Objectives: Estimated glomerular filtration rate (eGFR) is an important component of a patient’s renal function profile. The Modification of Diet in Renal Disease (MDRD) equation and the Chronic Kidney Disease- Epidemiology Collaboration (CKD-EPI) equation are both commonly used. The aim of this study was to compare the performance of the original MDRD186, revised MDRD175 and CKD-EPI equations in calculating eGFR in type 2 diabetes mellitus (T2DM) patients in Oman. Methods: The study included 607 T2DM patients (275 males and 332 females, mean age ± standard deviation 56 ± 12 years) who visited primary health centres in Muscat, Oman, during 2011 and whose renal function was assessed based on serum creatinine measurements. The eGFR was calculated using the three equations and the patients were classified based on chronic kidney disease (CKD) stages according to the National Kidney Foundation Kidney Disease Outcomes Quality Initiative guidelines. A performance comparison was undertaken using the weighted kappa test. Results: The median eGFR (mL/min/1.73 m2) was 92.9 for MDRD186, 87.4 for MDRD175 and 93.7 for CKD-EPI. The prevalence of CKD stage 1 was 55.4%, 44.7% and 57% while for stages 2 and 3 it was 43.2%, 54% and 41.8%, based on MDRD186, MDRD175 and CKD-EPI, respectively. The agreement between MDRD186 and CKD-EPI (к 0.868) was stronger than MDRD186 and MDRD175 (к 0.753) and MDRD175 and CKD-EPI (к 0.730). Conclusion:The performances of MDRD186 and CKD-EPI were comparable. Considering that CKD-EPI-based eGFR is known to be close to isotopically measured GFR, the use of MDRD186 rather than MDRD175 may be recommended.

G6PD deficiency is a genetic disease that weakens the immune system and renders affected individuals susceptible to infections. In the Sultanate of Oman resides a high number of recorded G6PD cases due to widespread consanguineous marriage, which may reach 25% of the population. We studied the infection patterns and risk factors for mortality to provide antimicrobial stewardship recommendations for these patients. After obtaining ethical approval, a registry of recorded cases was consulted retrospectively to include G6PD-deficient adult patients admitted to Suhar hospital over 5 years with microbiologically confirmed infections. Patient demographics, health-related information, infection causes, treatment, and clinical outcomes were studied. Data were analyzed to describe infection patterns and risk factors. Several variables, including underlying comorbidities and hospitalization details, such as length of stay, admission to critical care unit, blood transfusion, or exposure to an invasive procedure, were statistically associated with the acquisition of multidrug-resistant and hospital-acquired infections. Meanwhile, these infections were associated with a high mortality rate (28%), significantly associated with the patient’s health status and earlier exposure to antimicrobial treatment due to previous bacterial infection. The high prevalence of G6PD deficiency among the Omani population should alert practitioners to take early action when dealing with such cases during infection that requires hospitalization. Strict infection control measures, Gram-negative empiric coverage, hospital discharge as early as possible, and potent targeted antimicrobial therapy in this patient population can ameliorate the treatment outcomes and should be emphasized by the antimicrobial stewardship team.

Introduction: The sustained global epidemic of Human Immunodeficiency Virus (HIV) necessitates comprehensive, region-specific surveillance to inform public health policy. This 30-year retrospective observational cohort study delineated the epidemiological patterns, transmission dynamics, treatment efficacy, and long-term clinical outcomes of HIV infection in Oman to strategically align preventative and therapeutic programs with Oman’s Vision 2040 framework. Methods: We analyzed the clinical and epidemiological data of 429 confirmed HIV-positive patients with a minimum follow-up period of six months, registered at a secondary care facility in North Batinah, Oman, between January 1995 and December 2024. Predictors of mortality were rigorously assessed utilizing Kaplan–Meier survival analysis and Cox proportional hazards regression models. Continuous variables were evaluated using independent sample t-tests or Mann–Whitney U tests, while categorical variables employed chi-square or Fisher’s exact tests. Results: The cohort exhibited a male predominance (70.6%) with a mean age at diagnosis of 32.8 years (SD ± 12.17). Heterosexual contact constituted the predominant mode of acquisition (56%), followed by bisexual (17%) and homosexual (12%) contacts. Although 67.1% of patients presented with early, asymptomatic disease (WHO Stage 1), opportunistic infections were evident in 28.1% of the cohort, with recurrent sepsis (8.4%) and bacterial pneumonia (3.5%) being the most frequent complications. The WHO clinical stage at presentation was confirmed as a highly significant predictor of survival (p < 0.0001). Stage 1 patients achieved excellent long-term prognosis (approximately 75% survival beyond 30 years), markedly contrasting with Stage 4 patients, whose survival declined sharply (median survival of approximately 8 years, and only 10–15% surviving past 20 years). The tenofovir/emtricitabine/efavirenz regimen showed superior efficacy, achieving 75% survival at 30 years, relative to zidovudine-based regimens, which showed significantly poorer performance (15–20% survival at 20 years). Conclusions: This investigation substantiates the shift toward predominant heterosexual transmission and emphasizes the critical prognostic significance of the clinical stage at diagnosis. Optimal long-term survival mandates prompt diagnosis, timely initiation of contemporary antiretroviral therapies, and sustained viral suppression. These findings offer crucial evidence to strengthen HIV prevention and treatment programs within Oman.

Background/Objectives: Differentiating Type 1 from Type 2 diabetes mellitus (T1DM vs. T2DM) remains clinically challenging, especially in early-onset cases with overlapping features. This study assessed the diagnostic utility of diabetes-related autoantibodies in an Omani cohort and evaluated their predictive performance using machine learning. Methods: Clinical and laboratory data from 448 patients (aged ≥ 2 years) in Al Batinah North, Oman, were retrospectively analyzed. We assessed autoantibody positivity (anti-GAD, anti-islet, anti-TPO, anti-tissue), age, sex, and HbA1c. Receiver operating characteristic (ROC) curves and a neural network model were used to evaluate diagnostic accuracy. Results: Anti-GAD and anti-islet antibodies were significantly more prevalent in T1DM (69.0% and 64.1%) than T2DM (7.4% and 3.8%; p < 0.0001). HbA1c was elevated in both subtypes but lacked discriminatory specificity. Nearly half (48.5%) of T1DM patients showed multiple antibody positivity, especially in younger age groups. Anti-TPO and anti-tissue antibodies were more frequently detected in T1DM, suggesting broader autoimmunity. ROC analysis showed strong predictive value for anti-islet (AUC = 0.835) and anti-GAD (AUC = 0.827). Neural network modeling identified anti-GAD, anti-islet, and age as the most informative predictors, achieving over 92% classification accuracy. Importantly, antibody positivity in a subset of insulin-treated T2DM patients suggested potential latent autoimmune diabetes (LADA) misclassification. Conclusions: This is the first study in Oman to combine autoantibody screening with AI-based modeling to refine diabetes classification. Our findings highlight the value of immunological profiling in early diagnosis, uncover possible misclassification, and support AI integration to guide individualized management.

Background: While mapping Escherichia coli susceptibility in community acquired simple UTIs across 38 centres, DASH to Protect Antibiotics, (https://dashuti.com/), a multiregional study also assessed impact of socio-economic conditions and climate on antimicrobial susceptibility. Methods: The centres were located in the Indian subcontinent, Middle East, North and West Africa, Eurasia, Europe, and North America. Harmonic means were used for comparative analysis of the antimicrobial susceptibility of E. coli in simple cystitis. Kruskal-Wallis test was utilized to compare susceptibility means between the antimicrobials and the GDP. A two-way ANOVA to simultaneously analyzed the impact of the antimicrobials and GDP on the proportion of susceptible E. coli while adjusting for variables (low and high temperature, humidity and population density per sqkm). Findings: Antimicrobial susceptibility varied between regions and within large countries like India and Pakistan. Nitrofurantoin (89%) and fosfomycin (96%) emerged as the most effective antimicrobials. In majority of the centres, susceptibility to other oral antimicrobials was low: cotrimoxazole.

Background/Objectives: The neutrophil-to-lymphocyte ratio (NLR) is an emerging inflammatory biomarker associated with various metabolic disorders, including type 2 diabetes mellitus (T2DM). While poor glycemic control is linked to increased risk of complications, the relationship between glycemic status and NLR remains insufficiently characterized. This study aimed to assess the association between NLR and glycemic control in T2DM patients by comparing those with good glycemic control (GGC; HbA1c ≤ 7%) and poor glycemic control (PGC; HbA1c ≥ 7.1%). Methods: A retrospective cross-sectional study was conducted on 2907 T2DM patients from a tertiary care center. Patients were categorized into GGC (n = 1500) and PGC (n = 1407) groups based on HbA1c values. The mean age of participants was 53.53 ± 18.86 years in the GGC group and 54.31 ± 18.40 years in the PGC group, with comparable sex distribution between groups. Data were retrieved from electronic medical records and NLR was calculated using complete blood counts. Descriptive statistics were computed, and group comparisons were performed using Mann–Whitney U and independent t-tests. Spearman correlation and receiver operating characteristic (ROC) analysis were also performed. A p-value < 0.05 indicated significance. Results: The PGC group exhibited significantly higher mean NLR (3.96 ± 4.53) compared to the GGC group (3.23 ± 3.80) (p < 0.001). Median and interquartile range values confirmed this difference, and both parametric and non-parametric analyses supported the findings. Spearman correlation demonstrated a weak but statistically significant association between HbA1c and NLR (r = 0.101, p < 0.001). ROC analysis showed limited discriminatory ability of NLR (AUC = 0.560). Exploratory CRP results further suggested a link between inflammation and impaired glycemic control. Conclusions: NLR was significantly elevated in T2DM patients with moderate-to-poor glycemic control. This suggests that NLR may serve as a simple, cost-effective, and accessible marker of systemic inflammation and glycemic status. However, the effect size was small, and its discriminatory ability was limited, indicating that NLR should be interpreted as a supportive marker rather than a standalone clinical tool.