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Reinfection with SARS-CoV-2 is a rare phenomenon. To date, there has been some cases reported from countries such as United States, Ecuador, Hong Kong, the Netherlands and Belgium. This case report presents the first case of reinfection from Saudi Arabia, and probably the first dental student to have been re-infected with COVID-19. A 24-year-old male dental student presents with reinfection after a period of three months since he was first infected with COVID-19. The signs and symptoms reported by the patient were similar in both instances, except that he developed fever only at the time of reinfection. The infection and reinfection were confirmed with a RT-PCR test reports. This report highlights how it is necessary to continue to observe all the prescriptions recently indicated in the literature in order to avoid new contagion for all health workers after healed from covid-19 or asymptomatic positive, since as seen sometimes the infection does not ensures complete immunity in 100% of cases.

Chronic lymphocytic leukemia (CLL) typically occurs in the elderly and has a highly variable clinical course. Infectious complications have been known to be a major cause of morbidity and mortality in CLL patients. The management of hematological malignancies, including CLL, during the COVID-19 pandemic is challenging. Here we describe two patients with CLL who got infected with SARS-COV-2 as confirmed by positive nasopharyngeal swab PCR. The 1st patient, who was receiving treatment for CLL-associated autoimmune hemolytic anemia, was hospitalized with mild COVID-19 symptoms. The 2nd patient, who was on active treatment for CLL, had asymptomatic COVID-19 infection and was not hospitalized. Both patients recovered from COVID-19 without related complications.

Introduction: Alteration of the centrifugation time and protocol may impact the release of platelet-rich fibrin (PRF) scaffolds. The current study purpose was to investigate the released levels of fibroblast growth factor-2 (FGF-2) in standard PRF (S-PRF) and low-speed centrifugation concept known as advanced PRF (A-PRF and A-PRF+). Measurements were done at five times interval over 42 days. The aim was to assess the FGF release and the relation between initial platelet counts and the concentrations of FGF-2 release using the following technique: (1) S-PRF, (2) A-PRF, and (3) A-PRF+. Materials and Methods: Twenty-four blood samples were taken from eight random Saudi Arabian national healthy subjects enrolled in the investigation. Blood samples were processed using S-PRF, A-PRF, and A-PRF+ centrifugation protocols. Protein quantification was performed using enzyme-linked immunosorbent assay at 1, 7, 14, 28, and 42-day intervals. Results and Discussion: A statistically significant difference in the mean of FGF-2 measurement between protocols at the 7th day where both S-PRF and A-PRF were significantly higher than A-PRF+ (P < 0.012). Initial platelets' significant count for S-PRF, A-PRF, and A-PRF+ was on day 1, day 7, and 7th day, respectively. Both protocols S-PRF and A-PRF yielded significantly higher release of the FGF-2 when compared to A-PRF+ in Saudi healthy subjects.

This piece theorises the limitations of transitioning reflection from individualistic to participatory practice. It addresses the question: what are the challenges of introducing crowd-refl...

Fasting Ramadan is known to influence patients’ medication adherence. Data on patients’ behavior to oral anticoagulant (OAC) drug intake during Ramadan is missing. We aimed to determine patient-guided modifications of OAC medication regimen during Ramadan and to evaluate its consequences. A multicenter cross-sectional study conducted in Saudi Arabia. Data were collected shortly after Ramadan 2019. Participants were patients who fasted Ramadan and who were on long-term anticoagulation. Patient-guided medication changes during Ramadan in comparison to the regular intake schedule before Ramadan were recorded. Modification behavior was compared between twice daily (BID) and once daily (QD) treatment regimens. Rates of hospital admission during Ramadan were determined. We included 808 patients. During Ramadan, 53.1% modified their intake schedule (31.1% adjusted intake time, 13.2% skipped intakes, 2.2% took double dosing). A higher frequency of patient-guided modification was observed in patients on BID regimen compared to QD regimen. During Ramadan, 11.3% of patients were admitted to hospital. Patient-guided modification was a strong predictor for hospital admission. Patient-guided modification of OAC intake during Ramadan is common, particularly in patients on BID regimen. It increases the risk of hospital admission during Ramadan. Planning of OAC intake during Ramadan and patient education on the risk of low adherence are advisable. Electronic supplementary material The online version of this article (10.1007/s11239-020-02218-0) contains supplementary material, which is available to authorized users.

Background: Hydrocephalus is a worldwide disorder characterized by abnormal flow or rarely excessive production of cerebrospinal fluid, leading to the widening of the cerebral ventricles system due to the accumulation of the cerebrospinal fluid in the brain. Previous researches have shown that knowledge about the disorder is limited among healthcare providers and the population, affecting attitudes toward patients, as well as patient outcomes. Aim: To investigate healthcare providers and population's knowledge and attitudes towards hydrocephalus in Saudi Arabia. Methodology: A descriptive cross-sectional study was conducted through an electronic questionnaire. The survey was self-constructed in Arabic and English by the research team and inspired by other awareness questionnaires and validated before use by three experts. Results: There were 444 participants in this study, aged between 17 and 73 years with a mean age of 32.60 ± 10.98. Most of the participants were from the general population (74.8%). More than half of the participants had a bachelor's degree (60.1%). 38.4% of healthcare providers had negative knowledge while 61.6% had positive knowledge. In addition, 82.5% of the general population had negative knowledge, although 17.5% had positive knowledge. Moreover, it was observed that 17.0% of the healthcare providers had a bad attitude while 83.0% had a good attitude. In addition, 60.2% of the general population had a bad attitude, whereas 39.8% had a good attitude. Conclusion: This study revealed that the level of knowledge and attitude towards hydrocephalus among healthcare providers was good on both aspects, while it was poor among the general population.

The present study uses an amended version of a well-known investment model to investigate the levels of satisfaction and commitment of finance students enrolled on a blended e-learning programme. First, it presents new empirical evidence for the validity of each construct and validates the proposed investment model. Second, it examines whether students’ grade point average (GPA) scores influence their levels of satisfaction and commitment the course. A random sample of 100 undergraduate students enrolled at King Khalid University in Saudi Arabia was surveyed using both qualitative and quantitative approaches. The proposed investment model was suitable for predicting the levels of student satisfaction and commitment in a blended learning environment, especially finance courses. However, the levels of satisfaction and commitment among students did not reach the proposed cut-off point for high commitment/satisfaction, which implied that levels of student satisfaction and commitment were only in the middle of the range. Specifically, the results showed a significant negative correlation between the level of satisfaction and GPA score, but a significant positive correlation between student commitment and GPA score. The study also highlights areas in which further research and analysis is recommended.

Congenital pulmonary airway malformation (CPAM) is a developmental anomaly of the lower respiratory tract. We document a case of primary Hodgkin Lymphoma of lung occurring in a 13-year-old boy who had an incidental diagnosis of CPAM at the same time. Keywords: Hodgkin lymphoma, Lung, CPAM

Nocturnal enuresis or night time incontinence is a common condition that usually affects children and can be associated with significant psychological effects on the affected child if left untreated. It can be defined as night time wetting of the bed that usually occurs in children that are ≥5 years old. In this literature review, the aim was to discuss the etiology and management of nocturnal enuresis and the impact of the condition on the different age groups. Management of the underlying comorbidities, taking care of the overactive bladder and dealing with the potential psychological conditions might be the main key factors to nocturnal enuresis. Many pharmacological and non-pharmacological approaches have been proposed for these patients. However, the success rates of applying behavioral management approaches have been reported to be the highest as compared to other approaches. Early interventions should be applied for children that have multiple risk factors or with parents that once suffered from the condition as genetics were reported in the literature to have a significant role in the development of nocturnal enuresis. Pharmacological therapies have also been reported as effective modalities in resistant cases and desmopressin was reported to achieve a 100% success rate if used with alarm therapy. However, clinicians should care for the potential adverse events when approaching the pharmacological modalities.

Hodgkin’s lymphoma is a B-cell neoplasm, which usually presents with painless lymphadenopathy. Its presentation with autoimmune hemolytic anemia (AIHA) is rare, although the association of AIHA with other lymphoproliferative disorders is well known. Here, we report a case of a patient with warm AIHA who presented in a critical condition to hospital and was diagnosed with HL.

This study aims to discuss the blood pressure (BP) control with patients who suffer from a previous stroke or transient ischemic attack (TIA) in Saudi Arabia, to discuss the risk factors and to examine antihypertensive medication-dosing. The most recent office-based BP reading was compared with the BP

Objective: This study is an empirical analysis of the female students’ attitudes toward the medical educational environment and climate in the College of Medicine at King Khalid University. Setting: The Dundee Ready Educational Environment Measure (DREEM) questionnaire was administered on the same day to 100 female students studying in the third (pre-clinical), fifth and sixth (final) year at the College of Medicine, King Khalid University. Although the sample size was limited in size, it was deemed acceptable for research purposes. Method: The study is conducted using the DREEM questionnaire. This study is different from other studies regarding testing hypothesis and advanced statistical analysis. A set of hypotheses were placed and examined using statistical techniques. Results: In general, we find that the total mean score was 112.95 out of a 200 maximum, the ideal educational environment as measured by this scale. All the hypotheses set were rejected and there was no difference in the results according to year of study such as the difference found in some previous studies. It was found that there are no statistically significant differences in the mean scores according to the year of study. Conclusion: This study follows a long literature of studies in different universities around the world using the DREEM scale. The limitations of previous studies were considered carefully and were used to provide a framework for this work. These results spotlight the need to improve the medical educational environment in Saudi universities in general. This study has highlighted some areas where further research and analysis is recommended.

Primary thyroid lymphoma (PTL) is a rare disorder accounting for about 2 % of all malignant lymphomas. It is an aggressive extranodal non Hodgkin lymphoma mostly of B lineage. We report four cases of PTL and highlight the clinical issues and challenges posed by this rare disease.

Background Various therapeutic options are available for the management of Langerhans cell histiocytosis. However, treatment administered to control this disease may be complicated by acute leukemia. Case presentation A 34 years old male was diagnosed to have Langerhans cell histiocytosis in March 1999. Unfortunately, the cytotoxic chemotherapy and radiotherapy given to control the repeated relapses and exacerbations of the primary disease predisposed him to therapy-induced myelodysplastic syndrome which transformed into acute myeloid leukemia. After achieving complete remission of his leukemia, the patient received an allogeneic hematopoietic stem cell transplant. The allograft was complicated by chronic graft versus host disease that was controlled by various immunosuppressive agents and extracorporal photophoresis. Conclusion Management of complicated cases of histiocytosis requires various therapeutic modalities and a multidisciplinary approach. Having complications of therapy eg myelodysplasia or acute leukemia make the outcome more dismal and the management options limited to aggressive forms of treatment. High dose chemotherapy followed by an allograft may be a curative option not only for therapy-related myelodysplasia/acute leukemia, but also for frequently relapsing and poorly controlled Langerhans cell histiocytosis.

Introduction: Sickle cell disease (SCD) is an inherited genetic disorder characterized by various complications, including thrombosis. Increased levels of circulating microvesicles (MVs) and tissue factor (TF)- bearing MVs have been reported in SCD. Objectives: The present study compares the levels of circulating MVs and TF- bearing MVs in steady state SCD children with age- and gender- matched healthy controls using an indirect ELISA. Citrated whole blood was collected from 54 SCD patients homozygous for sickle haemoglobin (HbSS) (aged from 2 to 12 years-old) and 34 healthy controls. Results: SCD patients showed significantly higher levels of MVs in their plasma as compared to the controls (P = 0.0095). Although the TF activity on MVs was low in both groups, there was a significant difference between them P