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The Sultanate of Oman has a rich biodiversity, particularly in medicinal plants, and plays a crucial role in traditional healthcare practices. However, the wealth of knowledge about these plants is scattered across various literature, making it challenging for researchers, practitioners, and the public to access comprehensive information. Therefore, the availability of a centralized, user-friendly online database to catalog Oman's medicinal plants is of great importance. PlantMedOman presented here, which currently holds 186 records helps to enhance academic research, support drug discovery studies, promote the conservation of medicinal plants, and foster greater awareness of Oman's ethnomedicinal heritage.

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Introduction Immune checkpoint inhibitors (ICIs) have revolutionized the management of multiple cancers over the last decade. They work by employing the immune system and exhibiting activity over T cells resulting in immune upregulation. Despite their widespread use, they produce side effects that can limit their use. The immune-related adverse events (irAEs) can be sometimes significant. The irAEs caused by ICIs may occur at any time during the treatment and can vary in grade (G). We sought to study the prevalence and toxicity patterns of ICIs in Oman. Methods One hundred forty-one adult patients (≥18 years) who received at least one dose of nivolumab, pembrolizumab, atezolizumab, or durvalumab between 2016 and 2022 were included. The data were analyzed retrospectively using univariable and multiple-variable logistic regressions. The Wilcoxon rank-sum test and Cochran-Armitage trend test were also used to summarize the continuous and ordinal data. Results Out of the 141 patients, 80 patients (56.7%) received pembrolizumab, and 48 (34%) received nivolumab. Common irAEs included endocrine abnormalities, pneumonitis, and colitis. Thirty patients (21.3%) experienced varying irAE grade toxicity. Out of the 30, 23 patients (82%) developed grade 2 and 3 irAEs. Discussion Predictive analysis showed that male sex and lower hemoglobin (Hb) and bilirubin levels were all significant predictors (p < 0.05) when associated with irAE occurrence. The prevalence of irAEs was similar compared to other reports, literature reviews, or meta-analyses. Female sex has been mentioned previously also to be a predictive factor for endocrine-related toxicities.

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The circulation of Bluetongue (BT) and Epizootic Hemorrhagic Disease (EHD) in the Middle East has already been reported following serological analyses carried out since the 1980s, mostly on wild ruminants. Thus, an EHD virus (EHDV) strain was isolated in Bahrain in 1983 (serotype 6), and more recently, BT virus (BTV) serotypes 1, 4, 8 and 16 have been isolated in Oman. To our knowledge, no genomic sequence of these different BTV strains have been published. These same BTV or EHDV serotypes have circulated and, for some of them, are still circulating in the Mediterranean basin and/or in Europe. In this study, we used samples from domestic ruminant herds collected in Oman in 2020 and 2021 for suspected foot-and-mouth disease (FMD) to investigate the presence of BTV and EHDV in these herds. Sera and whole blood from goats, sheep and cattle were tested for the presence of viral genomes (by PCR) and antibodies (by ELISA). We were able to confirm the presence of 5 BTV serotypes (1, 4, 8, 10 and 16) and the circulation of EHDV in this territory in 2020 and 2021. The isolation of a BTV-8 strain allowed us to sequence its entire genome and to compare it with another BTV-8 strain isolated in Mayotte and with homologous BTV sequences available on GenBank.

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Giant esophageal hemangiomas are rare. The extent is usually in the mediastinum but may spread down to the upper abdomen. Such vascular pathology is hard to treat and typically to be resected along with the organs it is attached to. Here we report a novel way of treatment of giant distal esophageal hemangioma that was considered difficult for resection due to its anatomical spread. With endoscopic ultrasound (EUS) guidance, a few coils were placed in the hemangioma, which lead to stasis of blood and a significant reduction in the size of the lesion in over three months.

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The purpose of current paper is to create a smart and effective tool for telemedicine to early detect and diagnose COVID-19 disease and therefore help to manage Pandemic Crisis (MCPC) in Sultanate of Oman, as a tool for future pandemic containment. In this paper, we used tools to create robust models in real-time to support Telemedicine, it is Machine Learning (ML), Deep Learning (DL), Convolutional Neural Networks using Tensorflow (CNN-TF), and CNN Deployment. These models will assist telemedicine, 1) developing Automated Medical Immediate Diagnosis service (AMID). 2) Analysis of Chest X-rays image (CXRs). 3) Simplifying Classification of confirmed cases according to its severity. 4) Overcoming the lack of experience, by improving the performance of medical diagnostics and providing recommendations to the medical staff. The results show that the best Regression among the five Regression models is Random Forest Regression. while the best classification among the eight classification models and Recurrent Neural Network using Tensorflow (RNNTF) is Random Forest classification, and the best Clustering model among two Clustering models is K-Means++. Furthermore, CNN-TF model was able to discriminate between those with positive cases Covid-19 and those with negative cases.

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Traditional Chinese Medicine (TCM) has become an important part of the health system in the Sultanate of Oman. Although there is no independent law, the local health department has implemented the administrative measures such as the admittance assessment system of TCM doctors and the standardized examination and approval of TCM clinics. The development of TCM in the Sultanate of Oman is supported by the policies of the two governments, with the characteristics likemedical cooperation starting with high-level personnel, the cooperation in economy, trade and medical treatment, TCM and local traditional medicine showing inclusive with good base, and the advantages of TCM theory and treatment meeting the needs of the local medical market. The prospect of cooperation in TCM market is broad. It is suggested that the local government should promote the legislation of traditional medicine and improve the admittance system of practitioners. China needs to promote the formulation of international standards of TCM and optimize the cooperation platform of TCM by using Internet and other technologies. The practitioners in China need to carry out medical activities on the premise of understanding and respecting the local cultural background.In order to promote the development of TCM in Arab countries, the Sultanate of Oman will radiate the whole Middle East through the above strategies.

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This paper aims to evaluate the role and effects of national accreditation practices in the improvement and development of the Omani private higher educational institutions in term of Governance and Management. A documental collection, revision and analysis was performed in order to enhance our understandings of the impact of quality audit in terms of Governance and Management. The study focused on analysing the quality audit reports of 25 assessed Omani HEIs. It covered published reports of all private institutions who already completed the first stage of national accreditation process. From one side, the data analysis showed us that the majority of the Omani private higher education institutions operate their activities without having a clear strategic direction. Also, they don't have performant governance and management systems. From another side, a progress was observed in terms of institutional Affiliations for Programs and Quality Assurance, Student's grievance processes and Health and Safety management. Among other things, the findings revealed that the Omani HEIs perceive quality assessment programs as strategical imposed tool made under the constraint of accountability, rather than an effective mechanism of development.

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This study was investigated the cause of death of two captive adult Arabian tahrs (Arabitragus jayakari) died within 2-3 days after onset of fever and neurologic signs in a private farm in northern Batinah Region of Oman. Blood counting revealed leukocytosis attributed to neutrophilia and serum chemistry showed hypoproteinemia, increased creatine kinase and BUN. Upon autopsy, the animals exhibited mild ascites and hydrothorax, prominent hydropericardium, with large pale-yellow clear fluid coagulum, prominent epicardial petechiation, as well as severe pulmonary edema associated with frothy fluid in airways. Brain edema with congestion of meningeal and parenchymal vessels was prominent. Histopathology revealed severe congestion and edema of both lung and brain as well as cardiac myopathy. Ehrlichia ruminantium colonies (the causative organism of cowdriosis; OIE-listed disease) were demonstrated in the capillary endothelium of fresh brain squash and lung macrophages. This is the first report of natural E. ruminantium infection in Arabian tahr, the highly endangered species, based on typical clinical signs of acute cowdriosis and demonstration of E. ruminantium colonies in the brain capillary endothelial cells.

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BACKGROUND: The human hand is an important functional and sensory organ. Its complex anatomy reflects its important functional capabilities. Many Muslim countries observe the holy festivals with a traditional sacrifice of an animal in order to share the meat (basic commodity) with beloved ones. During such festivals hand injuries have been reported to increase. This study aimed to compare cases and controls of hand injuries treated at the national trauma center in the Sultanate of Oman during a 10-year time period. METHODS: This is a case-control retrospective review for 10 years in the Sultanate of Oman. The cases were all hand injuries registered and assessed at Khoula Hospital in the Sultanate of Oman during the 3 days of both holy festivals from January 2004 to December 2013. Controls were hand injuries registered and assessed at Khoula Hospital in the Sultanate of Oman during nonfestival days. Data were extracted and collected from the Emergency Department database. A descriptive and comparative analysis was done. RESULTS: There were 1091 cases reviewed in this study. Knife laceration was 2.4 more common during holy festivals than any other time. Extensor tendon injuries were 2.7 more common during holy festivals than nonfestival times. Thumb and index fingers constituted around 40% of the total injuries. Of all patients reviewed, 85% were treated and discharged home without admission. CONCLUSION: Holy festivals in the sultanate of Oman are risky times for hand injuries. Knife lacerations are more common during such times than any other times. Emergency and plastic services should be aware of the pattern of hand injuries during such times in order to prepare and plan services accordingly.

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The Sultanate of Oman is a rapidly developing Muslim country with well-organized government-funded health care services, and expanding medical genetic facilities. The preservation of tribal structures within the Omani population coupled with geographical isolation has produced unique patterns of rare mutations. In order to provide diagnosticians and researchers with access to an up-to-date resource that will assist them in their daily practice we collated and analyzed all of the Mendelian disease-associated mutations identified in the Omani population. By the 1 (st) of August 2015, the dataset contained 300 mutations detected in over 150 different genes. More than half of the data collected reflect novel genetic variations that were first described in the Omani population, and most disorders with known mutations are inherited in an autosomal recessive fashion. A number of novel Mendelian disease genes have been discovered in Omani nationals, and the corresponding mutations are included here. The current study provides a comprehensive resource of the mutations in the Omani population published in scientific literature or reported through service provision that will be useful for genetic care in Oman and will be a starting point for variation databases as next-generation sequencing technologies are introduced into genetic medicine in Oman.

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UNLABELLED: Traumatic brain injury (TBI) continues to be the main cause of death among trauma patients. Accurate diagnosis and timely surgical interventions are critical steps in reducing the mortality from this disease. For patients who have no surgically reversible head injury pathology, the decision to transfer to a dedicated neurosurgical unit is usually controversial. OBJECTIVE: To compare the outcome of patients with severe TBI treated conservatively in a specialized neurosurgical intensive care unit (ICU) and those treated conservatively at a general ICU in the Sultanate of Oman. DESIGN: Retrospective cohort study. METHODS: This is a retrospective study of patients with severe TBI admitted to Khoula Hospital ICU (specialized neurosurgical ICU) and Nizwa Hospital ICU (general ICU) in Oman in 2013. Surgically treated patients were excluded. Data extracted included demographics, injury details, interventions, and outcomes. The outcome variables included mortality, length of stay, length of ICU days, and ventilated days. RESULTS: There were 100 patients with severe TBI treated conservatively at Khoula Hospital compared with 74 patients at Nizwa Hospital. Basic demographics were similar between the 2 groups. No significant difference was found in mortality, length of stay, ICU days, and ventilation days. CONCLUSION: There is no difference in outcome between patients with TBI treated conservatively in a specialized neurosurgical ICU and those treated in a general nonspecialized ICU in Oman in 2013. Therefore, unless neurosurgical intervention is warranted or expected, patients with TBI may be managed in a general ICU, saving the risk and expense of a transfer to a specialized neurosurgical ICU.

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BACKGROUND: Domestic and industrial wastewaters are mostly treated by biological process such as activated sludge, aerobic pond, and anaerobic treatment. This study focuses on characterizing the quality of sewage sludge in the Sultanate of Oman chosen from three industrial sewage treatment plants (STPs): Rusayl Industrial Estate (RSL.IE); Sohar Industrial Estate (SIE); and Raysut Industrial Estate (RIE). METHODS: Samples of recycled activated sludge (RAS) and wasted activated sludge (WAS) were collected over a period of 12 months across above mentioned STPs. Parameters analyzed are electrical conductivity (EC), potential of hydrogen (pH), cations, anions and volatile content (VC). RESULTS: The obtained values for pH and EC were low for both RAS and WAS samples, except EC values of RIE that was more than 1000 µS/cm. The range of VC percentages in RAS and WAS samples were 44 to 86% and 41 to 77%, respectively. The measured values for chloride, sulfate, nitrate and phosphate were higher than the other anions. CONCLUSION: The average values of the cations in RAS and WAS samples were within the Omani Standards, suitable for the re-use of sludge in agriculture except for Cd in RSL.IE. The study recommends that a regular maintenance should be performed at the studied STPs to prevent any accumulation of some harmful substances, which may affect the sludge quality, and the sludge drying beds should be large enough to handle the produced sludge for better management.

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BACKGROUND AND OBJECTIVE: Elevated LDL (Low Density Lipoprotein) cholesterol is a major cause of Coronary Heart Disease (CHD) and LDL lowering therapy reduces the risk for CHD. The study was conducted with the aim of assessing the prescribing pattern of statins based on cardiovascular risk factor category, pattern of lipid monitoring followed among the patients and extent of attainment of goal Low Density Lipoprotein (LDL-C) observed among the patients. METHODS: A group of patient files (among those on statin agent during the year 2011) from the Department of Medicine in Nizwa Hospital were selected for targeted evaluation on the risk factor status of patients and efficacy of statins in attaining goal lipid levels. Goal LDL-C levels were estimated for each patient depending on their risk factor status. Subsequent follow ups of the patients were reviewed from the patient files and accordingly the attainment and maintenance of goal-LDL-C in the patients were evaluated. RESULTS: A total of 183 patients were identified. Mean age of the evaluated patients was 63.6 ± 11.58 years. Evaluating the status of patients on the presence of risk factors, majority (63.9%) of them had presence of CHD. Simvastatin was the most commonly used agent and titration of dose was done in only 3.3% of patients. Mean LDL-C level of the patient before initiation of treatment was 3.74 ± 1.9 mmol/L. Only in 59 (32.2 %) of the total evaluated 183 patients, there was evidence of attaining goal-LDL-C levels. Among them, there was evidence of maintenance of goal LDL-C in 16 (27.1%) of the patients. CONCLUSION: Statins were used less frequently for primary prevention of CHD. Absence of lipid monitoring; base line and follow up in a good number of patients as well as lack of dose titration among the patients were observed. Importance of adequate lipid monitoring and follow up to ensure attainment of goal LDL-C needs to be stressed to serve the objective of use of statins; primary and secondary prevention of CHD.

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Acupuncture and moxibustion is classified as category of alternative medicine and has been incorporated into the public medical institution in Oman. There are two public hospitals which have set up acupuncture and moxibustion service at present, but only in outpatient department regions. Private clinics of traditional Chinese medicine are not uncommon, and the local government is constantly improving the management policy on it now. The musculoskeletal system diseases are predominant diseases treated by acupuncture and moxibustion, and obesity female is mostly common. Compared with other Arabian countries, Oman is more inclusive to foreign culture and the local government attaches great importance to acupuncture and moxibustion, so there is much better development space for acupuncture and moxibustion in Oman.

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OBJECTIVE: This study aimed at evaluating the prevalence, pattern and predisposing factors for hepatic adverse effects with statins in a regional hospital in Sultanate of Oman. METHODS: A retrospective review of the patient files in Department of Medicine during the year 2011 was done to evaluate any hepatic dysfunction possibly related to statins among the patients. For each case of suspected statin induced hepatic effect, additional details on temporal relationship, pattern of presentation, management, final outcome and any contributing factors were obtained. Difference in the occurrence of hepatic effects based on the patient demographics and drug characteristics was additionally evaluated. RESULTS: A total of 927 patients meeting the inclusion criteria were included for the study. Mean age of the evaluated patients was 63.1 ± 11.37 and median duration of use of statin in months was 22 (IQR, 43.25). In 40 (4%) of the 927 patients, there was presence of a hepatic effect considered to be statin related and only in 12 (1%) patients a significant transaminase rise (>3 times) was observed. Median duration of use of statin among those patients who developed suspected statin induced hepatic effects and those who did not was 45 (IQR,52) and 21 (IQR, 43) months, respectively and the difference observed was statistically significant. A significant difference in the prevalence of hepatic effects was observed only based on the duration of statin use. CONCLUSION: There was an infrequent occurrence of significant hepatic effects associated with statins in the study population. Our results support the latest recommendations including from United States Federal Drug Administration (US FDA) that statins appear to be associated with a very low risk of serious liver injury and that routine periodic monitoring of transaminases does not appear to detect or prevent serious liver injury in association with statins.

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AIM: The aim of this study was to describe the epidemiology of burns admitted to the National Burns Unit (NBU) in the Sultanate of Oman between 1987 and 2011. METHODS: This is a retrospective review of burn patients admitted to Oman's National Burns Unit (NBU) between 1987 and 2011. The data extracted from the national burn registry. The study describes the admission rate by gender and age groups, occupation, causes of burns, time-to-admission, length of stay and in-hospital mortality of burns between 1987 and 2011. RESULTS: During a 25-year from 1987 to 2011, there were 3531 burn patients admitted to the National Burns Unit in Oman. The average admission rate to NBU is 7.02 per 100,000 persons per year. On average, males were more likely to be admitted to the NBU than females during the study period (P value < 0.04). Patients aged 1-10 years old constituted 46.6% of caseload during the study period. Flames and scalds caused 88.4% of burns. About half of all patients admitted to the NBU have burns to more than 11% of total body surface area (TBSA). The average stay in hospital was estimated to be 15.3 days per patient. The average in-hospital mortality rate was estimated to be 8.2% per year (range 1.9-22%). CONCLUSION: Burns are significant public health issue in the Sultanate of Oman. Children are disproportionately over-represented in this study. Prevention programmes are urgently needed to address this "silent and costly epidemic."

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OBJECTIVES: The aim of this study was to explore the knowledge and attitude of Sultan Qaboos University students towards premarital screening program. METHODS: A cross-sectional study conducted at the students' clinic from January to April 2011. A self-administered questionnaire was distributed to 590 unmarried Omani students of both genders. The questionnaire consisted of 3 main parts; the first part was based on socio-demographic data, the second part dealt with the students' knowledge about the premarital screening program while the third part explored their attitudes towards the screening program. RESULTS: Most of the participants (n=469; 79%) were aware about the availability of premarital screening program in Oman. The main sources of information were: school/college (n=212; 36%), media (n=209; 35%), family and friends (n=197; 33%), and/or health services (n=181, 31%). The vast majority of the participants (n=540; 92%) thought it is important to carry out premarital screening and agreed to do it. Around half of the participants (n=313; 53%) favored having premarital screening as an obligatory procedure before marriage and about one third (n=212; 36%) favored making laws and regulation to prevent marriage in case of positive results. CONCLUSION: Even though the majority of the participants thought it is important to carry out premarital screening; only half favored making it obligatory before marriage and one third favored making laws and regulations to prevent marriage in case of positive results. This reflects the importance of health education as a keystone in improving knowledge and attitude towards premarital screening program.

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OBJECTIVES: Responding to Pandemic Influenza A (H1N1) virus alert in 2009, Ministry of Health (MoH), Sultanate Of Oman arranged task force to deal with the emergency. MOH published articles in newspapers, prepared guidelines and hospitals were assigned to admit patients of H1N1. All the patients suspected of H1N1 were admitted and isolated as per the guidelines. This report describes clinical features and outcomes of 65 laboratory confirmed cases of H1N1 in Muscat, Sultanate of Oman. METHODS: From July to October 2009, 101 cases suspected of suffering from Pandemic Influenza A (H1N1) virus were admitted and isolated in Al Nahdha Hospital in Muscat. All the patients on admission were tested for H1N1, by real time reverse transcriptase polymerase chain reaction (RT-PCR). Immediately on admission, all of them were treated with Oseltamivir and antibiotics. RESULTS: Of the 65 confirmed cases of H1N1, 53.84% were males. Age of patients varied from 14 to 60 years, while 53.7% were aged between 31 to 55 years. Results showed that 70.8% had underlying co-morbidity; among which diabetes mellitus and respiratory illness were common. The most common presenting symptoms were fever (95%) and cough (94%). Also, 20% of the patients had leucopenia and 10.8% leucocytosis. Deranged LFT was observed in 26 (42.6%) of cases while 14 (21.5%) had hypokalemia. One patient (0.01%) with underlying severe co-morbidity died. Two patients (3.1%) had ARDS (Acute Respiratory Distress Syndrome); both recovered. Radiological infiltration was documented in 84.6% of cases, with lower zone involvement as the common finding. Hospital stay was between 1 to 12 days, 49.2% of patients were discharged within 3 days. CONCLUSION: Mainly adult population was affected during this epidemic. H1N1 infection can lead to severe illness. Incidence of H1N1 was higher in patients with underlying co-morbidity. Timely intervention and administration of Oseltamivir may need to be modified.

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BACKGROUND: Sultanate of Oman is geographically situated in south-west of Asia, having common borders on western side by the land with United Arab Emirates, Saudi Arabia and Yemen and with the Arabian Sea and the Gulf of Oman in the east and the north respectively. The country enjoys one of the best health care facilities including blood transfusion services in the region. STUDY DESIGN: Information was collected through informal personal interviews, digging out the past records, and the report presentations at various forums. RESULTS: A modest start by providing blood units through import, the country is now self-reliant on procuring blood units from voluntary non-remunerate blood donors within the sultanate. A steady growth of blood banks is witnessed in every aspect of blood banking including blood collection, blood processing and supply. Various modalities are adapted in promoting voluntary blood donation programme. CONCLUSION: Sultanate of Oman has created one of the best blood transfusion services in the region in providing safe blood for transfusion through voluntary donation, a use of blood components and irradiating blood products.

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BACKGROUND: Haemoglobinopathies are a major cause of morbidity in the Sultanate of Oman and premarital screening is being encouraged in order to reduce the number of affected births. The identification of ß-thalassaemia carrier status is an essential prerequisite of any screening programme. However, the level of Haemoglobin (Hb) A(2), which is used to detect ß-thalassaemia carriers, can be affected by other factors including iron deficiency, concurrent α thalassaemia and the type of DNA mutation present. OBJECTIVES: The following study was undertaken to ascertain if the Hb A(2) level is an appropriate tool for the identification of ß-thalassaemia carriers in the Omani population. METHOD: Hb A(2) was measured by high performance liquid chromatography (HPLC) in 160 obligate carriers of ß-thalassaemia. 158 subjects had Hb A(2) levels above 3.5% indicating ß-thalassaemia trait. Two subjects had slightly lower levels and were found to be iron deficient. After therapy both these subjects' Hb A(2) levels increased to above 3.5%. CONCLUSION: In the absence of iron deficiency, Hb A(2) is an accurate marker for the presence of ß-thalassaemia trait in the Sultanate of Oman.