Molecular characterization of rabies virus from wild and domestic animals in the Sultanate of Oman.

AIMS: Rabies virus (RV) is endemic in some Arabian countries. However, it is difficult to control RV without understanding the epidemiological evolution of endemic RV isolates. The current study aimed to characterize RV from domestic and wild animal clinical cases in Oman. METHODS AND RESULTS: Twelve brain samples from domestic (Five camels, three goats and one cattle) and wild animals (Two foxes and one honey badger) were investigated from different locations in Oman between 2017 and 2020. All samples were confirmed by RV nucleoprotein (N) gene-specific primers. Seven out of the 12 amplified samples were successfully sequenced and subjected to sequence and phylogenetic analysis. The detected RVs shared an in-between 96.8%-98.7% and 96.9%-99% nucleotide and amino acid identities, respectively. However, the wild animal RVs shared only 92.6%-93.9% and 95.9% nucleotide and amino acid identities with the domestic animal RVs, respectively. Negri bodies were detected histologically in six brain samples from camels (n = 3), goats (n = 1) and foxes (n = 2). The RVs from domestic animals shared 97%-98.7% and 98%-100% nucleotide and amino acid identities with the previously published fox RVs from Oman and Gulf countries. Phylogenetic analysis suggested that all RV sequences belong to a distinct clade confined to the previously reported clade V within the Middle Eastern Cluster. CONCLUSIONS: As indicated by the analysis of RVs from different locations between 2017 and 2020, a genetic variant isolated to the Gulf region may exist within the Middle East clade. Moreover, it appears that new RV lineages are emerging rapidly within this region. Therefore, a comprehensive genomic and phylogenetic analysis of the circulating RV is important for the development of future prevention and control strategies.

Polychlorinated biphenyls (PCBs) in the Persian Gulf and Gulf of Oman: baseline report on occurrence, distribution, and ecological risk assessment.

In the present study, 18 polychlorinated biphenyl (PCB) compounds were measured in marine sediments collected from 49 offshore stations in the Persian Gulf and the Gulf of Oman in 2019. After the last oceanographic cruise in 2006, no study has been performed on the offshore sediments of this region, and this is the first study on the PCBs in this area. The total amount of PCB compounds in the sediment samples ranged from 74.38 ng kg-1 (near Abu Musa Island) to 1212.98 ng kg-1 (near Siri and Kish Island). The maximum and minimum values of the individual detected PCB compounds were 175.88 ng kg-1 (PCB52) and 2.09 ng kg-1 (PCB156), respectively. The levels of total PCBs detected in sediments were lower than the Canadian interim sediment quality guideline value of 21500 ng kg-1 for marine sediments. The sedimentary mass inventories for Σ18PCBs were 0.6 and 0.2 mt for the Persian Gulf and Gulf of Oman, respectively.

Old World Micropholcus spiders, with first records of acrocerid parasitoids in Pholcidae (Araneae).

Micropholcus Deeleman-Reinhold & Prinsen, 1987 is one of only two Pholcidae genera known to occur both in the Old and New Worlds. However, there are major morphological and ecological differences among geographically separate groups of species, and it was mainly molecular data that have resulted in our current view of uniting all these species into a single genus. In the Old World, only four species have previously been described. Here, current knowledge about Old World Micropholcus is reviewed, redescribing three of the four previously known species, and describing twelve new species, originating from Saudi Arabia (M.dhahran Huber, sp. nov., M.harajah Huber, sp. nov., M.alfara Huber, sp. nov., M.abha Huber, sp. nov., M.tanomah Huber, sp. nov., M.bashayer Huber, sp. nov., M.maysaan Huber, sp. nov.), Oman (M.darbat Huber, sp. nov., M.shaat Huber, sp. nov.), Morocco (M.ghar Huber, sp. nov., M.khenifra Huber, Lecigne & Lips, sp. nov.), and the Philippines (M.bukidnon Huber, sp. nov.). We provide an exploratory species delimitation analysis based on CO1 barcodes, extensive SEM data, and first records of Acroceridae (Diptera) larvae in Pholcidae, extracted from book lungs.

Applying the Panarchy Framework to Examining Post-Pandemic Adaptation in the Undergraduate Medical Education Environment: A Qualitative Study.

Phenomenon: The COVID-19 pandemic necessitated an abrupt shift to online medical education, disrupting learning across knowledge, skills, and social connections. Post-pandemic, medical schools must evaluate how these disruptions shaped student experiences to optimize the return to in-person learning. Approach: This cross-sectional qualitative study explored medical students' perceptions of their learning environment during the post-pandemic reintegration period in Oman. Fifty-four preclinical and clinical students participated in six focus group interviews. Content analysis identified key topics characterizing students' perceptions of change and change processes in the post-pandemic learning environment. The panarchy framework, developed to characterize complex adaptive systems in nature, was used to frame the results. Findings: The return to in-person environments presented a mix of renewed connectivity, involving collaborative benefits alongside transitional adjustment strains. Five major topics characterizing student perceptions of change and change processes in their post-pandemic learning environment were identified: learning skills, developing clinical competence, faculty interactions, physical atmosphere, and social connections. Managing academic schedules and cognitive load as the learning environment opened challenged students' learning skills. Learners valued a renewed opportunity for interactive application of knowledge through collaboration, patient contact, and empathy skill-building to feel prepared for future practice. Returning to in-person instruction renewed a sense of community and peer support networks disrupted by pandemic isolation. Some students continued to struggle with study-life imbalance and felt ill-equipped to handle post-pandemic demands. Improved access to student support and wellness services was emphasized to ease transitional stresses. Students defined an ideal learning climate as supportive, active, personalized, relevant, challenging, accessible, and collaborative. Insights: While pandemic disruptions posed challenges, they provide opportunities to strengthen the educational system's resilience moving forward. Our findings highlight an opportunity for medical educators and learners to capitalize on the innovations that emerged during this period, integrating technology with interactive learning activities and reconnecting students with the core values of the medical profession. Applying the panarchy framework to frame this adaptive process could enable the tracking of multi-level interactions within the medical education environment and the evaluation of interventions targeted at identified areas of concern. Further exploration to achieve complete mapping of specific environmental domains onto the panarchical cycles merits future investigation to build integrated resilience frameworks.

Elimination of endemic measles and rubella transmission in Oman.

Objectives: The main objective of the study is to describe the five lines of evidence of measles and rubella elimination in Oman. Methods: A descriptive record review of the national surveillance database of fever and rash illnesses (measles and rubella surveillance) to demonstrate elimination status. Results: A total of 532 and 73 cases of measles and rubella cases were reported during 2000-2022, respectively. Of the reported measles cases during 2000-2022, 106 were sporadic cases and 36 outbreaks (426 cases) were reported. The size of the outbreaks was largely small and the largest and the longest outbreak was in 2016-2017 involving the Dhofar-South Sharqiyah governorates with 90 cases due to genotype B3, which lasted for 32 weeks. Of the reported rubella cases during 2000-2022; all 73 were sporadic cases with no outbreaks. The vaccination coverage of Measles Mumps Rubella 2 is high (>98.0%) at the national and sub-national levels since 2008, thus maintaining the high population immunity. The absence of endemic genotype was proven through genetic sequencing of all the reported cases and outbreaks of measles and rubella. The high-performance indicators showed quality surveillance system. Conclusions: Oman fulfills the criteria for measles and rubella elimination. All the five lines of evidence were verified and Oman was certified to have eliminated measles and rubella in 2019. After 3 years of post-elimination, Oman has continued to maintain its elimination status successfully. High population immunity and quality surveillance resulted in sustaining the elimination during the post-elimination period.

Surgical Management of Renal Cell Carcinoma: Comparisons of open and laparoscopic approaches.

Objectives: Renal cell carcinoma (RCC) is a leading urological malignancy with an age-standardised incidence rate of 2.5 per 100,000 per year in Oman. Experts are inclined towards the early detection and use of minimally invasive technology for the treatment of RCC. This study aimed report the shifting trend in the clinical presentation and management of RCC in Oman, comparing the outcomes of laparoscopic and open nephrectomy. Methods: This retrospective study included adult RCC patients from Sultan Qaboos University Hospital, Muscat, Oman, diagnosed from 2011-2022. Patient biodata, mode of presentation, diagnostic modality, final histopathology and details of treatment received including the perioperative outcomes were analysed. Results: A total of 56 patients that underwent surgical treatment for RCC, 34 underwent laparoscopic nephrectomy (LN) and 22 underwent open nephrectomy (ON). The mean ages in the LN and ON groups were 53.82 ± 13.44 years and 56.22 ± 15.00 years (P = 0.53), respectively. There were 47 patients of Omani descent and 9 patients were expatiates. The patients' mean tumour size was 6.25 ± 3.16 cm and 9.23 ± 5.20 cm for the LN and ON groups, respectively; 55.35% of the RCC cases were incidentally diagnosed. A trend towards LN was observed. Conclusion: This study found a trend towards early diagnosis of RCC in Oman, with the majority of cancers being discovered incidentally in the studied period. LN is more commonly used in the surgical management of RCC with acceptable morbidity. These trends remain aligned with those found in the global literature on RCC.

Health-Related Quality of Life of Omani Adult Patients with Sickle Cell Disease at the Sultan Qaboos University Hospital.

Objectives: This study aimed to determine the health-related quality of life (HRQoL) of adult Omani patients with sickle cell disease (SCD). The quality of life of these patients in Oman is unknown. Methods: This cross-sectional study was conducted at the Sultan Qaboos University Hospital, Muscat, Oman, from June to October 2022 and included patients with SCD. A validated Arabic version of the 36-Item Short-Form Health Survey (SF-36) was used to assess HRQoL in 8 domains. Results: A total of 235 patients with SCD were included in this study, the majority of whom were female (74.9%) and between 18 and 35 years of age (64.6%). The lowest HRQoL was reported for the domain of role limitations due to physical health (median score = 25.0, interquartile range [IQR] = 35.0), while the highest was seen for role limitations due to emotional problems (median score = 66.7, IQR = 100.0). Frequent SCD-related emergency department visits/hospital admissions and the adverse effect of SCD on patients' social lives had a significant negative impact on SF-36 scores for all 8 HRQoL domains (P ≤0.05). Additionally, SCD's impact on academic performance and a history of having been bullied due to SCD had a significant negative impact on SF-36 scores for 7 domains (P ≤0.05). Conclusion: Omani adult patients with SCD reported relatively poor HRQoL in several domains, with various factors found to be significantly associated with this. Healthcare providers and policy makers should consider offering additional clinical, educational and financial support to these patients to enhance their HRQoL.

Successful Treatment of Angiolymphoid Hyperplasia with Eosinophilia Associated with Scalp Demodicosis Using Cryotherapy and Topical Metronidazole.

Angiolymphoid hyperplasia with eosinophilia (ALHE) is a rare, benign, vasoproliferative tumour. We report a 25-year-old female patient who reported in 2021 to a dermatology clinic in Rustaq, Oman, with multiple, grouped, erythematous dome-shaped papules and nodules of 6 months duration on the left temporo-occipital region. Biopsy findings were consistent with a diagnosis of ALHE with evidence of Demodex mite infestation in the sebaceous ducts. The patient demonstrated significant improvement following 7 weeks of treatment with multiple cryotherapy sessions and topical application of metronidazole gel. This case suggests that scalp demodicosis may represent a novel trigger for the development of ALHE.

Adrenocorticotropic Hormone-Secreting Pituitary Microadenoma Presenting with Acute Psychosis, Delirium and Paroxysmal Sympathetic Hyperactivity.

Adrenocorticotropic hormone (ACTH)-secreting pituitary adenomas are known to be associated with behavioural changes but acute presentation including psychosis and delirium are less common. We report the case of a 42-year-old female patient with a known medical history of hypertension and diabetes mellitus, presenting with acute onset behavioural changes suggestive of psychosis to a tertiary care centre in Muscat, Oman in 2022. Further evaluation revealed an ACTH dependent Cushing's disease with a pituitary microadenoma. The patient was admitted for endoscopic resection of the adenoma. During the peri-operative period, she experienced worsening of psychosis in addition to delirium. She also developed episodes of unresponsiveness, posturing, severe diaphoresis and dyspnoea accompanied by tachycardia and hypertension which were managed with midazolam and levetiracetam. A seizure work-up and computed tomography brain scan were unremarkable. At follow-up, she showed full resolution of symptoms with good blood pressure and glycaemic control.

Erdheim-Chester Disease Presenting as Bilateral Facial Masses: A case report and review of literature.

Erdheim-Chester disease (ECD) is a rare form of non-Langerhans cell histiocytosis with unknown aetiology. It is recently recognised to be neoplastic with genetic mutations affecting the mitogen-activating protein kinase pathway. We report a 49-year-old female patient who initially presented in 2012 to a tertiary care centre in Muscat, Oman, with bilateral facial masses. These were removed but later recurred over a period of 10 years. She then presented with xanthelasmas, bone lesions, secondary infertility due to hypothalamic hypogonadism, diabetes insipidus and Hashimoto's hypothyroidism. The facial masses were biopsied and they showed classic morphological features in the form of diffuse infiltration by foamy histiocytes with scattered Touton type of giant cells, patchy lymphocytic infiltrates and dense fibrosis. The patient is stable and is being followed-up. The presented ECD case is particularly interesting due to the recurrent bilateral facial masses. To the best of the authors' knowledge, this is the first documented case in Oman.

Complications of Open Reduction and Internal Fixation of Mandibular Condyle Fractures in Oman.

Objectives: This study aimed to report the complication rate associated with open reduction and internal fixation (ORIF) of mandibular condyle fractures in Oman. Methods: This retrospective cohort study was conducted among patients who underwent ORIF of mandibular condyle fractures at Al-Nahdha Hospital and the Sultan Qaboos University Hospital in Muscat, Oman, from January 2008 to December 2020. Data collected included patient demographics, fracture aetiology, fracture side and type, surgical approach and recorded complications and outcomes. Results: A total of 68 patients (59 males and 9 females; mean age of 30.1 years) with 83 mandibular condyle fractures underwent ORIF during the study period. Subcondylar fractures were the most common type, occurring in 62.7% of patients, while bilateral fractures were observed in 21 (30.8%) patients. The most common surgical approach was retromandibular, used in 42.2% of patients. The overall complication rate was 42.6%, with the most frequently reported complications being transient facial nerve palsy (18.1%), malocclusion (14.7%) and restricted mouth opening (10.3%). Subsequent surgical interventions to correct malocclusion were performed in 6 cases. There was no statistically significant association between the overall complication rate and the patients' clinical characteristics. Conclusion: Although ORIF of mandibular condyle fractures generally offers favourable outcomes, it carries a risk of complications.

Association Between Internet Addiction and Dietary Habits Among Omani Junior College Students.

Objectives: This study aimed to investigate the association between internet addiction and dietary habits among Omani junior college students. Methods: This cross-sectional study was conducted at Sultan Qaboos University, Muscat, Oman, among junior college students surveyed in November 2020. The Compulsive Internet Use Scale and a dietary habits questionnaire were used. Chi-square cross-tabulation analyses were used to explore the relationship between internet addiction and dietary habits. Results: A total of 377 students were included in this study. Overall, 59.9% of the junior college students were identified as having an internet addiction. Within this group, 62.8% reported reduced meal sizes and 54.4% reported a decrease in appetite. There was a statistically significant difference in both meal size (X2 = 30.528; P <0.001) and appetite changes (X2 = 28.731; P <0.001) among students with different levels of internet addiction. Conclusion: The results of this study suggest a possible link between internet addiction and altered dietary habits among this population. This study highlights the need for strategies that encourage healthy living behaviours and raise awareness about the adverse effects of internet addiction.

Sharing Unpleasant Health Information with Patients: A baseline study exploring physician attitudes, practices and adherence to the SPIKES protocol at a tertiary hospital in Muscat, Oman.

Objectives: This study aimed to investigate the knowledge, attitude and experiences in sharing unpleasant health information and adherence to the SPIKES protocol among physicians at a tertiary hospital in Muscat, Oman. Methods: This cross-sectional study was conducted at the Sultan Qaboos University Hospital from August to October 2022. An electronic, self-administered questionnaire was used to gather data from physicians across various departments. Results: A total of 89 physicians completed the questionnaire (response rate = 22.3%). Most participants (n = 86, 96.6%) recognised the need for additional training in the delivery of unpleasant health information ('bad news'), with 78.7% (n = 70) expressing their willingness to undertake such training. Additionally, 32.6% (n = 29) reported negative experiences due to improper delivery of bad news, with an equal proportion admitting to disclosing bad news to patients' family without their consent. The majority (n = 77, 86.5%) demonstrated a high level of overall adherence to the SPIKES protocol, with 59.6-85.4%, 12.4-34.8% and 1.1-11.2% reported usually, sometimes and never following specific steps of the protocol, respectively. Marital status (P = 0.015) and qualifications (P = 0.032) were the only variables that were associated with adherence level, with married physicians and those with board and/or fellowship certificates reporting significantly better adherence compared to their counterparts. Conclusion: Physicians in Oman encounter challenges in delivering unpleasant health information, underscoring the interplay of cultural influences, training and adherence to protocols. To address these challenges, targeted and frequent training programmes are recommended, starting from undergraduate medical education and extending to continuous opportunities for physicians at various career levels.

A Common Disease, an Uncommon Location: Left Ventricle Papillary Fibroelastoma.

Cardiac papillary fibroelastoma (PFE) is a rare benign cardiac tumor, usually associated with cardiac valves. Cases of non-valvular, left ventricular (LV) cavity PFE are extremely rare. We report the case of a 75-year-old man with a history of exertional chest pain. He was referred to our tertiary-care hospital for evaluation. On the echocardiogram, the patient was found to have a LV lesion related to the papillary muscle. Cardiac magnetic resonance imaging revealed an enhancing mobile lesion related to the LV anterolateral papillary muscle which suggested a myxoma. The patient underwent surgical resection of the lesion, later histopathologically confirmed to be PFE.

Notes on the Ecology and Distribution of Species of the Genera of Bondarzewiaceae (Russulales and Basidiomycota) with an Emphasis on Amylosporus.

The family Bondarzewiaceae is an important and diverse group of macrofungi associated with wood as white rotting fungi, and some species are forest tree pathogens. Currently, there are nine genera and approximately 89 species in the family, distributed in tropical, subtropical, and temperate climates. To address the phylogenetic relationships among the genera, a combined ITS-28S dataset was subjected to maximum likelihood (ML), Bayesian inference (BI), and time divergence analyses using the BEAST package. Both ML and BI analyses revealed two major clades, where one major clade consisted of Amylosporus, Stecchericium, and Wrightoporia austrosinensisa. The second major clade is composed of Bondarzewia, Heterobasidion, Gloiodon, Laurilia, Lauriliella, and Wrightoporia, indicating that these genera are phylogenetically similar. Wrightoporia austrosinensisa recovered outside of Wrightoporia, indicating that this species is phylogenetically different from the rest of the species of the genus. Similarly, time divergence analyses suggest that Bondarzewiaceae diversified around 114 million years ago (mya), possibly during the Early Cretaceous Epoch. The genus Amylosporus is well resolved within the family, with an estimated stem age of divergent around 62 mya, possibly during the Eocene Epoch. Further, the species of the genus are recovered in two sister clades. One sister clade consists of species with pileate basidiomata and generative hyphae with clamp connections, corresponding to the proposed section Amylosporus sect. Amylosporus. The other consists of species having resupinate basidiomata and generative hyphae without clamps, which is treated here as Amylosporus sect. Resupinati. We provided the key taxonomic characters, known distribution, number of species, and stem age of diversification of each section. Furthermore, we also described a new species, Amylosporus wadinaheezicus, from Oman, based on morphological characters of basidiomata and multigene sequence data of ITS, 28S, and Tef1-α. With pileate basidiomata and phylogenetic placement, the new species is classified under the proposed A. sect. Amylosporus. An identification key to the known species of Amylosporus is presented. Ecology and distribution of species of the genera in the family are discussed.

Complementary and Alternative Medicine for People with Epilepsy: Opinions of Physicians in Oman.

Objectives: Several studies have explored the opinions of healthcare workers on the use of complementary and alternative medicine (CAM) in epilepsy treatment. We sought to survey the views of non-neurologist and non-psychiatrist physicians in Oman on the use of CAM for epilepsy. Methods: We used convenience sampling to recruit physicians (except neurologists and psychiatrists) from all 11 governorates of Oman. The online questionnaire was open to physicians from 5 January 2022 to 15 February 2023. This study collected anonymous data on their demographics, discipline, work settings, geographical area, and years of practice. Additionally, participants were asked to answer questions about their perception of CAM use and its effectiveness in treating epilepsy. Results: A total of 190 physicians participated, of whom 69.5% were men. Respondents were mostly 36 to 45 years old (51.1%). The majority (52.1%) were general practitioners, 21.1% were internists, 17.9% were pediatricians, and 8.9% were family physicians. Most participants (n = 144; 75.8%) believed that CAM may help treat patients with epilepsy (PWE). The most common therapies that participants considered helpful were meditation (46.0%), prayers (44.7%), yoga (32.6%), and exercise (31.1%). Conclusions: While the evidence supporting the use of CAM for the treatment of epilepsy is scarce, this survey showed that most physicians (non-neurologists and non-psychiatrists), who manage PWE in Oman, believed that some CAM modalities would help treat epilepsy. Well-designed controlled trials are needed to provide reliable evidence on the usefulness of CAM options in PWE.

Identifying disparities in pediatric cystic fibrosis care between low-middle and middle-high income countries in the Middle East.

Cystic Fibrosis (CF) care has advanced tremendously in the United States (US), North America, Australasia, and Europe in recent decades. Given the concern for global disparities in pediatric medical care in other parts of the world, we wanted to assess the availability of key aspects of current pediatric CF care in the Middle East as-compared to the US. We collected electronic surveys from pediatric CF providers in the Middle East and surrounding countries assessing whether treatments known to be widely available in the US were also available in surveyed countries. Many countries in the Middle East, as-compared to the US, do have less overall availability of many key CF diagnostic and treatment modalities. Within the Middle East, 80 % of higher-income countries had inhaled tobramycin available compared to none in lower-income countries. This study highlights the additional global collaboration needed to ensure all children with CF receive optimal care globally.

Evolutionary Relationships of Omani Macrotermes subhyalinus, Macrotermitinae.

A study was conducted to investigate the evolutionary relationships of Macrotermes subhyalinus from Oman, in the southeastern part of the Arabian Peninsula. Sequences of the mitochondrial COI and the nuclear large-subunit ribosomal RNA (LSU rRNA, 28S) genes were used to investigate the populations of M. subhyalinus across their distribution in Oman to determine their relationships with other Macrotermes species. Our findings indicate that M. subhyalinus in Oman is a member of an East African clade, distinct from those in West Africa. Analyses of the COI showed that there is base composition bias among the taxa (non-stationarity) that has not been considered in earlier studies. We provide the first report of pseudogene copies of 28S in M. subhyalinus that are differentially amplified.

Midazolam-Induced Seizure-Like Activity in Five Neonates: A case series.

An intravenous (IV) administration of midazolam may result in seizure-like activity or movement. This report describes 5 neonates who developed seizure-like movements after IV midazolam injection. The patients presented between 2019 and 2022 and were admitted to a neonatal intensive care unit located within an academic centre in Muscat, Oman. The abnormal movements occurred shortly after IV bolus administration of midazolam. None of the patients experienced seizure-like movements after receiving midazolam infusions. The seizure-like movements were aborted either spontaneously or by antiseizure medications. In addition, seizure recurrence was not observed in any of the infants during the later stages of their treatment. Since this adverse effect might be related to the speed of the bolus administration, IV midazolam must be given as a slow bolus over 2-3 minutes followed by a slow flush of normal saline. To prevent midazolam's potential adverse effect on newborns, neonatal caregivers must be aware of it.

A roadmap towards implementing health technology assessment in Oman.

PURPOSE: Health technologies are advancing rapidly and becoming more expensive, posing a challenge for financing healthcare systems. Health technology assessment (HTA) improves the efficiency of resource allocation by facilitating evidence-informed decisions on the value of health technologies. Our study aims to create a customized HTA roadmap for Oman based on a gap analysis between the current and future status of HTA implementation. DESIGN/METHODOLOGY/APPROACH: We surveyed participants of an advanced HTA training program to assess the current state of HTA implementation in Oman and explore long-term goals. A list of draft recommendations was developed in areas with room for improvement. The list was then validated for its feasibility in a round table discussion with senior health policy experts to conclude on specific actions for HTA implementation. FINDINGS: Survey results aligned well with expert discussions. The round table discussion concluded with a phasic action plan for HTA implementation. In the short term (1-2 years), efforts will focus on building capacity through training programs. For medium-term actions (3-5 years), plans include expanding the HTA unit and introducing multiple cost-effectiveness thresholds while from 6-10 years, publishing of HTA recommendations, critical appraisal reports, and timelines is recommended. ORIGINALITY/VALUE: Although the HTA system in Oman is still in its early stages, strong initiatives are being taken for its advancement. This structured approach ensures a comprehensive integration of HTA into the healthcare system, enhancing decision-making and promoting a sustainable, evidence-based system addressing the population's needs.