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Griebenow R, Herrmann H, Smith M, Bassiouny M, Gual A, Li PKT, Elsayed E, Schaefer RD, Al Sinani S, McMahon GT. Continuing Education as a Contributor to Mitigating Physician Burnout. J CME 2023; 12:2272461. [PMID: 37929072 PMCID: PMC10623890 DOI: 10.1080/28338073.2023.2272461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 10/05/2023] [Indexed: 11/07/2023]
Affiliation(s)
| | - Henrik Herrmann
- European Cardiology Section Foundation, Cologne, Germany
- Marburger Bund Germany, Berlin, Germany
| | - Michel Smith
- Royal College of Physicians and Surgeons of Canada, Ottawa, Canada
| | | | - Arcadi Gual
- Spanish Medical Professional Accreditation Council for CPD/CME (SEAFORMEC), Madrid, Spain
| | | | | | - Robert D Schaefer
- European Board for Accreditation of Continuing Education for Health Professionals, Cologne, Germany
| | | | - Graham T McMahon
- Accreditation Council for Continuing Medical Education, Chicago, USA
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Al-Naamani K, Al-Jahdhami I, Al-Tamtami W, Al-Amri K, Al-Khabori M, Sinani SA, Said EA, Omer H, Al-Bahluli H, Al-Ryiami S, Al-Hakmani S, Al-Naamani N, Al-Jahwari R, Al-Hinai M, AlWahaibi J. Prevalence and persistence of SARS-CoV2 antibodies among healthcare workers in Oman. J Infect Public Health 2021; 14:1578-1584. [PMID: 34688980 PMCID: PMC8442291 DOI: 10.1016/j.jiph.2021.09.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 08/04/2021] [Accepted: 09/08/2021] [Indexed: 12/15/2022] Open
Abstract
Objectives The primary objective is to determine the prevalence of SARS-CoV-2 antibodies persistence among HCWs and specifically among asymptomatic HCWs. A secondary objective is to determine the duration of persistent SARS-CoV-2 antibodies post infection and factors affecting this duration. The findings are expected to open the door for further research into the role of SARS-CoV-2 antibodies during the current COVID-19 pandemic. Methodology HCWs were divided into high, intermediate, and low risk based on their type and location of work. All participants filled a questionnaire. Blood samples were obtained for SARS-CoV-2 IgG/total antibodies. A documented SARS-CoV-2 PCR or Anti-SARS-CoV-2 IgG/total antibodies defined the primary outcome. The probability of persistence of antibody was calculated using the Kaplan–Meier estimator. Logistic and Cox regression were used where appropriate. Results A total of 1111 HCWs were included. The median age 37 years (IQR: 31–43). More than half (67.2%) were females. The primary outcome was seen in 373 (33.6%) participants with a median age of 36 years (IQR: 29–41). Only 37.2% of those with documented positive SARS-CoV-2 PCR had reactive serology, while only 16.2% of those with reactive serology had documented positive SARS-CoV-2 PCR. Male gender (OR 0.44, P < 0.001) and older age (OR 0.98, P < 0.019) were associated with a lower risk of acquiring SARS-CoV-2 infection. The probability of persistent SARS-CoV-2 antibodies at six months was 60.2% (95% CI: 49.5%–73.1%). Omanis had a higher probability of losing the antibody than others (HR 2.63, P = 0.021). Conclusion We report a high prevalence of anti-SARS-CoV-2 antibodies among HCWs in Oman, specifically among asymptomatic HCWs. Community was the most likely source of infection. Therefore, the society must adhere to the roles and regulations set to reduce the risk of transmission. We demonstrate a high percentage of seroconversion post initial infection, and the persistence of SARS-CoV-2 antibodies at six months in more than half of those previously infected. We demonstrated a new interesting finding of fast decline of SARS-CoV2 antibody levels over time among different nationalities and this requires further research.
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Affiliation(s)
- Khalid Al-Naamani
- Department of Internal Medicine, Division of Gastroenterology & Hepatology, Armed Forces Hospital, Muscat, Oman.
| | - Issa Al-Jahdhami
- Department of Internal Medicine, Division of Chest Medicine, Armed Forces Hospital, Muscat, Oman
| | - Wafa Al-Tamtami
- Department of Medical Laboratory, Division of Medical Microbiology, Armed Forces Hospital, Muscat, Oman
| | - Kawther Al-Amri
- Department of Internal Medicine, Division of Infectious Diseases, Armed Forces Hospital, Muscat, Oman
| | | | | | - Elias A Said
- Department of Microbiology and Immunology - College of Medicine, Sultan Qaboos University, Muscat, Oman
| | - Heba Omer
- Department of Internal Medicine, Division of Gastroenterology & Hepatology, Armed Forces Hospital, Muscat, Oman; Endemic Medicine and Hepatology Department, Faculty of Medicine, Cairo University, Egypt
| | - Hamad Al-Bahluli
- Department of Medical Laboratory, Division of Medical Microbiology, Armed Forces Hospital, Muscat, Oman
| | - Saada Al-Ryiami
- Department of Infection Control, Armed Forces Hospital, Muscat, Oman
| | - Saleh Al-Hakmani
- Department of Infection Control, Armed Forces Hospital, Muscat, Oman
| | | | - Ruqaiya Al-Jahwari
- Department of Medical Laboratory, Division of Medical Microbiology, Armed Forces Hospital, Muscat, Oman
| | - Musheera Al-Hinai
- Department of Medical Laboratory, Division of Medical Microbiology, Armed Forces Hospital, Muscat, Oman
| | - Juhaina AlWahaibi
- Department of Infection Control, Armed Forces Hospital, Muscat, Oman
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Al Sinani S, Al Naamani K. Programmatic Evaluation: A Prospect in Program Evaluation Design. Oman Med J 2021; 36:e260. [PMID: 34026280 PMCID: PMC8111505 DOI: 10.5001/omj.2021.122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 02/03/2021] [Indexed: 11/03/2022] Open
Affiliation(s)
- Siham Al Sinani
- Professional Competence Affairs, Oman Medical Specialty Board, Muscat, Oman
| | - Khalid Al Naamani
- Department of Internal Medicine, Armed Forces Hospital, Muscat, Oman
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Janecke AR, Liu X, Adam R, Punuru S, Viestenz A, Strauß V, Laass M, Sanchez E, Adachi R, Schatz MP, Saboo US, Mittal N, Rohrschneider K, Escher J, Ganesh A, Al Zuhaibi S, Al Murshedi F, AlSaleem B, Alfadhel M, Al Sinani S, Alkuraya FS, Huber LA, Müller T, Heidelberger R, Janz R. Pathogenic STX3 variants affecting the retinal and intestinal transcripts cause an early-onset severe retinal dystrophy in microvillus inclusion disease subjects. Hum Genet 2021; 140:1143-1156. [PMID: 33974130 PMCID: PMC8263458 DOI: 10.1007/s00439-021-02284-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 04/15/2021] [Indexed: 01/12/2023]
Abstract
Biallelic STX3 variants were previously reported in five individuals with the severe congenital enteropathy, microvillus inclusion disease (MVID). Here, we provide a significant extension of the phenotypic spectrum caused by STX3 variants. We report ten individuals of diverse geographic origin with biallelic STX3 loss-of-function variants, identified through exome sequencing, single-nucleotide polymorphism array-based homozygosity mapping, and international collaboration. The evaluated individuals all presented with MVID. Eight individuals also displayed early-onset severe retinal dystrophy, i.e., syndromic-intestinal and retinal-disease. These individuals harbored STX3 variants that affected both the retinal and intestinal STX3 transcripts, whereas STX3 variants affected only the intestinal transcript in individuals with solitary MVID. That STX3 is essential for retinal photoreceptor survival was confirmed by the creation of a rod photoreceptor-specific STX3 knockout mouse model which revealed a time-dependent reduction in the number of rod photoreceptors, thinning of the outer nuclear layer, and the eventual loss of both rod and cone photoreceptors. Together, our results provide a link between STX3 loss-of-function variants and a human retinal dystrophy. Depending on the genomic site of a human loss-of-function STX3 variant, it can cause MVID, the novel intestinal-retinal syndrome reported here or, hypothetically, an isolated retinal dystrophy.
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Affiliation(s)
- Andreas R Janecke
- Department of Pediatrics I, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria.
- Division of Human Genetics, Medical University of Innsbruck, Innsbruck, Austria.
| | - Xiaoqin Liu
- Department of Neurobiology and Anatomy, MSB 7.046, McGovern Medical School at the University of Texas HSC (UTHealth), 6431 Fannin Street, Houston, TX, 77030, USA
| | - Rüdiger Adam
- University Children's Hospital, Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, Germany
| | - Sumanth Punuru
- Department of Neurobiology and Anatomy, MSB 7.046, McGovern Medical School at the University of Texas HSC (UTHealth), 6431 Fannin Street, Houston, TX, 77030, USA
| | - Arne Viestenz
- Department of Ophthalmology, University Medical Center Halle, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - Valeria Strauß
- Klinik für Kinder- und Jugendmedizin, Universitätsklinikum Halle, Halle, Germany
| | - Martin Laass
- Klinik und Poliklinik f. Kinder- u. Jugendmedizin, University of Dresden, Dresden, Germany
| | - Elizabeth Sanchez
- Department of Pulmonary Medicine, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Roberto Adachi
- Department of Pulmonary Medicine, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Martha P Schatz
- Department of Ophthalmology, University of Texas Health Science Center, San Antonio, TX, USA
| | - Ujwala S Saboo
- Department of Ophthalmology, University of Texas Health Science Center, San Antonio, TX, USA
| | - Naveen Mittal
- Department of Department of Pediatrics, Division of Pediatric Gastroenterology, University of Texas Health Science Center, San Antonio, TX, USA
| | | | - Johanna Escher
- Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Anuradha Ganesh
- Department of Ophthalmology, Sultan Qaboos University Hospital, Muscat, Oman
| | - Sana Al Zuhaibi
- Department of Ophthalmology, Sultan Qaboos University Hospital, Muscat, Oman
| | - Fathiya Al Murshedi
- Genetic and Developmental Medicine Clinic, Sultan Qaboos University Hospital, Muscat, Oman
| | - Badr AlSaleem
- King Fahad Medical City, Children's Specialized Hospital, Riyadh, Saudi Arabia
| | - Majid Alfadhel
- Genetics Division and Medical Genomic Research Lab, King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, Saudi Arabia
| | - Siham Al Sinani
- Department of Child Health, Sultan Qaboos University Hospital, Muscat, Oman
| | - Fowzan S Alkuraya
- Department of Genetics, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Lukas A Huber
- Division of Cell Biology, Medical University of Innsbruck, Innsbruck, Austria
| | - Thomas Müller
- Department of Pediatrics I, Medical University of Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - Ruth Heidelberger
- Department of Neurobiology and Anatomy, MSB 7.046, McGovern Medical School at the University of Texas HSC (UTHealth), 6431 Fannin Street, Houston, TX, 77030, USA.
| | - Roger Janz
- Department of Neurobiology and Anatomy, MSB 7.046, McGovern Medical School at the University of Texas HSC (UTHealth), 6431 Fannin Street, Houston, TX, 77030, USA
- Center for Scientific Review, National Institutes of Health, Bethesda, MD, USA
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Al Bualy R, Al Sinani S, Al Naamani K. Navigating the 'Next Normal' in Medical Education Post COVID-19. Oman Med J 2020; 35:e144. [PMID: 32733696 PMCID: PMC7371264 DOI: 10.5001/omj.2020.63] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 05/17/2020] [Indexed: 11/03/2022] Open
Affiliation(s)
- Raghdah Al Bualy
- Graduate Medical Education Department, Oman Medical Specialty Board, Muscat, Oman
| | - Siham Al Sinani
- Graduate Medical Education Department, Oman Medical Specialty Board, Muscat, Oman
| | - Khalid Al Naamani
- Department of Internal Medicine, Armed Forces Hospital, Muscat, Oman
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Abstract
Cystic fibrosis (CF) is a multisystem disease caused by mutations in the CF transmembrane conductance regulator (CFTR) gene. CFTR is expressed in the apical surface of cholangiocytes. Homozygous CFTR gene mutation results in viscous and acidic bile secretions secondary to deficient surface fluid and bicarbonate efflux. Viscous, inspissated bile causes ductular obstruction and hepatotoxicity from retained bile components, leading to fibrosis and ultimately cirrhosis, known as CF liver disease (CFLD). CFLD is the third leading cause of death in CF patients. CFLD manifestations can take many forms. They range from asymptomatic elevation of transaminases to cirrhosis and end-stage liver disease. CFLD is diagnosed after excluding other causes of chronic liver disease. To date, there is no effective therapy to prevent or treat CFLD. Management of CFLD emphasizes on optimizing nutritional status. Ursodeoxycholic acid is the only available treatment that may prevent progression of CFLD at present. All CF patients with CFLD need annual investigations and follow-up for early detection of the disease. Liver transplantation should be considered in patients with decompensated cirrhosis and portal hypertension, with acceptable long-term outcomes. Novel therapies of CFLD are promising. This review article aims to summarize the published literature on CFLD, its pathophysiology, clinical features and complications, and management including new therapeutic options.
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Affiliation(s)
- Siham Al Sinani
- Graduate Medical Education Department, Oman Medical Specialty Board, Muscat, Oman.,Department of Child Health, Sultan Qaboos University Hospital, Muscat, Oman
| | - Sharef Al-Mulaabed
- Department of Pediatrics, Brookdale University Hospital Medical Center, Brooklyn, NY, USA
| | | | - Rabab Sultan
- Department of Child Health, Sultan Qaboos University Hospital, Muscat, Oman
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Al Sinani S. RE: Celiac Disease Prevalence in Omani Children with Type 1 Diabetes Mellitus. Oman Med J 2013; 28:460. [DOI: 10.5001/omj.2013.128] [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] [Received: 09/06/2013] [Accepted: 09/07/2013] [Indexed: 11/03/2022] Open
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Al Sinani S, Al Murshedy F, Abdwani R. Infantile systemic hyalinosis: a case report with a novel mutation. Oman Med J 2013; 28:53-5. [PMID: 23386947 DOI: 10.5001/omj.2013.12] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [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: 09/30/2012] [Accepted: 11/12/2012] [Indexed: 11/03/2022] Open
Abstract
Infantile Systemic Hyalinosis (ISH) (OMIM 236490) is a rare, progressive and fatal autosomal recessive disorder characterized by multiple subcutaneous skin nodules, gingival hypertrophy, osteopenia, joint contractures, failure to thrive, diarrhea with protein losing enteropathy, and frequent infections. There is diffuse deposition of hyaline material in the skin, gastrointestinal tract, muscle and endocrine glands. It is caused by mutations in the ANTXR2 (also known as CMG2) gene, which encodes a trans-membranous protein involved in endothelial development and basement membrane-extracellular matrix assembly. We describe a child with classical features of ISH presenting in infancy with severe chronic debilitating pain and progressive joint contractures. The diagnosis was confirmed by molecular DNA sequencing of ANTXR2 gene which revealed a novel homozygous mutation not previously reported; 79 bp deletion of the entire exon 11 (c.867_945del, p.E289DfsX22). Although this is the first reported case of ISH in Oman, we believe that the disease is under-diagnosed since children affected with this lethal disease pass away early in infancy prior to establishing a final diagnosis.
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Affiliation(s)
- Siham Al Sinani
- Department of Child Health, Sultan Qaboos University Hospital, Al Khoud, Sultanate of Oman
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Abstract
A number of disorders have been described to cause protein losing enteropathy (PLE) in children. Primary intestinal lymphangiectasia (PIL) is one mechanism leading to PLE. Few syndromes are associated with PIL; Hennekam syndrome (HS) is one of them. The principal treatment for PIL is a high protein, low fat diet with medium chain triglycerides supplementation. Supportive therapy includes albumin infusion. Few publications have supported the use of octreotide to diminish protein loss and minimize hypoalbuminemia seen in PIL. There are no publications on the treatment of PIL with octreotide in patients with HS. We report two children with HS and PLE in which we used octreotide to decrease intestinal protein loss. In one patient, octreotide increased serum albumin to an acceptable level without further need for albumin infusions. The other patient responded more dramatically with near normal serum albumin levels and cessation of albumin infusions. In achieving a good response to octreotide in both patients, we add to the publications supporting the use of octreotide in PIL and suggest that octreotide should be tried in patients with PIL secondary to HS. To the best of our knowledge, this is the first case report on the use of octreotide in HS-associated PIL.
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