HAMAD SINAWI
Sultan Qaboos University, Behavioural Medicine, Faculty Member
72 Aims – Clinical guidelines for the management of bipolar affective disorder published by The National Institute for Health and Clinical Excellence (NICE) recommend that all patients who are prescribed lithium should have their renal... more
72 Aims – Clinical guidelines for the management of bipolar affective disorder published by The National Institute for Health and Clinical Excellence (NICE) recommend that all patients who are prescribed lithium should have their renal and thyroid function checked every six months, and their serum lithium level checked every three months. Adherence to these recommendations has not been scrutinized in Arab population such attendees to a tertiary hospital in Oman. Methods – The computerised patient record system was used to identify all patients who were prescribed lithium between January 2010 and September 2013. The main outcome measure was the percentage of patients taking lithium who had adequate monitoring of lithium level, urea and electrolyte, thyroid function, lipids and glucose. Results – A total of 66 patients met the inclusion criteria for the clinical audit. For patients prescribed lithium for six months or more, the internationally set standard for monitoring lithium serum...
Research Interests: Psychiatry and Medicine
Objective: This study aims to determine the predictors of the length of inpatient hospital admission following deliberate self-harm (DSH). Method: This is a retrospective study; medical notes for all patients admitted from Jan 20012 to... more
Objective: This study aims to determine the predictors of the length of inpatient hospital admission following deliberate self-harm (DSH). Method: This is a retrospective study; medical notes for all patients admitted from Jan 20012 to Jan 2014 with DSH were reviewed for sociodemographic information, clinical diagnosis and length of hospital
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Research Interests:
ABSTRACT Studies worldwide have shown that people with mental illnesses (PWMI) tend to be stigmatized and thus suffer social exclusion. The authors investigated the attitudes of Omani people toward PWMI, and classified their responses on... more
ABSTRACT Studies worldwide have shown that people with mental illnesses (PWMI) tend to be stigmatized and thus suffer social exclusion. The authors investigated the attitudes of Omani people toward PWMI, and classified their responses on the basis of socio-demographic variables (age, gender, place of residence, place and type of employment, and previous exposure to PWMI) that were expected to correlate with their perceptions and attitudes towards PWMI. The data were collected by means of an online cross-sectional survey among the general Omani public, using the Attitude toward Mental Illness (AMI) Questionnaire. The online method via social media was selected in view of the high levels of literacy (93.97%), Internet usage (66.4%), and social media participation among Omanis. Of the 601 participants, 41.4% were men and 58.6% were women. The subjects were categorized in the age groups of 20–30 years (48%) and 31–45 years (46%). Nearly 90% of the participants were employed, while 10% were college students. The results indicated that Omanis share the worldwide tendency to harbor stigmatizing attitudes towards PWMI. The results further suggested that socio-demographic variables (such as urban–rural dichotomy and previous encounters with PWMI have significant correlation with Omanis’ attitudes towards the mentally ill.
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This study aimed to review general anaesthesia protocols for patients undergoing electroconvulsive therapy (ECT) at a tertiary care hospital in Oman, particularly with regards to clinical profile, potential drug interactions and patient... more
This study aimed to review general anaesthesia protocols for patients undergoing electroconvulsive therapy (ECT) at a tertiary care hospital in Oman, particularly with regards to clinical profile, potential drug interactions and patient outcomes. This retrospective study took place at the Sultan Qaboos University Hospital (SQUH), Muscat, Oman. The electronic medical records of patients undergoing ECT at SQUH between January 2010 and December 2014 were reviewed for demographic characteristics and therapy details. A total of 504 modified ECT sessions were performed on 57 patients during the study period. All of the patients underwent a uniform general anaesthetic regimen consisting of propofol and succinylcholine; however, they received different doses between sessions, as determined by the treating anaesthesiologist. Variations in drug doses between sessions in the same patient could not be attributed to any particular factor. Self-limiting tachycardia and hypertension were periproce...
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Objectives: The objective of this study is to determine the medical and socio-demographic features of patients with dementia attending neurology and psychiatry clinics along with identifying prescribed medications and physical co... more
Objectives: The objective of this study is to determine the medical and socio-demographic features of patients with dementia attending neurology and psychiatry clinics along with identifying prescribed medications and physical co morbidities at a tertiary care hospital in Oman. Methods: A Cross-sectional study was conducted on patients suffering from dementia through evaluating medical records of all dementia patients attending neurology and psychiatry clinics and those who were admitted at the medical wards at Sultan Qaboos University Hospital from May 2011 to May 2013. Basic information regarding patient’s age, gender, medical co-morbidity, and lists of medications prescribed were obtained and extracted from the electronic medical records. Results: A total of 101 patients with dementia (53 Females, 48 Males) attended the service during the study period. The mean age was 72 (9.09± SD) years, while the mean duration of illness was 2 years and median number of medications was 3. Medical co-morbidities among dementia patients were hypertension 56.4%, diabetes mellitus 31.7%, heart disease 23.6%, and dyslipidemia 19.6%. Conclusion: The commonest type of dementia in this study was Alzheimer’s dementia followed by vascular type. The most common co-morbidities were hypertension, cardiac disease, diabetes mellitus and dyslipidemia.
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A case of a girl who presented with symptoms of gender dysphoria is described here. She received cognitive behavioral therapy that helped her explore her thoughts and address any distorted cognition. She was able to live as a female and... more
A case of a girl who presented with symptoms of gender dysphoria is described here. She received cognitive behavioral therapy that helped her explore her thoughts and address any distorted cognition. She was able to live as a female and changed her mind about undergoing sex change surgery. This article explores the concept of gender dysphoria and the role of psychological interventions in its management.
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Health anxiety disorder is a very distressing disorder both to the patients and his health care providers. This case of a man who presented with a preoccupation with having human Immunodeficiency virus (HIV) infection that made him pay... more
Health anxiety disorder is a very distressing disorder both to the patients and his health care providers. This case of a man who presented with a preoccupation with having human Immunodeficiency virus (HIV) infection that made him pay for repeated tests-approximately more than 100 times. In this case report, we describe a case of a man who presented with preoccupations with having HIV that made him pay for repeated tests more around 100 times.
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Research Interests:
Research Interests:
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Studies worldwide have shown that people with mental illnesses (PWMI) tend to be stigmatized and thus suffer social exclusion. The authors investigated the attitudes of Omani people toward PWMI, and classified their responses on the basis... more
Studies worldwide have shown that people with mental illnesses (PWMI) tend to be stigmatized and thus suffer social exclusion. The authors investigated the attitudes of Omani people toward PWMI, and classified their responses on the basis of socio-demographic variables (age, gender, place of residence, place and type of employment, and previous exposure to PWMI) that were expected to correlate with their perceptions and attitudes towards PWMI. The data were collected by means of an online cross-sectional survey among the general Omani public, using the Attitude toward Mental Illness (AMI) Questionnaire. The online method via social media was selected in view of the high levels of literacy (93.97%), Internet usage (66.4%), and social media participation among Omanis. Of the 601 participants, 41.4% were men and 58.6% were women. The subjects were categorized in the age groups of 20–30 years (48%) and 31–45 years (46%). Nearly 90% of the participants were employed, while 10% were colle...
Research Interests:
1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) is an environmental toxin which selectively induces oxidative damage and mitochondrial and proteasomal dysfunctions to dopaminergic neurons in the substantia nigra leading to... more
1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) is an environmental toxin which selectively induces oxidative damage and mitochondrial and proteasomal dysfunctions to dopaminergic neurons in the substantia nigra leading to Parkinsonian syndrome in animal models and humans. MPTP is one of the most widely usedin vitromodels to investigate the pathophysiology of Parkinson's disease (PD) and, screen for novel therapeutic compounds that can slow down or ameliorate this progressive degenerative disease. We investigated the therapeutic effect of pomegranate juice extracts (PJE), Helow, Malasi, Qusum, and Hamadh against MPTP-induced neurotoxicity in primary human neurons by examining extracellular LDH activity, intracellular NAD+and ATP levels, and endogenous antioxidant levels including lipid peroxidation products, catalase, superoxide dismutase (SOD) and glutathione peroxidase (GPx) activities, and reduced glutathione (GSH) levels. MPTP induced a reduction in SOD and GPx activitie...
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Objectives: To evaluate the prevalence of polypharmacy in relation to gender, comorbidity, and age among elderly patients upon discharge from an academic tertiary care hospital in Muscat, Oman. Methods: This cross-sectional study was... more
Objectives: To evaluate the prevalence of polypharmacy in relation to gender,
comorbidity, and age among elderly patients upon discharge from an academic tertiary
care hospital in Muscat, Oman. Methods: This cross-sectional study was conducted at
Sultan Qaboos University Hospital between February and July 2014. We reviewed the
electronic medical records of elderly patients aged ≥ 60 years who were admitted to
any of the hospital’s medical wards during the study period and collected data on age,
gender, and diagnoses. We also collected information on the medications prescribed
on discharge. Polypharmacy was defined as the concurrent use of ≥ 5 medications.
Results: A total of 431 elderly inpatients were enrolled, of which approximately 50%
were female. Polypharmacy was identified in 76.3% of discharge prescriptions. Gender
(adjusted odds ratio (aOR), 1.17; 95% CI 0.73, 1.88, p = 0.502) and age (aOR, 0.98;
95% CI 0.95, 1.00, p = 0.075) had no impact on polypharmacy. On the other hand, a
significant association between polypharmacy and comorbidity was observed (aOR,
1.31; 95% CI 1.12, 1.54, p = 0.001). Cardiovascular diagnosis on admission was also
identified as being associated with polypharmacy (aOR, 2.66; 95% CI 1.49, 4.75,
p = 0.001). More patients had cardiovascular diseases on admission (31.0%), followed by
infections (23.0%), and gastrointestinal diseases (13.0%). The most commonly prescribed
drugs on discharge were cardiovascular drugs (48.0%), followed by drugs acting on the
gastrointestinal system (11.0%), endocrine system (9.2%), and nutrition and blood
(7.5%). Conclusions: The prevalence of polypharmacy among elderly medical patients
discharged from our hospital was high (76.3%) and was associated with a number of
comorbidities and cardiovascular disease as a cause of admission, but not with age or
gender. The prevalence of polypharmacy in our institution raises significant concerns
over its potential impact on patients’ health outcomes and requires further investigation.
Raising physicians’ awareness of health implications of polypharmacy may help reduce
the incidence of medication-related adverse events and improve treatment outcomes.
comorbidity, and age among elderly patients upon discharge from an academic tertiary
care hospital in Muscat, Oman. Methods: This cross-sectional study was conducted at
Sultan Qaboos University Hospital between February and July 2014. We reviewed the
electronic medical records of elderly patients aged ≥ 60 years who were admitted to
any of the hospital’s medical wards during the study period and collected data on age,
gender, and diagnoses. We also collected information on the medications prescribed
on discharge. Polypharmacy was defined as the concurrent use of ≥ 5 medications.
Results: A total of 431 elderly inpatients were enrolled, of which approximately 50%
were female. Polypharmacy was identified in 76.3% of discharge prescriptions. Gender
(adjusted odds ratio (aOR), 1.17; 95% CI 0.73, 1.88, p = 0.502) and age (aOR, 0.98;
95% CI 0.95, 1.00, p = 0.075) had no impact on polypharmacy. On the other hand, a
significant association between polypharmacy and comorbidity was observed (aOR,
1.31; 95% CI 1.12, 1.54, p = 0.001). Cardiovascular diagnosis on admission was also
identified as being associated with polypharmacy (aOR, 2.66; 95% CI 1.49, 4.75,
p = 0.001). More patients had cardiovascular diseases on admission (31.0%), followed by
infections (23.0%), and gastrointestinal diseases (13.0%). The most commonly prescribed
drugs on discharge were cardiovascular drugs (48.0%), followed by drugs acting on the
gastrointestinal system (11.0%), endocrine system (9.2%), and nutrition and blood
(7.5%). Conclusions: The prevalence of polypharmacy among elderly medical patients
discharged from our hospital was high (76.3%) and was associated with a number of
comorbidities and cardiovascular disease as a cause of admission, but not with age or
gender. The prevalence of polypharmacy in our institution raises significant concerns
over its potential impact on patients’ health outcomes and requires further investigation.
Raising physicians’ awareness of health implications of polypharmacy may help reduce
the incidence of medication-related adverse events and improve treatment outcomes.
Research Interests:
Objective: This study aims to determine the predictors of the length of inpatient hospital admission following deliberate self-harm (DSH).
Research Interests:
Aims – Clinical guidelines for the management of bipolar affective disorder published by The National Institute for Health and Clinical Excellence (NICE) recommend that all patients who are prescribed lithium should have their renal and... more
Aims – Clinical guidelines for the management of bipolar affective disorder published by The National
Institute for Health and Clinical Excellence (NICE) recommend that all patients who are prescribed
lithium should have their renal and thyroid function checked every six months, and their serum lithium
level checked every three months. Adherence to these recommendations has not been scrutinized in
Arab population such attendees to a tertiary hospital in Oman.
Methods – The computerised patient record system was used to identify all patients who were
prescribed lithium between January 2010 and September 2013. The main outcome measure was the
percentage of patients taking lithium who had adequate monitoring of lithium level, urea and electrolyte,
thyroid function, lipids and glucose.
Results – A total of 66 patients met the inclusion criteria for the clinical audit. For patients prescribed
lithium for six months or more, the internationally set standard for monitoring lithium serum levels every
three months was met in 30% of the patients. Six monthly monitoring of renal and thyroid function was
met in 9% and 11% of cases respectively.
Conclusions – The quality of lithium monitoring in patients who are in contact with mental health
services at SQUH falls short of recognised international standards and targets. Rigorous measures need
to be taken to improve adherence to monitoring recommended by clinical guidelines to close the audit
loop.
Institute for Health and Clinical Excellence (NICE) recommend that all patients who are prescribed
lithium should have their renal and thyroid function checked every six months, and their serum lithium
level checked every three months. Adherence to these recommendations has not been scrutinized in
Arab population such attendees to a tertiary hospital in Oman.
Methods – The computerised patient record system was used to identify all patients who were
prescribed lithium between January 2010 and September 2013. The main outcome measure was the
percentage of patients taking lithium who had adequate monitoring of lithium level, urea and electrolyte,
thyroid function, lipids and glucose.
Results – A total of 66 patients met the inclusion criteria for the clinical audit. For patients prescribed
lithium for six months or more, the internationally set standard for monitoring lithium serum levels every
three months was met in 30% of the patients. Six monthly monitoring of renal and thyroid function was
met in 9% and 11% of cases respectively.
Conclusions – The quality of lithium monitoring in patients who are in contact with mental health
services at SQUH falls short of recognised international standards and targets. Rigorous measures need
to be taken to improve adherence to monitoring recommended by clinical guidelines to close the audit
loop.
Research Interests:
Suicide is a global phenomenon in all regions of the world affecting people of all age groups. It has detrimental consequences on patients, their families, and the community as a whole. There have been numerous risk factors described for... more
Suicide is a global phenomenon in all regions of the world affecting people of all age
groups. It has detrimental consequences on patients, their families, and the community
as a whole. There have been numerous risk factors described for suicide including mental
illness, stressful life situations, loss of social support, and general despair. The association
of suicide with Islam has not been extensively studied. The common impression from
clinical practice is that being a practicing Muslim reduces the risk of suicide. Another
factor associated with suicide is starting a patient on antidepressants. However, this
has been questioned recently. This report describes a middle-aged man with depression
and multiple social stressors who survived a serious suicide attempt. The discussion
will focus on the factors that lead him to want to end his life and the impact of the
assumed protective factors such as religious belief and family support on this act of selfharm.
Such patients can be on the edge when there is an imbalance between risk factors
(such as depression, insomnia, and psychosocial stressors) and protective factors (like
religious affiliation and family support). All physicians are advised to assess the suicide
risk thoroughly in patients with depression regardless of any presumed protective factor.
groups. It has detrimental consequences on patients, their families, and the community
as a whole. There have been numerous risk factors described for suicide including mental
illness, stressful life situations, loss of social support, and general despair. The association
of suicide with Islam has not been extensively studied. The common impression from
clinical practice is that being a practicing Muslim reduces the risk of suicide. Another
factor associated with suicide is starting a patient on antidepressants. However, this
has been questioned recently. This report describes a middle-aged man with depression
and multiple social stressors who survived a serious suicide attempt. The discussion
will focus on the factors that lead him to want to end his life and the impact of the
assumed protective factors such as religious belief and family support on this act of selfharm.
Such patients can be on the edge when there is an imbalance between risk factors
(such as depression, insomnia, and psychosocial stressors) and protective factors (like
religious affiliation and family support). All physicians are advised to assess the suicide
risk thoroughly in patients with depression regardless of any presumed protective factor.
Research Interests:
Objectives: The objective of this study is to determine the medical and socio-demographic features of patients with dementia attending neurology and psychiatry clinics along with identifying prescribed medications and physical co... more
Objectives: The objective of this study is to determine the medical and socio-demographic features of patients with dementia attending neurology and psychiatry clinics along with identifying prescribed medications and physical co morbidities at a tertiary care hospital in Oman.
Research Interests:
A case of a girl who presented with symptoms of gender dysphoria is described here. She received cognitive behavioral therapy that helped her explore her thoughts and address any distorted cognition. She was able to live as a female and... more
A case of a girl who presented with symptoms of gender dysphoria is described here. She received cognitive behavioral therapy that helped her explore her thoughts and address any distorted cognition. She was able to live as a female and changed her mind about undergoing sex change surgery. This article explores the concept of gender dysphoria and the role of psychological interventions in its management.
Research Interests:
Adult onset citrullinemia type II is an autosomal recessive disorder of amino acid metabolism caused by a deficiency of liver specific arginino-succinate-synthetase-activity 1. Cases reported in the literature are few and most of them... more
Adult onset citrullinemia type II is an autosomal recessive disorder of amino acid metabolism caused by a deficiency of liver specific arginino-succinate-synthetase-activity 1. Cases reported in the literature are few and most of them were from Japan. The adult onset variant is known to present with neuropsychiatric manifestations.The authors report a case of a 30 year old Omani woman who presented with unusual episodic symptoms that mimicked schizoaffective disorder. The patient was admitted under psychiatry initially. Routine investigations were sent along with Electroencephalography which showed continuous epileptiform discharges. Neurology and genetic disorders teams were consulted. After through investigations, the case was diagnosed as adult onset citrullinemia type II.. Such cases necessitatesa low threshold for ruling out organic causes in patients presenting with psychiatric symptoms .
Adult onset citrullinemia type II is an autosomal recessive disorder of amino acid metabolism caused by a deficiency of liver specific arginino-succinate-synthetase-activity 1. Cases reported in the literature are few and most of them... more
Adult onset citrullinemia type II is an autosomal recessive disorder of amino acid metabolism caused by a deficiency of liver specific arginino-succinate-synthetase-activity 1. Cases reported in the literature are few and most of them were from Japan. The adult onset variant is known to present with neuropsychiatric manifestations.The authors report a case of a 30 year old Omani woman who presented with unusual episodic symptoms that mimicked schizoaffective disorder. The patient was admitted under psychiatry initially. Routine investigations were sent along with Electroencephalography which showed continuous epileptiform discharges. Neurology and genetic disorders teams were consulted. After through investigations, the case was diagnosed as adult onset citrullinemia type II.. Such cases necessitatesa low threshold for ruling out organic causes in patients presenting with psychiatric symptoms .
Research Interests:
Background: Ageing of the Omani society calls for the evaluation of functional abilities and the factors that should be addressed by health programs. This study was conducted to reveal the extent and determinants of dependency on IADL and... more
Background: Ageing of the Omani society calls for the evaluation of functional abilities and the factors that should be addressed by health programs. This study was conducted to reveal the extent and determinants of dependency on IADL and ADL among the elderly in Al-Dakhliyah governorate, Oman.