Formation of moiré interlayer excitons in space and time.

Moiré superlattices in atomically thin van der Waals heterostructures hold great promise for extended control of electronic and valleytronic lifetimes1-7, the confinement of excitons in artificial moiré lattices8-13 and the formation of exotic quantum phases14-18. Such moiré-induced emergent phenomena are particularly strong for interlayer excitons, where the hole and the electron are localized in different layers of the heterostructure19,20. To exploit the full potential of correlated moiré and exciton physics, a thorough understanding of the ultrafast interlayer exciton formation process and the real-space wavefunction confinement is indispensable. Here we show that femtosecond photoemission momentum microscopy provides quantitative access to these key properties of the moiré interlayer excitons. First, we elucidate that interlayer excitons are dominantly formed through femtosecond exciton-phonon scattering and subsequent charge transfer at the interlayer-hybridized Σ valleys. Second, we show that interlayer excitons exhibit a momentum fingerprint that is a direct hallmark of the superlattice moiré modification. Third, we reconstruct the wavefunction distribution of the electronic part of the exciton and compare the size with the real-space moiré superlattice. Our work provides direct access to interlayer exciton formation dynamics in space and time and reveals opportunities to study correlated moiré and exciton physics for the future realization of exotic quantum phases of matter.

Epidemiologic and clinical updates on viral infections in Saudi Arabia.

In the past two decades, the world has witnessed devastating pandemics affecting the global healthcare infrastructure and disrupting society and the economy worldwide. Among all pathogens, viruses play a critical role that is associated with outbreaks due to their wide range of species, involvement of animal hosts, easily transmitted to humans, and increased rates of infectivity. Viral disease outbreaks threaten public health globally due to the challenges associated with controlling and eradicating them. Implementing effective viral disease control programs starts with ongoing surveillance data collection and analyses to detect infectious disease trends and patterns, which is critical for maintaining public health. Viral disease control strategies include improved hygiene and sanitation facilities, eliminating arthropod vectors, vaccinations, and quarantine. The Saudi Ministry of Health (MOH) and the Public Health Authority (also known as Weqayah) in Saudi Arabia are responsible for public health surveillance to control and prevent infectious diseases. The notifiable viral diseases based on the Saudi MOH include hepatitis diseases, viral hemorrhagic fevers, respiratory viral diseases, exanthematous viral diseases, neurological viral diseases, and conjunctivitis. Monitoring trends and detecting changes in these viral diseases is essential to provide proper interventions, evaluate the established prevention programs, and develop better prevention strategies. Therefore, this review aims to highlight the epidemiological updates of the recently reported viral infections in Saudi Arabia and to provide insights into the recent clinical treatment and prevention strategies.

Electrolytes Play a Role in Detecting Cisplatin-Induced Kidney Complications and May Even Prevent Them-Retrospective Analysis.

Background and Objective: Cisplatin is a chemotherapy drug used to treat several types of malignancies. It is a platinum-based compound that interferes with cell division and DNA replication. Cisplatin has been associated with renal damage. This study evaluates the early detection of nephrotoxicity through routine laboratory tests. Materials and Methods: This is a retrospective chart review based on the Saudi Ministry of National Guard Hospital (MNGHA). We evaluated deferential laboratory tests for cancer patients treated with cisplatin between April 2015 and July 2019. The evaluation included age, sex, WBC, platelets, electrolytes, co-morbidities and interaction with radiology. Results: The review qualified 254 patients for evaluation. Around 29 patients (11.5%) had developed kidney function abnormality. These patients presented with abnormally low magnesium 9 (31%), potassium 6 (20.7%), sodium 19 (65.5%) and calcium 20 (69%). Interestingly, the whole sample size had abnormal electrolytes presenting magnesium 78 (30.8%), potassium 30 (11.9%), sodium 147 (58.1%) and calcium 106 (41.9%). Some pathological features were detected, such as hypomagnesemia, hypocalcemia and hypokalemia. In addition, infections that needed antibiotics were dominant in patients treated with cisplatin alone, representing 50% of this group. Conclusions: We report that an average of 15% of patients with electrolyte abnormalities develop renal toxicity and reduced function. Moreover, electrolytes may serve as an early indicator for renal damage as part of chemotherapy complication. This indication represents 15% of renal toxicity cases. Changes in electrolyte levels have been reported with cisplatin. Specifically, it has been linked to hypomagnesemia, hypocalcemia and hypokalemia. This study will help reduce the risk of dialysis or the need for kidney transplant. It is also important to manage any underlying conditions and control patients' intake of electrolytes.

Macrophage polarization is linked to Ca2+-independent phospholipase A2ß-derived lipids and cross-cell signaling in mice.

Phospholipases A2 (PLA2s) catalyze hydrolysis of the sn-2 substituent from glycerophospholipids to yield a free fatty acid (i.e., arachidonic acid), which can be metabolized to pro- or anti-inflammatory eicosanoids. Macrophages modulate inflammatory responses and are affected by Ca2+-independent phospholipase A2 (PLA2)ß (iPLA2ß). Here, we assessed the link between iPLA2ß-derived lipids (iDLs) and macrophage polarization. Macrophages from WT and KO (iPLA2ß-/-) mice were classically M1 pro-inflammatory phenotype activated or alternatively M2 anti-inflammatory phenotype activated, and eicosanoid production was determined by ultra-performance LC ESI-MS/MS. As a genotypic control, we performed similar analyses on macrophages from RIP.iPLA2ß.Tg mice with selective iPLA2ß overexpression in ß-cells. Compared with WT, generation of select pro-inflammatory prostaglandins (PGs) was lower in iPLA2ß-/- , and that of a specialized pro-resolving lipid mediator (SPM), resolvin D2, was higher; both changes are consistent with the M2 phenotype. Conversely, macrophages from RIP.iPLA2ß.Tg mice exhibited an opposite landscape, one associated with the M1 phenotype: namely, increased production of pro-inflammatory eicosanoids (6-keto PGF1α, PGE2, leukotriene B4) and decreased ability to generate resolvin D2. These changes were not linked with secretory PLA2 or cytosolic PLA2α or with leakage of the transgene. Thus, we report previously unidentified links between select iPLA2ß-derived eicosanoids, an SPM, and macrophage polarization. Importantly, our findings reveal for the first time that ß-cell iPLA2ß-derived signaling can predispose macrophage responses. These findings suggest that iDLs play critical roles in macrophage polarization, and we posit that they could be targeted therapeutically to counter inflammation-based disorders.

Pattern and diagnostic evaluation of systemic autoinflammatory diseases other than familial Mediterranean fever among Arab children: a multicenter study from the Pediatric Rheumatology Arab Group (PRAG).

To define the spectrum and phenotypic characteristics of systemic autoinflammatory diseases (SAIDs) other than familial Mediterranean fever (FMF) in Arab children and to delineate diagnostic evaluation. Data retrospectively collected on patients with clinical and/or genetically proven SAIDs other than FMF at 10 tertiary Arab pediatric rheumatology clinics from 1990 to 2018. The collected data comprised the clinical findings and diagnostic evaluation including genetic testing, the provided treatment and the accrual damage related to SAIDs. A total of 144 patients (93 female) with a median age at onset of 2.5 (range 0.1-12) years were enrolled. The initial diagnosis was inaccurate in 49.3%. Consanguinity rate among parents was 74.6%. The median time-to-diagnosis for all SAIDs was 2.5 (range 0.1-10) years. There were 104 patients (72.2%) with a confirmed diagnosis and 40 patients with suspected SAIDs. Seventy-two had monogenic and 66 patients with multifactorial SAIDs while six patients had undifferentiated SAIDs. The most frequent monogenic SAIDs were LACC1 mediated monogenic disorders (n = 23) followed by CAPS (12), TRAPS (12), HIDS (12), and Majeed's syndrome (6). The most frequent multifactorial SAIDs was CRMO (34), followed by PFAPA (18), and early onset sarcoidosis (EOS) (14). Genetic analysis was performed in 69 patients; 50 patients had genetically confirmed disease. Corticosteroid used for 93 patients while biologic agents for 96 patients. Overall, growth failure was the most frequent accrual damage (36%), followed by cognitive impairment (13%). There were three deaths because of infection. This study shows a heterogenous spectrum of SAIDs with a high number of genetically confirmed monogenic diseases; notably, LACC1 associated diseases. Hopefully, this work will be the first step for a prospective registry for SAIDs in Arab countries.

Random Cross-Sectional Determination of the Level of Awareness Among Female Saudi Patients About Breast Cancer.

The purpose of this study was to randomly determine the level of awareness and knowledge among female Saudi patients about the risk factors and symptoms of breast cancer as well as any awareness about the practices for breast cancer self-examination. A random cross-sectional survey was conducted over 4 months at two private medical clinics in Riyadh, Saudi Arabia. The 4-month period was from December 2013 to March 2014. The survey instrument was a questionnaire that was both self-explanatory and user-friendly. Our study subjects included 174 randomly selected Saudi female patients with no medical history of breast cancer. These patients visited these private clinics for medical advice or for consultation on problems unrelated to breasts. Participants' perception of risk factors regarding early menses showed only 47.1 %. The most common risk factor known by the participants was a family history of breast cancer (84 %). The most widely recognized symptoms of breast cancer were occurrence of breast lumps (86.2 %) and breast pain (93.7 %). Awareness of information regarding breast self-examination (BSE) was 81.6 % in general. Many were aware of the opinion that proper and assisted knowledge about BSE can help in early detection of breast cancer. The patients were also aware that BSE is the most widely used method of screening for breast cancer in clinics and hospitals. All the participants showed sufficient knowledge about the risk factors and symptoms of breast cancer. These baseline findings are encouraging for providing more self-explanatory information (to patients) and guidance to health authorities for developing effective breast health care programs in the entire Kingdom for the female population and not only for patients visiting health care clinics for advice on other medical issues.

Awareness, Attitudes, and Practices Related to Coronavirus Pandemic Among Public in Saudi Arabia.

New cases of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) were reported in Gulf countries in 2014, and to date, it has reportedly infected 837 people and killed 291 globally. Awareness of an individual's knowledge and being able to predict his or her behavior is crucial when evaluating clinical preparedness for pandemics with a highly pathogenic virus. The aim of this study was to identify awareness, attitudes, and practices related to MERS-CoV among the public in Saudi Arabia. A cross-sectional study of 1147 adult subjects recruited from various shopping malls in Riyadh was conducted. All the subjects were interviewed using a questionnaire that tested their knowledge, attitudes, and use of precautionary measures in relation to the MERS-CoV pandemic. The majority of the participants showed high levels of concern and had utilized precautionary measures. After adjusting for other variables, gender was the only significant predictor of the level of concern (P < .001), while knowledge was the significant predictor of both the level of concern and precaution (P < .001). High concern translated into a higher compliance with precautionary recommendations. Frequent communication between health care providers and the public is recommended to help dispel myths about the disease and to empower the public with the information needed to help the Saudi government in containing the disease outbreak.

The Knowledge, Attitudes, and Practices of Primary Healthcare Physicians in the Al Qassim Region, Saudi Arabia Regarding Travel Medicine: A Cross-Sectional Study.

Background and objective In the age of globalization, diseases associated with travel have emerged as a focal point of public health interest. This has become particularly relevant in Saudi Arabia after the changes in tourism policy in recent years. Primary care physicians are expected to suspect diseases of importance in certain geographic areas. They should dispense pre- and post-travel advice. This study aimed to assess the knowledge, attitudes, and practices of primary care physicians in the Al Qassim region, Saudi Arabia regarding travel medicine. Methods This cross-sectional study was conducted in the Al Qassim region, Saudi Arabia between October and November 2023. We reached out to all primary care physicians in the region regardless of their gender, nationality, and years of experience. The data were collected using a self-administered questionnaire, which was designed based on the available literature and validated by experts. Results A total of 197 physicians participated in the study; 74% were male, 46% were general practitioners, and 48% had 5-10 years of experience. More than half (51%) of the participants reported a weekly patient load of 50-100, while 47% engaged with 5-10 travelers annually; 53% provided travel health advice and a quarter of primary healthcare physicians never attended travel update sessions or conferences. In the last six months, 48% and 43% of the physicians conducted pre- and post-travel consultations respectively. Approximately 49.2% demonstrated a fair knowledge of the topic. Factors associated with fair knowledge included non-Saudi nationality, age below 30 years, minimal traveler exposure, and infrequent conference attendance (p<0.05). A positive attitude was linked to being under 30 years old, having <5 years of experience, seeing <5 travelers yearly, and possessing a fair knowledge of the topic (p<0.05). Conclusions Overall, about half of the physicians in the Al Qassim region engage with travelers and demonstrate good attitudes and practices toward travel medicine. Opening Saudi borders to tourism necessitates the inclusion of travel medicine in continuing medical education programs to prepare primary care physicians to care for travelers more efficiently.

Probing electron-hole Coulomb correlations in the exciton landscape of a twisted semiconductor heterostructure.

In two-dimensional semiconductors, cooperative and correlated interactions determine the material's excitonic properties and can even lead to the creation of correlated states of matter. Here, we study the fundamental two-particle correlated exciton state formed by the Coulomb interaction between single-particle holes and electrons. We find that the ultrafast transfer of an exciton's hole across a type II band-aligned semiconductor heterostructure leads to an unexpected sub-200-femtosecond upshift of the single-particle energy of the electron being photoemitted from the two-particle exciton state. While energy relaxation usually leads to an energetic downshift of the spectroscopic signature, we show that this upshift is a clear fingerprint of the correlated interaction of the electron and hole parts of the exciton. In this way, time-resolved photoelectron spectroscopy is straightforwardly established as a powerful method to access electron-hole correlations and cooperative behavior in quantum materials. Our work highlights this capability and motivates the future study of optically inaccessible correlated excitonic and electronic states of matter.

Epidemiology of Reportable Bacterial Infectious Diseases in Saudi Arabia.

INTRODUCTION: Bacterial infections have a significant impact on human health; they can cause severe morbidity and mortality, particularly in susceptible populations. Epidemiological surveillance is a critical tool for monitoring the population's health and facilitate the prevention and control of infectious disease outbreaks. Knowing the burden of bacterial communicable diseases is an initial core step toward public health goals. METHODS: Saudi epidemiology surveillance data were utilized to depict the changing epidemiology of bacterial infectious diseases in Saudi Arabia from 2018 to 2021. The cumulative numbers of cases, demographics, and incidence rates were analyzed and visualized. Parametric tests were used to compare the difference in the mean values between categorical variables. Regression analysis was employed to estimate trends in disease rates over time. Statistical significance was set at p value ≤ 0.05. RESULTS: The results revealed that brucellosis, tuberculosis, and salmonellosis were the most frequently reported bacterial infectious diseases in Saudi Arabia. Males were more significantly affected by brucellosis and tuberculosis infections than females. Salmonellosis infections were more significant among Saudi citizens, while pulmonary tuberculosis was more significant in non-Saudis. Interestingly, there was a decline in the incidence rates of numerous bacterial infectious diseases during the Coronavirus Disease 2019 (COVID-19) pandemic and COVID-19 restrictions. Some bacterial infectious diseases were rarely reported in Saudi Arabia, including syphilis and diphtheria. CONCLUSIONS: The future perspective of this research is to enhance disease surveillance reporting by including different variables, such as the source of infection, travel history, hospitalization, and mortality rates. The aim is to improve the sensitivity and specificity of surveillance data and focus on the mortality associated with bacterial pathogens to identify the most significant threats and set a public health priority.

Epidemiology of Viral Infectious Diseases Reported in Saudi Arabia.

INTRODUCTION: Efficient epidemiological monitoring of virus diseases is crucial in evaluating general public health, the prevalence of specific diseases, the pattern of spread, and implementing preventative and control strategies into action. METHODS: This study analyzed data obtained from the Field Epidemiology Program (FETP) which is part of the Ministry of Health (MOH) in Saudi Arabia, which contained reported cases of infectious diseases over four years, from January 2018 to December 2021, to investigate and highlight the significant trend and incidence rate for each viral infectious disease. RESULTS: Of the reported viral infectious diseases, hepatitis B and C, dengue fever (DF), influenza, chickenpox, and measles were the highest reported viral cases over four years. For the aforementioned diseases, males were often more susceptible to viral infections than females. Except for DF, this viral infection was more common in Saudi citizens. Viral illnesses like hand, foot, and mouth disease were less prevalent, while neurological viral disorders such as acute flaccid paralysis were rarely detected. There was an overall reduction in viral cases recorded during 2020-2021, which may be attributed to the implementation of preventive measures during the Coronavirus Disease 2019 (COVID-19) pandemic or an underreporting of cases during the lockdown of that time. CONCLUSION: The prevalence of these common viral infections in the Saudi population suggests that understanding the mechanisms influencing changes in these viruses, methods of transmission, and the burden of these diseases is a priority for health policy. This understanding is necessary to develop effective intervention and preventive strategies.

Three years versus four years Saudi Board Family Medicine program: Graduates' academic performance, perceptions, burnout, and satisfaction with professional life.

Background: The specialty of family medicine, established in Saudi Arabia in the 1980s, has rapidly progressed in healthcare settings and is increasingly utilized by the population as well as recent MBBS graduates. Universally, there is ambiguity in the duration, curriculum, and assessment methods used in family medicine specialization programs. Methodology: A cross-sectional study was conducted among 183 fresh graduates from a 3-year and 4-year residency program. Data were collected using electronic forms, which were subsequently transferred to Microsoft Excel. Following appropriate coding, the data were transferred to SPSS for analysis. The dataset was then cleaned, and statistical tests, such as Chi-square and independent t-tests, were used to draw inferences. Results: Males (50.3%) and females (49.7%) had almost equal distribution in the study. Overall, 67.6% of respondents had passed the final exam; the pass percentage was 69.3% for the 3-year residency program and 66.4% for the 4-year program. The overall mean score for perceived achievement of SaudiMED-FM 2020 competencies was 23.06 ± 5.52 out of a total score of 30. On comparing the 3-year versus 4-year residency program, there was no statistically significant difference between perceived competency scores and professional satisfaction scores. Among the study participants, 19 (10.4%) had 'serious burnout', and 22 (12%) had 'extremely serious burnout'. Professional satisfaction was significantly associated with burnout (P = 0.006). Conclusions: Based on the study results, there was no significant difference regarding academic performance, perceived competencies, and professional satisfaction among the graduates of the 3-year versus 4-year residency program. Approximately more than half of the graduates had suffered from burnout which was reported more by the females and those with financial issues. The majority of the respondents suggested improvements in clinical rotation and assessment methods.

Practice Patterns and Approach to Childhood Lupus Nephritis in Saudi Arabia.

Renal involvement of systemic lupus erythematosus needs aggressive treatment. Despite the development of multiple international guidelines, differences in practices exist. This study aimed to explore the current practices of pediatric rheumatologists and nephrologists for the diagnosis, management, and monitoring of lupus nephritis (LN) in Saudi Arabia through a survey. Among the 61 respondents, 54.1% were pediatric nephrologists and 49.9% were pediatric rheumatologists. Predominantly, the participating physicians received training either nationally (57%) or in North America (45%). Most of the respondents (77%) did not have a combined rheumatology-nephrology clinic, primarily because of space or time limitations (75%), or a lack of the other specialty (13%). In terms of the decision to request a renal biopsy, the most common factors were nephrotic-range proteinuria (85%) and a lower level of proteinuria associated with hypocomplementemia or elevated anti-double-stranded (ds) DNA (73%). There was marginal agreement over monitoring the disease's activity and treatment response; Complements 3 and 4, anti-dsDNA, protein-creatinine ratio, and estimated glomerular filtration rate were the most popular parameters. The main reason for repeating a renal biopsy was a new renal manifestation that was inconsistent with the previous biopsy. There was considerable variability in the induction therapies used to initiate and taper corticosteroids and conventional immunosuppressive drugs. Most respondents (91%) used angiotensin-converting enzyme agents to control proteinuria. Considerable agreement exists among Saudi physicians managing children with LN but significant variations exist regarding the therapeutic strategies. Additional endeavors are needed to establish a unified national clinical approach for managing LN in children.

Basal Cell Adenoma of the Parotid Gland: A Rare Disease Entity.

Neoplasms of the salivary glands are of rare incidence, have a vague presentation, and follow a complex long-term clinical course. Both minor and major salivary glands have been implicated in dysplastic transformation, with parotid gland tumors being the most notable. Most of these tumors are benign in nature and are typically diagnosed and classified based on their histopathological presentation. In this report, we exhibit a rare case of basal cell adenomas (BCA), localized to the right parotid gland, in a 69-year-old male patient. Volume acquisition computed tomography (CT) imaging of the region was obtained with and without contrast, with relative reconstruction in both the coronal and axial planes. A soft tissue mass of 5 cm in diameter was detected in the superficial lobe of the right parotid gland. Fine needle aspiration (FNA) with ultrasound guidance revealed a population of basaloid cells that is monomorphic with minimal nuclear atypia and scattered fibrillary matrix. Thereafter, the patient was treated with partial excision of the right parotid gland under general anesthesia, and the post-operative pathology report confirmed the diagnosis of basal cell adenoma. The patient was doing well post-operatively with no complaints and maintained routine clinic follow-ups.

Coexistence of a Nasopalatine Duct Cyst and Radicular Cyst: A Unique Clinical Presentation.

This study discusses a case of coexistence of two distinct cysts, a nasopalatine duct cyst (NPDC) and a radicular cyst, within the anterior region of the maxilla. NPDC is a prevalent non-odontogenic developmental cyst, while radicular cysts are commonly found in odontogenic inflammatory cysts. The clinical and radiographic characteristics of these cysts are explored, emphasizing the importance of accurate diagnosis and treatment planning. In this case, a 51-year-old male patient presented with swelling and pain in the maxillary anterior region. Radiographic examinations revealed a heart-shaped radiolucent lesion extending from tooth 13 to 23, associated with the NPDC, and a separate radicular cyst. Surgical enucleation and tooth extraction were performed as the treatment of choice. This unique case underscores the significance of meticulous radiographic assessment to detect multiple cystic lesions within the same area.

Basal Cell Adenoma of the Minor Salivary Glands in the Buccal Mucosa: A Rare Entity Arising in an Unusual Location.

One of the rare tumors of the salivary gland is known as basal cell adenoma (BCA). Only a small percentage of salivary gland tumors affect the minor salivary gland of the oral cavity while the majority are found in the parotid gland. We present a rare case of BCA involving the left buccal mucosa of a 45-year-old female. Magnetic resonance imaging (MRI) showed well defined solid mass measuring 1.9 x 1.5 cm in the left buccal space inseparable from the buccinator muscle. The T2-weighted image demonstrates a hyperintense signal post-contrast. Ultrasound-guided fine needle aspiration cytology revealed cellular basaloid neoplasm of uncertain malignant potential. Thereafter excision of the mass was performed through a transoral approach under general anesthesia. Histopathology of the mass showed encapsulated basal cell neoplasm in favor of BCA. The patient was doing well after the surgery and has intact facial nerve and adjacent nerves such as the auriculotemporal nerve and great auricular nerve with no complications then she kept on routine clinic follow-ups, and the surgical site recovered successfully. Therefore, we conclude that MRI and biopsy provide useful information to differentiate between benign adenoma and malignant adenocarcinoma. BCA should be considered in a differential diagnosis of an isolated neck mass. Surgical excision demonstrates an excellent prognosis.

A Wafer-Scale Nanoporous 2D Active Pixel Image Sensor Matrix with High Uniformity, High Sensitivity, and Rapid Switching.

2D transition-metal dichalcogenides (TMDs) have been successfully developed as novel ubiquitous optoelectronics owing to their excellent electrical and optical characteristics. However, active-matrix image sensors based on TMDs have limitations owing to the difficulty of fabricating large-area integrated circuitry and achieving high optical sensitivity. Herein, a large-area uniform, highly sensitive, and robust image sensor matrix with active pixels consisting of nanoporous molybdenum disulfide (MoS2 ) phototransistors and indium-gallium-zinc oxide (IGZO) switching transistors is reported. Large-area uniform 4-inch wafer-scale bilayer MoS2 films are synthesized by radio-frequency (RF) magnetron sputtering and sulfurization processes and patterned to be a nanoporous structure consisting of an array of periodic nanopores on the MoS2 surface via block copolymer lithography. Edge exposure on the nanoporous bilayer MoS2 induces the formation of subgap states, which promotes a photogating effect to obtain an exceptionally high photoresponsivity of 5.2 × 104 A W-1 . A 4-inch-wafer-scale image mapping is successively achieved using this active-matrix image sensor by controlling the device sensing and switching states. The high-performance active-matrix image sensor is state-of-the-art in 2D material-based integrated circuitry and pixel image sensor applications.

A Brief Review of Demographic and Clinical Correlates of Cholesteatoma Surgery in the Qassim Region.

Background Cholesteatoma is described as the accumulation of squamous epithelium and keratinocytes within and around the middle ear cleft. There is a paucity of information regarding demographic and treatment outcomes for cholesteatoma in Saudi Arabia. An evaluation of the prevalence of comorbidities, complications and associations, of surgical treatment and demographics in the Qassim region was conducted. Methods This was a six-year retrospective review of patients treated for cholesteatoma at a private health facility, from August 2016 to July 2022. Data for age, gender, nationality, presence of comorbidities, type of surgery, type of anesthesia, and associated complications were collected from the electronic medical records and analyzed with Statistical Package for Social Sciences software. Results A total of 60 participants records were retrieved. The average age of the study population was ([43.2 ±SD] 21.8) years. There was a slightly higher male preponderance (males 51.7% and females 48.3%). Hypertension was the most commonly reported comorbidity (31.7%), followed by diabetes mellitus (25%). Age and gender were not statistically significantly associated with type of surgery or complications. Conclusion Demographic variables were not significantly associated with clinical correlates, however, further studies with larger sample sizes, robust clinical information, and long-term follow-up are required.

Comparison between the ECG Outcomes of Metoprolol and Bisoprolol.

BACKGROUND: Beta-blockers are essential agents in the management of cardiovascular diseases, such as heart failure, acute myocardial infarction (MI), and cardiac arrhythmias. However, there are diurnal variations in the cardioprotective effects of the subgroups as a result of their different pharmacokinetic, pharmacodynamic, and pharmacogenetic profiles. OBJECTIVE: We aimed to compare metoprolol and bisoprolol in terms of electrocardiogram (ECG) outcomes. METHODS: A retrospective cross-sectional study was conducted at Prince Sultan Cardiac Center. The trial included 404 patients who met the inclusion criteria (204 in the metoprolol arm and 200 in the bisoprolol arm). Using case record forms that had already been created, information, such as patient demographics, medical histories, and treatment histories, was taken from their medical files. The most recent ECG records were also gathered. The ethical approval for this study was obtained from Qassim ethical committee (approval number: 45-44-902). RESULTS: There was no significant difference found between the patients in both arms in terms of baseline characteristics, age, or sex. CONCLUSION: In this retrospective cross-sectional study, we have compared the effects of metoprolol and bisoprolol beta blockers on ECG changes. The findings have indicated no difference between metoprolol and bisoprolol groups in terms of all ECG readings, particularly PR/ms, QTC-ms, and ventricular rate. Further studies are required to confirm these findings.

Prevalence of Risk Factors of Chronic Rhinosinusitis With Nasal Polyps Among the Saudi Population.

Background The burden of chronic rhinosinusitis symptoms experienced by Saudi citizens is considered an important factor in getting an overall insight of the problem in the region, therefore our study aimed to determine the prevalence of risk factors of chronic rhinosinusitis with nasal polyps and correlate the risk factors with various sociodemographic parameters among Saudi population. Methods This study analyzed five-year cross-sectional data from 2017-2021. A total of 386 participants were enrolled and subsequently divided into four groups: aged 18-25 years, 26-35 years, 36-45 years, and > 45 years. A study was conducted utilizing non-probability sampling targeting a population of Saudi nationality living in selected regions of Saudi Arabia. Data was collected through an online questionnaire which had been distributed through social media and had been analyzed accordingly using a statistical package for social sciences. Results In this study, 272 (70.5%) participants were female and 114 (29.5%) were male. A total of 374 (96.9%) participants were Saudis while 12 (3.1%) were non-Saudis. Risk factors were compared by age and gender of study participants. Having polyps in the nose (p-value 0.016) and a family history of polyps (p-value 0.049) showed a significant association with the gender of study participants. The frequency of having nasal polyps was significantly higher among male participants, however, having a family history of nasal polyps was significantly higher among female participants. The educational status of study participants showed a significant association with the use of cortisone (p-value 0.032) and having a broken nose (p-value 0.032). Having a family history of nasal polyps showed a significant (p-value 0.017) association with the socioeconomic status of study participants. Conclusion Nasal polyps are more common in males than females, however, having a family history of nasal polyps was significantly higher among female participants.