Knowledge and attitude toward eye disorders in children among pediatricians and family physicians: a survey study.

BACKGROUND: Vision-related disorders are common in children. Therefore, eye examination and thorough visual assessment by first-contact physicians are crucial in children. This study aimed to evaluate the knowledge of and attitude toward children's eye disorders among pediatricians and family physicians in the Ministry of National Guard Health Affairs-Western Region (MNGHA-WR) of Saudi Arabia. METHODS: In this observational, cross-sectional study, we used a self-administered, web-based questionnaire. The sample size was calculated to be 148 pediatricians and family physicians (of 240 in total) currently working at MNGHA-WR. The first section of the questionnaire dwelled on demographics, while the second section addressed the physician's knowledge of and attitude toward commonly encountered ophthalmological pathologies in children. Data collected were entered into Microsoft Excel and then transferred to IBM SPSS version 22 for statistical analysis. RESULTS: A total of 148 responses (92 family physicians and 56 pediatricians) were received. Most of the participants were residents or staff physicians (n = 105, 70.9%). The mean knowledge score of the respondents was 54.67% ± 14.5%. Participants' knowledge was further subclassified using Bloom's original cutoff points into high (n = 4, 2.7%), moderate (n = 53, 35.8%), and low (n = 91, 61.5%) levels of knowledge. Regarding practices, 120 (81%) participants performed ophthalmic examinations; however, only 39 (26.4%) conducted routine examinations as part of every child's visit. Fundus examinations were performed by 25 (16.9%) physicians. A significant deficiency in knowledge was noted in those with < 1 year of work experience (P = 0.014). Although statistically not significant (P = 0.052), family physicians possessed better knowledge than pediatricians regarding children's eye disorders. On the contrary, more pediatricians performed eye examinations than family physicians (P = 0.015). The male sex was also associated with higher rates of eye examination (P = 0.033). CONCLUSION: An unsatisfactory level of knowledge of eye disease among participating doctors was reported. The proportion was significantly higher among residents and staff physicians. Therefore, awareness efforts should be incorporated in both family medicine and pediatrics residency programs to limit the number of cases of ocular disorders going undiagnosed in children.

Implant Placement With Graftless Sinus Floor Elevation via the Lateral Approach: A Case Series With 4 Years Post-Loading Radiographical Outcomes and Implant Survival Rate.

ABSTRACT: The purpose of the present study was to evaluate the radiographical outcomes, survival rate, and amount of bone formation around implants placed during graftless lateral sinus lift approach (GLSLA). Five patients (6 sinus augmentations) were consecutively treated with GLSLA. After Schneiderian membrane elevation and implant insertion, only blood clot was left to fill the new sinus compartment. After 4 months of healing, implants were functionally loaded. in all cases, samples were taken for biopsy at the time of second-stage surgery. The radiographical marginal bone variations and apical bone gain were assessed using cone beam- computed tomography taken 4 months after the surgery (at crown insertion) and after 4 years of loading. A total of 14 implants were placed in a mean initial residual bone height of 3.1 mm (range 1.64 mm). No failure was recorded, and all the implants were successfully loaded yielding a 100% survival rate. Vital bone formation was 33% according to the histomorphometry data. Four years after loading the mean radiographic bone remodeling was 1.3 mm. The mean ridge height was 7.6 mm and the mean apical bone gain amounted for 3.8mm. Within the limitations of this study, the placement of dental implants in conjunction with GLSLA seems to be feasible and accompanied by high implant survival rate.

Effect of Primary Stability and Soft- and Hard-Tissue Thickness on Marginal Bone Loss: A Prospective Pilot Study.

OBJECTIVE: To compare prospectively the effect of different insertion torques (ITs) on marginal bone stability and study the effect of soft-tissue and buccal bone thickness as confounding factors while using a 3-dimensional radiographic evaluation. MATERIALS AND METHODS: Thirty-nine implants were placed in 22 patients. IT, soft-tissue thickness, and buccal bone thickness were recorded at implant placement. Marginal bone loss was evaluated on individualized periapical radiographs and cone-beam computed tomography at 1 year after loading. RESULTS: Three groups of implants emerged based on their IT: group I (<30 Ncm), group II (between 30-45 Ncm), and group III (>45 Ncm). Soft-tissue thickness was ≤2 mm in 10 implants (25.6% thin biotype) and more than 2 mm in 29 implants (74.4% thick biotype). No significant difference in marginal bone loss was found for different IT and different soft-tissue thickness. A significant correlation was found between initial buccal bone thickness (≥2 mm or <2 mm) and marginal bone loss at 1 year. CONCLUSIONS: IT and mucosal tissue thickness did not influence marginal bone loss. Buccal bone thickness of ≥2 mm was associated with a minimal marginal bone remodeling.

Standard Drilling Versus Ultrasonic Implant Site Preparation: A Clinical Study at 4 Weeks After Insertion of Conical Implants.

OBJECTIVE: Clinically evaluate implants placed after ultrasonic implant site preparation (UISP) and standard drilling (SD). MATERIALS AND METHODS: Ten patients received 21 implants placed using UISP (n = 11) or SD (n = 10). Bone quality was hand assessed and final insertion torque (IT), resonance frequency analysis (ISQ) at baseline and ISQ, and removal torque values (RTV) at 4 weeks were recorded and compared. RESULTS: Mean IT values were 70.91 and 72.40 N/cm in UISP and SD groups, respectively, and were not statistically different. IT significantly correlated to bone quality. Mean ISQ values at baseline and 4 weeks were not significantly different and were 74.72 and 74.73 for UISP and 76.70 and 73.20 for SD, respectively. Mean ISQ at baseline significantly correlated to IT values and bone quality in both groups. Mean RTV values in both UISP (51.32 N/cm) and SD (53.1 N/cm) were not significantly different but significantly correlated to IT values. All implants achieved osseointegration and were restored. CONCLUSION: Implant placement after ultrasonic preparation can be considered a predictable technique leading to clinical and biological responses similar to SD 4 weeks after insertion.

Buccal Bone Thickness Overlying Maxillary Anterior Teeth: A Clinical and Radiographic Prospective Human Study.

OBJECTIVES: The aim of this work was to measure the facial bone thickness overlying maxillary anterior teeth according to the periodontal biotype, the tooth position, and the bucco-palatal inclination of the tooth. MATERIALS AND METHODS: CBCTs of 47 patients were included. The periodontal biotype and the bucco-palatal inclination were examined for all maxillary anterior teeth as well as the sagittal tooth position according to the classification of Kan et al. Buccal bone thickness was measured at 4, 6, 8, and 10 mm apical to the cement-enamel junction (CEJ). RESULTS: At 4 mm from the CEJ, mean buccal bone thickness was 1.0 mm for all teeth and it decreased gradually and significantly in apical direction (6, 8, and 10 mm). A thin biotype was associated with a labial plate thickness half that of a thick biotype at all 4 distances from the CEJ. Class IV of Kan et al classification presented the thinnest facial bone (0.32-0.54 mm), whereas Class III demonstrated the thickest one (1.26-2.09 mm) at all distances from the CEJ. At 10 mm from the CEJ, the facial bone thickness increased with the vestibulo-palatal inclination of the tooth. CONCLUSION: A thin facial bone wall overlies almost all maxillary anterior teeth.

Effect of Intraoral Aging on Debris Accumulation and Friction of First Molar Tubes.

AIM: The aim of this article was to evaluate the impact of intraoral aging and site specificity on debris accumulation and friction in molar tubes after intraoral use. MATERIALS AND METHODS: A total of 80 intraorally used first molar convertible tubes were provided by 20 orthodontic adolescent patients after 6 months of treatment. The specimens were divided into eight groups (n = 10) according to the mouth quadrant and the type of examination [four groups of ten tubes for scanning electron microscope (SEM) and four groups of ten tubes for friction test]. Scanning electron microscope examination was performed after opening the convertible caps and friction test was executed using a 0.019'' × 0.025'' stainless steel wire, which was inserted in the tubes belonging to each group. The Mann-Whitney test, analysis of variance (ANOVA), and Bonferroni tests were performed for statistical analysis at 0.01 level of significance. RESULTS: There was a significant increase in the amount of debris and frictional force after 6 months of intraoral exposure (p < 0.0001). Debris scores were higher (10% increase) on the upper tubes when compared with the lower ones, with no statistical difference. Mean frictional force ranged from 0.22 to 0.26 N according to the mouth quadrant, but the difference between groups was also not significant. CONCLUSION: After 6 months of intraoral exposure, there was a significant increase in the amount of debris in the first molar tube slots, leading to significantly higher frictional forces during sliding mechanics. The influence of site specificity on the amount of debris and on frictional forces of the first molar tubes could not be demonstrated. CLINICAL SIGNIFICANCE: Molar tubes should be cleaned, before and during sliding mechanics, in order to minimize friction.

Resonance frequency analysis, insertion torque, and bone to implant contact of 4 implant surfaces: comparison and correlation study in sheep.

INTRODUCTION: Primary stability is evaluated using resonance frequency analysis (RFA) and insertion torque (IT). Although there is a strong correlation between RFA and IT, studies failed to find a correlation between RFA and bone to implant contact (BIC) or IT and BIC. OBJECTIVE: To compare RFA, IT, and BIC of SLA, SLActive, Euroteknika, and TiUnite implant surfaces and evaluate the correlation between them. MATERIALS AND METHODS: Thirty-two implants were placed in 8 sheep. RFA and IT were recorded. Animals were killed at 1 and 2 months. RESULTS: A significant difference was found in RFA between the 4 surfaces. No significant difference was found for IT. Mean BIC was different between all 4 surfaces. A significant positive correlation was found between RFA and IT with SLA. No significant correlation was found between RFA and BIC and between IT and BIC at 1 and 2 months. CONCLUSIONS: Implants with 4 different surfaces have similar IT values but different RFA and BIC. Additionally irrespective of the implant surface, there is no correlation between IT and BIC and between RFA and BIC.

Clinical, histological, and histomorphometrical analysis of maxillary sinus augmentation using inorganic bovine in humans: preliminary results.

The aim of the present study was to evaluate bone formation after maxillary sinus augmentation using bovine bone substitute material Bio-Oss alone by means of clinical, histological, and histomorphometrical examination of human biopsies. Deproteinized bovine bone (DPBB, Bio-Oss) was used to fill cavities after elevation of the sinus mucosa following major sinus pneumatization. Twenty patients with edentulous posterior maxillae were treated with 20 sinus augmentation procedures using a 2-stage technique. Residual lateral maxillary bone height was less than 3 mm. Forty-nine Straumann endosseous implants were used to complete the implant-prosthetic rehabilitation. Forty cylinder-shaped bone biopsies were taken from the augmented maxillary region 8 months after grafting during the second-stage surgery before implant placement. All implants were loaded 3 months after insertion, and no failures were recorded. Histomorphometrical analysis showed an average percentage of newly formed bone of 17.6% (± 2.8%) and a proportion of residual bone substitute material of 29.9% (± 4.9%) of the total biopsy area. Intimate contact between newly formed bone and Bio-Oss was detected along 28.2% (± 6.8%) of the particle surfaces. The results also showed that in all cases, the DPBB granules had been interconnected by bridges of vital newly formed bone. Inorganic bovine bone appears to be biocompatible and osteoconductive, and it can be used with success as a bone substitute in maxillary sinus augmentation procedures.

Influence of Crestal Implant Position and a Smooth Collar on Marginal Bone Level: A 2-Year Retrospective Radiographic Analysis.

This retrospective study evaluated the survival rate and the clinical outcome of an endosseous implant system, as well as the marginal bone level (MBL) and the impact of the machined collar neck position on crestal bone level changes up to 2 years later. A total of 96 implants were placed in 57 patients and loaded with a final restoration after at least 3 months of healing: 15 implants were immediately placed into fresh extraction sockets, and 81 were placed in healed ridges. Marginal bone loss around implants was determined radiographically at 12 to 24 months postloading. The effects on marginal bone loss of the site (mandible vs maxilla), location (anterior vs posterior), immediate vs delayed implant, smoking habit, sex, implant length and diameter, prosthesis type (screw-retained/cemented), and the machined collar position were evaluated. The implant survival rate was 98.96% at 1 year. The mean MBL decreased significantly (0.238 mm) between baseline and loading (P < .001; post hoc test) and decreased by 0.154 mm between loading and 1 year, but this was not significant (P = .085; post hoc tests). After 2 years, the mean MBL decreased significantly (0.263 mm) between baseline and loading (P < .001) and decreased by 0.111 mm between loading and 1 year and by 0.199 mm between loading and 2 years, but these were not significant (P > .05; post hoc tests). The mean bone loss after 1 and 2 years was not significantly associated with implant type or site, smoking habit, or type of implant surgery (P = .792). However, the mean bone loss was significantly associated with the type of prosthesis and was significantly greater for cemented prostheses compared to screw-retained prostheses. A supracrestal position of the machined collar (tissue level) was associated with no bone loss, while placing the collar below the alveolar crest led to bone loss over 2 years. Of the factors evaluated, marginal bone loss after 1 and 2 years was significantly associated with prosthesis type and the machined collar position.

Automated pupillometry in space neuroscience.

Modern pupillometers are automated, thereby providing an objective, accurate, and reliable evaluation of various aspects of the pupillary light reflex at precision levels that were previously unobtainable. There are many gaps in knowledge regarding pupil size and pupillary light reflex in nervous system changes related to space travel given the previous lack of a precise method to quantitatively measure it. Automated pupillometry has not been used previously in space. This novel tool has promising uses in altered gravity environments as a sensitive non-invasive tool to determine alterations due to headward fluid shifts and elevated intracranial pressure. This article discusses the potential use of automated pupillometry in space for monitoring of astronaut health and neurological pathology.

A Giant Eyelid Molluscum Contagiosum Revealing an HIV Infection: A Case Report and Literature Review.

Molluscum contagiosum (MC) is a common benign cutaneous viral infection. It can affect any part of the skin with a high propensity for facial skin, especially in human immunodeficiency virus (HIV) patients with low CD4 count. We report a case of a 16-year-old female patient who presented with a giant isolated right upper eyelid MC lesion that served as the first clinical indicator of her HIV infection and acquired immunodeficiency syndrome (AIDS). A final diagnosis of MC was made based on the history, clinical findings, and histopathological examination. Moreover, due to its vital location, large size, and atypical presentation, a surgical excision by simple unroofing and curettage was performed under local anesthesia to speed recovery, prevent corneal complications, and reduce transmission. Her follow-up visits showed satisfactory clinical and cosmetic outcomes. Patients presenting with giant atypical eyelid lesions must be thoroughly investigated for immunosuppressive states, especially HIV infection. MC can have atypical presentations in HIV patients. To our knowledge, this is one of a few cases in the literature reporting a giant isolated eyelid MC lesion leading to a diagnosis of HIV infection with AIDS.

Comparison of the OHIP-14 and GOHAI as measures of oral health among elderly in Lebanon.

BACKGROUND: The respective abilities of the GOHAI and OHIP-14 to discriminate between aged patients with different levels of oral diseases have rarely been studied in developing countries. The aim of this study was to compare the discriminative abilities of the OHIP-14 and the GOHAI in an elderly Lebanese population, and particularly to identify persons with different masticatory function. METHODS: A sample of elderly, aged 65 years or more, living independently was recruited in two primary care offices in Beirut, Lebanon. Data were collected by means of personal interview and clinical examination. The Arabic OHIP-14 and GOHAI questionnaires were used after cultural adaptation for use in Lebanon. The internal consistency, reproducibility and concurrent validity were verified. To test their discriminative abilities, the ADD (GOHAI and OHIP) and SC (GOHAI and OHIP) scores were dichotomized according to the 25th and 75th percentile respectively and logistic regressions were conducted using socio-demographic, clinical and subjective explanatory variables. RESULTS: Two hundred and six participants were included; mean age was 72 years and 60% were women. Good psychometric properties were observed for both questionnaires for internal consistency (Cronbach's alpha>0.88), reproducibility (ICC>0.86) and concurrent validity. Strong correlations were found between GOHAI and OHIP-14 scores but a high prevalence of subjects with no impact was observed using the OHIP-14. Both questionnaires were able to discriminate between participants according to age, perception of temporomandibular joint (TMJ) pain or functional status as represented by the number of dental Functional Units (FU). GOHAI was more discriminant since it identified participants with high dental care needs: high numbers of decayed teeth, low numbers of teeth and socially deprived status. CONCLUSIONS: Lebanese elderly with high dental care needs and impaired oral health were identified more easily with the GOHAI. These results may guide the choice of dental indicators to use in a national geriatric survey.

Implant primary stability determined by resonance frequency analysis: correlation with insertion torque, histologic bone volume, and torsional stability at 6 weeks.

OBJECTIVE: To determine if resonance frequency analysis (RFA) correlated with insertion torque (IT), bone volume (BV), and clinical osseointegration at 6 weeks. MATERIALS AND METHODS: For 18 patients, BV was evaluated histologically by retrieving bone core biopsies before placement of 40 dental implants. Peak IT was recorded at implant placement, and RFA values (implant stability quotient [ISQ]) were noted at baseline, 3 weeks, and 6 weeks. Osseointegration was evaluated at 6 weeks when torquing abutments to 30 N. ISQ values were correlated with IT, BV and abutment torquing results. Data were statistically analyzed. RESULTS: ISQ values significantly decreased at 3 weeks and increased at 6 weeks. There was a significant positive correlation between BV and ISQ at baseline and at 3 weeks, but not at 6 weeks, and between ISQ and jaw location, implant diameter and IT at baseline, 3 weeks, and 6 weeks. There was a significant correlation between spinning/painful implants during abutment torquing and low ISQ, low BV, and low IT values. CONCLUSION: Correlations between BV and IT values, and ISQ suggest that RFA may indicate primary implant stability. BV, IT, and ISQ values may anticipate the degree of osseointegration at 6 weeks.

A Case Report of Rickets Due to Severe Nutritional Deficiencies.

A 19-month-old boy presented to the general pediatric clinic with delayed development and multiple nutritional deficiencies, after being exclusively breastfed up to the age of nine months without vitamin D supplementation. Upon examination, imaging studies, and lab tests, the patient was diagnosed with nutritional rickets. The management included supplementation of cholecalciferol, ferrous sulfate, calcium carbonate, and multivitamin drops to support his diet, and was encouraged to follow a healthy balanced diet. Upon follow-up at the age of 20 months, the patient showed slight improvement and was able to walk, while at 22 months, the patient was developmentally up to age, and had a good appetite with a slight increase in weight. Despite the high incidence of nutritional deficiencies, there is still a lack of awareness and late presentations of such cases, which can lead to complications if not detected early. This case demonstrates the importance of prevention of similar cases by early education about adequate nutrition to the patients and caregivers and regular follow-ups with the general practitioner for early detection and early supplementation as required.

Marginal Bone Level and Bone Thickness Reduction in Delayed and Immediate Implant Placement Protocol 6 Months Post-loading: An Observational Clinical Prospective Study.

Objectives: The aim of this prospective study was to assess marginal bone level (MBL), buccal and palatal bone thickness reduction (BTR) around implants in delayed and immediate placement protocols, 6 months after loading. Materials and Methods: Twenty-four patients were assigned to two treatment groups, and treated with an immediate (Test) or delayed implant placement (Control). Baseline and 6 months post-loading periapical and Cone Beam Computed Tomography radiographs were used to measure mesial, distal, buccal, and palatal MBL change, and buccal and palatal BTR. Results: There was no statistically significant difference between groups, in MBL change, mesially (p = 0.4220), distally (p = 0.774), buccally (p = 0.221), and palatally (p = 0.195). There was more MBL change on the buccal side than on the palatal side in both groups, control (p = 0.012) and test (p = 0.005). Buccal bone thickness decreased significantly in both groups, and at all four levels (p < 0.05). Buccal BTR was higher in test implants at 0, 2, and 4 mm (p = 0.005, p = 0.0018, p = 0.006) on the buccal side, and at 0 mm (p = 0.006) on the palatal side. Implant stability increased in both groups (p < 0.001). A positive correlation was found between insertion torque and stability in the control group (p = 0.024). Conclusions: Within the study limitations, MBL changes occur around implants and are comparable between groups. More buccal than palatal MBL change occurs in both groups. Buccal BTR is higher in immediate cases. Implant stability augmented in both groups. Clinical Relevance: This data call for additive therapy to compensate for the expected bone loss, particularly in esthetically demanding cases. Trial Registration: ClinicalTrials.gov Identifier: NCT04346706 Registered 14 April 2020 - Retrospectively registered, http://www.clinicalTrials.gov.

Bilateral Papilledema and Right Esotropia as an Initial Presentation of Acute Myeloid Leukemia in a Young Girl.

Leukemia is a malignant hematologic neoplastic disease in which acquired mutations and genetic abnormalities in early hematopoietic precursors cause rapid proliferation of white blood cells (WBC). Acute myeloid leukemia (AML), a subtype of leukemia, is a rare form of cancer that typically manifests in adulthood. Symptoms typically arise due to abnormal proliferation of WBC. Ocular manifestations of such malignancies are rare and they occur more commonly in acute lymphoblastic leukemia (ALL) rather than AML. Furthermore, ophthalmic involvement usually is either a sign of central nervous system involvement or disease relapse. In this article, we report the case of a 14-year-old girl who presented initially with double vision and right eye squint. The patient was later diagnosed with AML with leptomeningeal involvement.

Compliance with contact lens care and factors driving noncompliance in health-care students in Jeddah, Saudi Arabia.

PURPOSE: This study aimed to assess compliance to contact lens care behaviors and determine common factors influencing noncompliance among a population of university students in Jeddah, Saudi Arabia. METHODS: This is an observational, cross-sectional study in which a previously validated self-administered questionnaire consisting of 12 questions addressing compliance to contact lens wear and care was E-mailed through the university message center. RESULTS: A total of 388 participants completed the questionnaire. Of those who completed the survey, 150 were contact lens users with an experience of 1 month or more. The average compliance rate to contact lens care was around 66%. High levels of compliance were reported in sharing contact lenses, sleeping with contact lenses, showering/swimming with contact lenses, and using water to clean contact lenses. Moderate levels of compliance were shown in overuse of contact lenses, adherence to instructions of lens cleaning, cleaning the lens case, and adherence to aftercare visits. The lowest levels of compliance were noted in washing hands before lens use and lens case replacement. Gender, smoking, contact lens experience, type and modality of contact lens usage, and contact lens purchase site were found to have a significant association with behaviors showing poor compliance. Believing there is no harm in wearing lenses for longer than the recommended replacement schedule was the primary reason given for overusing contact lenses. CONCLUSION: Moderate levels of compliance were generally reported by respondents, necessitating the need for better strategies to reinforce the importance of compliance to contact lens care in the Saudi population.

Inherited connective tissue diseases highlight macromolecular network interdependences in skin extracellular matrix: a histomorphometric study.

Mutation of just a single extracellular matrix protein, a receptor or enzyme involved in connective tissue metabolism is sufficient to cause systemic pathologies and failure of tissues that are subjected to strong mechanical stresses. Skin histological and computerized image analyses can provide a good qualitative and quantitative indication of these inherited connective tissue diseases. In this study, skin biopsies from young (10 to 25 years) and middle-aged patients (26 to 50 years) suffering from Ehlers-Danlos syndromes (EDS), Marfan syndrome (MS) or pseudoxanthoma elasticum (PXE) were studied after specific staining of both the collagen and elastic networks. Findings from the histomorphometric analyses conducted on skin sections of the patients with EDS, MS and PXE were compared to skin sections of healthy subjects from the same age groups. Our results show that both the collagen and the elastic networks were affected in all the studied pathological cases, but that the adverse changes to the elastic network in older patients were distinct from the physiological changes observed during aging process for healthy subjects. This degenerative process may be explained by an added phenomenon involving a general connective tissue proteolysis.

A Novel Mutation in the NAGLU (N-Acetyl-Alpha-Glucosaminidase) Gene Associated With Mucopolysaccharidosis Type III-B in a Saudi Girl.

Mucopolysaccharidosis type III-B (MPS III), also known as Sanfilippo syndrome, is a rare autosomal recessive lysosomal storage disease that primarily affects the brain and spinal cord. In this report, we describe the case of an eight-year-old female child who presented to the emergency room with an asthma exacerbation. She had coarse facial features, thick eyebrows, deep-seated eyes, thinning coarse hair, and macrocephaly. Moreover, she suffered from hepatosplenomegaly, generalized muscular atrophy, global developmental delay, and scoliosis. Urinary glycosaminoglycans (GAGs) were within normal limits. Full genetic testing confirmed the diagnosis of Sanfilippo syndrome type B with a deficiency of alpha-N-acetylglucosaminidase caused by a homozygous mutation c.889C>T, p.(Arg297*) in the NAGLU (N-acetyl-alpha-glucosaminidase) gene. Chromosomal microarray analysis (CMA) showed a copy number variant (CNV) within the 1q24 region. Thus far, CNVs similar in size and position have not been reported in the literature, making this a novel mutation.

Brain Metastases in Adults: A Five-Year Observational Study From King Abdulaziz Medical City.

Background As a well-documented fact, metastatic brain tumors are the most common cause of brain tumors in adults, with an incidence of 9-17%, based on various studies, although it was thought to be higher. The aim of this study was to describe recorded cases of metastatic brain tumors in the adult population of a tertiary care and oncology center in Jeddah, Saudi Arabia. Methods This study was conducted at King Abdulaziz Medical City (KAMC) at King Khalid Hospital in Jeddah, Saudi Arabia, including records from January 2016 to December 2020. The study implemented a retrospective cohort design to fulfill its aim. A data collection sheet containing demographic data such as age and gender, and information pertaining to the primary pathology, multiplicity, and survival outcome was used. Results A total number of 213 patients were enrolled in this study. Overall, 68.1% of the sample comprised of females. Approximately two-thirds (61.9%) of the patients' imaging results revealed multiplicity, whereas the remaining third (38.1%) had solitary lesions. The estimated overall survival median after the diagnosis of brain metastasis was six months (95% CI: 5.5-6.5). Conclusion We recommend conducting a nationwide study to better understand the incidence in accordance to geographical and gender differences. We can further expand our research to include other institutes in Saudi Arabia, and include important predictors such as time from the diagnosis of primary pathology to brain metastasis, disease progression cost, and disease progression in the months prior to the patients' death.