Incidence of Post-Thyroidectomy Hypoparathyroidism and Associated Preoperative and Intraoperative Risk Factors.

INTRODUCTION: Thyroidectomy technique and extent are related to parathyroid injury and hypoparathyroidism. Total thyroidectomy is one of the most commonly performed endocrine surgeries, and the majority of patients recover completely without any complications. However, persistent hypoparathyroidism is the most prevalent long-term consequence following total thyroidectomy. While it is seldom deadly, it can cause severe morbidity for the patient and raise healthcare expenses. METHODS: This retrospective cohort study was conducted at King Abdulaziz Medical City, Jeddah, Saudi Arabia. We included all confirmed thyroid cancer cases that underwent thyroidectomy with or without neck dissection between July 2016 and August 2022. The data was collected from a chart review of the electronic medical record system (BEST-care), and a data collection sheet was utilized. SPSS version 26 was used to analyze the data. RESULTS: A total of 192 patients undergoing thyroid surgery were enrolled. One hundred forty-three (74.5%) were females and the mean age of participants was 45.29 ± 16.88 years. Most patients, 170 (88.5%), had a papillary histological type, and total thyroidectomy was performed in 150 (78.1%). A significant association was found between the type of surgery and postoperative hypoparathyroidism (p=<0.05*). In addition, hypocalcemia was seen in 147 (76.6%) of the patients. Postoperative hypoparathyroidism was significantly higher among patients who had asymptomatic postoperative hypocalcemia and those who received IV calcium gluconate (p=<0.05*). Moreover, postoperative hypocalcemia, hypomagnesemia, and hyperphosphatemia were significantly associated with postoperative hypoparathyroidism (p=<0.05*). CONCLUSION: The incidence of postoperative hypoparathyroidism is significantly higher among patients who underwent total thyroidectomy and had a normal level of preoperative parathyroid hormone (PTH) and magnesium (Mg) levels. Identifying these factors is a crucial step to minimize the occurrence of such complications.

Knowledge and Attitude of Saudi Physicians Toward Cannabidiol for Pediatric Epilepsy: A Cross-Sectional Study.

Background Epilepsy is one of the most common neurological diseases. Various institutions have shown an interest to investigate the role of cannabidiol (CBD) in treating pediatric epilepsy. CBD is a chemical extracted from the cannabis plant and lacks the euphoria-inducing characteristic. Despite the FDA approval, the physicians' attitude toward CBD is controversial. Therefore, we aim to measure physicians' knowledge and acceptance of the use of CBD in managing epilepsy patients in Saudi Arabia. Objectives The aim of this study is to measure the knowledge and attitude of physicians regarding CBD use in pediatric epilepsy. Methods In this cross-sectional study, a validated electronic survey was distributed in the period between September 2021 and October 2021 among pediatricians and neurologists at King Abdulaziz Medical City. The survey consisted of four sections: demographics, the perceived knowledge regarding CBD, the knowledge test, and the attitudes toward CBD. Three-scoring systems were established to assess these sections. Results A total of 94 participants were included in this study; 50% of them were males, 81.9% of the participants were in the pediatric field, 13.8% were in the field of neurology, and 4.3% were pediatric neurologists. As for the professional tenure, approximately half of the participants were residents/trainees. Overall, respondents tend to have low perceived knowledge (94.7%) and attitude (93.6%) regarding CBD use. The perceived knowledge and attitude levels were found to be significantly associated with specialty (p < 0.001 and p = 0.001, respectively). Pediatric neurologists had a significantly higher self-assessment score, while pediatricians had the lowest attitude level (p < 0.05). For the knowledge test, surprisingly only one respondent answered all questions correctly, and age was found to be significantly associated with knowledge score (p = 0.001). Conclusion This study demonstrates that physicians have poor knowledge and attitude levels regarding the usage of CBD in pediatric epilepsy. Therefore, more education is highly suggested before the introduction of this medication to Saudi patients.

The Influence of the COVID-19 Pandemic on the Prevalence, Characteristics, Management, and Outcomes of Acute Appendicitis at the Academic Tertiary Center, Jeddah.

BACKGROUND: Acute appendicitis is the leading cause of acute abdominal pain that requires immediate intervention. Nonetheless, during COVID-19, hospital visits decreased as a result of serious COVID-19 concerns at that time, resulting in a decreased number of diagnosed cases with acute appendicitis due to COVID-19 restriction issues. OBJECTIVES: To report the percentage numbers, characteristics, applied management, and outcomes of patients with acute appendicitis during the COVID-19 pandemic and compare them to pre-COVID-19 cases. METHODS: A retrospective cohort study included all patients with acute appendicitis in the determined periods "pre-COVID-19" and "during COVID-19" at King Abdul-Aziz Medical City, Academic Tertiary Center, Jeddah, Saudi Arabia. Mean and standard deviation were used, while categorical data were reported as frequencies and percentages. Variables were analyzed by the Chi-squared test, Fisher's exact test, and Mann-Whitney test as appropriate. RESULTS: A total of 298 patients were included. The period of the pre-COVID-19 pandemic had 161 (54%) patients, while 137 (46%) were identified during COVID-19. The number of laparoscopic appendectomies performed during COVID-19 was less than the pre-COVID-19 pandemic of 96 cases (70.1%) vs 133 cases (82.6%) (P=0.0106). Uncomplicated appendicitis was the most commonly reported type of appendicitis in both periods: 113 (82.5%) during COVID-19 vs 135 (83.9%) pre-COVID-19, (P=0.7526). Furthermore, the number of patients who presented to the ER between 24 and 48 hours after the onset of symptoms was similar before and during the pandemic: 111 (68.9%) vs 89 (65%). CONCLUSION: Overall, we conclude that during the COVID-19 period, there was a reduction in the number of patients presenting with acute appendicitis and a lower chance of undergoing laparoscopic appendectomy due to COVID-19 restrictions. There was also an increase in perforated appendicitis and a decrease in gangrenous appendicitis.