. In the same period, College staff made a total of 392 presentations. Of these, 89 were s u l t a n qa b o o s un i v e r s i t y an d ho s p i t a l Executive Summary 5

16 international conference platform presentations and 101 international poster presentations. Clinical Activity The SQU Hospital saw further advances in the year with the start of the Joint Commission International (JCI) accreditation process and the opening of the Orthopaedic and Neurosurgery units. By the end of 2008, the Hospital staff had increased to 2,010 employees including 339 doctors, 715 nurses and 274 technicians. Clinical activity at SQUH expanded in all areas. Outpatient visits increased to 206,241 compared 191,843 the previous year. The number of day care patients also increased to 8,406 compared to 7,430 in Inpatient admissions increased further to 23,194 exceeding the 2007 figure of 19,880, the previous highest figure. The average length Eof stay increased slightly to 4.6 days compared to 4.3 days in 2007, the lowest figure ever. Finally, newborn deliveries have increased to 2,741 compared to 2,267 in Dr. Kamlesh Bhargava Chairperson, Annual Report Committee 6

17 Thanks are due for the preparation of this report to the members of the Annual Report Committee: Meriel Carboni, Vice-Chairperson, & Editor Dr. Jumana Saleh, Department of Biochemistry Dr. Yaseen Al-Lawatia, Department of Microbiology & Immunology Dr. Ahmed Al-Shukaily Asma Al-Siyabi, Postgraduate Studies & Research Taruna Dutt, Coordinator, Department of Biochemistry Amar Hussain, Graphic Designer & Photographer E s u l t a n qa b o o s un i v e r s i t y an d ho s p i t a l Executive Summary 7

18 O Overview 8

19 College of Medicine & Health 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, the Director of Administration, three Assistant Deans (Preclinical, Clinical and Research & Postgraduate Studies). O 1. Proposal for establishment of UNESCO Chair of Bioethics The College Board met 10 times in the academic year The following key decisions and actions were taken: 2. Completion and hand over of College of Nursing building 3. Approval of proposal for new MSc programme in Biochemistry 4. Graduation of first batch of BSc Nursing students 5. Guidelines for the collection, transfer and exchange of Human Genetic Data, Proteomic Data and Biological Samples 6. Proposal for Dean s Research Award for students 7. Approval of procedures for an International Federation of Medical Students Association s u l t a n qa b o o s un i v e r s i t y an d ho s p i t a l Overview Staff Dean Professor Bazdawi Al-Riyami, (to June 2008) Dr. Mansour Al-Moundhri, (from June 2008) 9

20 Assistant Deans Dr. Ali Al-Jabri, Preclinical Affairs Dr. Muna Al-Sadoon, Clincal Affairs Prof. Mohamed Idris, Research & Postgraduate Studies College Administration Badriyah Al-Hashar, Director of Administration Mahmoud Al-Abri, Deputy Director Sagar Hussain, Executive Assistant to the Dean Alphonsus Okoro, Examinations Officer Safaa Al-Harasy, Administrative Assistant Muna Al-Alawi, Administrative Assistant Zulfa Al-Busaidi, Administrative Assistant O Zakiya Al-Omairi, Administrative Assistant Shabbir Patel, Coordinator Glorio Almeida, Coordinator John George, Coordinator Mahmoud Al-Kindi, Coordinator Bakar Al-Hinai, Storekeeper Salem Al-Salhi, Photocopy Technician Qassim Al-Salhi, Messenger Khalid Al-Hinai, Messenger Hamed Bani Auraba, Driver 10 Education Programmes PRECLINICAL PROGRAMME BSC HEALTH SCIENCES This is a four-year programme in general and basic medical sciences. The BSc Health Sciences degree is awarded to students after successful completion of 120 credit hours at the end of semester 8 (see Appendices). Students who wish to obtain the MD have to complete all course requirements for the BSc Health Sciences before entering the clinical years. The student intake was 115 in Sep-

21 tember CLINICAL PROGRAMME This is a three-year clinical programme during which the knowledge acquired during the BSc in Health Sciences degree is applied to the clinical practice of medicine. An MD degree is awarded upon completion of this programme. See the Appendices for an overview of the MD programme. CLINICAL ELECTIVE PROGRAMME An eight-week Elective Placement Programme is part of the second year of the Clinical Programme and is essential 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 O organisations locally and internationally. INTERNSHIP TRAINING PROGRAMME This consists of visits to different hospitals in Oman and involves not only SQU graduates but those of other medical programmes in Oman. POSTGRADUATE STUDIES The College introduced a two-year Masters Programme in Biomedical Sciences in It has the following seven specialisations: Biochemistry and Molecular Biology; Pharmacology and Clinical Pharmacy; Microbiology and Immunology; Epidemiology and Medical Statistics; Physiology; Radiology and Molecular Imaging; Human and Clinical Anatomy. The Oman Medical Specialty Board (OMSB) was established in June 1994 and became an independent entity in November 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. s u l t a n qa b o o s un i v e r s i t y an d ho s p i t a l Overview 11

22 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 programmes as well as providing guidelines to ensure that the training meets international standards. Specialty 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 universities, Australia and the UK. Residents who have received residency and postgraduate training abroad are required to return to Oman to strengthen the Sultanate s manpower development efforts by focusing on the training of junior colleagues and students. Sultan Qaboos University Hospital Sultan Qaboos University Hospital is considered Oto be one of the most advanced tertiary hospitals in the Sultanate. It has a capacity of 507 beds with 483 beds are currently open, with a grand total of 553 if the beds in the ambulatory area are included. The goals of SQUH are to teach medical students from the College of Medicine and Health Sciences and other Colleges and Institutions in the Sultanate, conduct research and promote high quality specialised services. The SQU Hospital has seen major advances in the year with the start of the Joint Commission International (JCI) accreditation process and the opening of the Orthopaedic and Neurosurgery units. SQUH treated over 200,000 outpatients and over 23,000 inpatients in 2008 as well as delivering over 2,700 babies. The average bed occupancy rate in 2008 was 57%. By the end of 2008, the Hospital staff had increased to 2,010 employees including 339 doctors, 715 nurses and 274 technicians. 12

23 Sultan Qaboos University Hospital The Hospital Management embraces the senior leadership of all the units in the hospital reported elsewhere in this report, the Hospital Director-General, the Deputies for Clinical Affairs, Administration and Nursing and the senior officers. Under the Hospital Board, they are responsible for the ongoing operation of the hospital, continual pursuit of improvement and facilitating decisions about the character the hospital should have in the short and longer term. Hospital activities are orchestrated and served by a number of committees that coordinate them and appropriately utilise the available resources in order to maintain the high standard of quality and efficiency of care given to patients, of which Othe hospital is proud. Staff Dr. Masoud Kashoob, Director-General Dr. Ahmed Al-Mandhari, Deputy Director-General Mr. Ahmed Al-Kindi, Deputy Director-General (Admin, Finance, Technical Affairs & Training) Ms. Yusriya Al-Akbary, Deputy Director-General (Nursing Affairs) The Hospital Board meets monthly during the academic year. Through the recurrent agenda item: From the Hospital Director-General s office the members are kept informed about important matters in hospital management and developments in patient related activities. The Medical Advisory Committee (MAC), with representatives from all clinical departments, serves as a focal point for continuing improvement of care; it reports at every meeting of the Hospital Board. In this period, much discussion was devoted to accommodating the significant increase in patient flow and to the maintenance of standards of research, teaching and service in the face of budgetary constraints. s u l t a n qa b o o s un i v e r s i t y an d ho s p i t a l Overview 13

24 Developmental Activities The period saw further developmental activities: + ISO 9001/2000 recertification in May Opening of the Cardiothoracic Surgery Unit and the Orthopaedic and Neurosurgery Units. + Introducing new sub-specialties such as: Paediatric Gastroenterology, Neurosurgery and Orthopaedics. The Neonatology Department started newborn screening for inborn errors of metabolism, congenital hearing loss and cardiovascular disease. + Opening of 4 Purple Special Nursing Ward for private patients. + Opening of 4 new ICU beds for the Cardiothoracic Unit and an additional bed in the Paediatric ICU making a total of 4. O + Other projects and activities were: Upgrading of the 64 Slice CT Scanner; opening of the Biplanar state of the art Catheter Laboratory; acquisition of an Electroretinogram (ERG) machine, the only one in the Sultanate. + Construction was started on the new Haematology/Bone Marrow Transplant (BMT) Centre. The A&E Department was expanded to provide new registration and triage areas in order to improve access to care. New administration offices were also completed. + The Hospital was on the verge of expanding the existing facilities through the building of additional wards, and extensions to the Radiology & Molecular Imaging Department and the operating theatre block. 14 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 towards continuous improvement. Such developments are unattainable without proper training. In-house and external training has witnessed yet further improvement during the period

25 Table1: Outpatient activity 230, , , ,000 Visitor 150, , ,000 90,000 70,000 O The role of SQUH as a major Omani health service provider continued in this period with a total of 229,435 in and outpatients seen in Clinical activities at SQUH expanded in some areas during this period. Outpatient visits increased to 206,241 compared to 191,843 in 2007 thus nearly reaching the peak level of 213,894 experienced in 2005 [Table 1]. The number of Day Care patients was 8,406 thus exceeding the previous peak 2005 which saw 7,951 of these patients. 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 23,194 surpassing the previous highest figure of 19,880 reached in 2007 [Table 3]. The average length of stay rose slightly to 4.6 days compared to 4.3 days in 2007, which was the lowest figure ever. Nonetheless, the 2008 figure reflects the success of continuing efforts to deliver an efficient and fast high quality service compared to Year 2008 s u l t a n qa b o o s un i v e r s i t y an d ho s p i t a l Overview 15

26 Table 2: Use of day care Visitor Table 3: Inpatient admission 24,000 22,000 20,000 O Year 2008 Admissions in Year 18,000 16,000 14,000 12,000 10, Year 2007

27 Table 4: Declining length of inpatient stay O Finally, newborn deliveries showed a substantial increase to 2,741 compared to 2,267 in 2007, this 2008 figure being higher even than the previous peak years of when deliveries were earlier years [Table 4]. around 2,500 per annum [Table 5]. Table 5: Newborn deliveries Average Length of st Year 2008 s u l t a n qa b o o s un i v e r s i t y an d ho s p i t a l Overview 2300 New Born Babies Year

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29 Academic & Patient Care Departments Accident and Emergency Anaesthesia and Intensive Care Unit Biochemistry Child Health Family Medicine and Public Health Genetics Haematology Human and Clinical Anatomy Medicine Microbiology and Immunology Nursing Program Nursing Services Directorate Nutrition and Dietetics Obtetrics and Gynaecology Ophthalmology Oral Health Pathology Pharmacology and Clinical Pharmacy Pharmacy Physiology Physiotheraphy Radiology Sugery

30 A Accident and Emergency

31 Overview In compliance with its mission, the Accident & Emergency Department of Sultan Qaboos University Hospital provides acute emergency care for all major medical and surgical emergencies and also acute minor emergencies 24 hours a day, seven days a week. In the bid to realise the vision of the Department to be a national model for the development of emergency medicine with the integration of international standards, diversified training and learning activities are organised for a wide range of healthcare professionals from within and outside the Hospital. These include undergraduate and postgraduate medical and nursing students from SQUH, Oman Medical Specialty Board (OMSB), the Diwan, the Ministry of Health, the Health Institute, the Royal Oman Police and the Oman Medical Institute in Sohar. In addition the Department actively participates in the planning of disaster management and research at Hospital and national levels. A Staff Nabil Al-Zadjali, Consultant, Acting Head Daniel Ogunjumo, Senior Consultant Ammar Al-Kashmiri, Consultant Magdy Shehata, Senior Registrar Ashraf Naiem, Registrar Teodorico Diputado, Registrar Remanand Sudhir, Registrar Sabah Awad, Registrar Ashraf Ali, Registrar Rasha Abdulhadi, Senior House Officer Umar Shahzad, Senior House Officer Mohammed Awais, Senior House Officer Vinod Abraham, Senior House Officer Dept. 01 a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Accidnet and Emergency 21

32 Support Staff Ayida Al-Hadhrami, Coordinator Mercy Gandhirajan, Coordinator Highlights of the Year Introduction of end-of-rotation examination for 6th year students The in-course assessment of the performance of the 6th year medical students during their emergency medicine rotation, which is subjective, was supplemented with an objective assessment with 40 multiple choice questions which covers the core contents of the curriculum. Development of guidelines for the content and Aprocess of the tutorials and workshops for 6th year medical students. The guidelines cover the approach to the assessment and management of undifferentiated chest pain, shortness of breath, multiple trauma, poisoning, wounds, and cardio-respiratory arrest in the Accident & Emergency Department. This is to ensure adequate and effective coverage of the core contents of the curriculum by the members of staff participating in the teaching programme. Restructuring of the physical lay-out of the Department. Structural modifications were made to enhance patient flow and comfort and the efficacy of the work of the staff. These included the creation of two new triage rooms, fast-track (minor cases) cubicles, a work station for the doctors with computers and work benches, a treatment room, an observation room and a new registration office. 22 Acquisition of New Equipment The new equipment acquired to improve patient care included: a non-invasive positive airway pressure (NIPAP) machine, a glidoscope and a fibre-optic airway endoscope, and a blood gas analyser.

33 Intensification of Research Work Research work and the time studies on patient flow were intensified while studies on sickle cell disease patients and acute coronary syndromes were commenced. Dept. 01 Teaching Programmes Undergraduate clinical programme Clinical Skills Course for 5th Year Medical Students The Department coordinates and participates in the teaching of the clinical skills course for 5th year medical students. The course is held in the Training and Staff Development (TSD) centre of SQUH and involves lectures and hands-on practice in intravenous techniques, basic life support, monitoring, electrical therapy with manual and automated Aexternal defibrillators, and aseptic techniques. Departmental staff conducts the basic life support, monitoring and electrical therapy aspects of the course four times a year. Emergency Medicine for 6th Year Medical Students. The Department receives 6th year students in batches of 13 to 15 every 4 weeks commencing from August to May of the following year. Each batch is divided into 4 groups, and each group rotates through the emergency departments of SQUH, Armed Forces Hospital, and Khoula Hospital. The students are taught and supervised by the consultants and the resident doctors in the various hospitals. In addition to bedside teaching, manual skill laboratory sessions in wound care; basic life support; recognition and treatment of dynamic arrhythmias and defibrillator use are conducted in SQUH by the emergency medicine consultants with the occasional assistance of the registrars for each batch of students. Problem-based tutorials on common presenting potentially life-threatening complaints in the Department e.g. chest pain, multiple trauma, poisoning and shortness of breath are conducted every week by the consultants with the occasional assistance of the registrars. The performance of the students is assessed by the tutors during the workshops, tutorials, a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Accidnet and Emergency 23

34 bedside teaching, and at the end of the posting with a one-hour multiple choice questions examination which covers the core contents of the curriculum. This is to ensure that they have grasped and understand the basic principles of the practice of emergency medicine. Postgraduate Programme Interns Teaching and Training All interns rotate through the Department for one month during their postings to the Surgery Department, and some of them are also posted to the A&E during their rotation through the Paediatric Department. In addition to bedside teaching, they are taught during the departmental CME sessions. A Training Courses & CME Activities Residents Teaching and Training The residents undergoing the training programmes of the Oman Medical Specialty Board in Emergency Medicine, Family and Community Medicine and Surgery rotate through the Department at various periods of their training. They are taught on a daily basis by the consultants and the registrars during the course of their clinical duties. In addition, they are taught during the 4 hour weekly academic activities in which all the consultants actively participate. Advanced Cardiovascular Life Support (ACLS) Courses One of the Department s consultants is the director of the ACLS Courses in which the Department participates actively. The course is held 5 or 6 times a year (every 2 months) between October and June or August of the following year. The course participants include all interns, key hospital and nursing staff in the University, Ministry of Health, Diwan and some private hospitals. Recertification courses are conducted twice a year. 24 Departmental CME Activities CME activities are organised and held in the seminar room of the Department every two weeks. These include case discussions, mortality and morbidity review, journal club sessions, and presenta-

35 tion and discussion of various topics relevant to the practice of emergency medicine. All the doctors working in the Department participate in the activities. Dept. 01 Clinical and Diagnostic Services The table below shows the patient statistics from January to December of the years 2007 and Table 1: A & E Monthly Statistics from Jan to Dec 2008 Category Jan Feb Mar Apr May June July Aug Sep Oct Nov Dec Total A R O Y 2,353 2,541 2,803 2,448 2,673 2,291 2,483 2,546 2,824 2,722 2,413 2,605 30,702 G ,094 B MC ,076 SSU Total Minor 1,282 1,713 1,193 1,471 1, ,020 1,236 1,150 1,640 1,785 1,631 16,762 F/U DEF ,408 LWBS - T ,230 LWBS - C ADM ,216 TRANS DOA DAA SCD ,695 RTA ,307 a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Accidnet and Emergency 25

36 ADULTS 2,865 3,210 3,201 3,210 ` 2,739 3,015 3,211 3,163 3,503 3,418 3,365 - PEDS , ,084 - TOTAL 4,077 4,305 4,400 4,067 4,718 3,509 3,769 4,115 4,341 4,792 4,679 4,797 - Amb. Trans Activity Coverage Total Patients Jan-Dec 2007 = 45,309 Total Patients Jan-Dec 2008 = 51,569 Key to abbreviations R = Red category patients O = Orange category patients G = Green category patients B = Blue category patients F/U = Follow-up patients MC = Minor cases DEF = Deferred cases (to health centres) A Cases treated and transferred to other hospitals LWBS-T = Left without being seen before triage. LWBC-C = Left without being seen after triage ADM = Admitted cases TRANS. = DOA = Dead on arrival DAA = Dead after arrival SCD = Sickle cell disease RTA = Road traffic accident TRANS = Transfers The highlights of the statistical data are as follows - A total of 45,309 patients were seen in 2007 and 51,569 in 2008 an increase of 6,260. The majority of the patients were of yellow (urgent) category which means non-life-threatening emergency cases. This group constituted 64.4% of the total number of cases in 2007, and about 60% in A total of 17.7% of the patients seen were admitted in 2007 and about 16% in In addition to the care of the acutely ill and injured patients, consultants conducted daily review clinics. Most of the patients reviewed sustained musculo-skeletal injuries, while some presented with other acute or subacute disorders which required close monitoring and follow-up. 26 The SQUH trauma team, which has recently been established, commenced operation under the

37 leadership of the two trauma surgeons who returned to SQUH after a period of specialist training abroad. This has enhanced and improved the care of the victims of trauma and the education and training of the departmental physicians in the management of trauma. Dept. 01 Research A number of studies were commenced or continued with the aim of assessing and improving the quality of patient care in the emergency department. These include: + Time studies to detect the causes and points of delay in patient care in the Department. + Time intervals between patient arrival and administration of fibrinolytic agents in patients presentingwith acute chest pain due to myocardial infarction (door to drug interval). A + The value of chest radiography in non-traumatic chest pain in the Emergency Department. + Comparison of the efficacy of Troponin I and Troponin T in the diagnosis of myocardial infarction. + The frequency of the detection of abdominal organ injuries with CT scan in multiple trauma patients. + Comparison of interpretation of computed tomography (CT) scans of the head between emergency physicians and neuroradiologists. The investigators include the residents undergoing the OMSB training programme in emergency medicine and some of the consultants. No funding was required as the resources normally available for patient care were used.research Publications and Books Sickle Cell Disease in the Emergency Department, A Prospective Cohort Study Project Code: MREC# 258 Dates: 2007 Value: Unfunded a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Accidnet and Emergency 27

38 Investigators: Dr. Nabil Al-Zadjali, Department of Accident and Emergency, SQU; Dr. Abdullah Al-Reesi, Department of Accident and Emergency, SQU; Prof. Ian Still, Ottawa University Hospital, Canada; Prof. George Wells, University of Ottawa Heart Institute, Canada; Dr. Asma Al-Belushi, Department of Accident and Emergency, SQU. Journal Publications 1. Al-Naamani K, Al-Zadjali N, Barkan AN, Fallone CA. Does blood urea nitrogen level predict severity and high risk endoscopic lesions in patients with nonvaricoceal upper gastrointestinal bleeding? Can J Gastroenterol 2008; 22: Al-Reesi A, Al-Zadjali N, Pemy J, Fergusson D, Al-Shamsi M, Al-Thagafi M, Stiel I. Do beta-blockers reduce short term mortality following acute myocardial infarction? A systematic review and meta-analysis. Can J Emerg Med 2008; 10:215. A 28

39 Dept. 01 A a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Accidnet and Emergency 29

40 A Anaesthesia and Intensive Care Unit

41 Overview The Department of Anaesthesia, Intensive Care and Pain Management is a dynamic and very productive department of Sultan Qaboos University Hospital. Our key roles are in the operating theatre, anaesthetising patients for all surgical specialties and subspecialties and in the Intensive Care Unit, managing critically ill patients. The Department provides twenty-four hour elective and emergency anaesthesia services to the entire hospital, including referrals from other health institutions. We manage a 20 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 part of departmental functions with acute and chronic pain management services. Cardiopulmonary resuscitation is a significant function of this Department and cardiothoracic anaesthesia has also become a part of the Department. The Department forms a solid part of the SQUH trauma and disaster management service. A Staff Acting Head Amarnath Shetty, Consultant Staff Karin Nollain, Senior Consultant Ram Narayan Rao, Consultant Sinnakirouchenan, Consultant Rajini Kausalya, Consultant Ali Al-Abady, Consultant Jaswinder Sharma, Senior Registrar Binoy Zachariah, Senior Registrar Rosanna John, Registrar Pradipta Bhakta, Registrar Jyoti Burad, Registrar Dept. 02 a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Anaesthesia and Intensive Care Unit 31

42 Aravind Narayanan, Registrar Pragyandipta Mishra, Senior House Officer Qutaiba Tawfiq, Senior House Officer Madhanagopal, Senior House Officer Ahmed Khamis, Senior House Officer Support Staff Leena Chacko, Coordinator Ibrahim Al-Farsi, Coordinator Highlights of the Year A Workshops/Conferences Organised by the Department The Department of Anaesthesia & ICU conducted the First Annual Anaesthesia and Critical Care Scientific Meeting, which was organised by the Oman Society of Anaesthesia and Critical Care in collaboration with the Royal College of Anaesthetists, Ireland. This was held in January There were more than 300 participants from all over Oman consisting of anaesthesiologists, pulmonologists, respiratory therapists and nurses. The meeting had lectures and hands-on practice sessions. The senior staff of the Department were part of the Organising Committee. New Teaching Programmes The Anaesthesia Residency Programme of the Oman Medical Specialty Board was started in September The Department is in the process of actively developing this programme. Regular teaching sessions are being carried out by the senior staff of the Department. New Sub-specialty Anaesthesia for cardiothoracic surgery with postoperative intensive care monitoring started its services, which are now fully fledged. 32

43 Dept. 02 Teaching Programmes Undergraduate Clinical Programme The sixth year medical students carry out a compulsory two week rotation in Anaesthesia and Intensive Care Unit (ICU). During this rotation the students participate in the Department s clinical activities. Students are given hands-on experience, on both a manikin as well as patients, under close supervision of anaesthesiologists, witnessing and learning airway management, endotracheal intubation, intravenous cannulation, fluid management and monitoring of the anaesthetised patient. The tutorials are aimed at making the student Aunderstand the use of airway adjuncts, respiratory equipment, central venous and arterial cannulation, regional blocks and drugs used in anaesthesia and cardiopulmonary resuscitation. The emphasis of these lectures is on pre-anaesthetic evaluation, management of patients under anaesthesia, postoperative pain relief, pharmacology of anaesthetic drugs, acid base and electrolyte disorders and hypovolemic shock. The lecture is given on a rotation basis by one of the senior doctors. After the lecture there is a 30 minute case discussion. Postgraduate Programme A 4 year residency programme in anaesthesia was started in September 2007 under the Oman Medical Specialty Board. Two residents were enrolled under this programme. An exit examination is planned at the end of 4 years, after the successful completion of which 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 a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Anaesthesia and Intensive Care Unit 33

44 Training Courses & CME Activities The Department is actively involved in the teaching of training courses organised by the 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. Residents are encouraged to attend. Doctors of the Department actively participate by presenting interesting topics which prove beneficial to the staff. Members of the Department are also part of the Oman Society of Anaesthesia and Critical Care (OSAAC) which is involved in regular CME activities and scientific sessions. A Clinical & Diagnostic Services A total of 4,056 anaesthetic procedures were carried out in 2008 compared to 3,373 in 2007 and 3,200 in A total of 392 patients were admitted to the ICU during the year. This number excludes the patients admitted to Coronary Care Unit (CCU), Paediatric Intensive Care Unit (PICU) and the Renal Dialysis Unit (RDU). The bed occupancy in the ICU in 2008 was 99% compared to 88.8% in 2007 and 97% in Research Research Publications and Books Journal Publications 1. Bhakta P, Biswas BK, Goel A, Acherjee P. Propofol for management of excitatory symptoms of post-turp Glycine toxicity. Eur J Anaesth 2008; 25: Mishra P, Bhakta P, Tawfiq QA. Persistent low capillary blood glucose estimated by Fingerstick method may be an early indicator of limb ischemia in hypotensive patient requiring high inotropic support. Accepted for publication: Anaesthes Intensive Care. 3. Nollain K. The ICU Book Review. SQU Med J 2008; 8:95-6.

45 Number of Patients A Conference and Seminar Presentations Conference Presentations International Chengode S. Comprehensive TEE examination & Tricuspid and Pulmonary valve assessment. Wet Lab Session on Porcine heart dissection. First National Intraoperative Transesophagael Echocardiography Workshop. Narayana Hrudayalaya, Bangalore, India, March Seminar Presentations International 1. Kausalya R. Live Demonstration of Totally implantable Vascular Access devices. College of Medicine, University of Alexandria, Egypt, December Local 1. Kausalya R. Documentation & Internal Auditing in Quality. Directorate General of Health Services, Dhofar, SQU Hospital, Salalah, Oman, September Kausalya R. What s new in Cardiopulmonary Resuscitation. Fifth Regional Seminar of Anaesthesia & ICU. Ibri, Oman, March Jan Feb Mar Apr May June July Aug Sep Oct Nov Dec Figure1: Anaethesia statistics 2008 Emergency Elective Total Dept. 02 a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Anaesthesia and Intensive Care Unit 35

46 B Behavioural Medicine

47 Overview The Department of Behavioural Medicine s mission is to promote excellence in the research, development and teaching of psychiatry and its allied subjects and to apply and disseminate this knowledge with the aim of preventing mental disorders and developing treatment for the relief of suffering. The Department is both an academic and clinical department, responsible for teaching behavioural sciences to pre-clinical students and psychiatry to clinical students. The Department s policy is to make learning as far as possible student-centred. Accordingly, the lectures, seminars and tutorials for pre-clinical students are of an interactive nature, designed to encourage participation in the form of problem-based learning. The Department endeavours to develop a learning culture of direct relevance to the situation in Oman and develop in its students the right attitude towards patients and society. It also provides both outpatient and inpatient services for psychiatric patients in SQU Hospital as well as liaising with other clinical departments for the provision of B multidisciplinary care. The main focus of our research interests and programme are the magnitude, culture-specific expressions and prevention of mental illnesses, which are most common among people living in Oman. The Department publishes contributions on various aspects of behavioural medicine in medical literature. Our research interests include all aspects of psychiatry, eating disorders, psychological aspects of specific physical disorders, cognitive functions of schizophrenic patients, genetics of schizophrenia, obsessive-compulsive disorder, bereavement, deliberate self-harm, alcoholism, epidemiology of mental disorders, presenting symptoms of schizophrenia, brain imaging in acute psychosis, somatic symptoms as a presenting symptoms in depression and psychiatric problems in childhood. Dept. 03 a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Behavioural Medicine Staff Head of Department Ziad A J Zaidan, Associate Professor Faculty Ala Aldin Al-Hussaini, Professor 37

48 Marwan Sharbati, Associate Professor Samir Al-Adawi, Associate Professor Harith Ghassany, Assistant Professor Rodger Martin, Senior Consultant Amre El Guenedi, Senior Registrar Nonna Viernes, Registrar Aziz Al-Naamani, Registrar Yousef Obeid, Registrar Amal Ambusaidi, Senior House Officer Amira Al-Hosni, Senior House Officer Ibrahim Elzein, Senior House Officer Support Staff Samira Al-Hamdan, Psychologist Salwa Al-Redha, Psychologist Abdullah Al-Sulaimani, Social Worker Ahmed Al-Salmi, Social Worker Khamis Al-Balushi, Social Worker Khawala Al-Wahaibi, Social Worker Younis Al-Hashim, Social Worker Ravindran Kozhapatil, Coordinator Govindan Mundayadan, Coordinator B 38 Highlights of the Year The year witnessed an enormous growth and expansion of the Department. The psychiatric residency programme was implemented in conjunction with the Oman Medical Specialty Board (OMSB). In line with changes in medical education, the Department participated with other departments in the College in running the clinical communication skills course as well as liaising with other departments in interdisciplinary activities.

49 The Department was involved in local and international research collaborations and published a number of papers on various aspects of behavioural medicine, psychiatry, psychology and allied fields, for example: cross-cultural differences in morbid body preference; hazardous and harming drinking patterns in Oman; medical education and child psychiatry. In the departmental database, much research has been amassed on topics such as how distress is experienced in Oman; psychological aspects of specific physical disorders; 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 B Course Behavioural Sciences I Behavioural Sciences II Clinical Attachment in Psychiatry Semester Spring/Summer Fall/Summer Rotation of 8 weeks The number of students for each of the departmental courses was approximately 120. The Department participates with other departments in the College in running the clinical communication skills course. The number of students was approximately 140. Undergraduate Preclinical Programme The Department s policy is to make learning student-centred as far as possible. Accordingly, the lectures, seminars and tutorials for pre-clinical students are of an interactive nature, designed to encourage participation in the form of problem-based learning. The Department conducts three inter-related courses of Behavioural Sciences. The first course focuses on socio-cultural studies relevant to medicine. The second concentrates on factors associated with individual differences, developmental milestones and the third course introduces applied behavioural medicine as relevant for the doctor-patient relationship and clinical communication and cultural specific idiom of distress. Dept. 03 a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Behavioural Medicine 39

50 Outpatients Inpatients 308 B278 Figure: Statistics Psychiatry In & Outpatients Clinic ( ) Undergraduate Clinical Programme The interactive, student-centred approach of the Department is adopted even more strongly for teaching clinical students. During the rotation, our medical students are encouraged to develop skills in interviewing patients and their families, interpreting diagnostic tests, planning multidisciplinary treatment, making behavioural interventions, and administering pharmacological treatment as well as acquiring skill in using psychotherapeutic modalities. Students are also encouraged to participate actively in clinical case presentations of common psychiatric problems The main thrust of psychiatry teaching 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. The academic component includes a regular seminar in therapeutic skills of teaching and consultation, teaching on current 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

51 psychiatry elsewhere, a regular Journal-Club is held. External speakers are also part and parcel of this endeavour. Postgraduate Programme The Department continued to train Family and Community Medicine residents and contributed 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 exams and writing their programmes. Training Courses & CME Activities B The Department conducted a number of workshops on various aspects of stress and coping, 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 departments nationally which provide 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 psychologists, nurses, social workers and other clinicians. Dept. 03 a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Behavioural Medicine A wide range of assessments and treatments using various conceptual models including IQ, personality testing, neuropsychiatry, cognitive behaviour and psychotherapy are offered. It also offers comprehensive liaison psychiatry with other branches of medicine as well as psychosocial intervention and various social work services. The Department offers unique clinical and diagnostic services. The assessments provided by our staff employ specialised testing procedures to integrate medical, neurological, and behavioural 41

52 data with neuropsychological test findings 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 psychogenic and neurogenic 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 measures 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 in forensic cases. B The attitudes of adolescents and young adults in Omani second and third-cycle students to mobile phones Research Research Projects Project Code: CR/SCI/Math/08/01 Dates: Value: OR 12,700 Project Funder: Investigators: Sultan Qaboos University Dr. Samir Al-Adawi, Department of Behavioural Medicine, SQU; Professor Atsu Dorvlo, Department of Mathematic and Statistics, SQU; Dr. Charles Asante, Language Centre, SQU. 42 A Survey of Oman s Tomorrow doctors interests in Psychiatry at Sultan Qaboos University Project Code: MREC #272

53 Dates: Value: Investigator: Unfunded B Project Code: MREC #282 Dr. Samir Al-Adawi, Department of Behavioural Medicine, SQU. Prevalence of Anxiety & Depression among Patients with Epilepsy at a Tertiary Care Hospital in Oman Project Code: MREC #278 Dates: Value: Investigators: Unfunded Dr. Samir Al-Adawi, Department of Behavioural Medicine, SQU; Dr. Abdullah Al-Asmi, Department of Medicine, SQU. Determining the Culturally Specific Symptom Constellation of Posttraumatic Stress Disorder among Omanis Dates: Value: Investigators: Unfunded Dr. Samir Al-Adawi, Department of Behavioural Medicine, SQU; Dr. Liyam Eloul, Fulbright Scholar, Standford University, USA & SQU Research Publications and Books Journal Publications 1. Al-Adawi S, Al-Naamani A, Dorvlo ASS, Bhaya C, Martin RG, Al-Hussaini, A Al-Guenedi A. Withering before the Sowing? A Survey of Oman s Tomorrow s Doctors Interest in Psychiatry. Education for Health 2008; 21: Al-Sinawi H, Al-Adawi S, Al-Guenedi A. Ramadan Fasting Triggering Koro-like Symptoms during Acute Alcohol Withdrawal: A Case Report from Oman. Transcult Psych 2008; 45: Dept. 03 a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Behavioural Medicine 43

54 3. Al-Shafaee MA, Al-Shukaili S, Rizvi SGA, Al-Farsi Y, Khan MA, Ganguly SS, Afifi, M, Al-Adawi S. Knowledge and perceptions of diabetes in a semi-urban Omani population. BMC Public Health 2008, 8:249 doi: / Al-Mandhari A, Al-Adawi S, Al-Zakwani I, Al-Shafaee M, Eloul L. Impact of Geographical Proximity on Health Care Seeking behavior in Northern Oman. SQU Med J 2008; 8: Al-Sharbati M, Al-Adawi S, Ganguly S, Al-Lawatiya S, Al-Mshefri F. Hyperactivity in a Sample of Omani Schoolboys. J Atten Disord 2008; 12: Kayano M, Yoshiuchi K, Al-Adawi S, Viernes N, Dorvlo AS, Kumano H, Kuboki T, Akabayashi A. Eating attitudes and body dissatisfaction in adolescents: Cross-cultural study. Psych and Clin Neurosci 2008; 62: Jain NB, Al-Adawi S, Dorvlo AS, Burke DT. Association between body mass index and functional independence measure in patients with deconditioning. Am J of Phy Med & Rehab 2008; 87: Seif Eldin A, Habib D, Noufal A, Farrag S, Bazaid K, Al-Sharbati M, Badr H, Moussa S, Essali A, Gaddour N. Use of M-CHAT for a multinational screening Bof young children with autism in the Arab countries. Int Rev Psych 2008; 20: Al-Adawi S, Al-Naamani A, Dorvlo A, Lad SD, Al-Maashani A, Sharma RR, Gorman D. Open methylphenidate trial among brain injured population in Oman with acute vs. chronic working memory impairment. Brain Injury 2008; 22: Al-Naamani A, Al-Adawi S, Dorvlo A, Lad SD, Al-Maashani A, Sharma RR, Gorman D. Fatigue and affective functioning in cross-cultural survivors of traumatic brain Injury. Brain Injury 2008; 22: Al-Adawi S, Dorvlo Al-Naamani A, Lad SD, Al-Maashani A, Sharma RR, Gorman D. Disorder of selfneglect in brain injured population in Oman: incidence, neuropsychology and psychopharmacology. Brain Injury 2008; 22: Conference and Seminar Presentations CONFERENCE PRESENTATIONS International 1. Al-Adawi S. Disorder of self-neglect in brain injured population in Oman: incidence, neuropsychology and psychopharmacology. The Seventh World Congress on Brain injury of the International Brain Injury Association in conjunction with the Portuguese Society of Physical Rehabilitation Medicine. Lisbon, Portugal, 10 April Al-Sharbati et al. Hyperactivity in a sample of Omani schoolboys. 3rd World Conference of the International Iraqi Medical Association-online. Sharjah, UAE, March 2008.

55 3. Al-Sharbati M. ADHD in the Arab World. The future of ADHD in the Arab World. Manama, Bahrain, 27 March Al-Sharbati M. Child and Adolescent Psychiatry in Oman. Pan Arab Congress. Cairo, Egypt, June Dept. 03 B a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Behavioural Medicine 45

56 04 Biochemistry B Biochemistry

57 Overview The Department of Biochemistry is involved in both pre-clinical and clinical teaching. In the preclinical years, teaching concentrates 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 laboratory science to undergraduates; biochemistry to nursing students and offers a graduate programme leading to an MSc degree in Biomedical Sciences and/or Clinical Biochemistry. A PhD programme by research has also been offered since The Department has also been recognised by the Royal College of Pathologists, London, in relation to postgraduate education. The major research activities are focused around the development of molecular tests for detecting and mapping mutations associated with various genetic disorders including hypertension, diabetes, deafness and hyperlipidaemias. The Department Bhas a total of six academic staff in addition to clinical staff who are presently involved in the teaching programmes. There are five biomedical research scientists in the Department 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. Staff Head of Department Riad Bayoumi, Professor Faculty Jumana Saleh, Associate Professor Nadia Al-Wardy, Assistant Professor Clifford Abiaka, Assistant Professor Hamza Babiker, Assistant Professor Marit Delghandi, Assistant Professor Dept. 04 a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Biochemistry 47

58 David NKansa Dwamena, Senior Consultant Hemant Kulkarni, Consultant Khalid Al-Rassadi, Consultant Support Staff George Khaukha, Superintendent (College) Halima Adnan, Superintendent (Clinical) Mater Al-Maney, Chief Biomedical Scientist (Clinical) Adil Al-Wahaibi, Chief Biomedical Scientist (Clinical) Younis Al-Musafir, Senior Biomedical Scientist (Clinical) Khadija Al-Habsi, Senior Biomedical Scientist (Clinical) Romulo Cipriano, Senior Biomedical Scientist (Clinical) Nasser Al-Nazwani, Cheif Technician (College) B Mohammed Al-Kindi, Chief Biomedical Scientist (College) Hameeda Al-Barwani, Senior Biomedical Scientist (College) Mohammed Al-Toubi, Biomedical Scientist (College) Abdulrahim Al-Abri, Biomedical Scientist (College) Ayesha Al-Gazali, Junior Biomedical Scientist (College) Taruna Dutt, Coordinator (College) Marina Bendecio, Coordinator (Clinical) 48 Highlights of the Year The Department of Biochemistry conducted a workshop on Computational Biology from January 2007 in association with the Conference of Islamic Countries (COMSTECH). About 40 candidates were selected from the Middle East. Tutors were from the EMBL-European Bioinformatics Institute, Wellcome Trust Genome Campus, University of Cambridge, UK; Queensland Institute of Medical Research, Australia; Northcott Neuroscience Laboratory ANZAC Research Institute, Australia and Pharmacogenomics & Comparative Genomics Unit, Bioinformatics Department, Centro de Investigacion Principe Felipe c/ep Avda, Spain.

59 The course focused on the applications of Computational Biology in various areas of biological sciences. The main objectives of the workshop were to: + Provide an insight into the newly emerging field of computational biology + Upgrade knowledge and refine skills in the field + Provide a forum for the participants to exchange views and experiences The topics included were : Introduction to Bioinformatics (Ensembl Browser); Communication and analysis of biological data; Basic DNA Sequence Analysis; Sequence comparison; Basic concepts: identity, homology and mutation matrices; Principles of Sequence Similarity; Thorough explanation of the basis for sequence comparison; Determining Protein Structure from Sequence using Computational Approaches; The Machine Learning Approach; Automation of workflow; Database basics: manipulation, survey of data sets; Small and Blarge scale expression analysis; Genome data analysis; Phylogenetic Analysis; Molecular Databases; Scoring Matrices; Linkage Analysis and Micro-array analysis. Dr. Saeed Al-Yahyaee was promoted to associate professor and subsequently moved to become head of the Genetics Department. He was designated Deputy Vice-Chancellor for Academic Affairs and Community Service on 5th May Dr. Nadia Al-Wardy became Head of the Medical Education Unit in 2007 and Dr. Jumana Saleh was promoted to Associate Professor in Dr. David NKansa Dwamena joined the Department as Senior Consultant in Clinical Biochemistry in Dr. Marit Delghandi and Dr. Yahya Tamimi joined the Department in The Department also had a great loss by the sad demise of Dr. Mehmet Simsek in October Dept. 04 a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Biochemistry Mr. Fahad Al-Zadjali was granted a scholarship for his PhD at the Karolinska Institute, Sweden. Ms. Maha Al-Riyami and Ms. Amani Al-Khaifi were also awarded scholarship for their Masters degrees. Dr. Khalid Al-Rasadi completed his residency programme from McGill University, Canada and joined the Department in August

60 Teaching Programmes Departmental Courses Departmental Courses Semester Foundation Biochemistry 4 Metabolism 5 Genetics for Medicine 5 Applied Basic Medical Sciences 8 No. of students for each of the Departmental courses is approximately 120 System-based Courses System-based Courses Semester B Alimentary System 5 Early development Tissues & Integuments 4 Hemopoietic & Lymphoid Vascular System 6 Respiratory System 6 Endocrinology & Reproductive System 8 Urinary System 6 Nursing Program The Department offered a 3 credit course in Biochemistry for nursing students. BSc Medical Laboratory Sciences The Department had a heavy teaching load in the BSc MLS program. The courses for the BSc MLS programme in Biochemistry are: 50 Course Title Semester Basic Clinical Chemistry I 7 Basic Clinical Chemistry II 8

61 Carbohydrate and Lipid Metabolism 9 Nitrogen Metabolism: Proteins, Amino Acids and Nucleotides 9 Calcium, Trace elements and Vitamins 9 Water and electrolyte balance 9 Endocrinology 9 Diagnostic Toxicology and Therapeutic Drug Monitoring 10 Cancer and Tumor Markers 10 Molecular Diagnosis of Genetic Defects 10 Project 10 Undergraduate Clinical Programme The Department was involved in teaching Bthe clinical programme. Five groups of medical students (MD programme 7th year) rotated for one week in the Department. Postgraduate Programme The Department contributed to the Clinical Biochemistry Programme of the Oman Medical Specialty Board (OMSB) and had 4 residents specialising in biochemistry and supervised their postgraduate research projects. MSc Programme The Department offered the Biochemistry MSc programme for 6 candidates in The courses taught in the MSc programme are: Dept. 04 a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Biochemistry Course Credits Biochemical Basis of Disease 3 Instrumentation and Biomedical Techniques 3 Advanced Molecular Biology 3 Methodology in Clinical Biochemistry 3 51

62 Clinical and Diagnostic Services Service Provision The Department of Clinical Biochemistry in SQUH provides a wide range of routine and specialised investigations. Some of the specialised tests are unique and hence the Department offers a referral laboratory service for such investigations. The service is provided to the SQUH on 24 hour basis. The estimated number of tests performed in 2008 is 869,963, i.e. there has been a 24.8% increase in the workload compared to The Clinical Biochemistry Department manages the Commercial Laboratory Services offered to some selected hospitals within the private sector e.g. Muscat Private Hospital and Hatat Polyclinic. B Point of Care Testing (POCT) The Department ensures quality assurance of blood gas analysers in the Accident and Emergency Unit (A&E), Operating Theatres (OT), Intensive Care (ICU) and Neonatal (NNL) units. Teaching Teaching is conducted by Senior Biomedical Scientist 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 emphasize the importance of the pre-analytical phase to the nurses. This session is also included in the IV Therapy course for nurses during the induction program. 52 External Quality Assurance The Department continues to participate in the Royal College of Pathology of Australia s External Quality Assurance programme.

63 Research The Department undertook research on the following topics: Polymorphism of type 2 diabetes, Mutational analysis of candidate gene of spastic ataxia, Acylation Stimulating Protein, Deafness in Oman, Genetic characterization of lactose intolerance. Research Projects Polymorphism of type 2 diabetes candidate genes among individuals of Oman Family Study Project Code: Dates: Value: OR 17,300 Project Funder: Investigators: IG/MED/BIOC/07/01 B Sultan Qaboos University Prof. Riad Bayoumi, Department of Biochemistry, SQU; Prof. Mohammed O Hassan, Department of Physiology, SQU; Dr. Sulayma Al- Barwani, Department of Physiology, SQU; Dr. Saeed Al-Yayhaee, Department of Biochemistry, SQU Mutational Analysis of candidate gene of a novel server hereditary spastic ataxia Project Code: Dates: Value: OR 24,500 Project Funder: Investigators: IG/MED/BIOC/07/02 Sultan Qaboos University Dr. Saeed Al-Yahyaee, Department of Biochemistry, SQU; Dr. Abdulla Al-Asmi, Department of Medicine, SQU; Dr. Amna Al-Futaisi, Department of Child Health, SQU Dept. 04 a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Biochemistry 53

64 The Acylation Stimulating Protein (ASP): A potent lipogenic factor and its association with Obesity and related metabolic disorders in the Omani. Project Code: Dates: Value: OR 8,700 Project Funder: Investigators: IG/MED/BIOC/06/04 Sultan Qaboos University Dr. Jumana Saleh, Department of Biochemistry, SQU; Prof. Riad Bayoumi, Department of Biochemistry, SQU; Katherine Cianflone, University of Laval, Quebec, Canada; Hamad Al-Riyami, Department of Biochemistry, SQU B Genetic linkage mapping of recessive deafness in Oman Project Code: Dates: IG/MED/BIOC/08/01 Value: OR 31,300. Project Funder: Investigators: Sultan Qaboos University Dr. Nadia Al-Wardy, Department of Biochemistry, SQU; Prof. Riad Bayoumi, Department of Biochemistry, SQU; Mr. Mohammad Al- Kindi, Department of Biochemistry, SQU; Dr. Mazin Al-Khabori, Department of Ear, Nose & Throat, Al-Nahda Hospital, Ministry of Health, Sultanate of Oman. 54 Genetic Characterisation of Lactose Intolerance among Omanis Project Code: MREC #281 Dates: Project Value: Unfunded

65 Investigators: Prof. Riad Bayoumi, Department of Biochemistry; Mr. Abdulrahim Al-Abri, Department of Biochemistry Dept. 04 Biochemical and Genetic basis of Hypocalcaemia in Omani Children Project Code: MREC #273 Dates: Value: OR 3,000 Project Funder: Investigator: College of Medicine, SQU B Project Code: MREC #274 Dr. Nasser Nazwani, Department of Biochemistry, SQU Development of anticancer conjugate preparations for specific targeting of solid tumour cells Dates: Value: OR 4,000 Project Funder: Investigator: College of Medicine, SQU Dr. Nasser Nazwani, Department of Biochemistry, SQU; Dr. Hamed Al-Riyami, Department of Genetics, SQU; Mr. Abdulrahim Al-Abri, Department of Biochemistry. Research Publications Journal Publications 1. Moszczynska A, Saleh J, Zhang H, Vukusic B, Lee F, Liu F. Parkin Disrupts the α-synuclein/dopamine Transporter Interaction: Consequences Toward Dopamine-induced Toxicity. J Mol Neurosci 2007; 32: Koul R, Al-Futaisi A, Chako A, Rao V, Simsek M, Muralitharan S, Ganguly SS, Bayoumi RA. Clinical and genetic study of spinal muscular atropies in Oman. J Child Neurol 2007; 22: El-Sayed B, El-Zaki S, Babiker H, Gadalla N, Ageep T, Mansour F, Baraka O, Milligan P, Babiker A. A a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Biochemistry 55

66 randomized open-label trial of artesunate-sulfadoxine-pyrimethamine with or without primaquine for elimination of sub-microscopic P. falciparum parasitaemia and gametocyte carriage in eastern Sudan. PLoS Clin Trials 2007; 12:e Tanabe K, Sakihama N, Walliker D, Babiker HA, Abdel-Muhsin AM, Bakote e B, Ohmae H, Arisue N, Horii T, Rooth I, Farnert A, Bjorkman A, Ranford-Cartwright L. Allelic dimorphism-associated restriction of recombination in Plasmodium falciparum msp1. Gene 2007; 397: A-Elbasit EE, ElGhazali GA, Elgadir TME, Hamad A, Babiker HA, El-Bashir MI, Giha HA. Allelic polymorphism of MSP2 gene in severe P. falciparum malaria in an area of low and seasonal transmission. Parasitol Res 2007; 102: Tamimi Y, Ziebart K, Desaulniers N, Dietrich K, Grundy P. Identification of a minimal region of loss on the short arm of chromosome-1 in Wilms Tumor. Genes Chromosomes Cancer 2007; 46: Lopez-Alvarenga JC, Solis-Herrera C, Kent JW, Jaju D, Albarwani S, Al-Yahyaee S, Hassan MO. Bayoumi RA, Commuzzie AG. Prevalence and Heritability of clusters for Diagnostic components of Metabolic Syndrome: The Oman Family Study. Metab Syndr Relat Disord 2008; 6: B 9. Al-Wardy N. Medical Education Units: History, Functions, and Organisation. SQU Med J 2008; 8: Albarwani S, Bayoumi RA, Jaju D, Al-Yahyaee SA, Al-Hadabi S, Lopez- Alvarenga JC, Comuzzie AG, Hassan MO. Differing Definition-Based prevalence of Metabolic Syndrome in the Women of Oman Family Study: A Function of Multiparity. Metab Syndr Relat Disord 2008; 6: Saleh J, Al-Riyami H, Chaudhary T, Cianflone K. High pregnancy triglycerides increase fetal fat storage: A commentary. Lipids Online June 5, Saleh J, Al-Riyami H, Chaudhary T, Cianflone K. Cord blood ASP is predicted by maternal lipids and correlates with fetal birth weight. Obesity 2008; 16: Tamimi Y, Ekuere U, Laughton N, Milanovic A, Grundy P. WNT5A is Regulated by PAX2 and May be Involved in Blastemal Predominant Wilms Tumorigenesis. Neoplasia 2008; 10: Babiker HA, Schneider P, Reece SE. Gametocytes: Insights gained during a decade of molecular monitoring. Trends Parasitol 2008; 24: Babiker HA, Schneider P. Application of reverse transcription PCR (RT-PCR) for monitoring transmission stages of malaria parasites. IOP Biochemical Material 2008; 3: Nwakanma D, Kheir A, Sowa M, Dunyo S, Jawara M, Pinder M, Milligan P, Walliker D, Babiker HA. High gametocyte complexity and mosquito infectivity of Plasmodium falciparum in the Gambia. Int J Parasitol 2008; 38:

67 Conference and Seminar Presentations Conference Presentations International 1. Bayoumi RA, Hassan MO, AlYahyaee S, Albarwani S. Linkage Analysis of obesity QLTs in Omani Arabs of Oman Family Study. The 5th Annual Meeting of the African Society for Human Genetics. Cairo, Egypt, October Bayoumi RA. Advances in genetics of type 2 diabetes mellitus. The Second Pan Arab conference of Human Genetics. Dubai, UAE, November Ekuere U, Tamimi Y, Laughton N, Grundy P. WNT5A gene is a regulated by PAX2 transcription factor in foetal kid key cell line. Alberta Cancer Board (ACB) meeting. Banff, Alberta, Canada, 7-10 November Babiker HA. The brunt of mutations conferring drug resistance on the fitness of malaria parasites. 1st The Africa Health Research Organization (AHOR) International Malaria Symposium on Clinical Pharmacology of Antimalarial Drugs. Accra, Ghana, August Thesis Supervision Manal Al-Khanbashi Qualification: Title of Thesis: Supervisor: B Dr. Jumana Saleh MSc Date of Completion: Spring 2008 Salma Mahmmed Farag Al-Saai Qualification: Title of Thesis: Supervisor: Alterations in plasma Acylation Stimulating Protein levels (ASP) in relation to hormone profiles in Omani females. MSc Origin of pyrimethamine resistance among Plamsodium falciparum in eastern Sudan. Dr. Hamza Babiker Date of Completion: August 2007 Dept. 04 a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Biochemistry 57

68 Mohammed Al-Tobi Qualification: MSc Title of Thesis: Genetics of Wilson Disease in Omani Families Supervisor: Prof. Riad Bayoumi Date of Completion: July 2007 B 58

69 Dept. 04 B a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Biochemistry 59

70 C Child Health

71 Overview The Department of Child Health is one of the most active departments of the College of Medicine, Sultan Qaboos University and SQU Hospital. Its activities are spread across the following important areas: Dept The Department accounts for more than a third of total SQUH admissions and provides the best of patient care from birth to adolescence, encompassing all subspecialties. + Well-developed undergraduate teaching and training programmes, in collaboration with other sister institutions locally and internationally. + Highly integrated postgraduate training programme under the Oman Medical Specialty Board (OMSB), equipped with excellent clinical teaching units (CTUs) run by experienced teachers. Our Department started the first CTU in the Sultanate of Oman and has been complimented on this development by international medical educationists from different countries. C + Training of foreign undergraduate students, during their elective rotations. + Teaching and training of 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. + Subspecialty training of paediatric residents in metabolic diseases, haemato-oncology, neurology, immunology, rheumatology and neonatology. + High quality research with state of the art support from the genetic laboratories producing publications in high impact peer reviewed indexed journals. Collaboration with international centres of excellence in paediatrics benefiting large numbers of sick children especially those with haematological diseases. The Department takes great pride in continuing to serve the community and children with special needs by providing medical care to orphanages and centres for special education. Members of our Department also champion the cause of the neglected and abused child. a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Chilh Health 61

72 62 Staff Head of Department Yasser Wali, Associate Professor Faculty Zakia Al-Lamki, Associate Professor Muna Al-Saadoon, Assistant Professor Amna Al-Futaisi, Senior Consultant Saif Al-Yaarubi, Senior Consultant Ibtisam B Elnour, Senior Consultant Roshan Lal Koul, Senior Consultant SN Joshi, Senior Consultant PC Alexander, Senior Consultant Hussein Al-Kindy, Consultant Hamed Abdoon, Consultant Siham Al-Sinani, Consultant Salem Al-Tamemi, Consultant Reem Abdwaani, Consultant Lalitha Krishnan, Consultant Mathew Zachariah, Consultant Faraz Masud, Senior Registrar Zenaida Reyes, Senior Registrar Wafa Bashir, Senior Registrar Azza Al-Shidhani, Registrar Ma. Flordeliz Bataclan, Registrar Mohammed Fazalullah, Registrar Mahmoud Fathalla, Registrar Masood Ahmed, Registrar Ismail Beshlawi, Registrar C

73 Mohammed Atef, Registrar Islam El-Baroudy, Registrar Manjusha Hira, Registrar Haitham Mohamed, Senior House Officer Ashfaq Khan, Senior House Officer Hilal Al-Mandhari, Senior House Officer Renjit Mani, Senior House Officer Rana Abdel Rahim, Senior House Officer Dept. 05 Coordinators Ruth T Mujal Aisha Al-Maskary C Support Staff Najah Al-Maawaly, Social Worker Kawther Al-Khusaibi, Play Therapist Amna Al-Alawi, Play Therapist Fatma Al-Farsi, Play Therapist Fathiya Al-Hosini, Play Therapist Highlights of the Year The Department of Child Health, the first established clinical department at the Sultan Qaboos University Hospital, continues to excel in medical education, medical research and patient care. With increased patient load, the Department has bloomed into a centre of excellence, providing subspecialty services in paediatric haematology, pulmonology, rheumatology, cardiology, intensive care, neonatal medicine, endocrinology, immunology, neurology, nephrology, clinical genetics and metabolic diseases. a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Chilh Health 63

74 Conferences ORGANISED BY THE DEPARTMENT The 5th SIOP ASIA Conference, of the prestigious International Society of Paediatric Oncology- Asia, was hosted by the Department of Child Health from February 2008, in association with the International Society of Paediatric Oncology (SIOP), the International Network for Cancer Treatment and Research (INCTR) and the Middle East Childhood Cancer Alliance (MECCA). 64 Invited Speakers Prof. Maarten Egeler, President, SIOP Dr. Bharat Agarwal, Secretary General, SIOP. Prof. Purna Kurkure, President, SIOP Asia Dr. Anupam Sachdeva, Secretary, SIOP Asia Dr. Y Ravindranath, USA Prof. V Saha, UK C Dr. Judith Margolin, USA Prof. Leni Mathew, India Sir Alan Craft, UK Prof. Mammen Chandy, India Prof. Julia Cark, UK Dr. Aziza Shad, USA Prof. Sheila Nair, India Dr. Rizwan Naeem, USA Dr. Bensou Pau, Hongkong Prof. Greg Reaman, USA Prof. Alfred Reiter, Germany Prof. Rolf Kortmann, Germany Ms. Marianne B Philips, UK Dr. Scott Howard, USA Prof. Hans Peter Wagner, Germany Prof. Stefan Burdach, Germany In addition to the 26 invited speakers from the Middle East and GCC countries, 24 posters from

75 various countries were exhibited. A total of 278 delegates came from 29 countries to attend the conference. Dept. 05 A Childhood Cancer Survivors Parents Workshop was also held during the conference on 27 February The invited speakers were: Dr. Benson Pau, Hongkong Dr. Yasser El Din, Egypt Bahija Gouimi, Morocco In addition an Oncology Nursing Workshop was held on 25 February 2008 with Ms. Marianne B Philips from the UK As invited speaker. A CME day on Practical Paediatric Oncology was also held on 25 February The invited speakers were: C Dr. Rashmi Dalvi, India Dr. Bharat Agarwal,India Dr. Purna Kurkure, India Dr. Anupam Sachdeva, India Other distinguished visitors to the Department in were Prof. Hala Safwat, WHO Consultant, Global Polio Surveillance, on 15 November 2007 and Dr. George Rylance, Editor in Chief, BNF for Children, on 15 February a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Chilh Health PUBLICATIONS More than twenty publications were published in internationally renowned peer reviewed journals. Three of our senior members were on the editorial of board of various medical journals. Two books were published by the staff of the Department: Practical Paediatrics, Author House, UK (first edition) and Metabolic Disease for Beginners, Lulu online, (first edition). 65

76 CONFERENCES Our departmental members attended a large number of international and local conferences in Many papers were presented (platform and poster). Senior members chaired several scientific sessions in prestigious international conferences. INTERNATIONAL EXAMINATIONS The Department continued to be an internationally recognised centre for the following examinations: + Diploma in Child Health (Royal College of Physicians and Surgeons of Glasgow, UK). + Membership Examinations (Part I and Part II - Theory and Clinical), Royal College of Paediatrics and Child Health, UK. C Senior members of the Department continued to be examiners of the Royal College of Physicians and Surgeons of Glasgow and the Royal College of Paediatrics and Child Health, UK, both in GCC countries (Yasser Wali, Roshan Koul, SN Joshi, Ibtisam Elnour) and in the United Kingdom (Yasser Wali). Senior members of the department have been awarded fellowships of the Royal College of Paediatrics of Child Health, UK and the Royal College of Physicians of Ireland. COMMUNITY SERVICE Desktop calendars based on drawings by children with chronic ailments were published again in this year with the help of the Omani Charity Organisation, Dar Al-Atta. Financial support for poor families to bring their children with chronic diseases to hospital for treatment was completely funded by the Sheikh Saud Bahwan Charitable Trust and in 2007/2008, there was a substantial funding increase. Monthly parties were also organised for sick children by various student and community groups. A library with books, CDs, computer games and play stations for children with cancer and other chronic illnesses was inaugurated in September 2008 in the OPD Play Area. 66 The Department takes great pride in continuing to serve the community and children with special needs by providing medical care to orphanages and centres for special education. Supported by the Ministry of Social Welfare, members of our Department have been championing the cause of the

77 neglected and abused child, and often play the role of child advocates. Families of sick children from low socioeconomic groups are supported by various charitable foundations through our Department. Dept. 05 Teaching Programmes Undergraduate Pre-Clinical Programme The Department is actively involved in the Communication Skills and Clinical Skills Courses conducted in Year 4. Contributions were made to the College of Education in the form of lectures as part of training for teachers of pre-school children. Undergraduate Clinical CProgramme 5th Year Programme There are about 30 students posted for a total of 11 weeks in the Department in each rotation (total of 4 rotations). These students rotate between the Royal Hospital and SQUH. The clinical program is divided into 3 sessions: self learning, bedside teaching with demonstration of clinical signs and lectures. Furthermore, problem-based teaching (previously known as the integrated lecture series [ILS]) is conducted every Wednesday and covers all majors subspecialties. Students are required to sit an end of rotation examination held at both SQUH and the Royal Hospital. Logbooks are also used for assessment of the clinical activities and cases write up. 7th Year Programme There are 18 final year students posted for clinical rotation in the Department for a period of 7 weeks divided between the Royal Hospital and SQUH (total of 5 rotations). Students are posted to the Clinical Teaching Units till midday and then they have a clinical session with a tutor. They are attached to the team throughout their daily activities e.g. ward rounds, outpatients, meetings, consultations, etc. By the end of their rotation, they are assessed by the team in clinical skills, data interpretation and management of a variety of diseases. There is a formal end of rotation examination using extended short cases. The overall assessment is based on performance throughout a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Chilh Health 67

78 rotation in both the in-course assessment and end of rotation examination which is conducted both at SQUH and the Royal Hospital. Postgraduate Programme There are about 10 interns posted every 4 months who rotate through all the wards and the outpatient clinics. Continuing medical education activities are held which include radiology meetings, morning sign out meetings, journal clubs, mortality review meetings, clinical presentations and discussion of recent advances by senior doctors. The establishment of clinical teaching units was one of the major milestones accomplished by the Department of Child Health at SQUH in In order to improve the quality of general paediatric training offered to OMSB Residents, two units were formed to cater for general paediatric patients. This consolidates the experience of residents Cby exposing them to a large number and variety of general paediatric patients. Since graduate medical education is based on the principle of progressively increasing levels of responsibility in caring for patients, under the supervision of the faculty, a need for such units came up. The unit consists of a consultant, a registrar, one senior resident, two junior residents and two interns. Each person has defined roles and functions within this unit. Recently, the 7th year medical students were also incorporated in to the units; they found the experience very exciting and extremely rewarding for their educational process. Next year, we hope to have the final year students functioning more actively in the units and to have their schedule organised better so that they can take more active roles in patient care. Clinical Electives The Department receives medical students from various medical universities across the globe. Students from Cardiff University (UK), Universitat München (Germany), Amman University (Jordan), Arabian Gulf University (Bahrain), Al-Ain University (UAE) and the University of Ibadan, Nigeria, regularly rotate through the Department. Arica Nespar, an MD student, and winner of a Fullbright Schoolarship, chose SQUH, Child Health Department, to conduct her year of medical training and research in the area of perinatology. 68

79 Clinical Attachments More than 10 medical graduates from various medical schools have had clinical attachments in our Department in Dept. 05 The Department organised one MRCPCH (Membership of Royal College of Paediatrics and Child Health) course in March 2008, officially recognised by the Royal College of Paediatrics and Child Health, UK, with the faculty from the UK. Candidates from five GCC Countries attended these courses. The Department was the first overseas centre in the Middle East to be recognised for these courses. Training Courses & CME Activities Courses run by the Department in this period Cwere: + Basic Life Support Course - 6 (2008) + Paediatric Advanced Life Support Course - 3 (2008) + Neonatal Advanced Life Support Course - 4 (2008) + Pain Management Course + Monthly Histopathology Slide Seminars + Weekly Radiological Quiz sessions + Daily Clinical Presentations + Weekly Grand Rounds + Monthly Mortality Meetings + Monthly Journal Clubs + Monthly Senior Doctors lectures on Recent Advances in Paediatrics + Weekly Haematology Slide Seminars + Weekly Intern s Presentations a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Chilh Health 69

80 CLINICAL & DIAGNOSTIC SERVICES Currently the Department has the following sub-specialities: neonatology, paediatric intensive care, metabolic diseases, neurology, nephrology, endocrinology, rheumatology, cardiology, immunology, genetics, haematology and general paediatrics. In 2008, there were 7,600 admissions to the various Paediatric and Neonatal units as against 7,191 in One third of the total admissions to SQUH in 2008 were under the Department of Child Health. A total of 8,637 children were seen in the Paediatric OPD and 10,447 children (20% of total patients seen in 2008) were seen in A&E by paediatric doctors on call. The total number of beds allotted to the Department stood at 115 (1 Blue ward - 24; 1 Purple ward - 24; 2 Blue ward - 24; Day care unit - 4; Paediatric ICU- 3; Neonatal ICU - 12 and Postnatal ward - 24). The proposed Maternal Child Health unit, when completed, would provide state of the art facilities to the increasing population of Omani children. C Table 1: Paediatric Inpatients The Department continues to be the National Referral Centre for Acute Flaccid Paralysis and is the national focal point of the Polio Surveillance Programme directly supervised by Eastern Mediterranean Office of the WHO, based in Alexandria, Egypt. All cases of childhood leukaemia and inborn errors of metabolism are referred to Department of Child Health which is the only centre in the Sultanate that takes care of these children. Year No. of Admissions Av. Bed Occupancy (%) , , , Av. Length of Stay (Days) 70

81 Table 2: Paediatric Outpatients Year Booked Total Seen Admitted Discharged ,223 8, ,164 7, ,642 7, Dept. 05 Table 3: Neonatal Intensive Care Unit Year No. of Admissions Av. Bed Occupancy Av. Length of Stay (Days) C Table 5: Paediatric Intensive Care Unit Table 4: Postnatal Ward Year No. of Admissions Av. Bed Occupancy Av. Length of Stay (Days) , , , Year No. of Admissions Av. Bed Occupancy Av. Length of Stay (Days) a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Chilh Health Table 5: Paediatric services provided to the Department of Clinical Physiology: EEG, BAER, VEP, SSEP, Video EEG, EMG, NCV, Echocardiography, 24 hours Oesophageal Ph Monitoring Year No. of Procedures ,856 71

82 Research The Department has ongoing collaboration with Karolinska Institute (Sweden), Oakland Research Centre (USA), Hanover Medical School (Germany), King Faisal Specialist Hospital and Research Centre (Riyadh, Kingdom of Saudi Arabia), Genzyme Registry (USA), Orphan Pharma (France), King s College Medical School (UK), McGill University (Canada) and University of Nottingham (UK). Research Projects The Department has ongoing collaboration with Karolinska Institute (Sweden), Oakland Research Centre (USA), Hanover Medical School (Germany), King Faisal Specialist Hospital and Research Centre (Riyadh, Kingdom of Saudi Arabia), Genzyme Registry (USA), Orphan Pharma (France), King s College Medical School (UK), McGill University (Canada) and University of Nottingham (UK). C IG/MED/CHILD/06/01 Genetic polymorphism of the mannose-binding lectin gene in sickle cell disease patients: Clinical correlation with the type and severity of infections. Project Code: Dates: Value: OR 4,600 Project Funder: Investigators: Sultan Qaboos University Dr. Mathew Zachariah, Department of Child Health, SQU; Dr. Yasser Wali, Department of Child Health, SQU; Dr. Anil Pathare, Department of Haematology, SQU; Dr. Salam Al-Kindi, Department of Haematology, SQU; Dr. David Dennison, Department of Haematology, SQU; Mr. Shoaib Al-Zadjali, Department of Haematology, SQU. 72

83 Clinical Profile and Molecular Basis of Severe Combined Immunodeficiency Syndromes in Oman Project Code: Dates: Value: OR 10,350 Investigators: IG/MED/CHILD/06/02 Dr. Ibtisam El-Nour, Department of Child Health, SQU; Dr. Salim Al-Tamimi, Pediatric Immunologist, SQUH; Dr. George Paul, Division of Pediatrics, Royal Hospital; Dr. Anil Pathare, Department of Haematology, SQU; Dr. Sandy Raeburn, Department of Genetics, SQU; Dr. David Dennison, Department of Haematology, SQU; Dr. Adel Alnaqdy, Department of Microbiology & Immunology, SQU; Mr. Shoaib Al-Zadjali, Department of Haematology, SQU C IG/MED/CHILD/07/01 Pulmonary function test in children with sickle cell disease in correlation with haemoglobin s B chin haplotypes Project Code: Dates: Value: OR 5,000 Investigators: Dr. Hussein Al-Kindi, Department of Child Health, SQU; Dr. Omar Rawas, Department of Medicine, SQU; Dr. Yasser Wali, Department of Child Health, SQU; Dr. Anil Pathare, Department of Haematology, SQU; Dr. Salam Al-Kindi, Department of Haematology, SQU; Dr. Mathew Zachariah, Department of Child Health, SQU; Dr. Wafa Bashir, Department of Child Health, SQU; Mrs. Ruth Balaji, Department of Clinical Physiology, SQU; Mrs. Nasra Sultan, Department of Clinical Physiology, SQU. Dept. 05 a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Chilh Health 73

84 Clinical Profile, Laboratory Diagnosis & Molecular basis of Familial Haemophagocytic Lymphohistiocytosis [FHLH] in Oman Project Code: MREC #230 Dates: Value: OR 2,000 Investigators: C Project Code: MREC #256 Dr. Yasser Wali, Department of Child Health, SQU; Dr. Zakia Al- Lamki, Department of Child Health, SQU; Mr. S. Muralitharan, Department of Biochemistry, SQU; Dr. Mathew Zachariah, Department of Child Health, SQU; Mr. Shoaib Al-Zadjali, Department of Haematology, SQU; Dr. Anil Pathare, Department of Haematology, SQU; Ms. Aisha Al-Mammari, Department of Haematology, SQU. Incidence of Coeliac Disease among Omani Children attending SQUH Pediatric Outpatient Clinics Dates: Value: OR 2,000 Investigators: Dr. Hamed Abdoon, Department of Child Health, SQU; Dr. Ali Al- Jabri, Department of Microbiology & Immunology; Dr. Khaola Al-Said, Department of Microbiology & Immunology 74 Nutritional Rehabilitation of Children with Sickle Cell Disease and Delayed Growth in Oman Project Code: MREC # 261 Dates:

85 Value: OR 2,500 Investigators: Dr. Saif Al-Yaarubi, Department of Child Health, SQU; Dr. Yasser Wali, Department of Child Health, SQU; Dr. Azza Al- Shidhani, Department of Child Health, SQU; Dr. Mathew Zachariah, Department of Child Health, SQU. Dept. 05 Clinical Profile, Laboratory Diagnosis & Molecular Basis of Familial Haemophagocytic lymphohistiocytosis [FHLH] in Oman Project Code: MREC #254 Dates: C Value: OR 4,000 Investigators: Pediatric Discharge against Medical Advice Project Code: MREC #259 Dates: Value: Investigators: Dr. Yasser Wali, Department of Child Health, SQU; Dr. Zakia Al- Lamki, Department of Child Health, SQU; Mr. S. Muralitharan, Department of Biochemistry, SQU; Dr. Mathew Zachariah, Department of Child Health, SQU; Mr. Shoaib Al-Zadjali, Department of Haematology, SQU; Dr. Anil Pathare, Department of Haematology, SQU; Ms. Aisha Al-Mamaari, Department of Haematology, SQU Unfunded Dr. Muna Al-Sadoon, Department of Child Health, SQU; Mr. Khalid Al-Shamsi, Medical Student, SQU. a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Chilh Health 75

86 The Pattern of Sensitization to Inhalant Allergens in Omani Patients with Asthma, Allergic Rhinitis and Rhinoconjuctivitis Project Code: MREC #262 Dates: Value: Investigators: Unfunded Dr. Salem Al-Tamemi, Department of Child Health, SQU. 76 Multinational Study of Lycopene and Lutein Concentrations in Human Milk and Infant Plasma of the Mother-Infant Pair Project Code: MREC #271 C Dates: Value: Investigators: Unfunded Dr. Yasser Wali, Department of Child Health, SQU. Research Publications and Books Journal Publications 1. Udayakumar AM, Pathare AV, Al-Kindi S, Khan H, Rehmen JU, Zia F, Al-Ghazaly A, Nusrut N, Khan MI, Wali YA, Al-Lamki Z, Dennison D, Raeburn JA. Cytogenetic, Morphological, and Immunophenotypic Patterns In Omani Patients with De Novo Acute Myeloid Leukemia. Cancer Genet Cytogenet 2007; 177: Fathalla M, Javad H, Alkindy H, Wali YA. Cerebrospinal Fluid Hemophagocytosis in a Case of Visceral Leishmaniasis. SQU Med J 2007; 7: Wali YA. Book Review: Evidence Based Pediatric Oncology, Blackwell Publishing Ltd. SQU Med J 2007; 7: Daar S, Gravell D, Hussein HM, Pathare AV, Wali YA, Krishnamoorthy R. Haematological And Clinical Features Of β-thalassaemia Associated With Hb Dhofar.Eur J Haematol 2008; 80: Al-Kindi H, Abdoon H, Al-Khabori M, Daar S, El-Beshlawi I, Wali YA. Invasive Candidal Laryngitis as a Manifestation of Cyclic Neutropenia in an Omani Infant. Pediatr Hematol Oncol 2008; 25:

87 6. Ganesh A, Al-Zuhaibi S, Pathare A, William R, Al-Senawi R, Al-Mujaini A, Hussain S, Wali Y, Alkindi S, Zachariah M, Knox-Macaulay H. Orbital Infarction in Sickle Cell Disease. Am J Ophthalmol 2008; 146: Al-Kindi H, Abdoon H, Daar S, Beshlawi I, Wali YA. Invasive Candidal Laryngitis as a Manifestation of Cyclic Neutropenia in an Omani Infant: Case Report. Pediatr Hematol Oncol 2008; 25: R Abdwani, SG Rizvi, El-Nour IB. Childhood Systemic Lupus Erythematosus in Sultanate of Oman: Demographics and Clinical Analysis. Lupus 2008; 17: Ganesh A, Al-Zuhaibi SS, Bialasiewicz AA, Al-Abri R, Ahmed S, Al-Tamemi S, El-Nour IB. Necrotizing Pseudomonas infection of the ocular adnexa in an infant with leukocyte adhesion defect. J Pediatr Ophthalmol Strabismus 2007; 44: Jain R, Sawhney S, Koul RL, Chand P. Tolosa-Hunt Syndrome: MRI Appearances. Review. J Med Imaging Radiat Oncol 2008;52: Al-Maawali AA, Chacko AP, Javad H, Fathalla M, Shenoy A, Koul R. HIV disease presenting as a unilateral parotid gland swelling. Indian J Pediatr 2008; 75: C 12. Koul RL, Alfutaisi A. Prospective Study of Children with Guillain-Barre Syndrome. Indian J Pediatr 2008; 75: Epub 2008 Jun Brancati F, Travaglini L, Zablocka D, Boltshauser E, Accorsi P, Montagna G, Silhavy JL, Barrano G, Bertini E, Emma F, Rigoli L; International JSRD Study Group, Dallapiccola B, Gleeson JG, Valente EM. International collaborators Koul R. RPGRIP1L Mutations are mainly associated with the cerebello-renal phenotype of Joubert syndrome-related disorders. Clin Genet 2008: 74: Dick KJ, Al-Mjeni R, Baskir W, Koul R, Simpson MA, Patton MA, Raeburn S, Crosby AH. A novel locus for an autosomal recessive hereditary spastic paraplegia (SPG35) maps to 16q21-q23. Neurology 2008; 71: Epub 2008 May Al-Kindy H, Cote AN. Extreme cardio respiratory events in infants hospitalized for ALTE. Am J Resp Crit Care Med 167:A677. (Poster at ATS 2003). 16. Fathalla M, Hashim J, Al-Kindy H, Wali YA. Cerebral fluid involvement in a case of visceral leishmaniasis associated with haemophagocytic lymphohistiocytosis. SQU Med J; 7: Al-Kindi H, Abdoon H, Alkhabori M, Daar S, Beshlawi I, Wali YA. Invasive candidal laryngitis as a manifestation of cyclic neutropenia in an Omani infant. Pediatr Hematol Oncol 2008; 25: Al-Rawas OA, Al-Riyami BM, Al-Kindy H, Abdullah A Al-Maniri and Asya A Al-Riyami. Regional variation in the prevalence of asthma symptoms among omani school children: Comparisons from two nationwide cross-sectional surveys six years apart. SQU Med J 2008; 8: Alftuaisi A, Al-Yaarubi S, Alzakwani I, Alqasabi S, Alriyami S, Wali Y. Clinical and epidemiological characteristics of pituitary tumor using a web based pituitary tumor registry. SQU Med J 2007; 7: Dept. 05 a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Chilh Health 77

88 20. Almundher A, Al-Yaarubi S, Alfutaisi A. An infant with CMV induced sub acute thyroiditis. J Pediatr Endocrinol Metab 2008; 16: Abdulaziz Almahrezi A, Al-Yaarubi S, Al-Lawati H, Balkhair A, Al-Lawati F. Chronic adreno-cortical insufficiency associated with a unilateral adrenal mass. Oman Med J. Accepted for publication Feb Conferences and Seminar Presentations Conference Presentations International 1. Wali Y, Daar S. Controversies in the management of thalassemia intermedia-experience from Hemoglobin Dhofar. Thalassaemia Day. Cairo, Egypt, 7-8 May Wali Y. Management of sickle cell disease, Old and New Strategies. Egyptian Society of Paediatric Haematology/ Oncology (ESPHO) Conference. Cairo, Egypt, May C 6. Al-Kindy H. Presentation.The 8th Paediatric Pulmonary Congress, Nice, France, 1-3 March Wali Y. Acute Leukaemias in Oman, the past, the present and the future. 5th International Society of Paediatric Oncology SIOP-Asia Conference February 2008, Muscat, Oman. 4. Mathew Z. Infant Leukaemia. Review from University Hospital in Oman. 5th International Society of Paediatric Oncology SIOP-Asia Conference, February 2008, Muscat, Oman 5. Bashir W. Cancer Registry, Statistics and Outcome in Oman. 5th International Society of Paediatric Oncology SIOP-Asia Conference February 2008, Muscat Oman 7. Al-Kindy H. Presentation. The 4th GCC Paediatric Pulmonary Meetings. Qatar, 22 March Abdoon H. Bile Acid Synthetic defects. The 10th Conference of Arab Association of Paediatric Gastroenterology and Nutrition. Syria, June (Invited Speaker). 9. Abdoon H. Corrosive Ingestion, Complicated Cases. Second Saudi Paediatric Gastroenterology Symposium. Jeddah, Saudi Arabia, March ( Invited Speaker). 10. Mathew Z. Is Chemotherapy necessary for Secondary HLH with treatable Etiology? 21st Meeting of the American Society of Pediatric Haematology and Oncology. Cincinnati, USA Local 1 El-Nour IB. Intensive Care Management of Emergency and Malignant Hypertension. Paediatric Critical Care Symposium. Muscat, Oman, 7 September

89 Poster Presentations International 1. Wali Y. Hematological and clinical features of Hb Dhofar A thalassemic variant unique to the Sultanate of Oman. 21st Meeting American Society of Paediatric Haematology and Oncology ASPHO Meeting. Cincinati, USA, May Mathew Z. 21st Meeting American Society of Paediatric Haematology and Oncology ASPHO Meeting, Cincinati, USA, May Mathew Z, Al-Lamki Z, Bahsir W, Pathan G, Wali Y. Acute Myeloid Leukemia in Children: Experience from One Centre in Oman. 5th International Society of Paediatric Oncology SIOP-Asia Conference. Muscat, Oman, February Mathew Z, Wali Y. Is Chemotherapy Necessary for Secondary HLH with Treatable Etiology? 5th International Society of Paediatric Oncology SIOP-Asia Conference. Muscat, Oman, February C 1. Al-Lamki Z, Mathew Z, Wali Y, Wafa B. University Day. May Mathew Z, Bashir W, Soliman H, Pathan G, Wali Y. Unusual Presentation of Virus Induced HLH in a Two Month Old Child. 5th International Society of Paediatric Oncology SIOP-Asia Conference. Muscat, Oman, February Udayakumar AM, Pathare AV, Bashir WA, Al-Lamki Z, Al-Kindi S, Wali YA, Raeburn JA. Cytogenetics of Childhood Leukemia in the Sultanate of Oman: A Sultan Qaboos University Hospital Experience. 5th International Society of Paediatric Oncology SIOP-Asia Conference. Muscat, Oman, February Poster Presentations Local Seminar Presentations Local 1. Wali Y, Al-Kindy H. Workshop on Student Assessment. SQU. February Wali Y, Al-Kindy H, Al-Futaisi A, Al-Yaarubi S, Abdwani R. 1st Strategic Planning Workshop for Medical Specialities in Oman. February Al-Kindy H, Al-Futaisi A. Writing Education Goals and Objectives. College of Medicine, April Al-Kindy H, Abdwani R. Writing Learning Objectives-Phase III Coordinates, SQUH, 25 May Al-Kindy H. Assessment and Appraisal Workshop, OMSB, December Al-Kindy H. Certificate Course in Medicine Information Skills. SQUH, May Al-Yaarubi S. The Dakhilia Region Medicine Update Short Stature. Nizwa Hospital, March Dept. 05 a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Chilh Health 79

90 8. Al-Yaarubi S. Regional CME on Diabetes. Sohar Hospital, 17 May Al-Yaarubi S. Thyroid Disease in Children Al-Seeb Health Centre. 10. Al-Yaarubi. Diabetes Sick Day Management. Al-Seeb Health Centre, March Wali Y. Chronic Childhood Blood Disorders. Sohar Hospital, 15 June Wali Y. Hydroxyurea in Sickle Cell Disease. Nizwa Hospital, March Thesis Supervision Mohammed Nassr Al-Tobi Qualification: Title: Associate Supervisor: MSc (Biomedical Sciences) C Genetics of Wilson disease in Omani families. Dr. Surendranath Joshii Date of completion: September

91 Dept. 05 C a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Chilh Health 81

92 F Family Medicine and Public Health

93 Overview The Department of Family Medicine and Public Health is a major clinical and teaching department. The clinical services are provided through the University Health Center and the Student Clinic. The teaching activities include courses in epidemiology and medical statistics, nutrition, health education and village health care. It also runs a Junior Clerkship for the 5th year clinical students and a Senior Clerkship for final MD students. The postgraduate programmes include the Master s Program in Epidemiology and Medical Statistics, and the Family Medicine and Community Health Residency Program which has 57 residents. The Department conducts the MRCGP- INT (Membership of the Royal College of General Practitioners - International) examination. Staff F Head of Department Dr. Mohammed Al-Shafaee, Assistant Professor Faculty Shyam S Ganguly, Associate Professor Mushtaq Khan, Assistant Professor. Syed Rizvi, Assistant Professor Abdullah Al-Muniri, Lecturer Kamlesh Bhargava, Senior Consultant Thord Theodorsson, Senior Consultant Abdulaziz Al-Mahrezi, Consultant, Deputy Head of Clinical Services Ahmed Al-Mandhari, Consultant and Deputy Director SQU Hospital Youssef Osman, Consultant Mohammed Al-Azri, Consultant Ahmed Al-Waily, Consultant Zakiya Al-Busaidy, Consultant Hamdan Al-Habsi, Consultant Dept. 06 a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Family Medicine and Public Health 83

94 Kawther El-Shafie, Senior Registrar Anna Maria Serrano, Senior Registrar Rahma Al-Kindi, Senior Registrar Laila Ali Ramadhan, Registrar Yahya Al-Farsi, Registrar Osman Osman, Registrar Vrunda Pimpalkhute, Registrar Sheela George, Registrar Wahida Al-Maskeri, Dietician Coordinators Evelyn Malubay Perpetua Gabor Sulfa Al-Tobi F Highlight of the Years The Department continued to offer the MRCGP (Membership of the Royal College of General Practitioners) international examinations and other activities. The seventh diet of the examination was held in March An MRCGP International Oman Examiners training Workshop was held in November The examination attracted doctors from the neighbouring countries of Saudi Arabia, UAE and Pakistan. The Royal College of General Practitioners has appreciated the progress made in the development of this new examination concept which will improve the standards of primary health care in Oman. The annual National Primary Health Care Conference was jointly organized by the Department and the Ministry of Health. 84 The Department conducted an annual Regional workshop on evidence-based medicine (EBM) for health professionals from various specialities and organisations in the country and outside. This workshop has been conducted since 2000 in association with the World Health Organization, the Ministry of Health, the Centre of Evidence Based Medicine Oxford, UK, and the All India Institute

95 of Medical Sciences, New Delhi, India. A retreat day for all the teachers of the MD program from the MoH and SQU was held annually to review the MD teaching program and improve it. Dept. 06 The family medicine residency programme is well established and as of 2008, a total of 100 Omanis graduated as family physicians and moved to work all over the country. Teaching Programmes UNDERGRADUATE PRECLINICAL Programme Nutrition & Health Education FACH 2116 Village Health Care II (Blood Pressure) FFACH 2023 Village Health Care III (Nutrition) FACH 2024 Nutrition in Wellness & Illness Nursing 2003 EPIDEMIOLOGY AND MEDICAL STATISTICS ProgramS Course Title Students EPISTAT 1 BSc (HS) EPISTAT 2 BSc (HS) Computers for Research Univ Elective Principles of Epidemiology BSc (H Stat.) College of Science Special Epidemiology BSc (H Stat.) College of Science Health Management BSc (H Stat.) College of Science Biostatistics Nursing Epid. & Environ. Health Nursing Epidemiology & Medical Statistical MLS a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Family Medicine and Public Health 85

96 UNDERGRADUATE CLINICAL PRoGRAMME Year 5 - Junior Clerkship in Family and Community Medicine About 120 students, in groups of 30, have a 10-week clinical rotation in the SQU Health Center and in 7 of the accredited MoH Health Centres. The aim of the rotation is to teach students the consultation skills and knowledge that are required to manage various health problems at the primary care level in Oman. Other courses included in this rotation are: evidence-based medicine, oral health and basic life support. Teaching strategies include core topics presentation and patient-centred case presentation. Year 7 - Senior Clerkship In the final year of the MD programme, the students come for a 7 week rotation. The emphasis is on comprehensive management of the patient in the context of his/her family, culture, work and community. Daily clinical teaching takes place Fin the SQU Health Center as well as in a number of accredited MoH health centres. The course also includes a full week of lectures on public health programmes (communicable and non-communicable diseases) in the Ministry of Health. POSTGRADUATE ProGRAMME The Department runs a 4 year postgraduate training program under the auspices of the Oman Medical Specialty Board (OMSB) leading to an MRCGP (INT) certification. In , there were 56 residents in the programme at various levels of training. The training is conducted in various departments of the University Hospital and the Ministry of Health. The following postgraduate courses were conducted by the Department s Epidemiology and Medical Statistics Unit for the Masters Programme 86 Course Title Statistics and Computers Research Methodology Applied Epidemiology Statistical Methods in Quality Control Student Masters (Core Course) Masters (Core Course) Masters (Major) Masters (Elective)

97 Advanced Principles of Epidemiology Advanced Statistical Methods Categorical Data Analysis Research Project Masters (Major) Masters (Major) Masters (Major) Masters Dept. 06 Training Courses & CME Activities The Department arranged continuing medical education programmes every alternate Tuesday. Up to 2008 more than 220 sessions had been held. They are open to doctors, nurses and paramedicals from the Department, the MoH and also to University Hospital personnel. Clinical & Diagnostic FServices The SQU Health Center is a pioneer institution in Oman. It is the first health center in the country which received international accreditation as a model health center by the Arab Board and by the Royal College of General Practitioners (RCGP) UK for clinical services and teaching of family medicine. Our Health Center is the leading star in primary health care (PHC) in Oman as regards PHC ideology, quality and comprehensiveness of care and prevention. Patient services are provided at the SQU Health Centre and Students Clinic. A total of 39,000 (2008 figure) were seen at the Health Centre. This is an 18% increase compared to The Department has separate diabetes, antenatal and postnatal clinics besides the birth spacing and MoH infertility programmes and the extended programme of immunisation for MCH. The dermatology clinic gets referrals from all departments in the 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. a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Family Medicine and Public Health 87

98 Clinical workload in the Health Centre Year Total Patients Seen 25,203 43,408 26,353 32,153 39,000 Eligible New 1,439 1, Vaccination 4,960 8,444 6,016 6,701 4,057 ANC/PNC 404 1,712 1,489 / 79 1,092 / 77 1,247/127 Birth Spacing Derma ,638 3,510 Diabetic Triage - - 3,288 1, F Research RESEARCH PRoJECTS Towards a Balanced Assessment of Consanguineous Marriage in Oman Project Code: MREC #241 Dates: 2006 to 2008 Value: Project Funder: Investigators: Unfunded Sultan Qaboos University Dr. Mohammed Al-Shafee, Department of Family Medicine & Public Health, SQ; Dr. Alan Bittles, Department of Genetics, SQU; Dr. Erica Field, Department of Economics, Harvard University, USA; Dr. Seema Jayachandran, Department of Economics, Harvard University, USA. 88

99 Effect of High Parity on Occurrence of Pre-Diabetes, Low Birth Weight, and Anemia in Pregnancy in the Sultanate of Oman Project Code: MREC #246 Dates: Value: Project Funder: Investigator: Unfunded Sultan Qaboos University F Project Code: MREC #284 Dr. Yahya Al-Farsi, Department of Family Medicine & Public Health, SQU. Continuity of Care in Primary Care-Patients and Health Care Professionals Views of Continuity of Care in Oman Dates: 2008 to 2009 Value: RO 1,500 Project Funder: Investigators: Sultan Qaboos University Dr. Mohammed Al-Azri, Department of Family Medicine & Public Health, SQU; Dr. Mohammed Al-Shafee, Department of Family Medicine & Public Health SQU; Dr. Fatma Al-Ajmi, Directorate of Health Services, MoH, Oman; Dr. Salim Al-Saqri, Dr. Al-Shadi, Health Center, Directorate of Health Services, Muscat Governate, MoH, Oman; Abdullah Al-Maniri, Department of Family Medicine & Public Health, SQU. Dept. 06 a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Family Medicine and Public Health Research Publications and Books Journal Publications 1. Wali U, Al-Mujaini A, Nadia S Al-Kharusi, Bialasiewicz AA, Rizvi S. Quantitative and Qualitative Corneal Endothelial Morphology of Omani Patients with Pseudoexfoliation Syndrome. SQU Med J, 2008; 89

100 90 8: Al-Mandhari A, Al-Shafaee M, Al-Azri M, Al-Zakwani I, Khan M, Al-Waily A, et al. A survey of community members perceptions of medical errors in Oman. BMC Medical Ethics 2008; 9: Jain S, Sawhney S, Rizvi S, Belushi F, Abri T. Acute bone crisis in sickle cell disease: the T1 fat saturated sequence in differentiation of acute bone infarcts from acute osteomyelitis. Clin Radiol 2008; 63: Abdwani R, Rizvi S, Elnour I. Childhood Systemic Lupus Erythematous in Sultanate of Oman: demographics and clinical analysis. Lupus 2008; 30: Mathew M, Saquib S, Rizvi S; Polyhydramnios Risk factors and outcome. Saudi Med J 2008; 29: Al-Shafaee MA, Al-Shukaili S, Rizvi SG, Al-Farsi Y, Khan MA, Ganguly SS, Afifi M, Al-Adawi S. Knowledge and perceptions of diabetes in a semi-urban Omani population. BMC Public Health 2008; 8: Al-Farsi YM, Brooks DR, Wallenburg HC, Werler MM, Al-Shafaee MA, Cabral HJ. Effect of parity on occurrence of anemia-in-pregnancy in Oman. Am J Epidemiol 2008; 167:S Al-Mahrezi A, Al-Zakwani I, Al-Aamri A, Al-Khaldi S, Al-Zadjali N, Al-Hatali M, Al-Shukeili A. Control and F management of hypertension at a university health center in Oman. SQU Med J 2008; 8: Al-Mahrezi A, Lamb L, Ware MA, Shir Y, Al-Zakwani I. Intravenous lidocaine for refractory chronic orofacial pain: Two case reports and a literature review. SQU Med J 2008; Almahrezi A, Al-Shafaee M. Attributes of an ideal family medicine residency training program. Oman Med J. 2008; 23: Al-Mahrezi A, Balkhair A, Al-Yaarubi S, Al-Lawati H, Al-Lawati F, Al-Futaisi A Chronic adreno- cortical insufficiency associated with a unilateral adrenal mass. Oman Med J 2008; 23: Ganguly SS, Al-Shafaee MA, Al-Maniri. Some risk factors for coronary heart disease among Omani Males. SQU Med J 2008; 8: Burney IA, Al-Moundhri MS, Rizivi A, Ganguly SS, Al-Abri R, Ashrafi RA. Outcome as a measure of quality of care in oncology: Experience at SQU. SQU Med J 2008; 8: Al-Shafaee MA, Ganguly SS, Bhargava K, Duttagupta KK. Prevalence of metabolic syndrome among prediabetic Omani adults: a preliminary study. Metab Syndr Relat Disord 2008; 6: Dennison D, Al-Kindi S, Pathare A, Daar S, Nusrat N, Ur Rehman J, Zia F, Khan H, Khan MI, Alghazaly A, Al- Zadjali S, Tauro M, Al-Lawatia A, Ganguly S. Hematopoietic stem cell transplantation in Oman. Bone Marrow Transplant 2008; 42:S Maddali MM, Valliattu J, Al-Delamie T, Zacharias S, Ahmed A, Ganguly S. Arterial switch operation: troponin T does not predict ventilation requirements. Asian Cardiovasc Thorac Ann 2008; 16: Al-Moundhri MS, Al-Shukaili A, Al-Nabhani M, Al-Bahrani B, Burney IA, Rizvi A, Ganguly SS. Measure-

101 ment of circulating levels of VEGF-A, -C, and -D and their receptors, VEGFR-1 and -2 in gastric adenocarcinoma. World J Gastroenterol 2008; 28: Ganguly SS, Al-Shafaee MA, Bhargava K, Duttagupta KK. Prevalence of prehypertension and associated cardiovascular risk profiles among prediabetic Omani adults. BMC Public Health 2008; 8: Al-Jabri AA, Al-Shukaili AK, Al-Rashdi ZT, Ganguly SS. Reference ranges for lymphocyte subsets in healthy adult male Omanis. Saudi Med J 2008; 29: Ashktorab H, Brim H, Al-Riyami M, Date A, Al-Mawaly K, Kashoub M, Al-Mjeni R, Smoot DT, Al- Moundhri M, Al-Hashemi S, Ganguly SS, Raeburn S. Sporadic colon cancer: mismatch repair immunohistochemistry and microsatellite instability in Omani subjects. Dig Dis Sci 2008; 53: Bhargava K, Aerobic plus Resistance Training was more effective than either alone in Type 2 Diabetes, Commentary. Evid Based Med 2008; 13:40. Conference and Seminars Presentations F Conference Posters International 1. Saquib S, Mathew M, Rizvi S. Polyhydramnios - Risk factors and outcome. International Obstetric & Gynecology Conference December 2007, Muscat, Oman. Dept. 06 a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Family Medicine and Public Health 91

102 G Genetics

103 Overview The Department of Genetics aims to provide an integrated clinical and diagnostic service for patient care as well as being responsible for teaching medical students and other professionals in genetics. The Department uses its expertise to develop research with applications toward patient care, building up a sustainable infrastructure to support research. The Genetics Department is currently divided into four sections each of which provides a specialized service. These are clinical genetics, cytogenetics, immunogenetics and molecular genetics Dept. 07 Staff G Head AM Udayakumar, Assistant Professor & Acting HoD Faculty Fakhriya Al-Azri, Lecturer Clinical Dr. Halima Al-Shihi, Senior House Officer (5 other clinical staff members are on study leave) Support Staff Hamad Al-Riyami, Senior Biomedical Scientist Rayhanah Al-Mjeni, Senior Biomedical Scientist Varghese CM, Supervisor, Biomedical Scientist Robert Sigmani, Biomedical Scientist Fayza Al-Yahyai, Biomedical Scientist Khalsa Al-Kharousi, Biomedical Scientist Anand Rao, Biomedical Scientist Lavanya S, Biomedical Scientist Mariam Al-Nabhani, Biomedical Scientist a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Genetics 93

104 Aisha Al-Naamani, Biomedical Scientist Rahma Nasser Al-Jashmi, Biomedical Scientist Coordinator Maya Al-Azri Teaching Programmes The Department of Genetics contributed to the teaching of the following: UNDERGRADUATE PRECLINICAL Molecular Biology and Principles of Genetics. G UNDERGRADUATE CLINICAL Genetics Lecture in Clinical Practice to 7th year medical students (repeated every 6 weeks). MEDICAL LABORATORY SCIENCES Molecular Diagnosis and Biology of disease. NURSING 2 lectures on genetics. POSTGRADUATE Programme Senior house officer in-house training; Three Oman Medical Specialties Board residents training in cytogenetics. 94 Training Courses & CME Activities Regular in-house training for the staff; regular training in genetics for Omani graduates from SQU

105 and abroad. Dept. 07 Clinical & Diagnostic Services The Department of Genetics focuses on providing services for Sultan Qaboos University Hospital. These services are: CLINICAL CYTOGENETICS The main function of this section is providing cytogenetic investigations, (karyotyping) to clinical departments of SQUH. Since this section started, a total of 1,710 tests had been done by the end of 2008, an average of around 300 tests per year. As Figure 1 below shows, a total of 391 tests were done with major referrals from the Haematology and Obstetrics & Gynaecology departments and the rest from other major departments. G MONTHLY STATISTICS OF FISH SAMPLES FOR 2008 Month Number of samples processed for Biomnis, France January 10 February 03 March 08 April 01 May 03 June 06 July 03 August 05 September 04 October 01 November 03 a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Genetics 95

106 December 06 Total 53 HISTOCOMPATIBILITY AND IMMUNOGENETICS (TISSUE TYPING) This section has been providing the National Tissue Typing Service for recipients and donors of renal or bone marrow transplants. It continued to provide its service to SQUH, Ministry of Health and the Armed Forces Hospital with a very similar number of samples received each year. CLINICAL GENETICS The clinical service is the forefront of the following services, which involves the initial diagnose of genetic disorders through medical examinations. The team consists of medical doctors specialised in the field of clinical genetics and genetic Gcounsellors who manage and treat, where necessary, the genetically related disorders and alterations encountered. Since 2002, young clinicians from the University Hospital have been sent abroad to train in clinical genetics, which requires a commitment of over 5 years. Due to the duration of the medical specialisation in genetics, this service is hoped to commence by June Once established, this service will involve 6 clinical geneticists specialised in various subspecialties ranging from metabolic disorders to dismorphological disorders. Additionally, genetic counsellors will provide further support in the clinical setting. MOLEUCLAR GENETICS Currently the section is investigating the possibility of initiating a service for the most frequent genetic disorders observed at the different clinics at SQUH. The staff members of this section are undergoing training, which will assist in expediting the required diagnostic work. It is hoped that by early 2010 this section will be providing an initial services to the patients of SQUH. 96

107 Dept. 07 FAMCO 1 Oncology 1 Urology 2 Genetics 18 Referral Departments Medicine Endocrinology Paediatric Neonatal Child Health Obstetrics & Gynaecology Haematology ( Paediatrics ) Haematology ( Adult ) Referral Department Figure1: Patients karyotyped during 2008 G No. of Patients 161 a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Genetics 97

108 Research Research Projects 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: Value: OR 168,850 Project Funder: Investigators: His Majesty s Strategic Research Fund Prof. John Raeburn, Department of Genetics, SQU; Dr. Aisha Al- Khayat, Department Gof Biology, SQU; Dr. Ahmed Al-Mandhari, Department of Family Medicine & Public Health, SQUH; Ms. Rayhana Al-Mjeni, Department of Genetics, SQU; Dr. Shyam Ganguly, Department of Epidemiology & Statistics, SQU; Dr. Mohamed Al-Shafaee, Department of Family Medicine & Public Health, SQU; Dr. Anuradha Ganesh, Department of Ophthalmology, SQUH; Prof. Riad Bayoumi, Department of Biochemistry, SQU; Dr. Yasser Wali, HOD, Department of Child Health, SQU; Dr. AM Udayakumar, Department of Genetics, SQU; Dr. David Dennison, Department of Haematology, SQU Cytogenetics and Moelcular Characterization of Chronic Myeloid Leukemia Project Code: IG/MED/GENE /08/01 Dates: Value: OR 5,500 Investigators: Dr. AM Udayakumar, Department of Genetics, SQU; Dr. Salam Al- Kindi, Department of Haematology, SQU 98

109 Research Publications and Books Journal Publications 1. Udayakumar AM, Alkindi S, Pathare AV, Raeburn JA. Complex t(8;13;21)(q22;q14;q22) - a novel variant of t(8;21) in a Patient with Acute Myeloid Leukemia (AML - M2). Arch Med Res ( USA) 2008; 39: Udayakumar AM, Bashir WA, Pathare AV, Wali YA, Zacharia M, Khan A, Soliman H, Al-Lamki Z, Raeburn J. Cytogenetic profile of childhood acute lymphoblastic leukemia in Oman. Arch Med Res 2007; 38: Udayakumar AM, Pathare AV, Al-Kindi S, Khan H, Rahman J, Fehmida Z, Al-Ghazaly, Nusrut N, Khan I, Wali Y, Al-Lamki Z, Dennison D, Raeburn JA. Cytogenetic, morphological and immunophenotypic pattern in Omani patients with de novo acute myeloid leukemia. Cancer Genet Cytogenet 2007; 177: Udayakumar AM, Pathare AV, Muralitharan S, Al-Ghazaly AA, Al-Kindi S, Raeburn J. Trisomy 21 as a sole acquired abnormality in an adult omani patient with CD 7 and CD 9 positive acute myeloid leukaemia, Arch Med Res 2007; 38: Udayakumar AM, Pathare AV, Al-Kindi S, Raeburn J. Biphenotypic leukemia with interstitial del (9) (q22q32) as a sole abnormality. Cancer Genet Cytogenet G2007; 178: Al-Moundhri MS, Al-Shukaili A, Al-Nabhani M, Al-Bahrani B, Burney IA, Rizivi A, Ganguly SS. Measurement of circulating levels of VEGF-A, -C, and -D and their receptors, VEGFR-1 and -2 in gastric adenocarcinoma. World J Gastroenterol. 2008; 14: Dick KJ, Al-Mjeni R, Baskir W, Koul R, Simpson MA, Patton MA, Raeburn S, Crosby AH. A novel locus for an autosomal recessive hereditary spastic paraplegia (SPG35) maps to 16q21-q23. Neurology 2008; 71: Brim H, Mokarram P, Naghibalhossaini F, Saberi-Firoozi M, Al-Mandhari M, Al-Mawaly K, Al-Mjeni R, Al- Sayegh A, Raeburn S, Lee E, Giardiello F, Smoot DT, Vilkin A, Boland CR, Goel A, Hafezi M, Nouraie M, Ashktorab H. Impact of BRAF, MLH1 on the incidence of microsatellite instability high colorectal cancer in populations based study. Mol Cancer 2008; 7: Ashktorab H, Brim H, Al-Riyami M, Date A, Al-Mawaly K, Kashoub M, Al-Mjeni R, Smoot DT, Al-Moundhri M, Al-Hashemi S, Ganguly SS, Raeburn S. Sporadic colon cancer: mismatch repair immunohistochemistry and microsatellite instability in Omani subjects. Dig Dis Sci 2008; 53: Udayakumar AM, Pathare AV, Al-Kindi S, Khan H, Rahman J, Fehmida Z, Al-Ghazaly, Nusrut N, Khan I, Wali Y, Al-Lamki Z, Dennison D, Raeburn JA. Cytogenetic, morphological and immunophenotypic pattern in Omani patients with de novo acute myeloid leukemia. Cancer Genet Cytogenet 2007; 177: Ashktorab H, Brim H, Al-Riyami M, Date A, Al-Mawaly K, Kashoub M, Al-Mjeni R, Smoot DT, Al-Mandhari M, Al-Hashemi S, Ganguly SS, Raeburn S. Sporadic colon cancer: Mismatch repair and microsatellite instabilitygenes in Omani subjects. DigestDisease Sci 2007; 53; Al-Moundhri MS, Al-Kindi M, Al-Nabhani M, Al-Bahrani B, Burney IA, Al-Madhani A, Ganguly SS, Tanira M. NAT2 polymorphism in Omani gastric cancer patients-risk predisposition and clinicopathological associations. World J Gastroenterol 2007; 13: Dept. 07 a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Genetics 99

110 H Haematology

111 Overview The Department of Haematology functions both as a major clinical and as a 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 haematology (OMSB), as well as medical laboratory technicians in the BSc (MLS) course. The laboratory provides quality haematology testing for the University Hospital as well as highly specialised flowcytometric analysis for haematological malignancy diagnostics for the entire Sultanate. Dept. 08 Staff Head Salam Al-Kindi, Assistant Professor & Consultant HHaematologist Faculty Chao Hung Ho, Professor Shahina Daar, Associate Professor Salim Kaaba, Associate Professor Anil Pathare, Senior Consultant Naglaa Fawaz, Senior Consultant David Dennison, Senior Consultant Nadeem Nusrut, Senior Registrar Zeba Zabeen, Senior Registrar Mohammad Huneini, Registrar Khalil Al-Farsi, Registrar Hammad Khan, Registrar Fehmida Zia, Registrar Fauzia Wasim, Registrar Faisal Butt, Registrar Abdulmanan Adulgafoor, Registrar a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Haematology 101

112 Vinod Panjwani, Senior House Officer Najwa Abdulhameed, Senior House Officer Ghasan Ageed, Senior House Officer Mohamed Rehan, Senior House Officer 102 Support Staff Stuart Donaldson, Superintendent David Gravell, Senior Biomedical Scientist Ali Al-Marhoobi, Senior Biomedical Scientist Hamood Al-Haddabi, Senior Biomedical Scientist Rodrigo Villacrusis, Senior Biomedical Scientist Maria Cicillia, Senior Biomedical Scientist Abdulrehman NoorRashid, Senior Biomedical HScientist Qamariya Al-Abri, Biomedical Scientist Maryiam Al-Brashdi, Biomedical Scientist Sabah Al-Mahrooqi, Biomedical Scientist Sahima Al-Mamari, Biomedical Scientist Saif Al-Hosni, Biomedical Scientist Hamed Al-Gheithi, Biomedical Scientist Shoaib Al-Zadjali, Biomedical Scientist Sumaya Al-Hinani, Biomedical Scientist Asma Ahmed Musleh, Biomedical Scientist Karima Al-Falahi, Biomedical Scientist Badriya Al-Belushi, Biomedical Scientist Bushra Al-Said, Biomedical Scientist Deuel Labrador, Biomedical Scientist Enrique Pedojan, Biomedical Scientist Eufrosina Alverez, Biomedical Scientist Julian Neson, Biomedical Scientist Mohan Doraiswamy, Biomedical Scientist

113 Nestor Naniong, Biomedical Scientist Rene Gabucay, Biomedical Scientist Allan Santos Aurelio, Biomedical Scientist Adela Angeles, Biomedical Scientist Melani Tauro, Biomedical Scientist Rosamma Soney, Head Staff Nurse Binny Sam, Senior Staff Nurse Eman Al-Homiadi, Coordinator Tomichan Varghese, Coordinator Ibrahim Al-Amri, Clerk Al-Al-Khiary, Medical Orderly H Teaching Programmes Highlights of the Year In , the 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 2008, it offered comprehensive care for about 132 patients with transfusion dependent thalassaemia. Of national interest is the successful bone marrow transplant programme, run by this Department. By the end of 2008, a total of 146 allogeneic bone marrow transplants had been performed in this centre, with results as good as those from the best centres around the world. Undergraduates Preclinical Programme 3rd Year: Approx. 120 students. The Department participates in teaching the Haemato-Lymph-Vascular course Dept. 08 a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Haematology 5th Year: Approx. 129 students Integrated Lecture Series Course - Case based learning, Haematology, a 5 week Course 103

114 7th Year: Approx. 113 students + Clinical Rotation in Medicine (bedside Clinics/teaching) + Laboratory Rotation, 6 groups and each spending 5 days in the Department during the 7th year rotation. Clinical & Diagnostic Services The clinical service centres on four major areas: adult outpatients, adult inpatients, bone marrow transplantation and the thalassaemia day care unit. The laboratory services likewise cover specialised areas: haemostasis, flowcytometry, haemoglobinopathy, molecular diagnostics, general laboratory haematology and blood transfusion service which includes blood donation, storage, irradiation and apheresis facilities as well as the blood Hgrouping and cross matching laboratory. Bone Marrow Transplantation Programme The bone marrow transplant programme, established in 1995 in the Department, serves the entire country and continues to provide curative treatment for patients with haematologic malignancy, bone marrow failure and potentially fatal genetic diseases. In 2008, twelve transplants were performed, making a total of 146 transplants since 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 UK or the United States. 104 Cord Blood Bank The Department, in collaboration with Obstetrics & Gynaecology, has now set up a Cord Blood Bank. Cord blood, which would ordinarily be discarded at the time of delivery, can now be processed and stored in liquid nitrogen after consent from the parents. We have standardised the collection and storage of cord blood samples obtained from the Obstetrics Department and are now working on achieving accreditation. Ms. Melanie Tauro, is the technician responsible for the day-to-day management of the Cord Blood Bank.

115 Molecular Research and Diagnostic Laboratory Mr. Shoiab Al-Zadjali, who joined the Department in September 2004 after training from the Inserm Institute, Paris, is in charge of the Molecular Biology Laboratory. He performs DNA fingerprinting and chimerism studies in patients undergoing bone marrow transplantation and follow-up studies post-bmt. He also is actively involved in project work involving patients with neonatal cord blood screening, thrombophilia, and several immunodeficiency disorders aimed at defining the molecular profile of these congenital disorders. The Department now offers DNA diagnostic facilities for certain thrombophilic disorders like Factor V Leiden mutation, and prothrombin gene mutation. Recently, the Department has started offering pre-prescription analysis of CYP2C9 and VKORC1 genetic variants to harmonise the warfarin dosing in patients. Apheresis Unit of the Blood Bank Apheresis techniques have become part and Hparcel of all major haematology units and blood banks worldwide. The main indications are for harvesting platelets, platelet transfusions, performing therapeutic apheresis for various disease states and for collecting peripheral blood stem cells for stem cell transplantation. 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. Moreover, apheresis services are now made available in consultation with the attending haematologist on duty, to the Hospital wards and ICU units whenever the need for plasmapheresis 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 thalassemia is now fully operational. Ms. Marie Quernin from the INSERM Institute at Paris helped standardise and calibrate the busulphan pharmakokinetics assays which help in determining the busulphan concentration in the plasma using liquid chromatography with mass spectrometry. Ms. Melanie Tauro, who underwent the necessary training at the Hospital Dept. 08 a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Haematology 105

116 Robert Debré, France, to operate this machine, now looks after the day to day operations of the busulphan pharmakokinetics in patients undergoing BMT to assess the blood levels of the drug in order to optimise the treatment protocols. Haematology Clinics at the New Sohar Hospital The Department conducts a haematology clinic at the New Sohar Hospital once a month. The clinic is run by one of the haematology consultants who attend and run the clinic in turn. They are assisted locally by Dr. Ali Madhani, Registrar, Department of Medicine, Sohar Hospital. Laboratory Activities Year Patients % increase over previous year H Haematology % increase from 1994 Tests & Procedures % increase Over previous year % increase from ,53, % 210.8% 5,52, % 173.2% ,33, % 170.3% 4,97, % 146.0% ,17, % 137.6% 4,85, % 139.9% ,47, % 198.6% 5,97, % 195.4% Clinical Workload Year Haematology % % Haematology % In-Patients Change Day-Care Change Out-Patients Change , % 3, % 3, % , % 3, % 2, % , % 3, % 2, % , % 3, % 3, % 106

117 Research Research Projects Newborn haemoglobinopathy carrier screening: Towards comprehensive and improved patient care of Sickle Cell Disease in Oman. Project Code: SR/MED/ HAEM/05 /01 Dates: Value: OR 93,700 Project Funder: Investigators: His Majesty s Strategic Research Fund H Dr. Salam Al-Kindi, Dept. of Haematology, SQU; Dr. Anil Pathare, Dept. of Haematology, SQU; Mr. Hamood Al-Haddabi, Dept. of Haematology, SQU; Ms. Qamariya Al-Abri, Dept. of Haematology, SQU; Ms. Sahima Al-Maamaari, Dept. of Haematology, SQU; Mr. Shoaib Al-Zadjali, Dept. of Haematology, SQU; Dr. David Dennison, Dept. of Haematology, SQU; Dr. Shahina Daar, Dept. of Haematology, SQU; Dr. Mathew Zechariah, Dept. of Child Health, SQU; Dr. Yasser Wali, Dept. of Child Health, SQU; Dr. Kuntal Rao, Dept. of Obstetrics & Gynecology, SQU; Dr. Mariam Mathews, Dept. of Obstetrics & Gynecology, SQU; Mr. Muralitharan, Dept. of Biochemistry, SQU; Dr. Ali Al-Madhani, Dept of Medicine, New Sohar Hospital, Sohar; Dr. R. Krishnamoorthy, INSERM U763, Paris, France. Dept. 08 a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Haematology Targeted dose intravenous busulfan in combination with fludarabine and anti-thymocyte globulin as conditioning in bone marrow transplantation for high-risk homozygous beta thalassaemia. Project Code: Dates: IG/MED/ HAEM/06/02 107

118 Value: OR 6,350 Project Funder: Investigator: Sultan Qaboos University H Project Code: MREC #235 Dr. David Dennison, Dept. of Haematology, SQU; Dr. Salam Al- Kindi, Dept. of Haematology, SQU; Ms. Melanie Tauro, Dept. of Haematology, SQUH; Mr. Shoaib Al-Zadjali, Dept. of Haematology, SQUH; Dr. Anil Pathare, Dept. of Haematology, SQUH; Dr. Shahina Daar, Dept.of Haematology, SQUH; Aquila Taqi, Dept. of Pharmacy, SQUH; Dr. R. Krishnamoorthy, INSERM U 480, Paris, France; Dr. Shyam Ganguly, Family Medicine & Public Health, SQU. Plasma Haemoglobin and Haemoglobin F Levels in Patients with Homozygous sickle Cell Disease on Hydroxyurea Treatment. Dates: Value: OR 4,800 Project Funder: Investigators: Sultan Qaboos University Dr. Salim Kaaba, Dept. of Haematology, SQU; Dr. Salam Al-Kindi, Dept. of Hematology, SQU; Dr. Anil Pathare, Dept. of Haematology, SQU; Dr. Hamood Al-Hadabi, Dept. of Haematology, SQU; Dr. Ahmed Al-Shukaili, Dept. of Microbiology & Immunology, SQU. 108 Research Publications and Books Journal Publications 1. Daar S, Gravell D, Hussein HM, Pathare AV, Wali Y, Krishnamoorthy R Haematological and clinical features of beta-thalassaemia associated with Hb Dhofar. Eur J Haematol 2008; 80: Al-Kindi S, Dennison D, Pathare AV, Arterial and venous thrombotic complications with thalidomide in multiple myeloma. Arch Med Res 2008; 39: Udayakumar AM, Al-Kindi S, Pathare AV, Raeburn JA, Complex t(8;13;21)(q22;q14;q22)--a novel variant of

119 t(8;21) in a patient with acute myeloid leukemia (AML-M2). Arch Med Res 2008; 39: Al-Ghzaly A, Al-Kindi S, Pathare AV, Microbial yield in febrile sickle cell disease patients with acute painful episode from a University Hospital in the Sultanate of Oman. Saudi Med J 2008; 29: Al-Kindi S, Al-Khabori M, Daar S, Beshlawi I, Wali Y, Invasive candidial laryngitis as a manifestation of cyclic neutropenia in an Omani infant. Ped Hematol Oncol 2008; 25: Dennison D, Al-Kindi S, Pathare AV, Daar S, Nusrat N, Ur Rehman J, Zia F, Khan H, Khan MI, Al- Ghazaly A, Al-Zadjali S, Tauro M, Al-Lawatia A, Ganguly S. Hematopoietic stem cell transplantation in Oman. Bone Marrow Transplant 2008; 42: Ganesh A, Al-Zuhaibi S, Pathare A V, William R, Al-Senawi R, Al-Mujaini A, Hussain S, Wali Y, Al-Kindi S, Zachariah M, Knox-Macaulay H. Orbital Infarction in Sickle Cell Disease. Am J Ophthalmol 2008; 46: Rehman JU, Al-Kindi S, Pathare AV, Jain R, Choudry A. Recurrent priapism in sickle cell trait with protein S deficiency. J Pak Med Assoc 2008; 58: H Conference and Seminar Presentations 9. Al-Kindi H, Abdoon H, Al-Khaboori M, Daar S, Beshlawi I, Wali Y. Invasive Candidal Laryngitis as a Manifestation of Cyclic Neutropenia in an Omani Infant. Paed Haem Onc 2008; 25: Ho CH, Yu YB, Wu PH. The prevalence of iron deficiency anemia and its clinical implications in patients with colorectal carcinoma. J Chin Med Assoc 2008; 71: Rehman UR, Burney IA, Al-Kindi S, Raeburn J, Familial lymphoma in an Omani Kindred with identical class II HLA type. Leuk Lymphoma 2008; 49: Conference Presentations International 1. Al-Kindi S. Haemoglobinopathies screening - Oman experience. Qatar University, Doha, Qatar, March Al-Kindi S. Stem cell biology & cord blood banking. 5th International Conference of Obstetrics & Gynaecology. Muscat, Oman, Al-Kindi S: Presentation. 2nd CML Gulf Group. Abu Dhabi, UAE, November Pathare AV. Integrating Molecular Genetics Research in Clinical Practice. Qatar University, Doha, Qatar, March Daar S. Beta thalassaemia in Oman, Current status and future direction. International Symposium on Thalassaemia and Sickle Cell Anaemia. Riyadh, Saudi Arabia, April Dept. 08 a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Haematology 109

120 6. Dennison D. Hematopoetic stem cell transplantation for thalassaemia in Oman. International Congress on Bone Marrow & Stem Cell Transplantation. Riyadh, Saudi Arabia, November Local 1. Al-Kindi S. Recent advances in MDS. Nizwa Hospital, Oman, March Al-Kindi S. Approach to CBC. Nizwa Hospital, Oman, August Al-Kindi S. Flow cytometry- principles & practice. Rustaq Hospital, Oman, January Al-Kindi S. Update on SCD management. Sultan Qaboos Hospital, Salalah, Oman, August Al-Kindi S. Management of CML. Sultan Qaboos Hospital. Salalah, Oman, August Al-Kindi S. Sickle cell disease - interesting aspects. Al-Nahdha Hospital, Muscat, Oman, Pathare AV. Coagulation & Transfusion. Cardiothoracic Surgery Teaching Schedule. SQUH, Muscat, February, Daar S. Iron Chelation in Thalassaemia major. International Conference in Medicine and Child Health. Salalah, Oman, August H Conference Posters International 1. Pathare AV, Al-Kindi S, Al-Zadjali S, Al-Haddabi H, Gravell D, Dennison D. Rare Congenital Bleeding Disorders from the Sultanate of Oman. XXVIII International Congress of the World Federation of Hemophilia. Istanbul, Turkey, 1-5 June Al-Madhani A, Al-Kindi, Al-Zadjali S, Pathare AV. A novel mutation in exon 11 of the ALAS2 gene (11bp del) results in X-linked sideroblastic anemia. 13th Congress of the European Hematology Association. Copenhagen, Denmark, June Pathare AV, Al-Kindi S, Al-Zadjali S, Panjwani VK, Dennison D, Krishnamoorthy R. UGT1A1 gene variations & Gallstones in sickle cell disease patients from Sultanate of Oman. 13th Congress of the European Hematology Association. Copenhagen, Denmark, June Al-Kindi S, Al-Riyami A, Al-Zadjali S, Dennison D, Pathare AV. Incidence and significance of JAK2 V617F mutation in patients with chronic myeloproliferative disorders from the Sultanate of Oman. 13th Congress of the European Hematology Association. Copenhagen, Denmark, June Taher A, El Chafic A, Karimi M, El Beshlawy A, Belhoul K, Daar S, Pattoneri P, Fasulo R, Salah M, Cappellini M. Thalassaemia Intermedia Registry. European Haematology Association. June Al-Maamari S, Al-Zadjali S, Al-Maamari A, Pathare AV, Al-Kindi S, Dennison D. Dihyrorhodamine assay by flowcytometry to minter engraftment in patient transplanted for chronic granulomatous disease. International Congress on Bone Marrow & Stem Cell Transplantation. Riyadh, Saudi Arabia, November 2007.

121 8. Al-Zadjali S, Elnour I B, Al-Tamemi, Al-Kindi S, Dennison S. Partial donor chimerism is curative in hematopoietic stem cell transplantation for interferon gamma receptor deficiency. International Congress on Bone Marrow & Stem Cell Transplantation. Riyadh, Saudi Arabia, November El-Ghazaly A, Al-Mamaari S, Pathare AV, Gravel D, Al-Haddabi H, Al-Kindi S, Dennison D. Haematopoietic stem cell transplantation for Glanzmann s thrombasthenia in Oman. International Congress on Bone Marrow & Stem Cell Transplantation. Riyadh, Saudi Arabia, November Dennison D, Zia F, Al-Zadjali S, Tauro M, Al-Lawatia A, Daar S, Pathare AV, Al-Kindi S. Hemopoietic Stem Cell Transplantation for Thalassaemia in Oman. International Congress on Bone Marrow & Stem Cell Transplantation. Riyadh, Saudi Arabia, November Dennison D, Rehman J, AlTamemi S, Elnour IB, Al-Zadjali S, Al-Maamari S, Tauro M, Al-Lawatia A, Pathare AV, Wali Y, Al-Kindi S. Haematopoietic Stem cell Transplantation for Primary Immunodeficiency in Oman. International Congress on Bone Marrow & Stem Cell Transplantation. Riyadh, Saudi Arabia, November Al-Kindi S, Pathare AV, Al-Zadjali S, Daar S, Hadabi H, Al-Abri Q, Gravel D, Krishnamoorthy R. Neonatal cord blood screening with HPLC- towards Hcomprehensive and improved patient care of sickle cell disease in Oman. 2nd Pan Arab Human Genetics Conference. Dubai, UAE, November Al-Zadjali S, Al-Kindi S, Pathare AV, Dennison D, Krishnamoorthy R. The molecular basis of chronic granulomatous disease in Oman. 2nd Pan Arab Human Genetics Conference, Dubai, UAE, November Al-Zadjali S, Al-Kindi S, Pathare AV, Dennison D, Krishnamoorthy R. Variable genetic structure of the NCF-1 gene complex in Omani population/ patients complicates diagnosis of autosomal P47PHOX chronic granulomatous disease. 2nd Pan Arab Human Genetics conference. Dubai, UAE, November Dept. 08 a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Haematology 111

122 04 Biochemistry H Human and Clinical Anatomy

123 Overview The Department of Human & Clinical Anatomy 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 (BSc Health Sciences). It shares this with other basic medical sciences departments in the delivery of integrated system courses. However, a few department-based courses are taught by the Department. 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 postgraduates preparing for higher examinations e.g. FRCS, and nursing students from the College of Nursing. H In addition, the Department input involves teaching clinical and applied anatomy and applied cytogentics to Oman Medical Specialty Board candidates. Postgraduate teaching involves teaching of advanced histology and embryology to candidates specialising in Histopathology and Obstetrics & Gynaecology. Candidates preparing for their examinations for Fellowship of the Royal Colleges of Surgeons, enjoy the teaching facilities provided by the Department. The Department also provide services to other clinical departments and students of the Institute of Health Sciences. The Department makes modest contributions to the Master s Programme. Research continued to be pivotal to the academic activities of the Department. This embraced hypertension, immune response to pregnancy, calcification and bone resorption, bone marrow cells and blood cells, medical education, medical informatics and curricular development. Dept. 09 a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Human and Clinical Anatomy 113

124 Staff Head of Department Omar Habbal, Associate Professor Faculty Satei T Moqattash, Associate Professor Ibrahim Inuwa, Associate Professor Revinder Kenue, Assistant Professor Maimouna Al-Rawahi, Senior Registrar Support Staff Aida Al-Wahaibi, Associate Researcher Abdulgaffar El Hag, Superintendent H Aisha Al-Sheibi, Biomedical Scientist Musallam Salem Al-Alawi, Biomedical Scientist Nasser Al-Hashmi, Biomedical Scientist Nawal Al-Mukheini, Biomedical Scientist Sulaiman Al-Khiyari, Biomedical Scientist Talal Al-Hassani, Biomedical Scientist Alexander George, Coordinator Highlights of the Year Dr. Maimouna Al-Rawahi was promoted to Senior Registrar and Dr. Aida Al-Wahaibi was to Associate Researcher in September Dr. Ravinder Kenue, Assistant Professor, left the department in August Mr. Mohamed Al-Mushaiqri, Demonstrator, left in October 2007 on a 4 year scholarship for PhD studies at the University of Western Australia. 114

125 Teaching Programmes PRE-CLINICAL Programme The Department offered several courses in the B.Sc. (Health Sciences) program and contributed to most system-based courses: Course Title Early Development, Tissues and Integuments 4 Alimentary System 5 Locomotor System 5 Urinary System 6 Respiratory System 6 Cardiovascular System H 6 Haemopoietic-Lymphoid-Vascular System 6 Head and Neck 7 Human Nervous System & Special Senses 7 Applied Basic Medical Sciences 8 Endocrine & Reproductive System 8 Clinical Skills Course 8 Semester BSC NURSING Programme The Department offered anatomy and physiology courses in the BSc Nursing Program. Dept. 09 a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Human and Clinical Anatomy 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. Teaching of cytogenetics contributed 115

126 to the Core Program of the Oman Medical Specialty Board (OMSB). The Department also contributed to the postgraduate program (Histopathology) and took part in the SCRAPS medical seminar programme in the College of Medicine & Health Sciences Research Research Projects Plastination using Frankincense (Luban) as an Impregnation Resin Project Code: MREC #276 H Dates: Value: OR 2,670 Project Funder: Investigators: Sultan Qaboos University Dr. Ayida Al-Wahaibi, Department of Human and Clinical Anatomy, SQU; Dr. Omar Habbal, Department of Human and Clinical Anatomy, SQU; Mr. Abdulghafar El-Hag, Department of Human and Clinical Anatomy, SQU; Dr. Suliman Al-Kiyari, Department of Human and Clinical Anatomy, SQU. Research Publications and Books Journal Publications 1. Habbal O, Al-Jabri A, El-Hag AG. The Antimicrobial Activity of Lawsonia inermis: A Review. Aust J Med Herb 2008; 19: Al-Wahaibi A, Farihah HS, Azian AL, Wan Nazaimoon WM. Effects of Ovariectomy on weight and on the activity of 11-Beta Hydroxysteroid Dehydrogenase Type 1 In Liver and Adipose Tissue of Sprague Dawley Rats. Sci J KF Univ (Basic and Applied Sciences) 2008; 9:

127 Conference and Seminar Presentations Conference Presentations International 1. Inuwa I, Al-Toobi A, Al-Rawahy M. Online summative assessment in Anatomy using WebCt - A Five year experience at Sultan Qaboos University, Oman. Summer Conference of the Anatomical Socienty of Great Britain and Ireland. Nottingham, UK, July Inuwa I, M Ziada A. Differential parenchymal growth in the adrenal gland of the spontaneously hypertensive rate (SHR/Ntac) model of genetic hypertension. Summer Conference of the Anatomical Society of Great Britain and Ireland. Nottingham, UK, July H Dept. 09 a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Human and Clinical Anatomy 117

128 M Medicine

129 Overview The Department of Medicine endeavours to create an environment conducive to achieving excellence in learning for undergraduate and postgraduate students, to provide opportunities to conduct clinical research relevant to the area and to be the centre of excellence providing specialised, state-of-the-art clinical care in a tertiary care pattern. The Department participates in teaching communication and clinical skills to the medical students during the pre-clinical years and clinical medicine during the 5th and the 7th year of medical rotation. The Department is responsible for teaching the integrated learning system/problem-based modules during the 5th year. The major research themes include: asthma, breast cancer, gastric cancer, HIV, Hodgkin s lymphoma, non-hodgkin s lymphoma, stroke, and the use of the transcranial Doppler ultrasound. Research areas include epidemiology, molecular characterisation, study of genetic polymorphisms, and the study of novel mechanisms of etiology Mof various diseases. Members of the Department are principal or co-principal investigators of several funded research projects. The Department provides clinical services through a specialty-based system, and takes pride in providing continuous, comprehensive care to patients. Consultants from the following 9 different subspecialties are on-call daily: cardiology, endocrinology, gastrointestinal and liver disease, infectious disease, nephrology, neurology, oncology, respiratory and rheumatology. These different subspecialties offer medical services to patients in the capital area and also accept complicated referrals from all over the country Staff Head of Department Omar Al-Rawas, Associate Professor Faculty Bazdawai Al-Riyami, Professor & Dean CoMHS (to June 08) Nicholas Woodhouse, Professor Dept. 10 a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Medicine 119

130 120 Mansour Al-Moundhri, Associate Professor and Dean CoMHS (from June 08) Arunodaya Gujjar, Associate Professor Ali Al-Hinai, Assistant Professor Jamal Sallam, Assistant Professor Batool Hassan, Assistant Professor Masoud Al-Maskari, Assistant Professor Poovathor Chacko Jacob, Assistant Professor Masoud Kashoob, Senior Consultant & Hospital Director General William Johnston, Senior Consultant Ali Al-Shirawi, Senior Consultant Mehar Ali, Senior Consultant Abdullah Al-Asmi, Senior Consultant Ikram Burney, Senior Consultant M Mahfooz Farooqui, Senior Consultant Hafidh Al-Hadi, Consultant Abdullah Balkhair, Consultant Ali Al-Mamari, Consultant Juma Al-Kaabi, Consultant Omayma Elshafie, Consultant B N Jayakrishnan, Consultant Jojy George, Consultant Mansour Sallam, Consultant Hatem Farhan, Senior Registrar Mohammed Al-Ghilani, Senior Registrar Saif Khan, Senior Registrar Azhar Rizvi, Registrar Saeed Ahmed, Registrar Hassan Ali, Registrar Ammar, Registrar Fatma Ben Abed, Senior House Officer

131 Osama Hasan, Senior House Officer Mohammed Al-Rawahi, Senior House Officer Khalid Al-Bimani, Senior House Officer Ali Al-Lawti, Senior House Officer Irshad Mohammad Ali, Senior House Officer Support Staff Roselyn Natividad, Coordinator Ibrahim Al-Shoaibi, Coordinator Ghaniya Al-Siyabi, Coordinator Teaching Programmes M UNDERGRADUATE CLINICAL Program 4th Year Program The Department participates in the teaching of the Clinical Communication Skills and Clinical Methods courses during semester 8. Approximately 130 students participate in these courses. 5th Year Program Approximately 30 students are posted for a total of 11 weeks in the Department in each rotation (total of 4 rotations). These students rotate between the Royal Hospital (RH) and SQUH. The clinical programme consists of self-directed learning, clinical bedside teaching, demonstration of procedures and seminars. The seminars are presented by the students and supervised by staff. Furthermore, the problem-based series (previously known as the integrated lecture series [ILS]) is conducted every Wednesday and covers all major subspecialties. Students are required to sit an end of rotation examination held at both SQUH and the RH. Logbooks are also used for assessment of the clinical activities as are also cases write ups. 7th year program Approximately final year students are posted for clinical rotation in the Department for a Dept. 10 a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Medicine 121

132 period of 7 weeks divided between the RH and SQUH (total of 5 rotations). Students are posted to two subspecialties. They are attached to the team throughout their daily activities e.g. ward rounds, outpatients, meetings, consultations, etc. By the end of their rotation, they are assessed by the team in clinical skills, data interpretation and management of a variety of diseases. There is a formal end of rotation examination using short cases and an objective structured clinical examination (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. POSTGRADUATE Program Interns Around interns are posted for 4 month rotations in the Department. Every intern rotates in one subspecialty 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 M formally assessed on issues such as knowledge, clinical skills, attitude and professionalism. In September 2007, the Department started receiving Oman Medical Scientific Board (OMSB) residents for training in internal medicine. Undergraduates and postgraduates are involved in many educational activities including morning case reports, grand rounds, radiology meetings and journal clubs. Furthermore there is the mortality review meeting once a month. CME sessions are held every alternate week. Wednesday lunch-time is used for presentations by outside guest speakers. OMSB Residency Programme Members of the Department actively participate in the postgraduate teaching of interns, house officers and OMSB residents in internal medicine as well as residents from other subspecialties rotating through medicine, such as those from the Family Medicine and Public Health Department, dermatology, laboratory sciences and the Accident and Emergency Department. 122 Internal medicine residents are supervised by consultants on ward rotations and during electives to different sub-specialties of Medicine. Residents are provided with supervised exposure to the patients in A&E as well as in the ICU and CCU, when on call.

133 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 programmes, such as those in the A&E and the Family Medicine and Public Health departments. Dept. 10 Clinical & Diagnostic Services The Department received patients with difficult medical problems from all over the country. As a result our junior doctors and medical students gained valuable clinical experience. A total of 54,900 out-patient episodes were generated during the calendar year 2008 for Department of Medicine. These episodes included newly referred patients, follow-up of old patients and dispensation of medicines for people with chronic ailments. There were 8,343 episodes of inpatient and day care patients on medical wards during this period. These statistics are considerably higher than in previous years, because of the new system of computer generated episode recording. M Table 1: showing census of in and outpatients Procedures such as bronchoscopy and gastro-intestinal endoscopy were routinely performed. The Department provided protocols for the management of common medical problems, which were periodically updated. The Department employs electronic patient recording and is ISO certified. Year Outpatients Inpatients ,000 4, ,500 5, ,120 8,343 a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Medicine 123

134 Research Projects Lymphomagenesis in developing countries: a study of patient-related, environment-related, and disease-specific factors in Oman Project Code: Dates: Value: OR 20,150 Project Funder: Investigators: IG/MED/MEDI/06/01 Sultan Qaboos University Dr. Ikram Burney, Department of Medicine, SQU; Dr. Mansour Al- Moundhri, Department of Medicine, SQU; Dr. Bassim Al-Bahrani, Department Mof Medicine, Royal Hospital; Dr. Adil Naqdi, Department of Microbiology & Immunology, SQU; Dr. Said Al-Dhahri, Department of Microbiology & Immunology, SQU; Mrs. Kamla Al-Mawali, Department of Histopathology, SQU; Dr. Aisha Al-Hamadani, Department of Histopathology, SQU; Dr. Shyam Ganguly, Department of Family Medicine & Public Health, SQU. Monogenic Diabetes Mellitus in Oman. A search for established and novel gene mutations Project Code: Dates: Value: OR 16,000 Project Funder: Investigators: IG/MED/MEDI/07/03 Sultan Qaboos University Prof. Nicolas Woodhouse, Department of Medicine, SQU; Prof. John Raeburn, Department of Genetics, SQU; Dr. Ali Al- Mamari, Department of Medicine, SQU; Dr. Omayma El-Shafie, Department of Medicine, SQU. 124

135 Pulmonary Dysfunction in Omani patients with SLE Project Code: Date: Value: OR 8,000 Project Funder: Investigators: IG/MED/MED/07/01 M Epigenetics of Gastric cancer in Oman and Helicobacter Pylori genotyping Project Code: Dates: Value: OR 33,200 Project Funder: Investigators: Sultan Qaboos University Dr. Omar Al-Rawas, Department of Medicine, SQU; Dr. Batool Hassan, Department of Medicine, SQU; Dr. Jojy George, Department of Medicine, SQUH; Dr. Ranjan William, Department of Radiology, SQU; Prof. MO Hassan, Department of Physiology, SQU; Balaji Jothi, Department of Physiology, SQUH. IG/MED/ MEDE/07/02 Sultan Qaboos University Dr. Mansour Al-Moundhri, Department of Medicine, SQU; Dr. Ikram Burney,Department of Medicine, SQU; Jennifer Rusiecki, Dr. Ayesha Al-Hamdani, Department of Pathology, SQU; Dr. Shyam A Ganguly, Department of Family Medicine & PublicHeath, SQU; Kamla Al-Mawali, Department of Pathology, SQU; Maryam Al-Nabhani, Department of Genetics, SQU; Dr. Bassim Al-Bahrani, Samir Mwtaawe, Fatma Al-Ramdani, Sarah Kurvilla. Are cellular signaling pathways involved in the pathogenesis of virally associated lymphomas Project Code: IG/MED/MEDE/08/01 Dept. 10 a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Medicine 125

136 Date: Value: OR 27,700 Project Funder: Investigators: Sultan Qaboos University Dr. Ikram A Burney, Department of Medicine, SQU; Dr. Mansour Al- Moundhri, Department of Medicine, SQU; Dr. Aisha Al-Hamdani, Department of Pathology, SQU; Dr. Marit Delgandi, Department of Biochemistry, SQU; Dr. Ali Al-Madhani, Dr. Shyam S Ganguly, Department of Family Medicine & Public Health, SQU. Identification of intracranial vessel disease by transcranial doppler in acute ischemic stroke M Project Code: MREC #232 Date: Value: OR 2,700 Project Funder: Investigators: Sultan Qaboos University Dr. Arunodaya Gujjar, Department of Medicine, SQU; Dr. Abdullah Al-Asmi, Department of Medicine, SQU; Dr. P.C. Jacob, Department of Medicine, SQU; Dr. Rajeev Jain, Department of Radiology and Molecular Imaging, SQU. 126 A Study to investigate antibodies and other immunological parameters to monitor response of Omani patients with AIDS to Highly Active Antiretroviral Therapy (HAART). Project Code: IG/MED/ MICR/08 /01 Dates: Value: OR 21,900 Project Funder: Investigators: Sultan Qaboos University Dr. Abdullah Balkhair, Department of Medicine, SQUH; Dr. Ali Al-

137 Jabri, Department of Microbiology & Immunology, SQU. BRCA 1 and 2 Gene Mutations, Loss of Heterozygosity, and Methylation in Familial and Young Sporadic Breast Cancer. Project Code: Dates: Value: OR 14,800 Investigators: IG/MED/MEDI/08/03 Use of weekly Docetaxel, Oxaliplatin Mand Capecitabine in Advanced Gastric Cancer Project Code: MREC #268 Dates: Value: Investigators: Dr. Mansour Al-Moundhri, Department of Medicine, SQU; Dr. Ikram A Burney, Department of Medicine, SQU; Dr. Bassim Al-Bahrani, Royal Hospital; Dr. Aliya Al-Ansari, College of Science, SQU. Unfunded Dr. Mansour Al-Moundhri, Department of Medicine, SQU; Dr. Ikram A Burney, Department of Medicine, SQU; Dr. Bassim Al-Bahrani, Royal Hospital; Dr. Shyam Ganguly, FAMCO, SQU. Genetic Polymorphisms of Nutrient and Inflamatory Genes in Diffuse Large B Cell Lymophoma in Omani Arabs Project Code: MREC #277 Dates: Value: Investigators: Unfunded Dr. Ikram A Burney, Department of Medicine, SQU; Dr. Hamza Babiker, Department of Biochemistry, SQU; Dr. Mansour Al- Moundhri, Department of Medicine, SQU; Dr. Shyam Ganguly, FAMCO, SQU. Dept. 10 a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Medicine 127

138 Non-Invasive Hemodynamic Profile in Acute Stroke-Study with Thoracic Electrical Bioimpedance Project Code: MREC #280 Dates: Value: Investigators: Unfunded Dr. Arundaya Gujjar, Department of Medicine, SQU; Dr. Abduallah Al-Asmi, Department of Medicine, SQU; Mr. Jacob PC, Department of Medicine, SQU. 128 Assessment of Risk Factors and Awareness of Breast Cancer Among Omani Women M Project Code: MREC #265 Dates: Value: Investigators: Unfunded Research Publications and Books Dr. Mansour Al-Moundhri, Department of Medicine, SQU; Dr. Bassim Al-Bahrani, Royal Hospital; Dr. Shyam Ganguly, FAMCO, SQU. Journal Publications 1. Beasley R, Clayton T, Crane J, von Mutius E, Lai CK, Montefort S, Stewart AW and the ISAAC Phase Three Study Group (includes Al-Rawas OA). Association between Paracetomol use in infancy and childhood and risk of asthma, rhinoconjuctivitis and eczema in 6 to 7 year old children: analysis from Phase Three of ISAAC programme. Lancet 2008; 372: Al-Rawas OA, Al-Riyami BM, Al-Maniri AN, Al-Riyami AA. Trends in asthma prevalence and severity in Omani schoolchildren: Comparison between ISAAC Phases I and III. Respirology 2008; 13: Al-Rawas OA, Al-Riyami BM, Al-Kindi HA, Al-Maniri AA, Al-Riyami AA. Regional variation in the prevalence of asthma symptoms among Omani schoolchildren: Comparisons from two nationwide cross-sectional surveys six years apart. SQU Med J 2008; 8:

139 4. Al-Maniri AA, Al-Rawas OA, Al-Ajmi F, De Cost A, Erikson B, Diwan V. The influence of public and private sector employment on suspicion and knowledge of tuberculosis among general practitioners in Oman. BMC Public Health 2008; 8: Al-Rawas OA, Al-Riyami BM, Goddard C, Hassan MO. Use of the low frequency band of heart rate variability in the screening of patients with snoring for polysomnography. SQU Med J 2008; 8: Williams H, Stewart A, von Mutius E, Cookson B, Anderson HR and the ISAAC Phase One and Three Study Groups (includes Al-Rawas OA). Is eczema really on the increase worldwide? J Allergy Clin Immunol 2008; 121: Björkstén B, Clayton T, Ellwood P, Stewart AW, Strachan D, and the ISAAC Phase Three Study Group (includes Al-Rawas OA). Worldwide time trends for symptoms of rhinoconjunctivitis: Phase Three of the International Study of Asthma and Allergies in Childhood. Pediatr Allergy Immunol 2008; 19: Tapaiwala SN, Al-Riyami D, Cole E. A painful and knotted nasogastric tube. CMAJ 2008; 178:56. M 9. Al-Riyami D, Alam A, Badovinac K, Ivis F, Trpeski L, Cantarovich M. Decreased survival in liver transplant patients requiring chronic dialysis: a Canadian experience. Transplantation 2008; 85: Elshafie O, Sankhla D, AlKindy N, AlHamdani A, Grant C, Woodhouse NJY. Insulinoma; A rare cause of a common metabolic disorder-hypoglycaemia. SQU Med J 2008; 8: Woodhouse NJY, Elshafie O, BenAbid F, Doi S. Familial mineralocorticoid induced hypertension in Oman. SQU Med J 2008; 8: Elshafie O, BenAbid F, AlKindy N, Sankhla D, Woodhouse NJY. Cushing s disease; Pituitary surgery versus adrenalectomy. SQU Med J 2008; 8: Elshafie O, Hussein S, ElAdawy W, Woodhouse NJY. Graves disease following interferon therapy for hepatitis C infection. SQU Med J 2008; 8: Meenakshi-Sundaram S, Mahadevan A, Taly AB, Arunodaya GR, Swamy HS, Shankar SK. Wilson s disease: A clinico-neuropathological autopsy study J Clin Neurosci 2008; 15: Arunodaya GR, Sathyaprabha TN, Muralidhar M, Ratan Gupta. Thoracic Electrocal Bioimpedance cardiac output in post-cardiac surgery patients. Comparison with pulmonary artery catheter method. J Clin Monit 2008; 22: Shanmugiah A, Sinha S, Taly AB, Prashanth LK, Tomar M, Arunodaya GR, Reddy JY, Khanna S. Psychiatric manifestations in Wilson s disease: a cross-sectional analysis. J Neuropsychiatry Clin Neurosci 2008; 20: Shobha N, Mahadevan A, Taly AB, Sinha S, Srikanth SG, Satish S, Nandagopal R, Arunodaya GR, Chandramouli BA, Shankar SK. Hypertrophic cranial pachymeningitis in countries endemic for tuberculosis: diagnostic and therapeutic dilemmas. J Clin Neurosci 2008; 15: Dept. 10 a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Medicine 129

140 18. Meenakshi-Sundaram S, Mahadevan A, Taly AB, Arunodaya GR, Swamy HS, Shankar SK. Wilson s disease: a clinico-neuropathological autopsy study. J Clin Neurosci 2008; 15: Balkhair A, Ben Abid F. Gastric and cutaneous dissemination of visceral leishmaniasis in a patient with advanced HIV. Int J Infect Dis 2008; 12: Al-Muharrmi Z, Rafay A, Balkhair A, et al. Extended-spectrum β-lactamase (ESBL) in Omani Children: Study of prevalence, risk factors and clinical outcomes at Sultan Qaboos University Hospital, Oman. SQU Med J 2008; 8: Al-Mahrezi A, Balkhair A, Al-Yaarubi S, et al. Chronic adrenal insufficiency associated with a unilateral adrenal mass. Oman Med J (Accepted for publication March 2008). 22. Al-Muharrmi Z, Balkhair A, Rafay A, et al. Antibiotic Combination as empirical therapy for ESBLs. Oman Med J. (Accepted for publication August 2008). 23. Al-Abdwani RM, Khamis FA, Balkhair A, Sacharia M, Wali YAA. Child with human parvovirus B19 infection induced aplastic anemia and acute hepatitis: effectiveness of immunosuppressive therapy. 1: Pediatr Hematol Oncol 2008; 25: M 24. Ali BH, Al-Moundhri M, Eldin MT, Nemmar A, Al-Siyabi S, Annamalai K. Amelioration of cisplatin-induced nephrotoxicity in rats by tetramethylpyrazine, a major constituent of the Chinese herb Ligusticum wallichi. Exp Biol Med 2008; 233: Ashktorab H, Brim H, Al-Riyami M, Date A, Al-Mawaly K, Kashoub M, Al-Mjeni R, Smoot DT, Al-Moundhri M, Al-Hashemi S, Ganguly SS, Raeburn S. Sporadic colon cancer: mismatch repair immunohistochemistry and microsatellite instability in Omani subjects. Dig Dis Sci 2008; 53: Al-Moundhri MS, Al-Shukaili A, Al-Nabhani M, Al-Bahrani B, Burney IA, Rizivi A, Ganguly SS. Measurement of circulating levels of VEGF-A, -C, and -D and their receptors, VEGFR-1 and -2 in gastric adenocarcinoma. World J Gastroenterol 2008; 14: Al-Moundhri MS, Al-Kindi M, Al-Nabhani M, Al-Bahrani B, Burney IA, Al-Habsi H, Ganguly SS, Tanira M. Combined polymorphism analysis of glutathione S-transferase M1/G1 and interleukin 1ß (IL-1ß)/interleukin 1-receptor antagonist (IL-1RN) and gastric cancer risk in Omani population. J Clin Gastroenterol Ur Rehman J, Burney IA, Al-Kindi SS, Raeburn S. Familial lymphoma in an Omani kindred with identical class II HLA type. Leuk Lymphoma 2008; 49: Burney IA, Al-Moundhri MS, Rizvi SAJ, Ganguly SS, Al-Abri R, Ashrafi RA. Outcome as a measure of quality of care in Oncology: SQUH Experience. SQU Med J 2008; 8: Burney IA, Al-Moundhri MS. Major advances in the treatment of cancer: what does a non-oncologist need to know? SQU Med J 2008; 8:

141 Conference and Seminar Presentations Conference Presentations International 1. Dikshit, MB, Jaju D, Jothi B, George J, Rizvi S, Al-Rawas OA. Pranayam breathing and pulmonary and Cardiovascular function in patients with chronic obstructive pulmonary Disease (COPD). The 2nd International Conference of the Arab Society for Medical Research. Cairo, Egypt, November Al-Tamemi S, Al-Shidhani A, Al-Abri R, Jothi B, Al-Rawas OA, Al-Riyami BM. The Pattern of Sensitization to Inhalant Allergens in Omani Patients with Asthma, Allergic Rhinitis & Rhinoconjuctivitis. The 27th Congress of the European Academy of Allergology and Clinical Immunology. Barcelona, Spain, 7-11 June Al-Balushi K, Tanira M, Al-Rawas O, Sayers I, Wheatley A, Hall I. Comparative sequence analysis of ADRB2 in asthma subjects from Oman and UK. Eur Respir J; 2007 (suppl.). The 17th European Respiratory Society (ERS) Annual Congress. Stockholm, Sweden, September Woodhouse NY. Calcium Metabolism, Graz University, Austria, M Local 1. Al-Rawas O. Asthma Management update. Asthma Symposium. Oman Respiratory Society. Sohar, 8 November Arunodaya GR. Telemedicine Session. Health Informatics Symposium, 1st International Conference of Quality Management in Health Care. Sultan Qaboos University Hospital, Muscat, Oman, January Burney IA. Outcome as a measure of quality of care in Oncology: SQUH Experience. 1st International Conference on Quality Management. Muscat, Oman, January Al-Riyami D. Can we slow the progression of CKD? Think Kidney Symposium, Ministry of Health, Muscat, Oman, March, Poster presentations International 1. Baddar SA, Al-Rawas OA, Jayakrishnan, George J, Al-Riyami BM. Self-reported asthma management practice and facilities in general practice in Oman. Int J Immunorehab; 10:64-5; World ASTHMA & COPD Forum. Dubai, UAE, April Al-Rawas OA, Jayakrishnan, Ben Abid F, George J, Al-Riyami BM. Clinical Characteristics and management of patients with asthma attending a specialist center. Int J Immunorehab; 10:50-51; World ASTHMA & COPD Forum. Dubai, UAE, April Burney IA, Al-Moundhri MS, Al-Dhahry S. Sero-prevalence of hepatitis viruses in non-hodgkin s lymphoma in Oman. Accepted for presentation International Conference on Burkitt s Lymphoma and related lym- Dept. 10 a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Medicine 131

142 phoproliferative disorders. Kampala, Uganda, February, Seminar Presentations Local 1. Al-Abri MA, Al-Hashmi K, Jaju D, Al-Rawas OA, Al-Riyami BM, Hassan MO. Sleep Medicine Service in Oman: An audit from eleven years of experience. SQU Sci Res Abstracts, p.93. May Dikshit, MB, Jaju D, Jothi B, George J, Rizvi S, Al-Rawas OA. A preliminary report on the effect of pranayam breathing on respiratory pressures and sympatho-vagal balance in patients with chronic airflow limitation. SQU Sci Res Abstracts, p. 93, May Woodhouse NJY. Mineralocorticoid hypertension. University Day. Sultan Qaboos Univeristy, Muscat, Oman. May Al-Rawas OA, Baddar S, Jayakrishnan B, Al-Riyami BM. Self reported asthma care among general practitioners in Oman; resources & management. Department of Medicine Research Retreat. 22 May M 7. Woodhouse NJY. Diabetic comas; Obesity & thyroid disease. Ibra Hospital, Oman Al-Rawas OA, Ben Abid F, Jayakrishnan B, George J, Baddar S, Al-Riyami BM. Management & control of asthma in patients attending a specialist centre in Oman. Department of Medicine Research Retreat. 22 May Al-Maniri A, Al-Rawas OA, Al-Ajmi F. Tuberculosis suspicion & knowledge among private & public general practitioners; questionnaire based study in Oman. Department of Medicine Research Retreat. 22 May Arunodaya GR. Thrombolyisis in Acute Stroke. Ibra Hospital, Oman, February Jayakrishnan BN. Management of life threatening Asthma. Symposium on Medical Emergencies. Ibra Hospital, Oman Jayakrishnan BN. Acute severe asthma. Nizwa Hospital, Oman Jayakrishnan BN. Management of Asthma, recent concepts. Symposium on Asthma. Muscat, Oman, Farooqui M. Lupus Nephritis - Update on Management. National Nephrology Conference. Sohar Hospital, Sohar, Oman, 22 May Burney IA. Oncological emergencies. Update on Medical Emergencies. Ibra Hospital, Ibra, Oman, February Burney IA. Recent advances in the management of non-hodgkin s Lymphoma. First International Student Conference. Oman Medical College, Sohar, Oman, March Burney IA. Immune profile of Omani patients with non-hodgkin s lymphoma. University Day. Sultan Qaboos University, Muscat, Oman, May 2008.

143 16. Burney IA. Lymphomagenesis in developing countries: a study of patient-related, environment-related, and disease -specific factors in Oman (lymphoman - 3): interim results Departmental Research and Educational Retreat, Muscat, Oman. May Thesis Supervision Abdullah Al-Maniri Qualification: Title: Supervisor: MSc Date of Completion: 2008 Khalid Nassri Qualification: Title: Supervisor: Epidemiology of Tuberculosis in Oman Dr. Omar Al-Rawas M MBBS Date of Completion: 2008 Risk factors of chronic kidney disease in Oman: A hospital-based, case-controlled study Dr. Mehfooz Farooqui Dept. 10 a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Medicine 133

144 M Microbiology and Immunology

145 Overview The Department of Microbiology and Immunology continues to make a significant contribution to the teaching and understanding of the fundamental causes and treatment of infectious diseases and immunological disorders. The Department takes part in the BSc Health Sciences, MD, the BSc MLS, Nursing and MSc teaching and training programmes. Dept. 11 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 the Sultanate in bacteriology, virology, parasitology, mycology, serology and immunology. M Staff Head of Department Sharanjit Singh Thukral, Professor Faculty Mohammed Idris, Professor Ali Al-Jabri, Associate Professor Muhannad Al-Kobaisi, Assistant Professor Yaseen Al-Lawatia, Assistant Professor Basil Nzeako, Assistant Professor Crystal Koh, Assistant Professor Helmut Schuster, Senior Consultant Akbar Rafay, Senior Consultant Ashok Shenoy, Consultant Zakariya Al-Muharrmi, Registrar Ahmed Al-Shukaily, Research Associate a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Microbiology and Immunology 135

146 Khloud Al-Ma mari, Senior House Officer Badriya Al-Adawi, Senior House Officer Mahmood Al-Kindi, Senior House Officer Fatma Ba Alawi, Senior House Officer Turkiya Al-Siyabi, Senior House Officer Support Staff John Prentis, Superintendent Zahra Al-Mahrooqi, Superintendent Ahmed Al-Badawi, Chief Biomedical Scientist Jameel Nograles, Cheif Biomedical Scientist Robert Toki, Chief Biomedical Scientist Fadhila Al-Tooqi, Senior Biomedical Scientist Frank Emmanuel Serebour, Senior Biomedical Scientist Intesar Al-Balushi, Senior Biomedical Scientist Mohammed Al-Baloshi, Senior Biomedical Scientist Masoud Al-Kheyari, Senior Biomedical Scientist Said Nasser Al-Hinaee, Senior Biomedical Scientist Rehana Hoosen, Senior Biomedical Scientist Khazina Al-Harthy, Senior Biomedical Scientist Coordinator Al-Haj Al-Qureshi M 136 Highlights of the Year Staffing During the academic year , faculty members included immunologists, bacteriologists, virologists, a parasitologist and a mycologist who are supported by a good number of technical and biomedical scientists with PhD and MSc qualifications.

147 During 2008, Dr. Crystal Koh joined the Department as an Assistant Professor in Immunology while Dr. Said Al-Dhahry applied for an early retirement. Dr. Michele Monteil, who joint earlier as a visiting consultant in Immunology also left the Department, while Dr. Ali Al-Jabri continued to serve as the Assistant Dean for Pre-clinical Affairs and Professor Mohammed Idris as the Assistant Dean for Postgraduate Studies and Research, both until September On the Hospital side, Dr. Helmut Schuster joined as a Senior Consultant. Dr. Zakariya Al-Muharrmi left to the UK to obtain his membership which he did within a very short time to re-join the Department. Ms. Rehana Hoosen and Mr. Sahim Al-Ghafri joined as a Senior Biomedical Scientist and a Biomedical Scientist respectively. Visitors During this year both our external examiners finished their appointment and two new external examiners where appointed. Professor Farouk MShakib, Head of the Division of Immunology Faculty of Medicine & Health Sciences, University of Nottingham Queen s Medical Centre, Nottingham UK, replaced Professor Peter M. Lydyard from the Division of Pathology & Infectious Diseases at Windeyer Institute for Medical Sciences, London, UK who acted as an external examiner in Immunology. Professor Tibor Pall from the Microbiology & Immunology Department at UAE University in Al-Ain, UAE, replaced Professor AM Kambal from the Department of Microbiology, College of Medicine & King Khalid University Hospital after serving as the external examiner. Conference Attendance Different members of staff of the Department participated in the following activities: + XVII International AIDS Conference, Mexico City, Mexico, 3-8 August Third Al-Ain International Immunology Conference: Immunoregulation in Chronic Disorders, Al-Ain, UAE, March Fifth GCC Medical Students Conference, Kingdom of Bahrain, 6-9 February Second paper writing Workshop, Deanship of Postgraduate Studies, CAMS Conference, CoMHS, SQU, 23 November Dept. 11 a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Microbiology and Immunology 137

148 + Third Workshop for Strategic Planning for University and Higher Education in Oman, Education and Training for Development. Oman Research Council, SQU, 3-5 September International Conference on the Sultanate of Oman Research Strategy, October th International Congress of Immunology, Rio de Janerio, Brazil. (Presenter) August Real time PCR workshop, Microbiology & Immunology Dept, Sultan Qaboos University, February Global Vaccinology International Forum 8th Disease Immunization and Immunotherapy Conference, Muscat, Sultanate of Oman, May M Teaching Programmes + Inter-Country Meeting of Strategies to Eliminate Schistosomiasis in Low Endemic Countries of the Eastern Mediterranean Region (EMR). Muscat, Sultanate of Oman, November, Pre-clinical Programme The Department offered its two main courses in the BSc Health Sciences programme, namely Immunology, and Microbiology to 4th year medical students. Course Title Semester Immunology 6 Microbiology 7 BSc Medical Laboratory Science Programme The Department also contributed substantially to the BSc MLS programme. However, since the new curriculum was introduced in 2006, some courses were replaced by new ones and the amount of credit hours was also reduced. 138

149 Course Title Semester General Medical Microbiology I (new) 7 General Medical Microbiology II (new) 8 Medical Immunology (new) 8 Advanced Medical Microbiology I (new) 9 Advanced Medical Microbiology II (new) 9 Advanced Medical Microbiology III (new) 9 Projects 10 BSc Nursing The Department continues to offer a 3 credit Microbiology course which was taught to second year BSc nursing students and the course Mwas also offered during the summer semester. Clinical Programmes The Department contributed to the teaching of the integrated lecture series and case-oriented learning for the 5th year clinical students. As in the past, five groups of the 7th year medical students carried out a one week laboratory rotation. Normally this covers all the clinical laboratory sections of the Department. Students are assessed on the final day of the rotation. MSc Programme The Department had a new cohort of students who started with core courses and a medical microbiology course. There were two microbiology first/second year residents who did various rotations in clinical microbiology and immunology. We also participated in the training of the entire group of Oman Medical Specially Board (OMSB) residents. Dept. 11 a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Microbiology and Immunology The Department offered higher MSc training and participated in the Diploma in Tropical Medicine and Hygiene. Medical residents were prepared for Part 1 of the MRCP (Royal College of Pathologists, UK). 139

150 Specimens M Clinical & Diagnostic Services The two major units of the Department - Microbiology and Immunology - continued to offer diagnostic services primarily to SQUH, but also to other government and private hospitals. There was an expansion in the diagnostic services in molecular microbiology and immunology. In addition, in parallel with the increased patient activity within SQUH, there was an increase in the number of samples and tests carried out in our laboratories, as shown in the diagram below. Figure 1: Microbiology and Immuunology specimens/tests External Quality Assurance The Department continues to participate in the Royal College of Pathology of Australia External Quality Assurance programme. Tests 140 Research Research topics were: epidemiology of hepatitis A; respiratory viruses in children; serological follow-up of emergent schistosomiasis mansoni; molecular and functional characterisation of gene

151 polymorphisms associated with inflammatory diseases. Dept. 11 Research Projects 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: Value: Project Funder: Investigators: OR 22,500 - SQU + OR 23,365 - UAE University Sultan Qaboos University and UAE universities M Dr. Youssef Ali Abou-Zeid, Department of Biology, College of Science, UAE University; Dr. Muhannad Al-Kobaisi, Department of Microbiology & Immunology, SQU; Salem Awad, Gastroenterology Medical Consultant, UAE; Dr. Taoufik A. Zoubeidi, College of Business & Economics, UAE University Serological follow-up of emergent schistosomiasis mansoni in the Dhofar Governorate, Oman Project Code: IG/MED/ MICR /06 /01 Dates: Value: OR 8,000 Project Funder: Investigators: Sultan Qaboos University Prof. Mohamed Idris, Department of Microbiology & Immunology, SQU; Dr. Mahmoud Shaban, Ministry of Health, Salalah, Dhofar, Oman; Prof. Andreas Ruppel, University of Heidelberg, Germany; Dr. Hélène Moné, University of Perpignan, France; Dr. Gabriel Mouahid, University of Perpignan, France a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Microbiology and Immunology 141

152 Epidemiology and Laboratory Investigations of Respiratory Virus infections among Omani Infants and Young Children in Sultan Qaboos University Hospital Project Code: IG/MED/ MEDE/08 /02 Dates: Value: OR 18,400 Project Funder: SQU Investigators: Dr. Muhannad Al-Kobaisi, Department of Microbiology & Immunology, SQU; Dr. Faryal Ali Khamis, Medicine, Royal Hospital; Hussein Al-Kindi, Department of Peadiatrics, SQU; Ahmed Al-Manthari, Family and Community Health department, SQU. M Research Publications and Books Journal Publications 1. Al-Muharrami Z, Al-Jabri AA, Al-Rawahi G, Scrimgeour EM, Al-Marhobi A. HIV-1 viral load after leukodepletion. J AIDS 2008; 48: Al-Jabri AA, Lambkin R, Oxford JS. Lack of Evidence for Complete Resistance of Peripheral Blood Mononuclear Cells to HIV-1 and HIV-2 Infection. Viral Immunology 2008; 21: Al-Jabri AA, Al-Shukaili AK, Al-Rashdi Z, Ganguly SS. Reference ranges of lymphocyte subpopulations in the healthy adult male Omani population. Saudi Med J 2008; 29: Nzeako BC, Al-Lawati B. Comparative studies of antimycotic potential of thyme and clove oil extracts with antifungal antibiotics on Candida albicans. African J Biotechnol 2008; 7: Al-Mawali AA, Chacko AP, Javad H, Fatallah M, Shenoy A, Koul R, HIV disease presenting as a unilateral parotid swelling in 2.5 year old child. Indian J Pediatr; Accepted Habbal OA, Al-Jabri AA, El-Hag AG. Antimicrobial properties of Lawsonia inermis (henna): a review. Aust J of Med Herb 2008; 19: Book Chapters 1. Al-Jabri AA, Al-Adawi SA. Knowledge and attitudes of undergraduate medical and non medical students toward infectious diseases. In: Pierce RW, Schwartz Eds. New perspectives on knowledge, attitudes and practices in health. USA: Nova Science Publishers Inc2008. Pp

153 Local Publications 1. Al-Jabri AA. Is there a lack of trust between the Arab People and their Arab physicians? (Arabic). Al- Masar, 29th February 2008, Issue 130: Al-Jabri AA. Our immune system and the holy month of Ramadhan. Horizon, 30th September 2007, Issue 117:4. Dept. 11 Conference and Seminar Presentations Conference presentations International 1. Al-Shuaili I, Al-Jabri AA. The importance of anti-sm antibodies in the diagnosis of SLE in Omani patients. 4th GCC Conference for Medical Students. Kingdom of Bahrain, 7-9 February, M Thesis Supervision Poster presentations International 1. Al-Jabri AA, Al-Ghadani M, Al-Shuaili I. High frequency of Smith autoantibodies in Omani patients with Systemic Lupus Erythromatosus. Third Al-Ain International Immunology Meeting: Immunoregulation in Chronic Inflammatory Disorders. Al-Ain, UAE, March 17-20, Poster No. A214; PP: Al-Jabri AA, Al-Shukaili A. The presence of antibodies to nuclear antigens in the serum of patients with gastric cancer: their prognostic value. 13th International Congress of Immunology. Rio De Janeiro, Brazil, August 2007, Poster No. P0386. Khuloud Khalfan Al-Rahbi Qualification: Title: Supervisor: MSc Date of completion: 2007 Measurement of lymphocyte activation markers in healthy individuals Dr. Ali Al-Jabri a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Microbiology and Immunology 143

154 N Nursing Program

155 Overview The Baccalaureate Nursing (BSN) Program in the College of Medicine and Health Sciences, established in 2002 at Sultan Qaboos University, is committed to preparing graduate nurses of high calibre and competence. The Program has made significant achievements over the past years in the areas of faculty recruitment and development, student training, curriculum review, building of infrastructure and academic growth. Dept. 12 The Nursing Program believes in student centred education; students are given hands-on experience in the clinical areas after a period of skill mastery in the nursing skills laboratories, plus intense guided clinical experience in all clinical areas. The Nursing Program aims at preparing graduates to take up first level positions in nursing service, nursing education, nursing leadership and nursing research. The Program is actively involved in community health activities contributing to the Omani population s health and welfare. N The Nursing Diploma Graduates Program was launched in 2005 and is set up for the diploma holders to obtain their Baccalaureate Degree in Nursing. Staff Head Raghda Khalid Shukri Faculty Samira Maroof, Assistant Professor Naglaa El-Mokadem, Assistant Professor Anice George Jain, Assistant Professor Jothi Clara Michael, Assistant Professor Alice George, Assistant Professor Jahara Hayudini, Clinical Instructor Jayanthi Radhakrishnan, Lecturer a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Nursing Program 145

156 Ramesh Perumal, Lecturer Shreedevi Balachandran, Clinical Instructor Suresh Narayanan, Lecturer Wasfeih Ali Salloom, Clinical Instructor Renu Geetha, Lecturer Anoopa Suresh, Lecturer Girija Madhavan, Lecturer Savithri Raman, Lecturer Preethy D Souza, Lecturer C Deborah Paki Jothi, Lecturer Sakunthala Jayarajan, Clinical Instructor Nilima Bhore, Lecturer Sulekha Thankappan, Lecturer Alice Augustine, Clinical Instructor Anitha Thanka, Lecturer Asha Sasikumar, Lecturer Mohammed Nezar Al-Tamimi, Clinical Instructor Adenike Adepero Akintola, Lecturer Support Staff Bader Al-Amri, Director of Administration Nadeem Al-Zadjali, Coordinator Khalid Al-Harrasi, Coordinator Yunis Al-Hinai, Messenger N 146 Highlights of the Year The Graduation of the First Cohort The first cohort of 39 students of the regular baccalaureate nursing programme and five of the diploma graduate programme had their graduation in December Prior to the graduation, the

157 Nursing Program organised the historical oath-taking ceremony in November After the internship and the oath-taking, all graduates are currently employed as staff nurses at SQUH. Subsequently, the second cohort of 38 students completed the curriculum plan and started their six months internship period in June Dept. 12 External Examiners and Exit Examination The exit examination is part of the Advanced Clinical Nursing Course offered in the last semester. In May 2008, the second cohort underwent the exit examination. The examination was conducted by external examiners from the USA, the UK and Jordan and local examiners from the Program, SQUH, Khoula Hospital, the Ministry of Health (MoH), the Armed Forces Hospital and Ibn Sina Hospital. The overall feedback from the examiners was very positive. They described the standard of education as high and comparable to international standards. Moreover, they commended the well designed and balanced curriculum. Most Nimportantly, they appreciated the high calibre and performance of the students which was displayed in theoretical knowledge and clinical competence. Internship Programme The second cohort of nursing students started their six-month internship period from June Most had four months of internship training in SQUH and two months abroad, being posted in a different health care delivery system, while a few spent the whole six months at SQUH. The interns were sent to McMaster University, Canada and Jordan University. New University Elective The Program responded to the request from the Academic Council to set up elective courses for the University student body. Three University elective courses were designed and offered in the Arabic language starting from fall They were First Aid/CPR, Physical and Psychological Child Health, and Human Relations in Health & Illness. These courses attracted a large number of students from all colleges and there was a great demand for them to be offered in all semesters. a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Nursing Program 147

158 Online Courses The Nursing Program utilises innovative technology in teaching and learning. The initiative of establishing online courses started from 2006 onwards. The faculty use both MOODLE and Web CT. This approach is important in developing more reflective skills and a greater appreciation of professional learning. All course coordinators and students expressed satisfaction about the use of online teaching and examinations. Academic Advising Great emphasis was placed on academic advising in the Nursing Program. Academic advisors are working towards effective strategies to assist students who require special guidance, especially those who are under probation. Academic advisors are striving hard to set a good example in the University academic advising system. N Collaboration with Hospitals Nursing Program coordinated with all teaching nursing institutes and directorates of nursing in hospitals in Muscat to plan student clinical placements. The clinical training at SQUH is coordinated by a joint clinical training committee consisting of members from SQUH and the Nursing Program. The faculty also participate in many significant activities of the Nursing Services Directorate of SQUH. Interdepartmental Collaboration The Nursing Program collaborated with other departments of the College of Medicine & Health Sciences. Faculty of the Program was involved in teaching in the Clinical Methods course offered for medical students by the Anatomy and Physiology departments, participated in the Village Health Care Studies with the Family Medicine & Public Health Department and was involved in various committee activities such as the Health and Safety Committee, Medical Research and Ethics Committee and Ethics Task Force Committee etc. 148

159 Community Outreach Activities The Nursing Program was actively involved in community outreach activities. It conducted school health programmes which included health screening and health education in five schools in Muscat region. Apart from this, health awareness programmes were conducted in the Mabella and Alkhod Health Centres. Dept. 12 Alumni The Nursing Program alumni association named the SQU Nursing Alumni (SQUNA) was inaugurated by the Dean of College of Medicine & Health Sciences on November 6, 2007 at the oath taking and graduation ceremony. Board members were elected. An alumni brochure containing the objectives, activity and functions and list of board members was released on the same day. N New Building for The Nursing Program A new 3 floor building, tailor-made for the Nursing Program was completed. This building has number of laboratories and classrooms and is set to be equipped with all modern teaching resources. It was one of the objectives of the Nursing Program to set up the best nursing skills laboratory in the region. Functional Committees Considering the diverse needs of the Nursing Program, 17 committees were engaged in the development of the Program. During the year , the significance of these committees was evident in most of the events which took place. a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Nursing Program Public Relations Activities The Program is committed to be visible in internal publications of SQU and in the local newspapers as it is the first of its kind in the country. The key activities were covered in the newspapers, television and university publications. 149

160 Transition of Nursing Program to College of Nursing The year witnessed the transition stage of the Nursing Program to a full College of Nursing. The College of Nursing was officially recognised as the ninth college at SQU in September The Nursing Program moved to the new College of Nursing building in July Teaching Programmes The BSN curriculum consists of biomedical courses, nursing courses and university electives. The Program is responsible for teaching all the theory nursing courses, including behavioural sciences like psychology, sociology, nursing informatics, health education, health promotion, psychosocial aspects of care, critical thinking, nursing research, introduction to nursing profession, communication and group dynamics, history trends and issues in nursing etc. The Program also teaches the clinical N courses: Fundamentals of Nursing, Adult Health Nursing I, Adult Health Nursing II, Maternal Health Nursing, Child Health Nursing, Psychiatric Mental Health Nursing, Critical Care Nursing, Nursing Administration, Community Health Nursing and Advanced Clinical Nursing. Other Colleges especially College of Medicine and Health Sciences participate in teaching the Biomedical Science courses. The Program also offers three University elective courses in Arabic language: First Aid, Human Relations in Health and Illness, and Physical and Psychological Child Development. Students are given exposure to research through the courses of Nursing Research and the Graduation Project. Training Courses & CME Activities Several staff development activities were initiated based on the emerging needs of the Nursing Program. Ongoing staff development activities continued to be conducted periodically. Various workshops and symposia were organised to keep the staff abreast with the new trends. The areas focused on were research, on-line teaching, clinical teaching, student academic advising and student evaluation. 150 In collaboration with the Training and Staff Development (TSD) Directorate of SQUH, the faculty

161 of the Nursing Program had training in basic life support (BLS) instruction and intravenous (IV) therapy. The faculty contribute periodically to the teaching of BLS courses conducted by the TSD. An IV therapy course was also organised by the faculty of Nursing Program for the nursing students. Experts from the MoH, Oman Nursing & Midwifery Council (ONMC) and other institutions and colleges are often invited to deliver guest lectures for the nursing students. Dept. 12 The Annual International Nurses Day celebration was conducted on 5 May 2008 on the theme Future of Nursing Education in Oman included scientific sessions and exhibitions. The International Council of Nurses (ICN) sent a special message sharing their views on the theme which was delivered on the same day of the celebration. The students and faculty actively participated in this important occasion. Faculty members participated in activities such as committee memberships, seminars, symposia, local and international conferences and workshops. Faculty also actively participated in activities organised by MoH institutions, SQUH, Royal Hospital, Armed Forces Hospital, ONMC and Ministry of Higher Education. N Research Publications and Books Research The Nursing Program was involved in research at the department level mainly related to nursing education. Journal Publications 1. Clara JJ, Shukri R, Christopher L, Wardam L. Readiness of students and faculty members for utilizing webbased teaching-learning. Trends Nurs Admin and Educ (JTNAE) 2008; 1: Ahmad S, Al-Samadi M, Hayudini J. Training of Trainers on Breast Self Examination in Northern. J Pub Health Nurs (Accepted 2008) a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Nursing Program 151

162 Conference and Seminar Presentations Conference Presentations International 1. Clara JJ. Magnet status for Nursing. International Nurses Conference. Sri Ramachandra College of Nursing, Chennai, India, 4-6 Jan Madhavan GKM. Role of Nursing Education in Patient Safety. First International Quality Management and Patient Safety Conference. SQU, Muscat, Oman, Jan Rashid N, Dsouza P, George A, Geetha R. Exploratory study to assess the Stress and its Correlates among Mothers of Children with Leukemia. 5th SIOP Asia Pre-Conference on Childhood Cancer. SQU, Muscat, Oman, Feb Suad B, Dsouza P, George A, Geetha R. Evaluation of conscious sedation protocol for invasive procedures in the Pediatric hematology unit. 5th SIOP Asia Pre Conference on Childhood Cancer. SQU, Muscat, Oman, Feb N 5. Geetha R, George A, Dsouza P. Pediatric nurses perceptions of end of life care and helpful behaviors in providing end of life care for children and family. 5th SIOP Asia Pre- Conference on Childhood Cancer, SQU, Muscat, Oman, Feb Clara JJ. Effect of music on pain in women undergoing assisted reproductive technology. Midwest Nursing Research Society Annual Conference. USA, March Hayudini J. Transforming nursing students for a safer patient care through role modelling. Patient Safety Conference. Turkey, March Salloum W, Hayudini J. Reflective teaching of nursing skills in a virtual lab at SQU. The Second International Nursing Conference. Jordan, April Venkatesaperumal R. Quality of life and role of social support. Sigma Theta Tau Eta Pi Chapter Research Day. University of Wisconsin, USA, April, Nair SKN. Community Care of Elderly. 2nd International Nurse Education Conference. Dublin, Ireland, June Dsouza P. Effectiveness of a video film in preparing children undergoing major surgery. 19th International Nursing Research Congress Focusing on Evidence- Based Practice. Singapore, July Hayudini J. Effect of Simulation teaching strategy in basic preclinical nursing education. Education and its Global Reach and Relevance. Philippines, August Local 1. Shukri R. Educational Efforts for Best Practice. Nursing Scientific Conference on Best Practices, Sultan Qaboos

163 University Hospital. Muscat, Oman, May Conference Posters International 1. Suresh A. Factors contributing to non-compliance of drugs among clients with major mental illness. 2nd International Nurse Education Conference. Dublin, Ireland, June Radhakrishnan J. Role play as an effective teaching methodology in nursing. Technological Innovations in Nursing Education. Charlet, USA, June Geetha R. Effectiveness of a computer assisted learning program on selected area of the pediatric nursing course of the diploma nursing program. 19th International Nursing Research Congress Focusing on Evidence- Based Practice. Singapore, July Local 1. George A, Geetha R, Dsouza P, Shukri R. Role modeling behaviors of faculty as perceived by the Nursing students. International Nurses Day. College Nof Nursing, SQU, May Seminar Presentations International 1. Dsouza P. Palliative care-pediatric perspectives. 5th SIOP Asia Pre-Conference on Childhood Cancer. SQU, Muscat, Oman, Feb Dsouza P, Shukri R. Evidence based Nursing Practice. 5th SIOP Asia Pre-Conference on Childhood Cancer. SQU, Muscat, Oman, Feb George A, Shukri RK. Professional Networking. 5th SIOP Asia Pre- Conference on Childhood Cancer. SQU, Muscat, Oman, Feb Geetha R. Play therapy. 5th SIOP Asia Pre-Conference on Childhood Cancer. SQU, Muscat, Oman, Feb Shukri R. The Human Health and Environmental Challenges in the Middle East. Fulbright Academy Workshop. Doha, Qatar, March Dept. 12 a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Nursing Program Local 1. Shukri R, Mokadem N. Bed sore prevention and management. Continuing Nursing Education. Khoula Hospital, Muscat, Oman, March Shukri R, George A. Future of Nursing Education in Oman. International Nurses Day Symposium. SQU, Muscat, Oman, May

164 N Nursing Services Directoriate

165 Overview The Nursing Services Directorate is the largest department in the hospital with 947 nurses providing 24 hours service. Nursing practice in SQUH is guided by our 7 core standards of care, which emphasise continuous evaluation of structures and processes in relation to patient outcomes in ensuring nursing care of high quality. The Directorate seeks to promote and maintain a stimulating learning, teaching and research enhancing environment that is conducive to the clinical training of staff and students. Dept. 13 The vision of the Nursing Directorate is to strive for practice which is safe, caring, innovative, scientific and empowering based on a solid foundation of leadership. The Directorate seeks to be a model of excellence for all nursing services in the country. It aims to provide evidence-based practice and seeks to maintain a high standard in caring, teaching and training. N + Demonstrate patient advocacy while providing comprehensive, mutually defined care. The mission of the Nursing Directorate is to be responsible and accountable in the provision of high standard nursing care to patients. It is committed to the teaching of medical and nursing students and to the professional development of nurses. The Directorate seeks to: + Provide coordination of care delivery across the continuum using approaches that are compliant to international standards in achieving optimal patient outcomes. + Empower nurses with the responsibility to make decisions that promote their development and that of the profession. + Support and complement teaching and training activities. a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Nursing Services Directorate Staff At 31st December 2008, the Nursing Directorate had a total of 831 nurses in post, a multinational workforce responsible for the provision of nursing services in SQUH. 155

166 156 Yusriya Al-Akbary, Director of Nursing Salma S. Mahfudh, Assistant to the Director Roseliyah Shamsudin, Assistant to the Director Daniel Birru, Assistant to the Director Catherine Lausa, Assistant to the Director Shinuna Al-Harthy, Management Trainee Ayna Al-Riyamy, Management Trainee Fatma Al-Dhabari, Management Trainee Yousuf Al-Hasani, Management Trainee Padma Singh, Nursing Coordinator Lucia Pelser, Nursing Coordinator Zita Montesclaros, Nursing Coordinator Phang Ah Looi, Nursing Coordinator N Rose Gerorge, Nursing Coordinator Chu Jahayah Mohd Naseh, Nursing Coordinator Mansoor Al-Jabri, Infection Control Nurse Raiya Mohd Al-Rashdi, Infection Control Nurse Fatma Nelson, Infection Control Nurse Catherine M. Tobin, Head Nurse,Ward 1Purple Amelita Villamora, Head Nurse, Ward 1 Blue Norah Ngcamu, Head Nurse, Ward 2 Blue Thavamony Saravanan, Head Nurse,Ward 2 Red Sotinah Tariono, Head Nurse, Ward 2 Yellow Khairom Abdul Rashid, Head Nurse, Ward 2 Purple Rahma Al-Mahrazi, Head Nurse, Ward Bone Marrow Transplant Mariam Abdullah, Head Nurse, Ward 3 Red Belingeria Jaafar, Head Nurse, Ward 3 Yellow Lau Pek Hoon, Head Nurse, Ward 3 Blue Koh Choy Fong, Head Nurse, Ward 3 Purple Janet Ogonjumo, Head Nurse, Ward 4 Blue

167 Vijayarani Reddy, Head Nurse, Ward 4 Yellow Ong Mee Eng, Head Nurse, Ward 4 Red Lau Soo Hong, Head Nurse, Ward 4 Purple Sarala Kodamala, Head Nurse, Family Medicine & Public Health Clinic Rachael Wordley, Head Nurse, Theatres Sapiah Abbas, Head Nurse, Day Care Unit Robert Dimaiwat, Head Nurse, A&E Parvi Ponambalam, Acting Head Nurse, Neonatal Ward Barbara Swales, Head Midwife, Delivery Ward Augustine Karkada, Acting Head Nurse, Psychiatry Nooraini Yadi, Acting Head Nurse, Intensive Care Unit/Cardia CU/Paediatric ICU Rabia Al-Saadi Acting Head Nurse, Out Patients N Support Staff All nursing areas are strongly supported by coordinators, medical orderlies and ward clerks. + KPI for different nursing areas. Highlights of the Year BSI surveillance audit on January 2008 and again on 2-4 June 2008 with no non-conformity. + Hospital wide and unit specific peer audits carried out. + Competency based performance appraisal tool was introduced as a means of evaluating staff competencies and performance in accordance to the given responsibilities and grades. + National nursing scientific conference on Best practices was conducted on 21 May The objective was to exchange experiences related to best practice, share current trends in Oman and enhance collaborative efforts to enrich nursing practices in Oman. + Activities were held to enhance team building, teamwork, and work output. These included Dept. 13 a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Nursing Services Directorate 157

168 158 the Food Fair, Nurses Day and the Cultural Night. + A Think Clean Day was an initiative carried out by nurses on 18 March 2008, to promote hospital cleanliness. Peer audits together with poster competition were judged by top management, prizes were awarded to the winners. + More recognition to the nurses in the form of promotions, best practices and bonuses were granted. + A Patient and family education workshop was conducted for all ward managers on 27 May SWOT analysis conducted in December 2008 which provided insight to Nursing Services strengths, weaknesses, opportunities and threats. N + The nursing directorate won the QUALITY AWARD of batchs of BSN nursing graduates from College of Nursing started their internship on 1 February 2008 and on 14 June Recruitment trip to Malaysia for senior nurses and to India and Sri Lanka 24 March to 1 April 2008 for junior nurses. + New nursing grades received for the expansion of services and additional beds were opened as new nurses arrived. + Top management meeting with the nurses was held on 31 May 2008 in the medical theatre. Issues of concern from the nurses were discussed and feedback given. + A study on patient classification and nursing staff allocation was reviewed and reassessed in December This is a valid and reliable system for measuring nursing intensity and a key to predicting overall nursing staff requirement. + OUR NEWS is the bi-annual nursing newsletter. It is a communication tool designed to enhance understanding between nursing administrators, staff and nurses. It is the newsletter of nurses, by nurses and for nurses. + Best Practice Award: The aim was to maximise competitiveness in the different areas, and

169 thereby maximise performance. It is given to the best ward/unit that meets and achieves pre-set criteria and standards of nursing practice. + 1st Group of BSN nurses from our College of Medicine & Health Sciences started work in SQUH in Dept. 13 Teaching Programmes The Nursing Department continued to be heavily involved in the teaching and training of both medical and nursing students at the ward and the departmental level. Nursing students were received from SQU College of Medicine & Health Sciences and from different MoH institutes: Oman Nursing Institute, Muscat Nursing Institute and Oman Specialized Nursing Institute. Senior nurses were involved in the teaching programmes in the Training Directorate. The training of the CSSD and N ophthalmology students continued with the support of the technicians in the clinical areas. LESSON LEARNED This programme encourages nursing personnel, from upper level managers to junior nurses, to share lessons learned without fear of reprisal or ridicule. All lessons learned are significant. They provide opportunities for other nurses to gain knowledge and continually improve, thereby minimising the reoccurrence of problems. The immediate goal of the programme is for the quality of nursing to be enhanced with each lesson learned, and to continually improve with no limit as to how successful it can be. The best presentation every six months is awarded the Cup of Knowledge. COMPETENCY BASED TRAINING A bi-annual exercise to identify and schedule general and unit/ward specific learning and training needs to meet the competencies in the job and benefit the institution. Evaluation of the training is conducted after 3 months. a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Nursing Services Directorate CAREER PATH FOR OMANI NURSES An in-depth discussion between the Nursing Directorate and individual Omani nurses to de- 159

170 termine their career development path. The five year plan involves reflecting upon the needs of the services, nurse s interests, strengths, future goals and aspirations. The Nursing Directorate operated smoothly through the hard work, commitment and positive attitude of the nurses with continued support from the top management of the Hospital and the University main administration. The Nursing Directorate would like to express their sincere thanks and gratitude for the support given. N 160

171 Dept. 13 N a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Nursing Services Directorate 161

172 N Nutrition and Dietetics

173 Overview The Department consists of two main divisions: Dept Nutrition & Dietetics + Catering Administration Nutrition & Dietetics The Department of Nutrition & Dietetics has responsibilities in a range of areas including dietetic counselling to in-patients and out-patients, administration, health education and promotion through activities related to preventative medicine, and training. Several clinics are covered in both adults and paediatrics. Adult clinics include diabetic, renal, lipid, obesity and gynecology, whereas paediatric clinics include pre-term, haematology, metabolics, neurology, respiratory, general, endocrine and N nephrology. Dietetics Dietitians assess nutritional needs, diet restrictions and current health plans to develop and implement dietary management plans for patients 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 a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Nutrition and Dietetics 163

174 + Nutrition Support Dietitians work mostly in hospitals; however, they can also work in the community as health promoters, educators, as well as in sports or media. Nutrition 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. Catering Administration The purpose of the catering administration service is to ensure a supply of safe, nutritious, well presented food and to protect patients from contaminated, Ndecomposed or injurious food. The monitoring also prevents the use of misleading labels. Further monitoring activities encourage healthier and safer food by better standards of quality control in receiving food products from suppliers, correct storage, food preparation, cooking and serving food to patients. Staff Deputy Head of Department Majda Ahmed Al-Maamary, Registered Dietitian Registered Dietitians Shadya Mohammed Al-Harthy 164 Dietitians Yahya Khamis Al-Mukhaini, Senior Dietitian A Shaima Naser Al-Kindi Ayda Mansoor Al-Ghadheeb Fatma Mohammed Al-Hashmi

175 Salma Saif Al-Mahrouqi Catering Staff Catering Administration Superintendent Mohammed Rasheem Hameed Dept. 14 Highlights of the Year The Department participated in the Hospital Day Exhibition held on the 28th-29th of April Training Programmes & CME Activities N Programme Title Participators Date/Duration Infant Feeding Workshop 5th Year Medical Students 4-hour workshop, 6 times a year Complementary Feeding- BIFHI Nutrition & Dietetics Internship Programme Clinical training of new dietitian employees Inherited Metabolic Disease (Hospital Attachment) Nutrition & Dietetics Internship Programme Nursing Staff Nutrition students of the College of Agriculture Fatma Al-Hashmi Salma Al-Mahrouqi 1 ½-hour session, twice a year October November February - 2 July 2008 Ayda Ghadheeb April 2008 Nutrition students of the College of Agriculture June - October 2008 a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Nutrition and Dietetics 165

176 Number of patients Inpatient Outpatients Total 0 Sep- Dec 07 Jan-Aug 08 N Figure 1: Clinical consultation statistics Nutrition & Dietetics 166

177 Dept. 14 N a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Nutrition and Dietetics 167

178 O Obtetrics and Gynaecology

179 Overview The Department of Obstetrics and Gynaecology is one of the major departments involved in teaching undergraduate, postgraduate 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 family, 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, gynae-oncology and the high risk pregnancy clinic. 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: O + Addressing the biopsychosocial needs of a diverse patient population. + Applying an evidence-based approach to clinical management with a view to providing the best possible care to all our patients. + Collaborating across clinical disciplines within and outside the Department. Staff Head of Department Kuntal Rao, Acting Head of Department & Senior Consultant Dept. 15 a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Obtetrics and Gynaecology Faculty V Gowri, Assistant Professor Majda Al-Maarof, Consultant Lovina Machado, Consultant Mariam Mathew, Consultant Lamya Al-Kharusi, Consultant 169

180 Maha Al-Khaduri, Consultant Evelyn Moral, Senior Registrar Wadha Al-Ghafri, Senior Registrar Tamima Al-Dughaishi, Senior Registrar Anita Mohan, Registrar Shabnam Saquib, Registrar Seema Mundhra, Registrar Shahila Tazneem, Registrar Silja Armugham, Senior House Officer Hana Al-Sayed, Senior House Officer Sadaf Said Ayoob, Senior House Officer Syeda Iram Fatima, Senior House Officer Saria Ahmed Bala, Senior House Officer Farah Farouq Fathih, Senior House Officer O Support Staff Nasser Abdullah Al-Mufarji, Coordinator Aneesa Suleiman Al-Jahwari, Coordinator Highlights of the Year The Department introduced four new clinics in the outpatient department: the Urogynaecology Clinic, the Oncology Clinic, the Maternal Fetal Medicine Clinic and the Endoscopic Surgery Clinic. We received new equipment: an ST Analyser (STAN) and a new USG machine in the LDW & OPD respectively. 170 Teaching Programmes In 2007 and 2008, 92 and 114 students respectively presented for the MD examination in obstetrics and gynaecology.

181 4th Year The teaching done in the Department is in the clinical methods and communication skills programme. For the clinical methods course in obstetrics and gynaecology, the Department spends 2 hours for each of 3 days with 3 staff members required per day. For the communication skills programme, the Department spends 2 hrs in lectures and student exposure visits to the wards per week for 16 weeks. Dept. 15 5th Year One lecture is given as an interdisciplinary activity. 6th Year Students have 4 weeks training in the Department. Each student has to write 2 case reports and present one case. O 7th Year Students spend 7 weeks on placement: 3 weeks in SQUH, 2 weeks at the Royal Hospital and 2 weeks in Khoula Hospital. They are exposed to problem solving seminars, ward rounds with consultants and spend time in the operating theatre, outpatient clinic and wards. In the OPD, they see the whole spectrum of obstetric and gynaecology patients, attend the high risk pregnancy clinic and are exposed to ultrasound procedures. POSTGRADUATE Programme The Oman Medical Speciality Board (OMSB) programme started in September 2007; 3-5 students are posted at a time in the Department where they present cases, attend the Journal Club and participate in the management of clinical problems. a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Obtetrics and Gynaecology Training Courses & CME Activities The Department has daily teaching programmes in the form of Journal Clubs, RCOG Dialogues and CME programme meetings for residents, SHOs and registrars. An interdepartmental weekly meeting is conducted with the Neonatology Department. 171

182 Clinincal & Diagnostic Services 2007 and 2008 In the Gynaecology OPD, 10,780 cases were seen in 2007 and 13,501 cases in 2008 in general obstetrics and gynaecology, infertility, high risk pregnancy (HRP) and gynaecological malignancy. Research Research Projects Increased C-reactive protein levels in the polycystic ovary syndrome, a marker of cardiovascular disease - a prospective study O Project Code: MREC #269 Dates: Value: OR 300 Investigators: Dr. V. Gowri, Department of Obstetrics and Gynecology, SQU; Dr. Abdullah Al-Futaisi, Department of Medicine, SQU; Dr. Shabman Saquib, Department of Obstetrics and Gynecology, SQU; Dr. Kuntal Rao, Department of Obstetrics and Gynecology, SQU. 172 Research Publications and Books Journal Publications 1. Abiaka C, Machado L, Mathew M, Rao K. Erythrocyte indices, microminerals and ratios, antioxidants and lipids in Centrum Materna Diet supplemented Omani mothers. Biol Trace Element Res 2008; 124: Sawhney S, Machado M, Jain R. Prenatal MRI image of a fetus with semilobar holoprosencephaly. SQU Med J 2008; 8: Silja A, Gowri V. Torsion of a normal ovary in the third trimester of pregnancy: a case report. J Med Case Reports 2008: 2: Mathew M, Saquib S, Rizvi G. Polyhydramnios - Risk factors and outcome. Saudi Med J 2008; 29:

183 5. Anita K, Mathew M, Rizvi G. Use of Intravenous Sulprostone for the termination of Pregnancy with Fetal Death in second and early third trimester of pregnancy. SQU Med J 2008; 8: Mathew M. Untwisting and fixation of ovarian torsion in early pregnancy. J Arab Board Med Specializ 2008; 9:65-7. Dept. 15 Conference and Seminars Presentations Conference Posters International 1. Machado L, Sheik S. Changing trends of caesarean sections at a tertiary referral hospital in Oman. 5th International Obstetrics & Gynaecology Conference. SQU, Muscat, Oman, Dec Mathew M, Sheik S, Burney I, Al-Hamdani A, Shawney S, Rao K. Metastatic malignant melanoma during pregnancy - a case report. 5th International Obstetrics & Gynaecology Conference. SQU, Muscat, Oman, Dec O 3. Mohan AK, Mathew M, Rizvi SG. Use of Sulprostone in the termination of second trimester miscarriage and intrauterine fetal death- SQUH experience. 5th International Obstetrics & Gynaecology Conference. SQU, Muscat, Oman, Dec Local 1. Machado L, Shahila S. Methods of contraception. University Day. Sultan Qaboos University. Muscat, 2 May Mathew M, Silja AO, Moral E. Isolated torsion of tubal ectopic-a rare case. University Day. Sultan Qaboos University, Muscat, May Mathew M, Mohan AK. A rare case of recurrent cervical stenosis. University Day. Sultan Qaboos University, Muscat, May Mundhra S, Mathew M. Morbid obesity in pregnancy - A global problem. University Day. Sultan Qaboos University, Muscat, May a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Obtetrics and Gynaecology 173

184 O Opthalmology

185 Overview The Department of Ophthalmology is an academic and clinical Department, whose mission is to provide teaching, research and patient care at the highest and most competitive international level. The Department s policy is to provide access to excellent quality of patient care through helping acquire and enhance the competency of professionals and support staff, and procuring the latest technology, equipment and facilities. In contrast to non-academic facilities, we understand our role as a referral centre for the most complicated problems of Oman and the region. The Department is involved in training and educating medical students, who undergo block-wise individual bed-side teaching by the medical staff and each semester take part in an interdisciplinary case presentation. Continuing medical education programmes (internal and external), with invited academic authorities from all over the world, are carried out regularly for ophthalmologists, optometrists, nurses and ophthalmic technicians in Oman. Academic and clinical research is encouraged O and actively pursued by all staff in the Department. Keeping in mind national and international issues of preventable and curable blindness, glaucoma and diabetes clinical research programmes have been established together with the Department of Family Medicine and Community Health and the Ministry of Health. Staff Head of Department Nadiya Al-Kharusi, Senior Consultant Dept. 16 a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Ophthalmology Faculty Sana Al-Zuhaibi, Consultant Abdullah Al-Mujaini, Consultant Anuradha Ganesh, Consultant Caroline Montana, Registrar Upender Wali, Registrar Archana Thakral, Registrar 175

186 Nawal Al-Fadhi, Registrar Archana Thakral, Registrar Buthaina Saad Sabt, Registrar Agha Shahab Haider, Registrar Rana Al-Senawi, Senior House Officer Aisha Al-Busaidi, Senior House Officer Samia Al-Jabri, Senior House Officer Support Staff Janet Ogunjumo, Head Nurse Kuan Yok Leng, Assistant Head Nurse Habiba Al-Balushi, Chief Technician (Clinical) Bushra Al-Jabri, Optometrist, (Clinical) O Shreelata OK, Optometrist, (Clinical) Pascale Cooymans, Orthoptist (clinical Salim Al-Abri, Technician, (Clinical) Raya Al-Mughery, Technician (Clinical) Sadika Al-Ajmi, Technician (Clinical) Harith Al-Hosni, Technician (Clinical) Hanan Al-Harthi, Technician (Clinical) Emman Al-Hashmi, Technician, (Clinical) Eman Al-Harthy, Technician (Clinical) Cesaria Olivares, Coordinator (College) Melinda B. Manegdeg, Coordinator (Clinical) Saif Al-Hasani, Clerk 176 Highlights of the Year The year was challenging for the Department. In spite of a low staff situation in 2007, we were able to generate an increase in the OPD and in-patient output. In 2008, new staff members joined us: 2 senior registrars and 3 senior house officers to relieve the workload in the ward and

187 OPD. There was also an increased in research activity as well as in the number of publications from the Department. Dept. 16 The good standing of the Department s widely recognised and appreciated clinical teaching and services made it an awardee of the SQUH 2008 Best Quality Award from the Quality Management Department with the Department received the prestigious crystal trophy. In addition, on the occasion of the University Day in May 2008, one of the departmental posters exhibited, entitled Valsalva retinopathy in pregnancy, was awarded the Best Poster Award. New equipment was acquired in this year: the wireless indirect ophthalmoscope, OCT unit, handheld microscope, slit lamp camera, operating microscope and automated visual acuity charts that significantly contributed to the improvement in teaching and patient services. On the teaching side, continuing medical Oeducation was the preeminent activity of the Department with two national symposia. Six peer review sessions were conducted in the Department and a series of five optics and refraction lectures was delivered by the Head of Department. In general, the efficiency and quality of a department is measured by an increased output. Throughout , the Department maintained its high output in teaching, research and patient care. New subspecialties Cornea and external diseases and uveitis; medical retina and general ophthalmology; ocuplastics and general ophthalmology; paediatric ophthalmology and ophthalgenetics. Aside from these subspecialties, a further new sub specialty was added in vitreoretina surgery. a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Ophthalmology New services offered: A new diabetic screening clinic was established in

188 Teaching Programmes Undergraduate Preclinical Programme As in the previous years, the Department continued its teaching in the Integrated Learning Session (ILS) for the fifth year medical students by conducting a 3 day series of lectures on extra-ocular muscle evaluation and ophthalmoscopy. The Department also contributed in the endocrine Integrated Lecture series (ILS) with a topic on the diabetic eye for 5th year medical students. Undergraduate Clinical Programme (6th year Medical Students) The main objective of the course is to introduce students to ophthalmology as a branch of medicine and to provide them with a core of information, which will allow them to recognise, diagnose and O manage common diseases of the eye and the adnexa. Particularly, an awareness of the most frequent blinding diseases, and the partly preventable and curable maladies of the eye such as cataract, glaucoma, trachoma, diabetic retinopathy, trauma and congenital anomalies is created. As usual, the Department conducted a 4 week course in ophthalmology for the 6th year medical students. They spent two weeks in the University Hospital and two weeks at the Ministry of Health s Al-Nadha Hospital. They attended a two hour lectures on basic ophthalmology every morning for the first two weeks. In the spring semester of 2008, the students were exposed to the following 9 lectures under the new curriculum to cover the important topics in Ophthalmology: + Introductory lecture - anatomy and physiology + Red eye + Acute Visual Loss - primary narrow angle glaucoma (PNAG) + Chronic Visual Loss - primary open angle glaucoma (POAG) + Ocular Trauma + Uveitis and Neuroophthalmology 178

189 + Systemic Diseases of the Eye + Amblyopia and Strabismus + Optics & Refraction and Paediatric Ophthalmology A logbook of the patients seen is also maintained and a model case write-up was provided to enable the students to submit an appropriate case report for evaluation. After their 2 weeks rotation in MoH hospitals they returned to SQUH for an end of posting examination. Dept. 16 Postgraduate Programme From 2007 to 2008, the Department accepted 20 residents belonging to the Family Medicine & Public Health Department and three from the Accident & Emergency Department. They had a short term training course (3 months) to deal with basic ophthalmic emergencies and their management. They also attended 1-2 hours morning lectures with the undergraduate clinical students. O Elective The Department accommodated 1 elective student from Ain Shams University in September 2007 and one in November-December 2008 from another department. Clinical attachment Three ophthalmologists joined the department on a clinical attachment for a short period in They were Dr. Agha Shahab Haider, Dr. Dalal Abdulzahra, and Dr. Mohammed Hamdan. a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Ophthalmology Training Courses & CME Activities National CME In April 2007 the Department conducted a National CME on New Surgical Options for Keratoconous & Corneal Ectasia with a keynote speaker from Bordeaux, France. 179

190 Internal CMEs Internal continuing medical education programs are held two to three times a week to discuss difficult and interesting cases seen in the clinics or in current departmental research. Nearly 50 internal CMEs were conducted in the year 2007 to These CMEs were credited by the Training Services Directorate and therefore well attended by the Department doctors and technicians. Two SCRAPS were given by the Department: Finding a new pair of genes with the Department of Genetics and Fish or Meat: Tell Me What to Eat? with the Radiology Department. Clinical and Diagnostic Services Outpatient department (OPD) No. of patients booked O 8,223 No. of patients seen 8,195 No. of patients admitted 409 No. of patients DNA 1,971 No. of patients discharge 85 Minor OT procedures Minor operation 117 Blood Extraction 218 Sedation 174 Cannulation 178 Dilatation 3,788 Othe 331 Total 4,

191 Laser Argon 37 Yag 67 PDT 17 FFA 211 D.S 66 Orthoptic 267 Total 665 Technical Procedures Refraction 395 Ultrasound O 301 Pachymetry 328 Visual Field 422 OCT 112 Confoscan 42 Orbscan 82 Microperimetry 48 Photo 353 Total 2,083 Inpatient Statistics from January-October 2008 Month Patient Census Ward Referrals Eye Surgery January Adult: 42 Paed: February Adult: 32 Paed: March Adult: 29 Paed: April Adult: 25 Paed: May Adult: 43 Paed: Dept. 16 a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Ophthalmology 181

192 June Adult: 28 Paed: July Adult: 22 Paed: August Adult: 27 Paed: September Adult: 11 Paed: October Adult: 38 Paed: November Adult: 45 Paed: December Adult: 31 Paed: Main Theater Number of surgeries: Minor surgeries O Major surgeries Total no. of surgeries Research Research projects The Oman Fight for Sight project Project Code: Dates: Values: OR 5,000 Project Funder: Investigators: IG/MED/OPTH/07/01 Sultan Qaboos University Dr. Upender Wali, Department of Ophthalmology, SQU; Prof. Sandy Raeburn, Department of Genetics, SQU; Prof. Mohammed Hassan, Department of Physiology, SQU; Prof. Riad Bayoumi, Department of

193 Biochemistry, SQU. Importance of Central Corneal Thickness in Pediatric Aphakic and Pseudophakic Glaucoma Project code: IG/MED/OPTH/O9/11/MREC 283 Dates: Values: Investigators: Unfunded O Orbital involvement in Sickle Cell disease: A Clinicogenetic Study 2006 Project Code: MREC #242 Dates: Values: OR 1,000 Project Funder: Investigators: Dr. Sana Al-Zuhaibi, Department of Ophthalmology, SQU; Dr. Anuradha Ganesh, Department of Ophthalmology, SQU; Dr. Rana Senawi, Department of Ophthalmology, SQU; Dr. Syed Rizvi, Family Medicine & Public Health, SQU Sultan Qaboos University Dr. Sana Al-Zuhaibi, Department of Ophthalmology, SQU; Dr. Anuradha Ganesh, Department of Ophthalmology, SQU; Dr. Abdullah Al-Mujaini, Department of Ophthalmology, SQU; Dr..Yasser Wali, Family Medicine & Public Health, SQU; Dr. Salam Al-Kindi, Department of Haematology, SQU Dept. 16 a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Ophthalmology Research Publications and Books Journal Publications 1. Al-Mujaini A, Wali U, Ganesh A, Montana C. Natural course of central serous Choroidoretinopathy (CSCR) without subretinal exudates in normal pregnancy. Can J Ophthalmol 2008; 43:

194 2. Al-Mujaini A, Al-Senawi R, Ganesh A, Al-Dhuhli H, Al-Zuhaibi S. Intraorbital foreign body: clinical presentation, radiological appearance and management. SQU Medical Journal 2008; 8: Al-Mujaini A, Ganesh A, Cooymans P. Isolated, unilateral inferior rectus involvement in euthyroid orbitopathy. Oman Ophthalmol J 2008; 1: Al-Futaisi A, Abdwani R, Fathalla M, Al-Zakwani I, Javad H, Al-Zuhaibi S, Ganesh A, Koul RL. Idiopathic intracranial hypertension in Omani children. J Pediatr Neurology 2008; 6: Ganesh A, Al-Zuhaibi S, Pathare A, William R, Al-Senawi R, Al-Mujaini A,Hussain S, Wali Y, Al-Kindi S, Knox-Macaulay H. Orbital Infarction in Sickle Cell Disease. Am J Ophthalmol 26 July 2008 [Epub ahead of print] DOI: /j.ajo Ganesh A, Kumaramanickavel G. Progress in understanding mitochondrial disorders. Editorial. Middle East J Ophthalmol 2008; 15: Al-Senawi R, Ganesh A, Al-Busaidi A, Al-Futaisis A, Al-Habsi N, Al-Zuhaibi S. Visual Loss at presentation in children with Pseudotumor Cerebri. Oman Ophthalmol J 2008; 1: Madhavan J, Ganesh A, Roy J, Biswas J, OKumaramanickavel G. Retinoblastoma:Early Onset of the Disease Shows Association to Well-Differentiated Tumors. J Pediatr Ophthalmol Strabismus 2008; 45: Madhavan J, Ganesh A, Kumaramanickavel G. Retinoblastoma: From disease to discovery. Ophthalmic Res 2008; 40: (DOI: / ). 10. Bialasiewicz AA, Wali U, Shenoy R, Thakral A, Al-Fadhil N, Syed GR. Ipsilateral autorotational keratoplasty and cataract extraction in patients with trachoma and trauma in Oman : Report on visual rehabilitation. Ophthalmologe 2008 Jul 12. [Epub ahead of print]. German. 11. Al-Mujaini A. Gans M, Deschênes J. Cortical visual loss consequent to brain metastases from an endometrial carcinoma. Can J Ophthalmol 2008; 43: Al-Mujaini AS, Montana CC. Valsalva retinopathy in pregnancy: a case report. J Med Case Reports 2008; 2: Knox-McKaulay HHM, Ahmed MM, Gravell D, Al-Kindi S, Ganesh A. Sickle Cell-Haemoglobin E (HbSE) Compound Heterozygosity: A clinical and haematological study. Int J Lab Hematol 2007; 29: Conference Presentations Local 1. Sana Al-Zuhaibi. Retinopathy of Prematurity: Screening and Evaluation. International Workshop on Diabetic Retinopathy and Retinopathy of Prematurity. Sultan Qaboos University, Muscat, Oman, April Anuradha Ganesh. Retinopathy of Prematurity: Technology and Diagnosis the new frontier. International Workshop on Diabetic Retinopathy and Retinopathy of Prematurity. Sultan Qaboos University, Muscat, Oman 16-

195 17 April Al-Senawi, Al-Zuhaibi S, Ganesh A. Central Corneal Thickness and Intraocluar Pressure in Aphakic and Pseudophakic Children: The Sultan Qaboos University Hospital Experience. Al-Khareef International Ophthalmology Conference. Salalah, Oman, July Al-Mujaini Abdullah, Penetrating Orbital Foreign Body: What should we know? Al-Khareef International Ophthalmology Conference. Salalah, Oman, July Dept. 16 Conference & Seminar Presentations Conference Presentations Local 1. Al-Mujaini A. Valsalva Retinopathy in pregnancy. University Day. Sultan Qaboos University, Muscat, Oman, May Al-Kharousi N, Wali U. Photodynamic Therapy with Verteportfin for Choroidal hemorrhagic and non-hemorrhagic Neovascularization. University Day. Sultan Qaboos University, Muscat, Oman, May O 3. Al-Kharousi N, Wali U. Photodynamic therapy with Vertporfin in chronic Central Serous Choroidoretinopathy and Idiopatic Choroidal Neovascularization. University Day. Sultan Qaboos University, Muscat, Oman, May Al-Zuhaibi S, Al-Futaisi A, Ganesh A. Systemic manifestations of Incontinentia Pigmenti (IP). University Day. Sultan Qaboos Univesity, Muscat Oman, May Wali U, Al-Mujaini A. Pleomorphism and Polymegatism of Corneal Endothelial Cells in Ocular Pseudoexfoliation Syndrome. University Day. Sultan Qaboos University, Muscat Oman, May a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Ophthalmology 185

196 O Oral Health

197 Overview The Oral Health Department provides dental, oral and maxillofacial services for University students, staff and their relatives, hospital inpatients and referred outpatients. It also acts as a tertiary centre of referral for oral and maxillofacial treatment. The Department continues to provide dental services including basic primary dental care, oral hygiene therapy, restorative, endodontic and oral and maxillofacial surgery treatments. Dept. 17 Staff Head of Department Salim Al-Sudairy, Consultant Oral & Maxillofacial Surgeon O Deputy Head of Department Abdulaziz Bakathir, Consultant Oral & Maxillofacial Surgeon Other Staff Amur Al-Hajri, Consultant Sameera Al-Anqoodi, Registrar in Restorative Dentistry Awatif Al-Maskery, Registrar Hana Al-Raisi, Senior House Officer Rasha Hadi Ahmed, Senior House Officer Madelin Lima Hernandaz, Senior House Officer Nasriya Al-Harthy, Dental Hygienist/ Therapist Myrna Al-Wahaibi, Incharge Nurse Judy Mathew, Senior Nurse Lorena Mendoza, Senior Nurse Khamis Al-Mufarji, Dental Surgery Assistant Afrah Abdulbqi, Dental Surgery Assistant Sulaiman Al-Maqimi, Dental Surgery Assistant a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Oral Health 187

198 Support Staff Fatma Al-Siyabi, CSSD Technician Khamis Al-Jabri, Receptionist Thani Al-Salhi, Medical Orderly Rotating Radiographer Highlights of the Year The Department maintained a high standard of dental care to patients and continued to improve and expand its services. One of our main achievements in was the expansion of the oral and maxillofacial surgery service provided to our patients to include the management of facial bone fractures and the comprehensive management of patients with congenital and acquired bleeding O disorders. In addition, the Department provided continuous support to the expanding and specialised medical and surgical units of the University Hopsital and continued to play an important role in the holistic multidisciplinary care of patients at SQUH. The Department clinical staff members were actively involved in local scientific events and dental conferences conducted by the Oman Dental Society. Dr. Abdulaziz Bakathir has held the position of Deputy Chairman of the Oman Dental Society since November Clinical staff participated in many clinical conferences and workshops conducted in Oman, the United Arab Emirates and India. Dr. Abdulaziz Bakathir presented papers in regional and international dental conferences in the Kingdom of Bahrain and Turkey. Dr. Abdulaziz Bakathir continued to be an active member in the established network of dental research activities between SQUH, the Ministry of Health and the Dental, Oral & Maxillofacial Department of Al-Nahda Hospital. This network has resulted in the completion of one retrospective study on bone plate removal in patients with facial bone trauma in Oman. The result of this study was published in a peer-reviewed international scientific journal in May Some other projects are being conducted in collaboration with the Ministry of Health. 188

199 Teaching Programmes The Oral Health Department continues to provide teaching support to the medical students at the University College of Medicine and the Institute of Health Sciences of the Ministry of Health as follows: + Regular teaching seminars during the oral health totation - 5th year MD students. + Examination of oral cavity in clinical skills laboratory teaching - 4th year MD students. + Daily teaching to the Dental Surgical Assistance (DSA) students on room preparation and aseptic technique for surgical patients and infection control. + Teaching of DSA students at the Institute of Health Sciences, Ministry of Health. O Clinical and Diagnostic Services The Oral Health Department provides dental consultations and routine primary dental treatment as well as comprehensive oral and maxillofacial treatment. The Department has shown an increase in the number of patients attending the Outpatients Department in 2007 and 2008 by 4.8% and 7.8%, respectively (Figure 1). The Department is actively involved in a 24 hour on-call service in collaboration with the Accident & Emergency Department of SQUH. The Department is also an active 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 haematological malignancies, sickle cell anaemias and bleeding disorders. The dental service is provided at the outpatient clinical setting in the Department or in the operating theatre for inpatients or day care visitors. Dept. 17 a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Oral Health Research The following research topics were investigated by Dr. Abdulaziz Bakathir and Dr. Salim Al- Sudairy: 189

200 12000 Patients Figure 1: Total number of patients seen at the Oral Health Department Outpatient Department Year O 1. Maxillofacial trauma in Oman - A retrospective study ( ). 2. Attitude of general dental surgeon in Oman towards care of patients with thalassaemia. 3. Dental management of patients with bleeding disorders - A 10 years experience at Sultan Qaboos University Hospital. 4. Minor oral surgery in patients taking warfarin: A 5-year experience at Sultan Qaboos University Hospital. 5. Dental management of sickle cell anaemic patients: Experience at Sultan Qaboos University Hospital. 5. The effect of locally applied metronidazole gel in the incidence of alveolar osteitis after third molar surgery. 6. Factors that influence the auto-transplantations of mandibular lower third molar to replace first and second molars. 190 Research Publications and Books Journal Publications 1. Bakathir AA, Margasahayam MV, Al-Ismaily MI. Removal of bone plates in patients with maxillofacial trauma

201 - A retrospective study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008; 105:e32-e Bakathir AA, Margasahayam MV, Al-Ismaily MI. Maxillary hyperplasia and hyperostosis cranialis: A rare manifestation of renal osteodystrophy in a patient with hyperparathyroidism secondary to chronic renal failure. Saudi Med J 2008; 29: Conference & Seminar Presentations Conference Presentations International 1. Bakathir AA. Dental management of patients with Sickle Cell Disease. 4th Gulf Scientific Dental Conference. Bahrain, 28 Nov Bakathir AA. Removal of Bone Plates in Omani Patients with Maxillofacial Trauma: A Retrospective Study. 2nd International Congress on Oral & Maxillofacial Surgery of the Turkish Society of Oral & Maxillofacial Surgery. Antalya, Turkey, 17 May O Local 1. Bakathir AA. Dental management of patients with bleeding disorders. 10th Oman Dental Society Scientific Symposium: Haematological Disorders and Dentistry. Muscat, Oman, 11 September Al-Sudairy S. Complications of dentoalveolar surgery. 1st Oman Dental Society Scientific Day. Muscat, Oman, 3 Jan Bakathir AA. How safe is Oral Surgery in patients taking anti-platelets and anti-coagulants therapy? 1st Oman Dental Society Scientific Day. Muscat, Oman, 3 Jan Bakathir AA. Dental care of patients with Thalassaemias. 15th Oman Dental Conference. Muscat, Oman, Dec Ali Al-Mullahi. Dental management of childhood cancer. 15th Oman Dental Conference. Muscat, Oman, Dec Dept. 17 a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Oral Health Poster Presentations Local 1. Bakathir AA, Al-Hamdani AS. Extra-medullary relapse of acute lymphoblastic leukaemia in the jaw. 15th Oman Dental Conference. Muscat, Oman, Dec

202 P Pathology

203 Overview The Department of Pathology takes part in the BSc Health Sciences, MD, and the BSc MLS teaching and training programmes. It also participates in the Oman Medical Specialty Board (OMSB) postgraduate medical training programmes in pathology and other medical specialties. Dept. 18 In addition to its academic activities, the Department offers specialised diagnostic histopathology, cytology, immuno pathology, enzyme-histochemistry and electron microscopy services for SQU Hospital. It also functions as a referral centre for the Ministry of Health, the Armed Forces Hospital and other hospitals in the Sultanate. Also, the Department runs a central diagnostic and research facility (electron microscopy) for SQU, SQUH and the local community and is involved in many academic and postgraduate research projects. The Department is registered and subscribes to international external quality assurance programmes P in cytopathology, immunohisto-chemistry, renal pathology and anatomical pathology including a technical module. The postgraduate training programme is approved for Part I (FRCPath) of the Fellowship of the Royal College of Pathologists examination. Staff Head of Department Anand Date, Professor Faculty Aisha Al-Hamdani, Consultant, Deputy HoD, Clinical Affairs Anna Saparamadu, Consultant Dilani Lokuhetty, Consultant Dhuha Alwan, Senior House Officer Maiya Al-Bahri, Senior House Officer Radiya Al-Ajmi, Senior House Officr Asmaa Al-Shihi, Senior House Officer a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Pathology 193

204 Support Staff Emmanuel Odor, Superintendent Joseph Ogunfiditimi, Chief Biomedical Scientist Issa Al-Amri, Senior Biomedical Scientist, EM Unit Ishmael Nwabuebo, Chief Biomedical Scientist Kamla Al-Mawali, Senior Biomedical Scientist, Immunohistochemistry Usha Rani Bai, Senior Biomedical Scientist, Cytopathology Ahmed Al-Hinai, Mortician Coordinators Edna B Ranada Nadeera K Ammu P Teaching Programmes PRE-CLINICAL Program Semester 7 and summer courses, including general pathology with some applied content. CLINICAL Program Clinical Courses Course Title ILS Cardiovascular System 5 ILS Nervous System 5 ILS Respiratory System 5 ILS Endocrinology 5 ILS G.I.T. System 5 ILS Urinary system 5 Rotation and Laboratory 7 Year 194

205 BSc Medical Laboratory Sciences (MLS) courses Course Title Semester Applied MDLS (Lab Rotation) 7 Cellular Pathology 1 8 Cellular Pathology II 9 Biology of Cancer 9 Advanced Instrumentation in Cellular pathology 9 Project 10 POSTGRADUATE TEACHING The Pathology Department is a training centre Pfor OMSB and approved for Part I of the Fellowship examination (FRCPath) of the Royal College of Pathologists. There are up to 2 residents posted at a time for general pathology training. The Department also offer an elective rotation (4 weeks) for dermatology and obstetrics and gynaecology residents doing dermatopathology and gynaecology pathology. In addition to OMSB residents, there are 3 senior house officers employed by Sultan Qaboos University Hospital (SQUH) rotating between surgical pathology and cytopathology and acquiring basic training before they travel abroad for higher studies. The training programme in pathology for postgraduate residents is 5 years long. At present there are six OMSB trainees who are on rotation between the Royal Hospital, Khoula Hospital, the Armed Forces Hospital and SQUH. Dept. 18 a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Pathology Training Courses & CME Activities Clinico-pathological conferences/seminars are held once a month or more frequently as requested. Under CME activities, consultant pathologists participated in 13 presentations in the fields of: paediatrics, surgery, haematology, obstetrics and gynaecology, including 6 meetings on an interhospital basis in diagnostic pathology and renal pathology. A total of 8 SCRAPS CME presentations also had inputs from a consultant pathologist, 195

206 The Department of Pathology offers clinical attachments for laboratory medicine. The technical staff undertook the training of other staff in various disciplines. We trained 3 Omani students studying medical laboratory techniques from various hospitals and schools. In , the Department had one Sudanese student for hands-on training. Clinical and Diagnostic Services The Department maintains a high level of diagnostic services in different subspecialties. 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 the Sultanate. The diagnostic services offered include: P + Diagnostic histopathology service + Diagnostic cytopathology + Diagnostic immunocytochemistry + Diagnostic enzymehistochemistry + Diagnostic electron microscopy The number of requests and tests handled in the Department in 2008 (Figures 1 and 2) show an overall increase of 23% over 2007 figures. In the histopathology/immunocytochemistry and enzymehistochemistry division, there was an increase of 26% over 2007 figures. In the cytopathology division, there was an increase of 1.6% over the 2007 figures. In the Electron Microscopy unit, there was an increase of 33.4% over the 2007 figures. 196 The diagnostic activities of the Department are evaluated not only by departmental internal quality assurance programmes, but it is also registered and subscribes to international external quality assurance programmes.

207 Table 1: Department of Pathology, Number of Requests and Tests, 2007 & 2008 Requests & Tests SQUH Requests 5,323 6,871 SQUH Tests 24,998 33,341 Other Hospital Requests Other Hospital Tests 4,184 4,565 Grand Total Requests 5,936 7,563 Grand Total Tests 29,182 37,906 Conference and Seminar Presentations P CONFERENCE PRESENTATIONS International 1. Al-Hamdani A. Normal anatomy, cytology and histopathology of the cervix; Cytology and histopathology of cervical intraepithelial lesion. 5th International Obstetrics and Gynaecology Conference. SQU, Muscat, Oman, December 2007 POSTER PRESENTATIONS Local 1. Rani Bai U, Al-Adawi K. FNAC as a tool in clinical investigations. University Day. SQU, Muscat, Oman, May 2008 Dept. 18 a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Pathology Seminar Presentations International 1. Saparamadu A. Surgical Pathology case discussion. Annual Academic Session of the College of Pathologists. Sri Lanka, August

208 P Pharmacology and Clinical Pharmacy

209 Overview The Department of Pharmacology & Clinical Pharmacy plays an active teaching role in both the College s BSc and MD degrees. The Department offers a Masters Degree course in Clinical Pharmacy, and contributes to the teaching of the Masters courses in Biomedical Sciences. The Department coordinates the Research Method and Critical Analysis of Scientific Information course. Research activities embrace different areas of experimental and clinical pharmacology and therapeutics. The Department takes part in the Therapeutic Drug Monitoring Services at SQUH. Staff Head Musbah Tanira, Professor Faculty Badreldin Ali, Professor Aly Abdelrahman, Associate Professor Ragini Vaishnav, Assistant Professor Mohammed Al-Za abi, Assistant Professor Ibrahim Al-Zakwani, Assistant Professor Khalid Al-Balushi, Assistant Professor Yousuf Al-Suleimani, Lecturer Hamoud Al-Salmy, Associate Researcher Ikhlas Ali Ahmed, Associate Researcher P Dept. 19 a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Pharmacology and Clinical Pharmacy Support Staff Mercy Calma, Coordinator 199

210 Highlights of the Year The Department continued to teach in the pre-clinical BSc (HS) programme as well as in the MD programme. The Department recommenced offering the Masters in Clinical Pharmacy; three students were registered in Spring 2008 and four students in Fall In year 2008, Dr. Aly Abdelrahman was promoted to Associate Professor. Dr. Mohammed Al-Za abi was transferred from SQUH to the Department as an Assistant Professor. With this promotion, he officially became the Coordinator of the MSc Clinical Pharmacy. Dr. Ibrahim Al-Zakwani, Head of Pharmacy Department SQUH, was appointed as an Assistant Professor to the Department. Dr. Khalid Al-Balushi returned from his study leave on October 2008 after completing his PhD at the University of Nottingham, UK and Mr. Yousuf Al-Suleimani went to study for his PhD in University of Cambridge, UK. P In pre-clinical BSc (HS) programme, the Department contributed to the teaching of ten system- and non-system-based courses in the pre-clinical program of medical students. At pre-clinical 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. In addition, the General Pharmacology course introduced students to basic pharmacological concepts. In the year 2007, the Department offered a University elective course taught in Arabic. In clinical programme, the Department delivered a full course (Therapeutics Course) to 6th year medical students, contributed to the Integrated Lecture Series, interdisciplinary activities, clinical rotations in different clinical specialties and postgraduate programmes of the Oman Medical Specialty Board and the Masters Degree in Biomedical Sciences. 200 Research activities embraced different areas of experimental and clinical pharmacology and therapeutics. The areas under investigation encompass: study of genotyping of drug metabolising enzymes in Omanis with emphasis on cancer patients; toxicity and composition of Omani traditional remedies and plants; cyclooxygenase-2 inhibitors and cardiovascular function; the effect of superoxide dismutase (SOD) mimetic drug (M40403) on experimental cisplatin nephrotoxicity in rats; the effects of the administration of betaine and some biochemical, histological and physiological parameters in normal and hypertensive rats; the elucidation of cardiovascular and behavioural effects

211 of the medicinal plant (Rhazya stricta) Harmal; a study of use/misuse of antibiotics; a study of attitudes, perceptions, knowledge and use of sheesha (water pipe smoking). Dept. 19 The Department acquired new equipment: a freeze dryer to be used in our new research project. The research output for consisted of 13 national and international presentations and 13 contributions in peer-reviewed journals. Support staff were involved in some of these activities and featured as first author and co-authors. The Department also contributed to the world of medical science through its review and editorial activities in various medical journals. Staff members were involved in different research activities and participated in national and international conferences. The Department serves in several committees in the College, SQUH and University. P Teaching Programmes PRE-CLINICAL Programme The Department contributes to undergraduate teaching of the BSc (Health Sciences), MD and BSc (Medical Laboratory Sciences) degrees. The Department offers several courses in the BSc (Health Sciences) programme and contributes to all system-based courses (see Table 1). The pharmacology contribution during these courses is designed to teach the students basic concepts about the mechanism of action, pharmacological effects and interactions of drugs and to apply this knowledge through case studies. General Pharmacology and Pharmacology are fully delivered by the Department. A summer course was provided for the pharmacology course (PHAR 3110). The course is composed of lectures and case-based discussion, where the students are presenting as a preparation for their clinical years. The General Pharmacology course is offered in both semesters. a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Pharmacology and Clinical Pharmacy The Department continues to contribute to the Nursing Programme. Basic Pharmacology & Dosage Calculations and Pharmacology for Nurses are both delivered in Fall and Spring semesters. The Department also delivers the University elective course, Nutrients, Medicines and Narcot- 201

212 ics, during the spring semester. Table 1: Preclinical courses BSc Health Sciences Course Title Semester Alimentary System 5 General Pharmacology 4/5 Respiratory System 6 Cardiovascular System 6 Urinary System 6 Haematopoietic, Lymphoid & Vascular System 6 Human Nervous System 7 Endocrine & Reproductive System P8 Pharmacology 8 B.Sc. MLS Course Title Semester Biology of Disease 9 Diagnostic Toxicology and Therapeutic Drug 9 Monitoring College of Nursing Semester Basic Pharmacology & Dosage Calculations Fall & Spring Pharmacology for Nurses Fall & Spring Elective Course Semester Nutrients, Medicines & Narcotics Spring 202 CLINICAL PRoGRAMME The Department was involved in teaching in the clinical programme (Table 2). Pharmacology contributed to the Integrated Lecture Series (ILS) and to clinical rotations. The Department, solely, coordinates the Therapeutics Course which is provided to the 6th year medical students. Most of this teaching was based on the concept of case-based learning. The Department also contributed to

213 the Interdisciplinary Activities of 5th and 6th year medical students. Dept. 19 Table 2: Clinical courses Course Title ILS Gastroenterology 5 ILS Endocrinology 5 ILS Nephrology 5 Rotation Obstetrics & Gynaecology 7 Therapeutics Course 6 IDA Medical Ethics 6 IDA Gerontology 5 P POSTGRADUATE PRoGRAMME Year Masters Programme in Biomedical Sciences The Department plays an active role in the teaching in the Master s in Biomedical Sciences. The Department 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 + Pharmacotherapeutics I + Pharmacotherapeutics II The Department was given the responsibility of coordinating the Master s Degree core course, Research Method and Critical Analysis for Scientific Information. The Masters student numbers continuously increased and the course had to be offered in both semesters. a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Pharmacology and Clinical Pharmacy The Department is involved in the Core Programme of the Oman Medical Specialty Board. 203

214 Clinical & Diagnosatic Services The Department takes part in the Therapeutic Drug Monitoring Services at SQUH. Research Research Projects The effect of betaine on some biochemical, histological and physiological parameters in normal and spontaneously-hypertensive rats. Project Code: Dates: Value: OR 26,000 Project Funder: Investigators: IG/MED/PHAR/07/01 P Sultan Qaboos University Prof. Badreldin Ali, Department of Pharmacology & Clinical Pharmacy, SQU; Prof. Musbah Tanira, Department of Pharmacology & Clinical Pharmacy, SQU; Dr. Sulayma Al-Barwani, Department of Physiology, SQU; Dr. Aly Abdelrahman, Department of Pharmacology & Clinical Pharmacy, SQU; Dr. Ibrahim Inuwa, Department of Human & Clinical Anatomy, SQU. 204 COX-2 inhibitors and cardiovascular function Project Code: IG/MED/PHAR/05/01 Dates: Value: OR 21,000 Project Funder: Sultan Qaboos University Investigators: Dr. Aly Abdelrahman, Department of Pharmacology & Clinical Phar-

215 macy, SQU; Yousuf Al-Suleimani, Department of Pharmacology & Clinical Pharmacy, SQU Dept. 19 Research Publications and Books Journal Publications 1. Abdelrahman AM. Effect of chronic administration of cyclooxygenase-2 inhibitors on the cardiovascular system in L-NAME induced hypertensive rats. Sci J Al-Azhar Med Fac 2008; 29: Abdelrahman AM, Suleimani YM. Four-week administration of nimesulide, a cyclooxygenase-2 inhibitor, improves endothelial dysfunction in the hindlimb vasculature of streptozotocin-induced diabetic rats. Arch Pharm Res 2008; 31: Abdelrahman AM, Pang CCY. Vasodilator mechanism of intermedin/adrenomedulin-2 in anesthetized rats. Proc West Pharmacol Soc 2007; 50: Al-Barwani S, Al-Siyabi S, Ba-Omar H, Tanira PMO. Circadian heart rate variability is abolished by chronic administration of lisinopril in spontaneously hypertensive rats. FASEB J 2008; 22:1b Ali BH, Al-Moundhri M, Tageldin M, Al-Husseini IS, Mansour MA, Nemmar A, Tanira MO. Ontogenic aspects of cisplatin-induced nephrotoxicity in rats. Food Chem Toxicol 2008; 46: Ali BH, Al-Moundhri M, Eldin MT, Nemmar A, Al-Siyabi S, Annamalai K. Amelioration of cisplatin-induced nephrotoxicity in rats by tetramethylpyrazine, a major constituent of the Chinese herb Ligusticum wallichi. Exp Biol Med 2008; 233: Nemmar A, Melghit K, Ali BH. The acute proinflammatory and prothrombotic effects of pulmonary exposure to rutile TiO2 nanorods in rats. Exp Biol Med 2008; 233: Ali BH, Blunden G, Tanira MO, Nemmar A. Some phytochemical, pharmacological and toxicological properties of ginger (Zingiber officinale Roscoe): A review of recent research. Food Chem Toxicol 2008; 46: Hardy A, Vaishnav R. Bismuth Usage down the decades. Pharm Hist 2008; 38: Hardy AD, Farrant AJ, Rollinson G, Barss P, Vaishnav R. A study of the chemical composition of traditional eye cosmetics ( kohls ) used in Qatar and Yemen. J Cosmet Sci 2008; 59: Tanira MO, Dib R, Bann NR. The antimicrobial activity of Rhizopogon rubescen. FASEB J 2008; 22:1b Vaishnav R, Al-Aghbari T, Al-Masoudi T, Al-Jabri M. Re: Prevalence and determinants of sheesha tobacco abuse among adolescents in Oman. SQU Med J 2008; 8: Vaishnav R, Al-Naeem W, Al-Omrani F. Evaluation of antibiotic prescribing in upper respiratory tract infections. Fundam Clin Pharmacol 2008; 22:37. a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Pharmacology and Clinical Pharmacy 205

216 Conference and Seminar Presentations Conference Presentations International 1. Vaishnav R, Al-Naeem W, Al-Omairi F. Evaluation of antibiotic prescribing in upper respiratory tract infections. EPHAR 2008, Federation of European Pharmacological Societies. Manchester, UK, Conference Posters International 1. Tanira MO, Dib R, Banna NR. The antimicrobial activity of Rhizopogon rubescens. The Experimental Biology Meeting. San Diego, USA, 4-6 April Albarwani S, S Al-Siyabi, H Ba-Omar, MO Tanira. Circadian heart rate variability is abolished by chronic administration of lisinopril in spontaneously hypertensive rats. The Experimental Biology Meeting. San Diego, USA, 4-6 April Ali BH, Al-Moundhri M, Tag El Din M. Influence Pof age on cisplatin nephrotoxicity in rats in relation to their oxidant status. The IXth World Conference on Clinical Pharmacology and Therapeutics (CPT 2008). Quebec City, Canada, 27 July - 1 August Al-Balushi K, Tanira M, Al-Rawas O, Sayers I, Wheatley A, Hall I. Comparative sequence analysis of ADRB2 in asthma subjects from Oman and the UK. European Respiratory Society Meeting. Stockholm, Sweden, September Al-Suleimani YM, Abdelrahman AM. Effect of chronic administration of cyclooxygenase-2 inhibitors on the cardiovascular system in SHR. Australian Society of Clinical & Experimental Pharmacologists & Toxicologists ASCEPT Meeting. Adelaide, Australia, 3-6 December Abdelrahman AM, Al-Suleimani YM. Chronic administration of cyclooxygenase-2 inhibitors improves endothelial function in streptozotocin induced diabetic rats. British Society of Pharmacology Winter Meeting. Brighton, UK, December Vaishnav R, Al-Barwani S, Inuwa I. Learning and assessment in an integrated system-based course-raising the bar. The 13th Ottawa International Conference on Clinical Competence. Melbourne, Australia, 5-8 March Al-Omrani F, Vaishnav R. Evaluation of antibiotic utilization and prescribing in primary care at Sultan Qaboos University Hospital. 5th Scientific Conference for Medical Students in the GCC. Bahrain, Al-Jabri M, Al-Masoudi T, Al-Aghbari T, Vaishnav R. Prevalence of Sheesha smoking in Oman. 5th Scientific Conference for Medical Students in the GCC. Bahrain, Vaishnav R. Comprehensive faculty development programmes- empowered faculty members excel in creating vibrant pharmacology education. National Conference on Medical Education. New Delhi, India

217 Seminar Presentations Local 1. Ali BH. Is Coffee a Functional Food? College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman, 11 September Dept Al-Za abi M. Population Pharmacokinetics of Indomethacin in Premature Neonates with Patent Ductus Arteriosus. College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman, 20 April P a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Pharmacology and Clinical Pharmacy 207

218 P Pharmacy

219 Overview The Pharmacy Department at SQU Hospital continues to be the centre of excellence within the country in providing general and specialised pharmaceutical services, and promoting 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 appropriate 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 (MI) and the Pharmacy Sub-Store. P The Department is recognised nationally and regionally as a training centre that supports a range of quality programmes. It is responsible for teaching health care providers and students from the colleges of Medicine and Pharmacy and for the provision of in-service training for the pharmacy staff. It also provides individualised work experience placements for graduate pharmacy personnel. The Department has also carried out a number of research projects with the aim of further improving its services and the effectiveness of certain drug therapies. Staff Head of Department Dr. Ibrahim Al-Zakwani, Assistant Professor Dept. 20 a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Pharmacy Deputy Head & Training Coordinator Amna Al-Hashar, Clinical Pharmacist Assistant Head Aqeela Taqi, Clinical Pharmacist 209

220 Clinical Pharmacy Services Badriya Al-Zadjali, Clinical Pharmacist Ahmed Abusham, Clinical Pharmacist Asmahan Al-Barram, Pharmacist Maryam Al-Kindi, Pharmacist Samia Al-Ajmi, Pharmacist Outpatient Dispensing Issa Al-Rashdi, Pharmacist Nirmeen Basanty, Pharmacist Janardhanan Neelkantan Nair, Senior Pharmacist Saud Al-Shabibi, Pharmacist Medicine Information Services Intisar Al-Busaidi, Senior Pharmacist Nibu Nair, Pharmacist FAMCO, A&E Pharmacy Nagwa Mohammed, Pharmacist Kamla Al-Rahbi, Assistant pharmacist Manufacturing Felicidad Dizon, Pharmacist Ali Al-Jabri, Assistant Pharmacist P Pharmacy Sub-Store Khalid Al-Zadjali, Pharmacist Pharmacy Computer System Management Bruno Louis, Senior Pharmacist 210 Technical Services Ahmed Al-Mahruqi, Pharmacist

221 Coordinators Mahfoudh Al-Rawahi Faiza Al-Zadjali Dept. 20 Highlights of the Year WAITING TIME AND CUSTOMER SATISFACTION The patients average waiting time in the main pharmacy has significantly decreased from approximately 1 hour during 2006 to only 14 minutes in 2007 and 13 minutes in As a result, there was a marked decrease in the number of customer complaints and an improvement in patients satisfaction rate. A study was conducted in 2006, just prior to the implementation of the new computer system, looking into patients satisfaction rate towards outpatient pharmacy services. It P showed a satisfaction rate of 73%.The same study was conducted in 2008 and showed a significant improvement of satisfaction rate to 86%. REPORTING OF ADVERSE DRUG REACTIONS (ADR) The rate of ADR reporting has significantly improved from 50 and 96 reports in 2006 and 2007 respectively to 270 reports in This improvement was a result of efforts made by Medicine Information (MI) pharmacists to raise the awareness of health care providers through seminars, competitions and issuing the ADR newsletter. DECREASE IN THE NUMBER OF EXPIRED MEDICATIONS In 2007, there was a significant reduction in the expired pharmaceuticals and medical supplies which was acknowledged and appreciated by the hospital administration. a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Pharmacy THE SECOND CERTIFICATE COURSE IN MEDICINE INFORMATION (MI) SKILLS AND A ONE-DAY COURSE IN ADVERSE DRUG REAC- TIONS MAY 2008 The course was organised by the Department in coordination with the SQUH Training Direc- 211

222 torate. The course consisted of 3 levels (basic, intermediate and advanced) to allow for the different MI skill levels of the pharmacists. A one-day course in ADR was also organised for pharmacists, doctors and nurses. Both courses were conducted by Mr. David Woods, medicine information pharmacist from New Zealand and attended by about 100 pharmacists, assistant pharmacists, doctors and nurses from SQU as well as from other health institutions in Oman. COUNSELLING WORKSHOPS FOR PHARMACY STAFF These weekly workshops were organised by the MI and outpatient sections and conducted by Pharmacy staff. Their aim is to improve staff knowledge on counselling issues related to new therapies, devices and administration modes. They began in early 2007 and have been a continuing process. DEVELOPMENT OF FOOD AND DRUG ADMINISTRATION GUIDE- P LINES FOR HEALTH CARE PORVIDERS They were developed to improve patients knowledge and minimise food and drug interactions and will be published in a booklet format. DOCUMENTATION OF INTERVENTIONS DONE BY CLINICAL AND OUTPATIENT PHARMACISTS Documentation of intervention is an important activity that determines the value of the pharmacist review services in general as well as assisting in detecting areas that require implementation of change or enforcement of policies. There was a total of 1,082 documented reports filed in only the first 8 months of 2008 from both clinical and outpatient pharmacists. 212 DOCUMENTATION OF NON-AVAILABILITY OF CRITICAL ITEMS Continuous efforts are made to ensure the availability of critical items at all times. A study to document periods of unavailability of such items was conducted in 2008 and showed that 13 of 35 critical items were made available within less than 3 weeks and 14 of 35 critical items were made available within a period ranging from one month to less than 3 months. There is going to be a continuing monitoring process in the Pharmacy Substore.

223 Teaching Programmes Training has been provided for students from Dubai Pharmacy College, Oman Medical College, Oman Assistant Pharmacist Institute and Higher College of Technology and others. Dept. 20 In the Clinical Programme, the Pharmacy ran a seminar on prescription writing for twenty 5th year students; one on asthma inhaler devices for twenty 7th year students and a workshop on therapeutic drug monitoring for ten MSc Biochemistry students. Practice and internship programmes were provided for 24 students on Assistant, Undergraduate, Postgraduate Pharmacist Programmes and two courses were run for 25 nurses and 20 CSSD technicians as well as a lecture given on pain management. Clinical & Diagnostic PServices OUTPATIENT Dispensing of prescriptions to ambulatory patients is the major activity of this section. This service is offered at three different locations: the main hospital pharmacy, the FAMCO clinic and the A&E pharmacy (which offers a 24 hrs service). At the main hospital pharmacy, 2 rooms are dedicated for counselling patients. As the graph below shows, there was an increase in the number of prescriptions from 2007 to In 2008, the number of prescriptions was 17% more than in 2007 with an increase in the number of items dispensed of about 16%. a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Pharmacy IN-PATIENT CLINICAL PHARMACY Clinical pharmacy is a service provided by qualified clinical pharmacists to promote rational drug therapy that is safe, appropriate, and cost effective for all in-patients. Clinical pharmacists work in teams with other health care providers such as clinicians, nurses and others to achieve this goal. Clinical pharmacists perform a number of clinical activities and interventions in their day-to-day work. Therefore, documentation of interventions has been implemented in order to measure the 213

224 Prescriptions Items , , ,967 Frequency , , , P Figure 1: Total number of prescriptions & items dispensed in the years clinical and cost significance of the service. In the first 6 months of 2008, a total of 504 interventions were documented. On average, each intervention took 15 minutes, ranging from 1 minute to 3 hours. Figures 2 shows some of the results. MANUFACTURING (ASEPTIC PREPARATIONS) This section is responsible for the preparation of total parenteral nutrition (TPN), chemotherapy preparations and some sterile and non sterile products. The number of TPN bags prepared in 2008 was 26% higher than in 2007 (2059 in 2008 compared to 1634 in 2007). There was also a 28% increase in the number of prepared cytotoxic doses from 5,413 in 2007 to 6,930 doses in However, the number of compounding in 2008 was 15% lower than 2007 (391 items in 2008 and 331 items in 2007). The repacking of items also showed a reduction of about 16% in 2008 compared to 2007 (225 items in 2007 and 260 items in 2008). 214

225 Percent Efficiacy improved Efficiacy reduced Toxicity avoided Toxicity risk increased Avoid unnecessary exposure P Table 1: Summary of MI documented activities from MEDICINE INFORMATION SERVICES Medicine Information Services (MIS) provides unbiased evidence-based and critically evaluated information about medicines, poisons and diseases in an attempt to improve patient care. A summary of the documented number of inquiries, adverse drug reaction (ADR) reports and poisoning reports dealt with since 2006 are summarised in the following table: Number of Years Inquiries ADR Reports Poisoning Reports Figure 2: Clinical significance of the interventions (%) Unknown Dept. 20 a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Pharmacy PHARMACY SUB-STORE The Pharmacy Sub-store is the link between the hospital main stores and the Pharmacy De- 215

226 partment. 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 quantities of items to be purchased. A study was conducted in 2007 on the non-availability of some critical items. There was a higher number of items not available in the pharmacy for more than 30 days, but they were made available in less than 3 months. The Pharmacy Sub-store aims at ensuring the availability of critical items as soon as possible in co-operation with the Main Store and the Procurement Department. Another activity of the Sub-store is supplying medicines on requisitions for different clinics and units in the Hospital. There was a 3% increase in number of requisitions to 1,833 and a 23% increase in the number of items in 2008 (25,748) compared to P + Analysis of Clinical Pharmacists Interventions in a University Teaching Hospital in Oman Research In 2007/2008, Department staff carried out research on the following topics: + Discharge Medications Review by Pharmacists: Improving Patients Safety + Analysis of Outpatient Pharmacists Interventions in a University Teaching Hospital in Oman + Patients Waiting Time in Outpatient Pharmacy in Sultan Qaboos University Hospital + Satisfaction Survey of Patients visiting Sultan Qaboos University Hospital Pharmacy 216 Research Publications and Books Journal Publications 1. Al-Mandhari AS, Al-Shafaee MA, Al-Azri MH, Al-Zakwani IS, Khan M, Al-Waily AM, Rizvi S. A survey of community members perceptions of medical errors in Oman. BMC Med Ethics 2008; 29: Al-Futaisi A, Abdwani R, Fadllalah M, Al-Zakwani I, Javad H, Al-Zuhaibi S, Ganesh A, Koul R. Idiopathic intracranial hypertension in Omani children. J Pediatr Neurol 2008; 6: Almahrezi A, Al-Zakwani I, Al-Amri A, Al-Khaldi S, Al-Zadjali N, Al-Hatali M, Al-Shukeili A. Control and

227 Management of Hypertension at a University Health Centre in Oman. SQU Med J 2008; 8: Conference and Seminar Presentations Conference Presenataions Local 1. Al-Busaidi I. Adverse drug reaction reporting in pediatrics. The 5th SIOP Asia Conference Childhood Cancer - Pre-conference for Nurses. Muscat, Oman, 25 Feb Al-Busaidi I. Adverse drug reaction reporting in pediatrics. The Pharmacy Pediatric Workshop. Oman Pharmaceutical Society, Muscat, Oman, 14 Feb Abusham A. Medication Errors. 1st International Conference on Quality Management in Health Care. SQU, January 2008, Muscat, Oman P Thesis/Project Supervision 4. Taqi A. Quality in pharmacy practice. 1st International Conference on Quality Management in Health Care. SQU, Muscat, Oman, January Al-Zadjali B, Al-Busaidi B, Al-Mahrezi A. Learning from our own mistakes; Tenoxicam and Tamoxifen. 1st International conference on Quality Management in Health Care. SQU, Muscat, Oman, January Taqi A. Drug handling in pediatrics. Pharmaceutical Care in Pediatrics workshop. In collaboration with the Oman Pharmaceutical Society. Muscat, Oman, 14 February Al-Barram A. Paediatric diabetes. Paediatric Pharmacy Workshop. Oman Pharmaceutical Society. Muscat, Oman, 14 February Abusham A. Clinical pharmacy practice at SQUH. 4th Pharmacy National Symposium: Pharmaceutical Care Principle & Practice. Muscat, Oman, 24 April Ahmed Abdulrahim Abusham Qualification: PhD (will finish in 2010) University: Title: Dates: Supervisor: Omdurman Islamic University, SUDAN Prevalence and Predictors of Suboptimal Serum Gentamicin Levels in Haematology Patients. July, 2007 (Ongoing) Dr. Ibrahim Al-Zakwani Dept. 20 a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Pharmacy 217

228 P Physiology

229 Overview The Department of Physiology has two divisions: Basic Physiology and Clinical Physiology, located in the College of Medicine and the University Hospital, respectively. The Department imparts instruction in basic and clinical physiology and also familiarises medical students in various clinical physiological procedures. Physiology teaching is coordinated with other basic science departments in an integrated, multidisciplinary fashion. Dept. 21 The curriculum is further fortified by live models as well as simulated basic and clinical case demonstrations at different levels of medical training. Clinical students are further armed with hands-on as well as diagnostic skills of the most common clinical measurements that they are like to encounter after graduation. The Department of Physiology provides advanced clinical diagnostic services for the University P Hospital and for the whole of the Sultanate. It is the only Department of its kind where such procedures are carried out under one roof, with good quality assurance and cost effectiveness. All the equipment used in this Department is now digital and therefore the Department is ready to be linked to other hospitals in Oman for remote investigation and patient management. Apart from the addition of new diagnostic procedures, the number of existing clinical tests has increased in all specialties, with some having had a substantial increase. Medical research has also increased and results from various projects have been published. The Department has strong links with the universities of McMaster, Toronto, Oxford, Wisconsin, Graz and Groningen 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 regularly with these universities through exchange programmes. Technical and medical staff members receive regular training and are audited to meet international standards. a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Physiology 219

230 Staff Head Sulayma Al-Barwani, Associate Professor Faculty Mohammed O Hassan, Professor Mohan Dikshit, Associate Professor Abdul Aleem Khan, Assistant Professor Amal Ziada, Assistant Professor Sami Al-Rawas, Senior Registrar Khamis Al-Hashmi, Senior Registrar Mohammed Al-Abri, Senior Registrar P Deepali Jaju, Registrar Hajer Al-Rujeibi, Registrar Talal Al-Maskhani, Registrar Haifa Al-Abri, Senior House Officer Support Staff Adila Al-Tooqi, Acting Superintendent Mariam Al-Hooti, Senior Technologist Susan Al-Nabhani, Senior Technologist Hajer Ba Omar, Research Assistant Sultan Al-Siyabi, Research Assistant Jessy George, Coordinator Iluminada Calupig, Coordinator The support staff consists of 25 technicians (15 Omanis), 1 nurse and 2 departmental coordinators. The technicians work in the sections of Cardiology, Pulmonology, Neurophysiology and in the Sleep Disorders laboratories. 220 The support staff members are all actively involved in training, teaching and research activities of the

231 Department in both College and Hospital programmes. Dept. 21 Teaching Programmes The curriculum is fortified by live models as well as simulated basic and clinical case demonstrations at different levels of medical training. Clinical students are further armed with hands-on as well as diagnostic skills of the most common clinical measurements that they are like to encounter after graduation. UNDERGRADUATE PRECLINICAL Programme The Department of Physiology offers one departmental course and makes major contributions to system-based courses and to the Nursing Program which includes Anatomy & Physiology courses P I & II and Pathophysiology for Nursing. The Applied Medical Science course is a problem-based course shared with Anatomy and Biochemistry (Table 1). Table 1: Pre-clinical courses. Course Title Semester No. of students Early development Tissues and Integuments Alimentary System Respiratory System Cardiovascular System Urinary System Nervous System & Special Senses Endocrine & Reproductive System Applied Medical Sciences a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Physiology 221

232 NURSING Course Title Semester No. of Students Anatomy & Physiology I 2 60 Anatomy & Physiology II 3 60 Pathophysiology for Nursing 4 60 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 on during 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 Pinvolved in the Integrated Lecture Series (ILS), as well as Clinical Physiology rotations for year 5 and 7 of the MD program (Table 2). Table 2: Clinical courses Course Title Year ILS Cardiovascular System 5 ILS Alimentary 5 ILS Respiratory 5 Family and Community Medicine 5 Rotation in Clinical Physiology 7 POSTGRADUATE TEACHING The Department contributes to the core programme of the Oman Medical Speciality Board (OMSB) and to the preparation of trainees for the MRCP and FRCS examinations. Clinical Physiology senior house officers spend one year rotating in 2 units of Medicine of their choice and one year training in Clinical Physiology before going abroad. 222

233 Training Courses & CME Activities Regular in-house training is conducted for newly recruited technicians. As a part of this course, the technicians attend the Anatomy & Physiology course for nursing students. Regular CMEs are held on a monthly basis. Dept. 21 Clinical and Diagnostic Services The diagnostic tests provided by the Department cover most of the spectrum of neurophysiology, Number of Patients January February March April Cardiology Neurology Pulmonary P May June July August September October November December Figure 1: Shows the types and number of procedures performed in the Department of Clinical Physiology in 2008 a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Physiology cardiology, pulmonology, sleep medicine and other discrete tests. The sleep laboratory unit has 3 procedure rooms and a control room. An advanced autonomic function laboratory was introduced to the Department this year. Cardiology showed the largest number of procedures (8,174), followed by neurology (5,204) 223

234 P Figure 2: Shows the number of patients who attended the Department of Clinical Physiology during 2008 and pulmonary function tests (641) (Figure 1). Other procedures include skin tests (681), audiometry (2,142), polysomnography (245), and others (9). The total number of procedures during 2008 was 14,709 out of which outpatients were 6,895 and inpatients were 5,025 (Figure 2). A total of 2,789 patients were referred from outside government hospitals and private practitioners (Figure 3). January February March April May June July The total number of procedures for 2008 has increased due to the following reasons: the opening of new services within the Hospital such as new born acoustic screening test, the cardiothoracic unit and cardiac catheter laboratory. August September October November December 224

235 Decem ber Novem ber October Septem ber August Paying Other hospitals SQUH out patients SQUH in patients Dept. 21 July June May April March Feb January P Figure 3: Shows the annual distribution of referrals in the Department of Clinical Physiology in 2008 a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Physiology Research Hypertension and the Metabolic Syndrome in Oman - Intervention Clinical Trial and Mapping of Genes Project Code: Dates: SR/MED/PHYS/04/01 225

236 Value: OR 167,531 Project funder: Investigators: His Majesty s Strategic Research Fund Prof. Mohammed Hassan, Department of Physiology, SQU; Dr. Sulayma Al-Barwani, Department of Physiology, SQU; Dr. Said Al- Yahyaee, Department of Genetics, SQU; Dr. Ali Al-Hinai, Department of Medicine, SQU; Dr. Al-Haddabi S, Ministry of Health; Dr. A Comuzzie, Department of Genetics, Southwest Foundation, Texas, USA Obstructive Sleep Apnoea /Hypopnoea Syndrome and Metabolic Vascular Risk Factors Project Code: Dates: Value: OR 5,000 Project Funder: Investigators: IG/MED/PHYS/08/01 P Sultan Qaboos University Dr. Mohammed Al-Abri, Department of Clinical Physiology,SQU; Dr. Khamis Al-Hashmi, Department of Clinical Physiology,SQU; Dr. Deepali Jaju, Department of Clinical Physiology, SQU; Dr. Omar Al-Rawas, Department of Medicine, SQU; Prof. Mohammed Hassan, Department of Physiology, SQU. 226 Estimation of reference values for arterial stiffness indices in normotensive adult subjects and assessment of lifestyle effect Project Code: MERC #275 Dates: Value: OR 2,000 Project Funder: Investigators: Sultan Qaboos University Dr. Khamis Al-Hashmi, Department of Clinical Physiology, SQU.

237 Research Publications and Books Journal Publications 1. Parthasarathy H, Alhashmi K, McDonald A, Struthers A, Connell JMC, McInnes GT, Ford I, MacDonald TM. Does the aldosterone: renin ratio predict the efficacy of spironolactone over bendroflumethaiazide in hypertension? A clinical trial protocol for RENALDO (RENin-ALDOsterone) study. BMC Cardiovasc Disord 2007; 7: Albarwani SA, Bayoumi RA, Jaju D, Rizvi S, Al-Yahyaee S, Al-Hadabi S, Lopez-Alvarenga J, Comuzzie A, Hassan MO. Differing definition-based prevalence of metabolic syndrome in the women of Oman Family Study: a function of multiparity. Metab Syndr Relat Disord 2008; 6: Al-Rawas O, Al-Riyami BM, Goddard C, Hassan MO. Use of the Low Frequency Band of Heart Rate Variability in the Screening of Patients with Snoring for Polysomnography. SQU Med J 2008; 8: Lopez-Alvarenga JC, Solís-Herrera C, Kent JW, Jaju D, Albarwani S, Al-Yahyaee S, Hassan MO, Bayoumi R, Comuzzie AG. Prevalence and heritability of clusters for diagnostic components of metabolic syndrome: the Oman family study. Metab Syndr Relat Disord P2008; 6: Al-Abri MA, Al-Hashmi KM, Jaju D, Al-Rawas O, Al-Riyami BM, Hassan MO. An audit of the sleep medicine service in Oman. Saudi Med J 2008; 29: Al-Abri MA, Al-Hashmi KM. Obstructive Sleep Apnoea/Hypopnoea syndrome and Hypertension. SQU Med J 2008; 8: Ali BH, Al-Moundhri M, Eldin MT, Nemmar A, Al-Siyabi S, Annamalai K. Amelioration of cisplatin-induced nephrotoxicity in rats by tetramethylpyrazine, a major constituent of the Chinese herb Ligusticum wallichi. Exp Biol Med (Maywood). 2008; 233: Book Chapters 1. Riad Bayoumi, Al-Yahyaee S, Albarwani S, Jaju D, Comuzzie A, Lopez-Alvarenga J, Hassan MO. Some genetic determinants of Obesity, type 2 diabetes and dyslipidemias in Oman Family Study. In: Tadmouri GO, Al-Ali MT, Al-Khaja N, Eds. Genetic Disorders in the Arab World Oman. UAE: Centre for Arab Genomic Studies, pp ISBN: Dept. 21 a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Physiology Conference and Seminar Presentations Conference Presentations International 1. López-Alvarenga JC, Jaju D, Al-Yahyahee S, Albarwani S, Al-Hinai A, Bayoumi RA, Hassan MO,Comuzzie A. Triglycerides and BMI are associated with systolic dipping in the Oman Family Study. 15th European Congress on Obesity. Hungary, Budapest,

238 2. Jain R, Sawhney S, Jaju D. Diffusion-weighted MRI: a reliable test for the differentiation of malignant from benign focal liver lesions.? European Society of Gastrointestinal and Abdominal Radiology, Annual Meeting. Istanbul, Turkey, June Conference Posters 1. Hassan MO, Albarwani S, Al-Yahyee S, Jaju D, Alvarenga JC, Commuzie AG, Bayoumi R. A novel approach for the study of the genetics of hypertension in Arabs. Heritability and linkage analysis results of Oman Family Study. 2nd Pan Arab Human Genetics Conference. November Bayoumi R, Al-Yahyee S, Albarwani S, Alvarenga JC, Commuzie AG, Hassan MO. Identification of loci for the obesity-diabetes phenotype among Arabs of the Oman Family Study. African Society of Human Genetics Conference. Cairo, Egypt, November Bayoumi RA, Al-Yahyaee S, Albarwani S, Lopez-Alvarenga JC, Comuzzie AG, Hassan MO. Advances in the Genetics of Type 2 Diabetes Mellitus. 2nd Pan Arab Human Genetics Conference. Dubai, UAE, November Al-Siyabi SS, Ba-Omar H, Mohan G, Albarwani PS. Effect of chronic lisinopril administration on heart rate variability in spontaneously hypertensive rats. Experimental Biology Conference. Washington DC, USA, April Albarwani S, Al-Siyabi SS, Ba-Omar H, Tanira MO. Circadian heart rate variability is abolished by chronic administration of lisinopril in spontaneously hypertensive rats. Experimental Biology Conference. Washington DC, USA, April Local 1. Dikshit MB, Jaju D, Jothi B, George J, Rizvi SG, Al-Rawas O. A Preliminary report on the effect of pranayam breathing on respiratory pressures and sympatho-vagal balance of patients with chronic airflow limitation. Research Day. Sultan Qaboos University, Muscat, Oman, May Al-Jabri S, Jothi B, Balaji R, Al-Sinawi N, Jaju D, Dikshit MB. Pulmonary Function Tests: Occupational and Pathophysiological Relevance. Research Day. Sultan Qaboos University, Muscat, Oman, May

239 Dept. 21 P a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Physiology 229

240 Annual Research Report P Physiotheraphy

241 Overview The Department of Physiotheraphy covers three different disciplines: physiotherapy, occupational therapy and speech and language therapy. Physiotherapists identify and maximise movement potential through health promotion, preventive healthcare, treatment and rehabilitation. Occupational therapy 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. Speech and language therapy is concerned with improving clients communication skills. Dept. 22 Physiotherapy services cover in-patients, outpatients, Accident and 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, hand therapy, hydrotherapy, acupuncture, reflexology, neuro-rehabilitation, respiratory, paediatric rehabilitation, capping, women s health, (pre- and postnatal and female urinary Pincontinence), sports injury, public health education and splinting. Physiotherapists are involved in clinical teaching of physiotherapy and medical students. Occupational therapy service provides home modifications, adaptive devices, splinting, and help to improve oral motility, cognitive skills and to overcome learning disabilities. It aims to enable clients to reach their maximum level of functional independence in all their activities of daily living (ADL). Adaptive devices are advised or provided to compensate any disability, improve functional ability and help patients become independent members of society. In paediatrics, problems such as posture (proper seating), mobility (wheelchair and mobility devices), activities of daily living (adaptive devices), deformities (splinting), and dysphagia (feeding and eating troubles) are tackled to bring the child s development to as normal a level as possible. Treatment includes family counselling and home programmes. a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Physiotheraphy Speech and language therapy assesses, manages and treats a wide range of cases related to hearing impairments; cognitive, or other developmental delays; birth defects such as cleft lip or cleft palate; autism; motor planning problems; swallowing disorders; traumatic brain injury; neurological problems affecting communication, or voice problems. The speech and language therapist also provides an introduction to speech and language therapy to physiotherapy, occupational 231

242 therapy, dieticians, medical and nursing students. Staff Head of Department Suleiman Al-Alawi 232 Therapists Saif Al-Riyami, Deputy Head Omar Al-Tamimi, Senior Physiotherapist Nasser Al-Hajri, Senior Physiotherapist Said Al-Balushi, Senior Physiotherapist Zuwaina Al-Bahri, Physiotherapist Hilal Al-Rashdi, Physiotherapist Najma Al-Mahruqi, Physiotherapist Huda Al-Saadi, Physiotherapist Moza Al-Amri, Physiotherapist Sabah Al-Touqi, Physiotherapist Safiya Al-Hashmi, Physiotherapist Aisha Al-Talei, Physiotherapist Madiha Al-Kindi, Physiotherapist Ahlaam Al-Mazrui, Physiotherapist Karthikeyan G Nair, Physiotherapist Hasna Al-Rashdy, Physiotherapist Shaima Al-Saidi, Physiotherapist Hammad Al- Subhi, Physiotherapist Mahmoud Al-Hinai, Physiotherapist Inas Iqbal Ali, Physiotherapist Basma Al-Araimi, Occupational Therapist Vasant Naganur, Occupational Therapist P

243 Ibtisam Al-Wardi, Speech & Language Therapist Support Staff Laureana P Valderama, Coordinator Fathiya Al-Akhzami, Receptionist Hamood Al-Amri, Messenger Dept. 22 Highlights of the Year The Department was able to provide pre- and post cardio-rehabilitation to both in and outpatients. Speech & Language Therapy services were focused mainly on children with hearing impairments; cognitive, or other developmental delays; birth Pdefects such as cleft lip or cleft palate; autism; motor planning problems; swallowing disorders; traumatic brain injury; neurological problems affecting communication (e.g. CVA), or voice problems both inpatients and outpatients. Services were offered either on a one-to-one basis or in a small group. Caregivers also received training as necessary. A variety of therapeutic strategies are employed, including language intervention activities and articulation therapy. The speech and language therapist also provides an introduction to speech and language therapy to physiotherapy, occupational therapy, dieticians, medical and nursing students. Occupational therapy services had focused mainly on children of different ages with developmental delay, feeding and eating problems, sensory integration issues, seating and mobility, activities of daily living and splinting. The oral motor programme is the most important aspect of treatment with neonates having sucking difficulty and children who have feeding and eating problems. An introduction to occupational therapy was provided to medical, nursing, physiotherapy, dieticians, and speech & language therapy students. a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Physiotheraphy 233

244 Teaching Programmes UNDERGRADUATE CLINICAL Programme The Department is continuously involved in clinical teaching of students from inside and outside Oman, ranging from undergraduates in physiotherapy to qualified doctors. In 2008, twenty-two students from the Institute of Health Sciences in Muscat had 1 to 6 week part-time clinical placements, while a further 8 of their students had 10 week placements with us. Teaching sessions for trainee dieticians were also undertaken. POSTGRADUATE Programme Three resident doctors from the Department of Family Medicine & Public Health had their 4 week elective in the Department. A sports medicine doctor from the Royal Palace Services and a physiotherapist from Sur Hospital had 4 week clinical Pattachments with the Department. A physiotherapy clinical tutor from the Institute of Health Sciences had an 8 week clinical practice. Training Courses & CME Activities On a rotation basis, each therapist conducts in-service lectures and speaks at the journal club. We also invite visitors, i.e. doctors, nurses and other paramedics, to give lectures. Therapists write articles for the bi-annual Physiotherapy Newsletter on rotation basis. Therapists also conduct a lifting and handling lecture every Sunday for nurses, paramedics, medical orderlies and other hospital staff. 234 In 2008, the Department organised a 3-day reflexology course for its own staff. It ran a weekly inservice training session for its own staff as well as other SQUH staff. The following topics were covered: pneumonia; temporomandibular joint dysfunction; deep vein thrombosis; gastroesophangeal reflux; sense-ability; McKenzie; the hand; principles of lifting and handling; cardiopulmonary medicine; community based rehabilitation; sacroiliac joint pain; display screen equipment; multiple sclerosis; suppurative hidradenitis; rehabilitation programme on brachial plexus palsy; mental illness/mental disorders; meniscus tear; carpal tunnel syndrome; introduction to podiatry; myofascial trigger point; the myth of core stability; manual therapy; oral motor programme and personality disorders. A lifting and

245 handling lecture was conducted for 32 medical orderlies and an introduction lecture for nurses. A lecture on pre- and postoperative physiotherapy was conducted on surgical wards. Dept. 22 Lectures for the Training Services Directorate on Other Modalities of Pain Management; participation in the Interdisciplinary Activity Week and Clinical Methods Course in collaboration with the College of Medicine and Health Sciences; provision of a physiotherapy service during SQU Sports Day as well as to the Oman Football Association. Clinical and Diagnostic Services P Conference and Seminar Presentations Statistics No. of Patients No. of New Patients Physiotherapy 9,252 2,743 Occupational Therapy Speech & Language Therapy Conference Presentations International 1. Al-Tamimi O. Physiotherapy and Back Pain. The 9th Dubai Spine Conference. Dubai, UAE, April a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Physiotheraphy seminar Presentations Local 1. Al-Riyami S. Cardiovascular Fitness for Geriatric Patients. Nizwa Hospital, Muscat, Oman, April Al-Riyami S. Periformis Syndrome, Pelvic Dysfunction in relation to hip joint and Mulligan Techniques to SIJ. Pelvic Symposium. Institute of Health Sciences, Muscat, Oman, May Al-Riyami S. Shoulder Injury. Air Force Camp, Muscat, Oman, June Al-Bahri Z. Al-Hasmi S, Al-Subhi H, Nair KG. Trigger Point, Lifting & Handling Techniques and Acupuncture. SQUH Day April

246 R Radiology

247 Overview The Department of Radiology 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 radiation equipment, research, etc.) as well as routine radiological imaging. Dept. 23 The Department has been fully digitised since May 2002 after the installation of a complete PACS (picture and archiving communication system). Radiological examinations can be viewed by all doctors at SQUH on an internal web system together with the radiological report. The savings on films and chemicals have been substantial. It has also significantly improved patient management and made comparisons easier. We are now working on improving the database of the MagicWeb so that we can see more studies at a time and faster. R Research, teaching and training at both undergraduate and postgraduate level involves all 13 members of faculty, from both the College and Hospital sides. Radiology technicians are involved in teaching radiographers from the Institute of Health Sciences. We have been successful as a Department in sending young Omani technologists to study for university degrees abroad. Staff Head of Department Lamk Al-Lamki, Professor a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Radiology Faculty Neela Lamki, Professor Faisal Al-Azri, Deputy Head, Consultant Dilip Sankhla, Senior Consultant Samir Hussein, Senior Consultant Sukhpal Sawhney, Senior Consultant Rajeev Jain, Associate Professor 237

248 Nader Atari, Associate Professor Ranjan William, Assistant Professor Haddia Bererhi, Consultant Humoud Al-Dhuhli, Consultant Anupam Kakaria, Senior Registrar Sinan Al-Azawi, Senior Registrar Rashid Al-Sukaiti, Registrar 238 Support Staff Mohammed El-Gindy, Departmental Superintendent Per Rude, Deputy Superintendent, Chief Radiographer Nabil Al-Mohtasib, Technologist - MRI Bernardo Ramos, Technologist R Salvador De Vera, Technologist - CT Virginia Ablen, Technologist - MRI Antonio Velarde, Technologist Merlie Vanderlipe, Technologist Editha San Diego, Technologist - US Manuel Gaerlan, Technologist Meda Bersaba, Technologist - NM Ahmed Abdou, Technologist - NM Adnan Al-Kharousi, Deputy Superintendent, Technologist Abdulla Al-Siyabi, Technologist Raya Al-Naamani, Technologist - US Imelda Publico, Technologist Matheo Dilao, Technologist Merlinda Aguilar, Technologist Mahmood Al-Abri, Technologist Faiza Al-Salmi, Technologist - MRI Umaima Al-Ajmi, Technologist

249 Aziza Al-Jabri, Technologist - NM Mohammed Al-Saqri, Technologist - NM Nabila Al-Hesani, Technologist - US Ahmed Al-Shuhaimi, Deputy Superintendent, Technologist Jamal Al-Rubaiey, Technologist Sultan Al-Naamani, Technologist Hamoud Al-Ghafri, Technologist - CT Aida Al-Rahbi, Technologist - US Rania El Tigani, Technologist - US Hanan Yousuf, Technologist Khitam Al-Hijri, Technologist Ruqaya Al-Rawahi, Technologist Lubna Al-Esry, Technologist R Mathew George, Technologist Kalthoom Al-Shesawi, Technologist Victor Arulnathan, Technologist Kuriakose KP, Technologist Unnikrishnan Nair, Technologist Wesley Samuel Jacob Asirvatham, Technologist Coordinators Rhodora Campo Laddie Lara Edgardo Carino Jr Sharifa Moh d Al-Tobi Dept. 23 a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Radiology Medical Physics Afkar Al-Farsi, Biomedical Scientist Amaal Al-Rasbi, Biomedical Scientist Ibtissam Al-Maskery, Biomedical Scientist Hilal Al-Zeheimi, Biomedical Scientist 239

250 Mohammed Al-Subhi, Coordinator Highlights of the Year We have established the following 9 sections in our Department to better serve our patients and the clinical staff and also develop research in these fields: Neuroradiology; Interventional; Body Imaging; Emergency Radiology & General; Chest; Paediatrics; Mammography; Nuclear Medicine; Medical Physics. Teaching Programmes R Undergraduate Preclinical Programme 4th Year: Undergraduate Clinical 5th Year: Approximately 40 students ILS Anatomy Lecture Series, coordinated with Anatomy Department: more than 100 students. Clinical Skills (exam): more than 100 students The Department participates in teaching in the Integrated Lecture Series + Respiratory System + Cardiovascular System + Gastro-Intestinal System + Neurology + Infectious Disease + Uro/Nephrology 240

251 6th Year: 7th Year: Approximately 180 students Radiology Department rotation - 6 to 7 students per group every two weeks. Approximately 30 students: obstetrics and gynaecology lecture Dept. 23 Postgraduate Programme There were 26 Oman Medical Specialty Board (OMSB) Radiology residents in Clinical & Diagnostic Services R Exams 2008 Totals Chest 16,094 Routine 13,015 Ba. Oral 391 Ba. Enema 172 Fluoro/Misc. 132 IVU/MCU/Urethro 101 Dacro/Fistu/Sialo 15 HSG 103 Oral health 2,181 Mammography 391 Bone densitometry 532 Lithrotripsy 87 Ultrasound pregnancy 4,356 Ultasound general 9,554 Ultrasound Biopsy/aspiration 235 Ultrasound FNA 179 a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Radiology 241

252 CT Scan 3,785 Angio Gen. 82 Intervention 24 Angioplasty - Nuc. Med. 2,863 MRI 2,811 Total Exams ,429 Research Members of the Department are doing research on the following topics: 242 R + Value-Added Marine Raw Materials and Health + MRI Quantification of Hepatic and Cardiac Iron Content in Thalassemic Patients. Correlation with Histopathology and Estimation of Iron Content as Fraction of Dry Liver Weight. -An Open Label Multi-Center Trial on the Efficacy and Safety of Long-Term Treatment with ICL670 (Oral Chelating Agent) in BetaThalassemia Patients with Transfusional Hemosiderosis. Phase IVb Multi-Center Clinical Trial + Diffusion Weighted Imaging of Liver Tumors and Correlation with Histopathology of Explant Organs + T2* Imaging for Assessment of Liver and Cardiac Iron Overload + Diffusion-Weighted Imaging of Focal Liver Lesions - To Determine the Usefulness of Apparent Diffusion Coefficient (ADC) Values in the Differentiation of Focal Liver Lesions + Ultrasound-Guided Percutaneous Sclerosis of Low-Flow Vascular Malformations + Bone Infarction in Sickle Cell Disease - Correlation with Residual Splenic Function + Whole-Body Diffusion-Weighted Imaging in Assessment of Response of Lymphomas and Other Malignancies to Chemotherapy

253 + MR Angiographic Survey of Stenotic Lesions of the Internal Carotid and Cerebral Circulation in Symptomatic Patients - Rationale for Institution of Carotid Angioplasty Services + Magnetic Resonance Diffusion-Weighted Imaging in Bone Pathology: Correlation with Histology and Nuclear Scans + Resovist (Super-Paramagnetic Iron Oxide) Enhanced MRI and Dynamic Contrast Enhanced MRI in the Characterization of Hepatic Mass Lesions Dept. 23 Research Projects Carcinoma Cervix: Diffusion-Weighted MR Imaging for the Assessment of Tumor Necrosis in Response to Radiotherapy, as a Means to Optimize and Tailor Treatment Modality with Reduction of Morbidity. Project Code: Project Dates: R IG/MED/RADI/06/ Current Project Value: OR 4,500 Project Funder: Project Investigator: Sultan Qaboos University Dr. Rajeev Jain, Department of Radiology, SQU; Dr. B.K Mohanti, Department of Radiology, Royal Hospital; Dr. S. Sawhney, Department of Radiology, SQU; Dr. U. Sharma, Department of Gynecology, Royal Hospital; Dr. Noor Al-Moundhri, Department of Gynecology, Royal Hospital. a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Radiology The Efficiency of Thyroid Remnant Ablation with I-131 after rhtsh Stimulation and after Thyroxine Withdrawal: AProspective Randomized Control Trial Project Code: MREC #264 Project Dates: Value: Unfunded 243

254 Investigators: Dr. Samir Hussein, Department of Radiology & Molecular Imaging, SQU Usefulness of Leukoscan in the Diagnosis of Osteomyelitis in Patients with Sickle Cell Disease: Comparative Study with MRI Project Code: MREC #270 Dates: Value: Investigators: Unfunded Dr. Haddia Al-Berehi, Department of Radiology & Molecular Imaging, SQU 244 Research Publications and RBooks Journal Publications 1. Sankhla D, Ahmed S, Koul R, Waily A. Klippel-Treauany-Weber Syndrome in a Girl with Partial Motor Seizures. Neurosciences 2008; 13: El Shafie O, Sankhla D, Al-Kindy N, Al-Hamadani A, Grant C, Woodhouse NJ. Insulinoma: A Rare Cause of a Common Metabolic Disorder-Hypoglycaemia. SQU Med J 2008; 8: El Shafie O, Abid FB, Al-Kindy N, Sankhla D, Woodhouse NJ. Cushing s Disease: Pituitary Surgery Versus Adrenalectomy. SQU Med J 2008; 2: William RR, Sankhla D, Al-Qassabi B, Al-Ramadani K. Traumatic Rupture of the Right Hemidiaphragm: Diagnosis Aided by Computerized Tomography and Image Reformation: A Case Report. SQU Med J 2008;.8: El Shafie O, Hussein S, El Awady W, Woodhouse NJ. Graves Disease following Interferon Therapy for Chronic Hepatitis C Infection. SQU Med J 2008; 8: Hussein SS, Sawhney S, Al-Jarrah A. Case Report: Tc-99m Tetrofosmin Scintimammography for the Detection of Recurrent Breast Cancer in a Patient with Equivocal Mammography Study. SQU Med J 2008; 8: Jain R, Sawhney S, Rizvi SG. Acute Bone Crises in Sickle Cell Disease: The T1 Fat-saturated Sequence in Differentiation of Acute Bone Infarcts from Acute Osteomyelitis. Clinical Radiology 2008; 63: Jain R, Sawhney S. Pande GK, Rao V. Diffusion-Weighted MRI: A Reliable Test for the Differentiation of

255 Malignant from Benign Focal Liver Lesions? Eur Radiol 2008; 18: Sawhney S, Jain R. Sickle Cell Disease: Spectrum of MRI appearances of the Spleen and Relevance to Clinical Management. Eur Radiol 2008; 18: Jain R, Sawhney S, Acharya SK, Sahni P, Pande GK. Chronic Hepatic Venous Outflow Obstruction: US in the Diagnosis and Rationalizing Approach Towards Management. Eur Radiol 2008; 18: Jain R, Sawhney S, Acharya SK, Sahni P. Chronic Hepatic Venous Outflow Obstruction: Percutaneous management with transluminal membranotomy with balloon dilatation. Eur Radiol 2008; 18: Sawhney S, Machado L, Jain R. Prenatal MRI Image of a Fetus with Semilobar Holoprosencephaly. SQU Med J 2008; 8: Kakaria AK, Sawhney S, Jain R. Tracheal Bronchus. SQU Med J 2008; 8: Al-Sukaiti R, Robinson K, Menias C. Pancreatic Non-Functional Islet Cell Tumor and its Hepatic metastases: Evaluation with Multidetector CT (Abstract). Radiographics 2007; 796. R Conference and Seminar Presentations 15. Al-Sukaiti R, Stein L,. Christou N, Mesurolle B. Radiological Assessment and Spectrum of Small Bowel Obstruction Following a Retrocolic Antegastric Roux-Y-limb Gastric Bypass for Morbid Obesity. AJR 2007; 188: Al-Sukaiti R, Robinson K, Menias C. CT Imaging Features of Pancreatic Non-Functional Islet Cell Tumor (NFICT) and its Hepatic Metastases, A Retrospective Review in 28 Patients. AJR 2007; 190:212. Conference Presentations International 1. Lamki L. PET/CT. Annual Riyadh Radiology Review. Riyadh, Saudi Arabia, 3 September, Hussein SS. Evidence Based Medicine: The Past, Present and Future. Evidence Based Medicine Workshop. Syria, Hussein SS. Critical Appraisal of Randomized Control Trail Article. Evidence Based Medicine Workshop. Syria, Bererhi H. Radiopharmaceutical in Differentiated Thyroid Carcinoma: New Approaches. Second International Conference on Radiopharmaceuticals Therapapy. Ulaanbaatar, Mongolia, 3-7 September Dept. 23 a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Radiology Local 1. Lamki L. PET in Epilepsy and Other Neurological Disorders. Radiology Club of Oman Meeting. The Crown Plaza, Muscat, Oman, 1 November, Hussein SS. Basics of Meta-Analysis. 5th International Obstetrics & Gynecology Conference. Interpreting 245

256 Clinical Research in Obstetrics and Gynecology. Pre-Conference Course. Oman, 10 December Hussein SS. Evidence Based Medicine in Minimizing Medical Errors. The Third Patient Safety Symposium. Oman, January Jain R. Diffusion Weighted Imaging of the Brain: Should it be Performed Routinely? Radiology Club of Oman: Neuroradiology Day, Muscat, Oman, 1 November Jain R. Radiology as a Career Choice. GCC Medical Students Conference. Medical College, Sohar, Oman, 28 March, Conference Posters International 1. Jain R, Sawhney S, Pande GK, Rao V. Diffusion-Weighted Imaging of Focal Liver Lesions - To Determine the Usefulness of Apparent Diffusion Coefficient (ADC) Values in the Differentiation of Focal Liver Lesions. European Society of Gastrointestinal and Abdominal Radiology: 19th Annual Meeting and Postgraduate Course. Istanbul, Turkey, R 2. Sawhney S, Jain R. Sickle Cell Disease: Spectrum of MRI Appearances of the spleen and Relevance to Clinical Management. European Society of Gastrointestinal and Abdominal Radiology: 19th Annual Meeting and Postgraduate Course. Istanbul, Turkey, June Al-Sukaiti R, Robinson K, Menias C. Pancreatic Non-Functional Islet Cell Tumor and its Hepatic Metastases: Evaluation with Multidetector CT. 93rd Scientific Assembly and Annual Meeting of the Radiological Society of North America November Al-Sukaiti R, Robinson K, Menias C. CT Imaging Features of Pancreatic NFICT and its Hepatic Metastases, a Retrospective Review in 28 Patients. 108th Annual Meeting of the American Roentgen Ray Society April Local 1. Sawhney S. Metastatic Melanoma during Pregnancy: A Case Report. 5th International Obstetric and Gynecology Conference. SQUH, Muscat, Oman, December Sawhney S. Magnetic Resonance Imaging, State-of-the-Art. 1st International Radiology Conference of Oman. Oman, February Seminar Presentations Local 1. Jain R. Perinerual Spread of Head and Neck Cancer - Role of Magnetic Resonance Imaging. Department of Otorhinolaryngology, Head and Neck Surgery, Ministry of Health, Al-Nahda Hospital, Muscat, Oman, 30 April 2008.

257 Dept. 23 R a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Radiology 247

258 S Surgery

259 Overview The Department s mission is to teach and train students and doctors, conduct research, and provide specialised clinical services and patient care. Dept. 24 Staff Head of Department Christopher Grant, Professor Faculty Hani Al-Qadhi, Consultant, Deputy HOD for Clinical Affairs (Trauma Surgeon) Nayil Al-Kindy, Senior Consultant (General SSurgery) Norman Machado, Senior Consultant (General Surgery) Rashid Al-Abri, Senior Consultant (ENT) KV Krishna, Senior Consultant (Cardiac Surgery) Ashok Sharma, Senior Consultant (Cardiac Surgery) Krishna Prasad, Senior Consultant (Urology) Sultan Al-Maskari, Senior Consultant (Orthopaedic Surgery) Hilal Al-Sabti, Consultant (Cardiac Surgeon) Mohamed Al-Hashmi, Consultant (Endocrine Surgery) Khalifa Al-Wahaibi, Consultant (Vascular Surgery) Abdullah Al-Harthy, Consultant (Trauma Surgery) Joseph Mathew, Consultant (Urology) Pradeep Chopra, Consultant (General Surgery) Sreedharan VK, Consultant (General Surgery) Deepa Bhargava, Consultant (ENT) Mohammed Okbi, Senior Registrar (ENT) Mohammed S Mirza, Senior Registrar (General Surgery) Kamran Malik, Senior Registrar, (General Surgery) a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Sugery 249

260 Naveed Khatib, Senior Registrar, (General Surgery) Mohammed Salman Siddiqi, Senior Registrar (Cardiac Surgery) Mirdavron Mukaddirov, Senior Registrar (Cardiac Surgery) John Thomas, Senior Registrar (Orthopaedic Surgery) Muhammad Arain, Senior Registrar (Paediatric Surgery) Muhammad Baloch, Registrar (General Surgery) Suresh Kannan, Registrar (General Surgery) Zia Aftab, Registrar (General Surgery) Mooayad Ahmed, Registrar (General Surgery) Paresh Kuba, Registrar (Cardiac Surgery) Khalid Rahman, Registrar (Urology) Shahid Aquil, Registrar (Urology) Sudesh Kumar, Registrar (ENT) S Wameed Al-Bassam, Registrar (ENT) Mohammed Al-Hosni, Senior House Officer Ghalib Al-Baddai, Senior House Officer Intisar Al-Hashmi, Senior House Officer Ghazi Elshafie, Senior House Officer Mohd Al-Mutani, Senior House Officer Mohd Al-Yamani, Senior House Officer Omar Waad-Allah Sharef, Senior House Officer Sareyah Al-Sibai, Senior House Officer Najib Draz, Senior House Officer Ayman Al-Amri, Senior House Officer Hamood Al-Kindu, Senior House Officer Nesrin Qader, Senior House Officer 250 Perfusionists François Perron Balan Baskaran

261 Sayed Rizvi Coordinators Helen Leopoldo Ruel Natividad Dept. 24 Highlights of the Year Sub-Specialties The following sub-specialties were opened in this year: Cardiac Surgery in May 2008, Orthopaedic Surgery in July 2008 and Paediatric Surgery in September S Teaching Programmes New Services Offered In 2008, the following divisions started new clinics: Cardiac Surgery, Paediatric Surgery and Orthopaedic Surgery. Retroperitoneoscopy was introduced for minimally invasive treatment of renal lesions by the Urology division in UNDERGRADUATE CLINICAL Programme 4th Year: MD Students (Clinical Methods and Communication Skills) 5th Year (junior rotation): The Department catered for students in The students rotated in groups of 25-28, each group spending half of the 11-week rotation at the Royal Hospital. 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. In , Moodle was introduced to this course. 6th Year (ENT rotation): The ENT Division participated fully in the teaching of the ENT a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Sugery 251

262 course, in collaboration with the ENT Department at Al-Nahda Hospital. The ENT Division also catered for students. The students rotated in groups of 13-15, spending 2 weeks at the ENT Division. 7th Year (senior rotation): The Department received final year students in groups of in rotation for seven week courses. Altogether, there were approximately 130 students. POSTGRADUATE Programme Internship Interns undertook their surgical rotations in the Department in the year A one week Hospital Orientation SProgramme for interns was conducted in July. + OMSB Residency - 8 residents undertook a 6 months rotation in general surgery in the Department in the year Trauma Lecture Series This lecture series was started at SQUH in the year 2007 for residents and other junior surgeons. 252 Training Courses & CME Activities + Endoscopic Ear Surgery Workshop. College of Medicine & Health Sciences, SQU, 10 October Basic Surgical Skills Course (BSSC). 16 Trainees attended the 2-day course conducted at SQU, College of Medicine & Health Sciences, October Endoscopic Surgery. A one-day course started in the year 2007 and was conducted at SQU, College of Medicine & Health Sciences, attended by 7 surgical residents, October 2007.

263 + 7th International Live Workshop and Conference on Advanced Laparoscopic Surgery - Focus on Oncosurgery - Surgery Redefined and Refined, November Stapled Haemorrhoidopexy. Conducted by Dr. Angelo Stuto from Italy at the College of Medicine & Health Sciences, SQU, 30 December European Association of Endoscopic Surgery (EAES) - Advanced Laparoscopic G.I. Surgery Course attended and satisfactorily completed the course conducted at SQUH, February Open and Laparoscopic Hernia Workshop conducted by Dr. Tim Tollens Maurice, Imelda Hospital, Bonheiden, Belgium at SQUH, 27 February Dr. JS Rajkumar, Laparoscopic Surgeon from Lifeline Group of Hospitals, India, spoke on Stem Cell Therapy for Liver Diseases at SQUH on 7 October S + Dr. JS Rajkumar, Laparoscopic Surgeon from Lifeline Group of Hospitals, India spoke on Surgery for Morbid Obesity and Surgery for GERD at SQUH on 8 October Clinical and Diagnostic Services Statistics for : 15,000 10,000 Dept. 24 a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Sugery 5, Outpatients 13,538 13,559 Admissions 5,420 3,942 Procedures 4,562 2,898 Figure 1: surgical clinical services 253

264 254 Research Research Projects Clinically Significant Anatomical Variations of the Paranasal Sinuses in Omani Population Project Code: MERC #263 Dates: Value: OR 1,000 Project Funder Investigators: SQU Dr. Deepa Bhargava, Department of Surgery, SQU; Dr. Rashid Al- Abri, Department of Surgery, SQU; Dr. Sukhpal Sawhney, Department of Radiology & Molecular Imaging, SQU S Research Publications and Books Journal Publications 1. El Shafie O, Sankhla D, Al-Kindi N, Al-Hamadani A, Grant C, Woodhouse N. Insulinoma: A Rare Cause of Common Metabolic Disorder - Hypoglycemia. SQU Med J 2008; 8: Al-Sabti H. Therapeutic angiogenesis in cardiovascular disease. J Cardiothoracic Surg 2007; 2: Maddali MM, Valliattu J, Al-Sabti H, Mohamed B, Job LR. Errant migrant: An unusual cause of abdominal pain. J Cardiothorac Vasc Anesth 2007; 21: Maddali MM, Al-Bulushi AA, Al-Sabti H. Fish baffles doctors: scombroid fish poisoning or fish allergy? J Cardiothorac Vasc Anesth 2007; 21: Al-Sabti H, Maddali MM. Congenital Right Coronary Artery Fistula. SQU Med J 2007; 7: Al-Sabti H, Menon RG, Madalli MM, Valliattu J. Wandering permanent pacemaker generators in children: a case series. J Med Case Reports 2008; 2: Sudesh K. Bilateral first and second branchial anomaly: A case report. Ear Nose Throat J 2008; 87: Sudesh K. Inflammatory myofibroblastic tumor of larynx mimicking malignancy. Int J Pediatr Otolaryngol Externa Sudesh K. Basaloid cell carcinoma of maxilla: a case report and review of literature. Nat Rhinol 2008;

265 Conference and Seminar Presentations Seminar Presentations Local 1. Al-Wahaibi K. Varicose Veins for Nurses, Sultan Qaboos University Hospital, Muscat, Oman, August Al-Abri R. Rhinitis. Radio Interview. 25 May Al-Sabti H. Keep it beating. Clinicopathological Conference. Sultan Qaboos University. May 21, Machado N. Surgical and Urology update. Sohar Hospital, Oman, April Al-Wahaibi K. Acute Limb Ischemic. Oman Medical Specialty Board, Sohar Hospital, Oman, April Al-Abri R. Mobile Phones Effects. Radio Interview. Hala FM. April S 7. Al-Abri R. Hearing Loss. Radio Interview. 26 March Al-Wahaibi K. Nursing role in trauma. Sultan Qaboos University Hospital, Muscat, Oman, March Machado N. Laparoscopic Splenectomy and Approach to Difficult Cholecystectomy. Nizwa Laparoscopy CME Day. 28 February Al-Abri R. Health Informatics Workshop. SQUH, 23 January Al-Abri R. Third Symposium on Patient Safety. SQUH, January Al-Abri R. Clinical Ethics Workshop, SQUH, 18 January Al-Abri R. TV interview on Morning Coffee. Oman TV. January Machado N. Surgical symposium, Laparoscopic Surgery. Nizwa Hospital, Oman, February Al-Sabti H. Recent Advances in Mitral Valve Surgery. Royal Hospital, Al-Abri R. Communication Skills Workshop. Nizwa Hospital, 29 September Al-Abri R. Medical Ethics Workshop. Nizwa Hospital, 29 September Al-Abri R. Quality Improvement in Health Care. Nizwa, Hospital, 10 September Al-Abri R. Quality Improvement in Health Care. Salalah, Hospital, 4-6 September Al-Abri R. Quality Improvement in Health Care. Royal Hospital, 03 September Al-Abri R. Quality Improvement in Health Care. Khoula, Hospital, 29 October Al-Abri R. Fasting & Health. Radio interview. Oman Radio. October Al-Abri R. Communication Skills Workshop. Nizwa Hospital, November Dept. 24 a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Sugery 255

266 24. Al-Abri R. IRCA OH & S Auditor Certification Scheme. SQUH, November Al-Abri R. Medical Ethics Workshop. Nizwa Hospital, 01 November Al-Abri R. Quality Improvement in Health Care. Sur Hospital, 31 December Al-Abri R. Radio interview on Wrong Habits in ENT. Oman Radio. December Mathew J. Testosterone Deficiency Syndrome. Urology Symposium. Royal Hospital, Oman, 3 January Mathew J. Carcinoma Prostate An overview. Surgery & Urology Update. Sohar Hospital, Oman, 10 April 2008 S 256

267 Dept. 24 S a c a d e m i c an d pa t i e n t ca r e de p a r t m e n t s Sugery 257

268 Department M 258

269 Dept. 01 Support Departments Medical Library Medical Education Unit Sultan Qaboos University Medical Journal Hospital Finance M Hospital Housing Hospital Information System Hospital Medical Records Hospital Medical Stores Hospital Patient Services Hospital Public Relations and Information Directorate Hospital Quality Management Hospital Support Services Hospital Technical Affairs Directorate Hospital Training Directorate Hospital Transport s u p p o r t de p a r t m e n t s Medical Library 259

270 01 Medical Library Overview The main thrust of our library policy has always been towards developing and evaluating library resources and providing services more effectively. A major achievement in this respect was the implementation of online searching to support the programmes of the College of Medicine & Health Sciences and the University Hospital, Mespecially in research activities. Staff Mohammed Al-Wardi, Director Mariam Al-Sinani, Librarian A Mohammed Al-Higgi, Librarian B Huda Al-Farsi, Senior Deputy Librarian Huda Al-Haddabi, Senior Deputy Librarian Suad Al-Busaidi, Senior Deputy Librarian Salim Al-Farei, Senior Deputy Librarian Mohammed Al-Yahmadi, Deputy Librarian Nabil Al-Amri, Deputy Librarian Saif Al-Muharbi, Deputy Librarian Abdulla Al-Hinai, Assistant Librarian Jassim Al-Hasani, Assistant Librarian Qasim Al-Harrasi, Senior Programmer C 260

271 Support Staff Luthgarda Bongsalo, Coordinator Said Al-Alawi, Clerk Ahmed Al-Ghafri, Photocopy Operator Dept. 01 Highlights of the Year Circulation In this period, the total number of checked out materials was 6,695: 6,658 for books and 37 for audio-visual materials. The number of registered library members was 211. Acquisitions M In this period, 423 new book titles were added to the library collection. These were made up of 48 titles received from last year s orders, 122 book titles purchased from the Book Fair, Oman and 253 monographs received gratis from the Ministry of Health, Oman World Health Organization, and other sources. The total subscription of journals for 2008 was 257 titles at the cost of $288,108. A total of 38 journals from the Gulf Cooperation Council Region were received gratis. s u p p o r t de p a r t m e n t s Medical Library Interlibrary Loan Requests for journal articles not available in our collection totaled 154. A total of 39 articles at the cost of 503 were procured from BLDSC, London and 115 articles from the different Gulf Biomedical Libraries were received gratis. IT Services E-journals can be accessed through our website ( and Science Direct. 261

272 Training of Library Users The total number of Sultan Qaboos University students trained to use the Library was 32. Fourteen were from College of Nursing, 12 from Nutrition Department and 6 from Department of Library Science and Information. A total of 186 external students were also trained to use the Library. There were 78 from the Oman Specialist Institute, 28 from the Health Nursing Institute, 60 from the Insitute of Health Sciences and 20 from the Oman Nursing Institute. M 262

273 Dept. 01 M s u p p o r t de p a r t m e n t s Medical Library 263

274 02 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 full-time staff, but draws mainly on the voluntary participation of staff with either a formal qualification or a strong interest in the field of medical education Mfrom the different departments of the College and from the Ministry of Health. 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, assessment, 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. Recently, the Clinical Skills Laboratory has come under the management of the Unit. The Medical Informatics Group is a very productive group within the Medical Education Unit. It is concerned with the application of information and communication technology to medical education and research. Its main goals are to: Strengthen the integration of medical informatics technologies in the area of medical teaching, research and services + Increase the competency of faculty in the use of medical informatics tools + Design effective remote telemedicine conferences and workshops with international institutes + Evaluate the effectiveness of various medical informatics technology products in teaching and

275 learning medicine + Analyse and specify the College requirements for medical informatics equipment and infrastructure + Support hardware maintenance and provide a troubleshooting service The main functions of the Medical Informatics Group are to: Dept Provide consultation and support in a wide range of medical informatics learning environments to support learning, teaching and research + Develop and produce medical informatics programs and software + Develop and produce e-learning and web-based courseware M + Design a specialised web portal for departments, conferences and workshops + Produce multimedia products for preclinical and clinical students and the medical profession (e.g. Teaching and Conference CD-ORM) Staff Head of Unit Nadia Al-Wardy, Assistant Professor, Department of Biochemistry s u p p o r t de p a r t m e n t s Medical Education Unit Faculty Ibrahim Inuwa, Associate Professor, Department of Anatomy Zahra Al-Rawahi, Assistant Professor, Chair Computer & Information Technology Group Syed Rizvi, Assistant Professor, Department of Family Medicine and Public Health Samir Hussein, Senior Consultant, Department of Radiology & Molecular Imaging Abdullah Al-Asmi, Senior Consultant, Department of Medicine Omar Al-Hussaini, Department of Medicine, Royal Hospital, Ministry of Health Laila Al-Zadjali, Director of Training & Scholarships, Ministry of Health 265

276 Support Staff Hisham Abdul Hadi, College IDEAL Administrator Moosa Al-Rawahi, e-learning Developer Salim Al-Harthi, Web Master Zaid Al-Mahrooqi, Computer Technician Bader Al-Ismaili, Computer Technician Asila Al-Harthy, Coordinator Highlights of the Year In the year , the services offered by the Unit were the following: M - Hernia workshop (open & laparoscopic) Telemedicine Audio/visual live broadcasting from operation theatres to Annex Building through a plasma screen: - Workshop on stapled haemorrhoidectomy - Basic Surgical Skills Course - Workshop on endoscopic ear surgery Videoconferencing - Videoconferencing with Monash University, Australia - GSPR Telemedicine Access Gulf Paediatric Respiratory meeting - Gulf Paediatric Palimony Society meeting 266

277 Teaching Programmes Undergraduate Preclinical Programme The Medical Informatics section of the MEU was involved in teaching the following elective courses to undergraduate medical and nursing students: Dept Creative Thinking - Health Informatics Training Courses & CME Activities Several teacher-training workshops were conducted to update College, Hospital and affiliated staff in educational and assessment methods. Some of these workshops were conducted by internationally renowned faculty in medical education. The workshops were: M - Health Informatics Workshop - a full-day workshop held on 23 January Use of IDEAL Databank workshops - two half-day workshops held in October and November Departmental IDEAL representatives attended. - CHPE (Certificate course in Health Professions Education) - a three-day course held in February in A total of 45 College, Hospital, and affiliated staff and other health professionals participated in the course. - Student Assessment Workshop - A three-day workshop held in February in Twentyfive College, Hospital, and affiliated staff participated. - Designing Online Courses - two-hour workshops held on 24 February and 9 March Thirty-two College and Hospital staff participated. - Creating Online Assessments - two-hour workshop held on 23 March Thirteen College and Hospital staff participated. - Configuration of mailing system using Microsoft Outlook and Outlook Express - held on 20 s u p p o r t de p a r t m e n t s Medical Education Unit 267

278 April Eighteen College and Hospital staff participated. Research Research Publications and Books Journal Publications 1. Al-Wardy N. Medical Education Units: History, Functions, and Organisation. SQU Med J 2008; 8: Conference Presentations Local 1. Al-Rawahi Z. Bridging the Quality Gap in Healthcare with Information Technology. 1st International Conference in Quality Management. Oman, Jan M Poster Presentations 2. Al-Rawahi Z. The Role of Information Technology in Improving Patient Safety. Patient Safety Symposium. Oman, Feb International 1. Al-Wardy N, Rizvi S, Bayoumi R. Correlation between students grades in the final MD exam and their BSc (Health Sciences) GPA in the College of Medicine & Health Sciences, Sultan Qaboos University. AMEE Conference. Trondheim, Norway, September Al-Wardy N. An assessment programme for the new curriculum in the College of Medicine &Health Sciences, Sultan Qaboos University. AMEE Conference. Prague, Czech Republic, August

279 Dept. 02 M s u p p o r t de p a r t m e n t s Medical Education Unit 269

280 03 Sultan Qaboos University Medical Journal Overview The Journal was officially launched in 1997 with 7 issues published up to The Journal was relaunched in 2006 with two issues and renamed Sultan Qaboos University Medical Journal, SQUMJ. An Editorial Board was appointed of 15 Associate Editors from within the College. 270 S + To promote a culture of scientific publications in the medical and related disciplines at SQU. 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 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 communications, 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. + To enhance the research profile of SQU. + To be Indexed with the US National Library of Medicine and with the Community of Science (COS); thus it will appear in PubMed and Medline online databases of health related citations

281 and abstracts. + To be published both on line as well as in print and ultimately be fully electronic in dealings with authors and reviewers - online submission and review via our existing website. Dept. 03 Staff Editor-in-Chief Lamk Al-Lamki, Professor Radiology & Molecular Imaging Editor Samir Al-Adawi, Associate Professor Behavioural Medicine & Editor Associate Editors S Rashid Al-Abri, Consultant, Surgery Abdullah Al-Asmi, Senior Consultant, Medicine Sulayma Al-Barwani, Associate Professor, Physiology Riad Bayoumi, Professor, Biochemistry Ikram Burney, Senior Consultant, Medicine Vaidyanathan Gowri, Assistant Professor, Obstetrics & Gynaecology Omar Habbal, Associate Professor, Human & Clinical Anatomy Ali Al-Jabri, Associate Professor, Microbiology & Immunology Nadia Al-Kharousi, Consultant Ophthalmology Salam Al-Kindy, Assistant Professor, Haematology Neela Al-Lamki, Professor, Radiology & Molecular Imaging Zakia Al-Lamki, Associate Professor, Child Health Norman Machado, Consultant, Surgery Mansour Al-Moundhri, Associate Professor, Medicine John Raeburn, Professor, Genetics Muna Al-Sadoon, Assistant Professor, Child Health Marwan Al-Sharbati, Associate Professor, Behavioural Medicine s u p p o r t de p a r t m e n t s Sultan Qaboos University Medical Journal 271

282 Arabic Translator Marwan Al-Sharbati, Associate Professor, Behavioural Medicine Managing and Copy Editor Meriel Carboni Technical Editor Amar Hussain Higlights of the Year Three issues per year were published in 2007 and The rejection rate rose to 25% in SQUMJ became indexed in the WHO s Index Medicus for the EMOR region. S Numbers and Source of Articles SQUMJ aims to reach local, regional and international medical and other scientific audiences. Its 2007 and 2008 print run was 1,700 copies. 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 medical 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. Sources of Papers Received 2007 % 2008 % SQU MoH, Hospitals Oman Gulf/Middle East Further Field Total Manuscripts Received

283 Dept. 03 S s u p p o r t de p a r t m e n t s Sultan Qaboos University Medical Journal 273

284 04 Hospital Finance Overview The responsibilities of the Hospital Finance Department involve: + The preparation of the Hospital annual budget for approval by the Ministry of Finance; monitoring of the approved funds for effective utilisation; monitoring of the staff induction against staff budget approval; the maintenance of various statistics pertaining to staff, patients etc. H + The maintenance of a petty cash account. + The processing of staff salaries on a monthly basis and ensuring timely payments; the processing of leave salaries; the timely settlement of terminal benefits of staff leaving the hospital permanently etc. + The processing of suppliers and contractors bills for payment in coordination with supplies and stores departments. + The collection of revenue from paying patients, private hospitals etc. + Liaising with the Ministry of Finance and other government agencies. 274 Staff Nasser Al-Salmi, Director, Financial Affairs Yaqoob Al-Mahrizi, Director, Financial Affairs Adnan Al-Mosawi, Clerk Awadh Al-Bulushi, Clerk

285 Suleiman Al-Abri, Clerk Khamis Al-Muzaini,Clerk Salim Al-Sinawi, Clerk Hamoud Al-Farsi, Clerk Hilal Al-Daghaishi, Clerk Ahmed Al-Farsi, Clerk Sulaiman Al-Bulushi, Clerk Saleh Al-Nadabi, Clerk Selwa Al-Hinai, Clerk Zuweina Al-Habsi, Clerk Suroor Al-Rubaiey, Clerk Naeema Al-Saadi, Clerk Azhar Al-Dhgaishi, Clerk Mohammed Al-Ramadhani, Clerk M Rao, Senior Technician/Statistician H Highlights of the Year During the year ending 2008, the number of staff paid salaries was 2, The Hospital budget for the year 2008 was prepared and submitted on time to the Ministry of Finance for approval. + The Department also processed 3,017 vouchers of suppliers and contractors for payment during the year ending The Hospital revenue collection for the year ending 2008 was OR 375, Constant monitoring of the budgetary allocation and timely intervention has resulted in the utilisation of 95.7 % of the budget for the year ending The petty cash disbursement for the purchase of day-to-day urgent items for the year 2008 was OR 34, Dept. 04 s u p p o r t de p a r t m e n t s Hospital Finance 275

286 05 Hospital Housing 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 Htypes 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 number of residential units available in 2006 was 399; 508 in 2007 and 529 in This covered most of the hospital requirement in various categories. 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. 276 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

287 Khalid Al-Hossaini, 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 Omanised. Dept. 05 Highlights of the Year Sale of obsolete furniture in the University auction. H + Attendance at most of the workshops of the ISO Renewal of the legal agreement of hired complexes for one more year. + Substantial increase in hired accommodation within this year. + Removal of occupants from one building (doctor s accommodation JDH/A1) to13 independent houses belonging to the University. + Two apartments of three bedrooms on-campus, which had been sanctioned earlier for female Omani internship nurses, were no longer used for this purpose, due to the shortage of accommodation for hospital employees. + Participated in periodical orientation programmes for new employees. + Continued providing accommodation for female medical interns in cooperation with the College of Medicine. + Most furniture supply purchases have succesfully been achieved. + Followed up with the Maintenance Department the implementation of the yearly PPM schedules for all electrical items in the accommodation. + New Hospital Administration offices were completely furnished as a developmental process required by Hospital Administration. s u p p o r t de p a r t m e n t s Hospital Housing 277

288 + New cleaning checklists were drawn up to upgrade the cleaning process in the accommodation. + Updated posters for emergency services contact details have been given to all residences. Housing Allowance In order to cover residential accommodation shortages, there has been substantial 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 liaising. H Hospital On-campus and off-campus Accommodation Residence Cleaning The cleaning and preparation of residential units have successfully been completed before occupancy. Off-campus On-campus Type Hired Accommodation Total Family Single Shared 8 (R) 26 14(R) 198 (R) 276(R) 266)R) 206 ( R) 203 (R) 208 Total * ( R ) Room 278

289 Dept. 05 H s u p p o r t de p a r t m e n t s Hospital Housing 279

290 06 Hospital Informations System 280 Overview The vision of the Hospital Information Systems (HIS) Directorate is to promote the use of state of the art information technology (IT) in the health care field, in order to create an electronic working environment at Sultan Qaboos University Hospital (SQUH), make the staff IT literate and encourage them to use the electronic media extensively. H The main aim of the Hospital Information Systems Directorate is to provide availability, integrity and security of excellent information technology-based services in the areas of hardware, software, network, training and other IT related fields. Achieving this aim will facilitate the Sultan Qaboos University Hospital s mission as it applies to management, health care providers, researchers, patients and community services. Staff Ali Abdullah Hamed Al-Hashmi, Director Naeem Ali Duhaim Al-Shukaily, Head of Operations Elgen Juliano, Senior Systems Analyst Administrator Mohammad Arshad Ansari, Chief Database Administrator Mohsin Ali Al-Zadjali, Senior Systems Analyst Jokha Abdullah Mussalam Al-Kalbani, Senior Systems Analyst Vishnu Mampatta, Chief Systems Analyst Yaqoob Amer Al-Zuhly, Senior Network Administrator Abdullah Salim Hamed Al-Mahrooqi, Senior Network Administrator

291 Mohammad Khalid Khawaja Shaikh, Senior Network Engineer Ahmed Abdullah Al-Shaibany, Senior Systems Engineer Bader Saif Shamis Al-Kiyoumi, Senior Hardware Engineer Said Khalfan Salim Al-Harassi,Senior Network Engineer Lokesh Pandit, Senior Software Engineer Abdullah Said Abdullah Al-Rashdi, Senior Programmer Jamal Antar Salim Al-Busaidi, Systems Analyst Nasser Said Hamed Al-Azwani, Systems Security Specialist Nasser Ali Salem Al-Mandhari, Systems Engineer Akinyemi Akinbowale Koyi, Programmer Widad Said Al-Mamary, Programmer Moosa Saif Hamed Al-Rawahi, Technician Mustafa Soud Al-Hadhrami, Technician H Fatima Rashid Al-Masoudi, Technician Yahya Ali Saif Al-Salmi, Technician Younis Mohammed Al-Harthi, Technician Fahad Ali Al-Shukaily, Technician Hamza Ghassan Hilal Al-Jaafari, Technician Younis Ali Said Al-Habsi, Clerk Dorothy Paul, Coordinator Highlights of the Year Implementation of SQUH Internal Website. + Implementation of SQU external Website. + Risk Assessment Study and follow up of the findings. + Implementation of SMS Project. + Analysing and Implementation of the Blood Bank Module. + Launch of Meal Coupon System (Biometric) for Hospital Finance Department. Dept. 06 s u p p o r t de p a r t m e n t s Hospital Informations System 281

292 + Enhancement of Service Desk + Initiated Reengineering of the System for TRAKCARE upgrade. + Evaluation of the Ministry of Health (ALSHIFA) System. + Developing Incident Reporting System, Version First line support for the running modules of the Trust System. + Study, evaluation and implementation of Auto CAD solution for the Technical Affairs Department. + Installing 250 PCs, 20 Laptops and other peripherals in various departments in the Hospital. + More than 2,176 calls have been attended to by HIS Operation and Development Divisions during H + Implementation of the new WI+FI (802.11n standard) high speed wireless in SQUH. + Connecting the new Medical Records Department to HIS network. + Connecting the new offices in Administration to HIS network. + Training in the TRAKCARE System for doctors, interns, nurses, laboratory staff and clerks. + Conducting summer training programmes. 282

293 Dept. 06 H s u p p o r t de p a r t m e n t s Hospital Informations System 283

294 07 Hospital Medical Records Overview The goal of the Medical Records Service is to create and maintain systems which support health care providers, public studies, financial organisations and, most important of all, the needs of the patient. The hospital currently has a hybrid records system that involves most information being held in the new Hospital Information System, TrakCare, Hwhile a small amount of information is still held on paper records. The goal is to have a full electronic health record system functioning by the end of The Department operates with a sincere and highly committed staff team, consisting of 48 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, doctors, 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 that all other notes and reports are present. In addition, it ensures that records are assembled in an orderly and timely manner and signed-in in the system. Also, it scans all the important documents into the new electronic patient record which have not been entered directly, such as consent forms. 284 The Admission & Registration Section is the largest section. It is made up of clerks and receptionists of OPDs clinics, X-ray, Physiology, Oral Health, Family & Community Health and the Student Clinic. The registration of patients in the Accident & Emergency Department is an important part of our activity as it is a crucial and critical area in the Hospital, running 24 hours a day.

295 The Statistics Section prepares statistics for 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. Dept. 07 The Coding Section analyses all inpatients discharge records, and assigns a numeric code to diagnostic data based on the International Classification of Diseases system (ICD-10 and ICD-9-CM) for procedures. The Births & Deaths Section issues electronic birth notifications in Arabic and English for new born babies, and death notifications for those who died at SQUH. The Directorate of Civil Services issues the certificates. A copy of the register is sent to the Ministry of Health every three months. H Staff Salim Khloof Al-Wahaibi, Head of Department Ahmed Al-Farsi, Deputy Head of Department Saif Al-Raqadi, Supervisor Mubarak Al-Habsi, Supervisor Abdullah Al-Wahaibi, Supervisor Yousif Al-Falahi, Supervisor Salim Al-Hadi, Acting Supervisor Huda Al-Suwaidi, Acting Supervisor Mahfoudhah Al-Zadjali, Acting Supervisor Sulaiman Al-Siyabi, Acting Supervisor s u p p o r t de p a r t m e n t s Hospital Medical Records The statistics of our various activities for are shown in the table below: Activity Registration of patients in A&E 41,650 49,172 Processing inpatient coded records 18,977 21,920 Issuing birth notifications 2,297 2,

296 08 Hospital Medical Stores Overview The Hospital Medical Stores Department is one of the key departments in SQUH. It provides the Hospital with the necessities to run its various services. Inventory control is the major activity performed by medical stores staff. The Department carries out an inventory for about 10,000 line items. H The Medical Stores has 7 sections. Five of these sections supply different items to SQUH. The Medical Stores building is located around 200 metres away from the Hospital.The entire building is climate controlled. Utmost care is taken to store materials according to storage recommendations. Medical Stores has 45 staff in different positions handling and processing the inventory activities. Medical Stores operates 7 hours a day, 5 days a week, plus there is a 24-hour on-call system in place for providing services in emergency cases Pharmacy (PHY) + Medical Surgical Supplies (MSS) + Biomechanical Engineering & Hospital Maintenance (BME & HMD) + Laboratory (LAB) + Stationery (STA) + Receiving + Dispatch

297 Staff Zakaria Al-Kindi, Head of Department Ahmed Al-Kindi, Deputy Head of Department Nahya Al-Hinai Ahmed Al-Abri Yahya Al-Hasani Waleed Al-Suleimani Ahmed Al-Hamadi Dhaneen Al-Khatry Mohammed Al-Shuaili Hamed Al-Husaini Yohannan George H Samiha Al-Farsi Santosh Kumar Ajith Vharghese Hytham Al-Bulushi Zayana Al-Sheibani Ahmed Al-Rashdi Bader Al-Nabhani Yahya Al-Adi Yousuf Al-Jabri Rashid Al-Naimi Ahmed Al-Rashdi Abdullatif Al-Wahabi Mohd Al-Fazari Abdulla Al-Bakri Fairuz Saeed Al-Alawi Khalifa Al-Alawi Ali Al-Riyami Mubarak Al-Maqbali Dept. 08 s u p p o r t de p a r t m e n t s Hospital Medical Stores 287

298 Highlights of the Year The Medical Stores Department continued to provide its services to the Hospital through its inventory activities. These activities support the key objective that is continual supply of items needed by the Hospital. Activities which were carried out in 2008 were: + Item consumption reviewing + Indenting + Evaluation of quotations + Receiving of materials + Storage + Issuing of items + Stocktaking and data-keeping H 288

299 Dept. 08 H s u p p o r t de p a r t m e n t s Hospital Medical Stores 289

300 09 Hospital Patient Services Overview The Patient Services Department s role is to provide a 24 hrs, compassionate, accessible and high quality service to SQUH clients and visitors. The Department also works to resolve any misunderstandings that might arise between staff and clients so that the hospital runs with minimal interruptions. Staff members liaise with other internal/external departments so that clients receive maximum help. H The Department s responsibilities include the following: + Investigating the different problems that may occur between staff and SQUH clients and finding appropriate solutions. + Attesting sick leaves and certificates. + Coordinating with doctors when medical reports are requested. + Translating reports when required. + Coordinating with the Royal Oman Police regarding accidents and accident reports. + Releasing oxygen concentration machines to patients who fulfill specific conditions. + Supervising the Hospital security guards. In the unfortunate event of a patient dying, the Department has the following responsibilities: Informing the relatives. + Making sure that all documents such as death notification and dead body release forms are

301 properly done. + Helping the relatives in finding appropriate transportation to transfer the body. + If the person was a non-omani, the Department guides the relatives through the required procedure to transfer the body abroad. Dept. 09 Staff Director Ahmed Al-Khayari Ahmed Al-Barwani, Deputy Director Younis Al-Farsi, Secretary Khalsa Al-Salmi, Translator Ghosen Al-Ghaafri, Counselling psychologist Fakhria Al-Amri, Health Education Specialist Saleh Al-Hinai, Duty Administrator Said Al-Harthy, Duty Administrator Nasser Al-Alawi, Duty Administrator Masoud Al-Harthy, Duty Administrator Mansoor Al-Hinai, Duty Administrator Muneer Al-Belushi, Duty Administrator Juma Al-Ghafri, Clerk Ibrahim Al-Ghafri, Clerk Yousif Al-Habsi, Receptionist Khalid Al-Moaini, Receptionist Salim Al-Mamari, Receptionist Sultan Al-Sadi, Receptionist Juma Al-Muharbi, Receptionist H s u p p o r t de p a r t m e n t s Hospital Patient Services 291

302 Highlights of the Year In cooperation with doctors approximately 2,861 medical reports were issued. + Approximately 16,328 visiting passes have been issued. + Our visitors pass unit was transferred to the main reception area at the new main entrance of the Hospital. + 1,104 medical reports, including injury reports, were translated within the Department besides leaflets. + New staff has joined the department: Ahmed Al-Barwani as Deputy Director, Fakhria Al-Amri as Health Education Specialist and Yousif Al-Habsi, Khalid Al-Moaini,Sultan Al-Sadi and Juma Al-Muharbi as receptionists. H + 44 SQU & other colleges students were trained within the department lectures for inpatients were conducted with various topics besides 247 private visits for patients. + Work was begun on the Patient Services Department website 292

303 Dept. 09 H s u p p o r t de p a r t m e n t s Hospital Patient Services 293

304 10 Hospital Public Relations and Information Directorate Overview An organisation s success and reputation is dependent to a large extent on its image. The Public Relations & Information Directorate, therefore, works tirelessly on building and maintaining the positive image that SQUH deserves. The Directorate also provides top quality services to SQUH staff through its contacts with different governmental and private agencies. H + Cultural & Social Activities Department The Public Relations & Information Directorate serves the hospital through its four different departments: + Media & Information Department + Printing & Publishing Department + Employee Services Department 294 Staff Khamis bin Sulaiman Al-Farsi, Head of Department Sultan bin Rashid Al-Marhoobi, Acting Head of Department Sultan bin Hafidh Al-Abri, Director Humed bin Abdullah Al-Adwani, Deputy Director Salim bin Mohammed Al-Hinaai, Journalist Mohameed bin Abdullah Al-Zidi, Clerk

305 Abdullah bin Jumayyil Al-Owaisi, Clerk Maryam bint Mufti Al-Qureshi, Clerk Mohammed bin Abdullah Al-Salmi, Clerk Ahmed bin Saud Al-Hinai, Clerk Saif bin Mohammed Al-Ghithi, Clerk Yahya bin Nasser Al-Aamri, Clerk Hashim bin Ahmed Al-Balushi, Clerk Yonis bin Ali Al-Habsi, Clerk Ali bin Khalifah Al-Hatmi, Messenger Highlights of the Year H MEDIA & INFORMATION DEPARTMENT AND PRINTING & PUBLISH- ING DEPARTMENT Activities Covering all SQUH events in local media 20 Designing event invitation cards 14 Designing certificates of appreciation 10 Designing of patient educational materials (leaflets, posters) 39 Announcement of vacancies, tenders and training programmes 21 Providing banners for hospital events 11 Total/Year Coordinating with media agencies regarding interviews with hospital staff 12 (doctors) Designing of annual calendar 2 Producing of educational and awareness films 3 Designing of pop-up materials 4 Dept. 10 s u p p o r t de p a r t m e n t s Hospital Public Relations and Information Directorate 295

306 CULTURAL & SOCIAL ACTIVITIES DEPARTMENT Activities Supporting all SQUH departments in organising conferences, symposia and workshops Arranging all the needs for training programmes in coordination with Training Directorate Total/Year Organising graduation ceremony 2 Organising the SQUH Annual Exhibition Day 4 Patient visits and gift distribution 13 H Fun activities for children 16 Official visits 4 Picnic for staff 2 Opening ceremony (new department) 1 Other 16 EMPLOYEE SERVICES DEPARTMENT Activities Total/ Year Escorting of VIP patients 400 Police station visits 4 Court visits 2 Receiving employees from airport 100 Farewells 60 Visas issued 1,037

307 Visas deposited 160 ID cards issued 3,153 Road passes issued 320 Other 200 Dept. 10 H s u p p o r t de p a r t m e n t s Hospital Public Relations and Information Directorate 297

308 11 Hospital Quality Management Overview The Quality Management Department of Sultan Qaboos University Hospital is one of the newest departments in the hospital, being established in This department has taken the responsibility of improving quality assurance in the hospital through establishing an efficient Quality Management System (QMS). Continually working towards Himproving SQUH quality is made possible by having been awarded the ISO certificate. QMD is committed to enabling the provision of compassionate, ethical, and accessible general and specialised tertiary care to the community with integrity, commitment and respect towards patients and their families. QMD s work is highly productive and it is staffed by experienced and skilled team members. Furthermore, it seeks to promote excellence through continual improvement in teaching, research, patient services and staff development. This is supported by effective process delivery and efficient resource utilisation. QMD s works enabling on the following outcomes: Ensuring that the following activities are being maintained in order to achieve the highest standard of excellence: patient satisfaction; effective policies and internal communication; monitoring and measurement of inter-disciplinary clinics; hospital wide audits; liaison with referral hospitals; provision of a common framework for internal communication. + Improving claimed systems, processes and related results effectiveness. + Identifying objectives and focusing on the needs and expectations of patients and other customers.

309 + Achieving and maintaining desired services that will consistently meet customers stated or implied needs. Dept Monitoring our healthcare services outcomes. + Providing evidence of capability to customers and potential customers. + Providing internationally recognised standards of care. + Helping establish a baseline for improving performance and outcomes. + Providing a basis for certification and accreditation. Staff Director Rashid Al-Abri, ENT, Senior Consultant Deputy Director Yasmeen Al-Hatmi Support Staff Hamdan Al-Siyabi, Lead Auditor Sumaiyya Al-Busaidi, Risk Facilitator Carolina Vacalares, Coordinator H Highlights of the Year In this year the Department was upgraded to Directorate and now called Directorate of Development & Quality. s u p p o r t de p a r t m e n t s Hospital Quality Management Since achieving ISO certification, in May 2007 and re-certification in May 2008, SQUH has performed various activities in order to assure and control quality. Now the Directorate is working towards JCI accreditation. The SQUH continual improvement activities were as follows: 299

310 Hospital improvement activities: + Document control system established + Development of hospital statistics and analysis + Departmental quality representatives identified (DQR) + Peer Review department activities reported monthly to Hospital Medical Advisory Committee + Internal quality training courses conducted + SQUH quality workshops for Ministry of Health + Risk management programme initiated H + Patient education management introduced + JCI Accreditation introductory workshop run + Quality Conference organised + Affiliation of SQUH with accredited hospital SQUH internal training JCI Accreditation introductory course, 3-7 November 2007 OHSAS certified lead auditor course, November 2007 External training Most of the external training and workshops were given to Ministry of Health hospitals Quality workshops Phase 1: Risk management, auditing, documentation, certification and accreditation awareness and statistical data analysis courses were given to. 300

311 + Sultan Qaboos Hospital, Salalah, September Khoula Hospital, October Nizwa Hospital, Incident Workshop, 7 May Sur Hospital, Research Methodology, 8 May Buraimi Hospital, Quality Workshop, 11 June Sohar Hospital, Quality Awareness, 12 June 2008 Dept. 11 Phase 2 The advanced quality awareness and live audit courses were given to: + Sultan Qaboos Hospital, Salalah, Sept 2007 Ethics workshops The following were included in the workshops Hto external organisations: consent, confidentiality, clinical ethics, dilemmas, medical jurisprudence Communication workshops The following were included in the workshops given to hospitals: cultural aspects; personality styles; types of communication; breaking bad news; dealing with difficult patients. International participation + The QMD organised the First International Conference of Quality in Healthcare at SQU, January Dr. Rashid Al-Abri was invited as speaker in the Quality Summit in Dubai from 29 June - 1 July 2008 to present SQUH experience as a leading organisation in quality in healthcare. s u p p o r t de p a r t m e n t s Hospital Quality Management SQUH Quality News The first issue was distributed in April Development plans 2008 Incorporate accreditation standards and occupation health and safety standards with current 301

312 QMS system (ISO) + Prepare for Hospital accreditation project (JCI) + Expand Department to include development and health and safety + Lead SQUH to patient-centred care and be a patient-centred education institute + Introduction of health and safety auditing H 302

313 Dept. 11 H s u p p o r t de p a r t m e n t s Hospital Quality Management 303

314 12 Hospital Support Services Overview The Support Services Department provides services in four sections: The Housekeeping Section This section provides full cleaning services Hto the Hospital with a total of 138 male and female housekeeping staff at 50% Omanisation. Cleaning services are carried out through M/s Kalhat Trading and Services under strict supervision from the Hospital Housekeeping Supervisor. The Laundry Section This section is provides full laundry services to the hospital through a reputed company with a total of 22 male and female laundry staff at 30% Omanisation. All activities are directly controlled by the Hospital Laundry Supervisor. The Linen SECTION This section provides all linen, curtains patient gowns and staff uniforms to the Hospital. The linen stores are controlled under the strict supervision of the Linen Store Keeper. This year we have changed staff uniforms for the NNL, DEL, A&E and Cardiology departments. The Medical Orderly Section This section provides porter services to all wards and departments under strict supervision. 304