Multinodular goiter with a retropharyngeal extension: A report of two cases and literature review.

Multinodular goiter (MNG) is a chronic benign nodular enlargement of the thyroid gland. It presents as an anterior painless neck mass, potentially progressing to exert pressure on the trachea and esophagus and giving rise to compressive symptoms. MNG is a common thyroid gland disorder; however, retropharyngeal goiter is considered rare with few reported cases. We report the cases of two patients who presented to our institution with MNG with retropharyngeal extension: a 62-year-old female patient who presented with a progressive anterior neck mass with dilated neck veins; and a 49-year-old male who presented with a painless anterior neck mass. Both patients successfully underwent total thyroidectomy with an uneventful postoperative recovery. The clinical presentation of MNG with retropharyngeal extension varies with patients; hence, a high index of suspicion is of the utmost significance. While the retropharyngeal extension does not cause compressive symptoms, it should raise the suspicion of a large retrosternal component.

Perception of Saudi undergraduate medical students on telemedicine training and its implementation.

BACKGROUND: The use of telemedicine has increased considerably in healthcare delivery, especially during this time of the coronavirus disease 2019 (COVID-19) pandemic. It has, therefore, become necessary to train medical students to better equip them for this new means of healthcare delivery. The aim of the present study was to assess the perception of undergraduate medical students on telemedicine training. MATERIALS AND METHODS: A cross-sectional study was conducted on a total of 521 undergraduate medical students studying in the Eastern Region of Saudi Arabia. Data were collected via a self-administered pretested questionnaire comprising two main sections: demographics and knowledge and opinions regarding telemedicine training. RESULTS: About 73% students think that the use of telemedicine for patient care will increase in the future, and 59.3% think that the medical students should be trained in telemedicine. Majority of the students (78%) opined that telemedicine training should be optional and 58% said it should be taught during the clinical phase of the undergraduate curriculum. The best telemedicine training course learning objectives medical students opined to be included were: telemedicine practical skills (70.2%), legal aspects of telemedicine practice (68.3%), and potential positive and/or negative use of telemedicine tools and methods (67.6%). Telemedicine skills students would like to learn how to effectively engage patients, knowledge about telemedicine regulations and the consequences of breaching them. CONCLUSION: Medical students are aware of the importance of incorporating telemedicine training into the medical curriculum. Training these students is vital to ensure their competence as physicians in their future clinical careers, that is make them a digitally health-literate future workforce.

Video games and violence among children and adolescents in the Arab world: A systematic review.

BACKGROUND AND AIM: Video gaming has witnessed tremendous growth in recent years. Video games have been associated with various negative effects on players, such as aggressive behavior and reduced apathy. The present review aims to investigate the association between video games and violence among children and adolescents in the Arab world, while highlighting the influence of the type of video games played, time spent playing, and other possible associated factors. METHODS: A literature search was performed on PubMed and Web of Science electronic databases. All studies assessing video games and violence among children and adolescents written in English were eligible for inclusion in the review. A total of 9 studies were included in this systematic review. RESULTS: Six studies investigated the relationship between video games and aggression, five of which found a significant association. Several factors have been studied to assess their role in mediating the association between the two. A statistically significant association was found between aggression and age and sex of the players, with a predominance among early adolescents and males. Longer durations spent playing video games were found in three studies to be significantly associated with a greater risk of aggression. CONCLUSIONS: In the Arab world, studies addressing this subject are limited. The discrepancy of reported results between video games and amount of violence could be attributed to the lack of standardization across studies. Therefore, it becomes imperative to further explore the association through conclusive studies with standardized measures.(www.actabiomedica.it).

Dental implants and forensic identification: A systematic review.

The use of dental implants has witnessed great popularity in recent years. It has been documented that dental implants are valuable aids in forensic identification. In particular, in the event of mass disasters, where distortion of body features may render the process of forensic identification challenging. The present review aims to explore the application of the use of dental implants in forensic identification. A literature search was performed on PubMed and Web of Science electronic databases. All studies addressing the application of dental implants for forensic identification published in English were eligible for inclusion in the review. This systematic review included a total of 14 articles that demonstrated the significance of dental implants in forensic identification. Three studies reported the use of dental implants in the process of identification of the deceased, one of which found the distance of the implant from the maxillary sinus was a pathognomonic feature of identity. Four studies conducted incineration experiments to assess dental implant characteristics following incineration. The studies identified the batch number and characteristic threads and grooves on dental implants despite incineration. The remaining studies evaluated the role of radiological assessment in identification. The findings of the aforementioned studies highlighted the benefits of radiologic imaging in identification. Dental implants carry extreme significance in forensic identification owing to their durability and ability to withstand extreme temperatures. This process can be further enhanced by the implementation of advanced technology in forensic cases.

Incidence of Bacterial and Fungal Secondary Infections in COVID-19 Patients Admitted to the ICU.

Purpose: Secondary infections have been observed among coronavirus disease 2019 (COVID-19) patients, especially in the intensive care unit (ICU) setting, which is associated with worse clinical outcomes. The current study aimed to investigate the incidence, common pathogens, and outcome of bacterial and fungal secondary infections among ICU patients with COVID-19. Methods: A retrospective chart review of all patients admitted to the ICU at King Fahd Hospital of the University in Saudi Arabia. All adult patients aged ≥18 admitted in the ICU for ≥48 hours with positive COVID-19 reverse transcription-polymerase chain reaction test during the period between March 2020 till September 2021 were included. Results: Out of 314 critically ill patients, 133 (42.4%) developed secondary infections. The incidence of secondary bacterial infection was 32.5% with Pseudomonas aeruginosa (n = 34), Acinetobacter baumannii (n = 33), and Klebsiella pneumoniae (n = 17) being the predominant pathogens, while secondary fungal infection was 25.2% mainly caused by Candida albicans (n = 43). Invasive mechanical ventilation was significantly associated with the development of secondary bacterial infections (odds ratio [OR] = 17.702, 95% confidence interval [CI] 7.842-39.961, p < 0.001) and secondary fungal infections (OR = 12.914, 95% CI 5.406-30.849, p < 0.001). Mortality among patients with secondary infections was 69.2% (n = 92). Secondary infections were associated with longer hospital and ICU stays with a median of 25 days (interquartile range [IQR] 17-42) and 19 days (IQR 13-32), respectively. Conclusion: Bacterial and fungal secondary infections are common among COVID-19 patients admitted to the ICU with a predominance of gram-negative bacteria and Candida species. The development of secondary infections was significantly associated with invasive mechanical ventilation. Poor clinical outcomes have been observed, demonstrated with a prolonged hospital and ICU stays and higher mortality.