Risk factors for recurrence of chronic rhinosinusitis with nasal polyps after endoscopic sinus surgery: A retrospective study.

OBJECTIVES: To assess the pathophysiological factors leading to chronic rhinosinusitis (CRS) recurrence with nasal polyps (CRSwNP) after endoscopic sinus surgery (ESS) and compare the clinical and imaging findings between both groups. METHODS: A retrospective study was carried out at a tertiary hospital. Patients with recurrent nasal polyps were compared to those with no recurrence by demographics, risk factors, anatomical abnormalities, clinical features, and Lund-Mackey (LM) scores. Both groups were followed up for 24 months after the primary surgery to detect recurrence. RESULTS: Among the 134 patients who underwent ESS for CRSwNP, 69 patients were in the recurrence group and 65 in the non-recurrence group. No significant difference was found in demographics, comorbidities, and anatomical abnormalities between both groups. However, asthma was more prevalent in the recurrence group (73.9% vs. 29.2%; p<0.01). All clinical features were similar between both groups. However, the recurrence group had more patients with bilateral polyps than non-recurrence (95.7% vs. 80%; p<0.01). We found that 26.1% (n=18) of the 69 patients with recurrence needed revision surgery. Smoking rates were significantly different between reoperated vs. non-reoperated patients (16.7% (3/18) vs. 2% (1/51); p=0.02), and the extent of primary ESS was different between them. CONCLUSION: Asthma is a significant risk factor for CRS recurrence. Furthermore, smoking and inadequate primary surgery increase the chance of revision surgery in case of recurrence.

Primary Schwannoma of the Thyroid Gland in a 71-Year-Old Woman: A Case Report.

Schwann cells in the body's nerve sheath can develop into benign tumors known as schwannomas. While thyroid gland schwannomas are uncommon and are rarely documented in the literature, they are less unusual than those appearing in the head and neck region. The rare nature of schwannomas connected to the thyroid gland adds to the difficulty in detecting them prior to surgery. At present, the most popular form of treatment for thyroid schwannomas is surgical resection, which is considered to be curative. A mass excision or lobectomy has a favorable prognosis, few postoperative complications, and a low risk of tumor recurrence. This paper reports the case of a 71-year-old woman who presented with left neck swelling that had been increasing in size over a number of years. An ultrasonography examination revealed multiple bilateral thyroid nodules with high vascularity. The patient's right thyroid lobe exhibited benign nodular hyperplasia while the thyroid tissue of the isthmus exhibited benign nodular hyperplasia and schwannoma. Following the diagnosis, the patient's mass was successfully surgically removed.

Prevalence of and Factors Associated With Eustachian Tube Dysfunction Among the Public in Taif, Saudi Arabia.

Background The eustachian tube is a tubular structure connecting the middle ear cavity with the nasopharynx, providing ventilation and pressure equalization in the middle ear, mucociliary clearance, and preventing the reflux of sound and fluid from the nasopharynx. Therefore, any kind of deficiency in this tube will lead to eustachian tube dysfunction (ETD). Aim This study aims to evaluate the prevalence and associated factors of ETD in the Taif public. Materials and methods A descriptive cross-sectional survey was conducted among the public in Taif, Saudi Arabia and it was done during the period between September 7 and September 28, 2021. A predesigned online questionnaire in the Arabic language was used to collect the data. The questionnaire contained three main parts. The first one included demographic questions, the second risk factors, and the third manifestations of ETD. The questionnaire was initiated after a literature review of similar articles and after experts' consultation for validity and reliability. Results A total of 693 participants completed the study questionnaire. The exact 546 (78.8%) participants were females and 671 (96.8%) were Saudi. The exact 122 (61%) participants among those who had ETD or hearing loss reported improvement in their symptoms after moving to another city below sea level. The exact 146 (21.1%) participants had ETD while 547 (78.9%) had reported normal function. ETD was detected among 69.2% of those who were previously diagnosed with ETD versus 20.1% of others (P=0.001). Participants with a family history of hearing loss showed a nearly doubled risk for having ETD (OR=1.98; 95% CI: 1.33-2.94) and smokers had nearly the same doubled likelihood(OR=1.83; 95% CI: 1.01-3.48). Conclusion In conclusion, our study revealed a slightly high prevalence of ETD and hearing loss among the public in Taif, Saudi Arabia, and the factors associated with ETD.

Population Preference of Surgeon's Gender for Surgical Care and Their Attitudes Toward Female Surgeons in Taif, Saudi Arabia.

Introduction One contributing factor that has led to a reduction in the number of females entering the profession of surgery is discrimination against female surgeons. Little is known about the practices, attitudes, and perceptions of the Saudi population toward gender discrimination in the field of surgery. The aim of this study was to assess the practices, attitudes, and perceptions of the Taif population in choosing a surgeon based on their gender. Materials and methods An online pretested questionnaire was randomly sent to the participants living in Taif city. Collected data were subjected to scrutiny to check participants' study inclusion criteria. All the data were subjected to statistical analysis by an independent biostatistician. Pearson's chi-square test was used to search for a statistically significant association between categorical variables. Results About 49.5% of the participants preferred a surgeon of the same gender when consulting for a non-emergency visit to a surgery clinic, whereas females significantly preferred a female surgeon (p < 0.001). The most common reason to choose surgeons of the same gender was comfort, followed by ease of talking. About 71.8% of the participants preferred female surgeons for ''sensitive'' surgical cases such as genital, obstetric, or sexual disorders, whereas 12.1% preferred male surgeons. Conclusion Females have shown progress in the field of surgery, but there is still much to be done to convert the surgical workplace to be more supportive of women so that they contribute their best effort.

Steven Johnson Syndrome in a 102-Year-Old Woman in Saudi Arabia: A Case Report.

Medicines often cause serious immune-mediated mucocutaneous reactions including Steven-Johnson Syndrome (SJS) and toxic epidermal necrolysis (TEN). In the acute phase of SJS and TEN, a febrile illness is followed by cutaneous erythema with blister formation, skin and mucous membrane necrosis, and separation of the skin and mucous membranes. The patient swiftly becomes in danger of dying, necessitating immediate medical attention. In this case report, we described a case of Steven-Johnson Syndrome in a 102-year-old female who was receiving palliative care and had stage 5 chronic renal disease. Although the agent that caused SJS in this patient is unknown, the patient was managed with topical medication, bandages for the lesions, and oral antihistamines. Skin biopsy, abdomen ultrasound, and sezary cell test were advised for the patient. Such presentations at that age have not, to our knowledge, been documented before.

Impact of COVID-19 on psychological and academic performance of medical students in Saudi Arabia.

BACKGROUND AND OBJECTIVES: The COVID-19 pandemic affected the mental health and psychosocial conditions of everyone worldwide according to the WHO. Public health emergencies affect college students and are expressed as anxiety, worry, and fear. The aim of this study was to assess the impact of COVID-19 on the psychological health and performance of medical students. DESIGN AND SETTINGS: A cross-sectional study using an online survey was done. PARTICIPANTS AND METHODS: Participants were 1591 Saudi medical students. A predesigned questionnaire included questions on demographic characters, GPA, having a relative got COVID-19, how to face sad news and stressors, and satisfaction with online lectures. The Generalized Anxiety Disorder (GAD-7) scale was used that included seven items asking about the degree the participant was bothered by feeling anxious in the last 2 weeks. RESULTS: A total of 59.4% of students had various degrees of anxiety. Participant age, unsteady family income, high grade point average (GPA,) satisfaction with the online lectures, and being female were associated with higher GAD-7 scores. CONCLUSION: Mental health of medical students was significantly affected by the COVID-19 pandemic. Psychological support programs for medical students during the pandemic and provision of high-quality distance learning is essential for psychological well-being during the pandemic.

Does Male Infantile Galactocele Always Necessitate Surgical Intervention?

Galactocele is cystic dilatation of the mammary gland, which contains milk. Galactocele is usually presented as a painless breast enlargement with a fluctuant, soft, mobile, and non-tender mass in the breast. It is a rare disorder in the male pediatric age group, with only 31 cases reported in the literature. In this article, we present another case of unilateral galactocele in a 14-month-old male infant. Ultrasound imaging confirmed a simple cystic hypoechoic mass in the right breast, and needle aspiration was performed before surgery as a diagnostic procedure (a 1-cc extract revealed a milky-colored fluid).