A Measles Outbreak in Riyadh in 2023: Clinical and Epidemiological Characteristics.

Background Measles is a highly contagious viral disease that has recently made headlines due to outbreaks in several parts of the world. The disease can cause serious health complications, especially in young children, which has led to concerns about vaccination rates and public health policies. This study aims to investigate and describe the epidemiology, clinical characteristics, and outcomes of measles infection among children in Riyadh. Methodology We conducted a descriptive cross-sectional study among all pediatric patients with confirmed measles infection at a tertiary hospital from January 15, 2023, to March 15, 2023. We collected data including demographic characteristics, clinical presentations, and clinical outcomes. Results A total of 63 confirmed measles cases were reported. Most patients were under four years of age (82.7%), and 85.7% were unvaccinated. Adenovirus was the most common viral coinfection (12.7%). The most common complication was pneumonia (58.7%). Chest X-ray findings reported a localized right parenchymal infiltrate in 19% of patients and a patchy bilateral infiltrate in 15.9% of patients. In addition, 88.9% required hospital admission secondary to dehydration (47.6%) and hypoxia (41.3%). Among admitted patients, 17.5% were admitted to the pediatric intensive care unit (PICU), 9.5% were admitted due to respiratory failure, and 6.3% due to septic shock. Children under one year of age had a higher risk for PICU admission (p < 0.05). The mortality rate was 1.6%. Conclusions Measles is a serious disease that causes significant health effects and incurs high financial costs for public health systems. Vaccination remains the most effective way to prevent measles outbreaks and reduce their impact on individuals and communities.

State of well-being among residents in a tertiary center in Riyadh, Saudi Arabia.

BACKGROUND: Medical residency is a part of postgraduate medical education and involves clinical training in a selected specialty. It is a challenging step in a physician's professional development. This study aims to estimate the impact of the residency training program and demographic factors on the trainee's state of well-being (SOW). METHODS: This was an observational cross-sectional study carried out in the year 2019-2020, which aimed to measure the SOW of residents undergoing clinical training in Riyadh, Saudi Arabia. A total of 260 residents participated in the study. A self-administered validated online the World Health Organization, Quality of Life Scale questionnaire- BREF was distributed to collect the data. The collected information on four different domains was analysed and compared across the baseline characteristics and different specialties. When appropriate, the independent sample t-test, bivariate correlation analysis, and ANOVA tests were used. RESULTS: A total of 260 resident responses were included in the final analysis The results revealed a significant difference in physical health scores (p = 0.006), social relationship scores (p = 0.038), and environmental scores (p < 0.001) while no significant difference was found in psychological health scores among the physicians' specialties (p = 0.053). Post hoc comparison found statistically significant variations in the physical health domain between the medical and emergency specialties (p = 0.007), as well as surgical and emergency specialties (p = 0.024). There was also a significant difference between medical and emergency specialties (p = 0.008) in the social relationship domain. In the environment domain, significant variation was reported between medical specialties and emergency specialties (p = 0.001), as well asbetween surgical specialties and emergency specialties (p = 0.045). Female residents reported significantly lower quality of life in the physical (p = 0.020) and psychological (p = 0.032) domains. CONCLUSIONS: A significant relationship was found between physical, social, and environmental domains according to residents' specialties. The factors that affected one or more domains included age, female gender, marital status, disease status, the number of on-calls received, and workload. We emphasize the importance of implementing policies to regulate working hours and on-call schedules as well as prioritizing mental health support.

Isolated Perianal Endometrioma: A Case Report and Literature Review.

BACKGROUND Endometriosis, a common condition among women of reproductive age and infertile women, occurs when the endometrium extends outside the uterus. When this endometrial tissue grows and sheds, symptoms will develop. The presentation varies depending on the site involved; however, cyclical pain is among its most common symptoms, along with bleeding and cramping. It is frequently observed in the ovaries and fallopian tubes; in contrast, the anal canal is rarely involved. Here, we report a very unusual presentation of the disease. CASE REPORT A 33-year-old woman with a history of episiotomy presented to the Emergency Department reporting perianal swelling in the previous year. The swelling was associated with intermittent pain and difficulty passing stool. She reported no fever. On examination, there was a 3×4 cm palpable tender perianal mass extending to the anal sphincter at the 11 o'clock position. Bedside ultrasound revealed a mass. Magnetic resonance imaging showed a hemorrhagic 3×4 cm mass in the right perianal region pressing on and indenting the right aspect of the distal external sphincter. The mass was excised completely with local perianal incision over the mass at 11'o clock. Surgical pathology revealed an isolated endometrioma in the perianal area. CONCLUSIONS Isolated perianal endometrioma is a rare disease, with only 21 published cases. Its diagnosis is difficult to establish, and a wide range of tests is often needed. Laparoscopic or surgical intervention may be required in cases of rectal endometriosis for an accurate diagnosis. Careful history taking and examination along with a high index of suspicion are necessary to diagnose perianal endometrioma.