Polycystic ovary syndrome is a common endocrine disorder among women of reproductive age worldwide and is increasingly recognized in Oman. Hormonal imbalances, particularly elevated androgen levels, underline many of its manifestations, leading to excessive male-pattern hair growth, acne, and oily skin. These visible manifestations can significantly affect self-esteem and body image. Furthermore, these hormonal imbalances disrupt the menstrual cycle, causing irregular or absent periods, and making natural conception difficult. As such, polycystic ovary syndrome deeply influences a woman’s perceptions of her femininity and societal norms surrounding womanhood. This can be particularly distressing to women in Middle Eastern societies including Oman, where motherhood is highly valued. Recognizing this broad range of issues is important for developing culturally appropriate interventions to address both the physical and psychological consequences of this condition, thereby improving the quality of life of affected women.

Keywords:Polycystic Ovary Syndrome, Physiopathology; Female Infertility; Quality of Life; Oman.

Drug induced leukocytoclastic vasculitis is defined as the inflammation of blood vessels caused by the use of pharmacological agents. It may only affect the skin, resulting in cutaneous leukocytoclastic vasculitis, or it may be systemic, affecting other organs such as central nervous system, gastrointestinal tract, lungs, kidneys, and joints resulting is organ and tissue damage and even death. Early withdrawal of the causative drug is sufficient to promote rapid resolution and recovery. Here we report a case of tigecycline induced cutaneous leukocytoclastic vasculitis of hemorrhagic vesiculobullous type in an immunocompromised patient who was being treated with tigecycline for parapneumonic effusion with persistently elevated inflammatory markers.

Keywords:Drug-Induced Vasculitis; Leukocytoclastic Vasculitis; Tigecycline; Oman.

Acyl-coenzyme A-binding domain-containing protein 5 (ACBD5) is an acyl-CoA-binding peroxisomal membrane protein. Its deficiency impairs peroxisomal beta-oxidation of very long-chain fatty acids and causes an autosomal recessive disorder that manifests as retinal dystrophy and leukodystrophy. We report five Omani patients with ages ranging between 4 and 30 years. First presentation was in infancy with nystagmus and photophobia and progressed to legal blindness by 10 years of age. Electroretinogram confirmed severe cone-rod dystrophy. Motor neuroregression with variable ages of onset and signs of progressive cerebellar ataxia were seen in all patients, whereas cognitive decline was observed in some. Brain MRI revealed diffuse T2 signal abnormality in deep white matter, with involvement of corticospinal tracts. Plasma long chain fatty acid profile showed mild elevation of C26 and C26/22 ratio. Two homozygous variants in ACBD5 gene were identified; exons 7 and 8 deletion and exon 4 deletion. This series confirms retinal dystrophy and leukodystrophy as key features of ACBD5 deficiency with main symptoms of early onset visual decline, progressive spasticity, and cerebellar ataxia. This case series adds valuable insight in to this ultra-rare neurometabolic disease.

Keywords:Cone-Rod Dystrophy; Ataxia; Spastic Paraplegia; ACBD5; Peroxisomal Disorder; Oman.