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Hashmi SA, Hudar SA, Stephen E, Riyami DA, Maawali HA, Abdelhady I, Wahaibi KA, Rizvi S. Factors Affecting the Early Maturation of Arteriovenous Fistulae Created at a Tertiary Centre in Oman. Sultan Qaboos Univ Med J 2024; 24:37-43. [PMID: 38434458 PMCID: PMC10906777 DOI: 10.18295/squmj.9.2023.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 07/11/2023] [Accepted: 07/18/2023] [Indexed: 03/05/2024] Open
Abstract
Objectives This study aimed to determine the risk factors associated with the failure of arteriovenous fistulae (AVF) maturation. Methods This retrospective cohort study was conducted from January 2014 to December 2018 in Sultan Qaboos University Hospital, Muscat, Oman. Patients were followed-up 3 months after surgery, and their electronic medical records were accessed for demographic and clinical data. Univariate analysis was used to determine the risk factors associated with early AVF maturation and multivariant analysis was used to determine the predictive factors for AVF failure. Results A total of 269 patients were included. Female gender was a significant factor affecting AVF maturity (P = 0.049), while age (P = 0.626), diabetes (P = 0.954), hypertension (P = 0.378), dyslipidaemia (P = 0.907), coronary artery disease (P = 0.576), cerebrovascular accident (P = 0.864), congestive heart failure (P = 0.685), previous central venous catheterisation (P = 0.05), fistula type (P = 0.863) and fistula site (P = 0.861) did not affect AVF maturation. Binary logistic regression showed that all the risk factors were insignificant. Failure of early AVF maturation affected 11.5% in the cohort. Conclusion This study found that the proportion of early AVF maturation at our hospital is at par with that in the international literature. Failure of AVF maturation was significantly associated with the female gender. These findings can help nephrologists and vascular surgeons prognosticate AVF maturation rates. However, a larger study is needed for definitive conclusions.
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Affiliation(s)
| | | | - Edwin Stephen
- Department of Surgery, Sultan Qaboos University, Muscat, Oman
| | - Dawood Al Riyami
- Department of Internal Medicine, Sultan Qaboos University Hospital, Sultan Qaboos University, Muscat, Oman
| | | | | | | | - Syed Rizvi
- Department of Family Medicine & Public Health, Sultan Qaboos University, Muscat, Oman
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Al Riyami D, Mohammed S, Al Salmi I, Metry A, Al Kalbani N, Almurshadi F, Al Rasbi S, Al Ismaili F, Hola A, Hannawi S. Epidemiology, Management, and Outcome of Atypical Hemolytic Uremic Syndrome in an Omani Cohort. Oman Med J 2023; 38:e569. [PMID: 38317858 PMCID: PMC10839635 DOI: 10.5001/omj.2023.117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 06/13/2023] [Indexed: 02/07/2024] Open
Abstract
Objectives Atypical hemolytic uremic syndrome (aHUS) is a rare, life-threatening disease of chronic uncontrolled complement pathway activation that leads to thrombotic-microangiopathy, along with severe organ damage, including end-stage kidney disease. This study aimed to evaluate the epidemiology, management, and outcome of aHUS in an Omani population. Methods This retrospective descriptive cohort study assessed all cases of aHUS diagnosed and followed up at two tertiary care centers in Oman from January 2008 to December 2019, based on clinical features, complement pathway assays, histopathological, and genetic testing. Results The study accrued 19 patients who fulfilled the inclusion criteria, of whom 11 (57.9%) were male. The participants' median age was 25.0 years (range = 0.1-69.0). Most (15; 78.9%) patients presented in the acute phase of the disease. The triad of hemolytic anemia, acute kidney injury, and thrombocytopenia was present in all patients. A trigger factor (e.g., infection) was identified in 68.4% of cases. Of the 14 (73.7%) patients who underwent kidney biopsy, 10 (71.4%) were found to have aHUS in native kidneys and three in grafted kidneys. Of the 11 (57.9%) patients who underwent genetic analysis, five (45.5%) were found to have a known pathogenic variant in their aHUS susceptibility genes. Plasma exchange followed by eculizumab was the treatment method in 11 (57.9%) cases. Complete renal recovery was achieved in seven (36.8%) patients, while four (21.1%) passed away during the study period. Conclusions The wide spectrum and multiple expressions of aHUS make it a challenge to diagnose and consequently may delay the commencement of the targeted treatment. Eculizumab is considered the first-line therapy and should be commenced as early as possible.
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Affiliation(s)
| | - Saja Mohammed
- Department of Medicine, Sultan Qaboos University, Muscat, Oman
| | - Issa Al Salmi
- Department of Renal Medicine, Royal Hospital, Muscat, Oman
- Internal Medicine Residency Training Program, Oman Medical Specialty Board, Muscat, Oman
| | | | - Naifain Al Kalbani
- Pediatric Nephrology, Child Health Department, Royal Hospital, Muscat, Oman
| | | | - Samira Al Rasbi
- Nursing Directorate, Sultan Qaboos University Hospital, Muscat, Oman
| | | | - Alan Hola
- Department of Renal Medicine, Royal Hospital, Muscat, Oman
| | - Suad Hannawi
- Department of Rheumatology, Ministry of Health and Prevention, Dubai, UAE
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Stephen E, Al-Hinai M, Al-Maawali H, Abdelhady I, Al-Aufi A, Al Sukaiti R, Al Riyami D, Al-Wahaibi K. Systematic surveillance of arteriovenous fistula patency in renal failure patients – Our early experience. Indian J Vasc Endovasc Surg 2021. [DOI: 10.4103/ijves.ijves_52_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Balkhair A, Al Jufaili M, Al Wahaibi K, Al Riyami D, Al Azri F, Al Harthi S, Al Busaidi M, Al Mubaihsi S, Al Muharrmi Z, Al Riyami N, Al Belushi Z, Abdawani R, Al Hashar A, Al Mahrezi A, Al Maamari K, Al Busaidi I, Al Hinai Z, Alawi FB, Taher HB, Al Jabri M. "Virtual Interdisciplinary COVID-19 Team": A Hospital Pandemic Preparedness Approach. Oman Med J 2020; 35:e190. [PMID: 33110634 PMCID: PMC7578538 DOI: 10.5001/omj.2020.131] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 06/11/2020] [Indexed: 12/30/2022] Open
Abstract
The COVID-19 pandemic continues to move at record speed. Health systems and hospitals worldwide face unprecedented challenges to effectively prepare and respond to this extraordinary health crisis and anticipated surge. Hospitals should confront these unparalleled challenges with a comprehensive, multidisciplinary, coordinated, and organized strategy. We report our experience with the systematic application of the "4S" principle to guide our institutional preparedness plan for COVID-19. We used an innovative "virtual interdisciplinary COVID-19 team" approach to consolidate our hospital readiness.
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Affiliation(s)
- Abdullah Balkhair
- Department of Medicine, Infectious Diseases Unit, Sultan Qaboos University Hospital, Muscat, Oman
| | - Mahmoud Al Jufaili
- Department of Emergency Medicine, Sultan Qaboos University Hospital, Muscat, Oman
| | | | - Dawood Al Riyami
- Department of Medicine, Nephrology Unit, Sultan Qaboos University Hospital, Muscat, Oman
| | - Faisal Al Azri
- Department of Radiology and Molecular Imaging, Sultan Qaboos University Hospital, Muscat, Oman
| | | | - Mujahid Al Busaidi
- Department of Medicine, Intensive Care Unit, Sultan Qaboos University Hospital, Muscat, Oman
| | - Saif Al Mubaihsi
- Department of Medicine, Pulmonology Unit, Sultan Qaboos University Hospital, Muscat, Oman
| | - Zakaria Al Muharrmi
- Department of Microbiology and Immunology, Sultan Qaboos University Hospital, Muscat, Oman
| | - Nihal Al Riyami
- Department of Obstetrics and Gynecology, Sultan Qaboos University Hospital, Muscat, Oman
| | - Zainab Al Belushi
- Department of Surgery, Sultan Qaboos University Hospital, Muscat, Oman
| | - Raghad Abdawani
- Department of Child Health, Sultan Qaboos University Hospital, Muscat, Oman
| | - Amna Al Hashar
- Department of Pharmacy, Sultan Qaboos University Hospital, Muscat, Oman
| | - Abdulaziz Al Mahrezi
- Department of Family and Community Medicine, Sultan Qaboos University Hospital, Muscat, Oman
| | - Khuloud Al Maamari
- Department of Microbiology and Immunology, Sultan Qaboos University Hospital, Muscat, Oman
| | - Ibrahim Al Busaidi
- Department of Medicine, Infectious Diseases Unit, Sultan Qaboos University Hospital, Muscat, Oman
| | - Zaid Al Hinai
- Department of Child Health, Sultan Qaboos University Hospital, Muscat, Oman
| | - Fatma Ba Alawi
- Department of Microbiology and Immunology, Sultan Qaboos University Hospital, Muscat, Oman
| | - Hashim Ba Taher
- Department of Medicine, Infectious Diseases Unit, Sultan Qaboos University Hospital, Muscat, Oman
| | - Mansour Al Jabri
- Department of Infection Prevention and Control, Sultan Qaboos University Hospital, Muscat, Oman
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Al Salmi I, Al Rahbi F, Mohammed E, Al Riyami D, Al Alawi S, Hannawi S. Transplantation Model- Analytical Review: A Strategic Proposal and Moral Obligation. Trends in Transplant 2020. [DOI: 10.15761/tit.1000281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Al Riyami D. The spectrum of glomerular diseases on renal biopsy: data from a single tertiary center in oman. Oman Med J 2013; 28:213-5. [PMID: 23772291 DOI: 10.5001/omj.2013.58] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Accepted: 04/21/2013] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE To study the pattern of glomerular disease (GD) from the result of renal biopsies at our center. METHODS We conducted a retrospective review of 190 adult native renal biopsy reports from the pathology registry of renal biopsy performed at our hospital between 1992 and 2010. RESULTS Lupus nephritis was the most common pathology 48/133 (36.1%) with a female preponderance. The most common primary glomerular disease was focal segmental glomerulosclerosis (FSGS) 26/133(19.5%), followed by membranous glemerulopathy (MGN) 13/133 (9.8%), and mesangial proliferative glomerulonephritis 6/133 (4.5%). IgA nephropathy and acute proliferative glomerulonephritis each accounted for 4/133 (3.0%). Membranoproliferative glomerulonephritis accounted for 3/133 (2.3%). Focal proliferative and cresentic glomerulonephritis each accounted for 2/133 (1.5%). Vasculitis was not common and there was no report of anti-GBM disease. CONCLUSION Among the secondary glomerular diseases, lupus nephritis was the commonest condition with a female preponderance. Among the primary glomerular diseases, FSGS was the commonest. These results are consistent with global trend. IgA nephropathy is not common as the case in the Caucasian population. Vasculitis was not common and there was no report of anti-GBM disease.
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Affiliation(s)
- Dawood Al Riyami
- Sultan Qaboos University Hospital, Muscat, Al-Khoud, Sultanate of Oman
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