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Background Patients with diabetic foot ulcers may have a lower quality of life. The objective was to compare the quality of life and its psychosocial determinants among patients with and without diabetic foot ulcers. Methods A case-control study was conducted in 2017 among patients with (cases) and without (controls) diabetic foot ulcers. The study tools included the World Health Organization’s Quality of Life scale (WHOQOL-BREF), the Hospital Anxiety and Depression (HAD) scale for anxiety and depression, the Patient Health Questionnaire Physical Symptoms (PHQ-15) for the severity of somatic symptoms, and the Summary of Diabetes Self-Care Activities (SDSCA) measure for self-management. Results A total of 209 patients (45 cases and 164 controls) were included. The average age was 56.2 ± 11.7 years, and 55.5% were female. The average scores of WHOQOL-BREF, PHQ-15, and SDSCA were 74.4% ± 12.1% and 8.1 ± 6.1, and 30.4 ± 21.8, respectively. The prevalence of anxiety and depression were 19.6 and 24.9%, respectively. SDSCA was the only psychosocial determinants higher in cases than controls (mean difference = 15.0, 95% CI = -8.0–22.0). The correlation coefficients of WHOQOL-BREF scores with anxiety, depression, and PHQ-15 scores in all patients were − 0.559 (p p p Conclusion Quality of life and psychosocial determinants with the exception of self-management were not associated with diabetic foot ulcers. Depressive symptoms were independent determinant of poor quality of life, irrespective of the status of diabetic foot ulcers.

Objective To evaluate cochlear implantation in Vogt-Koyanagi-Harada syndrome with regard to surgical difficulties and hearing outcomes. Patients Single case report. Intervention(s) Therapeutic complete electrode insertion during surgery despite evident intra-cochlear fibrosis. Main outcome measure(s) Postoperative speech audiometry, categories of auditory performance, and speech intelligibility rating. Results Vogt-Koyanagi-Harada syndrome is a multisystem autoimmune disease that affects tissues containing melanin. It is characterized by bilateral uveitis with auditory, vestibular, and dermatologic manifestations. Standard treatment comprises aggressive administration of systemic corticosteroids.This report describes the use of bilateral cochlear implants in a 30-year-old Saudi woman who presented with uveitis and was diagnosed with Vogt-Koyanagi-Harada syndrome. She had progressive hearing loss in both ears and experienced minimal improvement with hearing aids. The patient underwent sequential cochlear implantation, which was challenging because it was difficult to insert the electrode in the right ear due to intra-cochlear fibrosis. After more than 5 years of follow-up, she has good hearing in both ears, despite the advancement of ocular disease and recurring visual complaints. Conclusion This study suggests that patients with Vogt-Koyanagi-Harada syndrome could develop intra-cochlear fibrosis during cochlear implantation due to the autoimmune nature of disease. Moreover, cochlear implantation becomes more difficult with disease advancement. Therefore, it is essential that healthcare professionals consider early detection and prompt treatment of hearing loss in patients with this syndrome.

Background: The current guidelines recommend the use of intranasal corticosteroids (INCS) as the first-line treatment for allergic rhinitis(AR), chronic rhinosinusitis(CRS) and acute rhinosinusitis(ARS). INCS is associated with various topical side effects in 5%–10% of patients. Improper technique of administration is a major factor that influences the incidence of adverse effects of INCS, therefore patient education about the proper technique of administration of these agents is imperative. Objective: To find out whether improper use of INCS will lead to increase the incidence of their side effects. Methods: It is a cross-sectional study conducted at the rhinology clinic of king AbdulAziz university hospital, Riyadh, KSA, over a 6-month in the period extending from February to August 2018, where the questionnaire distributed for patients who are using INCS. Data analysis was performed using Statistical Package for the Social Sciences software. Results: A total of 150 patients responded for the questionnare. 97.3% reported the use of the right hand for spraying both nostrils, 2% use of the ipsilateral hand for spraying and none them use the contralateral technique. Only 5.3% of the patients directed the nozzle of the dispenser away from the septum (proper technique), whereas the remaining 94.7% patients reported aiming the nozzle in the improper direction (toward the septum or in a straight(parasagital) direction). Improperly directed spray was significantly associated with nasal dryness (P = 0.008) but not with epistaxis and pain. Conclusion: Improperly directed nozzle of INCS is associated with higher incidence of nasal dryness Key words: Corticosteroids, rhinosinusitis, nasal spray, side effects.