Objectives: Given the increasing prevalence of breast cancer, understanding why women perform or do not perform breast self-examination (BSE) is essential to promote self-care. This study explored the perceptions of primary healthcare workers about barriers and facilitators to performing BSE in Oman and identified potential interventions to promote BSE. Methods: A qualitative study using four focus group discussions was conducted with 30 healthcare workers (nurses, physicians, administrators, and radiographers) from primary healthcare centers in Muscat. Discussions were audio-recorded, transcribed, and analyzed thematically analyzed using constructs from the Health Belief Model. Results: Barriers to BSE included inadequate knowledge of correct BSE techniques (low self-efficacy), limited access to accurate information and professional recommendations (lack of cues to action), sociocultural stigma, fear of cancer (perceived barriers), and low motivation. Facilitators included higher educational level and personal exposure to breast cancer (perceived susceptibility), peer and family support, and positive healthcare experiences (perceived benefits). Religious beliefs played dual roles, acting both as fatalistic barriers and as motivators for self-care. Participants expressed uncertainty about the effectiveness of BSE compared to other screening methods but acknowledged its role in early detection and monitoring disease progression. Suggested strategies included introducing BSE into educational curricula, strengthening its role in clinical practice, engaging communities, and conducting public health awareness campaigns. Conclusions: BSE remains a useful tool for women to detect breast abnormalities. Enhanced efforts are recommended to integrate BSE education and practice across academic institutions, workplaces, healthcare facilities, and community services.

Keywords:Self-Examination; Breast Cancer; Primary Health Care; Health Personnel; Health Promotion; Oman.

Objectives: Artificial intelligence (AI) platforms based on large language models such as ChatGPT, are increasingly being used by both the public and medical professionals to obtain medical information. This rapid growth in reliance makes it essential to systematically evaluate the accuracy and clinical reliability of AI-generated medical content. The objective of this study was to evaluate the accuracy of responses provided by ChatGPT regarding prevention, screening, treatment, and risk factors of common gynecological cancers. The assessment focused primarily on the use of ChatGPT by primary care providers and the public with limited subject-specific knowledge.Methods: We evaluated the reliability of ChatGPT (version 3.5) in answering questions about two of the most common gynecological cancers. ChatGPT was posed a total of 40 questions on the prevention, screening, and treatment of endometrial cancer (20 questions) and cervical cancer (20 questions). Responses were independently reviewed and categorized as accurate, inadequate, or inaccurate by five physicians with a mean of 18 ± 3 years of experience in gynecological oncology. Reviewers provided reasons for deeming some responses as inadequate or inaccurate. Results: Overall, 20 out of 40 (50%) responses by ChatGPT 3.5 were regarded as either inaccurate or inadequate. Most of the deficient responses were related to questions on the treatment of the two cancers, while responses to questions about prevention were mostly accurate. Conclusions: ChatGPT may provide accurate information about prevention of gynecological cancers, but the public and health professionals should not rely on its responses to make medical decisions, as many responses in this domain were inadequate or inaccurate. Consultation with qualified physicians or specialists is essential for individualized decision-making. Medical information sourced from AI tools such as ChatGPT should be integrated with clinician oversight to improve reliability.

Keywords:Gynecologic Neoplasms; Uterus; Cervix Uteri; Artificial Intelligence; Large Language Models; ChatGPT.

Objectives: Antenatal care (ANC) visits during pregnancy aim to identify and address factors associated with unsafe pregnancy while educating pregnant women on the nuances of pregnancy and motherhood. The recommended number of visits varies across different countries. We compared the adverse maternal and fetal outcomes in participants with adequate ANC visits to the Focused ANC (FANC) model by the World Health Organization with those in the adequate and adequate plus categories of the Adequacy of the Prenatal Care Utilization (APNCU) index, to evaluate if the number of visits had any influence on these outcomes. Methods: We conducted a prospective observational study among consenting participants who had received one or more antenatal visits elsewhere before presenting to our hospital for further care between January 2021 and September 2022. We collected details on previous pregnancy, prior ANC visits, adverse maternal, and fetal outcomes after delivery, and then statistically analyzed the data. Categorical variables were analyzed using the chi-square test, and the level of significance was set at p ≤ 0.05 with a confidence interval of 95%. Results: A total of 500 participants were included. Of these, 2.0%, 13.4%, 46.6%, and 38.0% received adequate plus, adequate, intermediate, and inadequate prenatal care, respectively. There was a statistically significant difference between participants with adequate visits as per the FANC model and those with adequate and adequate plus visits as per the APNCU index in the distribution of high-risk factors in the index pregnancy, such as anemia, hypertensive disorder, and gestational diabetes mellitus. Similarly, statistically significant differences were found between adverse maternal outcomes like post-partum hemorrhage and intensive care unit admission, and adverse neonatal outcomes like preterm birth, low birth weight, birth asphyxia, neonatal hypoglycemia, meconium aspiration, neonatal intensive care unit admission, and stillbirth. Conclusions: Although the number of participants receiving adequate ANC based on the FANC model was greater than those in the adequate and adequate plus categories according to the APNCU index, the frequency of adverse maternal and fetal outcomes was higher in the FANC model. This most likely indicates that less frequent ANC visits are probably inadequate for the timely identification of issues of concern, and therefore for preventing adverse outcomes.

Keywords:Pregnancy; Pregnant Women; Prenatal Care.

Splenic infarction is an extremely rare complication of Epstein-Barr virus (EBV) infection. We report a case of a healthy young man who presented with fever and pharyngitis and was diagnosed with acute EBV infection. During his hospital stay, he developed sudden left upper quadrant abdominal pain. Computed tomography scan of the abdomen demonstrated hepatosplenomegaly and multiple splenic hypodense lesions suggestive of infarcts. The patient was managed conservatively and discharged on prophylactic anticoagulation therapy. He is currently under close clinical follow up to minimize the risk of splenic rupture. We aim to highlight the importance of suspecting splenic infarction in patients presenting with fever, splenomegaly, and new onset abdominal pain, particularly in the setting of an ongoing or recent EBV infection.

Keywords:Epstein-Barr Virus; Splenic Infarct; Infectious Mononucleosis; Thrombosis; Greece.

An eight-year-old boy presented with a history of intermittent episodes of spastic abdominal pain accompanied by bilious vomiting. Imaging revealed an abnormal position of the large bowel loop, which was associated with an abnormal vascular course. Additionally, a mesenteric cystic lesion was found in relation to the small bowel. A possibility of isolated hindgut malrotation with an enteric duplication cyst was suggested based on these findings. The surgical team confirmed this diagnosis during the procedure. Furthermore, they discovered an internal hernia intraoperatively, with a defect in the colonic mesentery through which the terminal ileum, ileocecal junction, cecum, and appendix herniated.

Keywords:Intestinal Malrotation; Enteric Duplication Cyst; Internal Hernia.