The Pediatric Endocrine unit is the principal center for caring of all children with endocrine disorders in Oman. It evaluates and manages children with disorders of pituitary, thyroid, parathyroid, adrenal, gonad and metabolic bone diseases. It also provides leadership for the diagnosis and management of diabetes in children in the country and sets protocols for referral and follow up of patients managed in the peripheral institutions.
STAFFING
Dr. Aisha Al Senani, MD, MRCPCH (UK), DCH (Glasgow), Senior Consultant and Head of Unit
Dr. Shashwat Saran, MBBS, DCH, MRCPCH (UK), Specialist
Dr. Moza Al Yahyai, MD, DCH, Junior Specialist
CLINICAL ACTIVITIES
The Pediatric Endocrine Unit at the Royal Hospital is the only unit in the Sultanate of Oman offering a fully specialized endocrine service for children. Hence it gets a large number of referrals from all parts of the Sultanate.
Outpatient:
Two endocrine clinics are run per week. About 1300 patients with all endocrine disorders are seen annually in general endocrine clinic.
Two diabetic clinics are held per month.
Insulin pump clinic is held 4 times year. There are about 25 patients on Insulin Pump
Day Care Services:
A day care service is run for dynamic tests twice per week. Saturdays are meant for those who require overnight stay, while Sundays are reserved for patients who need to stay in the morning hours. These dynamic tests include: Growth hormone stimulation test, GnRH stimulation test, ACTH stimulation test, HCG stimulation test, Dexamethazone suppression test, Water deprivation test, Fasting for evaluation of Hypoglycemia.
Inpatient Services:
The team looks after all endocrine-related inpatients who admitted through Emergency room and those who are referred from other hospitals.
Inpatient referrals are also received from neonatal unit, intensive care unit and other units in the Royal Hospital.
The unit provides consultation to peripheral hospitals regarding the plan and management of any child with endocrine diseases.
Patients with endocrine diseases, especially diabetes, need lifelong treatment. Hence the unit has developed a well structured plan for counseling and education of diabetic children and their parents.
ACHIEVEMENTS
- Establishment of an efficient system for the referral and management for paediatric endocrine patients in Oman.
- A protocol has been prepared for all acute paediatric emergency and chronic endocrine diseases.
- Introduced Insulin Pump for patients and establish the services since last year.
- Established a protocol for patients with Osteogenesis Imperfecta so as to decrease the need for Orthopaedic admission.
- In-service training of 3 pediatricians who are aspire to be paediatric endocrinologists.
- We liaise with two genetic centers abroad by sending samples free of charge for our neonatal diabetes patients and hyperinsulinism patients.
- Diagnosis of the most rare cases of thyroid resistance hormone by establishing genetic mutation of those patients
- A small illustrative book for Type I diabetes in children has been published.
ACADEMIC ACTIVITIES
- Teaching undergraduate and postgraduate residents
- Practical training in Insulin pump for both paediatricians and diabetic nurse.
- Combined meeting twice per month with the biochemistry to discuss the lab data and clinical details for the patient.
- Clinical research and analysis: Mutations of neonatal diabetes in Oman; Genetic mutation for hypoglycemic hyperinsulinism in Omani children; Retrospective study of Type I diabetes in Omani children presented in the Paediatric Endocrine workshop in 2009. Many case reports are under study.
FUTURE PLANS
- To establish a full service for paediatric children with diabetes in the National Diabetic Center that is being constructed.
- Prenatal diagnosis for CAH so as to avoid most surgery for affected female children.
- To screen ambiguous genitalia children, so there will be no doubt or problems in determining sex of these children.
