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Background: Spina bifida is one of the neural tube defects substantially related to significant morbidity and mortality worldwide. A complex of environmental and genetic factors has been a risk factor for spina bifida. This study aims to assess the prevalence of spina bifida and related risk factors in Taif city, Saudi Arabia. Methods: A retrospective chart review was done at Taif Hospitals, Saudi Arabia. The study was conducted by reviewing medical files of all infants and children born with spina bifida between January 1, 2018 and December 31, 2020. All files fulfilling the inclusion criteria were reviewed for data extraction using pre-structured data extraction sheet. Results: A total of 15 infants and children with spina bifida among 43,890 live births in Taif city were identified with an incidence of 3.5 per 100,000 children. Among the 15 studied subjects, 9 were females, and the other 6 children were males. The exact of nine (60%) children with spina bifida had Myelomeningocele. Mothers ages at child delivery were 30 years or more was among 60% of the cases mothers. Two-thirds of cases mothers had no folic acid supplements during pregnancy. Conclusion: In conclusion, the current study revealed that spina bifida was around the global reported incidence, which was more common with more serious complications among females. Lack of folic acid supplementation at the periconceptional period was found to be the most reported risk factor.

In recent years, green synthesis of nanoparticles has been the cornerstone of development of nanotechnology and its applications, as it emphasizes on promoting environmental sustainability. The aim of the present study was to investigate the potential health benefits of the green-synthesized titanium nanoparticles (TiO2NPs). TiO2NPs were synthesized using titanium(iv) isopropoxide and lupin bean extract. The synthesized particles were characterized to assess the average particle size by dynamic light scattering, and X-ray diffraction method was used to study the crystalline nature. The average particle size recorded was 9.227 nm with a polydispersity index (PDI) of 0.382. The morphology of the particles was assessed by scanning electron microscope and transmission electron microscopy which showed varied shapes of the nanoparticles, uniform spherical and crystallite rod shaped. Further, the cytotoxic efficacy of the nanoparticles was assessed against the breast cancer (MCF-7) cell line using 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromidefor (MTT) assay. The antibacterial activity of the nanoparticles was evaluated against clinical pathogens via the disc diffusion assay. The key findings showed that the TiO2NPs exhibited potent cytotoxicity against the MCF-7 cell line with an IC50 of 41.1 µg. It also showed profound antibacterial activity. Thus, the synthesized nanoparticles could have potential biomedical applications owing to their therapeutic efficacy.

Aim This study aimed to assess the relationship between loneliness and hypothyroidism in patients with hypothyroidism and to determine predictors of loneliness. Materials and methods A cross-sectional study was conducted on hypothyroid patients attending the endocrine clinics at Alhada Military Hospital and Prince Mansour Military Hospital, Taif, Saudi Arabia between the period of December 2020 and May 2021. Patients with more than 18 years of hypothyroidism were included and those with other thyroid diseases were excluded as well as those with other comorbidities and psychiatric disorders and those who were living alone. Data were collected using an online pre-structured questionnaire. Results The study included 231 hypothyroid patients with a mean age of 43.34 ± 12.9 years, and 90.9% were females. The majority (96.5%) were taking levothyroxine, and 27.3% were practicing physical activity. Only 2.2% of the participants had a high degree of loneliness, whereas 47.2%, 34.6%, and 16% had low, moderate, and moderately high degrees of loneliness, respectively. Discussion In this study, 2.2% of sampled hypothyroid patients had high (2.2%) or moderately high degrees of loneliness feelings (16%). Duration of hypothyroidism was a significant predictor for high loneliness score.

Patient: Male, 4-day-old Final Diagnosis: Gastric perforation and necrosis Symptoms: Acute abdominal distension • metabolic acidosis • respiratory distress Medication: — Clinical Procedure: — Specialty: Pediatrics and Neonatology • Surgery Objective: Congenital defects/diseases Background: Gastric necrosis and perforation are rare life-threatening conditions in preterm neonates, which require urgent diagnosis and surgical intervention. Case Report: We report a case of a 4-day-old patient with neonatal gastric necrosis. The patient presented with sudden acute abdominal distension, respiratory distress, and metabolic acidosis. The abdomen was markedly distended, tender, and tympanic with collateral circulation. An X-ray of the abdomen showed a huge pneumoperitoneum. An urgent exploratory laparotomy revealed 2 wide horizontal perforations and necrosis of the fundus and gastric body. Subtotal gastrectomy with esogastric anastomosis was done. Postoperatively, the patient was administered total parenteral nutrition and triple antibiotics and improved gradually. He passed stool and the abdomen was soft, lax, and non-distended and the wound healed. An upper gastrointestinal tract (UGIT) contrast study 1 week after the operation showed no leakage or stricture. The patient was discharged 2 months postoperatively with a bodyweight of 2 kg and was followed in the Outpatient Department (OPD). The patient survived after 80% gastric resection for necrosis of the stomach, which was a unique outcome for this major surgery. Conclusions: Gastric perforation is a rare life-threatening condition in preterm neonates, usually managed by direct closure in layers. Exceptionally, partial gastrectomy is needed, which is a major operation, with a high mortality rate and poor outcome. We present a case of a preterm neonate who survived after 80% gastric resection for stomach necrosis.

Haptoglobin (Hp) is a plasma α2-glycoprotein that binds free haemoglobin and is thought to have a role in the immune pathway of different pathologies depending on its phenotype. A total of 497 Sudanese patients with viral infections and non-infectious diseases were typed for haptoglobin phenotypes, in this study, using the polyacrylamide non-reducing gel electrophoresis separation method to determine possible associations between haptoglobin phenotypes Hp1-1, Hp2-1 and Hp2-2. Viral infections included human immunodeficiency virus (HIV) (n= 129) and hepatitis B (HBV) (n=171). The non-infectious diseases were: liver cirrhosis (LC) (n=68) and chronic renal failure (CRF) (n= 129). Healthy controls (n= 65) were also typed. Each disease sample was compared with the control. Expected percentages of each of the three phenotypes in Sudan estimated using SPSS were between 51.38-51.49% for Hp1-1, 36.71-36.81% for Hp2-1 and 11.76-11.91% for Hp2-2. Hp1-1 was found the most significantly prevalent among patients with LC (P≤0.05). Patients with HIV/AIDS and HBV showed the same distribution of haptoglobin phenotypes as the healthy control (i.e. a majority of Hp2-1); whereas the highest percentage of patients with Hp2-2 were those with CRF (≥23%) although not significantly different from the control. Using Hardy-Weinberg equilibrium (HWE) as a null model, hp1allele frequency was calculated to be 0.69 and hp2allele frequency was 0.31 in Sudan. The healthy control, LC and CRF sampled populations were significantly deviated from HWE (P=0.05). In this study, we found that Hp1-1 has a significant association with LC. HIV/AIDS and HBV showed the same distribution of phenotypes as control and the highest percentage of patients with Hp2-2 were those with CRF. hp1and hp2allele frequencies were 0.69 and 0.31 in Sudan.

Khalid M Alshehri,1 Raghad A Althobaiti,2 Athar I Alqurashi,3 Nada E Algethami,4 Khaled A Alswat5 1Medicine and Endocrinology, AlHada Armed Forced Hospital, Taif, Saudi Arabia; 2Obstetrics and Gynecology Department, Prince Sultan Military Medical City, Riyadh, Saudi Arabia; 3Internal Medicine Department, King Abdulaziz Specialist Hospital, Taif, Saudi Arabia; 4Medical College, Taif University, Taif, Saudi Arabia; 5Department of Medicine, School of Medicine, Taif University, Taif, 21944, Saudi ArabiaCorrespondence: Raghad A Althobaiti, Obstetrics and Gynecology Department, Prince Sultan Military Medical City, Al Sulaimaniah, Riyadh, Saudi Arabia, Tel +966 505388455, Email Ralthobaiti@hotmail.comBackground: Women with diabetes mellitus or thyroid disorders are at risk of sexual dysfunction. This study aimed to estimate the prevalence of female sexual dysfunction (FSD) in women with diabetes and/or thyroid disorders and the impact of disease control on the ASEX score.Methods: A cross-sectional study for female patients who had a routine clinic visits was included. The Arizona Sexual Experience Scale (ASEX) was used to evaluate for FSD. Those with a total score of ≥ 19 or scored ≥ 5 on any item or ≥ 4 on three items were considered to have FSD.Results: A total of 253 female patients with a mean age of 39.1 ± 7.3 years were included. Two-thirds of the participants have no FSD. More than half (57.7%) of the participants had a strong desire for sex, and about 20% of the participants were unsatisfied with their orgasm. Compared to those with no FSD, those with FSD had lower BMI (P = 0.375), more likely to have a master’s degree or higher (P = 0.117), diabetes (P = 0.879), hypothyroidism (P = 0.625), diabetes-related microvascular and macrovascular complications (P = 0.049), higher HbA1c, fasting glucose, and TSH (P = 0.731, P = 0.161, and P = 0.561, respectively), lower total cholesterol and LDL (P = 0.368 and P = 0.339, respectively), and exercise more regularly (P = 0.929).Conclusion: FSD was highly prevalent in our study population. Those with type 1 diabetes had the highest ASEX scores. We showed non-significant negative correlations between total ASEX score and both BMI and TSH, as well as a non-significant positive correlation between total ASEX score and both HbA1c and fasting glucose value.Keywords: diabetes mellitus, thyroid disorders, female sexual dysfunction, prevalence

Background: With the onset of the spread of the Coronavirus around the world, the Saudi Ministry of Health has taken protective measures early to prevent the spread of the disease in the region, and the most effective of these measures is Quarantine and home isolation, which can have an impact on the individual's mental health. The purpose of this study is to assess the compliance of Quarantine in a family with an allergic and immunologically diseased child and its psychological impact on them. Methods: A cross-sectional study conducted between June-August 2020 was conducted via a selfreported online questionnaire that includes fear of COVID-19 scale for parents, Revised children's anxiety and depression scale to assess Quarantine's psychological effect, fear of getting the infection and also to know the family's attitude towards COVID-19 and public health measures. Results: This study included 4,436 participants, and the findings revealed that (13.3%) of participants had a child with allergies or immune diseases, (30.2%) had children between 6-10 years of age, the mean fear score was 18.74 ± 6.48 (7-35) which is nearly moderate;the mean values of the Child Anxiety and Depression Sub-Scale for Parents (RCADS) were 4.81 5.61 and 18.74 ± 6.48, respectively. This study showed a highly statistically significant positive relationship between the mean values for fear of COVID-19 Score scale and mean scores for child anxiety and depression (P =

Background: Foreign body aspiration (FBA) is a life-threatening condition with a high mortality rate, especially in children less than three years of age. Delayed diagnosis is often due to the non-specific presentation of symptoms and the absence of a witness to the aspiration event. Aim: This study aimed to assess parental knowledge and practices toward aerodigestive paediatric foreign bodies ingestion or inhalation, in Saudi Arabia. Materials and Methods: A descriptive cross-sectional survey was conducted among Saudi parents in western region, Saudi Arabia during the period between 1st To 20th August. A pre-structured validated self-administered questionnaire containing 11 questions of awareness and 4 questions of practices toward aerodigestive pediatric foreign bodies, was distributed online via various Social Media platforms. The questionnaire was initiated after literature review for similar articles and after experts’ consultation for validity and reliability. Results: A total of 611 child caregivers completed the study questionnaire. Exactly 508 (83.1%) respondents were children’s mothers and 103 (16.9%) were their fathers. Exactly 93.1% of the study parents heard of swallowing or inhaling foreign objectsand 77.3% reported that children aged 1-5 years are more likely to swallow or inhale foreign objects while 20.5% reported for children aged less than 1 year. About 69% of the parents buy children toys that contain small parts but to different degrees. As for protective actions, keeping small items out of children’s reach was reported by 95.4% of the parents. Conclusion: In conclusion, the study revealed that parental knowledge and practices toward FBA were on average (but not satisfactory) especially for the correct actions for swallowed objects and timely visits to ER even for asymptomatic ingested FB. On the other hand, safe practice, especially keeping small objects out of children’s reach, was high, but observing young aged children while playing was unsatisfactory. Key words: Children, foreign body aspiration, knowledge, parents, practices

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).

Objectives:To assess factors affecting Saudi population preference in losing weight either by bariatric surgeries or by conservative strategies. Methods:A cross sectional study was done using a self-administered questionnaire distributed online. Study was done on 518 participants (group 1) who did not prefer to undergo bariatric surgery and preferred conservative strategies in weight reduction and group 2 (84 participants) who preferred to undergo bariatric surgery. Results:Participants in group 1 and group 2 represented 86% and 14% of the sample. Group II had a significant higher percent of obese and per-obese individuals, who usually eat basic meals every day, who usually have soft drinks as beverages, who eat fast food for more than 2 times weekly, who had more than 6 attempts to lose weight in the last 5 years and who thought that their families would support their efforts in improving their food habits. Group II had a statistically significant higher percent of those who consider bariatric surgery as an effective tool for weight loss, who believed that they would lose more weight with bariatric surgery, and who believe that surgery will cause a drastic change in their lifestyle. Group 1 had a significant higher percent of those who eat fruit and vegetables every day, who reported always practicing physical activity during the entire year. Conclusion:Factors affecting the preference of weight loss were eating habits, physical activity, and attempt of dieting. An efficient health education programs about bariatric surgeries is needed to correct misconceptions regarding the surgery.&nbsp

الملخص: أهداف البحث: فحص تأثير التدريب بمقياس التنفس المحفز على الوظائف العضلية للفم، ووظائف التنفس عند أطفال متلازمة داون. طرق البحث: تم تقسيم ٣٤ طفلا مصابين بمتلازمة داون من الجنسين من عمر ٦ -٢١ سنة عشوائيا لمجموعتين. المجموعة أ تلقت تمرينات عضلية للفم، والمجموعة ب تلقت تمرينات عضلية للفم بالإضافة إلى التدريب بمقياس التنفس المحفز. تم استخدام قياس التنفس المحوسب ذي شاشة رئيسة لاختبار وظيفة الرئة لقياس وظائف التنفس (القدرة الحيوية القسرية، وتدفق الزفير القسري في ثانية واحدة والزفير)، واستخدام التقييم العضلي الفموي بالدرجات لتقييم الوظائف العضلية للفم قبل وبعد تلقي العلاج. النتائج: نتائج ما بعد العلاج أوضحت فرقا إحصائيا واضحا في الوظائف العضلية للفم ووظائف التنفس في كل من المجموعتين ولكن لم يوجد فرق واضح بين المجموعتين في النتائج. الاستنتاجات: التمرينات العضلية للفم أكثر تأثيرا من التدريب بمقياس التنفس المحفز في تحسين كلا من وظائف التنفس والوظائف العضلية للفم لدى أطفال متلازمة داون. Abstract: Objectives: This study investigated the effect of incentive spirometry training on oromotor and pulmonary functions in children with Down's syndrome. Methods: Thirty-four children with Down's syndrome were randomly divided into two groups; the children were of both sexes and aged between 6 and 12 years. Group A received only oromotor exercises, while Group B received oromotor exercises and incentive spirometry training. The pulmonary function test was performed using computerized spirometry model master screen that assessed pulmonary functions (peak expiratory flow, forced vital capacity, and forced expiratory volume in 1s), while the orofacial myofunctional evaluation with score (OMES) was used to evaluate oromotor function before and after treatment. Results: The post treatment results showed significant difference in oromotor and pulmonary functions within both groups, but no significant differences were found between the two groups. Conclusions: Oromotor exercises are more effective than incentive spirometry training in improving both pulmonary and oromotor functions in children with Down's syndrome. الكلمات المفتاحية: متلازمة داون, وظائف التنفس, الوظائف العضلية للفم, القدرة الحيوية القسرية, التقييم العضلي الفموي بالدرجات, Keywords: Down's syndrome, Oromotor functions, Orofacial myofunctional evaluation with score, Peak expiratory flow, Pulmonary functions

Spigelian hernia-undescended testes (SH-UDT) syndrome is a rare disorder, with only 57 cases reported in the literature. The presentation can be asymptomatic or symptomatic in the form of pain, tenderness, or a lump. We present a case of a 50-day-old boy with SH-UDT syndrome. The patient presented with signs and symptoms of acute intestinal obstruction. Exploration confirmed a Spigelian hernia containing small bowel loops and right undescended testis. Orchidopexy was done after ligation of the hernial sac. A follow-up visit after two years revealed right testicular atrophy.

There are many well-known risk factors for keloids and hypertrophic scars (HTS) including ethnicity, family history, and history of previous keloids or HTS. An association, which has been previously observed, exists between pregnancy and growth and worsening of keloid and HTS. This association is less well known amongst physicians and less documented in the literature. In this paper we discuss two cases of extreme worsening of keloid scars during pregnancy. We have also witnessed the transformation of a pre-existing scar into a keloid scar during puberty. We attribute this to the hormonal effects of pregnancy and puberty hormones which could potentially trigger the growth of pre-existing keloids and HTS. This may have an impact on many patients and we therefore recommend women and girls who have keloid and hypertrophic scarring be made aware of this potential effect.

Introduction Studies on sudden infant death syndrome (SIDS) in Saudi Arabia are limited due to strict religious faith-related observances. The aim of this study was to assess Saudi mothers’ awareness about SIDS. Methodology A cross-sectional online electronic survey was administered in different Saudi regions. A self-reported validated Arabic questionnaire was used for collecting data. The study sample included 363 respondents from 384 sample members. Results The final sample consisted of 363 (94.8%) respondents, a reduction in size due to 21 non-responders from the total 384 sample members. Two-hundred and thirty-two (63.9%) of the 363 respondents reported not having heard of any SIDS prevention messages, while 36.1% of them had received such messages. Most of the respondents (53.2%) correctly reported that babies should be laid on their backs while putting them to sleep, and only 5.5% reported that babies should be laid in their stomachs when being put to rest. Participants > 50 years, of urban residence, and with primary education had higher knowledge levels. Participants with an age of 18 to 29 years and those with higher education had higher knowledge levels about the correct baby position. Participants with an age between 30 and 39 years, of urban residence, and those with a primary educational level had a higher prevalence of receiving messages about SIDS. Conclusion A very good understanding of the proper way to put a baby to sleep among the participants was found, and most of them thought that messages about SIDS were not useful. This study suggests that health education messages regarding SIDS should be directed to all pregnant mothers.

Background: The COVID-19 pandemic has significantly impacted the health-care system worldwide, and physicians face challenges in clinical practice, especially in managing cancer patients. This study aimed to assess the impact of COVID-19 on physicians managing breast cancer patients in Saudi Arabia.Methods: A cross-sectional study was conducted from May to October 2020 among physicians practicing in Saudi Arabia, using an online-based survey. The questionnaire included items on physicians’ sociodemographic, barriers faced with breast cancer patients, concerns about and satisfaction with breast cancer patients’ management, and treatment protocols they follow.Results: A total of 317 physicians participated in this study. Most of them faced difficulties in their work with breast cancer patients during this pandemic, and 77.3% reported that they diagnosed at least one breast cancer case. Many patients missed chemotherapy sessions, and half of the centres indicated that more than 10% of their patients missed at least one session. 83% of the physicians were satisfied with the way they managed breast cancer patients, and 73% follow a specific protocol in managing breast cancer patients.Conclusions: The study’s findings show that the active COVID-19 pandemic led to a more stressful situation among physicians, which has affected management of breast cancer patients. COVID-19 is reshaping the delivery of not only breast cancer care but also general oncology practice. Currently, due to the availability of effective vaccination and more understanding of COVID-19, we believe that breast cancer operations should be performed on their scheduled date.