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Background Breast cancer is the most common cancer in women and accounts for 14.7% of cancer-related deaths among females worldwide. Its core management includes surgical removal of the tumor either by breast-conserving surgery (BCS) or mastectomy. Choosing between these two procedures may be influenced by factors that are not studied in our region. We aimed to determine the prevalence of BCS and mastectomy and the factors that may influence the choice of procedure. Methods This retrospective study was carried out by reviewing the records of female breast cancer patients who underwent BCS or mastectomy at between 2009 to June 2017, excluding those with metastasis or recurrence. Frequencies and multivariate tests were used for detecting correlations between procedures and demographic, clinicopathological, and radiological factors. Results Of 335 patients (mean age 52.75 ± 12.2 years), 62.4% had mastectomy and 37.6% had BCS. Modified radical mastectomy accounted for 70.8% of mastectomies. Multivariate analysis showed non-Saudi nationality (P = 0.002), multifocal (P = 0.0001) and multicentric tumors (P = 0.0001), large tumor size (P = 0.0001), tumor stages IIIA (P = 0.005) and IIIB (P = 0.014), positive HER2 (0.009), and triple-negative receptor status (P = 0.010) significantly correlated with mastectomy. Conclusion Mastectomy has a much higher prevalence than BCS in our study mainly due to advanced tumor stage at the time of diagnosis. This emphasizes the urgent need for early detection of breast cancer to move towards BCS, with education and increasing awareness of breast cancer and the surgical options, especially that it is more common in a significantly younger population in our area.

Background Poorly differentiated thyroid cancer (PDTC) is now classified as a separate thyroid tumor entity. It has male predominance and poor prognosis compared to differentiated TC. Case We report a case of a patient with PDTC who was previously deemed inoperable. A trial of neoadjuvant lenvatinib therapy was given to the patient after that the tumor become operable and the surgery went successfully. Conclusions Lenvatinib is a feasible option in patients with inoperable TC and can stabilize the lesion size or even reduce it, leading to a more favorable surgical outcome.

Introduction: Cesarean section (CS) is a surgical procedure that often saves the lives of both the mother and the baby, while a previous CS is one of the main indications for cesarean delivery in current pregnancy. Aim: Our aim was to determine the surgical and obstetrical outcomes and complication for the mother and the neonate after 4 or more CSs and compare it with mothers who had less than 4 previous CSs. Methods: This case-control study was conducted by reviewing the records of all women who underwent multiple CSs from 2013 to 2018. Our study group comprised of 394 women who had 4 or more CSs, and our control group comprised of similar number of women who had previous history of two or three CSs. Results: A total of 788 patients were enrolled in our study. We found that adhesions were the most common complications in our study group with a considerable increase in number of both moderate and severe adhesions in the study group compared to the controls with p-value of

Background: National data on the prevalence of daytime sleepiness and other sleep-related issues are limited for the general Saudi population.Objectives: The aim of this study was to screen a sample of the Saudi population for the prevalence of symptoms of disturbed sleep and excessive daytime sleepiness (EDS), in addition to the sleep duration of the sample.Patients and Methods: A cross-sectional, descriptive population-based sample of n = 1419 participants was randomly recruited from two major public places in the Eastern Province of the Kingdom of Saudi Arabia. The sociodemographic information was collected, and the Epworth Sleepiness Scale (ESS) was used to measure EDS. These and other sleep-related data were assessed after verbal agreements were received from the participants.Results: The total number of participants was n = 1419, with a mean age of 34.1 ± 9.8 years. The response rate was 76.2%, and 917 (65%) were males. The EDS based on the ESS was 53.8% for the sample, with an increasing trend in the higher age groups (11.4 ± 5.8), particularly in the 30–39 years' old age category. Snoring was highly prevalent in the males at 44% versus the females at 21%, and 55% of the participants were smokers. The mean sleep duration was 6.72 ± 1.97 h.Conclusion: EDS was prevalent in particular higher age groups in the general studied population. Snoring was among the highest prevalent sleep-related symptoms with reported shorter sleep duration in the general population. Public awareness of sleep hygiene or psychoeducation and large epidemiological studies are needed to rule out cultural factors and improve the general well-being of the population of the Kingdom of Saudi Arabia.

Aim To find out the factors and causes that motivate medical students to choose ear, nose, and throat (ORL head and neck surgery) as a specialty in Saudi Arabian medical universities. Materials and methods A cross-sectional study was conducted at Kingdom of Saudi Arabia by distributing a self-administered questionnaire to 1,516 medical students across all medical universities. Chi-squared test and logistic regression analyses were used to examine the association between the participants' choices and factors motivating their choice of specialty. Results ORL head and neck surgery was chosen as a future specialty by 27% of the participants. Of these, 52% chose lifestyle as the most influential factor determining their choice of specialty. Further analysis of participant preferences revealed that 87.6% listed flexibility within medicine as their main reason for choosing a specialty, followed by reasonable hours of practice in 86%, while 15.9% considered a strong mentor relationship to be important. Students from King Abdulaziz University more frequently chose ORL head and neck, along with those from the eastern kingdom compared with other areas. Student preference for ORL head and neck did not vary significantly with gender, age, or duration of clinical rounds. Conclusion Approximately 27% of students chose ORL head and neck, with lifestyle being the most influential factor, followed by flexibility within medicine. Among students who chose ORL head and neck, the highest percentage was from King Abdulaziz University.

Context: Depression in patients with a skin condition can lead to severe consequences that affect the quality of life. To our knowledge, the estimated prevalence of depression in patients who visited dermatological clinics in Jeddah remains unknown. Aims: To assess the prevalence of depression among patients with dermatological conditions and evaluate the association between clinical and demographic characteristics and depressive symptoms. Settings and Design: A cross-sectional study was conducted among dermatological patients at King Abdulaziz University Hospital in Jeddah, Saudi Arabia. Materials and Methods: The Patient Health Questionnaire-9 (PHQ-9) was used for screening depression. Statistical Analysis Used: Chi-square test and odds ratios (ORs) were used to determine the association among variables. Results: The study included 273 participants. More than two-thirds (194) of the participants were women (71.1%). Depressive symptoms were prevalent in 43 (15.8%) participants. Depression was the most prevalent among patients with psoriasis (39.5%, P < 0.001), followed by those with acne (30.2% P = 0.04) . Conclusion: Psychosocial assessment should be addressed when evaluating and treating dermatological diseases. Screening tools, including PHQ-9, can facilitate the early detection of depressive symptoms and improve clinical outcomes. Addressing psychosocial aspects of skin conditions may help in reducing exacerbation of symptoms, mainly for conditions aggravated by stress, including dermatitis and psoriasis.

BACKGROUND: Recent studies suggest that unhealthy food practices and lack of exercise are the main cause of the progressive increase in the obesity prevalence. AIM: We aim to assess the prevalence of obesity among school students and its relationship to dietary and physical habits. METHODS: A cross-sectional study from 18 intermediate and high schools located in Taif, Saudi Arabia, between April 2014 and June 2015. We excluded any student with a psychological disease or chronic diseases. We calculated the body mass index (BMI) of students by measuring their height and weight. Dietary, physical, sleep habits, and socioeconomic status were assessed. RESULTS: A total of 2943 students participated with a mean age of 15.4 ± 1.7 years. The majority of these were boys and attending government schools with a mean BMI 22.7 ± 8.6 kg/m2. Overall, 13.6% were overweight and 12.8% were obese. One-third of students report a sedentary lifestyle. Compared to girls, boys were more likely to have lower BMI (p < 0.001), be overweight (p < 0.001), exercise for >300 min/week (p < 0.001), own electronic devices other than smartphone (p < 0.001), use the electronic devices 300 min/week (p < 0.001), and walk to and from school at least once weekly (p < 0.001). CONCLUSION: A quarter of the students were either overweight or obese. Girls were more likely to be obese with less favorable socioeconomic, media consumption, dietary, and physical profiles.

Background: Rheumatoid Arthritis is one of the most common autoimmune disorders. Drugs used are only to slow the progression and to enhance the quality of life. These therapies have several disadvantages as lack of selectivity and it can cause loss of patient compliance. Aim: To identify the most common type of infection, rheumatoid arthritis patients in our region encountered, while using biologics and/or traditional DMARDs. Method: Cross-sectional study was carried out in Rheumatology clinics at King Abdulaziz University Hospital, included Rheumatic patients who visit the clinics from 2013 to 2017. Data sheet was including demographic, using drug and American College of Rheumatology classification criteria for RA were added. Result: Total of 164 patients were included in this study, 18 (11%) males, and 146 (89%) females. Trends among the target sample showed that 40 (24.4%) had diabetes and 51(31.1%) had hypertension. Patients who had been taking both DMARDs and Biologics, DRMADs only, biologics only were 49 (29.9%), 74(45.1%) and 15(9.1%) respectively. The total number of the infections was 180, among them 62.78% were taking DMARDs only and the most common infection was lower urinary tract infections (UTI) 28(37.38%). Conclusion: UTI have the highest rate of infection in patients using traditional DMARDs and patient using both drug groups. And we recommend conducting a cohort study to identify these infections. It can help in assessing their outcomes.

Background: Knowledge of ear health and hearing loss is essential for early intervention and treatment, but the state of public knowledge of such in Jeddah, Saudi Arabia, remains unknown. Objectives: To measure public knowledge of ear health and hearing loss. Method: This cross-sectional study was conducted during August 2018 in Jeddah, Saudi Arabia. An electronic survey questionnaire was distributed to 2372 residents of various districts in Jeddah. The survey was created in 2013 by adopting previously published World Health Organization material, designed to assess knowledge and perception of ear health. All males and females aged 10 years or older living in Jeddah had the chance to participate in this study. A total of 2372 people participated. Percentages mean ± standard deviation, one-way analysis of variance (ANOVAs) and independent t -tests were applied to determine the significant difference. p -values of 0.05 or less were considered significant. Results: The overall mean number of correct responses on the survey’s true/false questionnaire was 10.66 ± 1.92 out of 14. Female participants gave a higher mean number of correct answers than did male participants (10.73 ± 2.03 vs. 10.54 ± 2.03, respectively). Participants with a family history of hearing loss gave a higher mean number of correct answers compared with participants who reported a negative family history (10.89 ± 1.82 vs. 10.53 ± 1.97, respectively). Conclusion: Overall awareness of ear health and hearing loss management is fair. However, the results indicate a need for more integrated educational materials to be made available both to the general population as well as to hearing loss individuals and their families.

Background Obstruction of the Eustachian tube is a common condition that is unpleasant and might lead to various middle ear disorders. Objective This study aimed to estimate the prevalence of Eustachian tube dysfunction (ETD) among the public in Jeddah, Saudi Arabia. Methods This cross-sectional survey-based study was conducted in Jeddah during August 2018 by distributing an electronic survey form to participants from different districts of the city. All male and female residents of Jeddah aged 10 years and above had the chance to participate in this study. Results A total of 2372 participants (female, 1535/2372, 64.71%; male, 837/2372, 35.28%; mean age 31.31 years, SD 11.85 years) agreed to contribute to our study. Upon analysis of their answers to the questionnaire, the overall prevalence of ETD in our sample was found to be 42.49% (1008/2372). The prevalence was higher among participants who reported a previous diagnosis of ETD and hearing loss (1897/2372, 80.00% and 1902/2372, 80.21%, respectively). Additionally, participants with a family history of hearing loss had a significantly higher prevalence (1136/2372, 47.92%) of ETD than those with no family history of hearing loss. Our analysis also showed that females were at a greater risk of developing ETD than males (P=.01). Conclusions As per our prevalence data, ETD is a common disease in Jeddah, pointing to the need for more attention, awareness, and research.

Aim: This study aims to evaluate the public's knowledge and awareness of the association between cigarette smoking and skin aging in Jeddah, Saudi Arabia. Methods: This is a cross-sectional study conducted by distributing a questionnaire to the general population of Jeddah across different age groups in 2018. Data were organized using a frequency distribution table, and analysis was done using Chi-square test. Results: Among 2443 participants, 68.2% were female and 12.6% were current smokers. More than half (64%) of the participants answered correctly that smoking increases facial aging. Slightly higher number of nonsmokers responded correctly than current and former smokers. There was a statistically significant difference between gender and the response to the association of smoking and skin aging, with majority of the females (71%) responding correctly (P Conclusion: The society's lack of knowledge about the association between cigarette smoking and skin aging needs more attention. Knowledge needs to be spread by prompting health campaigns and by the participation of health authorities to make more effective public health policies against smoking.

Objective: The objective of this study was to assess the level of awareness regarding primary home management of epistaxis among high- and middle-school students and their teachers. Materials and Methods: This cross-sectional study was conducted in December 2018 by distributing a paper-based questionnaire to high-and middle-school students and teachers in Jeddah, Saudi Arabia. Results: The study included 706 individuals (53.4% males and 46.6% females) with a mean age of 16.58 ± 5.57 years. Based on the correlation between our variables, 57.5% of the participants had a good knowledge score, while only 3.5% had an excellent score. Male high-school students were significantly more knowledgeable than female middle-school students. Conclusion: Awareness of first-aid management of epistaxis was fair. However, more integrated educational resources should be made available for the general population and school students and teachers.

Purpose: To review the incidence and risk factors for retinopathy of prematurity (ROP) King Faisal Specialist Hospital and King Abdulaziz University Hospital in Jeddah, Saudi Arabia. Material and methods: In this prospective cohort study, preterm infants who were admitted to a neonatal intensive care unit from 2012 to 2013 were evaluated for ROP. Inclusion criteria were, preterm infants with gestational age

Background: Neck masses are a common complaint in children worldwide, and constitute a major indication for surgical consultation in many pediatric surgical centers. Most of the neck masses in children are benign in their nature and clinical course. The broad spectrum of etiology of neck masses that ranged from congenital benign to acquired neoplastic lesions is varied and related to multiple factors. This retrospective study was done with the objective to assess the distribution of neck masses related to gender, age, pathology, and anatomical location of neck masses in Aseer Central Hospital. Methods: Medical records of 62 patients with neck masses were collected from the department of pathology at Aseer Central Hospital KSA. The cases were reviewed for data on gender, age, the type of origin tissue, the type of lesion, and the anatomical location. Comparison between genders, age groups, and tissue origins were performed. All statistical tests were performed with SPSS software. We exclude thyroid, parathyroid and salivary gland masses. Results: Over a period of 5 years, a total of 62 patients 53.2% and women 46.8% had neck masses resected for pathological assessments. The age of presentation was ranging from 1 to 14 years. 22.6% developed in (from 1 years to 5 years old), 38.7% developed in (6 to 10 years), and 38.7% developed, in (11 to 14 years). The histopathological diagnosis of the neck masses were congenital 40.3%, inflammatory 33.9%, and malignant tumor 25.8%. Conclusions: The differential diagnosis of the pediatric neck mass includes a wide array of congenital, inflammatory, benign and malignant lesions. The exact diagnosis may only be obtained by histopathological examination. In our study the most common masses in pediatric patient thyroglossal duct cyst, all midline masses are congenital.