J. Oman Med. Assoc., Volume 3, Issue 2 (December 2026) – 6 articles

Tuberculosis (TB) and malnutrition remain major health challenges among migrant children living in low-resource urban settings. Identifying clinically relevant patterns associated with these conditions may support standardized clinical assessment and public health planning. The present study aimed to identify clinical, anthropometric and sociodemographic factors associated with TB and malnutrition among migrant children under five years of age in urban Pakistan. A community-based cross-sectional study was conducted in migrant settlements of Rachna Town, Lahore, Pakistan. Clinical, demographic and anthropometric data were collected from 300 children under five years of age. A Genetic Algorithm (GA) combined with Random Forest analysis was applied to identify the most informative variables associated with TB and malnutrition. Model performance was assessed using internal cross-validation. The analytical approach identified a concise subset of variables showing stable internal performance. Key factors associated with malnutrition included Bacillus Calmette-Guérin vaccination status, formula feeding, chest X-ray findings and gastrointestinal symptoms. The most relevant variables associated with TB were Bacillus Calmette-Guérin vaccination score, erythrocyte sedimentation rate, gastrointestinal indicators and parental occupation. The final models demonstrated good internal discrimination and substantial agreement. These findings suggest that routinely collected clinical, anthropometric, laboratory, radiological, and sociodemographic variables may support the identification of clinically relevant patterns associated with TB and malnutrition during standardized community-based assessments. The proposed data-driven approach should be interpreted as an analytical and decision-support framework for prioritizing informative variables and supporting clinical assessment, rather than as a pre-diagnostic or early risk prediction tool. Full article

Background: Chronic rhinosinusitis (CRS) impairs the quality of life (QoL), but its impact and risk factors remain unknown among Iraqis, including medical students. We aim to assess the QoL using the Sino-Nasal Outcome Test-22 (SNOT-22) in CRS-affected Iraqi medical students, categorize impairment severity, and identify associated correlates via multivariable analysis. Methods: We surveyed 435 Iraqi undergraduates with CRS to identify QoL correlates, SNOT-22 severity strata, associated symptoms, seasonality, and treatment history. Data analysis, including multivariable models, was conducted in IBM SPSS version 27. Results: Among 435 surveyed individuals, 76.6% had impaired QoL. Binary logistic regression identified key correlates: immune disturbances (OR = 2.68; p = 0.028), family history (OR = 2.12; p = 0.003), chronic comorbidities (OR = 2.07; p = 0.037), and pre-clinical (basic) educational level (OR = 1.95; p = 0.007). In sex-stratified models, chronic comorbidities predominated in females (OR = 4.64; p < 0.001) and immune disturbances in males (OR = 3.89; p = 0.014). Ordinal regression confirmed immune disturbances (β = 0.65; p = 0.017), chronic comorbidities (β = 0.58; p = 0.023), and family history (β = 0.57; p = 0.003). Logistic and ordinal regression exhibited good model fitting (p > 0.05) and showed comparable statistical accuracy (76.8% vs. 76.1%). Conclusions: Impaired QoL was common among CRS-affected medical students, with immune disturbances and family history as the strongest correlates. Sex-specific differences existed. Findings highlight the need for personalized management of high-risk groups. Full article

Breast cancer is the most commonly diagnosed cancer among women worldwide and remains a leading cause of cancer-related mortality. The most frequent histological subtypes are invasive ductal carcinoma (IDC) and invasive lobular carcinoma (ILC), which demonstrate different biological behaviours and heterogeneous imaging features. ILC is more likely to produce subtle radiological findings such as architectural distortion or asymmetry, whereas IDC commonly presents as a well-defined mass with spiculated margins and associated calcifications. This retrospective cohort study was conducted at Sur Hospital, Oman, and included Omani female patients diagnosed with histologically confirmed IDC or ILC between 2017 and 2025. Mammographic and ultrasound features were reviewed in relation to age, breast density, tumour size, and BI-RADS classification. A total of 46 cases were included, of which 91.3% were IDC and 8.7% were ILC. The median age at diagnosis was 50 years, and the median tumour diameter was 3.0 cm. On mammography, masses with calcifications and architectural distortion were the most common findings. Ultrasound demonstrated predominantly irregular lesions with hypoechoic or heterogeneous echotexture. Most lesions were classified as BI-RADS IV or V. This study documents the mammographic and ultrasound patterns encountered in routine clinical practice. Because only four ILC cases were included, the ILC observations should be interpreted descriptively and should not be regarded as evidence of definitive subtype-specific differences. Full article

Introduction: Crimean–Congo hemorrhagic fever (CCHF) poses a significant health threat and is an acute, potentially fatal tick-borne disease. The disease is endemic in Oman, and is characterized by periods of increased case numbers, particularly linked to specific times of the year and high-risk activities. We review the epidemiology of CCHF in Oman and propose future strategies to address it. Methods: A retrospective descriptive epidemiological method was used to assess all confirmed national surveillance cases of CCHF reported in Oman between January 2017 and December 2024. Quantitative data were analyzed to generate frequencies, percentages, incidence, and case-fatality rates. Results: A total of 64 confirmed cases of CCHF were reported between 2017 and 2024. CCHF incidence fluctuated, peaking in 2019 (0.411 per 100,000 population) and reaching a low in 2021 (0.044 per 100,000 population), before rising again in 2024 (0.16 per 100,000 population). The overall case-fatality rate was 20.8%. There was a male predominance (87.5%), with 56% of the cases occurring in the 30–44 age group, and 65% of infections in 2022 linked to animal slaughter during Eid al-Adha. Conclusions: The rise in CCHF underscores specific preventive strategies, such as enhanced surveillance, utilization of personal protective equipment, regulation of slaughter practices, and public awareness initiatives during periods of elevated risk. Full article

Background: The rising incidence of knee osteoarthritis in Oman has increased the demand for total knee replacement (TKR) surgeries, highlighting the critical role of evidence-based postoperative physiotherapy. However, no prior study has systematically assessed physiotherapy practices post-TKR in Oman. This study aimed to fill this gap by assessing current physiotherapy practices post-TKR in Oman, evaluating adherence to international guidelines, and identifying barriers to optimal care. Methods: A cross-sectional study was conducted between January and March 2025 using a self-administered, structured questionnaire distributed to 189 physiotherapists in governmental hospitals. Data were analyzed using descriptive statistics with SPSS version 26. Results: High adoption rates were found for preoperative education (94.2%) and strengthening exercises (95.3%). In acute-stage rehabilitation, functional training (96.35%) and early mobilization (94.27%) were prevalent. However, utilization of standardized outcome measures (e.g., WOMAC) was low (74.47%) and variability existed in discharge criteria. Major barriers included a shortage of physiotherapists (91.66% agreement), limited resources (92.18%), and patient-related challenges (94.79%). Conclusion: While foundational rehabilitation practices are implemented effectively in Oman, significant gaps remain in standardized assessments and adherence to specific international protocols. Addressing workforce shortages, resource limitations, and implementing unified national guidelines are essential for optimizing post-TKR rehabilitation outcomes. Full article

Clostridioides difficile infection (CDI) is the leading cause of antibiotic-associated diarrhea; however, its association with antituberculous therapy (ATT) remains underrecognized. This review examines the risk, mechanisms, and clinical implications of CDI in patients with active tuberculosis (TB). Although ATT is traditionally considered low risk, prolonged exposure, particularly to rifampicin, may lead to cumulative disruption of gut microbiota and loss of colonization resistance. A characteristic feature of CDI in this setting is delayed onset, typically occurring several weeks to months after ATT initiation, which complicates timely diagnosis. Rifampicin plays a dual role, contributing to microbiota alterations and selection of resistant strains, while potentially affecting the pharmacokinetics of co-administered drugs. CDI in TB patients is associated with increased morbidity and mortality, with reported mortality rates up to 9.9%. Fidaxomicin is preferred due to its microbiota-sparing effect and lower recurrence rates, although cost remains a major limitation in high TB-burden settings, since vancomycin is an appropriate alternative. Management requires an individualized approach that balances the risk of CDI recurrence against the necessity of maintaining effective TB therapy. Full article