J. Oman Med. Assoc., Volume 2, Issue 1 (June 2025) – 9 articles

Evidence-based practice in nursing supports clinical practice. Several studies have tested the knowledge and attitudes of nurses toward journal clubs (JCs) and evidence-based practice. However, no study has reported knowledge of and attitudes towards evidence-based practice (EBP) and journal club workshops in Oman whilst attending highly structured workshops with the aim of critiquing the method. This study aims to assess the knowledge of and attitude towards evidence-based practice (EBP) and JC sessions among nurses attending the EBP/JC workshop at Royal Hospital, Oman. Data were collected from 22 nurses who participated in the workshop through an online self-report validated questionnaire that examined knowledge, attitude, and satisfaction. The knowledge among the participants showed improvement after the EBP intervention (p = 0.002). There was no statistical difference (p = 0.33) between the pretest and post-test attitudes towards EBP. The indicators suggest that the workshop with the highest mean value (4.14 out of 5 points), followed by the EBP workshop, which is helpful for clinical practices (mean value = 4.09), should continue in the future. The participants of the EBP workshop also agreed that they would recommend others for similar workshops. Research and EBP workshops can increase nurses’ knowledge and effectively engage them in EBP activities. Care should be given to the organization of the workshops as it directly influences the level of satisfaction. Nurses who are satisfied with EBP workshops are more likely to recommend them to others and maintain their future attendance. Full article

Glycyrrhiza glabra (licorice) has been used as an herbal medicine for a long time due to its anti-inflammatory, antioxidant, and antimicrobial properties. Additionally, multiple reports have demonstrated its ability to promote wound healing. Several randomized controlled or clinical trials (RCTs) have demonstrated its potentially therapeutic effects in oral mucosal diseases, especially in recurrent aphthous stomatitis (RAS). This systematic review aims to summarize the evidence for Glycyrrhiza glabra in treating RAS. A systematic search was performed across five databases: PubMed (Medline), ScienceDirect, Scopus document, Cochrane Central Register of Controlled Trials (CENTRAL), and the Cochrane Library Database of Systematic Reviews. This study was reported following the PRISMA guidelines. RCT study using Glycyrrhiza glabra for treating RAS was included in this study with several reported outcomes like changes in ulcer diameter, pain, and healing periods. Seven RCTs were included, which used Glycyrrhiza glabra in the form of patches, pastes, mucoadhesive tablets, and mouthwashes for treating RAS. Glycyrrhiza glabra treatment in various regimens showed significant improvements in pain, ulcer diameter, and healing time in patients with RAS. This review suggests the potential of Glycyrrhiza glabra as an alternative treatment option for RAS. Full article

Purpose: The purpose of this scoping review was to systematically identify and summarize the existing literature on non-spinal clinical applications of EOS imaging and identify related evidence gaps. Method: The study followed the PRISMA-ScR guidelines. A systematic literature search was conducted in Embase, MEDLINE, CINAHL, Scopus, Cochrane, Academic Search Premier, and OpenGrey databases in November 2022 and updated in December 2023. Original research from 2003 to 2023 was eligible if in English, Danish, French, German, Norwegian, or Swedish. Two authors screened articles by title and abstract, while data extraction from full texts was performed by seven authors using a structured template. Results: A total of 8176 articles were identified, with 1350 selected for full-text review and 268 included in data extraction. Among adults, 187 articles were included, with 88 focused on surgical applications like hip arthroplasty or osteotomy. In pediatrics, 68 general and 13 surgery-related articles were included. Lower extremity analysis was the most frequent topic, with other uses identified, such as rib cage geometry, patellar dislocation, and X-linked hypophosphatemia. Conclusions: Key clinical applications of EOS imaging include lower extremity analysis, e.g., leg length assessment and knee/hip arthroplasty planning), pelvic and spinal alignment studies, and emerging uses in rib cage geometry. Evidence gaps include limited research on the diagnostic accuracy of EOS for cerebral shunt placement, reliability in bone age estimation, and an unclear role in foot and ankle morphology. Full article

The serendipitous discovery of antiparasitic drugs, such as quinine and artemisinin, of plant origin reveals that searching new chemical pharmacophores from medicinal plants is valuable. The present study sought to explore the antiplasmodial, antileishmanial, and antitrypanosomal activities of Lippia adoensis extracts. Crude extracts of L. adoensis leaves and twigs, which were obtained by extraction using 70% ethanol in water, were assayed for antiplasmodial activity against P. falciparum 3D7 and Dd2 through the SYBR green I-based fluorescence assay; and for antileishmanial, antitrypanosomal, and cytotoxic effects on Leishmania donovani, Trypanosoma brucei brucei, and Vero cells, respectively, using resazurin colorimetric assays. In vitro phytochemical analysis of L. adoensis extracts was performed using standard methods. Moreover, liquid chromatography–mass spectrometry (LC-MS) feature-based detection and molecular networking flow on Global Natural Product Social (GNPS) were also used for the phytochemical screening of L. adoensis extracts. Crude extracts from L. adoensis inhibited the growth of P. falciparum (3D7 and Dd2) (IC₅₀s; (3D7): 10.00 and 97.46 μg/mL; (Dd2): 29.48 and 26.96 μg/mL), L. donovani (IC₅₀s: 22.87–10.52 μg/mL), and T. brucei brucei (IC₅₀s: 2.30–55.06 μg/mL). The extracts were found to be non-cytotoxic to Vero cells, thus yielding median cytotoxic concentrations (CC₅₀s) above 100 μg/mL. In vitro phytochemical analysis of the crude extracts revealed the presence of alkaloids, terpenoids, phenolic compounds, and carbohydrates. The LC-MS tandem molecular networking flow predicted that the extracts contained valsafungin A and bacillamidin in the first cluster, and fatty acids, ketone, and aldehyde derivatives in the second cluster. Overall, the present study demonstrated the antiparasitic effects of L. adoensis extracts, thus justifying the use of this plant in the traditional treatment of fever and malaria conditions. Nevertheless, detailed metabolomic studies and antiparasitic mechanisms of action of the extracts are expected to unveil the potential antiparasitic hit compounds. Full article

Background: Oncoplastic surgery combines oncological resection with esthetic breast reconstruction, offering significant advancements in breast cancer management. Local perforator flaps, such as lateral intercostal artery perforator (LICAP) and anterior intercostal artery perforator (AICAP) flaps, are promising options for small-to-medium breast reconstructions. These flaps preserve underlying muscle and nerve structures, minimizing donor-site morbidity and enhancing esthetic outcomes and patient satisfaction. This study evaluates the clinical outcomes of LICAP and AICAP flaps for immediate breast reconstruction following quadrantectomy. Methods: A retrospective study was conducted at ASST Santi Paolo e Carlo Hospital, Milan, from September 2023 to March 2024. Twenty-five female patients who underwent quadrantectomy and immediate breast reconstruction with LICAP or AICAP flaps were included. Outcomes assessed included oncological safety, reoperation rates, flap viability, and esthetic outcomes using the BREAST-Q scale at 1 and 3 months postoperatively. Results: All patients achieved negative margins with no reoperations for oncological reasons. Flap viability was 100%, with no complications. BREAST-Q scores showed significant improvements in breast symmetry, shape, and quality of life, alongside enhanced emotional well-being and reduced postoperative pain. Conclusions: LICAP and AICAP flaps are safe and effective for immediate breast reconstruction, offering excellent esthetic outcomes, minimal donor-site morbidity, and improved patient satisfaction. Full article

Human papillomavirus (HPV) infection poses significant public health issues for both men and women. Recent studies have brought attention to the substantial impact of HPV-linked cancers in men despite historically focusing more on its effects on women. It was revealed that in 2019, HPV was the root cause of approximately 70,000 cancer cases in men. Modes of transmission for HPV include sexual contact, encompassing various practices such as vaginal, anal, and oral intercourse, as well as the use of sexual devices. Moreover, HPV-associated cancers are becoming increasingly common in men, with anal, penile, and oral cancers being the most prevalent. Although the human body can clear HPV infection in about 90% of cases, it’s crucial to take preventive measures to lower the risk of transmission and developing cancer. Using condoms, quitting smoking, and male circumcision are identified as essential factors in preventing HPV among heterosexual couples. However, the most promising preventive measure is HPV vaccination. There are ongoing discussions regarding its protective efficacy and cost-effectiveness; vaccinating boys before their sexual debut presents a compelling rationale. The existing literature primarily focuses on HPV-linked cancer in women and lacks a comprehensive review of the development and prevention methods specifically related to HPV-related cancers in men. This review strives to bridge this gap by offering a detailed overview of HPV-linked cancers in males, particularly anal, penile, and head & neck cancer. It will cover important aspects of prevention and treatment strategies to provide valuable information for public health initiatives and clinical practice. Full article

Burn injuries cause severe muscle wasting and weakness. However, the relative contribution of neuromuscular junction (NMJ) degradation remains elusive. We investigated the associations of plasma c-terminal agrin fragment-22 (CAF22), a marker of NMJ degradation, with muscle decline in burn patients. We recruited male patients with burns (n = 32, age = 32.3 ± 4.5 years, percent burn area = 15.2 ± 2.3) and age-matched controls to evaluate handgrip strength (HGS), skeletal muscle mass index (SMI), phase angle, and creatine kinase and plasma levels of CAF22, c-reactive protein, and 8-isoprostanes. We used an unpaired t-test and regression analysis for statistics. The burn patients had lower HGS, SMI, and phase angle than the controls (all p < 0.05). These patients also exhibited higher plasma CAF22, CRP, 8-isoprostanes, and creatine kinase than the controls (all p < 0.05), suggesting NMJ degradation and heightened inflammation and oxidative stress. Correlation analysis revealed significant correlations of plasma CAF22 with HGS and phase angle in the burn patients, suggesting the potential contributions of NMJ degradation to muscle weakness and atrophy (both p < 0.05). We also found correlations of plasma CRP with HGS and phase angle in these patients (both p < 0.05). Altogether, NMJ degradation appears to play a significant role in burn-induced muscle injury and may warrant further investigation for potential therapeutic interventions. Full article

Numerous factors contribute to COVID-19 symptoms, with individuals who have pre-existing health conditions at the highest risk for severe SARS-CoV-2 infection. This study investigated the socio-demographic and comorbidity profiles within a large Turkish population diagnosed with SARS-CoV-2, including 47,875 patients diagnosed between March 2020 and May 2022 across six hospitals in different Turkish cities. Patients with SARS-CoV-2 confirmed via laboratory tests and presenting symptoms were included. The data collected covered socio-demographic details, infection onset dates, COVID-19 symptoms, pre-existing health conditions, radiological findings, treatments, disease progression, and relevant variables. A total of 47,875 files were included in the analysis. The median age was 43.7 years, with 84.5% testing positive for PCR SARS-CoV-2, often correlating with severe symptoms. Notably, 11.8% of the participants exhibited mild symptoms, and approximately 12.8% had comorbidities, increasing to 17.6% among severe cases. Females with PCR-positive COVID-19 had a comorbidity rate of 13.8%, compared to 12.5% in males. Among the patients with comorbidities, those aged 70 and above had the highest rates, at 22.1% (n = 1103). The most prevalent comorbidity was hypertension, followed by diabetes and cardiovascular diseases. Severe cases had a significantly higher prevalence of comorbidities (58.4%) compared to non-severe cases (27.6%). We hope that the evaluation of our findings will contribute to the research and treatment processes of the COVID-19 outpatients. Full article

This research aims to investigate the associations between comorbidities and clinical outcomes, specifically their impacts on mortality rates among COVID-19 inpatients, while also assessing the varying significance of different comorbidities. We conducted this study to understand the interplay between SARS-CoV-2 infection, socio-demographic factors, disease severity, and co-morbid conditions in a sample of 26,835 hospitalized COVID-19 cases. Our analysis extended to examining the frequency of infection symptoms, pre-existing health issues, treatment strategies, intensive care unit (ICU) and hospital stays, clinical symptoms, and radiological findings. Among the 26,883 cases analyzed, comprising 53.7% males and 53.3% females with an average age of 48.5 years, we observed mean clinical values for temperature, heart rate, respiratory rate, and blood pressure. Leveraging logistic regression modeling helped untangle the complex relationships and confounding variables influencing COVID-19 mortality. Notably, our findings underscored the significance of total length of stay, prolonged ICU stays exceeding ten days, and the presence of significant symptoms in affecting mortality rates among COVID-19 patients. These insights unveil potential trends crucial for informing future management strategies tailored to the needs of COVID-19 patients, emphasizing the importance of addressing comorbidities and optimizing care approaches for better outcomes. Full article