Retraction: Eagle Syndrome: A Rare Cause of Stroke in a Young Patient.

[This retracts the article DOI: 10.7759/cureus.21102.].

Dry versus wet temporalis fascia graft in type-I tympanoplasty: a systematic review and meta-analysis of randomized controlled trials.

OBJECTIVES: To conduct a systematic review and meta-analysis of all randomized controlled trials (RCTs) that examined the efficacy of dry versus wet temporalis fascia graft among patients undergoing type-I tympanoplasty. METHODS: Web of Science, Scopus, PubMed, and CENTRAL databases were screened from inception until July 2022. The Cochrane risk of bias tool was used to assess the quality of included RCTs. The outcomes were summarized as risk ratio (RR) or mean difference (MD) with 95% confidence interval (CI) in a random-effects model. RESULTS: Eight RCTs with 989 patients (dry group = 514 and wet group = 475) were included. The overall quality was 'low', 'some concerns', and 'high' risk of bias in five, two, and one RCT(s), respectively. There were no significant differences between both groups regarding the surgical success rate (n = 8 RCTs, RR 0.99, 95% CI [0.95, 1.03], p = 0.6), audiological success rate (n = 5 RCTs, RR = 0.93, 95% CI [0.73, 1.13], p = 0.48), mean difference in pure tone average (n = 2 RCTs, MD = 2.73 Hz, 95% CI [- 2.31, 7.77], p = 0.29), and mean difference in graft placement time (n = 3 RCTs, MD = - 2.18 min, 95% CI [- 5.11, 0.76], p = 0.15). However, the mean difference in operative time was significantly lower in favor of the wet compared with the dry temporalis fascia group (n = 2 RCTs, MD = 2.95 min, 95% CI [- 1.80, 4.11], p < 0.001). The surgical success rate was not significantly different between both groups according to the tympanic membrane perforation size and site. CONCLUSIONS: The type of temporalis fascia graft (dry or wet) did not influence the clinical outcomes of type-I tympanoplasty.

The Awareness of Child Abuse and Neglect Among the Saudi Population: A Narrative Review.

Child abuse and neglect (CAN) is a pressing global issue with profound implications for the well-being of children. The aim of this review is to examine the existing literature and synthesize evidence on the awareness, knowledge, and attitudes toward child abuse and neglect within the Saudi population. This review synthesizes the existing literature to illuminate the awareness, knowledge, and attitudes surrounding CAN within the Saudi population. Ten studies spanning the years 2019-2023 were meticulously analyzed, offering a comprehensive snapshot of CAN perceptions across various segments of society. The studies, encompassing diverse methodologies and populations, collectively underscore the commendable levels of awareness and knowledge demonstrated by healthcare professionals, including primary healthcare (PHC) physicians, nurses, and medical practitioners. Notably, several studies reveal that these professionals exhibit robust recognition of different forms of child abuse, a vital aspect in the identification and prevention of abuse cases. While positive attitudes toward CAN were prevalent among healthcare providers, barriers to reporting were highlighted. The fear of consequences and uncertainty emerged as key deterrents to reporting among medical and dental students and nurses, respectively. These findings emphasize the necessity for creating supportive environments that empower professionals to report suspected cases of abuse while addressing apprehensions. The parental perception of CAN also came into focus, revealing a disparity between the recognition of CAN as a common problem and the adequate knowledge of emotional abuse and neglect. These findings point toward a need for targeted public awareness campaigns that differentiate between disciplinary practices and abusive behaviors. In conclusion, this review offers a nuanced understanding of the Saudi population's awareness, knowledge, and attitudes toward child abuse and neglect. The synthesis of findings across diverse studies informs future interventions, advocating for enhanced awareness, reporting, and prevention strategies. By empowering individuals and professionals alike, a safer environment for Saudi children can be nurtured, fostering a future free from the shadows of abuse and neglect.

Oral Nystatin Prophylaxis for the Prevention of Fungal Colonization in Very Low Birth Weight Infants: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

We conducted this systematic review and meta-analysis of randomized controlled trials (RCTs) to investigate the prophylactic role of oral nystatin in the prevention of fungal colonization in very low birth weight (VLBW) infants compared with placebo or no treatment intervention. From inception until June 2022, we screened four major databases for pertinent RCTs and examined their risk of bias. The main outcomes were the rate of fungal colonization, rate of invasive fungal infection, rate of mortality, mean length of stay in the neonatal intensive care unit (NICU), and mean duration of antibiotic treatment. We summarized data as risk ratio (RR) or mean difference (MD) with 95% confidence interval (CI), using the fixed-effects model. Five RCTs met our inclusion criteria. One RCT was evaluated as having "high risk," one RCT was evaluated as having "some concerns," and three RCTs were evaluated as having "low risk" of bias. Compared with the control group, oral nystatin prophylaxis was correlated with substantial decrease in the frequency of fungal colonization (n=4 RCTs, RR=0.34, 95% CI {0.24, 0.48}, p<0.0001), the rate of invasive fungal infection (n=4 RCTs, RR=0.15, 95% CI {0.12, 0.19}, p<0.0001), and the mean duration of antibiotic treatment (n=3 RCTs, MD=-2.79 days, 95% CI {-5.01, -0.56}, p=0.01). However, there was no significant difference between both groups regarding the rate of mortality (n=4 RCTs, RR=0.87, 95% CI {0.64, 1.18}, p=0.37) and mean length of stay in NICU (n=3 RCTs, MD=-2.85 days, 95% CI {-6.52, 0.82}, p=0.13). In conclusion, among VLBW infants, the prophylactic use of oral nystatin was correlated with favorable antifungal benefits compared with placebo or no treatment intervention.

Eagle Syndrome: A Rare Cause of Stroke in a Young Patient.

Stroke is a common acute neurological injury that may develop due to arterial thrombosis or hemorrhage. However, it is uncommon in the young population. The etiologies of stroke in young patients are different compared with those for the elderly population. They include various non-atherosclerotic angiopathies, hematological conditions, and inflammatory disorders. We report the case of a 26-year-old man who presented to the emergency department because he noticed that his right hand had become clumsy. He first noticed this symptom five days before his presentation, but he noticed that his symptom had improved significantly since it began. He reported that he had episodes of neck pain and pain around the ear. He visited the family physician clinic several times for this complaint and was diagnosed as having a temporomandibular joint disorder. Neurological examination revealed decreased muscle strength in the right upper limb with a power of 4/5 along with a sensory deficit. The coordination was intact. No gait ataxia was noted. Considering the patient's age, the initial diagnosis was a demyelinating disorder such as multiple sclerosis. The patient underwent magnetic resonance imaging of the brain. It demonstrated an increased signal intensity in the territory of the left middle cerebral artery representing a left-sided infarction. Subsequently, the patient underwent computed tomography angiography of the head to rule out any structural malformation. The scan showed the presence of an elongated styloid process that appeared in close proximity to the neck vasculature. These radiological findings are consistent with Eagle syndrome. The patient underwent surgical resection of the styloid process. Eagle syndrome is a rare clinical condition that may have a myriad of clinical presentations. A high index of suspicion for this condition is vital to reach the diagnosis. Physicians should keep this condition in the differential diagnosis of stroke in the young population with no risk factors.