Incidence and predictive factors of bleeding following tonsillectomy among pediatrics: A retrospective cohort study.

OBJECTIVES: To estimate the incidence of post tonsillectomy bleeding and to identify its predisposing factors among the pediatric population. METHODS: A retrospective cohort study included 1280 pediatric patients (18 years or younger) who underwent tonsillectomy at King Abdullah Specialized Children Hospital, Riyadh, Saudi Arabia between 2019 and 2020. The study sample was divided into 2 groups based on the development of postoperative bleeding and were compared using Chi-square test and independent t-test. Significant variables (p-value ≤0.05) were included in the logistic regression model to determine the predictors of bleeding following tonsillectomy. RESULTS: The bleeding rate following tonsillectomy was 3.4% in 43 (95% confidence interval [CI] 2.4-4.5) patients. In the multivariable logistic regression model, the significant predictors of post tonsillectomy bleeding were age ≥12 years (odds ratio [OR]: 2.685, p=0.027), decreased postoperative oral intake (OR: 4.244, p=0.042), and single use of postoperative analgesia (OR: 53.124, p<0.001). Out of the 43 patients, 39 (90.7%) patients experienced secondary bleeding, and more than half of the patients who developed bleeding required surgical intervention 27 (62.8%). CONCLUSION: Tonsillectomy is a safe and common surgical procedure but carries risks for postoperative bleeding. Age ≥12 years, poor postoperative oral intake, and the use of a single postoperative analgesic increase the risk of bleeding. We encourage healthcare providers to ascertain early resumption of oral intake and ensure effective pain management. We recommend a dual alternating analgesic regimen with weight-based dosing for optimal pain control. Furthermore, educating caregivers about the importance of adequate oral intake following tonsillectomy may improve patient outcomes.

Major salivary gland carcinoma in KSA: A 10-year nationwide retrospective study of 571 cases.

Objectives: Major salivary gland carcinoma (MSGC) comprises a morphologically diverse group of rare tumours with different clinical behaviours, and epidemiology findings in the literature substantially vary by geographic location. The aim of this study was to conduct a comprehensive analysis of the incidence rates, anatomical sites, and histological subtypes of different salivary gland malignancies in the population of KSA. Methods: This retrospective cohort study included patients diagnosed with MSGC in KSA from 2008 to 2017, on the basis of the demographic characteristics and histological data retrieved from the Saudi Cancer Registry database. Malignant lesions were identified according to the International Classification of Diseases for Oncology, Third Edition (ICD-O-3) codes. Results: Salivary gland malignancies were diagnosed in 571 patients (50.10% males and 49.90% females) over the course of 10 years. The parotid gland was the site of origin in 69.9% of cases. The most common histological type was mucoepidermoid carcinoma (29.1%). Over a decade, the incidence rate ranged from (0.15-0.24) per 100,000 inhabitants. The peak incidence of salivary gland malignancies was observed in the fourth, fifth, and sixth decades of life (17.5%, 18.2%, and 16.8%, respectively). Conclusion: Compared with that in other parts of the world, the incidence of MSGC is significantly lower in KSA, with 0.15-0.24 cases per 100,000 people each year. However, the clinical manifestations of carcinoma of the salivary glands in KSA are similar to those described worldwide.

The Prevalence of Pediatric Lower Limb Fractures Following Motor Vehicle Accidents at King Abdullah Specialist Children's Hospital, Riyadh, Saudi Arabia.

Background Pediatric injuries are a very common and serious issue that may result in permanent harm. Regardless of the etiology of the injury, children represent up to 25% of all cases visiting the emergency room. Children suffer nearly twice as many fractures as adults, with males being more vulnerable to this type of injury. Methods A retrospective cohort study was conducted among 2777 patients, and a total of 203 patients who fit the inclusion criteria were included. Data were collected using the electronic system at King Abdullah Specialist Children's Hospital (KASCH). Participants were selected by a non-probability purposive sampling method and data analysis was carried out using the SPSS program. Results The prevalence of motor vehicle accidents (MVAs) related to lower limb fractures was estimated to be 7.3%. The patients had an average mean age of 8.6±4 years, with 10-14 years being the most common age group affected (48.3%) with male predominance (72.4%). Furthermore, femoral fractures were the most commonly identified type (31.5%), and a pedestrian was the most common mechanism of multiple lower limb fractures. Additionally, the highest reported mechanism of injury of lower limb fractures was MVAs. Moreover, the current study shows that most of those patients were treated surgically (55.1%). Conclusion Conclusively, our cohort estimated that the prevalence is 7.3% of MVAs-related lower limb fractures among all children presented to the KASCH Emergency Department. Our study showed that children who were 10-14 years of age were the most affected. There is a male over female predominance. A femur was the most common bone to be affected. Lastly, further safety awareness programs and campaigns are important to be initiated by governmental authorities.