Oman Medical Journal最新文献

{"title":"Clinico-radio-histopathological Correlation of Leiomyoma Variant, STUMP, and Sarcoma: A Retrospective Study.","authors":"Jayasree Santhosh, Shima Al-Mughairfi, Huda Al-Ghaithi, Zainab Al-Hilal, Reem Hamood Al-Maqbali, Ahmed Al-Salmi, Jokha Al-Kalbani, Ruqaiya Al-Shamsi, Thuria Al-Rawahi","doi":"10.5001/omj.2025.49","DOIUrl":"https://doi.org/10.5001/omj.2025.49","url":null,"abstract":"<p><strong>Objectives: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":19667,"journal":{"name":"Oman Medical Journal","volume":"40 1","pages":"e715"},"PeriodicalIF":0.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12056707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short-term Metabolic Outcomes After Laparoscopic Sleeve Gastrectomy: A Retrospective Cohort Study from Oman.","authors":"Halah Al Hadhrami, Nawal Al Nabhani, Bader Al Hadhrami, Hana Al Sumri, Sanaa Al Sumry","doi":"10.5001/omj.2025.52","DOIUrl":"https://doi.org/10.5001/omj.2025.52","url":null,"abstract":"<p><strong>Objectives: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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 (<i>p =</i> 0.014). The percent EWL was positively correlated to preoperative BMI (<i>p</i> < 0.001); however, no significant associations were observed with various comorbidities, including HTN, T2DM, dyslipidemia, and obstructive sleep apnea (<i>p</i> > 0.050).</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":19667,"journal":{"name":"Oman Medical Journal","volume":"40 1","pages":"e717"},"PeriodicalIF":0.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12066982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary Squamous Cell Carcinoma of the Kidney: A Case Series.","authors":"Noor Nabi Junejo, Muhammad Humza Kamal, Shahid Aquil, Fathiya Al Rahbi, Ghalib Amur Rashid Al Badaai, Khurram Mutahir Siddiqui","doi":"10.5001/omj.2025.04","DOIUrl":"10.5001/omj.2025.04","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":19667,"journal":{"name":"Oman Medical Journal","volume":"1 1","pages":"e721"},"PeriodicalIF":0.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12066939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70693889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Risk Factors of Significant Hepatic Fibrosis in Omani Patients with HBeAg-negative Chronic Hepatitis B Virus Infection: A Retrospective Study.","authors":"Halima H Al-Shuaili, Bushra Al Mashikhi, Ahmed Al Sinani, Ahmed Alwassief, Said A Al-Busafi","doi":"10.5001/omj.2024.113","DOIUrl":"https://doi.org/10.5001/omj.2024.113","url":null,"abstract":"<p><strong>Objectives: </strong>Hepatic fibrosis remains a potential complication for hepatitis B e antigen (HBeAg)-negative chronic hepatitis B virus (HBV) infection. The affected individuals, known as inactive HBV carriers, tend to have a favorable prognosis. This study aimed to determine the prevalence of significant fibrosis and associated risk factors among Omani patients diagnosed as inactive HBV carriers.</p><p><strong>Methods: </strong>A retrospective study was conducted on Omani inactive HBV carriers visiting a tertiary hospital in Muscat, Oman, between January 2017 and December 2018. Significant hepatic fibrosis (stage F2 or higher) was identified using two-dimensional shear-wave elastography, with baseline clinical, laboratory, and radiological data analyzed for associations.</p><p><strong>Results: </strong>Among the selected 200 participants (mean age = 44.6 ± 9.3 years), 53.0% were male. Significant fibrosis was present in 40 (20.0%) patients, with a preponderance of male (<i>p =</i>0.007) and those aged ≥ 60 years (<i>p =</i>0.024). Fatty changes, as detected by liver ultrasound, were independent risk factors (<i>p =</i>0.044).</p><p><strong>Conclusions: </strong>The findings underscore the importance of periodic assessment and monitoring of inactive HBV carriers in Oman, particularly those with risk factors for fibrosis progression, such as male sex, older age, and fatty liver. Non-invasive tests can aid in early detection and management of fibrosis, thereby improving patient outcomes.</p>","PeriodicalId":19667,"journal":{"name":"Oman Medical Journal","volume":"39 6","pages":"e693"},"PeriodicalIF":0.0,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11980033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144037346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical Site Infection Rates in Five Middle Eastern Countries: International Nosocomial Infection Control Consortium Findings.","authors":"Victor Daniel Rosenthal, Ruijie Yin, Zhilin Jin, Safaa Abdulaziz Alkhawaja, Saleh Fakher Mohamed Sowar, Athraa S H Naser, Fatema E S Naser, Amani El-Kholy, Victor Bayani, Wafaa Alwakil, Ziad A Memish","doi":"10.5001/omj.2024.108","DOIUrl":"https://doi.org/10.5001/omj.2024.108","url":null,"abstract":"<p><strong>Objectives: </strong>This study of surgical site infection (SSI) rates covers 29 International Nosocomial Infection Control Consortium (INICC) member hospitals in 22 cities across the Middle East, including Bahrain, Egypt, Kuwait, Lebanon, and Saudi Arabia.</p><p><strong>Methods: </strong>Prospective cohort multinational surveillance data were collected through the INICC Surveillance Online System. Centers for Disease Control and Prevention/National Healthcare Safety Network (CDC/NHSN) definitions were applied for SSI. Surgical procedures (SPs) were categorized into 12 types according to the International Classification of Diseases, ninth revision (ICD-9) criteria, 9^thedition.</p><p><strong>Results: </strong>From 2014 to 2023, we collected data on 304 SSIs associated with 21 322 SPs. Among the 12 observed types of SPs, comparable incidences were noted between the INICC hospitals of the Middle East and CDC/NHSN datasets across six types of SPs: breast, 1.1% vs. 0.9% (<i>p =</i>0.870); cholecystectomy, 0.1% vs. 0.2% (<i>p =</i>0.360); craniotomy, 3.0% vs. 2.1% (<i>p =</i>0.510); herniorrhaphy, 0.8% vs. 0.7% (<i>p =</i>0.770); abdominal hysterectomy, 1.2% vs. 1.1% (<i>p =</i>0.880); and laminectomy, 1.6% vs. 0.7% (<i>p =</i>0.100), respectively. INICC hospitals of the Middle East exhibited a significantly lower cesarean section rate compared to CDC/NHSN rates: 1.04% compared to 1.5% (relative ratio (RR) = 0.71, 95% CI: 0.58-0.87; <i>p =</i>0.001). However, the following four types of SPs showed SSI rates significantly higher than those of CDC/NHSN: Appendix surgery, 1.8% vs. 1.1% (RR = 1.55, 95% CI: 1.02-2.36; <i>p =</i>0.041); coronary artery bypass, 4.5% vs.1.4% (RR = 3.32, 95% CI: 1.82-6.08; <i>p</i> < 0.001); open reduction of fracture, 2.5% vs. 1.1% (RR = 2.24, 95% CI: 1.50-3.36; <i>p</i> < 0.001); and exploratory abdominal surgery, 3.8% vs. 1.7% (RR=2.30, 95% CI: 1.56-3.39, <i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>Most SSI rates in this set of hospitals in the Middle East are similar to those of CDC/NHSN. It is recommended to focus on implementing effective interventions to reduce SSI rates for procedures with higher rates.</p>","PeriodicalId":19667,"journal":{"name":"Oman Medical Journal","volume":"39 6","pages":"e689"},"PeriodicalIF":0.0,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11983378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144037566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Additional Role of Magnetic Resonance Imaging to Ultrasound in Assessing Placenta Accreta Spectrum Disorders: A Retrospective Cross-sectional Study from Vietnam.","authors":"Viet Hung Nguyen, Quang Huy Huynh, To Nguyen Ha, Minh Chau Ngoc Nguyen, Phuc Nhon Nguyen","doi":"10.5001/omj.2024.119","DOIUrl":"https://doi.org/10.5001/omj.2024.119","url":null,"abstract":"<p><strong>Objectives: </strong>Placenta accreta spectrum (PAS) is commonly associated with adverse pregnancy outcomes. While ultrasound (US) is the primary imaging tool, magnetic resonance imaging (MRI) plays a crucial complementary role in assessing PAS disorders. This study aimed to evaluate the MRI features in PAS diagnosis and enhance the role of MRI in conjunction with US for better management. Additionally, the study examined the association between imaging findings and clinical outcomes.</p><p><strong>Methods: </strong>This retrospective cross-sectional study was conducted between January 2017 and June 2022 at Tu Du Hospital, Vietnam. A total of 87 cases were eligible for inclusion. Antenatal MRI and US findings were compared to intraoperative diagnoses and/or histopathological confirmation, which is considered the gold standard. The diagnostic value of each MRI feature was calculated, and the association between MRI/US findings, estimated blood loss, and surgical methods was analyzed. Statistical significance was determined with a <i>p</i>-value < 0.05.</p><p><strong>Results: </strong>Among the 87 women suspected of PAS on US, 83 were confirmed to have PAS through intraoperative diagnosis and/or histology. The mean maternal age was 35.9 5.7 years and the mean gestational age at cesarean section was 31.1 7.1 weeks. MRI sensitivity (Se) in detecting PAS ranged from 10.8-94.0%, while the specificity (Sp) ranged from 25.0-100%. Loss of retroplacental T2 dark zone demonstrated the highest diagnostic value. When combining three to six MRI signs, Se increased from 53.0-100%, and Sp from 25.0-100%. The highest Youden?(tm)s index (0.759) was observed with five MRI signs (Se = 75.9%, Sp = 100%). PAS diagnosed via MRI/US was associated with more significant blood loss during cesarean section (1000 (600-2000) mL vs. 500 (250-850) mL and 1000 (600-2000) mL vs. 300 (300-500) mL, respectively). Furthermore, the percreta type of PAS identified on MRI/US was linked to significantly higher rates of cesarean hysterectomy compared to conservative surgery (56.4% vs. 43.6% and 63.5% vs. 36.5%, respectively).</p><p><strong>Conclusions: </strong>MRI provides a reliable diagnostic value for PAS, particularly following uncertain US findings. Depending on resource availability, a stepwise approach utilizing both imaging modalities should be considered. MRI can guide strict interdisciplinary management in cases of suspected PAS, especially percreta type. Further studies are needed to solidify the role of MRI in severe PAS cases.</p>","PeriodicalId":19667,"journal":{"name":"Oman Medical Journal","volume":"39 6","pages":"e697"},"PeriodicalIF":0.0,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12010303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epileptic Nocturnal Wanderings in a Young Female: A Rare Case Report and Review of the Literature.","authors":"Alawi A Al-Attas, Attas A Al-Attas, Maryam A Al-Attas, Saleh K Swailem","doi":"10.5001/omj.2024.37","DOIUrl":"10.5001/omj.2024.37","url":null,"abstract":"<p><p>Sleep-related hyperkinetic seizures are a frequent symptom of frontal lobe epilepsy that occurs at night. Although temporal lobe-originating sleep-related seizures have been documented, they often lack hyperkinetic activity. Furthermore, episodic nocturnal wandering is rarely observed and is believed to represent an unusual form of nocturnal epilepsy that responds to anti-seizure medications. In this report, we present a case of a 14-year-old right-handed girl with recurrent sleepwalking and wandering. Interictal electroencephalography revealed an epileptogenic focus in the left temporal lobe and intermittent slow-wave activity originating from that region. During her nighttime wanderings, the patient exhibited unusually violent and nonviolent conduct, putting herself at risk of minor or serious injuries.</p>","PeriodicalId":19667,"journal":{"name":"Oman Medical Journal","volume":"1 1","pages":"e701"},"PeriodicalIF":0.0,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11979738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70684896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Isolated Hypogonadotropic Hypogonadism in a Young Woman with Primary Amenorrhoea.","authors":"Zalkha Al Kharusi, Nadia Al Mabaihsi, Amani Al Rawahi, Abeer Al Hadhrami, Maisa Al Kiyumi, Almundher Al-Maawali, Abdulaziz Al Mahrezi","doi":"10.5001/omj.2024.39","DOIUrl":"10.5001/omj.2024.39","url":null,"abstract":"<p><p>We describe a case of a young woman who presented with delayed secondary sexual development and primary amenorrhoea. She had low levels of oestradiol, follicle-stimulating hormone, and luteinizing hormone with normal levels of other pituitary hormones. Genetic testing revealed a rare diagnosis of autosomal recessive hypogonadotropic hypogonadism 8. She was treated with hormone therapy to promote the growth of the uterus and secondary sexual characteristics. Combined contraceptive pills were initiated. A pelvis ultrasound taken after six months revealed a growing uterus.</p>","PeriodicalId":19667,"journal":{"name":"Oman Medical Journal","volume":"1 1","pages":"e703"},"PeriodicalIF":0.0,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11979737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70685455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chilblain Lupus Masquerading as Tinea Pedis.","authors":"Sarah Al Qassimi, Fatima Abdulla, Mohamed Elarabi, Rajaie Namas","doi":"10.5001/omj.2024.38","DOIUrl":"10.5001/omj.2024.38","url":null,"abstract":"<p><p>Chilblain lupus erythematosus is a frequently misdiagnosed condition. Our case report describes a young Jordanian male who underwent a skin biopsy revealing the diagnosis of chilblain lupus erythematosus after multiple incorrect diagnoses. It emphasizes the importance of skin biopsy in establishing the correct diagnosis and avoiding unnecessary treatment.</p>","PeriodicalId":19667,"journal":{"name":"Oman Medical Journal","volume":"1 1","pages":"e702"},"PeriodicalIF":0.0,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11993907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70685031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Long-term Statin Therapy and New-onset Diabetes in Cardiovascular Risk Patients in the UAE.","authors":"Romona D Govender, Saif Al-Shamsi, Raya Almazrouei, Abeer Tahrawi, Rehab Mersal","doi":"10.5001/omj.2024.109","DOIUrl":"https://doi.org/10.5001/omj.2024.109","url":null,"abstract":"<p><strong>Objectives: </strong>In the UAE, the relationship between long-term statin use and new-onset diabetes mellitus (NODM) has never been studied. Therefore, this study investigates the incidence and risk of NODM among long-term statin-using UAE nationals with cardiovascular risk factors.</p><p><strong>Methods: </strong>We analyzed retrospective data of patients who were initiated on statin therapy from April to December 2008 and followed up till January 2020. Propensity score matching was applied to match statin users to an equal number of nonusers. Multivariable Cox proportional hazards regression analysis estimated the risk of NODM in statin users compared to nonusers.</p><p><strong>Results: </strong>Patients (N = 631) with one or more vascular risk factors were followed for a median of 10.1 years (IQR = 7.9-10.9 years). Age- and sex-adjusted incidence of NODM was higher among statin users than among nonusers (21.2 vs. 8.3 events per 1000 person-years). Statin users were also more than three times as likely to develop NODM over 10 years. We estimated that one in 19.2 patients (95% CI: 10.9-90.9) treated with statins for 10 years may develop NODM.</p><p><strong>Conclusions: </strong>Long-term statin use in Emirati patients is associated with an increased NODM risk. Though this risk is small relative to the anti-cardiovascular disease benefits of statins, clinicians should regularly monitor users of statin therapy for early indications of diabetes.</p>","PeriodicalId":19667,"journal":{"name":"Oman Medical Journal","volume":"39 6","pages":"e690"},"PeriodicalIF":0.0,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11979740/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}