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Background: Safe use of intravascular (IV) contrast media in medical imaging is important. We aimed to assess the clinicians’ knowledge and attitudes toward safe use of IV contrast media in medical imaging regardless of their specialty and experience. Methods: A cross-sectional study was conducted using a self-administered questionnaire in selected hospitals at Qassim, Saudi Arabia. The participants were exposed to 30 items to assess their knowledge and attitudes toward safe use of contrast media. The mean percentage scores were correlated with the specialty, level of training, experience, and frequency of contrast study requisition. Results: A total of 227 participants enrolled in the study. Internal medicine and pediatric were the highest specialties among participants (26.4%). Nearly half of participants (40.5%) had more than 10 years of experience in their field. Majority of the participants had insufficient knowledge (85.9%) and negative attitudes (80.2%) toward safe use of contrast media. The results indicate some variations in level of knowledge in between different specialties in favor of internal medicine (p = 0.041), and statistically significant association between the participants’ attitudes and their perception of level of knowledge (p = 0.004). Finally, there is a statistically significant relation between knowledge and attitudes (p< 0.01) with correlation coefficient (0.331) that consider as low. Conclusions: The study confirms overall unsatisfactory knowledge and negative attitudes toward safe use of IV contrast media among clinicians. Such findings might interfere with patient’s safety or postponing necessary study. Improving knowledge on contrast media safety is highly recommended through curricular or non-curricular activities.

Hospital-acquired infections (HAIs) contribute to increased length of hospital stay, higher mortality and higher health-care costs. Prevention and control of HAIs is a critical public health concern. This study assessed the knowledge, attitude, and practice (KAP) of standard infection control precautions among health-care workers (HCWs) in Qassim, Saudi Arabia. A cross-sectional online survey among HCWs was conducted using a structured questionnaire. Predictors of KAP were investigated using multivariate logistic regression analyses and independent sample t-tests. A total of 213 HCWs participated in the survey. The prevalence of good (≥80% correct response) knowledge, attitude, and practice were 67.6%, 61.5%, and 73.2%, respectively. The predictors of good knowledge included the age of the HCWs (&gt, 34 years) (adjusted odds ratio: 30.5, p &lt, 0.001), and training (13.3, p &lt, 0.001). More than 6 years of work experience was a significant predictor of having a positive attitude (5.5, p &lt, 0.001). While the predictors of good practice were having &gt, 6 years of experience (2.9, p &lt, 0.01), previous exposure to HAIs (2.5, p &lt, 0.05), and training (3.5, p &lt, 0.01). However, being female (0.22, p &lt, 0.001) and older (&gt, 34 years) (0.34, p &lt, 0.01) were negatively associated with knowledge. Results indicate that arranging training for HCWs might be useful in improving their knowledge of standard infection control precautions and is also expected to facilitate positive attitude and practice.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is RNA virus, responsible for coronavirus disease 2019 (COVID-19), which has now taken the form of a pandemic. Even though the world has undertaking all possible measures to impede the spread of this droplet infection, still the prevalence of COVID-19 is on the rise and has infected more than 208 countries all over the globe. Reviewing the website and global articles from PubMed, Scopus and other cites on COVID-19 a global pandemic, this review article provides an update on the all major aspects of coronavirus such as origin, epidemiology, mode of transmission, structure and molecular characterization, characterization of spike protein, clinical features including cutaneous manifestation, radiological features, molecular testing, histopathology and the current preventive approaches. Importantly, review also provides an update on current projections of Saudi Arabia on COVID-19 pandemic.

Purpose Melanotic schwannoma (MS) was formerly known as a rare variant of schwannoma. The behavior of MS is unpredictable, with a tendency for recurrence and metastasis. The purpose of this study was to illustrate the imaging characteristics of these rare and misdiagnosed tumors. The prognosis of MS is discussed, along with the importance of follow-up exams to assess for recurrence and metastasis. Furthermore, we compare our results with those previously published on MS in order to have a better understanding of this rare entity. Methods Three MS cases were encountered between 2008 and 2015 at our institute. All available data were reviewed, including the clinical history, imaging findings, operative notes, and the histopathology results. A follow-up magnetic resonance imaging (MRI) scan was also reviewed up to 23 months post surgery to assess for recurrence. Results Three cases of MS are included: one in the brain and two in the spine. The brain lesion was in the occipital region. The spine lesions were thoracic intramedullary and sacral intradural. All cases were hypointense on T2-weighted imaging. Gross total resection was achieved for all lesions without adjuvant therapy. To date, the brain lesion recurred 15 months after surgery. Conclusions MS is a rare and distinct entity rather than a variant of schwannoma, and it poses both diagnostic and management dilemmas. Although MS has characteristic MRI features, including T1 and T2 shortening, the preoperative diagnosis is always challenging. Accurate diagnosis is crucial for management planning, including long-term follow-up exams to assess for recurrence and metastasis.

Background The COVID-19 pandemic has impacted education in myriad ways, primarily leading to an abrupt paradigm shift in teaching and learning practices towards distance learning. The study aims to assess the effectiveness of teaching radiology to undergraduate medical students using synchronous distance learning compared to traditional on-campus learning through exploring students’ perceived satisfaction and concerns. Students’ perceptions were correlated with their attendance, grades, and frequency of technical difficulties. Methods The study was designed as an observational study involving fourth-year medical students (2019/2020) from two institutions. The cohort students were exposed to traditional learning, distance learning, or both. Students completed an online self-administered questionnaire concerning their perceptions of distance learning. Students’ attendance, engagement, technical difficulties, and post-clerkship knowledge assessments were analyzed using descriptive and inferential statistics. Results A total of 145 participants completed the clerkship using the following strategies: traditional learning (n = 66), both traditional and distance learning (n = 67), and distance learning alone (n = 12). The most important result indicates that the abrupt transition to distance learning was well perceived. Most students preferred distance learning over traditional learning in the radiology clerkship (p = .05). During the synchronous sessions, student attendance was high, reaching to 100%. Technical difficulties were limited (1.9%), and they did not affect learning. Conclusion Synchronous distance teaching promotes learning, interaction, and enjoyment in undergraduate radiology education, and it can be as effective as traditional on-campus learning. The technical difficulties encountered, although they were limited, can be overcome by recording the synchronous sessions.

Background: Parsley (Petroselinum crispum L) (PAR) is used widely as an antioxidant, antihyperlipidemic, diuretic, and medication to reduce hypertension. At the same time, conventional drugs such as Simvastatin (SV) are also used to manage hyperlipidemia in hypertensive patients. However, no studies have reported any interactions for the concomitant use of PAR and SV. Objectives: The study aimed to evaluate the enzyme-inducing or inhibiting role of PAR for SV at the level of cytochrome P-450 metabolic enzyme. Methods: This is an open-label (unblinded) study conducted with 24 healthy albino rats (4X6 = 24), at Imam Abdulrahman Bin Faisal University, Saudi Arabia, in the year 2018 with protocol approval No. IRB-2018-145-Pharm and approval date 18/04/2018. The animals were administered with a loading single oral dose of SV (80 mg), Clarithromycin (CLAR; 80 mg), Carbamazepine (CBZ; 80 mg), and PAR, i.e., dried herb powder (200 mg), in order to achieve a steady state concentration in the blood. Blood samples were collected at specified time points including pre-dose (0.0) and after-treatment, i.e., 0.5, 1, 1.5, 2, and 3 hours, and centrifuged. The plasma was extracted to analyze for SV by LC-MS using a previously developed method. Results: The analysis of pharmacokinetic parameters revealed enhanced Cmax (mean plasma maximum concentration) and AUC0-∞ (area under the concentration-time curve) as 2 and 2.2 folds, respectively, for SV+PAR (P < 0.01) as compared to SV alone. A decrease in CL/F (total-body clearance of drug from the plasma) for SV (P < 0.01) and an increased t1/2 (mean half-life) from 3.20 to 6.12 hours for SV co-administered with PAR were observed. Conclusions: Parsley combined with Simvastatin increased the Cmax and AUCs for Simvastatin as 2 and 2.5 folds; thereby, the moderating enzyme-inhibiting role of Parsley for CYP 3A enzyme may be proposed. Hence, caution is required when administering Parsley with Simvastatin for any therapeutic purpose.

Squamous cell carcinoma (SCC) of the kidney is a rare entity. Coexistence of SCC with xanthogranulomatous pyelonephrits is exceedingly rare with only few reports in the literature. We report a case of a 45-year-old male patient with xanthogranulomatous pyelonephritis coexistence with renal SCC in one kidney, which proved radiologically and histopathologically. The patient presented to the medical care with bone metastasis. Full radiology workup is also provided which includes computed tomography, magnetic resonance imaging, and positron emission tomography-computed tomography. Keywords: Renal squamous cell carcinoma, Xanthogranulomatous pyelonephrits, Bone metastasis

Upper gastro intestinal bleeding is one of the most common reasons of emergency department visits, totaling up to 400,000 annual admissions in the United States. Peptic ulcer disease and variceal bleeding are two of the most common causes of GI bleeding. Several studies have been done, and major advancements were made in its management leading to significant drop in morbidity and mortality. Our aim is to study the common causes of upper gastrointestinal bleeding that come to the emergency department and understand the latest guidelines to manage them. We conducted this review using a comprehensive search of PubMed, MEDLINE, and EMBASE from March 1981, through November 2017. The following search terms were used: upper gastro intestinal bleeding, management of upper GI bleeding, variceal bleeding, peptic ulcer bleeding, hemorrhage in the emergency department. Acute upper gastrointestinal bleeding is one of the most common cases encountered in the emergency department and leading to significant morbidity and mortality. Clearing airway and breathing and stabilizing the vitals of the patient by achieving hemodynamic stability and bleeding control is the primary goal in the emergency department.

Estimates say that Helicobacter pylorus affects more than half of the general population over the world. Its prevalence varies significantly among different areas. Studies done in 1990 reported a prevalence of 70% of people older than 20 years who live in Saudi Arabia, and 40% of people aged 5-10 years. The first line regimen of helicobacter pylori infections in Saudi Arabia is 7 days of triple therapy. However, in areas of high antibiotic resistance, or in cases of failure of triple therapy, a ‘rescue’ quadruple therapy (that contains bismuth) is indicated. In this study we aimed to look at the prevalence of H. pylori infection and its association with gastroesphageal reflux disease in Saudi Arabia. We also tried to understand the approach for diagnoses and treatment in the Kingdom. We did a systematic search for helicobacter pylori and GERD in Saudi Arabia using PubMed search engine (http://www.ncbi.nlm.nih.gov/) and Google Scholar search engine (https://scholar.google.com). The following search terms were used: H. pylori, gastroesophageal reflux disease, prevalence of GERD in Saudi Arabia, lifestyle Saudi Arabia, gastroenterology Saudi Arabia. All studies done shows prevalence in Saudi Arabia to be relatively high (reaching 70%) and increasing. Despite being highly prevalent, no solid guidelines are present to help clinicians diagnose and treat helicobacter pylori infection properly. These, along with other causes like improper use of antibiotics have led to the emerging of new strains that are resistant to typical antibiotic treatment.

Hydatid cyst of the breast is endemic in some areas like sheep-raising countries. The location of the disease is mostly in the liver and lungs. We presents a case of 66-year-old female with hydatid cyst of the breast diagnosed pre-operatively by core needle biopsy. Complete radiology workup are also provided which includes mammography, ultrasound, and computed tomography images. Hydatid cyst of the breast is extremely rare even in endemic areas, its only accounts for 0.27% of all cases. Only few reports are published in the literatures about breast hydatid cyst and majority of cases have been diagnosed post-operatively with no complete radiology workup.Pan African Medical Journal 2013; 14: 99

Renal cell carcinoma (RCC) is encountered in about 3% of all adult neoplasms. Presence of any kidney malformation can change the plan for surgical treatment of RCC with organ preserving surgery. We report a case of clear cell RCC in a horseshoe kidney. Computed tomography scan revealed a horseshoe kidney anomaly with a large mass in the left side. The diagnosis of RCC was confirmed by pathology and histology findings.