The Relationship Between Noise-Induced Hearing Loss Awareness and the Use of Personal Listening Devices in Makkah Region, Saudi Arabia.

Introduction Noise-induced hearing loss (NIHL) is one of the most common avoidable reasons for hearing impairment worldwide. Work-related, genetic, infectious, and environmental factors all have a part in defining the level of hearing impairment. Nevertheless, the use of personal listening devices (PLDs) is popular nowadays, particularly among younger people. Healthy behaviors are needed to prevent them from developing hearing loss. Our objective is to evaluate the knowledge level of NIHL among the people of Makkah, Saudi Arabia, and understand its association with PLDs. Methods A cross-sectional survey was performed in December 2022 by sending an online survey on various social media applications. An electronic Arabic questionnaire with a total of 37 questions was designed to explore the participants' demographic data, history of hearing loss, risk factors, attitudes, and awareness of NIHL. Results Almost 22% of the study had mild-to-severe hearing impairment. Hearing issues were especially common among male individuals. A higher incidence of hearing impairments was seen in individuals who were utilizing a sound degree of more than 80%. The causes for NIHL comprised exposure to occupational noise, duration of the listening session per day, and the level to which the sound of the television or the broadcasting was raised. Approximately 77% of the participants preferred to reduce the sound of their personal audio devices (PADs) to prevent NIHL. Conclusion According to this study, there is a high prevalence of hearing problems in the Saudi population. Most of the respondents understood the risk factors linked to NIHL. There is a need for more NIHL awareness campaigns to educate the Saudi population and reinforce positive, healthy listening habits.

Prevalence and Risk Factors of Allergic Rhinitis Among the Population in the Makkah Region, Saudi Arabia: A Cross-Sectional Study.

Background Allergic rhinitis (AR) is considered a high global disease burden; hence, the shortage of knowledge would lead to poor adherence to management and preventive measures and increase the exacerbation of AR symptoms. This study aimed to evaluate the prevalence and risk factors, and assess the knowledge and practices of the population regarding AR among the population in Makkah city, Saudi Arabia. Methodology This was an online survey cross-sectional study conducted in December 2022 via social media platforms (WhatsApp and Twitter) to collect data on participants' demographics, prevalence, risk factors, knowledge, and attitudes toward AR, using a validated Arabic version of a self-administered questionnaire. Results The study involved 466 participants. Of the participants, 55.8% were aged 31 to 45 years, and 286 (61.4%) were females. The prevalence of AR among the participants was 45%. The most common symptoms were a blocked nose (79.6%), sneezing (74.2%), and a runny nose (71.5%). Furthermore, the prevalence of rhinoconjunctivitis in this study was 56%. The most common inhalant allergen was house dust (73.0%). Only the age and history of asthma or eczema were significant factors associated with AR. Overall, most of the subjects (94.85%) had adequate knowledge regarding AR. Conclusion A high prevalence of AR was observed. Understanding the factors linked with AR is imperative to ensure better adherence to preventive management plans.

Neuropsychiatric Lupus and Lupus Nephritis Successfully Treated with Combined IVIG and Rituximab: An Alternative to Standard of Care.

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with unpredictable course and flares. The clinical manifestation can vary from mild to severe and life-threatening disease. Infection is the primary cause of mortality in hospitalized SLE patients. There is a paucity of evidence to support the co-management of SLE with major organ involvement and sepsis. We describe the clinical response of a 35-year-old male diagnosed with SLE; then, he developed severe sepsis and a flare of SLE with major organ involvement including lupus nephritis (LN), myocarditis, and neuropsychiatric systemic lupus erythematosus (NPSLE). Based on the patient's condition, a treatment dilemma was encountered, and after a multidisciplinary meeting, the decision was made to use a combination of rituximab (RTX), intravenous immunoglobulin (IVIG), and pulse steroid. Shortly, the patient's condition started to improve, and his symptoms were resolved. In conclusion, our clinical case suggests that combined RTX, IVIG, and pulse steroid seem to be effective and safe in achieving clinical response, thus representing a good choice for managing severe SLE flares in sepsis.

Hereditary Hemochromatosis Associated With Idiopathic Refractory Aplastic Anemia in a Five-Year-Old Boy: A Case Report.

Hereditary hemochromatosis (HH) is a multisystem disease characterized by iron overload and various clinical presentations, including cirrhosis, diabetes mellitus, and heart failure. HH can be caused by the human homeostatic iron regulator (HFE) and non-HFE gene mutations. Aplastic anemia is a rare, life-threatening bone marrow failure in which fat replaces pluripotent stem cells, resulting in pancytopenia and hypoplasia of bone marrow. We present a case of a five-year-old-boy who initially presented with a large ecchymosis located at the right side of the chest and abdomen. These started suddenly after minor trauma. Later, he was diagnosed with idiopathic aplastic anemia and treated with immunosuppressive therapy (IST). As part of the workup for pancytopenia, we ordered whole exome sequencing (WES) and diagnosed the patient with autosomal recessive hereditary hemochromatosis (ARHH). The ARHH is caused by HFE pathogenic gene mutation variant (c.187C>G p homozygous genotype). After six months of IST, he still had persistent disease. Human leukocyte antigen (HLA) typing showed he has a sister who is a full match but also has ARHH. Because of this, a haploidentical hematopoietic stem cell transplantation (hHSCT) from the father was performed. The hHSCT had a successful outcome. We suggest that in children with idiopathic aplastic anemia, physicians should be aware of the possibility of co-existing hereditary hemochromatosis or secondary hemochromatosis. Serum ferritin and transferrin saturation should also be measured regularly in order to detect early hemochromatosis.