Sultan Qaboos University Hospital

In the published publication [...].

Anatomy is one of the fundamental subjects taught in the medical curriculum. The knowledge of anatomy helps the student in a later career for clinical diagnosis and treatment. Over the past decades, anatomy teaching has undergone various changes. Students have been exposed to methods that help them learn lifelong. The traditional curriculum has its own merits and demerits. Many institutions have adopted the modern integrated approach. Information technology has been incorporated into teaching and learning. There is a need to look at the curriculum in any institution and make necessary changes. Also, we need to determine which skills to prioritize and which need to be phased out. Artificial intelligence could be incorporated into teaching and learning. Anatomy plays an important role in all surgical fields. The volatile subject of anatomy is often quickly forgotten, and young surgeons must revisit the anatomy department to brush up on their knowledge and sharpen their skills. The present review discusses the importance of anatomy in traditional and modern curricula, the challenges faced in the transition, and its importance in the surgical field. We discuss the role of variations, incisions, wound suturing, and dressing, which could benefit the surgical field. We also highlight various teaching tools that could benefit teaching and learning. KEYWORDS: Anatomy, learning, skills, medical education.

Background: Obesity is a known cardiovascular risk factor, yet its role in predicting chemotherapy-induced cardiotoxicity remains unclear. This study aimed to evaluate body mass index (BMI) as an independent risk factor for cancer therapy–related cardiac dysfunction (CTRCD). Methods: We conducted a retrospective cohort study involving 133 patients with human epidermal growth factor receptor 2-positive breast cancer treated with trastuzumab between 2022 and 2025. After excluding individuals with major cardiovascular comorbidities, 65 patients who developed CTRCD were matched with 68 controls who completed therapy without cardiotoxicity. CTRCD was defined according to the European Society of Cardiology using echocardiographic and biomarker assessments. BMI was categorized according to the World Health Organization, and its association with CTRCD risk and severity was analyzed. Results: No statistically significant difference in baseline BMI was observed between the CTRCD (29.6 ± 7.6) and control (30.5 ± 10.2; P = 0.62) groups, suggesting that BMI alone does not independently predict the development of CTRCD. However, in the CTRCD group, patients with moderate/severe dysfunction had significantly higher BMIs than those with mild CTRCD (32.1 ± 8.2 vs. 28.9 ± 6.8; P = 0.04). A trend suggesting a synergistic interaction between obesity and anthracycline use was observed ( P = 0.08). Conclusion: BMI was not an independent predictor of CTRCD occurrence in this cohort, but a higher BMI was associated with increased severity of cardiotoxicity. Our findings suggest that traditional definitions of obesity based solely on BMI may not adequately reflect cardiometabolic risk in cancer patients. Future studies should focus on fat distribution and metabolic health markers.

Metabolic syndrome (MetS) is a complex disorder that comprises metabolic abnormalities such as central obesity, insulin resistance, dyslipidemia, and hypertension. Eventually, MetS leads to type 2 diabetes (T2DM) and increases the risk of other cardiovascular diseases. Patients with MetS are approximately five times more prone to develop T2DM. The increase in global prevalence of MetS is a major cause of concern. The microelement zinc is an essential trace element that plays a pivotal role in numerous biological processes occurring in the body. We carried out a thorough search of published studies in Scopus, PubMed, and Google Scholar databases. Zinc plays an important role in the functioning of the immune system, wound healing, protein synthesis, metabolism, inflammation, and different oxidative stress pathways. It is also vital for insulin homeostasis and signaling. The potential role of zinc in managing insulin resistance may be a key component in the treatment of MetS. Zinc acts via various signaling pathways, such as AMPK and mTOR, and influences lipid and glucose metabolism. The regulation of zinc metabolism at the cellular level is important for various biological processes, and disruption in zinc homeostasis results in the development of many diseases. The present review aims to discuss the role of zinc in MetS. It is concluded that zinc level modulation may be a key point in the prevention and treatment of MetS.

Colorectal cancer (CRC) is a major public health challenge in Oman and a leading cause of cancer-related mortality. The rising incidence has been associated with lifestyle changes, urbanization, and genetic factors. The CRC Subtyping Consortium has defined four consensus molecular subtypes (CMS1-CMS4); however, data on their distribution in the Gulf region, including Oman, remain limited. This study aimed to characterize the distribution of CMS subtypes in Omani CRC patients and assess their clinicopathologic correlations using a practical immunohistochemistry (IHC) panel supplemented by a limited targeted molecular approach. This study included 273 CRC patients diagnosed between 2023 and 2024 at two major referral hospitals in Muscat. Initially, the mismatch repair (MMR)-deficient tumors (dMMR) were assigned as CMS1, while the MMR-proficient (pMMR) tumors were further evaluated for β-catenin, P53, KRAS, and TGF-β expression. Mutations in BRAF, TP53, and KRAS were analyzed by sequencing. The cohort comprised 51.6% males, with a mean age of 59.1 years. Most tumors were left-sided (70.7%). dMMR (CMS1) comprised 31 cases (11.35%). Out of the pMMR tumors, 111 cases (40.65%) showed positive expression of β-catenin and P53 (CMS2), 63 cases (23.0%) showed KRAS mutations (CMS3), and 68 cases (24.9%) showed TGF-β-positive expression (CMS4). The cases were predominantly concentrated in Muscat (41%). This study demonstrated the feasibility and clinical relevance of CMS-based classification in Oman and its potential role in precision oncology and healthcare planning.

Achievement and performance are important indicators that play significant roles in institutions of higher learning. To study the factors that influence performance, samples consisting of 400 students selected from the Sultan Qaboos University's Education, Engineering, Science, and Commerce colleges were utilized. Questionnaires and performance records were utilized as tools to study the influence of various factors such as demographics. The study reveals that performance and achievement are notably influenced by various factors such as individual motivation, learning strategies, teaching, and program alignment. Other factors that influence performance and achievement include the home and socioeconomic environments, peers, and familiarity and comfort with technology. Nonetheless, individual learning strategies and effective teaching are the fundamental drivers of high performance, while the other variables are significant but less influential. Science performers exhibited high achievement, and despite efforts, performance and equality for the opposite sex were marginally addressed. This study makes it clear that performance and achievement would benefit significantly if institutions of higher learning and the government were to focus on the various factors that influence performance, including but not limited to individual factors, but as well as other factors that influence performance. In the case of the 40th anniversary initiative, performance and achievement would benefit if the focus shifted to the development and improvement of teaching, familiarity and comfort with technology, and program and strategy alignment.

BackgroundSickle cell disease (SCD) is associated with an increased risk of thrombosis and often leads to mortality.ObjectivesThis study aimed to compare the clinical outcomes of direct oral anticoagulants (DOACs) with warfarin in the management of patients with SCD and first venous thrombosis.MethodsThis retrospective study included adult patients aged ≥ 18 years with SCD who developed their first episode of venous thrombotic event. Recurrent thrombosis and bleeding were compared between patients treated with DOACs and warfarin. Data were analyzed using IBM Statistical Package for the Social Sciences version 21.ResultsWe included 99 patients, of whom 67 (67.7%) were treated with DOACs and 32 (32.3%) with warfarin. The median follow-up time was 44 (1-130) months. Pulmonary embolism was the most common type of thrombosis observed in 64 patients (64.6 %). Three patients developed recurrent venous thromboembolism within 6 months of the first episode, whereas 6 patients developed recurrent thrombosis after 1 year. No significant difference was noted among patients on either type of anticoagulation in terms of major bleeding episodes (OR = 1.1; 95% CI: 1.1-1.8; P: 1.00), recurrence of thrombosis (OR = 0.68; 95% CI: 0.03-11.2; P: .68), or mortality (OR = 0.46; 95% CI: 0.06-3.4; P: .59). Clinically relevant nonmajor bleeding was significantly lower in patients on DOACs than those on warfarin (OR = 0.06; 95% CI: 0.01-0.52; P: .01).ConclusionDOACs are associated with similar clinical outcomes and fewer bleeding complications as compared to warfarin in the management of patients with SCD and thrombosis. Randomized controlled trials are required to further confirm our findings.