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Background: Anterior cruciate ligament (ACL) tears are common knee injuries, particularly in physically active individuals. While ACL reconstruction (ACL-R) is the standard treatment, it has notable limitations. Recent interest in primary ACL repair offers a potential alternative, especially for specific tear types and patient demographics., Purpose: To evaluate the outcomes of primary ACL repair in a selected patient cohort with strict inclusion and exclusion criteria, focusing on the survival of the procedure, functional outcomes, and factors influencing success rates., Methods: This prospective single cohort study included 61 patients who underwent primary ACL repair between June 2016 and June 2022. Patients were 50 years or younger, with recent ACL injuries and no previous knee surgeries or multiligament injuries. The primary outcomes were the survival of the repair beyond two years, measured by revision rates, and functional outcomes assessed using the Lysholm knee score, Tegner activity scale, and Lachmeter stability measurements., Results: Fifty-four patients completed a minimum follow-up of three years (average 49.6 months). The overall success rate was 82.2 %, with Sherman type 1 tears showing significantly fewer failures compared to type 2 (4.3 % vs. 31.8 %). The mean Lysholm score for successful repairs was 96, and the Tegner score dropped from a pre-injury average of 6 to 5. Adolescents had the highest failure rate (50 %), while other age groups showed better outcomes. The mean side-to-side difference in stability was 1.4 mm, favoring the control side., Conclusion: Primary ACL repair is a viable option for selected patients, particularly those with Sherman type 1 tears. While age and tear type significantly affect outcomes, the procedure shows promising results with high functional scores in successful repairs. Further research with larger cohorts and extended follow-ups is necessary to validate these findings and refine patient selection criteria. Primary ACL repair offers a less invasive alternative to ACL reconstruction, with potential for comparable outcome., Competing Interests: Written informed consent after through and detailed explanation of the study and the procedure was taken from all the study participants. Surgery was performed at the earliest opportunity following clinical and radiological diagnosis., (© 2024 Professor P K Surendran Memorial Education Foundation. Published by Elsevier B.V. All rights are reserved, including those for text and data mining, AI training, and similar technologies.)

Objectives: Strokes are a major cause of morbidity and mortality. This study aimed to evaluate the effectiveness of routine cardiac investigations in identifying a cardioembolic aetiology for ischaemic strokes., Methods: This retrospective study involved patients who presented with a stroke to the Sultan Qaboos University Hospital, Muscat, Oman, between January and December 2019., Results: A total of 183 patients (mean age = 66.2 ± 13.5 years), the majority of which were male (n = 109, 59.6%), were included. The common risk factors included hypertension (74.9%), diabetes (61.7%) and hyperlipidaemia (54.6%). The middle cerebral artery was the most common artery affected, in 44 patients (24.0%). On admission, 14 (7.6%) patients were in atrial fibrillation (AF), while the rest were in sinus rhythm. The 24-hour electrocardiogram (ECG) Holter monitoring revealed no abnormalities in 135 patients. AF was observed in 15 (8.1%) patients (inclusive of the 14 who had AF on resting ECG). Furthermore, 32 (17.4%) patients had evidence of non-sustained atrial arrhythmia, and nine (4.9%) had non-sustained ventricular tachycardia. Frequent supraventricular ectopics (>30/hour) was noted on 30 patients (16.3%), while five (2.7%) patients had a high ventricular ectopic burden (>10% burden). No significant abnormalities were noted in the echocardiograms of the patients; however, 10 out of 132 (7.5%) patients presented a positive bubble echo. Enlarged left atria were found in 24 (13.1%) patients., Conclusion: The overall diagnostic yield of the abnormalities from routine cardiac testing for patients with stroke appears to be low. Targeted screening of patients with cryptogenic stroke, as suggested by newer guidelines, is recommended., Competing Interests: CONFLICT OF INTEREST The authors declare no conflicts of interest., (© Copyright 2023, Sultan Qaboos University Medical Journal, All Rights Reserved.)

Phase-alteration phenomenon has a considerable influence on the dynamics and distribution of fluids in porous media. One of the major factors affecting the phase behaviour of fluids in reservoirs is the capillarity effect, which becomes unavoidably significant as the media becomes tighter (confinement effect) and contains more pores at nano sizes. Comprehending the nature of vaporization and condensation of hydrocarbon in such confined media is important for accurate modelling of two-phase envelopes and thereby the performance of energy production from hydrocarbon reservoirs. This paper studies the vaporization of single- and multicomponent hydrocarbons in different types of rocks (namely sandstones, limestones, tight sandstones, and shales). The vaporization temperatures were measured experimentally in each rock type and compared with boiling points measured at bulk conditions to investigate the deviation between the phase-change temperatures in capillary media and bulk values. The deviation between the measured vaporization temperatures and the bulk measurements ranged from 4.4% (1.6% in Kelvin unit) to 19.7% (5.2% in Kelvin unit) with single-component solvents and 1.4% (0.4% in Kelvin unit) to 27.6% (5.3% in Kelvin unit) with the hydrocarbon mixtures. The vaporization temperatures, obtained from the experiments, were also compared with the computed two-phase envelopes, calculated by the classical Peng-Robinson Equation of State. The deviation percentages of measured vaporization temperatures from the computed values were at least 4.4% (1.6% in Kelvin unit) with single-component solvents and 2.1% (0.7% in Kelvin unit) with the hydrocarbon mixtures., (© 2023. The Author(s).)

Objectives: Stroke is the second leading cause of death worldwide, resulting in 5.5 million deaths in 2016. Vascular interventions, including carotid endarterectomy (CEA) and carotid artery stenting, play a major role in stroke prevention, especially when performed early after onset of symptoms. This study aimed to define the role of vascular surgeons in ischaemic stroke management and hence improve referral patterns by creating an algorithm for the referral process. This could reduce time to intervention and optimise patient benefit from intervention., Methods: This retrospective study reviewed symptomatic and asymptomatic patients with atherosclerotic disease of the carotid artery who were referred to the Vascular Surgery Unit of Sultan Qaboos University Hospital, Muscat, Oman, from April 2018 to March 2020 to examine factors influencing recognition of suitable candidates for intervention. Following analysis of the data, algorithms/protocols were created to simplify the referral process of symptomatic and asymptomatic carotid artery disease for surgical intervention., Results: A total of 38 patients with ischaemic stroke were recognised as having carotid artery stenosis and were referred to the vascular surgery service during the study period. Only six met the criteria for CEA, four of which underwent the procedure., Conclusion: Choice of patients for CEA involves multiple steps, with potential for missed opportunities. By involving a multidisciplinary team approach, the recommended protocol aims to lead to early and appropriate referral to a vascular surgeon or an interventional radiologist, resulting in increased and optimised intervention in stroke prevention., Competing Interests: CONFLICT OF INTEREST The authors declare no conflict of interest., (© Copyright 2022, Sultan Qaboos University Medical Journal, All Rights Reserved.)

The displacement characteristics of gas-liquid systems in capillary media under nonisothermal and nonisobaric conditions are controlled by capillarity as phase alteration (specifically vaporization) starts earlier in smaller (nano)capillaries compared to the larger ones. For an accurate modeling of these types of natural and engineered processes, this thermodynamically dictated displacement process should be well understood. With this aim, the capillarity effect on phase change and the displacement dynamics of hydrocarbon liquids in homogeneous and heterogenous silicate microfluidics chips was studied. It was observed that the boiling temperatures of pentane, a pentane-heptane mixture, and a pentane-heptane-octane mixture were 1.6-6.9% lower than bulk measurements due to confinement effects, and the early vaporization had a significant influence on the vapor displacement process. In homogeneous (uniform capillary pressure distribution) porous media, the consistency of capillary pressure resulted in a uniform and quicker propagation/displacement of vapor. However, in the media with variable capillary pressure (heterogeneous pore structure), the vapor's flow tended to take place nonuniformly along the system, thus leading to a major gas fingering and gas-flow restriction. The presence of other-heavier-components (liquid phase) in the porous medium developed an excessive barrier against the vapor's flow throughout the pore channels that was specifically caused by the viscous forces of the liquids. Moreover, it was observed that the existence of liquids with high boiling points contribute to slowing the vapor propagation of the lighter components, and the gas displacement becomes slower as the density and viscosity of the liquid-phase components increases.

The thermodynamics of fluids in confined (capillary) media is different from the bulk conditions due to the effects of the surface tension, wettability, and pore radius as described by the classical Kelvin equation. This study provides experimental data showing the deviation of propane vapour pressures in capillary media from the bulk conditions. Comparisons were also made with the vapour pressures calculated by the Peng-Robinson equation-of-state (PR-EOS). While the propane vapour pressures measured using synthetic capillary medium models (Hele-Shaw cells and microfluidic chips) were comparable with those measured at bulk conditions, the measured vapour pressures in the rock samples (sandstone, limestone, tight sandstone, and shale) were 15% (on average) less than those modelled by PR-EOS.