Prevalence of thyroid nodules and characteristics of thyroid ultrasound in children with goiter: a single center experience.

BACKGROUND: Goiter is a common presenting sign of various thyroid diseases in children. Thyroid nodules are clinically and/or radiologically significant findings due to their high malignancy rate. The ultrasound (US) characteristics of pediatric patients with goiter are rarely reported in literature; thus, the purpose of this study is to assess the characteristics of thyroid US and the prevalence of thyroid nodules in pediatric patients with goiter. METHODS: A retrospective review of children and adolescents under the age of 18 (2015-2020) referred for neck ultrasound due to goiter in clinical examination. RESULTS: A total of 262 patients were included with a mean age of 13.77 ± 3.7 years. Thyroid antibodies were positive in 119/262 (45.4%) patients. Thyroid US reported to be abnormal in 210/262 (80%) patients. Thyroid nodule were found in 33.6% (n = 88/262) of patients with goiter and in 41.9% (n = 88/210) of patients with abnormal thyroid US result. Patients with positive antibodies had more of heterogeneity and hypervascularity of the gland on thyroid US (P < 0.001). On the other hand, thyroid nodules were more likely to be presented in patients with negative thyroid antibodies (P = 0.025). The heterogeneity within the thyroid positive group was significantly correlated with increasing TPOAb (P < 0.001) and TSH levels (P < 0.028). Heterogeneity on US had a positive predictive value (P = 0.041), while hypervascularity had low prediction for thyroid nodules (P = 0.022). Age, gender, family history of thyroid diseases, antibodies status and echogenicity in US did not show any significant associations with thyroid nodules. Papillary thyroid carcinoma was diagnosed in six patients and one of these patients was positive for thyroid antibodies. CONCLUSION: Thyroid nodules are quite common in our population. Thyroid nodules were significantly associated with heterogeneity in US. Although, no clinical or biochemical factors could predict the presence of thyroid nodules on thyroid US in our cohort, the absence of thyroid antibodies should lower the threshold for performing thyroid US.

The relationships between 7-kchol, 7ß-ohchol, chol-triol, Lp (A) and PON1 with coronary heart disease in patients with diabetes mellitus T1DM and T2DM.

Oxysterols (OXY) are oxidized derivatives of cholesterol associated with oxidation and can increase the risk of cardiovascular diseases. The aim of the current study is to examine the relationships between OXY profile, lipids, lipoprotein(a) [Lp(a)] and paraoxonase1 (PON1) with coronary heart disease (CHD) in patients with diabetes mellitus type1 (T1DM) and type2 (T2DM). 120 diabetic patients (T1DM=40, T2DM=80) and 60 healthy subjects were recruited in the study. OXY profile (7-KChol, 7ß-OHChol and Chol-triol) was measured using liquid chromatography-mass spectrometry. The clinical profile of the study participants was also collected. 7-KChol, 7ß-OHChol and Chol-triol and Lp(a), FBG and glycation parameters were higher in diabetic patients compared to controls (p>0.01), whereas PON1 was lower in patients compared to controls (p>0.01). Within the T2DM group, 7-KChol and 7ß-OHChol levels were associated with CHD, obesity, and smoking (p<0.05). In addition, KChol, 7ß-OHChol and Chol-triol levels were associated with smoking in T1DM (p>0.05). In both diabetic types, 7-KChol, 7ß-OHChol and Chol-triol were significantly correlated with TC, LDL, ApoB and Lp(a), glycation parameters and inversely with PON1 (p>0.05). OXY profile in diabetic patients can be used as a reliable biomarker of CHD, particularly in T2DM.

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.

Relationship between bad oral habits, signs, and symptoms of temporomandibular joint disorders among Saudi population: A cross-sectional study.

Background: According to the American Dental Association, temporomandibular disorders (TMD) refer to a group of disorders characterised by pain in the temporomandibular joint (TMJ), the periauricular area, or the muscles of mastication. TMJ noise/sounds, and any deviations or restriction during jaw movements. Many oral habits are common and usually do not harm the TMJ and associated structures. However, these habits may result in TMJ disorders, if the activity goes beyond someone's physiological tolerance. The causes of degenerative changes of TMJ are believed to be multifactorial and controversial too. Objectives: This study aims to evaluate the prevalence of oral habits and its relationship with temporomandibular disorders in the Saudi population of Taif city. Materials and Methods: This questionnaire-based cross-sectional study was conducted from March 2021 to July 2021 at Taif city, Kingdom of Saudi Arabia (KSA). The Arabic version of a standardized questionnaire (recommended by the American Academy of Orofacial Pain) was used and distributed randomly among 441 citizens of Taif city. Results: Our study showed that many respondents had different TMJ disorders, such as pain during eating, sound in jaw joint, pain around ear, temples, and cheek, headache and neck pain, change in bite, and pain during opening and closing of the mouth. On the other hand, many respondents answered that they had TMD, pain associated with nail biting/object biting, lip biting, clenching teeth, and chewing gum. Conclusion: In the present study, a relationship between harmful oral habits and the development of signs and symptoms of TMDs among adolescents who lived in Taif city, KSA was noted. In the present study, no clinical examinations were conducted and only consisted of closed-ended questions, all of which may have a lower the validity rate. An effort was made to overcome these limitations by using a well-designed standardized questionnaire by the American Academy of the Orofacial Pain. We conclude that further studies are required and using of clinical examination to measure the severity of the signs and symptoms for better understanding the association of oral habits with TMJ disorders.

The association between the knowledge on prostate cancer screening with the beliefs and behaviors of Saudi men attending King Khalid University Hospital.

Background: The evidence showed that prostate cancer (PC) is the second most common malignancy in men globally. Unfortunately, it rarely produces symptoms, and the diagnosis is delayed until the tumor is advanced. Objectives: To determine the participants' uptake of prostate cancer screening (PCS). Also, to assess their perceptions regarding PCS. Furthermore, to evaluate the association between patients' knowledge of PC and their beliefs and behaviors towards PCS. Methods: This cross-sectional study recruited men aged older than 40attending the King Khalid University Hospital (KKUH) between October 2020 and March 2021. SMS messages were sent to a random sample of 228 participants, inviting them to participate in an online self-administered questionnaire. The questionnaire consisted of 1- demography and history of PCS; 2- the knowledge questionnaire about PC; 3-the Champion's Health Belief Model (HBM). Results: Out of the 228 participants, 45.2% were men aged 60 years and above, 54.4% with college degrees and postgraduate studies, and 92.5% were married. The median knowledge score was 5, and the range was 12. Most men (72.4%) had a low knowledge score, and 79.4% of them did not have a previous PCS. Men aged 60 + were more likely to undergo the screening than their counterparts, with P values of 0.005. Higher knowledge scores were associated with the perceived benefits of prostate-specific antigen (PSA), digital rectal examination (DRE), and health motivation, P values of 0.0001, 0.0001, and 0.02, respectively. PSA and DRE>s perceived barriers were associated with low knowledge scores, P values of 0.0001 and 0.003, respectively. A higher probability of PCS participation was associated with the older age group, a P value of 0.001. Low participation was associated with perceived barriers of DRE, a P value of 0.031. Conclusion: The majority of the participants had poor knowledge regarding PC and PCS. Only a fifth of the men did PCS. High knowledge was associated with PSA and DRE perceived benefits and health motivation.

Sudden Cardiac Arrest at the Triage of Emergency Medicine Department in a Patient With COVID-19.

A pneumonia outbreak with an unknown microbial etiology was reported in Wuhan, Hubei province of China, on December 31, 2019. This was later attributed to a novel coronavirus, currently called as severe acute respiratory system coronavirus 2 (SARS-CoV-2). Coronavirus disease 2019 (COVID-19) mainly affects the respiratory system and can also cause acute or chronic damage to the cardiovascular system. We present a case of a 64-year-old female with past medical history of diabetes mellitus and hypertension who presented to the Emergency Medicine Department with shortness of breath and worsening chest discomfort, then had a ventricular fibrillation (VF) arrest while in triage, in the context of COVID-19 diagnosis. Cardiovascular complications during the COVID-19 pandemic should be brought to medical attention; it is crucial that physicians be aware of the complications and treat it as an emergency.