Conjunctival Lesions: A 5-Year Basic Demographic Data and Clinicopathological Review in a Tertiary Eye Care Hospital.

BACKGROUND: Conjunctival lesions are common with a wide spectrum of benign, premalignant, and malignant lesions. Few histopathological studies have been conducted on conjunctival lesions with variable designs and results. Our aim in this study is to provide information on common conjunctival lesions seen in an ophthalmology tertiary care center in Saudi Arabia. METHODS: A retrospective, observational study of all consecutive conjunctival tissue specimens sent for histopathological assessment to the pathology department from 2015 to 2019 were analyzed. Clinical data were collected from medical records, and the histopathological slides were reviewed by a single pathologist. RESULTS: A total of 110 conjunctival specimens from 108 patients were included (mean age: 53 years, 67 males and 43 females). Bilateral involvement was mostly found in inflammatory lesions (40%). Most lesions were benign (91%), with a significantly longer duration of symptoms in malignant lesions (p = 0.036*). The clinical diagnosis matched the final histopathological diagnosis in 75.5% of the total specimens. The most frequent category of benign lesions was fibrodegenerative and proliferative lesions (53.6%), with a significantly higher prevalence among adult males (p < 0.001). Melanocytic lesions were more common in children (33.3%) than adults (9.8%), and the mean age of children was significantly lower (p = 0.013). The most frequent malignant lesion was ocular surface squamous neoplasia (50%), with equal prevalence among males and females. The overall outcome was favorable in 89.4% and unfavorable in 10.6%, mostly due to surgical complications, further progression of the lesion, or recurrence. CONCLUSION: This study shows variability in the frequency of conjunctival lesions based on gender, age, geographical, racial, and environmental factors. There has been a shift in the gender-based prevalence of ocular squamous neoplasia over the last three decades, probably due to a change in lifestyle.

Utilization of Intravenous Tissue Plasminogen Activator and Reasons for Nonuse in Acute Ischemic Stroke in Saudi Arabia.

BACKGROUND: Recombinant tissue plasminogen activator (rt-PA, alteplase) within 4.5 hours of symptom onset decreases the rate of disability after acute ischemic stroke (AIS). Due to various reasons, alteplase remains underutilized in certain regions (∼3% in low- and middle-income countries). AIMS: We aimed to estimate the alteplase utilization rate and identify the reasons for nonuse in Saudi Arabia. METHODS: We retrospectively reviewed all patients admitted with suspected stroke in the past 24 hours to the stroke unit at King Abdulaziz Medical City, Riyadh, Saudi Arabia from February 2016 to July 2018. We estimated the alteplase utilization rate among patients with AIS who could be treated within 4.5 hours of symptoms onset (≤225 minutes, allowing 45 minutes for door to needle time). We examined potential predictors of alteplase use using multivariable logistic regression analyses. Study was approved by local IRB. RESULTS: Of 1366 patients with suspected stroke, 819 (60%) had AIS. The alteplase utilization rates were 8.6% and 29% for all AIS and AIS arrived within the therapeutic window, respectively. The most common reason for no alteplase treatment was late arrival. Only 244 (29.8%) of AIS patients arrived within the time window for treatment. Among patients with sudden neurological deficit who arrived within the therapeutic time window, the most common reasons were mild neurological deficit (National Institutes of Health Stroke Scale score <5, 29.9%), stroke mimics (16.6%), and hemorrhagic stroke (8.1%). CONCLUSIONS: Our study showed a comparable alteplase utilization rate with most international estimates. The low utilization rate was mainly attributed to late patient arrival. Urgent interventions are needed to improve public awareness of stroke recognition and prehospital stroke care.

Prevalence and severity of temporomandibular disorders among university students in Riyadh.

OBJECTIVE: The aim of this study was to evaluate the prevalence and severity of temporomandibular disorders (TMDs) among male university students in Riyadh, Saudi Arabia. The role of relevant medical and dental histories in the assessment of TMD in this Arab population was also addressed. METHODS: Required information was collected via a questionnaire. The first part of the questionnaire was used to obtain the medical and dental histories of participants. The second part included 10 questions regarding common TMD symptoms. Fonseca's anamnestic index (FAI) was used to classify TMD severity as "no dysfunction", "light dysfunction", "moderate dysfunction", or "severe dysfunction". RESULTS: Of the 600 distributed questionnaires, 400 questionnaires were completed (response rate: 66.6%). Mean age of eligible participants was 21.90 ± 1.79 years. Psychological stress (30.5%) and direct restorations (77%) were the most commonly reported items on the medical and dental histories respectively for the total number of participants. According to the FAI, 53.2% of participants were classified as having no dysfunction, followed by light (36.1%), moderate (9.6%), and severe dysfunction (1.1%). CONCLUSIONS: Based on the FAI, mild to moderate prevalence of TMD appears to exist among male university students in Riyadh. Histories of psychological stress and dental treatment were evident among these students. Information obtained from the FAI may be helpful in assessing the prevalence of TMD and has important implications for the early diagnosis of TMD and the prevention of future TMD-related complications.