Pharmacists' Attitudes Towards Long-Term Use of Nasal Decongestants: A Cross-Sectional Study.

Background: Rhinitis medicamentosa is a nonallergic inflammation of the nasal mucosa caused by topical decongestants overuse. It mainly affects young and middle-aged adults. Therefore, the aim of this study was to investigate the attitudes of pharmacists regarding the utilization of over-the-counter intranasal decongestants. Methods: An online cross-sectional study was conducted from November 2021 to January 2022. The target population of the study included pharmacists who work in community pharmacies in Saudi Arabia. Binary logistic regression analysis was used to identify predictors of having positive attitude towards controlling the use of decongestant. Results: A total of 220 participants were included in this study. Around 15.0% of them reported that ND come with a physician prescription. The majority of the participants (87.3%) reported that the less than 5 days is the maximum safe duration for the use of NDs. Overall, the study participants demonstrated moderately positive attitude towards controlling the use of decongestant with a mean attitude score of 2.5 (standard deviation: 1.2) out of 5; which represents 50.0% of the maximum score. Binary logistic regression analysis identified that pharmacists aged 31-40 years were two-folds more likely to have positive attitude towards controlling the use of decongestant compared to others (p<0.05). Around 45.9% of them reported that they recommend other over-the-counter treatments like nasal irrigation, nasal steroids, or antihistamine if they see a patient with RM asking for ND with or without prescription. Conclusion: The majority of pharmacists in Saudi Arabia demonstrated sufficient awareness and understanding on the adverse effects associated with the excessive use of NDs. Rhinitis medicamentosa can be avoided by appropriate measures, highlighting the importance of raising awareness about the excessive use of decongestants among healthcare professionals and patients alike.

Understanding olfactory dysfunction in the COVID-19 era: insights from a cross-sectional survey of the Saudi community.

Background and objectives: COVID-19 has emerged as a public health emergency caused by the coronavirus 2 (SARS-CoV2). However, only a few studies have reported that anosmia is an early predictor of COVID-19. Therefore, this study aimed to assess the current level of knowledge regarding smell dysfunction in COVID-19 era in Saudi community. Materials and methods: An online survey was conducted using Survey Monkeys in Saudi Arabia. The survey was distributed through Twitter and WhatsApp. The questionnaire included individuals' demographic information, such as sex, age, residence, income, and qualifications, as well as their knowledge of the early symptoms of COVID-19. ANOVA and Mann-Whitney U-test were conducted to analyze the data. There were twelve items on knowledge dimensions which were assessed through five-point Likert scale. Results: In total, 809 respondents completed the questionnaire. Among them, 658 (81.3%) had no knowledge of how sudden loss of or change in the sense of smell can be the only symptom of COVID-19. However, most participants, 738 (91.2%), knew that fever was a symptom of COVID-19. Similarly, 707 (87.4%) and 772 (95.5%) participants knew that cough and shortness of breath were the major symptoms of COVID-19, respectively. In addition, 395 (48.3%) participants had no information regarding taste changes as a symptom of COVID-19. Notably, participants who were female, married, or diagnosed with COVID-19 had significantly greater knowledge of smell-related issues due to COVID-19 than males, unmarried, and healthy/those without COVID-19. Conclusion: This study revealed that the Saudi population has an fairly good level of knowledge regarding common COVID-19 symptoms as more than 90% of the participants understood symptoms of COVID-19, but less acceptable knowledge regarding smell and taste dysfunction as more than 80% had no knowledge of change in olfactory and taste function was due to COVID-19.

Experience of People With Chronic Sinusitis During COVID-19 Lockdown in Saudi Arabia: Insights and Lessons.

Background This study aims to evaluate the effect of the COVID-19 lockdown period on chronic rhinosinusitis (CRS) symptoms control. Methodology This cross-sectional study was carried out on adult patients (aged ≥18 years) who visited King Abdulaziz University Hospital within six months before the lockdown starting date. Background information, including patients' diagnosis, presence of rhinitis, number of previous surgeries, and medications, was collected. CRS symptom burden was measured using a validated Arabic version of the 22-item Sino-Nasal Outcome Test (SNOT-22). Study participants were required to complete the survey two months after the start of the lockdown. Results Out of 66 patients, 43 agreed to participate. The majority of respondents (34, 75.6%) were diagnosed with CRS with nasal polyps. The study revealed no differences between pre- and post-lockdown total symptom scores. Conclusions The COVID-19 pandemic has affected the health system worldwide in many ways. Regarding the scope of our study, CRS symptoms, fortunately, did not worsen with the pandemic. This is considered the first reported study to assess such symptom control among people with CRS in Saudi Arabia during the COVID-19 lockdown period.

Seasonal variations in serum levels of vitamin D and other biochemical markers among KSA patients prior to thyroid surgery.

OBJECTIVES: Serum levels of vitamin D can vary between seasons, which may affect serum calcium levels in post-thyroidectomy patients. This study aimed to determine seasonal variations in serum levels of vitamin D and other biochemical markers in patients prior to thyroid surgery in a KSA hospital. METHODS: In this study, we analysed the data of 685 post-thyroidectomy patients. The preoperative laboratory values of all patients were collected, and the patients were categorized into groups based on the month when the surgical procedure was performed as follows: cold (November-February) and warm/hot groups (March-October). RESULTS: Serum vitamin D levels were deficient in 70% of the patients, insufficient in 18%, and optimal in 12%. The mean age of patients in the deficient group was significantly lower than that in the optimal group. There were significantly more patients who had vitamin D deficiency during the cold season than during the warm/hot season (p = 0.024). Serum vitamin D levels did not vary between seasons (p = 0.836); however, the preoperative magnesium and thyroid stimulating hormone (TSH) levels were significantly higher during the warm/hot season than during the cold season (p = 0.039 and p < 0.001, respectively). Preoperative calcium level was not significantly different between the cold and warm/hot months (p = 0.282). CONCLUSION: This study suggests a non-significant seasonal fluctuation in serum levels of vitamin D with insignificant variation in serum calcium levels during cold and warm/hot seasons. The findings necessitate a careful review of the patients' biochemical status prior to surgery. Future prospective longitudinal studies are needed to confirm this variability.

Medical Students' Awareness of Smell Loss as a Predictor for Coronavirus Disease 2019.

Background: Anosmia has been reported as an early presentation of coronavirus disease 2019 (COVID-19). However, the pathophysiological mechanism of olfactory dysfunction is still unclear. Aim: The aim of this study to evaluate the knowledge regarding common symptoms, anosmia, treatment options, and PPE among medical students in three different universities of Saudi Arabia. Methods: This cross-sectional survey conducted among medical students in Saudi Arabia. Google Forms was used to create the survey. The questionnaire included demographic information, knowledge of COVID-19 symptoms, sources of information, and the level of awareness of specific symptoms (loss of smell and taste). Results: A total of 494 students completed the questionnaire. The majority of the participants were aware of common COVID-19 symptoms like fever and cough (79.8 and 67.2%, respectively), but less than half were aware that smell or taste dysfunction might be a symptom of COVID-19 (44.3 and 30.2%, respectively). The present study revealed that the source of information also plays a critical role in medical students' awareness regarding the symptoms of COVID-19. Students using international organization's websites, medical databases, or published research had better knowledge of anosmia as a COVID-19 symptom compared to those who used WhatsApp, Google, or unofficial social media pages. In our study, a minority (11.9%) of the participants relied on unofficial social media pages as the main source of their information. Conclusion: Saudi medical students understand that smell or taste dysfunction can be a potential symptom of COVID-19, but this knowledge was not as widespread as the knowledge regarding the most common COVID-19 symptoms.

Assessment of International Frontal Sinus Anatomy Classification among senior residents through inter- and intra-rater reliability.

OBJECTIVES: To evaluate the International Frontal Sinus Anatomy Classification (IFAC) reliability among Saudi board otorhinolaryngology senior residents. METHODS: This cross-sectional study was carried out at King Abdulaziz University Hospital, Riyadh, Saudi Arabia between April 2019 and December 2019, included 32 senior residents. Questionnaires with 4 computed tomography images showing the different frontal cell types were used in this survey. All scans included 3 planes (axial, sagittal, coronal) and the tested cell was marked with arrows. Residents chose the answer from multiple choices according to the IFAC system. All residents filled the same questionnaire twice with 2 weeks interval. RESULTS: Approximately 68.8% of residents agreed that the classification was applicable clinically. The resident's attitude toward the importance of understanding IFAC was 65.6%. Residents' correct classification of the marked cells increased significantly for most of the questions from baseline to 2 weeks. CONCLUSION: The frontal sinus is not easy to treat surgically, and its inadequate treatment causes the failure of drainage, as in the case of chronic rhinosinusitis. Therefore, surgeons must fully understand the IFAC system to avoid major and minor complications.

Awareness of head and neck cancers in Saudi Arabia. A questionnaire based study.

OBJECTIVES: To address the gap in knowledge by providing data and analyses of the status of awareness among Saudi adults. METHODS: This cross-sectional questionnaire-based study was carried out in Saudi Arabia from August 2018 to August 2019 through social media platforms using SurveyMonkey. The domains of the questionnaire included demographic information, knowledge of types and symptoms of head and neck cancers (HNCs), and the relation of HNCs to human papillomavirus (HPV) and its vaccine. RESULTS: A total of 3171 respondents completed the questionnaire. The analysis revealed that many of the study respondents (49.3%) were not knowledgeable about HNCs. Almost two-thirds (61.2%) of the study population incorrectly believed that brain cancer was included in HNCs. Over half (57.8%) did not recognize headaches as a symptom. In terms of the risk factors, males showed higher awareness of tobacco and excessive alcohol as risk factors, while females were more knowledgeable about HPV infection (p less than 0.05). CONCLUSION: This study revealed that there is a lack of knowledge and awareness of the clinical features of and risk factors for HNCs among the Saudi population.

Intramural Bronchogenic Cysts in the Pediatric Population.

A bronchogenic cyst is a rare congenital malformation. It occurs due to the development of buds in any part of the tracheobronchial area. It can also lead to fatal complications, especially in the early stages of life. However, data on its diagnosis and treatment are scarce, owing to the rarity of the disease. This review article aimed at evaluating the literature on the manifestations of intramural bronchogenic cysts in the pediatric population. Medical databases were examined thoroughly to explore eligible articles for inclusion. Twenty-three articles appeared in the search result. The produced reports were evaluated against the predecided inclusion criteria. After reviewing the literature, eight articles were eligible for inclusion in this review. The included articles were published between 2000 and 2020. An intramural bronchogenic cyst is a rare condition that should not be neglected in a differential diagnosis. Surgical excision is currently the recommended management strategy. Further extensive studies about the management of the complications of intramural bronchogenic cysts are needed.