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Internal Medicine

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At internal medicine, our teams of specialized health care professionals are committed to providing high-quality comprehensive service to every patient, whether it is for an urgent acute medical procedure or any medical subspecialty care.

A full spectrum of various medical conditions including rheumatological disorders, immunity problems, infectious diseases, psychiatric, endocrine, and metabolic disorders.

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The Acute Medical Admission is responsible for the acute care of various medical conditions with daily admissions up to 30 per day, in addition to a medical high dependency unit with a capacity of 8 beds providing immediate care for deteriorating/critically ill patients and serving as a step down for medical patients being transferred from the Intensive care unit.

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The Nephrology department at the Royal Hospital is the biggest in the whole country.

It offers a comprehensive approach to the diagnosis, management, and treatment of Nephrology diseases in adults.

We have inpatient and out patients services for the Nephrology disease as well as Renal Transplant. We accept complicated cases from all over the Sultanate.

We do around 100-120 native and graft kidney biopsies/year. The Nephrology department at the Royal Hospital is the only center in the country to offer kidney transplant for the End stage kidney disease patients.

Moreover, we take all the blocked or infected dialysis accesses like Blocked Tunnelled catheter, blocked Arterio-Venous Fistulas and Grafts.

Temporary dialysis catheters like Femoral venous catheters and Internal Jugular catheters are inserted by the Nephrology Doctors while the Tunnelled catheters are inserted by the Interventional Radiologists.

The subspecialties constitute:

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Gastroenterology
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Rheumatology Unit

Chest Medicine Unit

Adult Chest Medicine Unit is the only tertiary care service at the moment for the Country.

With its expertise of specialized doctors in Adult chest medicine, complex and difficult cases are referred from all over the country and investigated and managed in lines with the international guidelines. The unit has gained local, regional and international recognition. This is the only centre that has Sleep Medicine services.

More than 1000 patients undergo intervention procedures and with success rate comparable to international standards. The unit is heavily involved in continues improvement, innovation, academic activities and research.

With its talented leadership, and a great team the center is moving forward to more advance interventional procedures and Sleep medicine.

Scope of Services

  • General Pulmonology.
  • Sleep medicine.
  • Pulmonary Function Lab
  • General and advanced interventional procedures.
  • Pleural services.
  • Initiation and plan for biological treatment in severe asthma.
  • Day care serviced for various procedures.

Our doctors are specialize in

  • General Bronchoscopy.
  • Endobronchial Ultrasound.
  • Intercostal drains.
  • Pleural biopsies.
  • Thoracic Ultrasound.
  • Thoracic Imaging.

CHEST - Clinical Excellence

Chest medicine is known locally and in the region for

  • Managing advanced and complexed respiratory diseases.
  • Evaluating and diagnosing sleep disorders.
  • Managing high risk and severe asthma patients.
  • Expertise in pulmonary hypertension.
  • Expertise in interstitial lung disease.

Strategies to Assess and Meet Patient Care Needs - Performance Improvement Projects

  • Reduce waiting list for all services
  • Early discharge
  • Provide Service updated guidelines and protocols
  • Reduce hospital acquired infection
  • Reduce waiting time for the Sleep studies

Commitment to Society

As part of health care mission and vision, increasing community awareness about respiratory diseases is integrated in all services.

The unit has annual participation in world asthma day. Many exhibitions and conferences have been done in different governate to orient people and update them about prevention and basic knowledge of respiratory diseases. With recent advancement in online presentations, multiple sessions has been delivered with thousands of participants.

International Collaborations/ Affiliations

  • Sultan Qaboos university.
  • National University of Science and Technology.
  • Oman Respiratory Society.
  • Saudi Respiratory society.
  • Emirates Respiratory Society.
  • European Respiratory Society.

Milestones

  • First and only center with the EBUS.
  • Pleural procedures.
  • Pleural imagining.
  • Severe Asthma management.
  • Use of Biologics for the severe asthma patients.

Gastroenterology

The gastroenterology and Hepatology unit provides a comprehensive array of diagnostic and therapeutic interventions for conditions affecting the gastrointestinal (GI) tract, liver, biliary tracts and pancreas. Patients who 13 years of age and more are eligible to be seen in gastroenterology clinics.

Given the diversity of gastrointestinal diseases we have general gastroenterology clinics and specialized clinic. Patients with general GI symptoms, IBS, organic and functional dyspepsia, GERD, deranged liver chemistry and similar conditions are evaluated in general GI clinic. We also provide highly specialized services in biliary clinic and inflammatory bowel disease clinic which are considered the main referral clinics from ministry of health hospitals.

Hepatology services is expanded to include patients with viral hepatitis, deranged LFT, metabolic liver diseases, non-alcoholic fatty liver disease, autoimmune hepatitis, and liver cirrhosis. Liver transplant clinics assess patients eligibility for transplant and follow all patients after undergoing liver transplant.

Gastroenterology unit provide diagnostic and therapeutic endoscopic services including OGD, colonoscopy, push enteroscopy, flexible sigmoidoscopy and video capsule endoscopy. Therapeutic procedures include endoscopic management of GI bleeding, banding of esophageal varices, injecting gastric varices, stenting upper and lower GI tumors, polypectomy and dilatation of strictures. Screening for GI cancers are performed within the unit as well with upper and lower GI endoscopies.

Advanced endoscopic interventions including ERCP and EUS are performed to diagnose and manage many conditions like obstructive jaundice, CBD biliary stones, biliary strictures, PSC, cholangiocarcinoma, biopsy from submucosal GI tract lesions, and pancreatic tumors. New advanced endoscopic services will be introduced soon including Spyglass cholangioscopy, and double balloon enteroscopy.

In addition to outpatients, inpatients and endoscopy services, gastroenterology unit see patients in daycare for infusions of biological agents, IV iron in IBD patients as well as patients preparation for liver biopsy and video capsule endoscopy.

Rheumatology Unit

Rheumatology unit at Royal Hospital offer a comprehensive approach to the diagnosis, management, and treatment of rheumatic diseases in adults.

There are more than 200 recognized rheumatic diseases including Lupus, Rheumatoid arthritis, Psoriatic arthritis, Spondyloarthropathy, Systemic sclerosis, Vasculitis, Behcet’s Disease Juvenile idiopathic arthritis and related autoimmune inflammatory disorders, and others.

Rheumatic diseases are disorders of the joints, muscles and soft tissues of the body and can often be difficult to diagnose and treat. Some, like osteoarthritis, are the result of wear and tear. Others, such as rheumatoid arthritis, are immune system problems. Rheumatology services treatment plans may include different medications, exercise regimens, dietary recommendations, stress management and rest of the affected area. Treatment plan options will be at the discretion of the rheumatology specialist.

Scope of Services

We offer a range of specialist clinics, with close links with several other departments. Our clinics see both new referrals and follow up patients. Our specialized clinics include:

  • Rheumatology clinics
  • Lupus clinic
  • Combined Obstetric/Rheumatology clinic
  • Telemedicine clinics, in which patients are contacted by phone

Our doctors are specializing in

  • Treat various type of rheumatic diseases. The treatment may involve advance therapies like immunosuppressive medications and biological therapies.
  • Perform various procedures including joint injections, joint aspiration, and skin biopsy.
  • Musculoskeletal Ultrasound of various joints.
  • Training and teaching interns and residents.
  • Performing medical research in collaboration with several national and international organizations.

Clinical Excellence

  • Our rheumatology department is one of the largest departments of its kind in Oman. We receive referrals from different regions around the sultanate.
  • We offer the most advance and new therapy in managing rheumatic diseases.
  • We have the only specialized clinic dealing with Lupus around the country.
  • We also carry a specialized clinic in collaboration with Obstetric& Gynae Department to take care of pregnancy in Lupus patients and other high-risk patients with rheumatic diseases.

Strategies to Assess and Meet Patient Care Needs - Performance Improvement Projects

  • Reduce follow up and new appointments waiting list by discharging the patients to their allocated health facilities according to catchment areas.
  • Provide service with updated guidelines and protocols.
  • Improve patient awarness about their diseases by conducting lectures and providing educational booklets and leaflets.
  • Creating WhatsApp patients’ group to enhance their knowledge about diseases (e.g., Lupus group).
  • We have established a rheumatology WhatsApp service for patients to communicate to us about their different needs.
  • Our rheumatologists collaborate with colleagues in a variety of related specialties, since rheumatic diseases can affect different organs in the body.
  • Together, we strive to provide each patient with innovative therapies and personalized care to manage their condition and improve their quality of life.

Committed to Society

  • We aim to improve patients awarness about their diseases, which will reflect in their compliance level by conducting lectures and providing educational booklets and leaflets.
  • Also, we work in partnership with Oman rheumatology society to achieve this mission. Under this partnership, as an example, we had collaboration with woman association to deliver awarness lectures about topics related to our field.

International Collaboration / Affiliations

  • Oman Medical Specialty Board
  • Oman Rheumatology Society
  • Arab League Against Rheumatism
  • European League Against Rheumatism
  • American College of Rheumatology
  • British Society of Rheumatology

Significant Achievements

  • Leading the largest national study in Lupus (Oman Lupus Study) in 2021.
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Adult Immunology and allergy
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Infectious Diseases Unit

Adult Immunology and allergy

The service covers the diagnosis and management of various Immunological and allergic disorders:

  • Primary Immunodeficiencies
  • Secondary Immunodeficiencies
  • Anaphylaxis
  • Hereditary angioedema
  • Food, Drug and Insect allergy
  • Allergic rhinitis and allergic rhino conjunctivitis
  • Allergic Asthma
  • Acute and chronic urticaria
  • Atopic dermatitis
  • Allergy testing (skin prick test, Intradermal test, Challenge test)
  • Drug desensitization
  • Allergen Immunotherapy (Subcutaneous and sublingual)

The Immunology and Allergy unit was awarded recognition certificates by the GA²LEN (the Global Allergy and Asthma European Network) as:

  • An Urticaria Center of Reference and Excellence (UCARE)
  • An Angioedema Center of Reference and Excellence (ACARE)

Infectious Diseases Unit

The Royal Hospital infectious diseases (ID) team helps to manage the most complex infections encountered in the hospital setting through consultation or admissions.

Scope of Services

  • General ID and highly specialized Care for adult ID
  • Outpatient clinics
  • Antimicrobial Stewardship Program
  • Outpatient Antimicrobial Therapy (OPAT)
  • Combined Diabetic Foot clinic
  • Combined OBGYN/ID Clinic for pregnant women with HIV infection

Our doctors are specialize in

The service collaborates with other specialties to provide multi disciplinary care to the patients.

  • HIV
  • Infections in immunocompromised host
  • Multidrug resistance MDR/XDR Tuberculosis
  • Atypical Mycobacterial infections
  • Sexually transmitted Diseases
  • Tropical diseases

Clinical Excellence

  • State of the art quality care for HIV in the country
  • Referral center for patients hospitalized with multi drug resistance MDR/XDR tuberculosis
  • Management of diabetic foot infections
  • Assessment of infection risks in transplant patients (prophylaxis, preemptive therapy, surveillance and vaccination)
  • Education and training for local and international medical students, residents and doctors

Strategies to Assess and Meet Patient Care Needs - Performance Improvement Projects

Improving antimicrobial utilization: The service plays a critical role in improving overall antimicrobial utilization by providing expert advice on the appropriate use of antimicrobials, education of prescribers, and developing and implementing evidence-based guidelines for management of infections, empiric antimicrobial therapy and prophylaxis.

Improving Sepsis recognition and management: increased emphasis on improving the care of sepsis patients based on the latest updated global adult sepsis guidelines, by the Surviving Sepsis Campaign (SSC)

Reducing rates of multi drug resistance organisms by adopting a multifaceted approach based on latest guidelines and protocols

Committed to Society

  • High standard quality care to patients with infections in Oman
  • Collaboration with the media and other social network platforms to increase public awareness on emerging and re-emerging infections
  • Yearly campaigns on HIV, TB and antibiotics utilization

International Collaborations / Affiliations

  • Infectious Diseases Society of America (IDSA)
  • European Society of Clinical Microbiology and Infectious Diseases (ESCMID)
  • Croatian Society for Infectious Diseases (CSID)

Significant Achievements

Team-based care for diagnosis and management of complicated infectious diseases that is recognized nationally and regionally

Research: The ID unit has significant contribution to enhance research internationally and locally with more than 100 publications in peer reviewed journals.

KASHIF: Designing an App for daily self- reporting of COVID-19 symptoms for health care workers

Certificates, Awards, & Accreditations

  • National Research Award in Research in Health and Community Service 2021
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