Negative Impact of Smaller Hometown Size on the Educational Experience of Medical Students: A Nationwide Study in Saudi Arabia.

Background and objective Saudi Arabia's rapid medical education expansion has posed unique challenges for its students, particularly concerning specialty selection. Having broad exposure to medical specialties is crucial for making informed decisions. This study explores how the size of students' hometowns influences their exposure to their preferred specialty, thereby affecting their choice. Methods Our cross-sectional study collected data from medical students in their 4th and 5th years, interns, and graduates across Saudi Arabia. An electronic survey gathered information about medical specialty choice, interest levels, students' self-ranking compared to their peers, and level of exposure to the chosen specialty. Overall exposure to specialties was quantified by tallying participants' experiences in preclinical observerships, didactic lectures, research projects, core and elective rotations, and attended conferences. We divided the students into three city sizes: primary urban centers, intermediate urban cities, and small townships and compared the outcomes between these three groups. Results Responses were obtained from 1,072 participants, with 424 (39.6%) from primary urban centers, 367 (34.2%) from intermediate urban cities, and 281 (26.2%) from small townships. Student hometown size was an independent predictor of specialty exposure, with students from smaller cities reporting lower exposure scores (OR = 0.73, (0.63-0.84), p<0.01). The study also identified gender disparities in exposure, with female students found to be correlated with a lower exposure score (OR = 0.72, (0.58-0.89), p<0.01). Conclusion City size is a significant determinant of specialty exposure for Saudi medical students. These findings highlight the need for initiatives that promote equal educational experiences, ensuring comprehensive specialty exposure to all students.

A Retrospective Review of Seasonal Patterns of Idiopathic Facial Nerve Paralysis in a Tertiary Care Center.

Background The objective of this retrospective study was to investigate the seasonal patterns of idiopathic facial nerve paralysis, specifically Bell's palsy, in Riyadh, Saudi Arabia. The study aimed to determine if there is a correlation between cold weather and the incidence of Bell's palsy, as well as to examine the relationship between age, gender, comorbidities, and the development of the disease. Methodology Data were collected from King Abdulaziz Medical City in Riyadh, Saudi Arabia, between 2016 and 2021. Electronic medical records of adult patients diagnosed with idiopathic facial paralysis were reviewed. Patients with facial paralysis caused by known illnesses were excluded. Demographic information, clinical characteristics, and the course of the disease were analyzed using SPSS version 25 (IBM Corp., Armonk, NY, USA). Results The study included 136 Bell's palsy patients, with a mean age of 39.9 years. Males represented 58.1% (79) of the sample, and the right side of the face was more commonly affected in 71 (52.2%) patients. The majority of patients had House-Brackmann grade III (51, 37.5%). The monthly distribution showed a higher number of Bell's palsy cases during the winter months, particularly December, October, and November, but the seasonal distribution did not yield a statistically significant difference in incidence. Conclusions While this study observed a higher incidence of Bell's palsy during the winter months, it did not establish a statistically significant correlation between cold temperatures and the onset of Bell's palsy in Riyadh, Saudi Arabia. Furthermore, the study found that Bell's palsy predominantly affects middle-aged males, and comorbidities did not appear to be significant risk factors for the development of the disease. This research lays the groundwork for future investigations into the relationship between weather and the pathogenesis of Bell's palsy in the region.

Approach to Sudden Hearing Loss Among Primary Care Physicians in Riyadh, Saudi Arabia.

INTRODUCTION: A medical emergency known as sudden sensorineural hearing loss (SSNHL) affects the ears suddenly, has a considerable probability of negative cognitive and functional outcomes, and can influence the patient's quality of life. Primary care physicians play a crucial role in diagnosing SSNHL and initiating prompt and efficient management since they are the ones who would likely encounter it initially. This study aims to evaluate the present knowledge, diagnostic, and management perspective of SSNHL among primary care physicians in Riyadh, Saudi Arabia. METHODS: A self-generated questionnaire with 17 questions was developed, and a link to the online survey was delivered to primary care physicians (PHPs) in Riyadh, Saudi Arabia, concerning the management of SSNHL. RESULTS: The knowledge level regarding SSNHL was evaluated, in which 21 (25%) of the participants had a low knowledge level, 34 (40.5%) had moderate knowledge, and 29 (34.5%) had a high knowledge level. Among 84 participants, 20 (23.8%) were confident in their ability to administer and understand the findings of tuning fork tests (TFT) to differentiate between sensorineural hearing loss and conductive hearing loss, whereas 64 (76.2%) were unsure about it. In addition, to distinguish between sensorineural hearing loss and conductive hearing loss, 62 (73.8%) participants were confident, and 22 (26.2%) participants were skeptical about their ability to interpret a formal audiogram. CONCLUSION: Considering SSNHL as a medical emergency, in our survey, many family doctors would make proper referral and treatment decisions. However, TFTs were underutilized for guiding management decisions compared to other ways to distinguish between conductive and sensorineural hearing loss.

Major salivary gland carcinoma in KSA: A 10-year nationwide retrospective study of 571 cases.

Objectives: Major salivary gland carcinoma (MSGC) comprises a morphologically diverse group of rare tumours with different clinical behaviours, and epidemiology findings in the literature substantially vary by geographic location. The aim of this study was to conduct a comprehensive analysis of the incidence rates, anatomical sites, and histological subtypes of different salivary gland malignancies in the population of KSA. Methods: This retrospective cohort study included patients diagnosed with MSGC in KSA from 2008 to 2017, on the basis of the demographic characteristics and histological data retrieved from the Saudi Cancer Registry database. Malignant lesions were identified according to the International Classification of Diseases for Oncology, Third Edition (ICD-O-3) codes. Results: Salivary gland malignancies were diagnosed in 571 patients (50.10% males and 49.90% females) over the course of 10 years. The parotid gland was the site of origin in 69.9% of cases. The most common histological type was mucoepidermoid carcinoma (29.1%). Over a decade, the incidence rate ranged from (0.15-0.24) per 100,000 inhabitants. The peak incidence of salivary gland malignancies was observed in the fourth, fifth, and sixth decades of life (17.5%, 18.2%, and 16.8%, respectively). Conclusion: Compared with that in other parts of the world, the incidence of MSGC is significantly lower in KSA, with 0.15-0.24 cases per 100,000 people each year. However, the clinical manifestations of carcinoma of the salivary glands in KSA are similar to those described worldwide.

Antrochoanal Polyp in Anterior Nasal Cavity: A Case Report.

We report a case of antrochoanal polyp, which has unusual presentation according to the location of the polyp in a 15-year-female patient. The patient came complaining of nasal obstruction, headache, and postnasal drip for a two-week period. The antrochoanal polyp measured 2.5 x 2 cm in the left maxillary sinus and extended to the anterior part of the nasal cavity. CT imaging demonstrated a total opacified left maxillary sinus, maxillary ostium with widening of the left maxillary ostium by polypoid mucosal thickening suggesting an antrochoanal polyp obstructing the left anterior nasal cavity. This case is reported as there are not many articles in world literature describing an antrochoanal polyp presented in the anterior nasal cavity.