Prevalence, Clinical Characteristics and Determinants of Unsuccessful Treatment Outcomes Among Pulmonary Tuberculosis Patients: A 5-Year Registry-Based Retrospective Cohort Study.

Purpose: Despite the existence of effective medications, pulmonary tuberculosis (PTB) remains a significant global public health concern, The evaluation and feedback of national TB control programs are crucial, requiring diligent monitoring of TB treatment outcomes and analysis of the factors influencing these outcomes. This study aims to provide valuable insights into the challenges faced by TB patients, which can inform better strategies for treatment and management in the future. Patients and Methods: We conducted a study in King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia (KSA), from January 1, 2018 to December 31, 2023. The study was a registry-based retrospective cohort study. Patients' data were sourced from the National Tuberculosis Registry database of Saudi Arabia. Treatment outcomes were determined as either success or failure, considering clinical evaluation, changes in chest X-rays, and the results of subsequent sputum examinations during follow-up. To evaluate the data, SPSS version 28.0 was used. Results: A total of 427 PTB patients participated in the study. The results show successful treatment outcomes among 88.5% of patients. Among the patients, males exhibited a higher likelihood of treatment failure as compared to females (aOR 1.3; 95%Cl 1.2-1.5, p < 0.001). Patients with positive sputum smear (aOR 1.3; 95%Cl 1.1-1.3 p < 0.00) and the presence of cough were associated with an increased risk of treatment failure (aOR1.5; 95%Cl 1.1-1.4, p < 0.001). Conclusion: This study shows that the percentage of unsuccessful treatment outcomes is high, ie, 11.5%, due to patients' deaths and loss to follow-up. Enhanced supervision and treatment monitoring for tuberculosis patients at high risk of treatment failure can lead to improved treatment success rates in Saudi Arabia.

Retraction: A Rare Case of Solitary Schwannoma of Submandibular Gland.

[This retracts the article DOI: 10.7759/cureus.21373.].

Successful removal of a congenital fibrovascular pupillary membrane in 2 cases with variable age at presentation and sparing of the crystalline lens.

INTRODUCTION AND IMPORTANCE: Congenital fibrovascular pupillary membranes (CFPMs) represent a rare poorly understood condition that has been sporadically reported in the literature. The presence of such a membrane can cause pupillary block and further complications, therefore must be properly diagnosed and managed. CASE PRESENTATION: We are presenting the successful treatment of 2 cases with CFPM. The first patient presented 2-days after birth with an absent red reflex and had a less complicated clinical course. The second presented at a later age of 5-months and was referred as a case of congenital cataract. This baby had associated pupillary block glaucoma. Each of these cases was managed surgically by membrane peeling with sparing of the lens, which was found to be clear in the second case. DISCUSSION: Even though CFPM has been rarely reported, it should be correctly identified since it can progress with the development of glaucoma and lens changes. The etiology of CFPM is not well understood but might be related to the presence of ectopic iris tissue, which was suspected as an etiology in our second case. Several techniques have been described to remove the membrane, and occasionally this might necessitate removal of the lens. We described successful removal of CFPM in 2 cases without affecting the crystalline lens. CONCLUSION: General Ophthalmologists and Pediatricians should be aware of CFPM, especially when dealing with an absent or dull red reflex in a newborn. Referral for definitive diagnosis and treatment is essential to preserve vision.

Prevalence of screen time use and its relationship with obesity, sleep quality, and parental knowledge of related guidelines: A study on children and adolescents attending Primary Healthcare Centers in the Makkah Region.

BACKGROUND: Since the use of handheld electronic devises is prevalent among people of all ages, health organizations have specified appropriate screen times for the different age groups. The aim of this study was to investigate the prevalence of screen use and its association with sleep quality and obesity. MATERIALS AND METHODS: This cross-sectional study was conducted on people attending three Primary Healthcare Centers in the Makkah region between January and October 2019. The three-part questionnaire filled by parents collected data on sociodemographics, parental knowledge of guidelines, and asleep quality. Data were analyzed using STATA 14.2. For continuous variables, groups were compared using t-test; Pearson Chi-squared test or Fisher's exact test, as appropriate, was employed for categorical variables. RESULTS: A total of 450 individuals completed the questionnaire. Children 2-12 years old spent more time and used phones, tablets, and television (TV) more frequently, while those younger than 2 or older than 12 used phones and TVs more than other devices. High body mass index was associated with the daily usage of electronic devices. Fewer hours of sleep, longer time to fall sleep, and longer hours in bed were associated with the usage of all electronic devices. Furthermore, a good knowledge of the maximum time allowed for children and teenagers and content scoring system was associated with hours slept per night, and low knowledge was associated with higher frequency of using electronic devices. CONCLUSION: Children spent long periods using electronic devices, and despite knowing the guidelines, parents still allowed their children to exceed the time acceptable for the use of electronic devices, which could lead to future social problems.

A Rare Case of Solitary Schwannoma of Submandibular Gland.

Tumors of the salivary gland constitute a heterogeneous group of variable histological and biological behaviors. Patients with salivary gland tumors typically present with painless swelling. However, several neoplastic and non-neoplastic pathologies can result in salivary gland enlargement. We report the case of a 35-year-old woman complaining of a left neck swelling for 3 months duration. She had no relevant past medical or surgical history. On examination, there was a left submandibular swelling that was firm in consistency, non-tender, non-pulsatile, relatively mobile, and was not tethered to the underlying structures. Otherwise, examination of the head and neck was unremarkable. A CT scan of the neck revealed a well-defined hypodense lesion in the left submandibular region with foci of calcification along with multiple enlarged lymph nodes. After surgical exploration, the submandibular gland region, a mass lesion was found arising from the submandibular gland. Histopathological examination revealed the diagnosis of schwannoma. Salivary gland schwannoma is a very rare form of neurogenic tumor. Surgical resection is the treatment of choice; however, neural deficits are important and common postoperative complications.

Manifestation of Panuveitis after Intraocular Surgery in a Child with Blau Syndrome.

Blau syndrome (BS) is a rare granulomatous disease with autosomal dominant inheritance. It is characterized by a triad of dermatitis, arthritis, and recurrent uveitis. This case presents the onset of panuveitis in BS after intraocular surgery. A 10-year-old boy presented to the outpatient clinic with retinal detachment in the left eye after 6 years following early-onset cataract surgery. Bilateral panuveitis occurred 3 weeks after surgical repair and resulted in a total visual loss in the left eye and was persistent to conventional treatment in the right eye. Genetic testing revealed a mutation in NOD2 gene. The addition of adalimumab to the treatment regimen resulted in long-term uveitis control and maintenance of 20/70 vision in the right eye. We propose that NOD2-mediated inflammatory cascade can be activated by intraocular surgery and results in the manifestation of BS.

Prevalence and Risk Factors of Dry Eye Symptoms in a Saudi Arabian Population.

BACKGROUND: The information about dry eye epidemiology in Saudi Arabia is few in literature. PURPOSE: To estimate the prevalence and identify determinants of dry eye symptoms (DES) in Al-Ahsa, Saudi Arabia. METHODS: Using a multi-stage proportionate sampling technique, Saudis of both genders from 6 urban and 4 rural Primary Health Care centers in Al-Ahsa were enrolled. They were interviewed to gather data on sociodemography, symptoms of dry eye, factors potentially related to dry eye, and chronic comorbidities. If one or more of DESs present often or constantly, we labeled the person with DES. RESULTS: We examined 1858 Saudi adults with mean age of 39.3 ± 14.1 years. The age-adjusted prevalence of DES was 32.1% (95% confidence interval [CI] = 30.0-34.3). Multivariate logistic regression analysis showed that female gender (adjusted odds ratio [aOR] = 2.1, 95% CI = 1.7-2.6), older age (>56 years; aOR = 1.5, 95% CI = 1.0-2.1), current smoking (aOR = 1.4, 95% CI = 1.1-1.8) and history of diabetes mellitus (aOR = 1.5, 95% CI = 1.2-2.0) were significantly associated with DES. Nonsignificant variables included residence (urban/rural); work status; wearing contact lenses; multivitamin use; caffeine use; history of trachoma, hypertension, bronchial asthma, coronary artery disease, thyroid disease, arthritis, hemolytic blood diseases (sickle cell-thalassemia), gout, and osteoporosis. CONCLUSION: DES are highly prevalent among the adult population of Al-Ahsa. Females, persons more than 55 years of age, smokers and diabetics were associated to DES.