Cytoreductive Surgery with Bidirectional Intraoperative Chemotherapy (BDIC) Using Intravenous Ifosfamide Plus Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in Patients with Peritoneal Sarcomatosis: A Retrospective Cohort Study.

BACKGROUND: Peritoneal sarcomatosis (PS) is a rare tumor with limited therapeutic options. Bidirectional intraoperative chemotherapy (BDIC) using intravenous ifosfamide and doxorubicin-based hyperthermic intraperitoneal chemotherapy (HIPEC) after cytoreductive surgery (CRS) is an emerging treatment for peritoneal malignancies. PATIENTS AND METHODS: Patients with PS who underwent CRS/BDIC using intravenous ifosfamide and HIPEC from January 2017 to July 2021 were retrospectively analyzed. The last follow-up date was May 2022. RESULTS: A total of 29 patients were included. Overall survival (OS) rates at 6, 12, 24, and 48 months after CRS/BDIC were 93.1%, 89.2%, 81.4%, and 73.3%, respectively. As of May 2022, 6 patients (20.6%) had died, including four (13.8%) with a proven recurrent tumor and two with incomplete tumor resection [completeness of cytoreduction (CC)-2 or CC-3]. Of the 20 patients (68.9%) with CC-0 or CC-1, 7 had locoregional tumor recurrence without distant metastasis, whereas the other 13 were alive with no evidence of recurrent tumor in May 2022. Disease recurrence rates were 15% at 6 months and 35% at 12, 24, and 48 months after CRS/BDIC. Clavien-Dindo class ≥ IIIa complications developed in 9 patients (31.0%) with no deaths. Leukopenia occurred in 5 patients (17.2%) and thrombocytopenia in 12 patients (41.3%); these hematologic abnormalities resolved. A total of 9 (31.0%) patients developed nephrotoxicity; all recovered except one, who progressed to chronic kidney disease. CONCLUSIONS: CRS/BDIC using intravenous ifosfamide and doxorubicin-based HIPEC is a potentially effective treatment for PS and has an acceptable rate of complications.

Left Femur Neck Fracture and Left Eye Esotropia as Initial Clinical Presentations of Gastric Cancer in a 54-Year-Old Female Patient: A Case Report and Review of Literature.

Although the incidence of gastric cancer has decreased worldwide, it is still among the most common cancers worldwide. Usual manifestations of gastric cancer include gastrointestinal-related symptoms such as weight loss and abdominal pain. Isolated symptomatic bony metastasis at initial presentation is very rare. Here, we present an infrequent case of a middle-aged lady who presented with a left femur neck fracture and left eye esotropia as the initial presenting clinical manifestations of gastric cancer. She was found to have an isolated bone metastasis seen throughout the body skeleton with no extraosseous metastasis. The patient was treated conservatively and received external beam radiation therapy as part of palliative therapy. This report signifies the importance of considering the diagnosis of gastric cancer in middle-aged patients with isolated symptomatic bone metastasis. It also reviews the overall poor prognosis of such cases and recommends further studies on the role of chemotherapy and radiation therapy in such cases.

Do various personal hygiene habits protect us against influenza-like illness?

BACKGROUND: Several studies have reported an association between improvements in hand hygiene and the reductions in rates of intestinal parasitic diseases. However, only a some have addressed its link to the frequency of influenza-like illness. The current study aimed to find the correlation between personal hygiene habits and the frequency of influenza-like illness. METHODS: A cross-sectional study targeting 3000 participants conducted in Riyadh city, Saudi Arabia. A systematic random sampling methodology was applied for participant from different part of Riyadh city using a computer generating system. The researcher first started by calling each participant. A full explanation was given to each participant in details (from the purpose of the research, consent to answer the questionnaire, to the explanation of the outcome definition). Each point of the questionnaire was explained to them to make sure they had excellent comprehension, and therefore, respond accurately. Descriptive statistics and Odds Ratio and its 95% confidence intervals were used to determine the association between frequency of influenza-like illness and the studied variables. RESULTS: Two thousand eighty-two (69.4%) completed the questionnaire. The participants who spent 5-10 s in handwashing with soap and rubbing were at increased risk of more frequent influenza-like illness (odds ratio = 1.37, 1.08-1.75). Handwashing with soap and rubbing after handshaking is an independent protective habit against frequent influenza-like illness (adjusted OR = 0.59, 0.37-0.94). CONCLUSION: The decrease of the frequency of influenza-like illness could be done through the following: getting the influenza vaccine annually, washing hands with soap and hand rubbing not less than 15 s after getting out of the bathroom, before and after handshaking and before eating. Soap companies should invent soaps that take less rubbing time to kill bacteria, and subsequently may maximize compliance in the community.

Parental Knowledge, Attitudes and Practices Towards Paediatric Ear Infections in Riyadh, Saudi Arabia: A quantitative study.

OBJECTIVES: This study aimed to assess the knowledge, attitude and care-seeking practices of parents towards childhood ear infections in Riyadh, Saudi Arabia. METHODS: This quantitative cross-sectional study was conducted in Riyadh, Saudi Arabia, between April and June 2018. An online survey was sent to a random selection of parents who were ≥18 years old with children of ≤10 years old. Associations between parental knowledge, attitude, care-seeking practices, socioeconomic status, level of education and age were assessed using the chi square test and logistic regression analysis. RESULTS: A total of 782 subjects participated in this study (response rate: 78.2%). Most respondents were knowledgeable (76.2%), had a positive attitude (78.9%) and had positive care-seeking practices (89.5%). There was a statistically significant difference on both bivariate and multivariate analyses (P <0.05) between parental care seeking practice and knowledge. Parents who sought modern approaches to treatment were found to be almost nine times more likely to have a good attitude towards ear infections than those who did not seek treatment (odds ratio = 8.907, 95% confidence interval = 2.655-34.928; P <0.001). A statistically significant relationship was found between good care-seeking practice and age, as well as socioeconomic status (P <0.05 each). CONCLUSION: This study showed that knowledge, attitude and practice regarding paediatric ear infections were positive in the majority of parents in Riyadh, Saudi Arabia. Future studies should assess other factors that enhance the knowledge, attitude and practices regarding ear infections.

Public Awareness regarding Common Eye Diseases among Saudi Adults in Riyadh City: A Quantitative Study.

AIM: The current study aimed to evaluate the knowledge of eye disease and awareness of eye care among the Saudi adults and to explore existing eye-related misconceptions in the community. METHODS: A cross-sectional study was conducted in Riyadh city during May and June 2016. A self-administered anonymous online questionnaire was used to explore the most common misconceptions related to eye diseases and eye care. RESULTS: Out of 1000 individuals, only 711 (71.1%) participant responses were received. The participants' acceptable knowledge (score ≥50%) was high about the eye problem in diabetes (88.6%), ocular trauma (81.2%), and other general eye diseases (91.3%), whereas low about refractive errors (63%), pediatric eye problems (51.5%), and glaucoma (14.8%). The variation in knowledge about specific ocular morbidities was significant (p < 0.001). The majority of participants reported sources of information about the common eye diseases and eye care encountered from the community, internet-based resources, and social media. CONCLUSIONS: The majority of the participants had awareness about the common eye diseases, whereas low percentage of participant's awareness about specific condition of eye diseases. Public eye health awareness should be more focused on social media and the internet to be able to cover the younger individuals of the community.