Research activity

MEA-SIM is a low-cost, re-usable endoscopy simulator developed at the Muscat Endoscopy Academy to provide realistic hands-on training in EMR/ESD and advanced hemostasis using a standard clinical endoscope, camera system, and electrosurgical generator. The sealed, odor-resistant enclosure opens along a longitudinal hinge for easy cleaning and rapid organ exchange, and contains a fixed metal tray that anchors ex-vivo tissue (e.g., bovine/porcine stomach or colon). Standard accessory ports support injection, traction, irrigation/suction, and CO₂ insufflation, while an integrated return-plate interface enables authentic cutting/coagulation behavior.

The project has two aims: (1) iterative engineering of a robust, compact simulator that withstands repeated electrosurgery without fluid leaks or smell retention; and (2) validation of performance metrics for skills assessment. Training tasks include mucosal marking, incision, submucosal tunneling, pocket-creation, en-bloc resection, margin ablation, defect closure, and controlled perforation repair. Objective metrics captured from session videos include task time, en-bloc/RO resection rate (template-based margin scoring), bleeding/perforation events, economy of movement, electrosurgical error counts, and a global technical rating, enabling learning-curve analysis and benchmarking across courses.

MEA-SIM is designed for rapid deployment in resource-constrained settings and for multicenter courses across the GCC. Current work focuses on standardizing “tissue cartridges,” printable lesion stencils for margin-accuracy scoring, and a simple video-based scoring rubric to ensure inter-rater reliability. We welcome collaboration on materials engineering, metric validation, multicenter trainee studies, and industry evaluations of accessories and energy settings to accelerate safe adoption of advanced therapeutic endoscopy in the region.

Colorectal cancer is increasing in Oman, yet the optimal invitation pathway for population screening remains uncertain in a setting where uptake can be low. OASIS-CRC is a pragmatic, randomized invitation trial in average-risk adults (45–74 years) comparing two strategies used internationally: an at-home faecal immunochemical test (FIT) pathway with diagnostic colonoscopy for positives, versus a direct invitation to screening colonoscopy. Analyses follow an intention-to-invite framework to reflect real-world effectiveness. The primary outcome is participation. Key secondary outcomes include advanced neoplasia detected per 100 invited and per 100 colonoscopies, colonoscopy demand and quality indicators, and short-term procedure-related adverse events. A brief barriers survey will provide implementation insights relevant to the region. By delivering precise, locally derived estimates of uptake, yield, and service load for each strategy, OASIS-CRC will inform policy on the preferred entry pathway for colorectal cancer screening in Oman and guide capacity planning for scale-up. Recruitment is ongoing.

TRUST is a prospective observational cohort in Oman that measures real-world adherence to Helicobacter pylori eradication therapy and links it to treatment outcomes. Adults with confirmed H. pylori infection who start standard triple/quadruple therapy provide spot urine samples on Day 7 and Day 14. Using liquid chromatography–tandem mass spectrometry (LC-MS/MS), we detect antibiotics and PPIs to classify adherence objectively as full, partial, or non-adherent. Eradication is assessed 4–6 weeks after therapy via urea breath test or stool antigen testing.

Primary outcomes are (i) adherence rates and (ii) the relationship between adherence category and cure. Secondary outcomes include the extent and patterns of missed doses, regimen-specific adherence, and patient-reported drivers of non-adherence (e.g., side effects, pill burden, cost, access), collected through a brief questionnaire. Analyses will estimate the effect of adherence on eradication while adjusting for key covariates (age, sex, regimen, prior antibiotic exposure, and baseline test modality).

By replacing self-report with objective drug detection, TRUST provides an actionable picture of how adherence influences first-pass cure and informs targeted adherence support and antibiotic-stewardship strategies. Enrollment is ongoing; we welcome collaboration on recruitment, LC-MS/MS method development, data analysis, and implementation science to scale this approach across clinics and health systems.

We are conducting the first prospective study in the Middle East and North Africa to evaluate an Arabic translation and cultural adaptation of the Group Health Association of America nine-item patient satisfaction questionnaire (GHAA-9) for gastrointestinal endoscopy. The target sample is 500 consecutive adult patients undergoing upper or lower endoscopy; 100 participants have been enrolled to date. Primary outcomes include internal consistency (Cronbach’s alpha), test–retest reliability, construct validity against global satisfaction ratings, and known-groups validity by procedure type and sedation. Secondary analyses will identify key drivers of satisfaction—such as waiting times, clarity of explanations, staff and physician manner, and procedural comfort—to guide quality improvement. This work aims to establish a validated Arabic tool for routine monitoring of patient experience and to inform targeted enhancements to endoscopy services across the region.

Pyoderma gangrenosum (PG) is a complex inflammatory skin condition, often associated with inflammatory bowel disease (IBD) and rheumatoid arthritis, and requires early detection and comprehensive management, particularly as it can be an early symptom of IBD. While corticosteroids remain a cornerstone of therapy, their variable success rates necessitate additional agents such as cyclosporine, tacrolimus, and especially tumour necrosis factor-α inhibitors like infliximab and adalimumab, with the latter achieving response rates of up to 87%. Beyond pharmacological treatment, management of PG demands a holistic approach, including meticulous wound care tailored to the inflammatory state, treatment of underlying conditions such as IBD, and a collaborative multidisciplinary strategy to optimize patient outcomes.

We present a case of a 41-year-old woman who visited the emergency department (ED) with acute abdomen. She was diagnosed with perforated appendicitis and abscess formation on CT. She was treated conservatively with antibiotics and discharged. On control CT 3 months later, the appendix had healed, but signs of thickening of the terminal ileum were noticed and colonoscopy was performed, which was uneventful and showed no signs of inflammation. Twelve hours later, she developed pain in the right lower quadrant, followed by fever, and visited the ED. Physical examination and blood work showed signs consistent with acute appendicitis, and appendectomy was performed laparoscopically 6 hours later. The patient recovered remarkably shortly afterwards. Whether colonoscopy resulted in de novo appendicitis or exacerbated an already existing inflammation remains unknown. However, endoscopists should be aware of this rare, yet serious complication and consider it in the workup of post-colonoscopy abdominal pain.