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Mohammed A Almatrafi,1 Lama Sindi,2 Malak Alshehri,2 Esraa Sendi,2 Ghufran Sindi,2 Ghaida Alzahrani,2 Joud Alwan,2 Emad Salawati,3 Hassan Alwafi,4 Faisal Minshawi,5 Rafat Mosalli,1 Mohammed Samannodi6 1Department of Pediatrics, Umm Al-Qura University, Makkah, Saudi Arabia; 2Medical College of Umm Al-Qura University, Makkah, Saudi Arabia; 3Department of Family Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia; 4Department of Pharmacology and Toxicology, Umm Al-Qura University, Makkah, Saudi Arabia; 5Department of Laboratory Medicine, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia; 6Department of Medicine, College of Medicine, Umm Al-Qura University, Makkah, Saudi ArabiaCorrespondence: Mohammed Samannodi, Department of Medicine, College of Medicine, Umm Al-Qura University, Makkah, 21955, Saudi Arabia, Tel +966548293937, Fax +966125502188, Email Samannodi@gmail.comBackground: Parent’s misconceptions or lack of knowledge about childhood urinary tract infections (UTIs) can negatively impact their children’s health. Therefore, the present study aimed to determine the childhood urinary tract infections awareness and understanding among parents in Saudi Arabia.Patients and Methods: An online validated cross-sectional survey of parents in Saudi Arabia was conducted from August to September 2021. Study participants who met the inclusion criteria were selected using a convenience sampling technique. A questionnaire with two domains was used to assess parental awareness of childhood urinary tract infection symptoms, complications, treatment, prevention, epidemiology, and diagnosis. The total childhood urinary tract infections awareness scores were classified into three categories: low awareness, moderate awareness, and high awareness. Descriptive statistics were used to determine the data distribution. A chi-square test was used to evaluate the relationship between parental awareness about urinary tract infections in children and other variables. Statistical significance was established at 0.05.Results: Of the 1688 parents who completed the survey, 1289 (76.4%) were female, 1581 (93.7%) were married, and 1161 (68.8) had a university degree. Parent’s total awareness scores were high; however, individual domain scores indicate a moderate level of knowledge. Statistically significant relationship were observed between total awareness and gender, occupation, and level of educational level ((P=0.004, P=0.001, P=0.007, respectively). Another statistically significant relationship was noted between the history of urinary tract infections and awareness of disease prevention (P=0.009).Conclusion: In Saudi Arabia, parental knowledge about childhood urinary tract infections is moderate to high. However, future studies are needed to investigate gender, educational, and occupational variations in childhood UTI knowledge among parents in Saudi Arabia.Keywords: urinary tract infections, awareness, parents, childhood

Saudi Arabia has seen a significant improvement in its healthcare system over the past four decades resulting in an increase in life-expectancy. Transcatheter aortic valve implantation (TAVI) has spread widely in Saudi Arabia and has become a routine procedure in many centers. The expanding clinical indications and the availability of the technology have made it possible for many large and intermediate centers all over the country to commence their own TAVI programs. So, the aim of this document is to standardize TAVI practices in different Saudi Arabian centers through reasonable guidelines based on the evaluation and summarization of the best available evidence. The review committee, composed of different experts in several aspects of the management of patient undergoing TAVI, based their recommendations on the reviewed and analyzed evidence and the class and level of recommendations were discussed until a consensus was reached by the panel., Competing Interests: Conflict of interest: None declared., (© 2024 Saudi Heart Association.)

Background: In recent era, digitalization in the dental sciences has been observed in wide ranges. This cross-sectional study aimed to assess knowledge and practice of additive manufacturing (AM) in dentistry among university teaching faculty in Saudi Arabia., Methods: A questionnaire was prepared and validated to distribute to the different dental colleges in Saudi Arabia. The questionnaire was divided into three parts: demographic information, knowledge and practices of AM among the dental teaching faculty. After receiving all the responses, descriptive statistics were used for the frequency distribution of all the responses., Results: A total of 367 responses were received from the different faculty members. Most of the participants were male (67.30%), holding assistant professor (52.50%) positions in the field of prosthodontics (23.40%). In terms of knowledge, even though most of the participants were aware of AM (64.30%); however, do not understand the AM techniques (33.50). Moreover, 71.90% of the participants had no experience working with AM and only 13.60% of participants used AM in their respective dental colleges., Conclusion: AM techniques are not commonly used in the field of dentistry in Saudi Arabia; therefore, more platforms should have created to enhance the knowledge and practice of AM in the current population., (© 2024. The Author(s).)

Introduction The Boston Naming Test (BNT) is a widely used US neuropsychological evaluation of confrontation naming for the examination of adults and children with learning disabilities and diagnosis of communication disorders, aphasia, dementia, and acquired brain injury or dysfunction. The purpose of the present study is to evaluate the practicality of the original English version of the 60-item BNT (BNT-60) on an Arab population and the need for a new adaptive Arabic version sensitive to cultural biases and to offer normative data that can serve as a reference for researchers and clinicians in the Gulf region, especially the Kingdom of Saudi Arabia (KSA). Data relating to the familiarity degree of the BNT-60 were also collected. Methods This research involved 105 randomly selected and cognitively healthy college students who were native Arabic speakers recruited in Jeddah. The Montreal Cognitive Assessment (MOCA) was administered with a cutoff score of 26. The participants were examined for naming accuracy, naming agreement, and familiarity in using the BNT-60. The data were then analyzed and compared with the findings from studies conducted in the United States. Results The BNT-60 was administered to 105 university students from the KSA, and the results were compared with the BNT-60 booklet norms (second edition). Their average performance was noticeably below the norms established by the original test standards. Compared with the participants in the US studies, the participants made approximately 65% more errors on the items including pretzel, wreath, beaver, harmonica, acorn, stilts, harp, hammock, knocker, pelican, muzzle, unicorn, funnel, accordion, asparagus, tripod, yoke, and trellis and 25% more errors on the items including seahorse, dart, igloo, sphinx, palette, and abacus. The item "boomerang" was not compared with the US sample because of differences in the version of the BNT, but the errors in naming this item were as frequent as those in naming the other misrecognized items. The internal consistency among the items' degrees of familiarity was also very high (α = 0.966), and a significant connection (r = 0.837, P < 0.001) was observed between object familiarity and naming accuracy. The Arabic-speaking population in the KSA and English-speaking population in the United States showed very different levels of familiarity with numerous items. Conclusion The participants' familiarity with the BNT objects varied depending on their culture and impacted their naming accuracy and overall scores on the test. Accordingly, the possibility of cultural biases should be considered when administering the BNT to the population of the KSA and the possibility of making changes so that the test better reflects the Arab culture as suggested., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Basura et al.)

Background: Hospital readmission rates among heart failure (HF) patients remain a persistent challenge. While various risk factors have been identified, their impact on individual patients varies, and not all patients with these risk factors will necessarily experience readmission within 90 days. This study aimed to identify and assess the significance of risk factors associated with readmission of HF patients within 90 days., Methods: A retrospective cohort study was conducted at King Abdulaziz University Hospital in Jeddah, Saudi Arabia. The sample size comprised 130 patients. Data was collected from hospital records of all HF patients readmitted within 90 days of discharge between 2018 and 2022., Results: The study included 130 patients. The majority (70%) were between 51 and 70 years old. Most patients had a hospital stay ranging from 1 to 10 days (83.1%). Shortness of breath (SOB) was the most common reason for readmission, accounting for 80% of cases. Other reasons included chest pain (CP) (6.2%), orthopnea (13.1%), paroxysmal nocturnal dyspnea (PND) (5.4%), lower limb edema (LLE) issues (1.5%), and heart failure (HF) itself (2.3%). Less common reasons included fever (1.5%), pneumonia (1.5%), altered level of consciousness (1.5%), and urinary tract infection (1.5%)., Conclusion: Readmission rates for HF patients remain high, attributed to factors such as non-adherence to medication and lifestyle changes, comorbidities, inadequate discharge planning, and social determinants of health. Males may be more prone to experiencing SOB and subsequently requiring readmission at a higher rate. These findings underscore the need for comprehensive interventions that address these risk factors to minimize readmission rates and improve patient outcomes., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, S Alsulymani et al.)

Aim: To compare fracture resistance of multiple treatment modalities intended for mutilated teeth using polyether ether ketone (PEEK) and zirconia materials., Materials and Methods: The study was divided into four groups according to treatment modality adopted ( n = 14): fiber post (F), Nayyar core (N), endocrown (E), and Richmond crown (R). Each group was further subdivided into two groups ( n = 7) according to the type of material used: zirconia (Z) and PEEK (P). Using computer-aided design/computer-aided manufacturing, restorations were constructed from both materials following tested treatment options and manufacturer direction. Finished restorations were then tried, seated, and cemented to their corresponding acrylic teeth. All specimens were tested for fracture resistance in universal testing machine with cross head speed of 0.5 mm/min speed until failure, which was confirmed by a sudden drop in the measurements of the testing machine. Results were recorded, tabulated, and statistically analyzed. Shapiro-Wilk normality tests were considered to evaluate the normality of the data distributions. One-way analysis of variance (ANOVA) followed by Tukey's post hoc analysis was conducted to analyze the fracture resistance significant differences., Results: Descriptive statistics of the restoration material revealed statistically a higher mean value for PEEK material (3609 ± 188.1) than zirconia (2404 ± 425.6). One-way ANOVA revealed statistically significant differences between zirconia group ( p < 0.0001). Regarding zirconia group statistical significance was detected between fiber post vs endocrown ( p = 0.0299), fiber post vs Richmond crown ( p < 0.0001), and Nayyar core vs Richmond crown ( p = 0.0004). However, there was no statistically significant difference between PEEK group ( P = 0.1614)., Conclusion: Polyether ether ketone could present a reliable treatment option in endodontically treated teeth., Clinical Significance: Using one-piece Richmond crowns constructed of PEEK could present a viable treatment option against conventional treatment options of root canal treatment (RCT) single-rooted teeth.

Pulmonary hypoplasia is a rare form of the congenital disorder that leads to lung underdevelopment. It is more common in children and infrequently noticed in adulthood. While congenital lung abnormalities are frequently discovered in the early years of life, these conditions are also often detected incidentally following routine radiographic imaging and investigations. We report the case of a 1-year-old girl who presented to the emergency department with a three-day history of cough, shortness of breath, fever, and respiratory distress. Investigations revealed right lung hypoplasia, left lung hyperinflation, and an invisible pulmonary artery and vein. A diagnosis of right lung hypoplasia as an incidental finding with associated anomalies was made. She was admitted to the pediatric ward and received supportive care and empirical antibiotics. She was then discharged in a good condition with supportive management for follow-up. This case report aims to describe a rare condition occurring in children with various clinical pictures and presentations to aid future early detection to achieve better diagnostic outcomes., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Rashed et al.)

Background In this study, we aimed to determine the site of obstruction if surgical treatment is considered. Flexible nasopharyngoscopy is an invasive procedure currently used for the assessment of snoring and the level of obstruction. Here, we examine the role of Somnoscreen™ plus, a noninvasive cardiorespiratory polysomnographic device, in identifying the site of obstruction in patients presenting with snoring. Methodology This cross-sectional study was conducted in the Sleep Research Center at King Abdulaziz University Hospital. Polysomnography was conducted using Somnoscreen™ plus. All participants underwent flexible nasopharyngoscopy after polysomnography. Results Nasopharyngoscopy revealed that the most common site of obstruction was the nose and the soft palate (35.4%), followed by the soft palate alone (25%). Somnoscreen revealed that the site of obstruction was the nose and the soft palate in 18 (37.5%) patients and the nose alone in 16 (33.3%) patients. However, distal obstructions were not detected using Somnoscreen. The concordance of nasopharyngoscopy and Somnoscreen was 52.9%. However, it showed a discrepancy in identifying distal obstructions, which Somnoscreen™ plus failed to detect. Conclusions Somnoscreen appears to be sensitive for identifying proximal airway obstructions. The audio signal recordings can potentially be used as a tool to detect the site of airway obstruction in snoring; however, further studies are needed., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Alhejaili et al.)

Background: The aim of this study is to investigate the impact of ceramic material and preparation design on the marginal fit of endocrown restorations. Methods: Forty endocrown restorations were CAD/CAM-fabricated for forty extracted maxillary first premolar teeth. Samples were divided into two groups (n = 20) according to the ceramic materials used: Celtra Duo and Vita Enamic. Each group was divided into two subgroups (n = 10) according to the preparation design: with no intraradicular extension and with 3 mm intraradicular extension. The marginal gap was examined using a digital microscope. Results: Celtra Duo without intraradicular extension recorded the least mean marginal gap (7.74 ± 1.55 µm), while Group Celtra Duo with 3 mm intraradicular extension recorded the highest mean marginal gap (29.54 ± 6.32 µm). Group Vita Enamic recorded a lesser marginal gap (18.03 ± 12.11 µm) than group CD (Celtra Duo) (18.64 ± 12.05 µm). There is a statistically non-significant difference between the two groups of materials (p = 0.873). There is a statistically significant difference between the two tested preparation designs (p < 0.001). Conclusion: All groups recorded a marginal gap within clinically accepted values. Material selection may influence the fitting of restorations. Intraradicular extension for endocrown restorations adversely affects the marginal fit, however, the marginal gap is still within the clinically accepted range.

We are reporting the case of a 3-year-old-girl who initially presented with unilateral eyelid swelling and ptosis. A diagnosis of acute lymphoblastic leukaemia (ALL) was eventually made based on an orbital incisional biopsy and a bone marrow examination. Historically, orbital involvement had been linked to myeloid leukaemia; however, in lymphoid leukaemia, they are increasingly being implicated and had been reported as the sole presentation of the disease. These findings stress the importance of conducting ophthalmologic assessments in cases diagnosed with ALL in order to prevent delays in proper assessment and treatment. Management options in orbital disease are fortunately not significantly different than well-established treatment protocols., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2021 Ahmed Alsalem et al.)

Intracardiac metastases in the absence of inferior vena cava involvement is a rare occurrence in patients with metastatic renal cell carcinoma (mRCC). There is limited evidence regarding the efficacy and safety of standard treatment modalities for mRCC patients with intracardiac metastases. Presence of intracardiac metastases is known to indicate poor prognosis and may potentially increase risk of treatment-related complications. Recent advances in RCC management have integrated nivolumab, a programmed death-1 (PD-1) receptor inhibitor, as a preferred treatment option in the second-line setting after failure of prior anti-angiogenic therapy; or in combination with ipilimumab, an anti-Cytotoxic T-lymphocyte antigen-4 antibody as first-line therapy for intermediate to poor risk patients with mRCC. The efficacy and toxicity of nivolumab in patients with mRCC and intracardiac metastases has never been reported previously. We herein present the first reported case of mRCC with intracardiac metastasis and a resultant excellent response to nivolumab treatment and discuss the imaging techniques and treatment options for this rare presentation.

Background: Adolescents rarely present with breast lumps, and such lumps are usually due to benign causes. Foreign bodies in the breast are an uncommon finding and could be detected incidentally during imaging or be symptomatic and present as a painful mass. Sometimes they cause diagnostic dilemmas as they mimic malignancies. To the best of our knowledge, this is the second case reported in the literature about an abscess caused by a migrating retained temporary epicardial pacing wire., Case Presentation: A 13-year-old girl of African ancestry was referred to our clinic with a left breast mass that had been gradually increasing in size for 2 years. The mass was tender but was not associated with skin changes, nipple discharge, or fever. She had a history of rheumatic heart disease and had undergone mitral and tricuspid valve repair more than 2 years ago. Blood work and biochemistry were within normal ranges. An ultrasound of her left breast showed a large, irregular, complex, heterogeneous mass measuring 4.3 × 2.7 × 3.5 cm at 6 o'clock position with central cystic changes but no significant intrinsic vascular flow. There was significant associated skin and subcutaneous edema. Given the echogenicity of the mass, an infectious cause was considered likely, and malignancy was less likely but could not be excluded. An ultrasound-guided biopsy was performed and revealed cores of breast tissue heavily infiltrated with mixed acute and chronic inflammatory cells, consistent with a chronic abscess. She received a 10-day course of antibiotics. However, she remained symptomatic, and the mass did not decrease in size. Therefore, we proceeded to surgical excision. The breast mass was excised. It was fixed to the underlying rib, and a thin, long, metallic wire that moved with her heartbeat was observed protruding from a small opening above the rib. This was a migrated retained epicardial pacing wire from the previous valve repair surgery. The histopathology of the mass revealed mammary tissue with acute and chronic inflammatory cells., Conclusion: Temporary epicardial pacing wires should be removed completely by cardiothoracic surgeons after surgery to avoid migration that might lead to unexpected complications.