Effectiveness of protective thyroid shield in chest X-ray imaging.

Chest X-ray imaging is the most common X-ray imaging method for diagnosing coronavirus disease. The thyroid gland is one of the most radiation-sensitive organs of the body, particularly in infants and children. Therefore, it must be protected during chest X-ray imaging. Yet, because it has benefits and drawbacks, using a thyroid shield as protection during chest X-ray imaging is still up for debate.Therefore, this study aims to clarify the need for using a protective thyroid shield during chest X-ray imaging. This study was performed using different dosimeters (silica beads as a thermoluminescent dosimeter and an optically stimulated luminance dosimeter) embedded in an adult male ATOM dosimetric phantom. The phantom was irradiated using a portable X-ray machine with and without thyroid shielding. The dosimeter readings indicated that a thyroid shield reduced the radiation dose to the thyroid gland by 69% ± 18% without degrading the obtained radiograph. The use of a protective thyroid shield during chest X-ray imaging is recommended because its benefits outweigh the risks.

Time in therapeutic range for virtual anticoagulation clinic versus in-person clinic during the COVID-19 pandemic: a crossover study.

BACKGROUND: COVID-19 infection affects the quality of the medical services globally. The pandemic required changes to medical services in several institutions. We established a virtual clinic for anticoagulation management during the pandemic using the Whatsapp application. OBJECTIVES: Compare anticoagulation management quality in virtual versus in-person clinics. DESIGN: A retrospective crossover study SETTINGS: Specialized cardiac care center PATIENTS AND METHODS: The study included patients who presented to Prince Sultan Cardiac Center in Riyadh for anticoagulation management during the pandemic from March 2020 to January 2021. We compared time in therapeutic range (TTR) in the same patients during virtual and in-person clinics. All international normalized ratio (INR) measures during the virtual clinic visits and prior ten INR measures from the in-person clinic were recorded. Patients who had no prior follow-up in the in-person clinic were excluded. MAIN OUTCOME MEASURE: TTR calculated using the Rosendaal method. SAMPLE SIZE: 192 patients RESULTS: The mean age was 58.6 (16.6) years and 116 (60.4%) were males. Patients were diagnosed with atrial fibrillation (n=101, 52.6%), mechanical mitral valve (n=88, 45.8%), mechanical aortic valve (n=79, 41%), left ventricular thrombus (n=5, 2.6%) and venous thromboembolism (n=8, 4.2%). Riyadh residents represented 56.7% of the study population (n=93). The median (IQR) percent TTR was 54.6 (27.3) in the in-person clinic versus 50.0 (33.3) (P=.07). CONCLUSION: Virtual clinic results were comparable to in-person clinics for anticoagulation management during the COVID-19 pandemic. LIMITATIONS: Number of INR measures during the virtual clinic visits, retrospective nature and single-center experience. CONFLICT OF INTEREST: None.

Herpes zoster in the era of COVID 19: A prospective observational study to probe the association of herpes zoster with COVID 19 infection and vaccination.

Herpes zoster (HZ) is caused by reactivation of the latent varicella zoster virus (VZV) following decline in cell-mediated immunity. All over the world, in the past couple of years, the Corona Virus 2019 (COVID-19) has emerged as a viral cause of severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) infection. Based on the current limited evidence, co-infection of COVID-19 with VZV or reactivation of VZV after COVID-19 vaccination has been sporadically reported. All patients diagnosed with HZ, in Farwaniya Hospital in Kuwait, from March 2020 to July 2021, having either (A) a positive COVID-19 polymerase chain reaction (PCR) test, or (B) been vaccinated against SARS-CoV-2 were enrolled in the study. All patients' demographic information, medical history, laboratory findings, and vaccination status was documented. All statistical analyses were performed using SPSS Statistics version 21.0 software. Twelve cases infected with COVID-19 with a positive PCR (group 1) and five cases vaccinated against SARS-CoV-2 (group 2) were documented. Out of the 12 COVID-19 infected patients (group 1), only two patients (16.67%) required hospitalization, while the remaining 10 patients had mild/moderate lymphopenia. Furthermore, amongst the 12 positive COVID-19 cases, four patients with HZ were diagnosed within the first week of COVID-19, while the remaining eight cases were diagnosed within 8 weeks of COVID-19. Thoracic segments were affected in five cases (41.67%), cervical in one case (8.33%), cranial in two cases (16.67%), lumbar in three cases (25%) and sacral in one case (8.33%). In group 2, three patients presented with HZ within 4 weeks of having received the first dose of the vaccine and two patients after the second dose. Blood investigations for all five vaccinated patients did not show any abnormalities. Cervical segments were affected in two patients (40%), and cranial, thoracic, and lumbar segment in the remaining patients respectively (20%). Experts must be aware of the probable increased risk of HZ during the COVID 19 pandemic. We propose appropriate curative and preventive measures against HZ infection, including a systematic follow-up of these patients to ensure that they stick to extreme safety measures till the diagnosis of COVID-19 is omitted.

Teledentistry-Knowledge, Practice, and Attitudes of Dental Practitioners in Saudi Arabia: A Nationwide Web-Based Survey.

The present survey assessed the knowledge, attitudes, and practice of teledentistry (TD) among dental practitioners in Saudi Arabia. This questionnaire-based cross-sectional study was conducted with dental interns and practicing dentists in Saudi Arabia. An online questionnaire was sent to all potential respondents. Questions related to knowledge, practice, attitudes, and training regarding TD were presented. A total of 603 (227 dental interns, 376 practicing dentists) completed the questionnaire. Generally, the participants revealed poor knowledge and practice of TD, with only 38% having heard about TD and only one-quarter of the sample (23.2%) reporting practicing TD at their current workplace. However, most of the participants expressed positive attitudes and a willingness to practice TD in the future. Specialists and those in practice for >5 years showed significantly better knowledge and practice of TD than general dentists and those with lesser clinical experience (p < 0.01). While only one-fifth of the participants (20.2%) reported having attended a workshop/lecture about TD, the majority (69.7%) felt that they needed training on TD. The results revealed poor knowledge, practice, and training with regard to TD among practicing dentists in Saudi Arabia. However, the positive attitude expressed by most of the participants towards practicing TD in the future is an encouraging sign for dental educators and planners of oral health care. Continuous education through periodic workshops and training courses on TD is crucial to improve dentists' knowledge, practice, and attitudes towards TD. Integration of TD topics into undergraduate/postgraduate curricula is highly recommended. Special attention should be directed to training general dental practitioners and junior dentists.

COVID-19 with dermatologic manifestations and implications: An unfolding conundrum.

The novel coronavirus SARS-CoV-2 has caused Coronavirus Disease 2019, widely known as COVID-19, now a pandemic with extraordinary infectivity, mortality, and fomite adhesiveness. We delineate cutaneous manifestations of COVID-19, some of which may represent adverse cutaneous drug reactions, and skin changes associated with COVID-19 lifestyle alterations in patients and health care workers. We review COVID-19 from both a dermatologic and public health perspective.