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: Viral Hepatitis reactivation can occur in patients receiving tyrosine kinase inhibitors (TKIs), with potentially fatal complications. We aimed to assess hepatitis reactivation in patients with chronic myeloid leukemia (CML) treated with TKIs. Methods: We retrospectively reviewed the clinical and laboratory records, including antiviral therapy and hepatitis testing data, of CML patients treated with TKI at Sultan Qaboos University Hospital between 2006 and 2020. Results: The participants comprised 98 Omani CML patients who underwent TKI therapy (mean age = 41.1 years; range = 4–77 years). No cases met study criteria for viral hepatitis reactivation during TKI therapy. Imatinib was the first-line CML therapy for 87 (88.8%) patients; Imatinib was used as first line in 93 (94.9%) patients; most patients subsequently switched to other TKIs. Anti-HBc was positive at baseline in 16 (16.3%) patients of whom six with hepatitis B surface antigen-positivity were treated with antivirals along with TKIs, with positive outcomes. The only hepatitis C virus positive CML patient in the cohort also achieved long-term remission from both with combined interferon therapy and TKI. The overall mortality rate was nine (9.2%). Conclusions: In this cohort of Omani patients, no hepatitis B virus or hepatitis C virus reactivation case was documented in association with TKI therapy.

Keywords:Chronic Myeloid Leukemia; Tyrosine Kinase Inhibitors; Prevalence; Antiviral Agents; Hepatitis B; Hepatitis C; Oman.

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.

Objectives: This study aimed to investigate the etiology and risk factors of infertility among Omani couples aged 18–49 years. Methods: Subjects in this retrospective cross-sectional study were selected using purposive sampling method from Omani couples who attended the infertility clinic of a tertiary referral hospital in Muscat between January 2015 and December 2022. Demographic variables, clinical findings, imaging results, hormonal profiles, surgical history, and semen parameters extracted from the hospital information system were analyzed. The main outcomes included male and female infertility etiologies and associated risk factors. Results: The participants included 259 Omani couples. Female-factor infertility accounted for 53.7% of cases, male-factor infertility for 41.7%, and unexplained infertility for 4.6%. Combined factors accounted for 14.3%. Among couples with primary and secondary infertility, mean ages of the female partners age were 37.0 ± 7.1 years and 43.0 ± 5.5 years respectively. Overall, 39.6% of women were obese or overweight. Polycystic ovarian syndrome (PCOS) (21.6%), fibroids (16.0%), endometriosis (7.8%), and tubal block (14.4%) were the main female factors. There was a significant association between body mass index and PCOS and between higher age and fibroids (r = 0.211; p < 0.010). Male abnormalities included oligospermia (45.4%), asthenozoospermia (18.5%), multiple semen abnormalities (23.1%), azoospermia (11.1%), and teratozoospermia (1.9%). Conclusions: Higher maternal age, high body mass index, particularly in association with PCOS and anovulatory disorders, were important modifiable risk factors of infertility in this cohort of Omani couples. Early identification and targeted interventions are recommended to improve fertility outcomes.

Keywords:Infertility; Male Infertility; Female Infertility; Polycystic Ovarian Syndrome; Endometriosis, Oman.

Peroneal neuropathy is the most prevalent compressive neuropathy of the lower extremity and may result from prolonged squatting. However, bilateral peroneal nerve paralysis following prolonged squatting is uncommon. Squatting-induced common peroneal nerve neuropathy in the workplace has been reported among agricultural workers, sewer pipe workers, and harvesting farm workers, but little is known about this type of neuropathy in other professions. In this report, we present a case of a floor tile worker who, after prolonged squatting for 6–7 hours over two months, developed bilateral lower-leg numbness and weakness due to a bilateral peroneal nerve injury. Two months after cessation of work and physiotherapy, his symptoms and neurophysiological abnormalities had completely resolved. Avoiding prolonged squatting, especially in small spaces, and incorporating knee and knee muscle stretching exercises are highly effective in preventing this neuropathy in workers.

Keywords:Peroneal Nerve; Paralysis; Posture; Work.

Spontaneous ovarian hyperstimulation syndrome is a rare condition seen in women of childbearing age. It could be gestational or non-gestational. Most reported cases are associated with multiple pregnancies and hypothyroidism. We report a case of spontaneous ovarian hyperstimulation syndrome in a young non-pregnant woman with a pituitary macroadenoma which regressed after surgical resection of the pituitary adenoma, but recurred after four years.

Keywords:Pituitary Macroadenoma; Spontaneous Ovarian Hyperstimulation Syndrome; Oman.

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.

Calcifying fibrous tumor (CFT) is a rare benign tumor of mesenchymal origin that may develop in several sites in the body, including the gastrointestinal tract. CFTs could present with clinical symptoms or remain asymptomatic. We report a rare case of CFT located at the jejunal mesentery and attached to a mesenteric band causing small bowel obstruction. This case is distinctive due to the presence of a mesenteric CFT combined with a mesenteric band, causing constriction of the small bowel. To our knowledge, this is the first case in the literature to report a congenital band associated with CFT. The mass was surgically removed, and the band was released and ligated.

Keywords:Soft Tissue Tumor; Gastrointestinal Tract; Benign; Mesenchymal; Intestine, Small; Oman.

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.