Objective: We noticed a change in the pattern of presentation of trauma cases at SQUH, before the pandemic and during the two waves. Our study aimed at studying this observation. Methods: This retrospective study was from January 2019 to October 2021. Data of all trauma patients was collected from the hospital information system after ethics committee approval. The pattern of trauma was divided into pediatric, adult, and geriatric age groups. Location of trauma was described as outdoor, home and roads along with the details of mechanism of trauma was collected. Patients with incomplete data were excluded. Results: Based on the inclusion criteria 589 records were analyzed. The mean age of presentation was 29 years. Majority were male (71%). Adults were (54.2%), pediatrics (34%) and geriatric (11.9%). There was a gradual increase in percentage of pediatric trauma during pre-COVID, COVID wave 1 and COVID wave 2 (29%, 32%, 51%), respectively. A significant decline in the number of geriatric trauma by almost 50% between pre-covid and covid phase II. Increase in trauma at home during COVID phase II (65.9%) as was an increase in penetrating trauma during COVID phase II (16.5%). ICU admissions increased during the first wave of the pandemic (10.5%). Conclusion:  We noted a true change in the pattern of trauma cases before and during the COVID -19 pandemic. Observations made could lead to better safety guidelines for the pediatric age groups and take steps to reduce penetrating trauma. Keywords: Trauma, coronavirus, COVID-19, Oman, Muscat, Epidemiology.

Background: Refractory peptic ulcers are ulcers in the stomach or duodenum that do not heal after eight to twelve weeks of medical/surgical treatment or those that are associated with complications despite medical tssreatment. We herein present a case of a 44 year old man with a recurrent perforated duodenal ulcer requiring emergent surgical intervention.

Objectives: The Anatomical Subunit Technique for unilateral cleft lip repair has gained popularity worldwide. The purpose of this study is to report our experience using this technique. Methods: 114 consecutive cases of cleft lip underwent primary cleft lip repair with closed rhinoplasty by a single surgeon from 2015 to 2020. In addition to the demographic data, severity and type of the cleft lip, the surgical outcomes, including vermillion notching, were assessed by an independent senior surgeon and rate of revision surgery were collected from Al-shifa plus 3 health electronic system. Parents’ satisfaction regarding scar quality, lip and nose aesthetic appearance was collected anonymously. The documented data were evaluated using statistical analysis. Results: 82 cases satisfied the inclusion criteria. The mean age at surgery for cleft lip was 32 weeks. 35 cases (43%) were complete cleft lips and 47 cases (57%) were incomplete. 43 children (52%) were born of consanguineous marriage. Six patients (7%) needed revision surgery. The digital survey was completed by 40 subjects and showed 85% satisfaction rate with the postoperative scar, 77.5% satisfaction with the aesthetic appearance of nose. Conclusion: In our hands, the anatomical subunit technique resulted in a predictable result with high patient’s satisfaction rate as related to scar quality, nasal and lip symmetry in children with varying severity of cleft lip. Revision for vermilion excess was needed in 7 % of cases. The high percentage of consanguinity (52%) in our study highlight the need for more targeted national campaigns involving premarital counselling in the Omani population. Keywords: Cleft Lips, cheiloplasty, Oman, Surgical Technique, Millard Technique, Fisher, Consanguinity.