Hemimaxillary enlargement, asymmetry of the face, tooth abnormalities, and skin findings (HATS) syndrome, a rare developmental disorder, involves the first and second branchial arches and is ...characterized by hemimaxillary enlargement, abnormal appearance of skin and teeth, and facial asymmetry. It is generally detected at birth or during early childhood and is associated with unilateral abnormalities of the face, including the bones, teeth, gums, and skin. Becker nevus is the most common cutaneous manifestation of HATS syndrome. Although patients with HATS syndrome have been treated with various therapeutic regimens, no standard or definitive treatment regimen has been established. This study describes this rare condition in a 12-year-old girl.
The infectiousness of COVID-19 is high among the susceptible population, making the calculation of the reproduction number (R) an essential step to implement preventive measures. We aim to estimate ...COVID-19 transmission to determine if the disease is successfully controlled or extra measured should be adopted to attain this goal. The daily incidence data of COVID-19 in Saudi Arabia from March 2
nd
, 2020, to April 4
th
, 2021, were obtained from the continuously updated Saudi Ministry of Health COVID-19 repository. To get accurate estimation of the situation over the last 4 months (from December 1
st
, 2020, to April 4
th
, 2021), we calculated the weekly (every 7 days) R starting from March 2
nd
, 2020, and till the last week of the available data. The calculated values of R were represented as median, first quantile (Q1), and third quantile (Q3). As early as the first week of December 2020, the median R was 0.81 (0.80–0.83) which means that each existing infected case would transmit infection to only one person. This was followed by fluctuations over the next few weeks around R value of 1, reaching its highest level of 1.45 (1.42–1.47) between December 31
st
, 2020, and January 6
th
, 2021. This was followed by a relatively steady decline over the following weeks, with some till mid-March where the R values started to slightly rise again. Social distancing, protective precautions, avoiding abuse of the partial lifting, expanding the screening process, and other Saudi measures sound to be successful and should be replicated in similar communities. This measure should be continued till the vaccination process is completed, to reduce the number of contacts and to avoid uncontrolled transmission of the disease.
Linear porokeratosis (LP) is an epidermal keratinization disorder manifesting in the form of annular plaques with an atrophic center and hyperkeratotic margins. Although rare, LP carries a ...significant risk of skin cancer. Histological examination usually reveals the cornoid lamella, a parakeratosis column visualized in the outer layer of the epidermis. First-line treatment of LP is retinoids. However, the effects of combination therapy of isotretinoin and topical statins on LP are not well-understood. Herein, we attempted treatment with both isotretinoin and 2% cholesterol/atorvastatin ointment, with considerable improvement observed using the former but not the latter. These findings suggest that 2% topical cholesterol/atorvastatin treatment may not carry any additional benefits, even if used alongside retinoids. Further studies are needed to assess the potential effects of statins on LP.
The study aims to evaluate the perceptions of pediatric residents under the night float (NF) on-call system and its impact on well-being, education, and patient safety compared with the traditional ...24-h on-call system.
The study is prospective in nature and conducted on two pediatric resident training centers who apply the NF on-call system as a pilot project. Senior residents (PGY-3 and PGY-4) enrolled in the two training centers were invited to participate before and 6 months after the implementation of the change in the on-call system. A self-administered online questionnaire was distributed. Responses were rated using a five-point Likert-type scale (1 = strongly disagree; 5 = strongly agree). The items covered three main domains, namely, residents' well-being, ability to deliver healthcare, and medical education experience. Pre- and post-intervention scores were presented as means and compared by t-test for paired samples.
A total of 42 residents participated in the survey (female = 24; 57.1%). All participants were senior residents; 25 (59.6%) were third-year residents (PGY-3), whereas 17 (40.4%) were fourth-year residents (PGY-4). The participants reported that many aspects of the three domains were improved with the introduction of the NF system. The system was perceived to exert less adverse health effect on the residents (mean: 2.37 ± 1.01) compared with the 24-h on-call system (mean: 4.19 ± 0.60; P < 0.001). In addition, the NF system was perceived to lead to less exposure to personal harm and result in less negative impact on quality of care, better work efficiency, reduced potential for medical errors, more successful teaching, and less disruptions to other rotations compared with the 24 h on-call system (P < 0.001).
The perception of senior residents toward the 24-h on-call system pertains to negative impacts on well-being, education, and patient safety compared with on-call systems with restrictive duty hours, such as the NF system, which is perceived to be less harmful, to exert positive impacts on the quality of delivered healthcare services, and more useful from pedagogic aspect.
The increase in demand for Telemedicine globally has continued to rise in recent months, showing remarkable success in a variety of medical fields. As dermatology shows one of the most prolific rates ...of success, having a clear national picture of practitioner opinion on the subject is important. In this study we aimed to quantify the overall level of acceptance and satisfaction of Saudi dermatologists towards the practice of teledermatology.
Data was collected by means of a survey which included demographic data and level of exposure and overall satisfaction towards Telemedicine in their field. Results: A total of 102 questionnaires were returned of which 57.8% had engaged in at least one teleconsultation. Of these, 71.2% showed support for the technology, with negative responses being associated with poor infrastructure or implementation in the workplace.
The acceptance of dermatologists to teledermatology consultations in Saudi Arabia shows a positive tendency, with the majority of those who engaged in the practice saying they would do so again and find it satisfactory. Creating more reliable and robust tools and greater training in their use would be beneficial for its further incorporation.
The Himalayan Mountains are geodynamical important, featuring a wide climatic range with a rich diversity of flora, fauna, human communities, culture, and social set-up. In recent decades, due to ...constant anthropogenic pressure and considerable changes witnessed in the climate of the region, species of this region are threatened. Here, we assessed the impact of nomadic settlement and associated disturbances on plant species composition, diversity parameters, ecosystem properties, and fire incidence in high-altitude forests of Western Himalaya, India. Based on the distance between nomadic settlement location and forest, we classified forest as near nomadic settlement (NNS) or away nomadic settlement (ANS) forest types. We found a significant variation in plant species composition between forest types. Three species, namely, Sibbaldia cuneata, Poa annua, and Abies pindrow, contribute 25% of the cumulative variation in plant species composition. Studying live plants, we found a significant difference only for density, in which ANS had a higher average density than NNS. Considering dead plants, we found a significant difference in all nine plant-related parameters evaluated between sites. NNS had a higher value of all parameters evaluated, except for height, which was higher in ANS sites. ANS forest type show 1.3 times more average carbon stock (160.39 ± 59.03 MgCha−1; mean ± SD) than NNS forest type (120.40 ± 51.74 MgCha−1). We found a significant difference in plant diversity evaluated between forest types. ANS had higher values of Margalef and Fisher diversity but lower values of evenness. We found that NSS had significantly higher values of fire incidences, whereas ANS has a higher normalized differential vegetation index and enhanced vegetation index. Overall, our study showed that species composition, diversity, and fire incidence are strongly impacted due to nomadic settlements. These findings are paramount for designing appropriate livelihood options for indigenous communities and management policies of the long-term forest harvest to achieve global goals and the UN Decade on Ecosystem Restoration targets (2021–2030) to protect the sustainable development of forest mountainous regions.
The nomadic pastoral indigenous communities of the Ladakhi people share roots with Tibetan culture in terms of food, clothing, religion, festivals, and habits, and rely widely on plant resources for ...survival and livelihood. This survey was conducted during 2019–2021 to document the indigenous knowledge about plant resources of the Balti, Beda, and Brokpa communities of the Ladakh region, trans-Himalayas. Open- and close-ended semi-structured interviews (N = 184) and group discussions (N = 17) were used to collect the data. Quantitative data was further analyzed using various statistical tools. A total of 105 plant species belonging to 82 genera and 39 families were used as medicine, fuel wood, fragrance, oil, food, flavor, fodder, decoration, and dye. Among these, medicinal use was most prevalent, with 70% of use reports, followed by fodder and fuel wood. Leaves (27%) were the most preferred plant part used, followed by roots and flowers. The principal component analysis revealed five clusters of ethnobotanical usage, i.e., food, medicine, fuel wood, fodder, and fragrance, oil, dye, and flavor. The maximum number of plant species used was reported by the Brokpa, while the Beda reported the minimum number of plant species uses. Delphinium brunonianum, Waldheimia tomentosa, and Juniperus indica played a significant role in the cultural and religious ritual aspects, whereas Allium przewalskianum, Waldheimia tomentosa, Juniperus indica, and Hippophae rhamnoides were commonly used as a livelihood source among Ladakhi communities. The local people collected most plants (65%) for self-consumption, while the rest (35%) were sold in markets as a source of income. The sustainable utilization and management of plant resources by local people is a strategy to boost livelihoods and food security and alleviate poverty.
Hirschsprung's disease (HSD) is a congenital disease characterized by the absence of ganglion cells in the myenteric and submucosal plexuses of the gastrointestinal tract. Many genetic causes of HSD ...have been investigated, although the most common and widely accepted is the RET gene located on chromosome 10q11.2. The presence of other coinciding genetic abnormalities with HSD, such as Cri-du-chat (CDC) syndrome, might provide a better understanding of the genetic bases of the disease.
We present a case of a term baby boy who had features of Cri-du-chat syndrome at birth that were confirmed genetically. Later, the patient developed features of lower GI obstruction and was diagnosed with HSD by suction rectal biopsy. He underwent surgery and recovered well.
We conclude that physicians involved in the care of babies with CDC and lower GI obstruction should consider the possibility of HSD and investigate accordingly. Additionally, when CDC and HSD coexist in a patient, the CDC genotype should be determined by whole exome sequencing and examined to identify mutations associated with HSD.
Chronic mucocutaneous candidiasis (CMC) is a primary immunodeficiency condition caused by a genetic abnormality that increases the risk of recurrent and persistent skin, nail and mucous membrane ...infections with Candida species, typically Candida albicans. Signal transducer and activator of transcription 1 (STAT 1) gene mutation is a genetic trigger that causes CMC, which increases the risk of infections, multisystem disorders and cancer susceptibility. We describe the first case of a Saudi female patient with clinical features of CMC with an underlying (STAT 1) gene mutation.
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