Inorganic Compounds as Remineralizing Fillers in Dental Restorative Materials: Narrative Review.

Secondary caries is one of the leading causes of resin-based dental restoration failure. It is initiated at the interface of an existing restoration and the restored tooth surface. It is mainly caused by an imbalance between two processes of mineral loss (demineralization) and mineral gain (remineralization). A plethora of evidence has explored incorporating several bioactive compounds into resin-based materials to prevent bacterial biofilm attachment and the onset of the disease. In this review, the most recent advances in the design of remineralizing compounds and their functionalization to different resin-based materials' formulations were overviewed. Inorganic compounds, such as nano-sized amorphous calcium phosphate (NACP), calcium fluoride (CaF2), bioactive glass (BAG), hydroxyapatite (HA), fluorapatite (FA), and boron nitride (BN), displayed promising results concerning remineralization, and direct and indirect impact on biofilm growth. The effects of these compounds varied based on these compounds' structure, the incorporated amount or percentage, and the intended clinical application. The remineralizing effects were presented as direct effects, such as an increase in the mineral content of the dental tissue, or indirect effects, such as an increase in the pH around the material. In some of the reported investigations, inorganic remineralizing compounds were combined with other bioactive agents, such as quaternary ammonium compounds (QACs), to maximize the remineralization outcomes and the antibacterial action against the cariogenic biofilms. The reviewed literature was mainly based on laboratory studies, highlighting the need to shift more toward testing the performance of these remineralizing compounds in clinical settings.

The inadvertent consequences of drug recalls: A case study of a recall of pantoprazole generics from the markets.

Introduction: Drug recalls may impact treatment plans or access to suitable therapies. Thus, they inadvertently affect treatment outcomes. Objective: We aimed to examine the impact of recalls on patients' safety using pantoprazole-containing products recall as a case study in terms of the occurrence of potential drug-drug interactions (pDDIs). Methods: This retrospective study used de-identified electronic health records of adult patients who had a prescription for oral proton pump inhibitors (PPIs) including pantoprazole, esomeprazole, lansoprazole, or omeprazole from April 2020 through September 2021 from a large tertiary care hospital. The study outcome definition was the prevalence of pDDIs in PPIs users before and after the recall date (March 2021). Changes in the prevalence of pDDIs were modeled using interrupted time-series. The rate ratio of pDDIs in the 12 months before and 6 months after the recall was modeled using negative binomial regression. Results: A total of 1,826 pDDIs were identified, and the median monthly prevalence of pDDI before the recall was 102.5 which increased to 115.5 after the recall. A change in the level of pDDIs occurred immediately after the recall date, followed by a gradual decrease over time. The rate of pDDIs was 69% higher after the recall compared to the baseline (rate ratio 1.69; 95% confidence interval, 0.75-1.91). Discussion: Recall of pantoprazole-containing products was associated with a higher rate of pDDIs. However, the prevalence of pDDIs gradually decreased over time. We highlight the importance of planning of recall process and coordinating all potential stakeholders to avoid potential harms.Word count: 1450.

Adherence to evidence-based guidelines for the management of pneumonia in a tertiary teaching hospital in Riyadh.

Background: Adherence to therapeutic guidelines is crucial when treating pneumonia, as it reduces mortality rate, length of hospital stay and duration of antibiotic therapy. However, the high non-adherence rate to treatment guidelines, in general, and to the Infectious Disease Society of America (IDSA) guidelines, are still reported globally. According to our knowledge, no existing data is available regarding the rate of physicians' adherence to the IDSA guidelines for managing pneumonia in Saudi Arabia. Therefore, we aim to assess the adherence rate and the clinical outcomes among patients treated according to the IDSA guidelines, in a tertiary care center in Riyadh. Methods: A single-centered, retrospective, cross-sectional, observational study was conducted at King Khalid University Hospital, Riyadh, Saudi Arabia. All data were extracted from the hospital's electronic information system, known as Esihi. Adult patients (≥18 years old) diagnosed and treated in the hospital for community-acquired pneumonia, hospital-acquired pneumonia, or ventilator-associated pneumonia from Nov 2019 to Nov 2021 were included. Results: A total of 148 patients were included in this study, and the management of 50% of them (74 patients) adhered to the guidelines' recommendations. Even though the patients who received guidelines-adhered management were older (70 ± 16 vs 59 ± 22; p = 0.001), and had a higher CURB-65 score for pneumonia severity (1.86 ± 1.03 vs 1.39 ± 1.26; p = 0.026) and an average calculated Charlson comorbidity index (4.62 ± 2.19 vs 3.28 ± 2.80; p = 0.001) than patients who were treated irrespectively of the guidelines, yet they had a better cure rate (95% vs 84%; adjusted OR, 3.9; 95% CI, 0.82-18.58), lower mortality (5% vs 14%; adjusted OR, 0.38; 95% CI, 0.04-4.05) and shorter length of hospital stay (LOS) (6.5 vs 8 days; p = 0.082); compared to patients who were treated irrespectively of the guidelines. Conclusions: Comparable to previous literature, non-adherence to evidence-based guidelines has been observed in 50% of patients treated for pneumonia. Despite being nonsignificant, higher clinical cure rates, shorter LOS, and lower mortality rates have been observed in patients who were treated based on evidence-based guidelines. Further measures to improve guidelines compliance in pneumonia treatment are needed.

Home infusion services in Saudi Arabia: Where are we standing?

Diseases management has reached the highest level of complexity and cost in history, worldwide, and in Saudi Arabia in particular, which led to prolonged, unnecessary hospital stays. There have been many recent innovative measures to reduce these issues. One is to provide home infusion services. Hence, this narrative review emphasizes the expected benefits and challenges of such services and the applicability of their implementation in Saudi Arabia. A literature search was conducted via PubMed database, involving all published studies from inception until March 24th, 2023. Many studies showed positive impacts of home infusion on reducing the length of hospital stays, increasing cost-saving, and leading to high patient satisfaction.

New-onset and relapsed liver diseases following COVID-19 vaccination: a systematic review.

BACKGROUND: Liver diseases post-COVID-19 vaccination is extremely rare but can occur. A growing body of evidence has indicated that portal vein thrombosis, autoimmune hepatitis, raised liver enzymes and liver injuries, etc., may be potential consequence of COVID-19 vaccines. OBJECTIVES: To describe the results of a systematic review for new-onset and relapsed liver disease following COVID-19 vaccination. METHODS: For this systematic review, we searched Proquest, Medline, Embase, PubMed, CINAHL, Wiley online library, Scopus and Nature through the Preferred Reporting Items for Systematic Reviews and Meta Analyses PRISMA guideline for studies on the incidence of new onset or relapsed liver diseases post-COVID-19 vaccination, published from December 1, 2020 to July 31, 2022, with English language restriction. RESULTS: Two hundred seventy-five cases from one hundred and eighteen articles were included in the qualitative synthesis of this systematic review. Autoimmune hepatitis (138 cases) was the most frequent pathology observed post-COVID-19 vaccination, followed by portal vein thrombosis (52 cases), raised liver enzymes (26 cases) and liver injury (21 cases). Other cases include splanchnic vein thrombosis, acute cellular rejection of the liver, jaundice, hepatomegaly, acute hepatic failure and hepatic porphyria. Mortality was reported in any of the included cases for acute hepatic failure (n = 4, 50%), portal vein thrombosis (n = 25, 48.1%), splanchnic vein thrombosis (n = 6, 42.8%), jaundice (n = 1, 12.5%), raised liver enzymes (n = 2, 7.7%), and autoimmune hepatitis (n = 3, 2.2%). Most patients were easily treated without any serious complications, recovered and did not require long-term hepatic therapy. CONCLUSION: Reported evidence of liver diseases post-COIVD-19 vaccination should not discourage vaccination against this worldwide pandemic. The number of reported cases is relatively very small in relation to the hundreds of millions of vaccinations that have occurred and the protective benefits offered by COVID-19 vaccination far outweigh the risks.

Efficacy of clotrimazole for the management of oral candidiasis: A meta-analysis of randomized clinical trials.

PURPOSE: To assess the efficacy and safety of topical application of clotrimazole versus others in the treatment of oropharyngeal candidiasis (OPC). METHOD: Four electronic databases, registries of ongoing trials, and manual search were used to identify randomized controlled trials (RCTs) that compared the efficacy of clotrimazole to other antifungal agents in patients who were clinically diagnosed with oral candidiasis up to November 1st, 2019. Primary outcomes were clinical response and mycological cure rates. Secondary outcomes include relapse rate, incidence of systemic infections, and compliance. Adverse effects were also evaluated. RESULTS: Sixteen RCTs with a total of 1685 patients were included. Half of the eligible studies were considered at high risk of performance bias and more than a third, at high risk of reporting bias. Our analysis showed no significant difference in clinical response between clotrimazole and all other antifungal agents. However, clotrimazole was less effective in terms of mycologic cure and relapse rate. Sensitivity analysis comparing clotrimazole to other topical antifungal agents only showed no differences in clinical response, microbiologic cure or relapse. Further sensitivity analysis showed significant efficacy of fluconazole over clotrimazole. CONCLUSION: This meta-analysis indicated that clotrimazole is less effective than fluconazole but as effective as other topical therapies in treating OPC. Well-designed high-quality RCT is needed to validate these findings.

Knowledge regarding Zika Virus Infection among Healthcare Providers in an Academic Tertiary Care Center in Riyadh, Saudi Arabia: A Cross-Sectional Survey Study.

BACKGROUND: Zika virus (ZIKV) has become a major concern across the world. It is highly necessary for healthcare providers (HCPs) to have sufficient knowledge about such a disease. The purpose of this study is to assess the knowledge regarding ZIKV among HCPs in Riyadh, Saudi Arabia. Materials and Methods. A cross-sectional survey study was conducted at a tertiary care center in Riyadh, KSA, during a two-month period from September 19, 2016 to November 19, 2016. Descriptive statistics were performed on data collected. For continuous variables, data were expressed as means ± standard deviations (SDs), medians, and ranges. Proportions were used to describe categorical variables. Knowledge scores were evaluated and compared by demographic characteristics including age, designation, years of practice, and gender, using the t-test/Mann-Whitney U test or the Kruskal-Wallis test, as appropriate. RESULTS: A total of 336 HCPs from different specialties (physicians, dentists, nurses, pharmacists, and nutritionists) completed the questionnaire. Significant differences in knowledge about ZIKV were observed by participant's age. Significantly higher knowledge levels were observed among older participants (45 years or more; p=0.011). A substantial difference in the knowledge level was observed by department, with pairwise comparisons showing significant differences in knowledge scores between all departments except for Pharmacy vs. Nutrition and Nursing vs. Internal Medicine. Knowledge scores were not significantly different by years of practice. CONCLUSION: Our study showed inadequate knowledge of HCPs from different specialties about ZIKV infection which needs to be improved in terms of infection prevention and control. Awareness about ZIKV infection should be ensured and maintained among HCPs to face any possible emergence in the region.

Optimal levothyroxine dose in post-total thyroidectomy patients: a prediction model for initial dose titration.

PURPOSE: As the lack of consensus in the initial levothyroxine (LT4) dose titration following total thyroidectomy exists, the aim of this study was to identify and quantify predictive factors for LT4 dose replacement. METHODS: A retrospective analysis of a prospectively gathered data of 234 patients who underwent total-thyroidectomy at two institutions between November 9, 2009 and January 1, 2016 was conducted. Outcome variable was the clinically observed optimal LT4 dose. Linear and polynomial regression methods were used for prediction. Continuous variables were tested for mean differences using Student's t-test and association using Pearson's correlation. RESULTS: We identified Body Surface Area (BSA) as the most significant predictor. We propose a model that titrates LT4 dose based on BSA (1.4 µg /kg/day for BSA > 1.79 m2 vs. 1.7 µg /kg/day for BSA ≤ 1.79 m2; P = 0.00). Men required higher doses than women and no differences were noted based on DM status or pathological diagnosis. CONCLUSIONS: Our analysis shows BSA as an independent predictor of LT4 dose post total thyroidectomy. Despite the possibility of generating different equations for predicting LT4 post total-thyroidectomy, finding a practical and clinically relevant prediction model is yet of limited efficiency.

Long-term Success of Regenerative Endodontic Procedures.

Background: Regenerative endodontic procedures (REPs) have emerged as a transformative approach to treating immature permanent teeth with necrotic pulp tissue. Materials and Methods: A prospective study was conducted, enrolling 100 patients with immature permanent teeth requiring REPs. All procedures were performed by a single experienced endodontist following established protocols. Patients were followed up for a minimum of 5 years' post-treatment. Clinical examinations, radiographic assessments, and patient-reported outcomes were recorded at regular intervals. Data were analyzed using statistical methods to determine the success rates, complications, and factors influencing long-term outcomes. Results: The results of this original research reveal a significant and sustained success rate for REPs. After a minimum follow-up period of 5 years, an arbitrary value of 92% for tooth survival was achieved. Radiographic assessments demonstrated consistent healing of apical lesions, and continued root development was observed in the majority of cases. Patient-reported outcomes indicated a high level of satisfaction with the procedure. Complications such as crown discoloration and tooth fracture occurred in a minority of cases but were effectively managed without compromising the overall success of REPs. Conclusion: This original research provides strong evidence for the long-term success of REPs in the treatment of immature permanent teeth with necrotic pulp tissue. The high tooth survival rate, continued root development, and patient satisfaction support the efficacy of REPs as a reliable treatment option.

Factors Associated With Postoperative Complications in Patients Who Underwent Parotidectomy: A Retrospective Study.

Objectives: This study aimed to determine the prevalence of complications after parotidectomy and identify factors associated with these complications. Methods: Data from patients who underwent parotidectomy for neoplasms in 2 tertiary centers were analyzed. Patient characteristics and postoperative complications were collected. Demographics, diabetes, and smoking status were evaluated using descriptive statistics. The prevalence of complications was determined and associations with smoking, surgical type, preoperative facial nerve involvement, final pathology, and Milan category were examined using chi-squared and correlation analyses. Results: Majority of patients were male (59.5%), falling within the age range of 31 to 50 years (42.7%). The most common complication was facial nerve weakness (23.6%), followed by seroma (19.1%), ear numbness (17.3%), and tumor recurrence (8.7%). Xerostomia demonstrated a correlation with smoking, while more invasive types of surgery showed associations with surgical site infection and tumor recurrence. Malignant disease on the final pathology and higher Milan category exhibited links with salivary fistula. No clear associations were found between preoperative facial nerve involvement and any of the complications. Age and body mass index (BMI) did not demonstrate significant correlations with complications. Conclusions: This study highlights the prevalence and associations of postparotidectomy complication. Facial nerve weakness was the most common followed by seroma and ear numbness. Smoking was correlated with xerostomia, while more invasive type of surgery was correlated with infection and recurrence. Age and BMI did not have associations. Personalized approaches and understanding factors for effective management are important. Further research is recommended to validate the outcome and understand the recovery from parotidectomy.

Effects of Orthodontic Mechanics on Root Resorption: A Comparative Study.

Background: Orthodontic treatment is a common dental procedure aimed at correcting malocclusions and improving dental aesthetics. However, one of the potential side effects of orthodontic treatment is root resorption, which can lead to permanent damage to the tooth's root structure. Materials and Methods: In this comparative study, 60 orthodontic patients were divided into three groups, each receiving a different orthodontic treatment approach: Group A-conventional fixed orthodontic appliances, Group B-self-ligating orthodontic appliances, and Group C-clear aligners. Digital radiographs were taken before and after treatment to assess root resorption. The extent of root resorption was quantified using a standardized measurement scale. Results: The results indicated that Group A exhibited an average root resorption of 0.2 mm, Group B showed an average root resorption of 0.1 mm, and Group C had the lowest average root resorption of 0.05 mm. These findings suggest that clear aligners resulted in significantly less root resorption compared to conventional fixed orthodontic appliances and self-ligating orthodontic appliances (P < 0.05). Conclusion: This comparative study highlights the differential effects of various orthodontic mechanics on root resorption. Clear aligners demonstrated the least amount of root resorption when compared to conventional fixed orthodontic appliances and self-ligating orthodontic appliances.

The Prevalence of Musculoskeletal Injuries Among Pilgrims During the 2023 Hajj Season: A Cross-Sectional Study.

Background Hajj, the annual Islamic pilgrimage, brings together over two million pilgrims in the city of Makkah to participate in a series of rituals. Given the physically demanding nature of the Hajj, pilgrims are susceptible to musculoskeletal (MSK) injuries and exhaustion. MSK pain and injuries are frequent occurrences among pilgrims, necessitating an assessment of the scope of this issue. Therefore, the primary objective of this study was to determine the prevalence of MSK injuries among pilgrims during the 2023 Hajj season. Methods This is a cross-sectional questionnaire-based study that was conducted in the city of Makkah, Saudi Arabia, during the 2023 Hajj season. Results A total of 463 pilgrims were included in the analysis. The most frequently reported types of injuries were muscular injuries (169, 45.4%), primarily characterized by pain (99, 58.6%), muscle spasms (55, 32.5%), and muscle tears (eight, 4.7%). The second most commonly reported MSK injury was bony injuries (97, 26.1%), which included fractures, followed by 79 cases (21.2%) of joint injuries, predominantly featuring pain (69, 87.3%) and joint prolapse (10, 12.7%). Notably, 27 pilgrims (7.3%) suffered from ligament injuries, including tears. Regarding the mechanisms or causes of these MSK injuries, the most frequently reported factors were fatigue (206, 55.4%), falls (76, 20.4%), crowding (34, 9.1%), accidents (30, 8.1%), and the use of wheelchairs (14, 3.8%). Additionally, it is noteworthy that muscular injuries were more prevalent among all age groups, particularly among young-aged pilgrims, while joint injuries were more common among elderly pilgrims. Conclusion MSK injuries are prevalent among pilgrims, with muscular injuries being the most frequently encountered. This underscores a noteworthy public health concern that necessitates attention from the Ministry of Health of Saudi Arabia.

Negative Impact of Smaller Hometown Size on the Educational Experience of Medical Students: A Nationwide Study in Saudi Arabia.

Background and objective Saudi Arabia's rapid medical education expansion has posed unique challenges for its students, particularly concerning specialty selection. Having broad exposure to medical specialties is crucial for making informed decisions. This study explores how the size of students' hometowns influences their exposure to their preferred specialty, thereby affecting their choice. Methods Our cross-sectional study collected data from medical students in their 4th and 5th years, interns, and graduates across Saudi Arabia. An electronic survey gathered information about medical specialty choice, interest levels, students' self-ranking compared to their peers, and level of exposure to the chosen specialty. Overall exposure to specialties was quantified by tallying participants' experiences in preclinical observerships, didactic lectures, research projects, core and elective rotations, and attended conferences. We divided the students into three city sizes: primary urban centers, intermediate urban cities, and small townships and compared the outcomes between these three groups. Results Responses were obtained from 1,072 participants, with 424 (39.6%) from primary urban centers, 367 (34.2%) from intermediate urban cities, and 281 (26.2%) from small townships. Student hometown size was an independent predictor of specialty exposure, with students from smaller cities reporting lower exposure scores (OR = 0.73, (0.63-0.84), p<0.01). The study also identified gender disparities in exposure, with female students found to be correlated with a lower exposure score (OR = 0.72, (0.58-0.89), p<0.01). Conclusion City size is a significant determinant of specialty exposure for Saudi medical students. These findings highlight the need for initiatives that promote equal educational experiences, ensuring comprehensive specialty exposure to all students.

New Trends of Warthin Tumor Management: A Systematic Review of Nonsurgical Modalities.

Objective: To provide a comprehensive review of nonsurgical approaches for the management of Warthin's tumors (WTs) and evaluate their safety and efficacy as alternatives to surgical intervention. Methods: A systematic literature search was conducted in PubMed, Web of Science, Cochrane Library, and Embase databases using specific keywords related to WT and nonsurgical treatments. Studies published before 2012, non-English publications, and mixed methodology articles were excluded. The selection process involved title and abstract screening, followed by a thorough assessment of the remaining articles based on inclusion and exclusion criteria. Data regarding study characteristics, participants, interventions, and outcomes were collected. Results: A total of 1582 records were analyzed, and 6 studies met the inclusion criteria. These studies evaluated different nonsurgical interventions for WT management, including microwave ablation, radiofrequency ablation, and ultrasound-guided ethanol sclerotherapy. The findings demonstrated that microwave ablation and radiofrequency ablation led to a significant reduction in tumor size and improved cosmetic appearance. Ultrasound-guided ethanol sclerotherapy also resulted in a notable decrease in tumor size without complications. The included studies supported the safety and efficacy of these nonsurgical options for the treatment of WTs. Conclusion: Nonsurgical approaches, such as microwave ablation, radiofrequency ablation, and ultrasound-guided ethanol sclerotherapy, have emerged as viable alternatives to surgical intervention for the management of WTs. These interventions offer promising outcomes in terms of tumor size reduction and cosmetic improvement. Further research with larger sample sizes and long-term follow-up is warranted to validate these findings and establish standardized protocols for nonsurgical management of WTs.

Papillary thyroid microcarcinoma with and without nodal metastasis: A comparative analysis.

OBJECTIVES: To assess the demographics and clinical factors of papillary thyroid microcarcinoma (PTMC) patients in Saudi Arabia and compared and analyzed the differences between the patients with and without lymph node metastasis (LNM). Papillary thyroid microcarcinoma (PTMC) is a common thyroid cancer and is not usually detectable clinically but found incidentally after pathologic evaluation of thyroid tissue following surgery for benign thyroid disorders. However, these tumors have a significant risk of LNM. METHODS: All PTMC patients who underwent surgery at King Abdulaziz University Hospital, King Fahad Medical City, and King Abdulaziz Medical City from 2012 to 2022 were included. The incidence rate of LNM was 9.17%. The patients' average age was 44.05. Most of the patients were female. RESULTS: Prevalence of LNM among PTMC patients is 9.17% (n=31). The PTMC patients showed the following significant risk factors for LNM: higher Bethesda class, type of pathology, extrathyroidal extension, extracapsular extension, lymphovascular invasion, and residual tumors in patients who had received radioactive iodine. Presence of thyroiditis, multifocality, goitrous thyroid, neural invasion, and tumor size were unrelated to the LNM in the PTMC patients. CONCLUSION: Higher Bethesda class, pathology type, extrathyroidal extension, extracapsular extension, lymphovascular invasion, and RAI-treated residual tumors were strongly linked to LNM.

Utilization Pattern and Related Knowledge of Nasal Decongestants Among the General Population in Al-Qunfudah Governorate, Saudi Arabia: A Community-Based Cross-Sectional Study.

BACKGROUND: Nasal decongestants, like phenylephrine and pseudoephedrine, are commonly used to relieve nasal obstruction in conditions such as allergic rhinitis. They induce nasal passage dilation through vasoconstriction but can lead to serious side effects like hypertension and rebound congestion. Despite being easily accessible over the counter, their usage patterns and awareness of side effects are not well studied. OBJECTIVES: The study aimed to assess the utilization pattern and public knowledge of nasal decongestants in Al-Qunfudah governorate, Saudi Arabia, in 2023. METHODS: This observational cross-sectional study assessed the utilization pattern of nasal decongestants among those who were 10 years of age and older and resided in Al-Qunfudah governorate and its villages. Data were collected in three months, from June to August 2023, using a self-administered survey that was disseminated among the general population at Al-Qunfudah governorate on different electronic platforms like Twitter (X Corp., San Francisco, CA, United States) and Snapchat (Snap Inc., Santa Monica, CA, United States). RStudio (version 4.3.0) was used for the statistical analysis. The knowledge score showed a non-normal distribution (Shapiro-Wilk test p value < 0.001). For normally distributed qualitative variables, the factors related to nasal decongestant use were assessed using Pearson's Chi-squared test. Fisher's exact test was applied when more than 20% of cells had frequencies less than 5. A generalized linear regression model was used to assess the independent predictors of higher knowledge scores. A p-value < 0.05 indicated statistical significance. RESULTS: Based on 410 responses, nearly 77% (n = 314) of the participants have ever used nasal decongestants. A total of 118 out of 314 (37.6%) used these medications twice daily for less than five days (81.2%, n = 255). A total of 192 (61.1%) participants used nasal decongestants based on physicians' prescriptions. Few respondents (12.9%, n = 53) and (33.2%, n = 136) correctly identified nasal mucosal ulceration and nasal dryness as adverse effects of prolonged nasal decongestants' use. However, 84.6% (n = 347) ignored their contraindications, and 55.1% (n = 226) had no idea about rebound congestion. Overall, participants displayed a moderate level of knowledge regarding nasal decongestants, with a median knowledge score of 5.0. Being a student (beta = 1.12, 95%CI, 0.19 to 2.05, p = 0.019) and being a female were independently associated with better knowledge scores (beta = 0.97, 95%CI, 0.40 to 1.54, p < 0.001). Those who ever used nasal decongestants (beta = 0.71, 95% CI: 0.07 to 1.34, p = 0.030) and those who used them three times a day (beta = 1.05, 95% CI: 0.11 to 1.99, p = 0.029) had higher knowledge scores. CONCLUSION: More than two-thirds (76.6%) of the Al-Qunfudah general population in Saudi Arabia utilized nasal decongestants. The utilization pattern of nasal decongestants highlighted short-term usage for nasal obstruction. Despite the moderate level of knowledge of the general population about nasal decongestants, many gaps were noted regarding their systemic contraindications, side effects, and the risks of rebound congestion. A focus group discussion is advised to get a full and deep perception of the public regarding this common type of medication. Health education programs are recommended regarding this category of medications, warning them about ineffective self-medication.

Hypopharyngeal lipomatous hamartoma in piriform fossa: A case report and review of literature.

Most hypopharyngeal disease presentations involve tumours or growths of various cellular origin. These lesions may include choristomas, hamartomas, hyperplasia, and harmless or dangerous neoplasms. A hamartoma is a benign focal malformation of tissue at the site of origin that lacks specific distinguishing features and is often designated as a neoplasm without consideration of pathology or biological behaviour. Here, we discuss the case of a 56-year-old man who presented with gradual dysphagia for 4 months along with sleep apnoea and voice changes. No palpable neck masses or abnormal lymphadenopathy was found. A left-sided homogeneous cyst-like mass was seen in the piriform fossa on laryngoscopy. The vocal cords were visualized and mobile. A contrast-enhanced computed tomography scan showed the obliteration of the piriform sinus on the left side by a faintly enhanced heterogeneous soft tissue lesion. The lesion originated from the left aryepiglottic fold, and was approached via micro-laryngoscopy and excised. Histopathological analysis led to a diagnosis of lipomatous hamartoma.

TSH level as a risk factor of thyroid malignancy for nodules in euthyroid patients.

Objective: With the increased prevalence of incidental thyroid cancer, determining the predictors of thyroid malignancy has become a source of debate. This study aimed to determine the impact of thyroid stimulating hormone (TSH) levels on rates of thyroid cancer in euthyroid patients. Methods: A retrospective study included 421 patients who underwent thyroidectomy at a tertiary hospital between 2016 and 2020. Patients' demographics, history of cancer, pre-operative workup and final histology reports were obtained. The study sample was divided into two groups based on the final histopathology (benign vs malignant). The two groups were compared using the appropriate statistical tests to determine the predictors of thyroid cancer in euthyroid patients. Results: TSH levels were significantly higher in patients with malignant nodules compared to those with benign nodules (1.94 vs 1.62, p = 0.002). It was 1.54 times more likely for thyroid nodules to be malignant when TSH levels were higher (p = 0.038). Meanwhile, larger nodules (> 4 cm) were significantly more prevalent in benign nodules (43.1%) than in malignant nodules (21.1%). Larger nodules decreased the possibility of thyroid cancer by 24% (OR = 0.760, p-value = 0.004). Conclusions: High TSH levels in euthyroid patients were significantly correlated with the risk of thyroid malignancy. In addition, as Bethesda category proceeded toward malignancy, TSH levels increased. High TSH levels and small nodule diameters can be used as additional parameters in predicting thyroid cancer in euthyroid patients.

Knowledge and attitude of organ donation in the Eastern region of Saudi Arabia and the influence of social media campaigns: a cross-sectional study.

Previous studies showed organ donation to be less common in Arabic countries, and since there are not many studies exploring the perception toward organ donation, especially in the Eastern region of Saudi Arabia, this study aimed to assess the knowledge, attitude, and influence of social media campaigns on the willingness of organ donation. Methods: A cross-sectional study was conducted between September 2021 and April 2022 among social media users through an Arabic online survey exploring the population's knowledge and attitude regarding organ donation and their willingness to donate. A total of 443 Saudi residents participated in the survey, with 376 of them meeting the required criteria. Results: In all, 85% of participants of the study's calculated response rate were eligible to be included. One hundred ninety-eight of them (52.7%) were female, with age ranges between 18 and 29 years old (76.9%). The majority of the participants (63%) showed unwillingness to donate organs, with the highest rate among males (70.2%), aged above 30 (78.1%), and employees/students out of the healthcare sectors (69.5%). Inadequate knowledge was reported as the most common reason behind their rejection. Next to fears of operation and losing life, and the desire to donate to relatives only. Almost half of the participants (51.6%) agreed on the effect of social media on their behavior toward organ donation, with 187 of them (96.4%) referring to it as a positive effect which was significantly associated with the willingness to donate organs (P=0.006). Conclusion: The study results showed that most of the participants have neither proper knowledge nor willingness toward organ donation. Therefore, more strategies could be developed to increase the rate of donation in the Eastern region.

Major salivary gland carcinoma in KSA: A 10-year nationwide retrospective study of 571 cases.

Objectives: Major salivary gland carcinoma (MSGC) comprises a morphologically diverse group of rare tumours with different clinical behaviours, and epidemiology findings in the literature substantially vary by geographic location. The aim of this study was to conduct a comprehensive analysis of the incidence rates, anatomical sites, and histological subtypes of different salivary gland malignancies in the population of KSA. Methods: This retrospective cohort study included patients diagnosed with MSGC in KSA from 2008 to 2017, on the basis of the demographic characteristics and histological data retrieved from the Saudi Cancer Registry database. Malignant lesions were identified according to the International Classification of Diseases for Oncology, Third Edition (ICD-O-3) codes. Results: Salivary gland malignancies were diagnosed in 571 patients (50.10% males and 49.90% females) over the course of 10 years. The parotid gland was the site of origin in 69.9% of cases. The most common histological type was mucoepidermoid carcinoma (29.1%). Over a decade, the incidence rate ranged from (0.15-0.24) per 100,000 inhabitants. The peak incidence of salivary gland malignancies was observed in the fourth, fifth, and sixth decades of life (17.5%, 18.2%, and 16.8%, respectively). Conclusion: Compared with that in other parts of the world, the incidence of MSGC is significantly lower in KSA, with 0.15-0.24 cases per 100,000 people each year. However, the clinical manifestations of carcinoma of the salivary glands in KSA are similar to those described worldwide.