Utilizing the McGill Thyroid Nodule Score to compare between hemithyroidectomy cases who required completion thyroidectomy and cases of hemithyroidectomy alone

ObjectivesThis study aims to evaluate whether the McGill Thyroid Nodule Score (MTNS) accurately helps to decide the extent of surgery (hemithyroidectomy versus total thyroidectomy) based on the malignancy risk and to assess whether its use lowers the rate of completion thyroidectomy in cases of indeterminate thyroid nodules.MethodsWe performed a retrospective cohort study comparing MTNS results of patients undergoing hemithyroidectomy in King Abdulaziz Medical City, NGHA, Jeddah from the period of January 2013 to December 2017. We divided the cases into hemithyroidectomy who required completion and hemithyroidectomy who did not need completion surgery. The pre-operative indeterminate FNA biopsy subgroup comprised of Bethesda type III (atypia of undetermined significance/follicular lesion of undetermined significance) and Bethesda type IV (follicular neoplasm/suspicious for a follicular neoplasm/Hurthle cell neoplasm). Post-operative histopathology was divided into benign or malignant groups.ResultsOf the 501 patient charts reviewed, 111 (22.2%) had an indeterminate FNA biopsy. 97 (87.4%) patients were females and 14 (12.6%) were males. In the hemithyroidectomy group, the pre-operative mean of the MTNS was 6.65, while in the completion thyroidectomy the mean was 11.47. The median MTNS was 7 (32% risk of malignancy) for the hemithyroidectomy group and 11 (63% risk of malignancy) for the completion thyroidectomy group (p < 0.001).ConclusionsBased on the MTNS the risk of malignancy in cases of hemithyroidectomy who required completion surgery was significantly higher than those who underwent hemithyroidectomy only. The MTNS can be of value to thyroid surgeon in the pre-operative decision-making when dealing with an indeterminate thyroid nodule on FNA biopsy.     

Genetic association of apolipoprotein E polymorphisms with inflammatory bowel disease

AIM:To study the association of apolipoprotein E(APOE) polymorphisms with the susceptibility ofinflammatory bowel disease(IBD) in Saudi patients.METHODS:APOE genotyping was performed to evaluate the allele and genotype frequencies in 378 Saudi subjects including IBD patients with ulcerative colitis(n = 84) or Crohn's disease(n = 94) and matched controls(n = 200) using polymerase chain reaction and reverse-hybridization techniques.RESULTS:The frequencies of the APOE ε2 allele and ε2/ε3 and ε2/ε4 genotypes were significantly higher in IBD patients than in controls(P 0.05),suggesting that the ε2 allele and its heterozygous genotypes may increase the susceptibility to IBD.On the contrary,the frequencies of the ε3 allele and ε3/ε3 genotype were lower in IBD patients as compared to controls,suggesting a protective effect of APOE ε3 for IBD.The prevalence of the ε4 allele was also higher in the patient group compared to controls,suggesting that the ε4 allele may also increase the risk of IBD.Our results also indicated that the APOE ε4 allele was associated with an early age of IBD onset.No effect of gender or type of IBD(familial or sporadic) on the frequency distribution of APOE alleles and genotypes was noticed in this study.CONCLUSION:APOE polymorphism is associated with risk of developing IBD and early age of onset in Saudi patients,though further studies with a large-size population are warranted.     

Study of cystic echinococcosis in slaughtered animals in Al Baha region, Saudi Arabia: Interaction between some biotic and abiotic factors

The variation in cystic echinococcosis (CE) prevalence and mean intensity was studied in relation to site, season and host age and sex. A total of 12,911 slaughtered animals, 140 camels, 2668 cattle, 6525 sheep and 3578 goats were inspected for hydatid cysts in Al Baha region, Saudi Arabia, in three study areas during four seasons from June 2008 to May 2009. The prevalence of infection was 32.85%, 8.28%, 12.61% and 6.56% in camels, cattle, sheep and goats respectively. The prevalence of the parasite varied significantly in relation to site, season and host age classes and sex in most host species. Spring showed the highest prevalence in camels, cattle and sheep. A significant association was found among host age classes and likelihood of infection in all examined hosts and the oldest age class was significantly more likely to be infected. The main effects in parasite intensity were host sex and age in most examined host species. A positive correlation was found between intensity of CE and host age class in all animal species examined. The most commonly infected organs were liver and lungs which constituted 48.75% and 32.83% respectively, of the total infected organs. There was a significant difference among host species in fertile cysts (P < 0.0001). The higher percentages of fertile cysts were in sheep (47.67%) and goats (23.99%) indicating that sheep and goats are the most important intermediate hosts for Echinococcus granulosus. Examined hydatid cysts of the liver had a higher fertility rate (38.79%) than those of the lungs (25.13%). Cysts size ranged from 1 to 8 cm in diameter. The mean cyst diameter was found in the lungs higher than that in the liver in all hosts. The range in the number of cysts was 1-33 in infected animals. The mean number of cysts was higher in lungs than that in liver in all examined animals. The viability rate of protoscoleces of liver fertile cysts (62.20%) was significantly higher than that of lung cysts (52.73%). In conclusion, these findings of infection, mean abundance and fertility rates of CE in slaughtered animals, prompt plans for further epidemiological studies and control programmes.     

Dental experiences related to oral care of children with autism spectrum disorders in Saudi Arabia: A literature review

The burden of autism spectrum disorder (ASD) in Saudi Arabia remains unclear with a dearth of literature, which focus on risk factors, prevalence, or interventions. This study is a review of the published literature related to dental experiences of children with ASD in Saudi Arabia. Twenty-two studies were included in this review, based on the predefined inclusion criteria which examined dental disease prevalence in children with ASD, identified the risk factors and the potential barriers to oral care. Results uncovered a lack of systematically published studies from Saudi Arabia which might have led to the limited development of effective oral health policies in the Kingdom. Identification of research gaps and potential intervention policies are needed to improve the oral health and quality of life of children with ASD in Saudi Arabia.     

Cardiovascular disease in Hajj pilgrims

The changing pattern of hospital admissions during Hajj, the Muslims yearly pilgrimage attracting millions of pilgrims from all around the globe, has gradually seen infectious causes of hospital admission replaced by cardiovascular diseases as a leading cause of both intensive care unit admission and death. While this trend is partly associated with the high quality of medical services and awareness programs targeted at reducing the spread of infections, at the same time it underscores an urgent need to establish a pragmatic system to manage the challenge of cardiovascular morbidities and mortality during Hajj.Search strategy and inclusion criteriaA PubMed Central (PMC) literature search without date restrictions was performed for articles reporting on the medical experience during Hajj. There were 109 articles were returned using “Hajj” and “mortality” as search terms. After determining relevance to the current theme based on both direct and indirect reference to the pattern hospital admission during Hajj, 20 articles reporting on conducted studies were obtained. Data from these studies reporting on the pattern and outcome of hospitalization during Hajj were examined and helped in arriving at the conclusions presented in this review.     

Awareness,attitude, and distribution of high blood pressure among health professionals

BackgroundBP control is suboptimal Worldwide. Little is known about attitudes of health professionals toward their BP status.AimTo estimate awareness, attitudes, and distribution of blood pressure among health professionals.Study designProspective cross-sectional survey.MethodsStudy was conducted among health professionals in two tertiary hospitals in Riyadh, KSA during December 2010. Socio-demographics, risk factors for high BP, awareness, and adherence to treatment were recorded.ResultsSix hundred and seventy-two subjects, 66.6% females, mean age 36.2 + 13.9 years. Prevalence of Hypertension (HTN) was 28%. 114 (60.6%) patients had self reported HTN in HTN group while 74 (11%) of total study population, were not aware that they have HTN which was detected on screening. Stress and lack of formal exercise were prevalent risk factors for HTN, present in 44.1% and 36.1%, of patients, respectively, while obesity was present in 19.4%. Many participants were not aware of recently recommended target value of blood pressure. 22.3% patients were irregular for their follow-up. 12.2% patients were not adherent to the treatment. Isolated systolic hypertension was more common in men. A point of serious concern was that relatively young health professionals, who were not known to be hypertensive did not monitor their BP, found to have HTN.ConclusionSuboptimal awareness and lack of adherence to the treatment for BP among health professionals is of serious concern, for increased chances of cardiovascular events. Physical exercise, correction of obesity and compliance with treatment may reduce the risk of HTN-related adverse outcome in this special subset of the population.