Oman Medical College

Objective: This study aimed to assess the prevalence, resistance patterns, and clinical predictors of MDROs in neurosurgical patients at a tertiary hospital in Oman. Materials and Methods: A retrospective analysis was conducted on 238 patients admitted to the neurosurgical and neurology departments at Khoula Hospital from January to December 2019. Data included demographics, clinical diagnoses, hospital stays, and antimicrobial resistance profiles. Statistical analyses, including Chi-square tests and logistic regression, identified predictors of prolonged hospital stay and high-risk patient groups. Results: Methicillin-resistant Staphylococcus aureus (MRSA, 54.2%) and carbapenem-resistant Enterobacteriaceae (CRE, 34.5%) were the most prevalent MDROs. Resistance was highest against b-lactams (95.4%), sulfonamides (95.4%), and quinolones (91.6%), with no resistance observed to oxazolidinones and lipopeptides. Multidrug resistance and CRE were significant predictors of prolonged length of stay (LOS) ( p < 0.001), and logistic regression identified a high-risk subgroup (10.1%) requiring focused interventions. The predominance of multi-source diagnostics (69%) underscored the importance of comprehensive testing in managing MDRO infections. Conclusion: The study highlights the substantial burden of MDROs in neurosurgical care in Oman, necessitating robust antimicrobial stewardship, targeted interventions, and ongoing surveillance. Future research should focus on multicenter studies to address the growing challenge of antimicrobial resistance.

This research assesses the influence of digital payments, specifically digital commerce and mobile point-of-sale (POS) payments, on the financial performance and risk management of retail banks in Bahrain. The study covers the period from 2018 to 2023, utilizing secondary data from seven retail banks, which include both commercial and Islamic banks. The bank’s performance is measured by return on assets (ROA) and return on equity (ROE). Additionally, the debt-to-capital ratio (DTC) and debt-to-equity ratio (DTE) are employed to assess risk. To analyze the impact of digital payment adoption on bank performance and risk, the Arellano-Bond generalized method of moments (GMM) dynamic panel data model was applied using Stata software. It is a similar approach used in financial technology studies examining banking performance (Irmaningtyas & Rosadi, 2014). The findings reveal that the adoption of digital commerce and mobile POS payments has an insignificant impact on traditional performance measures, such as ROA and ROE, during the study period. However, these digital payment technologies show a significant association with DTC, while these results highlight the insignificant effects of digital commerce and mobile POS payments on the DTE ratio. These findings contribute to the ongoing discussion on the role of financial technology in shaping banking performance and risk, addressing a key research gap in the literature such as Phan et al. (2020).

Triple-negative breast cancer (TNBC) is the most common malignant tumor among Arab women, accounting for 18.8% of female cancer cases in Oman. TNBC lacks estrogen and progesterone receptors, as well as the Human Epidermal Growth Factor Receptor 2 (HER2). Its growth is stimulated by Insulin-Like Growth Factor 1 (IGF-1), which is secreted by the liver and found in blood, saliva, and milk. High levels of IGF-1 are found in tumor growth. Cow’s milk, a complex biological fluid, is known to increase systemic IGF-1, insulin, and estrogen signaling, which may contribute to breast cancer progression. This study investigated the effects of cow’s milk, soy milk, and almond milk on TNBC cell proliferation in vitro. It was hypothesized that cow’s milk would enhance cancer cell proliferation and IGF-1 levels, whereas soy and almond milk would have minimal effects. The MDA-MB-231 TNBC cell line was selected for this study. The experiment was divided into four groups: Cow’s Milk A, Cow’s Milk B (from two different commercial brands), and Almond milk, and Soy milk as a control. These four different types of milk were introduced into cultured cancer cells at 25 µL/mL, 50 µL/mL, 100 µL/mL, and 200 µL/mL concentrations, and incubated for 24 and 48 hours. Cell viability and proliferation were assessed using MMT assay. IGF-1 and IGF-1 receptors were measured using the ELISA technique which were compared to control samples. At 24 and 48 hours, Cow’s Milk A and B gradually increased cancer cell proliferation from 50 to 200 µL/mL concentrations. Conversely, almond and soy milk did not show an increase in cell proliferation with rising concentrations. These findings suggest that cow’s milk may promote TNBC cell proliferation through IGF-1 signaling, while plant-based alternatives may have a lesser impact. Additional research is necessary to better understand the influence of IGF-1 in cow’s milk on the development and progression of triple-negative breast cancer (TNBC).

This paper details the pivotal role of a low solids, low rheology monovalent brine-based drilling fluid (LS-LR-DF) in drilling a vertical, onshore well through hard rock formations. The engineered LS-LR-DF contained a combination of a dual-function synthetic polymer (DFSP) and a nanocomposite wellbore sealant (NCWS). This approach delivered increased stability and performance of the fluid at elevated temperatures in a slim hole well design. The LS-LR-DF application resulted in a significant improvement in drilling efficiency through hard rock formations when compared to offset wells drilled with a high temperature (HT) salt polymer fluid. The target fluid formulation required a low rheology to reduce standpipe pressure (SPP) at high flow rates to facilitate hydraulic horsepower delivery at the bit whilst supporting hole cleaning considerations. Furthermore, the fluid also needed to have sufficient filtration and sealing characteristics at elevated downhole temperatures of ~150°C static downhole temperatures (sDHT) and high overbalance conditions (~1,000 psi) across tight formations with permeabilities up to 4.04 mD. During well execution, the performance of the LS-LR-DF was evaluated with the analysis of hydraulics, standpipe pressure, equivalent circulating density (ECD), and hole cleaning efficiency. Throughout the section, the fluid proved easy to maintain with low rheology supporting hole cleaning in a turbulent flow regime and readily controllable filtration properties (HPHT and PPT). Two round trips were completed without overpull or drag being observed. The actual sDHT was 148.4°C. The higher spurt loss increased initial invasion and the depth of cut from the drill bit. This resulted in a higher ROP compared to the offset wells drilled with the HT salt polymer fluid. The ROP improvement was twofold higher than the 10 previous wells drilled with the HT polymer fluid and resulted in a seven-day reduction in drilling time for the 6-in. interval. The DFSP and NCWS helped mitigate the risk of differential sticking in the low solids fluid through controlled total filtration rates under high temperature conditions that resulted in a thin, low permeability filter cake. The engineered LS-LR-DF yielded a low rheology fluid with higher spurt loss and increased hydraulic horsepower, and jet force impact resulting in lower standpipe pressure (SPP). This softened the drilled formation and doubled the ROP in hard rock formations.