Objectives: We sought to compare the epidemiological and clinical features of variant leiomyoma, smooth muscle tumors of uncertain malignant potential (STUMP), and sarcoma to classical leiomyoma and assess the radio-histological correlation.Methods: This retrospective, observational study was conducted in Royal Hospital, Muscat, Oman. We included all patients who underwent surgical treatment for uterine fibroids from 1 January 2011 to 31 December 2016. Data was retrospectively collected from electronic patient records, pictures archiving system, and histopathology reports, and analyzed using SPSS version 29 and MedCalc Statistical Software. Results: Out of the 14269 patients who attended the gynecology outpatient department, 19.5% were clinically diagnosed with uterine fibroids. Surgical procedures were performed in 545 (19.6%) women. Diagnosis from histopathology reports was classical leiomyoma in 508 (93.2%) cases, variant leiomyoma in 35 (6.4%), and sarcomas in two (0.4%); there were no cases of STUMP. Magnetic resonance imaging (MRI) correctly identified 125 (89.9%) cases of classical leiomyoma and 2/11 (18.2%) cases of variants. The sensitivity and specificity of MRI to predict non-classical varieties was 22.22% and 88.65%, respectively. MRI had a strong negative predictive value (94.7%) for leiomyoma variants. The area under the curve for classical and variant leiomyoma was 0.63 (0.55–0.71) and 0.55 (0.47–0.64). The accuracy of MRI in predicting classical leiomyoma was 86.00 (79.40–91.12) and 84.67 (77.87–90.03) the non-classical varieties. Conclusions: Epidemiological and clinical features were not helpful in distinguishing between classical leiomyoma and non-classical varieties. MRI had weak discriminatory power to distinguish between classical and non-classical varieties.

Keywords:Leiomyoma; Magnetic Resonance Imaging; Oman.

Objectives: Obesity poses a significant challenge worldwide, increasing the risk of various metabolic diseases, including type 2 diabetes mellitus (T2DM), hypertension (HTN), and dyslipidemia. Bariatric surgery, specifically a laparoscopic sleeve gastrectomy (LSG), is effective in inducing weight loss, thereby improving the rate of obesity-related metabolic diseases. This study aimed to assess the short-term effectiveness and metabolic effects of LSG procedures among patients in Oman. Methods: This retrospective cohort study was conducted at the Royal Hospital, Muscat, Oman, and included patients who underwent LSG between 1 January 2017 and 31 December 2018. Demographic, clinical, and anthropometric data were collected from the hospital’s computerized records preoperatively and one year postoperatively. Results: A total of 168 patients were included in the study, of whom most were female (66.1%). Before surgery, the mean age was 36.1 years, and the mean body mass index (BMI) was 50.8 kg/m2. In terms of comorbidities, 28.6% had T2DM, 28.6% had HTN, and 20.8% had dyslipidemia. Postoperatively, more than two-thirds of the cohort (n = 132; 78.6%) achieved a target percent excess weight loss (EWL) of > 50%, including 89.5% and 73.0% of male and female patients, respectively (p = 0.014). The percent EWL was positively correlated to preoperative BMI (p < 0.001); however, no significant associations were observed with various comorbidities, including HTN, T2DM, dyslipidemia, and obstructive sleep apnea (p > 0.050). Conclusions: The results of this study indicate that LSG is effective for the short-term achievement of percent EWL among Omani patients with morbid obesity. However, further studies are needed to assess the long-term effectiveness of LSG on percent EWL and its effect on obesity-related metabolic diseases.

Keywords:Obesity, Morbid; Body Mass Index; Diabetes Mellitus, Type 2; Retrospective Studies; Bariatric Surgery; Treatment Outcome; Hypertension; Dyslipidemias; Weight Loss; Oman.

Pericardial-pleural fistula (PPF) may complicate between 0.8–6% of echocardiography-guided pericardiocentesis procedures, but reports are sporadic. A 22-year-old male presented to the general medical ward with underlying end-stage renal disease complicated by secondary hyperparathyroidism with worsening left pleuritic chest pain and shortness of breath for one week. Ultrasonographic investigations revealed global pericardial effusion, with no pleural effusion initially. After echocardiographic-guided pericardiocentesis via the apical approach, the patient developed respiratory distress. Follow-up ultrasound revealed a new pleural effusion with resolved pericardial effusion. The patient recovered with drainage of the pleural effusion. Bacterial and tuberculous cultures were negative, and fluid cytology was benign. Hyperparathyroidism may have contributed to the increased risk of PPF due to pericardial calcification. Clinicians should be aware of the potential risk of PPF after pericardiocentesis in patients with hyperparathyroidism.

Keywords:Pericardial Effusion; Fistula; Hyperparathyroidism.

Primary squamous cell carcinoma (SCC) of the renal parenchyma without a history of urolithiasis is a rare entity. Renal SCC is usually associated with other conditions like renal stone disease, chronic inflammation, and infection. We report three cases of primary SCC with no history of renal stone disease or identifiable risk factors. We also present a current review of the literature and a detailed description of the morphological features.

Keywords:Kidney; Carcinoma, Squamous Cell; Oman.