Comprehensive Management of Distal Clavicle Ewing's Sarcoma: A Case Highlighting Surgical Resection, Oncologic Challenges, and Rehabilitation Outcomes.

This case report presents an unusual manifestation of Ewing's Sarcoma (EwS) in the distal clavicle of a 32-year-old male. The patient's journey began with an initial misdiagnosis of a shoulder mass as a benign condition, but advanced imaging techniques later uncovered the malignant nature of the lesion. Emphasizing the complexities of managing EwS in atypical locations and in adult patients, this report details the implementation of a neo-adjuvant chemotherapy regimen. The chemotherapy aimed to reduce tumor size and mitigate the spread, preparing for a more effective surgical resection. The subsequent surgical strategy involved a meticulous resection of the distal clavicle, focusing on achieving clear margins while preserving the functional integrity of the shoulder, crucial for the patient's profession. The postoperative phase was marked by a comprehensive rehabilitation program, crucial for recovery and return to occupational activities. This case underscores the importance of early and accurate diagnosis, the effectiveness of a preoperative chemotherapy strategy, and the need for a multidisciplinary approach, including oncological treatment, surgical precision, and rehabilitative care.

Dermoid Cyst in the Posterior Fossa Associated With Dermal Sinus and Abscess Formation: A Case Report.

Posterior fossa dermoid cysts are rare intracranial tumors. Most are congenital and develop during early pregnancy but manifest later in life. We report a case of a congenital posterior fossa dermoid cyst in a 22-year-old patient presenting with fever and multiple neurological complaints. Imaging studies revealed a bony defect in the occipital bone suggestive of sinus formation, heterogeneous hypointensity on T1-weighted image (T1WI), and post-contrast peripheral enhancement suggestive of an infectious process and abscess formation. The histopathological examination was typical for a dermoid cyst containing adnexal structures. This report reviews the case with its unique location and unusual radiological features. Further, the clinical presentation, diagnosis modalities, and treatment outcomes are discussed.

Epidemiology of pediatric trauma in Makkah, Kingdom of Saudi Arabia: An observational cohort study.

OBJECTIVES: To explore the epidemiology and patterns of pediatric trauma in addition to length of hospital stay and outcome. METHODS: A single-center retrospective study of 605 patients aged 14 years and younger was carried out from January to December 2022. The study included all patients who experienced intentional or unintentional trauma aged 14 years or below in 2022 and excluded trauma that did not prompt an emergency room visit. RESULTS: Most pediatric trauma cases involved boys (69.1%, n=418), and girls comprised only 30.9% (n=187). Trauma was most common in children one to 5 years old (41.5%, n=251). Falling from a height was the most common mode of injury in both girls and boys (n=253, 41.8%). The most common body parts involved were the extremities (n=357, 59%), followed by the head (n=210, 34.7%). Most children were transferred to hospital via emergency medical services (n=234, 38.7%). In most cases, the child was admitted to the surgical ward (n=458, 75.7%), while others were managed in the emergency department without admission (n=93, 15.4%). Most patients were stable after receiving standard care (n=558, 92.2%). CONCLUSION: To reduce health care expenses and improve public health outcomes, prioritizing preventive measures is crucial. This includes increasing public awareness, implementing safety protocols, and enacting government regulations to prevent avoidable injuries.

Knowledge, perception, and beliefs of Saudi physicians at King Abdulaziz Medical City, Riyadh related to medical cannabis: Literature review and a cross-sectional survey.

Cannabis is an herbaceous flowering plant, originally an indigenous plant in Eastern Asia, which later spread globally due to widespread agricultural practices. Cannabis was used medicinally until the early twentieth century, but subsequently prohibited due to the psychoactive effects. Aims: To explore the medical cannabis-related level of knowledge of physicians at King Abdulaziz Medical City, including patient needs, perceptions of therapeutic effects, potential harm, and the willingness to prescribe if legalized in future. Methodology: The study was a cross-sectional questionnaire-based survey. It was conducted at King Abdulaziz Medical City in Riyadh from February 2020 to February 2021. All physicians from the different specialties, who consented to participate, were included in this study. Statistical Analysis: Descriptive statistics are presented as mean and standard deviation and proportions. An ANOVA test was applied to measure the association of the beliefs regarding the right to prescribe with overall knowledge. All tests were considered significant at P < 0.05. Results: A total of 249 physicians participated with the majority (70%) male. The sample was similar regardless of the physician's position in the medical hierarchy, with a mean work experience of 8 years. Almost half of the participants indicated that they do not have good knowledge regarding the effects of MC products and more than half that they are unaware of the different MC products and formulations currently available. Conclusion: The majority of the sample lacked knowledge about the medicinal use of cannabis for specific indications and felt uncomfortable to discuss the medicinal use of cannabis with their patients.

Knowledge and Perception Toward Neuromodulation Devices Among Medical Students at Umm Al-Qura University.

Introduction Neurologic and psychiatric disorders affect many people worldwide and are crucial to medical care. It is crucial to note that primary care doctors initially evaluate patients who will eventually require neuromodulation (NM) therapy. There is a growing concern about the extent of medical students' knowledge regarding NM therapy. Insufficient education and limited exposure of future doctors to different treatment approaches can limit their ability to refer patients promptly and appropriately, thereby impeding access to necessary treatment. Methods The study employed a non-probability stratified snowball sampling technique to recruit participants. The population consisted of undergraduate medical students (excluding interns) at Umm Al-Qura University (UQU) in Saudi Arabia. Data collection was conducted through an online questionnaire. Results The sample comprised 301 medical students, with an average age of 21.62±1.54 years (ranging from 18 to 25). The majority were female (65.1%), and in the clinical years (57.8%), a considerable portion of respondents (57.5%) lacked awareness that NM devices are approved by the FDA for treatment. Both pre-clinical and clinical-year students exhibited insufficient knowledge (91.3% and 91.4%, respectively). Females showed a higher proportion (95.9%) of poor attitudes toward NM compared to males (83.8%). Notably, preclinical students showed a higher level of knowledge (11.0%) compared to clinical students (6.3%). Conclusions The study revealed a significant lack of knowledge among medical students regarding NM devices. This is concerning given the growing prevalence of NM devices in clinical practice. To ensure optimal patient care, it is crucial to provide comprehensive education on NM devices to medical students.

Knowledge, Attitude, and Practice Regarding Diabetic Retinopathy Screening and Eye Management Among Diabetics in Saudi Arabia.

Background Globally, one of the leading causes of blindness is diabetic retinopathy (DR). However, many patients do not participate in DR screening because of a lack of awareness. This study aims to assess the knowledge, attitude, and practice (KAP) level regarding DR screening and eye management among diabetic patients in Saudi Arabia. Methodology This cross-sectional study was conducted among diabetic patients aged 18 years or older in Saudi Arabia between October 2022 and February 2023. A validated online KAP-36 questionnaire collected information on sociodemographic data, diabetes profile, diabetes-related complications, and KAP regarding DR screening and management. Results Of the 1,391 diabetic patients, 736 (52.9%) had good knowledge about DR screening and care, while 655 (47.1%) had poor knowledge. A positive attitude toward eye examination for the early detection of DR was noticed among 1,124 (80.8%) participants. Regarding the participants' practice of regular fundus examination, 1,000 (71.9%) participants had good practice. Significant relationships were found between education level (p = 0.017), diabetes mellitus (DM) type and duration (p= 0.01, 0.02), type of treatment (p = 0.001), and a high degree of knowledge. Significant determinants of patients' favorable attitudes included their type of diabetes (p = 0.003), region of residence (p = 0.038), and work or education outside the medical field (p = 0.001). Age (p = 0.001), location of residence (p = 0.015), educational attainment (p= 0.041), and type of diabetes (p = 0.045) were the factors that determined good practice. Conclusions Many diabetic patients supported DR screening and engaged in it regularly. Unfortunately, only around half of the participants had a good understanding of DR. Type 2 diabetes mellitus (T2DM), a longer history of DM, and being highly educated were factors associated with a diabetic patient's higher level of knowledge. Positive attitudes were significantly higher among those living in the central Saudi region, employed outside of the medical field, and those with T2DM. Finally, regarding the practice of eye screening and management among diabetic patients, elderly patients living in the southern Saudi region and those with T2DM were adherent to their regular eye examinations. Consequently, the key to ensuring adequate adherence to DR screening may be intervention techniques and focused education to increase patients' knowledge of DR.

Knowledge, awareness, and vaccination compliance of hepatitis B among medical students in Riyadh's governmental universities.

BACKGROUND: Hepatitis B is a blood-borne infectious liver disease caused by the Hepatitis B Virus (HBV) and it is best prevented by immunization. Due to occupational exposure, medical students have an increased risk of contracting HBV. Therefore, it is essential for all medical students to have good knowledge about HBV and to complete their HBV vaccinations. AIMS: The aim of this study was to assess and compare HBV knowledge, awareness, and vaccination compliance among pre-clinical medical students in four universities. SETTINGS AND DESIGN: A cross-sectional study was conducted in September 2018 at the College of Medicine of four governmental universities: King Saud Bin Abdulaziz University for Health Sciences, King Saud University, Princess Noura university, and Imam Mohammed bin Saud Islamic University, in Riyadh, Saudi Arabia. METHODS AND MATERIALS: Two-hundred-sixty-three pre-clinical medical students completed a questionnaire with sections about demographics, HBV awareness, knowledge, and vaccination compliance. STATISTICAL ANALYSIS USED: The data was transferred to Excel and SPSS version 22 was used for statistical analysis. A significance level of P < 0.05 was considered statistically significant. RESULTS: The overall knowledge about HBV and vaccination compliance were poor. KSU students had the highest vaccination compliance (n = 52, 54.2%) and KSAU-HS the lowest (n = 19, 23,8%). The most-cited reasons for noncompliance were "forgetting about the vaccine" and "busy schedule". CONCLUSION: Overall, most of the participants had poor HBV knowledge and vaccine compliance. Therefore, we recommend the implementation of pre-clinical vaccine checking and the addition of an infectious disease awareness and prevention program.

Predictors of Seatbelt Use Among Saudi Adults: Results From the National Biobank Project.

Introduction: Road traffic crashes (RTCs) are a leading cause of death and disabilities and impose a significant burden on the healthcare system and economy of Saudi Arabia. Around 20% of all hospital beds are occupied by victims of RTCs, which represent approximately 80% of trauma deaths occurring in these facilities. Using a seatbelt is an effective method to reduce traffic deaths and minimize the extent of associated injuries. However, little is currently known about the prevalence and predictors of seatbelt use in Saudi Arabia. More studies are needed to determine the trends of seatbelt use and study the relationship between individual factors and compliance with seatbelt use laws. The aim of the present study is to examine the prevalence and predictors of seatbelt use using the National Saudi Biobank dataset. Materials and Methods: This cross-sectional study was conducted using an in-person survey from the Saudi National Biobank (SNB). The participants were adults affiliated with the Ministry of National Guard Health Affairs in Riyadh who were examined between 2017 and 2019. Chi-squared and Wald tests were used to assess the association between the respondents' characteristics and their seatbelt use. In addition, logistic regression models were constructed to assess the univariate and multivariate associations between seatbelt use and potential predictors. All statistical tests were two-sided, and the findings were considered significant at P < 0.05. Results: A total of 5,790 adults participated in the survey. The majority of the participants (52.44%) were between 18 and 25 years old, half were males, and 58.80% were single. About 42.83% of the participants reported consistent seatbelt use as drivers or passengers. In the multivariable analysis, females were 86% less likely to wear seatbelts than males (OR = 0.136, 95%CI = 0.107-0.173). Individuals who rated their mental health as "weak" were 26% less likely to wear seatbelts than those who reported "excellent" mental health status. Conclusion: Seatbelt use remains low in the country and substantially lower than in developed countries. Young adults, females, and individuals reporting suboptimal mental health were less likely to fasten their seatbelts. These findings are valuable for public health programs to target specific groups and raise awareness about the need to increase seatbelt compliance and reduce traffic injuries.