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As per WHO estimates, around 17% of the adult Omani population are hypertensive. However, people with hypertension are often unaware of the diagnosis, and so the May Measurement Month (MMM) programme was set up to raise awareness of the importance of blood pressure (BP) screening. A cross-sectional screening of BP of subjects aged 18 years or more was carried out in May 2018 at various sites in Muscat, Oman. Screening sites were set up at the reception areas of participating hospitals, and at a few public areas such as shopping malls and workplaces of the volunteers. Blood pressure was measured according to a standardized protocol, and hypertension was defined as per the 2018 European Society of Hypertension guidelines. The data were analysed centrally by the MMM project team. A total of 12 689 individuals (mean age 40.6 ± 12.5 years, 72% male) were screened. The crude mean BP of the second and third readings (where three readings were taken, n = 4 738) was 127.1/79.2 mmHg. After multiple imputations, the average age and sex standardized BP was 127.3/80.2 mmHg. Of all participants, 29.8% had hypertension. There were 1 983 patients with a previous diagnosis of hypertension, of whom 1 810 were on antihypertensive medication. A further 1 973 subjects were newly diagnosed with hypertension. Of those on antihypertensive medication, 34.9% had uncontrolled BP readings. Screening programmes such as MMM are useful to identify persons with undiagnosed hypertension. However, more educational activities are required to increase the public awareness regarding the dangers of hypertension.

Objective: Hypertension is a major cardiovascular risk factor yet many patients remain undiagnosed. The aim of the May Measurement Month (MMM) screening programme was to identify individuals with undiagnosed hypertension. Design and method: This study was part of a global screening programme with screening centers set up in various hospitals and public areas in Muscat, Oman during the months of May 2017 and 2018. Screening was done according to the MMM protocol with three blood pressure (BP) readings taken along with a questionnaire of demographic, lifestyle and other risk factors. Hypertension was defined according to the European Society of Hypertension 2018 guidelines,(systolic BP(SBP) greater than140mmHg and/or diastolic BP(DBP) greater than 90mmHg) Results: A total of 13,621 individuals (age 40.8 + 12.6 years, 30.1 % male, 88.4% arab ethincity) were screened over the two month period. The mean of the first BP was 132.1 + 19.1/ 81.1 + 12.2 mmHg. The average of the second and third readings, where available (n = 5,934, age 41.5 + 14.3 years, 64.4% male) was 128.5 + 17.7/79.1 + 11.1 mmHg. This was significantly lower than the first BP reading alone (p < 0.001 for both SBP and DBP). Women were more likely to have only one reading. Further analysis was done only where three BP readings were available. In those with 3 BP readings, 1438 individuals (of which 471 were on antihypertensive medication) had BP in the hypertensive range. This works out to 47.7% of patients on medications(n = 988) having uncontrolled BP. The remaining 967 were newly diagnosed hypertensive. The number of hypertensives in our sample therefore was 1,955, giving a proportion of 32.9% of hypertensive individuals (of those with three BP readings) in our sample. Pregnant women had significantly lower BP than non pregnant women. By binary logistic regression, the factors predicting BP in the hypertensive range were age, sex, previous stroke, but not diabetes, previous MI or ethnicity Conclusions: In Oman, the proportion of individuals having hypertension is comparable to previous estimates and surveys. A high proportion of individuals on treatment still have uncontrolled BP. More needs to be done to educate the public regarding the need for better BP control.

OBJECTIVEScreening patients on anthracycline-based chemotherapy regimens for the development of cardiotoxicity can be resource intensive. We therefore studied various traditional ECG parameters to correlate and possibly predict the development of positive Troponin I as a surrogate marker of anthracycline-induced cardiotoxicity.METHODSThis was a single centre prospective cohort study done between Januray 2014 to January 2016. Baseline ECG was compared with ECG done after chemotherapy and different parameters were compared. Patients were divided into Troponin I positve and negative groups based on the test performed at the end of chemotherapy using a cut-off of 0.06 ng/dL.RESULTSOf the 160 patients studied, 131 (81.9%) were Troponin I negative (TnI-) and 29 (18.1%) were positive (TnI+). Breast cancer accounted for 79% of all cancers in this study. Many ECG parameters where compared between TnI- and TnI+ groups. Of them, TP and TP/QT showed a significant decrease in the TnI+ group. The mean (95% CI) TP in TnI- group was 162.9 (145.4, 180.4) and in TnI+ groups was 117.9 (89, 146.8), p = 0.03. Corresponding values for TP/QT were 0.47 (0.42, 0.51) and 0.35 (0.27, 0.42), p = 0.02. These changes were not significant in multivariate analysis and likely reflected the different mean heart rates (HR) in both the groups as shown by Pearson’s partial correlation which was run with HR as confounder.CONCLUSIONSECG parameters like QTcH, TP and TP/QT are not helpful in predicting Troponin I elevations in patients on anthracycline-based chemotherapy. Further studies based on hard endpoints like clinical systolic dysfunction occuring at one year would give better information on their utility.

Background Various inotropic agents/vasopressors combinations are used in patients of cardiogenic shock. We performed this study to observe hemodynamic effects of various inotrope/vasopressor combinations in patients with NSTEMI cardiogenic shock (CS) at tertiary cardiac centre Methods and materials Of 3832 NSTEMI, we studied 59 consecutive such patients with CS who hadn't undergone revascularization in the first 24 h in a prospective, open label, observational study. Group 1 comprised of background Dopamine with Noradrenaline titration(N = 38), Group 2 had background Dobutamine and Noradrenaline titration(N = 15) and Group 3 comprised of triple combination of Dopamine, Noradrenaline & Adrenaline(N = 6). Results The mean change in hemodynamic parameters between these groups from baseline to 24 h showed no statistical difference. Cardiac output(CO), mean arterial pressure(MAP), central venous pressure(CVP) and cardiac power output(CPO) in group 2 were favorable at 6 and 24 h compared to baseline but mean change was insignificant as compared to others. In group 3, the increase in MAP was significant. IABP use did not change CO, CPO or SVR in any group except lower dosages of Dobutamine (49%) in IABP group. Lower in-hospital mortality in group 2 compared to others (P = 0.004) may be reflective of sicker patients in group 1 and 3. Conclusion The mean changes in hemodynamic parameters were not significant between all groups. All regimes of inotropes when selected as per clinical indication in CS with ACS resulted in similar hemodynamic effects. The mortality difference may not truly be reflective of regimes rather reflect sicker patients in the higher mortality group.