Breast cancer diagnosis has several devastating psychosocial impacts on women in Oman. Healthcare professionals working with women with breast cancer should be aware of the different psychosocial impacts of the disease on women's lives. Appropriate measures must be taken by the decision makers whenever needed, including enforcing positive views and support of Oman's society towards women with breast cancer.

Tuberculosis (TB) is a chronic granulomatous infection which can present in an atypical form. Isolated muscle involvement is very rare. We report a 25-year-old man who presented with a massive cystic swelling on the right side of his back, extending from the lower thoracic to the gluteal region. He had a history of contact with a friend who was suspected of having TB. Magnetic resonance imaging (MRI) showed that the origin of the cyst was from the erector spinae muscles. The result of a fluid aspirate showed acid fast bacilli. The swelling disappeared after treatment with anti-tuberculous medications. Muscular involvement in TB is very rare. In our patient, the reports of an ultrasound and MRI confirmed isolated muscle and subcutaneous involvement without bony lesions. This case is reported to increase physician awareness regarding soft tissue TB. Although it is rare, similar cases may be seen in the future.

Only 30% of the BP of the hypertensive diabetics met the recommended BP for diabetes. More effort should be dedicated to control the BP in diabetics. Physicians should be careful in the selection of hypertensive medications, because in some combinations, they are not useful.

Vitamin B12 deficiency is common in developing countries and should be suspected in patients with unexplained anaemia or neurological symptoms. Dermatological manifestations associated with this deficiency include skin hyper- or hypopigmentation, angular stomatitis and hair changes. We report a case of a 28-year-old man who presented to the Sultan Qaboos University Hospital in Muscat, Oman, in November 2013 with localised hyperpigmentation of the palmar and dorsal aspects of both hands of two months' duration. Other symptoms included numbness of the hands, anorexia, weight loss, dizziness, fatigability and a sore mouth and tongue. There was no evidence of hypocortisolaemia and a literature search revealed a possible B12 deficiency. The patient had low serum B12 levels and megaloblastic anaemia. An intrinsic factor antibody test was negative. A gastric biopsy revealed chronic gastritis. After B12 supplementation, the patient's symptoms resolved. Family physicians should familiarise themselves with atypical presentations of B12 deficiency. Many symptoms of this deficiency are reversible if detected and treated early.

Background. Diabetes mellitus and thyroid diseases are common endocrine disorders in the general population and found to exist simultaneously. This study aimed to establish the prevalence of thyroid dysfunction among Omani type 2 diabetics and its association with glycemic control. Methodology. A retrospective cross-sectional randomized primary and secondary care based study of 285 Omani type 2 diabetics, ≥ 30 years of age with known thyroid function. The following parameters were examined: age, sex, duration of diabetes, duration of thyroid disease, thyroid morphology, thyroid function, thyroid antibodies, and the mean glycated hemoglobin (mean HbA1C). The prevalence of thyroid dysfunction was compared to an independent control group of randomly selected healthy individuals with known thyroid function. Results. Thyroid dysfunction was found in 12.6% of the diabetic patients compared to 4.9% in the control group. The prevalence was higher among the diabetic females (86%) compared to diabetic males (14%). The commonest thyroid dysfunction among diabetics was overt hypothyroidism (4.6%). Subclinical hypothyroidism was the commonest thyroid dysfunction seen in less controlled diabetics at a mean HbA1c of 7.8 (± 0.7). Conclusion. Screening for thyroid dysfunction in patients with type 2 diabetes mellitus should be routinely performed considering the higher prevalence of thyroid diseases in this group compared to the general population.