Secondary syphilis presenting with non-arteritic anterior ischemic optic neuropathy (NAION).

Syphilis is a sexually transmitted disease caused by the spirochete bacterium Treponema pallidum. Syphilis is a significant public health issue, notably in (HIV) positive patients. Due to the absence of pathognomonic signs in secondary syphilis and its ability to present and mimic a wide variety of clinical findings, it gained the name "the Great imitator '(mimicker).' Herein, we describe a case of a 51-year-old man who presented with acute painless loss of vision of the right eye preceded by a few erythematous plaques with thick scales over bilateral legs and multiple discrete and confluent scaly papules over the palms and soles. During the hospital stay, a diagnosis of non-arteritic anterior ischemic optic neuropathy (NAION) as a manifestation of neurosyphilis is made. To the best of our knowledge, this is the first reported case of NAION as the presenting symptom of neurosyphilis in secondary syphilis in an immunocompetent patient.

Factors affecting the choice of dermatology as a specialty by medical students: Data from 28 KSA medical schools.

Objectives: Choosing a future career path is a very important decision for undergraduate medical students. Determining the factors that affect specialty choices is essential to attaining a balanced distribution. Dermatology is known to be one of the most appealing and highly competitive specialties. The aim of this study was to determine the factors influencing the choice of dermatology as a future career by medical students. Materials and Methods: A cross-sectional study was carried out in 28 medical schools throughout Saudi Arabia. The questionnaire was prepared following a literature search of relevant studies and was distributed electronically to medical students and interns. The self-administered questionnaire included sociodemographic data, interest in dermatology as a future career, and factors that may affect specialty choices. Results: The study included 1087 participants. Sixty percent were female, and 39% were male. Approximately half of the participants considered dermatology as their preferred specialty. We found that 53.6% of females were more interested in dermatology. Students who were exposed to dermatology in both pre-clinical and clinical years showed greater interest. Personal interest, lifestyle/flexible work schedule, and private sector opportunities were the most captivating factors. Personal interest and high competition in dermatology residency program matching were the main factors among students who did not consider dermatology as a future career choice. Conclusions: Several factors are influencing medical students when choosing dermatology as their future specialty; the lifestyle/flexible work schedule and personal interest were the most attractive factors. Recognizing these factors could be a useful tool that may lead mentors and residency training program directors to reach a balanced distribution of doctors in the various specialties.

Prevalence of Hypothyroidism Among Carpal Tunnel Syndrome Patients at a Hospital in Saudi Arabia.

Introduction Patients with carpal tunnel syndrome have a high prevalence of hypothyroidism, therefore, it is recommended to assess thyroid function routinely in patients with carpal tunnel syndrome. This study aims to determine the prevalence of hypothyroidism among carpal tunnel patients and to relate carpal tunnel in hypothyroidism to other socio-demographic factors. Methods This was a retrospective study carried out in King Fahad Medical City (KFMC) in Riyadh, Saudi Arabia. A total of 422 samples were collected conveniently from the files of patients who underwent carpal tunnel release surgery. The Statistical Package for the Social Sciences (SPSS) version 23 was used for data processing. The chi-square test was used to test the association between the categorical variables. A p-value of less than .05 was considered to be significant. Results Most of the respondents were females and most of them within the age group of 46 to 60 years. Thirteen point eight percent (13.8%) of the respondents are suffering from hypothyroidism and 5% from the sub-clinical form of the disease. More than two-thirds of those with hypothyroidism were asymptomatic. The duration of the disease was one to five years, and bilateral nerve concerns were mostly present in patients with carpal tunnel syndrome. The presence of thyroid abnormality doesn't affect the duration of carpal tunnel syndrome but body mass index (BMI) is significantly associated with hypothyroidism (p-value = .001). Conclusion Clinical symptoms of hypothyroidism are mostly absent in patients with carpal tunnel syndrome. Most patients with carpal tunnel syndrome have the disease for one to five years and this is not significantly associated with abnormal thyroid. Most patients have bilateral wrist involvement with no apparent symptoms and signs.