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Effective Tuberculosis (TB) control measures in Oman have reduced the annual incidence of tuberculosis cases by 92% between 1981 and 2016. However, the current incidence remains above the program control target oflt;1 TB case per 100,000 population. This has been partly attributed to a high influx of migrants from countries with high TB burdens. The present study aimed to elucidate

Background The Sultanate of Oman is country a low TB-incidence, with less than seven cases per 105 population detected in 2020. Recent years have witnessed a persistence in TB cases, with sustained incidence rate among expatriates and limited reduction among Omanis. This pattern suggests transmission from the migrant population. The present study examined the genetic profile and drug resistance-conferring mutations in Mycobacterium tuberculosis collected from Omanis and expatriates to recognise possible causes of disease transmission. Methods We examined M. tuberculosis cultured positive samples, collected from Omanis (n = 1,344) and expatriates (n = 1,203) between 2009 and 2018. These isolates had a known in vitro susceptibility profile to first line anti-TB, Streptomycin (SM), Isoniazid (INH), Rifampicin (RIF), Ethambutol (EMB) and Pyrazinamide (PZA). The diversity of the isolates was assessed by spacer oligo-typing (spoligotyping). Drug resistance-conferring mutations resulted from full-length sequence of nine genes (katG, inhA, ahpc, rpoB, rpsL, rrs, embB, embC, pncA) and their phenotypic relationship were analysed. Results In total, 341/2192 (13.4%), M. tuberculosis strains showed resistance to any drug, comprising mono-resistance (MR) (242, 71%), poly-resistance (PR) (40, 11.7%) and multi-drug resistance (MDR) (59, 17.3%). The overall rate of resistance among Omanis and expatriates was similar; however, MDR and PZAR were significantly higher among Omanis, while INHR was greater among expatriates. Mutations rpsL K43R and rpoB S450L were linked to Streptomycin (SMR) and Rifampicin resistance (RIFR) respectively. Whereas, katG S315T and inhA –C15T/G–17T were associated with Isoniazid resistance (INHR). The resistance patterns (mono-resistant, poly-resistant and MDR) and drug resistance-conferring mutations were found in different spoligo-lineages. rpsL K43R, katG S315T and rpoB S450L mutations were significantly higher in Beijing strains. Conclusions Diverse drug resistant M. tuberculosis strains exist in Oman, with drug resistance-conferring mutations widespread in multiple spoligo-lineages, indicative of a large resistance reservoir. Beijing’s M. tuberculosis lineage was associated with MDR, and multiple drug resistance-conferring mutations, favouring the hypothesis of migration as a possible source of resistant lineages in Oman.

Due to the increasing number of breast cancer (BC) cases in Oman and the impact of the novel coronavirus disease 2019 (COVID-19) on bed situation in the hospital, a policy of early discharge (ED) with drain after BC surgery was initiated at one of the tertiary hospitals in Oman. The uniqueness of this policy is no home visit follow-up conducted after discharge and the main mode of communication was through social media account (Instagram media). This policy then was evaluated by conducting a quasi-experimental study using a survey with ten open and closed-ended questions, five questions to explore patient experience using a five-point Likert scale. A total of 41 female patients responded to the survey. Almost 96% of the participants stated being well informed about drain care pre- and post-surgery at home. 9% of the participants developed early sign of infection and was managed at out-patient clinics. Participants with bilateral drains expressed more pain than those with single drain. 90% stated satisfied being discharged with breast drain whereas 10% preferred to stay in the hospital until the drains were removed. This study found that the policy of ED with a drain after breast cancer (BC) surgery is practical and well-accepted by most patients. The role of breast nurse and presence of family and institutional support enhanced the success of the policy implementation. To optimize patient care, conducting a training program by breast nurse for nurses at local health centres about care management of patients with drain could improve care and enhance patient satisfaction.

Breast cancer is the commonest cancer amongst females. The incidence of breast cancer is estimated to be around 260K yearly. Oral hormonal medication is an essential part of the management of breast cancer for hormone receptor-positive patients. Adjuvant hormonal medication is recommended to be taken daily for 5-10 years. Adjuvant hormonal medication reduces mortality by 30% and the recurrence rate in receptor-positive patients.This study's primary goal is to evaluate the rate of nonadherence to Endocrine Therapy for hormone receptor-positive breast cancer patients at Oman National Oncology Center. This study included patients taking hormonal therapy (either with Tamoxifen or Aromatase inhibitor) and presented for regular followup between June 2019 and February 2020 at the National oncology center, Oman. Data was collected using a written questionnaire. Descriptive analysis was done by using SPSS. A cross-sectional descriptive study for patients taking oral hormonal therapy. 131 patients were included.One hundred thirty-one patients were included, Tamoxifen was used by 73 (55.73%). 71 (54%) of breast surgery was "WLE" The majority of patients 95 (72.5%) did not identify a specific reason for non-compliance. The most commonly reported adverse effects were musculoskeletal symptoms by 75 patients (57.3%), with other reported side effects included hot flashes (33.6%), anxiety (30.5%), gynecological toxicity (29.8%), decreased concentration (19.1%), neurological symptoms (16%), and depression (9.9%).We reported that patients with hormone receptor-positive breast cancer have a high adherence rate to the medication than developing countries; selfreported non-compliance to oral hormonal medication is 41.22% below the average of non-compliance to chronic disease therapy of developing countries as WHO report. Medical insurance, unemployment, or drug cost is not a cause for non-compliance to medication.The self-reported nonadherence to oral hormonal medication is (41,22%). Most of the patients (72.5%) did not report a specific cause for non-adherent to medication. Close follow-up is recommended increasing compliance to medication.