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Objectives The study aims to assess interns' perceptions of Integrated Management of Childhood Illness (IMCI) pre-service education at Sultan Qaboos University (SQU). Specifically, it evaluates how IMCI training during phases 2 and 3 influences interns' clinical practice readiness and knowledge acquisition. The findings will inform evidence-based enhancements to IMCI training programs, ensuring they meet interns' educational needs and optimize clinical skills acquisition. Methods This cross-sectional study was conducted at the College of Medicine and Health Sciences (CoMHS) at SQU, Muscat, over a two-month period (September 20, 2023, to November 30, 2023). The questionnaire evaluated interns' sociodemographic factors, perceptions regarding pre-service IMCI training, and IMCI knowledge. IBM SPSS Statistics for Windows, Version 24 (Released 2016; IBM Corp., Armonk, New York) was used to analyze Likert scale responses for frequencies and proportions. Results Out of 103 invited interns, 75 participated in the study, resulting in a response rate of 72.8%. Interns who attended three or more IMCI lectures, tutorials, and practical sessions demonstrated a more advanced understanding of IMCI principles compared to those attending fewer sessions. Overall, 63 (84.0%) interns agreed on the effectiveness of IMCI training, 57 (76.0%) interns acknowledged skill enhancement, and 69 (92.0%) interns perceived its practicality for illness assessment. However, only 60.0% (n=45) felt confident in managing sick children. The knowledge assessment revealed varied understanding of IMCI objectives (82.7%, n=62) and components (61.3% (n=46) to 64.0% (n=48)). Clinical case evaluation showed mixed recognition of clinical features and danger signs of childhood illnesses, while awareness of disease preventability through immunization was generally high, except for tuberculosis (74.7%, n=56) and rotavirus (40.0%, n=30). Conclusion Interns exhibit positive attitudes towards IMCI principles, demonstrating a strong grasp of related concepts through effective case-based question responses. These results highlight the effectiveness of IMCI training in improving interns' understanding of pediatric healthcare principles, with potential implications for enhancing clinical practice and patient care. Future investigations should explore the impact of IMCI training on interns' clinical practice and patient outcomes., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Medical Research Ethics Committee (MERC) of the College of Medicine and Health Sciences (CoMHS) issued approval MREC#2757. The ethical approval was obtained from the Medical Research Ethics Committee (MERC) of the College of Medicine and Health Sciences (CoMHS) at Sultan Qaboos University on May 30, 2022 (MREC#2757). Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Al Huti et al.)

With increasing mental health risks among school populations and prevalent bullying, school mental health professionals (SMHP) are crucial globally. This study explores the perspectives of SMHP on bullying in Omani schools, focussing on definitions, types, current practices, and future strategies. Involving 50 Omani SMHP from Muscat Governorate with at least three years of experience, data was collected through structured interviews and analyzed using Braun and Clarke's six-step thematic analysis. Six key themes emerged: The definition of bullying, its components, common types, current anti-bullying practices, challenges, and future suggestions. Bullying, termed "سلوكعدواني" ( Suluk Audwani ), meaning aggressive behavior, includes five components: perpetrators, victims, harmful behavior, spectators, and psychosocial factors. Verbal bullying, physical bullying, and cyberbullying are common and vary by age. SMHP frequently employ awareness-raising and psychological first aid. Challenges include resistance from students and parents and institutional barriers. In the future, SMHP will emphasize greater awareness to effectively address Suluk Audwani. Oman has adopted international best practices to recruit SMHP. SMHP's perspectives on Suluk Audwani reflect both their training and Omani cultural influences. Future research should explore various social strata to improve evidence-based understanding and prevention of Suluk Audwani .

Objectives: We sought to assess the attitude of Omani families toward accidental injuries among children (aged < 6 years) and evaluate the safety measures and available preventive measures to reduce child injuries at home., Methods: We conducted a cross-sectional survey examining the self-reported attitudes of Omani parents about accidental injuries (poisoning, falls, burns, and drowning) at home among children younger than six and house safety measures. A total of 220 parents of children aged < 6 years, admitted to a tertiary healthcare teaching hospital, were invited to participate over a period of six months (May to November 2018). Analysis of 178 participant data was performed using SPSS, as 44 of the answered questionnaires had missing data, or were related to children over the age of six., Results: Only 16.9% of the Omani families had a history of a child injury in the year before the study. Males were more injured (61.0%) and 66.0% were younger than three years at the time of injury. A door to control access to stairs was available for 53.8% of the families. In 42.5% and 16.0% of the houses, children could access electrical sockets and wires, respectively. Fire alarms and extinguishers were not available in 90.8% and 82.1% of houses, respectively. Those who did not store medications and chemicals in safe places out of reach of children accounted for 56.7% and 63.3% of families, respectively., Conclusions: Many of the studied families are not providing an adequate safe environment for children in their houses. Therefore, actions should be taken to increase awareness about accidental injuries prevention within homes and to implement actions so that a safe home environment can be enjoyed by children., (The OMJ is Published Bimonthly and Copyrighted 2024 by the OMSB.)

Objectives: This study aimed to investigate and compare the clinical knowledge implications of the integrated management of childhood illness (IMCI) preservice education between pre-clerkship and junior clerkship medical students., Methods: This observational comparative cross-sectional study was conducted between June and August 2022 at Sultan Qaboos University, Muscat, Oman. A self-administered questionnaire was utilised and included questions on sociodemographic data, duration of IMCI preservice training, knowledge of the participants concerning the IMCI objectives and information on a range of childhood conditions., Results: A total of 97 medical students were included in the study. The majority of students (42.3%) had received 2 lectures in IMCI preservice training. The role of the IMCI approach in reducing childhood morbidity and mortality was advocated by the majority of students (80.8% in the junior-clerkship [JCR] group and 73.3% in the pre-clerkship group). The awareness of the IMCI component of improving the health system was higher in JCR compared to pre-clerkship participants ( P = 0.044). When compared to pre-clerkship students, the JCR participants demonstrated a slightly higher awareness of skin pinch ( P = 0.038), chest indrawing ( P = 0.008), anaemia assessment based on nail bed examination ( P = 0.002), diagnostic assessment of malnutrition based on palm examination ( P = 0.018), sucking capacity in breastfeeding ( P = 0.025), and vaccines such as those for tuberculosis ( P = 0.001), pneumococcal ( P = 0.018) and rotavirus ( P = 0.007)., Conclusion: The majority of students displayed good IMCI knowledge and JCR students showed better knowledge compared to pre-clerkship candidates., Competing Interests: CONFLICTS OF INTEREST: The authors declare no conflict of interest., (© Copyright 2024, Sultan Qaboos University Medical Journal, All Rights Reserved.)

This study aimed to assess the prevalence of neuropsychiatric sequelae following traumatic brain injury (TBI) among the Western Asian, South Asian and African regions of the global south. All studies on psychiatric disturbances or cognitive impairment following TBI conducted (until August 2021) in the 83 countries that constitute the aforementioned regions were reviewed; 6 databases were selected for the literature search. After evaluating the articles using the Joanna Briggs Institute guidelines, the random effects model was used to estimate the prevalence of depression, anxiety, post-traumatic stress disorder (PTSD), TBI-related sleep disturbance (TBI-SD), obsessive-compulsive disorder (OCD) and cognitive impairment. Of 56 non-duplicated studies identified in the initial search, 27 were eligible for systematic review and 23 for meta-analysis. The pooled prevalence of depression in 1,882 samples was 35.35%, that of anxiety in 1,211 samples was 28.64%, that of PTSD in 426 samples was 19.94%, that of OCD in 313 samples was 19.48%, that of TBI-SD in 562 samples was 26.67% and that of cognitive impairment in 941 samples was 49.10%. To date, this is the first critical review to examine the spectrum of post-TBI neuropsychiatric sequelae in the specified regions. Although existing studies lack homogeneous data due to variability in the diagnostic tools and outcome measures utilised, the reported prevalence rates are significant and comparable to statistics from the global north., (© Copyright 2024, Sultan Qaboos University Medical Journal, All Rights Reserved.)

Reports from different parts of the world suggest that the COVID-19 pandemic and the resultant lockdown and social distancing measures have heralded unprecedented mental health challenges among children and adolescents. To date, there is a dearth of studies emerging from the Arabian Gulf, where the majority of its population are children and adolescents. The study aims to examine the prevalence of anxiety-related symptoms and their covariates among children and adolescents in an Arabian Gulf country, Oman. This is a cross-sectional analytic study carried out over two weeks (1st to 15th of August 2020) during the COVID-19 pandemic across Oman. Parents were asked to complete the online survey, which consisted of the parent version of the Screen for Child Anxiety Related Emotional Disorders (SCARED) instrument and questions regarding basic socio-demographic information. Logistic regression was used to identify the contributing variables associated with anxiety-related symptoms. A total of 790 valid responses were received. Among the 790 children, 33.3% (n = 263) were diagnosed with anxiety-related symptoms by the SCARED instrument. Logistic regression analysis suggested that anxiety-related symptoms in children and adolescents were significantly associated with three demographic variables. The model shows that children with divorced or separated parents were 1.9 times more likely to have anxiety-related symptoms than children of married couples (OR = 1.93, p = 0.035). Children living in families with an income below USD 1000/month, were 1.8 times more likely to have anxiety-related symptoms than a family with an income of USD 4000/month (OR = 1.833, p = 0.018). Children in grades 3-6 were 1.8 times more likely to have anxiety-related symptoms than those in grades 1-2 (OR = 1.79, p = 0.024). Anxiety-related symptoms are common among Omani children and adolescents. They are more likely to be reported in middle scholastic grade levels and children from families with marital discord and low socioeconomic status. It is not clear whether the presently observed rates of anxiety exceed the prevalence that would have been observed prior to the COVID-19 pandemic. More studies are therefore warranted using children and adolescents' self-reported scales., (© 2024. The Author(s).)

Background Inconsistent evidence concerning the clinical practice implications of the Integrated Management of Childhood Illness (IMCI) pre-service education exists in the literature. The aim of this study is to assess the IMCI pre-service training perceptions of medical students, including their willingness to prospectively utilize the IMCI guidelines in clinical settings. Methods This is an observational cross-sectional study that was conducted between June 1 and August 31, 2022, at the College of Medicine and Health Sciences, Sultan Qaboos University (SQU), Muscat, Sultanate of Oman. The demographic data and IMCI pre-service education perceptions were recorded via the 10 close-ended questions. The questions focused on the student's perception of the usefulness of IMCI pre-service training in improving their knowledge, attitude, and practice (KAP) regarding childhood illnesses and how well it has enhanced their skills in dealing with sick children. SPSS Statistics version 26.0 (IBM Corp. Released 2019. IBM SPSS Statistics for Windows, Version 26.0. Armonk, NY: IBM Corp.) was used to analyze the data. Results A total of 196 responses were collected, with 117 of them being from female participants and the remaining 79 from male participants. Participants were subcategorized into phase 2 (n=103), phase 3A (pre-clerkship, n=45), and phase 3B (junior clerkship, n=48). At least 67.8% of 171 medical students complying with one to two training sessions intended to apply their IMCI pre-service education knowledge and skills in clinical practice and parental counseling. The medical knowledge and clinical practice skill enhancement abilities of the IMCI sessions were recognized by ≥49.7% of medical students. The student responses regarding childhood illness management (p=0.03) and holistic assessment confidence (p=0.042) varied significantly between the study phases. The IMCI pre-service skills, knowledge, and confidence levels were observed in 47.1% (phase 2), 13.2% (phase 3A), and 35.5% (phase 3B) of medical students. Similarly, 40.2% (phase 2), 23.7% (phase 3A), and 54.8% (phase 3B) of subjects believed in the IMCI pre-service training's influence on their ability to perform holistic assessments in the pediatric population. Conclusion The overall results of this study advocate the clinical practice implications, based on the positive student perceptions, of the IMCI pre-service training in SQU. Future qualitative studies should evaluate these findings with wider student populations., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Al-Yahyahi et al.)

Purpose: The study aims to describe the quality of life (QoL) in Omani children with epilepsy at Sultan Qaboos University Hospital, Oman., Methods: One hundred and one Omani children, with an age range from 5 to 18 years, diagnosed with epilepsy were enrolled in the study over 3 months. Descriptive epidemiology was used to characterize QoL in these children. QoL was measured using the PedsQL (4.0) questionnaire, a 23-item child and parent report questionnaire. Analysis of variance (ANOVA) was used to compare mean QoL scores, and agreement between the QoL reports of children and parents was evaluated using Spearman's rho; while, Multivariate analysis of variance (MANOVA) was performed to determine differences in subscale ratings., Results: Factors affecting QoL included family status, income level, social security coverage, type of treatment, seizure frequency, age of onset, and seizure-free duration in years. Children between 5 and 7 years and females, in general, were most affected, as reflected by the overall QoL subscale. Consistency between the children's self-reports and parent proxy reports on the PedsQL™ was moderate to low., Conclusion: Omani children with epilepsy have poor QoL, and their psychosocial function is severely affected. Therefore, QoL should be an important outcome measure in managing children with epilepsy rather than just seizure control., (© 2023. The Author(s).)

The temporal relationship between work-life balance/imbalance, occupational burnout, and poor mental health outcomes have been widely explored. Little has been forthcoming on cognitive functioning among those with work-life imbalance. This study aimed to explore the rate of work-life imbalance and the variation in neuropsychological functioning. The relationship between affective ranges (anxiety and depressive symptoms) and work-life balance was also explored. The target population in this study are Omani nationals who were referred for psychometric evaluation. The study employs neuropsychology measures tapping into attention and concentration, learning and remembering, processing speed, and executive functioning. Subjective measures of cognitive decline and affective ranges were also explored. A total of 168 subjects (75.3% of the responders) were considered to be at a work-life imbalance. Multivariate analysis showed that demographic and neuropsychological variables were significant risk factors for work-life imbalance including age and the presence of anxiety disorder. Furthermore, participants indicating work-life imbalance were more likely to report cognitive decline on indices of attention, concentration, learning, and remembering. This study reveals that individuals with work-life imbalance might dent the integrity of cognition including attention and concentration, learning and remembering, executive functioning, and endorsed case-ness for anxiety., Competing Interests: The authors have declared that no competing interests exist.

Objectives: Neurocognitive dysfunction has been established in several studies in children with beta-thalassemia major (TM). However, despite its wide occurrence in populations across the Arabian Peninsula, scant attention has been paid to shedding light on neuropsychological functioning among adults with TM. This study aimed to examine the level of neuropsychological functioning among Omani adults with TM regularly followed-up at a tertiary care hospital in Oman. A related aim was to examine the factors associated with neuropsychological performance., Methods: Standard neuropsychological tests were used to measure attention and concentration, learning and remembering, verbal fluency, and executive functioning. Participants were also gauged on indices of intellectual ability and affective range. As normative data for neuropsychological functioning in Oman is scarce, healthy age- and sex-matched controls underwent the same testing procedure. The log-linear model was used to identify factors associated with TM patients on demographic and neuropsychological performance., Results: This study recruited 28 adult patients with TM (age 30.0±6.5) and 39 healthy controls (age 29.2±6.1). Findings suggested that having a diagnosis of TM was significantly associated with symptoms of depression ( p < 0.001) and anxiety ( p < 0.001), indices of executive functioning (verbal fluency) ( p = 0.003), working memory (digit span) ( p < 0.001), and verbal and auditory attention scores (California Verbal Learning, p = 0.002)., Conclusions: The data appears to suggest that short-term memory capacity, verbal fluency, and verbal and auditory attention may be impaired in TM compared to controls. Studies on a larger cohort are therefore warranted., (The OMJ is Published Bimonthly and Copyrighted 2021 by the OMSB.)

Background: The Gulf Cooperation Council (GCC), with a predominant 'youth bulge' among its 54 million people, has witnessed an exponential increase in research pertinent to child and adolescent mental health (CAMH). Aside from a few narrative reviews, to date, no critical appraisal examining the magnitude of CAMH has emerged from this region., Aims: This study aimed to report the prevalence rates of CAMH disorders in the GCC through a systematic review of the existing literature followed by a meta-analysis., Methods: A systematic review of the literature from the six GCC countries (Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates) was conducted. The databases used included Scopus, ProQuest, Pubmed, and a final check was performed on Google Scholar to account for any remaining studies that may have still been under review. Meta analytic techniques were then used to estimate prevalence rates of each specific mental disorder, i.e. ADHD, depression, anxiety, stress, eating disorders, and tobacco use disorder., Results: A total of 33 studies from the six countries were included. The pooled prevalence of ADHD as per the Vanderbilt ADHD Diagnostic Rating Scale (VADHDDRS) , clinical judgments, Attention Deficit Disorders Evaluation Scale (ADDES), and the Strengths and Difficulties Questionnaire (SDQ) was found to be 13.125%, 13.38%, 26.135%, and 12.83%, respectively. The pooled prevalence of depressive symptoms solicited by the Patient Health Questionnaire (PHQ-9), Depression, Anxiety, and Stress Scale (DASS), and Mini-International Neuropsychiatric Interview for Children and Adolescents (MINI Kid) was 44.684%, 45.09%, and 26.12%, respectively. The pooled prevalence of anxiety according to the DASS and the MINI Kid was 57.04% and 17.27%, respectively, while the pooled prevalence of stress as per the DASS was found to be 43.15%. The pooled prevalence of disordered eating solicited by the Eating Attitudes Test (EAT-26) was 31.55%. Lastly, the pooled prevalence of tobacco use disorder per the Global Youth Tobacco Survey was 19.39%., Discussion: To date, this is the first systematic review and meta-analysis of its kind from the GCC. The prevalence rate of CAMH disorders appears to be in the upper range of international trends. The higher rates could be attributed to the existing studies using suboptimal methodological approaches and instruments to solicit the presence of CAMH., Competing Interests: None. The authors declare that there are no conflicts of/or competing interests., (© 2021 Publishing services provided by Elsevier B.V. on behalf of King Faisal Specialist Hospital & Research Centre (General Organization), Saudi Arabia.)

Background: Despite efforts to improve patient safety, medical errors remain prevalent among healthcare workers., Objective: The aim of this study was to investigate the relationships between self-reported medical errors, occupational outcomes and socio-demographic variables., Methods: The study employed a cross-sectional design to survey healthcare workers at a large tertiary hospital in Muscat, Oman. The survey questionnaire included socio-demographic variables, a self-assessment of medical errors, work-life balance, occupational burnout and work-related bullying., Results: A total of 297 healthcare workers participated in this study. In this sample, the average of self-reported medical errors was 5.4 ± 3.3. The prevalence of work-life imbalance, bullying and moderate/high burnout was 90.2%, 31.3% and 19.5%, respectively. Multivariate analysis showed that gender, nationality, age, profession, occupational burnout and bullying were significantly associated with self-reported medical error. Being male was associated with higher self-reported medical errors compared to female workers (β = 1.728, P < 0.001). Omani workers reported higher medical errors compared to their non-Omani colleagues (β = 2.668, P < 0.001). Similarly, healthcare workers in a younger age group reported higher medical errors compared with those in the older age group (β = ‒1.334, P < 0.001). Physicians reported higher medical error than nurses (β = 3.126, P < 0.001). Among occupational outcomes, self-reported medical errors increased with higher burnout rates (β = 1.686, P = 0.003) and frequent exposure to bullying (β = 1.609, P < 0.001)., Conclusion: Improving patient safety has become paramount in the modern age of quality improvement. In this study, medical errors reported by healthcare workers were strongly related to their degree of burnout and exposure to work-related bullying practice. This study makes a unique and tangible contribution to the current knowledge of medical errors among healthcare workers in Oman., (© The Author(s) 2021. Published by Oxford University Press on behalf of International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

COVID-19 has gripped the world with lightning speed. Since the onset of the pandemic, activity throughout the world came to a grinding halt. However, business had to continue and people have to learn to live with the virus while the pandemic continues to rage. Medical education is no exception and may even deserve special mention, as it prepares frontline workers against the endemics of tomorrow. We discuss here the journey of medical education at the College of Medicine and Health Sciences at Sultan Qaboos University, Muscat, Oman, as the pandemic struck the world and Oman. This work suggests a roadmap for changes, discusses challenges and proposes measures to mitigate the effects of COVID-19 on medical schools., (© Copyright 2021, Sultan Qaboos University Medical Journal, All Rights Reserved.)

Objectives: This study aimed to evaluate Oman's readiness for implementing large-scale child maltreatment prevention (CMP) programmes., Methods: This cross-sectional study was conducted between May and August 2016 in Oman. Participants, referred to as key informants, were individuals with influence and decision-making powers over CMP. The multidimensional Readiness Assessment for the Prevention of Child Maltreatment tool, developed by the World Health Organization with the help of collaborators from middle- and low-income countries, was used to assess 10 dimensions of readiness, each with a maximum score of 10., Results: A total of 49 participants were included in this study (response rate = 98%). The mean total score for the 10 dimensions was 50.17 out of 100 possible points. The participants showed high mean readiness scores on legislation, mandates and policies (9.08) followed by knowledge of CMP (7.55), institutional resources and links (6.12), willingness to address the problem (5.35), informal social resources (5.15) and current programme implementation and evaluation (5.10). Participants had low scores in readiness in association with human and technical resources (2.44), attitudes towards CMP (2.90), scientific data on CMP (3.06) and material resources (3.46)., Conclusion: The results of this study indicate that Oman has a moderate level of readiness to implement large-scale evidence-based prevention programmes against child maltreatment; however, several dimensions still need to be strengthened. It is important to develop a national strategy that outlines a framework for organising and prioritising efforts towards CMP., Competing Interests: CONFLICT OF INTEREST The authors declare no conflicts of interest., (© Copyright 2020, Sultan Qaboos University Medical Journal, All Rights Reserved.)

Background and Objectives: Child maltreatment (CM) is a global public health problem that has received growing attention over the past five decades. There have been many recent advances in child maltreatment prevention (CMP). The objective of this study is to assess CMP readiness to implement large-scale evidence-based CMP programs in Gulf Cooperation Council (GCC) countries., Methods: This cross-sectional study (n = 244) was conducted in the GCC countries. Participants were key decision makers and senior managers in the field of CM. The Readiness Assessment for the Prevention of Child Maltreatment (RAP-CM) was used to assess 10 dimensions of CMP readiness., Results: The key informants gave CMP readiness scores of 47.8 out of 100. Four of the dimensions (knowledge of CMP; legislation, mandates, and policies; institutional resources and links; and informal social resources) had high readiness scores (≥5), while six dimensions (attitudes towards CMP; scientific data on CMP; current program implementation and evaluation; will to address the problem; material resources; and human and technical resources) had low readiness scores (<5)., Conclusion: GCC countries have moderate-to-fair readiness to implement large-scale evidence-based CMP programs. Strengthening their material, human, and technical resources, and improving the quality of scientific data, collaboration, and attitudes towards CMP are required to improve each country's readiness., (© 2019 Publishing services provided by Elsevier B.V. on behalf of King Faisal Specialist Hospital & Research Centre (General Organization), Saudi Arabia.)

Research about bullying among school pupils in the Arab/Muslim population is scarce. This study evaluates the characteristics of bullying and its impact among school pupils in Oman via cross-sectional survey among eighth grade school pupils (n = 1,229) during the academic year 2006-2007. The participants were selected using stratified random selection among 6 administrative divisions of one the governorates in the country. Data were collected using self-completed structured questionnaires. This study found similar percentages of males and females (76%) have experienced one form of bullying, and the majority of the incidents (80%) occurred in the vicinity of the school. In almost half of the cases, the bullying was initiated by a student of the same age or older than the victim. The most common type of bullying encountered in this study was verbal (47.7%), followed by misuse (45.9%), physical (43.9%), and, finally, social isolation/exclusion (22.5%). Although the failure of an academic year was uncommon among victims of bullying, the number of pupils who missed 4-6 and ≥ 7 school days was higher among bullied pupils. If this study will withstand further research, educational initiatives are needed to mitigate the rate of bullying in Oman.

Child maltreatment (CM) is common worldwide, and can take many forms. It may even endanger the child's life, especially when younger children are the victims. CM affects the child's quality of life and consequently leads to long term issues to be dealt with by the child, family and community. This case series discusses six children who have been subjected to CM, and diagnosed by the child protection team of the departments of Child Health and Behavioural Medicine at Sultan Qaboos University Hospital (SQUH), Oman. The aim of this case series is to increase the level of awareness of CM among Oman's medical professionals and to highlight the difficulties encountered in diagnosing and providing optimal care for these children. Although treatment is provided in Oman's health care system, it is clear that there are gaps in the existing system which affect the quality of child protection services provided to the children and their families.

Shaken baby syndrome (SBS) is a form of abuse that is characterised by brain injury. Because of the subtle and yet debilitating neurobehavioural impairment which ensues, SBS represents a diagnostic dilemma for attending clinicians. The situation is made worse by the young age of the affected child who may not be capable of explaining what happened. SBS has been reported in many parts of the world. To our knowledge, there is a dearth of literature on the topic from Arab/Islamic countries. This article attempts to shed light on the syndrome by reviewing information on the aetiology of SBS, as well as on its diagnosis and the reasons for delayed diagnosis. The central aim of this review is to increase awareness of SBS so that enlightened policies for prevention and intervention could be developed in the region and particularly in Oman.

Background: Recent case-control studies on breastfeeding and childhood leukemia risk have indicated that longer duration of breast feeding (> 6 months) is associated with decreased risk of the disease., Objective: To investigate the relationship between duration of breastfeeding and risk of childhood leukemia in Oman., Materials and Methods: In a case control study all recently diagnosed and registered cases of childhood leukemia at the National Registry during (1999-2009), a total of 70 cases, were recruited. For each case, a gender and age matched control was selected either from the family relatives or from the neighbors of family siblings., Results: Breastfeeding is culturally favored for longer periods of time (up to 24 months) in Oman. Data of this study revealed that 21% of cases and 12 % of their gender and age matched controls were breastfed for an average duration of 6-12 months. In 75% of the cases and 81% of controls the period of breastfeeding was between 12-24 months. Only 4% of the cases and 7% of controls were breastfed for a period more than 24 months. No significant (P>0.05) differences were observed between the cases and controls with respect to breastfeeding and the risk of childhood leukemia in Oman. Similarly the duration of breast feeding did not have any significant (P>0.05) effect on the risk., Conclusion: This study indicated that duration of breastfeeding was not associated with risk of childhood leukemia in Oman and there may be some other environmental and genetic factors that might be responsible for the occurrence of this disease that must be explored further.