Association Between Serum Vitamin D Levels and Body Mass Index Status: A Cross-Sectional Study at King Khalid Hospital, Jeddah, Saudi Arabia, From 2019 to 2020.

Introduction Low vitamin D levels have been associated more with overweight and obese people in previous studies. One of the possible explanations behind this association is the lipophilic property of vitamin D that causes the vitamin to deposit in adipose tissue and reduces the serum concentration of the vitamin, which still warrants further evaluation. Objective This study estimated the association between serum vitamin D levels and body mass index (BMI) among male patients in Jeddah, Saudi Arabia. Methods This is a cross-sectional study of male patients that was carried out in King Khalid Hospital, Jeddah, Saudi Arabia. Patients were included between October 2019 and November 2020. Results We concluded that almost half of the patients, 1,132 (48.3%), had adequate vitamin D, followed by 773 (33%) with vitamin D inadequacy, and only 288 (12.3%) had vitamin D deficiency. There was a significant relationship between age and vitamin D levels; younger people had lower vitamin D levels compared to older people (p<0.001). It was found that there was no significant relationship between BMI categories and vitamin D levels (p>0.05). Conclusion According to the findings of the current study, there was no discernible relationship between serum vitamin D levels and BMI. However, there was a substantial correlation between age and vitamin D levels, with younger age groups having lower amounts than older individuals. Future studies should adopt a prospective design encompassing multiple centers and preferably include the risk factors for developing vitamin D deficiency, such as sun exposure, dietary habits, comorbidities, etc. Such studies can provide a more accurate assessment of the association between BMI and vitamin D levels.

Gliosarcoma Invading the Temporal Bone, Temporalis Muscle, and Skull Base.

Gliosarcoma (GS) is a primary central nervous system tumor. It is an unusual type of glioblastoma multiforme (GBM) and rarely invades the skull base. It has a biomorphic tissue pattern with rapid alternation zones of glial and mesenchymal differentiation. We report the case of a 62-year-old male who presented with a one-month history of unsteady gait associated with dizziness. Brain MRI showed a right temporal mass that invaded the skull base with perilesional edema and a significant mass effect on the right lateral ventricle. The patient underwent a right-sided frontotemporal craniotomy with gross total resection. The pathology confirmed the diagnosis of GS. Postoperatively, the patient had an uneventful recovery with no complications and was discharged two days post-surgery.

Factors affecting the choice of becoming a neurosurgeon in the western region of Saudi Arabia.

Background: The preference of medical specialty for students can start even before enrollment into medical school, or as late as following their graduation. During their senior years, students often get a prospective on the working environment and the difficulties faced in the field. This, along with other factors, can strongly alter their career choice. This study aims to explore the degree of interest in neurosurgical specialty among medical students and the factors influencing their choice of becoming a neurosurgeon in the western region of Saudi Arabia. Methods: This is a cross-sectional study which was done across three universities of the western region of Saudi Arabia including King Saud bin Abdulaziz University for Health Sciences, Umm Al Qura University, and King Abdulaziz University. Results: A sample of 1023 students from the second medical year up to the internship was conducted, and out of them, 585 (57.2%) were males and 438 (42.8%) were females. Three hundred and fifty-nine (35.1%) of the students were interested in neurosurgery, while 664 (64.9%) were not. The data show that females have more interest (40.8% of females) compared to males (35.1% of males). Furthermore, there was a general trend toward a decrease in the interest in neurosurgery with time. The impact on patients "rewarding feeling" was the most reported attraction to the specialty, followed by income. Stress was the most reported deterring factor among students. Neurosurgery is one of the most challenging specialties, yet it is still considered one of the most competitive ones. Conclusion: Many factors have been found to influence medical students' choices to apply for neurosurgical training as we described. Interestingly, we noted higher interest among female students, and among college freshmen compared to their counterparts. Further studies should be conducted on a larger scale to analyze these findings.

Early-Age Manifestation of Singleton Merten Syndrome With Systemic Lupus Erythematosus Features: A Case Report.

Singleton Merten syndrome (SMS) is one of the rarest multisystem genetic disorders that had been recognized in only a few cases. Patients who have this syndrome often present with calcification of the aorta and heart valves, dental dysplasia, joint calcification, distinct facial features, and growth and developmental delay. Other physical findings usually associated with SMS may include glaucoma, skeletal abnormalities including tendon rupture, muscle weakness, and arthropathy. In individuals with SMS, autoimmune diseases like psoriasis and systemic lupus erythematosus (SLE) can occur. In this case, we report a pre-term baby girl that developed congenital aortic calcification, renal hypertension, dental anomalies, multiple joint calcifications, atypical facial features, mild mental retardation, and developmental delay. At 17 years, the patient developed SLE based on positive antinuclear antibody (ANA) with clinical and immunological features like fever, malar rash, pericardial effusion, proteinuria, high ANA concentration, high anti-double-stranded DNA, low C4 complement, and presence of anti-Smith antibodies.

Multisystem Inflammatory Syndrome in Children (MIS-C) With Hematological Manifestations: A Case Report.

Multisystem inflammatory syndrome in children (MIS-C) is a new emerging severe form of coronavirus disease 2019 (COVID-19) that recently has been recognized in April 2020 in the United States and the United Kingdom. MIS-C is an uncommon condition that mainly affects children who previously had a COVID-19 infection, and it can have serious outcomes if left untreated properly. The full clinical spectrum of this disease is yet not fully determined or understood. Here, we report a case of a 12-year-old girl, previously medically free, who presented to the emergency room complaining of shortness of breath and dizziness for two days. The patient was confirmed to have a COVID-19 infection in the workup. Laboratory studies showed elevated inflammatory markers, leukopenia, and elevated liver enzymes. Upon admission, the patient developed a persistent fever with a spike of 40ºC, not resolved with antibiotics or anti-inflammatory drugs. This was managed with intravenous immunoglobulin (IVIG) followed by steroids but did not show dramatic change initially. The patient eventually improved with management and was discharged.

Pattern and Factors Associated With the Utilization of Herbs As Medications Among Patients in a Tertiary Care Hospital in Western Saudi Arabia.

BACKGROUND: Herbs are used worldwide as a treatment for plenty of diseases, and some herbs are used as the origin of modern medications. Although the therapeutic benefit was reported mostly from China, over time the world seemed to realize its importance. The use of herbs as medicine is also very common in the Arab region and Saudi Arabia. OBJECTIVES: This study was conducted to assess the pattern of use of herbs as medications in Saudi Arabia and factors associated with its use. METHODS: A convenience sample of adult patients in a tertiary care hospital in Jeddah, western Saudi Arabia was used. A questionnaire consisted of two sections, i.e., demographic characteristics and the knowledge, attitudes, and practices on the use of herbs. The data collection was conducted during December 2019. RESULTS: Three hundred and eighty patients were included, of which 53.3% were female. Almost half (49.7%) were college graduates. More than half of patients (55.6%) used herbs themselves, and (59%) reported members of the family used herbs for the past 12 months. Most patients (62.6%) use herbs without medical consultation. Patients used herbs following information received from family members (57.8%), social media (22.5%), doctors (8.1%), books (6.6%), or TV (5%). The most-reported herb was Anise followed by cumin and cinnamon. CONCLUSION: The use of herbs is common in Saudi Arabia. Herbs are mostly used for a variety of medical conditions following family members' experience and social media recommendations. Detailed information on the type of herbs used, doses, and effects are worth further study with a focus on variation based on different regions.

Effective, Low-Cost Recovery of Toxic Arsenate Anions from Water by Using Hollow-Sphere Geode Traps.

Because of the devastating impact of arsenic on terrestrial and aquatic organisms, the recovery, removal, disposal, and management of arsenic-contaminated water is a considerable challenge and has become an urgent necessity in the field of water treatment. This study reports the controlled fabrication of a low-cost adsorbent based on microscopic C-,N-doped NiO hollow spheres with geode shells composed of poly-CN nanospherical nodules (100 nm) that were intrinsically stacked and wrapped around the hollow spheres to form a shell with a thickness of 500-700 nm. This C-,N-doped NiO hollow-sphere adsorbent (termed CNN) with multiple diffusion routes through open pores and caves with connected open macro/meso windows over the entire surface and well-dispersed hollow-sphere particles that create vesicle traps for the capture, extraction, and separation of arsenate (AsO43- ) species from aqueous solution. The CNN structures are considered to be a potentially attractive adsorbent for AsO43- species due to 1) superior removal and trapping capacity from water samples and 2) selective trapping of AsO43- from real water samples that mainly contained chloride and nitrate anions and Fe2+ , and Mn2+ , Ca2+ , and Mg2+ cations. The structural stability of the hierarchal geodes was evident after 20 cycles without any significant decrease in the recovery efficiency of AsO43- species. To achieve low-cost adsorbents and toxic-waste management, this superior CNN AsO43- dead-end trapping and recovery system evidently enabled the continuous control of AsO43- disposal in water-scarce environments, presents a low-cost and eco-friendly adsorbent for AsO43- species, and selectively produced water-free arsenate species. These CNN geode traps show potential as excellent adsorbent candidates in environment remediation tools and human healthcare.