Objective To assess SARS-COV-2 seroprevalence in Oman and longitudinal changes in antibody levels over time within the first 11 months of the COVID-19 pandemic. Methods This nationwide cross-sectional study was conducted as a four-cycle serosurvey using a multistage stratified sampling method from July–November 2020. A questionnaire was used and included demographics, history of acute respiratory infection and list of symptoms, COVID-19 contact, previous diagnosis or admission, travel history, and risk factors. Results In total, 17,457 participants were surveyed. Thirty percent were female, and 66.3% Omani. There was significant increase in seroprevalence throughout the study cycles, starting from [5.5 (4.8–6.2)] for the first cycle and ending with [22 (19.6–24.6)] for the forth cycle. There was no difference in seroprevalence between genders, but significant differences between age groups. There was a transition of seroprevalence from being higher in non-Omanis in cycle one, [9.1 (7.6–10.9)] to Omanis [3.2 (2.6–3.9)] to being higher in Omanis [24.3 (21.0–27.9)] to non-Omanis [16.8 (14.9–18.9)] in cycle four. There was remarkable variation in seroprevalence of COVID-19 according to governorate. Close contacts of people with COVID-19 had a 96% higher risk of having the disease, (adjusted odds ratio [AOR]=1.96, 95% confidence interval [CI] 1.64–2.34); laborers have 58% higher risk of infection compared to office workers (AOR=1.58, 95% CI; 1.04–2.35). Conclusion The study showed a wide variation of SARS-CoV-2 dissemination between governorates in Oman, with higher seroprevalence estimates in migrants in the first two cycles. Prevalence estimates remain low and are insufficient to provide herd immunity.

Introduction Vaccinations against COVID-19 were licensed with limited testing assurances to the public triggering a widespread hesitancy around expected adverse reactions. Limited data was reported from Arabian Gulf countries on vaccine adverse effects. Objectives This study looked at the rate of reporting at least one side effect post-COVID-19 vaccination and its associated factors (sociodemographic characteristics, clinical condition, and type of vaccines). Additionally, questions about safety and willingness to recommend them were included. Study design Phone interviews on post-COVID-19 vaccination adverse effects were utilized to record responses related to reporting at least one side effect post vaccinations across the studied variables. Data collection continued for two months (from 1 st March to 30 th April 2021). Methodology Participants were adults (Omani citizens and non-citizens) who received AstraZeneca (AZ) or Pfizer (PF) vaccines from primary care facilities in Muscat and were randomly selected from the health information system. Responses were saved in a bespoke Google form/questionnaire. Chi-squared tests were utilized to determine potential factors associated with the dependent variable. Results A total of 753 participants completed the phone interviews. The mean age was 52 (3.5), males (54.1%), and 65.1% were Omanis. Hypertension (39.7%), diabetes (34.1%), and asthma (16.7%) were the commonest comorbidities. AZ and PF were administered to 78% and 22% of the participants. Of them, 49.8% reported at least one adverse effect post-COVID-19 vaccination. The proportion of participants with at least one adverse effect was significantly more in individuals who were younger, females, with more than secondary education, and employed (p value < 0.001, 0.01, <0.001, and <0.001, respectively). There was no severe reaction (anaphylactic shock) to the vaccines, and most adverse effects were mild-moderate. The proportion of individuals who reported adverse effects were higher with AZ vs PF (53% vs 38.6, p = 0.001). The most common reported localized adverse effects were pain and tenderness (28.3% and 12.1%). Fever and body aches were the commonly reported systemic adverse effects (33.5% and 29.2%). The safety of COVID-19 vaccines was well perceived, and most participants were willing to recommend them to others. Conclusions The current study confirms findings from existing literature on the mild to moderate adverse effects of AZ and PF vaccines. Despite the subjective nature of this study, it is reassuring that the studied COVID-19 vaccines can be administered safely. However, more longitudinal studies are needed to test their efficacy in disease prevention.

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Introduction: Hyperprolactinemia is a common side effect associated with the use of anti-psychotic medications. This study aimed at exploring the rate of hyperprolactinemia induced by anti-psychotic drugs in adult patients admitted to Sultan Qaboos University Hospital (SQUH) and Al Masarra hospital (AMH). Additionally, factors associated with higher prolactin levels in anti-psychotic patients were explored.Methods: Bespoke XL sheets on age, gender, region (place of stay), BMI, diagnosis, type of drugs, dose, symptoms, and prolactin levels were recorded from the existing health information system. All adult patients who were on anti-psychotic medication between January 2016 and June 2019 were included. Patients diagnosed with pre-existing endocrine conditions, pregnant females, and those with high prolactin levels at baseline were excluded.Results: A total of 1103 cases were included in this study of which 34.1% were from the SQUH vs 65.9% from AMH. The mean (SD) age of the study population was 35.6 (12.1), 56.7% were females and 58.7% cases were from Muscat. The common diagnoses were schizophrenia (59.3%) and bipolar affective disorder (14.7%). High prolactin levels existed in 68.3% of the cases from which 59.6% were treated with atypical antipsychotic drugs. The proportion of cases with high prolactin levels in AMH was significantly different (higher) compared to cases in SQUH (76.9% vs 51.6%, P<0.001).The most common symptoms were painful breasts (55.2%), galactorrhoea (10.5%), amenorrhea (14.3%) and irregular periods (20.0%). Type of drugs used [haloperidol (typical) vs risperidone (atypical) anti-psychotics (P<0.001)], older vs younger age (P=0.03), and presence vs absence of symptoms (P<0.001) were predictors for the high prolactin levels.Conclusion: Similar to evidence from the west, results from this study showed a high rate of hyperprolactinemia in adults treated with anti-psychotics. More work is required to standardize antipsychotic management and monitoring guidelines for psychotic patients across all psychiatric hospitals in Oman.

In Middle Eastern countries, cultural traditions, values, and beliefs play significant roles in decision making about cancer care, prevention, diagnosis, and management. As cultural factors are involved at every stage of cancer care from prevention to palliative care and they pose challenges that can influence cancer related behaviours in Middle Eastern countries, in cancer care, these factors should be addressed in all efforts to prevent and control the disease. This chapter focuses on a number of cultural factors relating to cancer care including family, family values and dynamics, religion and spiritual needs, stigma and social values, taboos about death and dying, and communication with patients. The reflections contained in this chapter offer insights into some of the ways the culture of Middle Eastern countries influences cancer care and how it affects the patients’ and their families’ attitudes and choices regarding this care. Reflections on these cultural perspectives suggest that if cancer care in Middle Eastern countries is to be improved, health professionals need to be aware of, and be sensitive to cultural factors and balance respect for patients’ cultural perspectives with the need to provide effective care and improve patient outcomes.