Hypermagnesemia is a relatively uncommon but potentially life-threatening electrolyte disturbance characterized by elevated magnesium concentrations in the blood. Magnesium is a crucial mineral involved in various physiological functions, such as neuromuscular conduction, cardiac excitability, vasomotor tone, insulin metabolism, and muscular contraction. Hypomagnesemia is a prevalent electrolyte disturbance that can lead to several neuromuscular, cardiac, or nervous system disorders. Hypermagnesemia has been associated with adverse clinical outcomes, particularly in hospitalized patients. Prompt identification and management of hypermagnesemia are crucial to prevent complications, such as respiratory and cardiovascular negative outcomes, neuromuscular dysfunction, and coma. Preventing hypermagnesemia is crucial, particularly in high-risk populations, such as patients with impaired renal function or those receiving magnesium-containing medications or supplements. Clinical management of hypermagnesemia involves discontinuing magnesium-containing therapies, intravenous fluid therapy, or dialysis in severe cases. Furthermore, healthcare providers should monitor serum magnesium concentration in patients at risk of hypermagnesemia and promptly intervene if the concentration exceeds the normal range.

The global shortage of healthcare professionals is a critical concern, with an estimated deficit of 18 million workers by 2030, particularly in low- and middle-income countries. Oman faces challenges with its doctor-to-population ratio falling below the global average. This study examines the factors influencing residency program choices among Omani medical students and interns, with a specific focus on internal medicine. A cross-sectional survey using a validated, context-specific questionnaire was distributed to medical interns and clinical clerkship students at Sultan Qaboos University and the National University.Descriptive statistics and univariate analyses were used to explore demographic patterns and factors influencing specialty choices, including internal medicine. Out of 803 distributed surveys, 459 responses were collected, yielding a response rate of 58.8%. The study comprised 459 participants, with 26.1% males and 73.9% females, and an average age of 23.85 years (SD = 1.70). Internal medicine was selected by 19.9% of participants. Key factors influencing the choice of internal medicine included societal respect and a comfortable specialty department atmosphere. Gender differences showed that men prioritized factors such as aptitude for the specialty, attainable lifestyle, and risk of malpractice lawsuits, while women focused on the workplace environment. Role models played an important role in career decisions, with 25.7% of participants identifying a physician role model. Internal medicine emerged as a popular specialty among Omani medical students and interns, driven by intellectual stimulation, job security, and work-life balance. Addressing gender-specific influences and expanding mentorship opportunities are essential to optimizing career guidance. The findings also emphasize the need for targeted strategies to address rural healthcare professional shortages. Not applicable.

Pulmonary vein thrombosis (PVT) is an uncommon but potentially fatal condition often misdiagnosed due to nonspecific symptoms such as cough, hemoptysis, and dyspnea. The true prevalence of PVT is difficult to determine and is mainly derived from case reports, influenced by the lung’s robust venous collateral network. Specific clinical situations, including post-lobectomy, lung transplantation, and metastatic cancer, can precipitate PVT. Accurate and prompt diagnosis, requiring a high index of suspicion and advanced imaging techniques like computed tomography, magnetic resonance imaging, and echocardiography, is crucial to prevent severe complications such as peripheral embolization and acute stroke. Risk factors include surgical procedures, cancers, and potentially atrial fibrillation, with a high post-surgical thrombosis risk, especially after left upper lobectomy. Management must be tailored to the underlying pathology and can include antibiotics, anticoagulation, thrombectomy, and lung resection. This review underscores the need for increased clinical awareness and comprehensive diagnostic approaches to mitigate the severe consequences of PVT.

Mephedrone is a synthetic cathinone with sympathomimetic effects, but has not previously been linked to pulmonary arterial hypertension (PAH). We report a 42‐year‐old woman with no prior cardiopulmonary disease who presented with severe pre‐capillary PAH after a decade of near‐daily mephedrone use. Extensive evaluation—including autoimmune, infectious, genetic, and imaging studies—excluded recognised causes of PAH. Following cessation of mephedrone and initiation of dual oral PAH‐targeted therapy, she demonstrated substantial initial clinical and haemodynamic improvement; however, the response remained incomplete, necessitating further treatment escalation with selexipag. This appears to be the first reported case of PAH linked to mephedrone use.

Ameboma refers to the rare development of an inflammatory, ulcerated, exophytic mass in the gastrointestinal tract that can resemble carcinoma. Typically it presents as a right lower quadrant abdominal mass, Patients may also present with diarrhea or constipation and associated systemic symptoms, including weight loss and fever. In this article we present a young man with a background of ANCA associated vasculitis, who presented with fresh lower gastrointestinal bleeding during hospital admission for severe covid-19 pneumonia which turned out to be caecal aemboma. This case is highlighted for its rarity, the diagnostic challenge, and for the major role of colonoscopy as a diagnostic tool for this pathology.