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Salmonella typhi (S. typhi) infections typically present with fever and gastrointestinal symptoms. This case report on S. typhi enteritis documents atypical clinical, radiological, and endoscopic findings raising diagnostic challenges. A 31-year-old male in the Kingdom of Saudi Arabia (KSA) presented with severe abdominal pain, vomiting, bloody diarrhea, and no fever. Initial diagnosis included amebiasis and other gastroenteritis infections. Despite treatment with ciprofloxacin and metronidazole, the patient's condition did not improve, and he kept having intractable abdominal pain and vomiting. Subsequent investigations, including abdominal ultrasound and esophagogastroduodenoscopy, revealed extensive and rapidly progressive intestinal inflammation with wall thickening and ascites. Stool culture eventually identified a multidrug-resistant strain of S. typhi, sensitive only to ceftriaxone. Treatment with ceftriaxone and continuous infusion of proton pump inhibitor (PPI) led to significant improvement. The absence of fever in the context of bloody diarrhea, and the rapid development of ascites not improving with first-line treatment of gastroenteritis, led to the search for other diagnoses such as inflammatory bowel syndromes or tuberculosis. The presentation of diffuse intestinal wall thickening with intractable vomiting, bloody diarrhea, and progressively increasing ascites is not frequently encountered with S. typhi. The case also underscores the growing concern of antibiotic-resistant S. typhi strains. The patient's response to targeted antibiotic therapy emphasizes the importance of accurate microbial identification and susceptibility testing in managing infectious diseases. This case report illustrates an atypical presentation of S. typhi enteritis with progressively increasing ascites and increased intestinal wall thickening. The uncommon complicated clinical picture led to challenges in diagnosis and management. It emphasizes the need for high clinical suspicion and comprehensive diagnostic approaches in atypical cases of common infections, especially in the context of increasing antibiotic resistance.
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Introduction Thyroid cancer, one of the most frequently diagnosed endocrine malignancies, has witnessed a discernible global surge, predominantly among young adults. The etiological spectrum of thyroid cancer ranges from genetic mutations to environmental triggers. The early and precise detection of thyroid nodules (TNs) is crucial, given their latent potential for malignancy. Thyroid Imaging Reporting and Data System (TI-RADS) is an evidence-based stratification tool designed to standardize the assessment of TNs. Within this system, nodules categorized as TI-RADS 3 present an intermediate risk of malignancy, thereby necessitating meticulous evaluation. The objective of this study is to investigate the rates of cancer within thyroid nodules classified as TI-RADS 3, to determine the accuracy and effectiveness of the TI-RADS classification system in predicting malignancy at this intermediate-risk level, and to improve the diagnostic process and management strategies for these nodules. Methods A retrospective study was carried out on patients diagnosed with TI-RADS-3 thyroid nodules at King Fahad Hospital, Al-Hufof, between January 2019 and May 2023. Data were extracted from electronic medical records and encompassed patient demographics, and clinical and pathological details. Statistical analyses were performed using SPSS software version 27.0.1 (IBM Corp., Armonk, NY) examining the relationship between clinical characteristics and biopsy outcomes. Results The study involved 162 participants, mostly females (82.1%), with a median age of 43 years. Thyroid nodule analysis revealed 92.0% benign and 8.0% malignant cases, with the most common nodule size ranging from 2 to 2.4 cm. No significant correlation was found between clinical characteristics and biopsy results, indicating neither age nor gender significantly predicts malignancy in thyroid nodules within this cohort. Conclusion The majority of TI-RADS 3 nodules at King Fahad Hospital were benign. Yet, relying solely on TI-RADS for clinical decisions is not advised. An integrated approach, encompassing TI-RADS gradings and other nodule features, is essential for balanced patient management between intervention and observation.
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INTRODUCTION: Cancer-related stigmatization is a noteworthy phenomenon, yet it has not received sufficient attention in public health studies. Despite recent advancements in treatment and improvements in survival, the burden of stigma remains a challenging concern for individuals diagnosed with cancer. AIM: This study aims to assess the presence of cancer stigma in the Saudi Arabian population by using the Cancer Stigma Scale (CASS). METHODS: A cross-sectional study was conducted among the general population of Saudi Arabia. Data collection was facilitated through a self-administered online questionnaire, incorporating socio-demographic variables such as age, gender, and regional residence and employing the CASS instrument to gauge the prevalent attitudes and stigmas related to cancer. RESULTS: Out of the 874 participants, a majority of 87.1% were female, with 60.2% aged between 20 and 39 years. Notably, 59% reported having a close friend or family member diagnosed with cancer. The average CASS score stood at 1.59 (SD 0.39) on a 5-point scale, with an overwhelming 97.1% registering scores under 2.5, suggesting a generally low stigma perception. In dissecting the CASS components, 'severity' recorded the highest mean score (mean: 2.23), followed by 'awkwardness' (mean: 1.86) and 'financial discrimination' (mean: 1.71). 'avoidance' registered the lowest mean score at 1.11. Notably, a trend of increasing stigma was observed with advancing age, and male respondents indicated a marginally higher propensity towards stigmatizing attitudes. CONCLUSION: In Saudi Arabia, cancer-related stigma is generally low. However, 'severity' is the most prominent stigma aspect, with 'avoidance' being the least. Older individuals and males exhibit slightly higher stigmatizing attitudes. These insights highlight the need for targeted public health efforts to address remaining stigmatization, especially based on age and gender.
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Hydatid cyst (HC) is a parasitic infection originating from the cestode of the Taeniidae family, predominantly occurring in the liver and lungs. Muscular involvement, however, remains a rarity. This report delineates the case of a 32-year-old female from Saudi Arabia presenting with a six-month history of an enlarging mass in her left thigh accompanied by significant localized pain. The clinical features were suggestive of an abscess, yet diagnostic imaging, specifically ultrasound, uncovered the presence of multiple daughter cysts within a primary lesion. MRI confirmed a well-defined encapsulated cystic mass. With an additional backdrop of a previously treated hepatic HC and living in proximity to a domestic cat, the clinical suspicion gravitated toward echinococcosis. Following surgical excision of the cystic lesion, histopathological examination confirmed the diagnosis of an infected HC. Postoperatively, the patient displayed an uneventful recovery with no recurrence or complications. This case underscores the diagnostic challenge posed by HC, especially in non-typical locations, and the pivotal role of imaging modalities in facilitating accurate diagnosis and subsequent management.
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INTRODUCTION: Hematopoietic stem cell transplantation (HSCT) is a vital medical intervention for treating various conditions. The preferred methods, i.e., bone marrow transplantation and peripheral blood stem cell transplantation, have saved lives and attracted attention. Saudi Arabia, with a high sickle cell disease and leukemia incidence, faces the challenge of matching donors for HSCT. Factors like knowledge, attitudes, cultural beliefs, and access to information impact donation decisions. METHODS: In May 2023, a cross-sectional online survey was conducted in Saudi Arabia, targeting the general population. Data were collected through an online questionnaire, analyzing demographics, knowledge, attitudes, and factors influencing donation intention. RESULTS: Demographic analysis showed that females, younger individuals (18-25 years), those with higher education, and healthcare workers had better knowledge. Attitudes toward donation varied: 42.4% were willing to donate, while 57.6% were not. Psychological barriers, health concerns, pain, and inadequate knowledge influenced donation reluctance. Of the participants, 3.5% were registered stem cell donors, with 58.8% expressing willingness but not registered. Donors' intent was influenced by family members' need for transplants and knowledge. A majority (56.6%) supported employer support for health programs, while 65.7% believed government funding should assist donors. CONCLUSION: HSCT is vital in treating diseases like sickle cell and leukemia in Saudi Arabia. While many recognize its importance, knowledge gaps about its specifics and donation deter potential donors. Enhanced awareness campaigns and support from employers and the government could increase donor registrations.
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An appendiceal mucocele is a rare disease characterized by the dilation of the appendix lumen with mucus accumulation. Although this disease is often found incidentally during appendectomy, it is crucial to differentiate it from acute appendicitis preoperatively to select adequate surgical management. We present a case of a 31-year-old male, medically free, with right-sided abdominal pain associated with nausea and vomiting. He was diagnosed with appendiceal mucocele and underwent laparoscopic appendectomy. The absence of a distinct clinical presentation and biochemical parameters necessitates a comprehensive and collaborative diagnostic approach for mucocele of the appendix. Achieving an accurate diagnosis prior to surgery is imperative to ensure the appropriate surgical technique is chosen, thereby minimizing the risk of serious intraoperative and postoperative complications such as pseudomyxoma peritonei.
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Introduction Cancer is a group of diseases with uncontrollable growth of abnormal cells. Colorectal cancer (CRC) is one of the most common cancers. Increased intake of animal-source foods, sedentary lifestyle, decreased physical activity, and increased prevalence of excess body weight are independently associated with CRC risk. Additional risk factors include heavy alcohol consumption, cigarette smoking, and consumption of red or processed meat. Ultra-processed food (UPF) is made utilizing multiple components and a number of procedures. Soft drinks and salty or sugary snacks typically contain a lot of added sugar, fats, and processed carbohydrates, which negatively affect the balance of the gut bacteria, nutrients, and bioactive substances that are necessary for the prevention of CRC. The aim of this study is to assess the awareness of the general population in Saudi Arabia toward the relationship between UPF and CRC. Methods A cross-sectional questionnaire-based study was conducted in Saudi Arabia between June and December, 2022. Result The study involved 802 participants, of which 84% consumed UPF and 71% were aware of the link between UPF and CRC. Only 18.3% were familiar with the particular type of UPF and only 29.4% knew how to prepare them. The prevalence of participants who were aware of the link between UPF and CRC was significantly more among the older age groups, people living in the Eastern Region, and those who knew how to manufacture UPF, while the prevalence of awareness was significantly less among those who regularly consumed UPF. Conclusion The study showed that a significant portion of subjects regularly ate UPF, and only a few were aware of its link to CRC. This highlights the need for greater awareness of the fundamentals of UPF and its impact on health. Governmental organizations should develop a strategy to raise public awareness of excessive UPF use.
