Intranasal corticosteroids (INCS) are generally safe and effective treatments for allergic rhinitis (AR). The improper use of INCS may not alleviate AR symptoms, and it could lead to complications and an impaired quality of life. We evaluated the knowledge of, attitudes towards, and practices of INCS usage and associated factors among AR patients using a pretested Arabic questionnaire. Of the 400 participating AR patients, 39.3%, 29.0%, and 36.5% had poor scores for knowledge, attitude, and practice, respectively. We found a significant association between knowledge and education (p< 0.001) and follow-up facilities (p = 0.036). The attitude category was significantly associated with age (p = 0.003), marital status (p = 0.004), and type of allergic patients (p< 0.001), and the practice category was significantly associated with education (p = 0.027), type of allergic patients (p = 0.008), and follow-up facilities (p = 0.030). Smoking status was significantly associated with all three categories. Furthermore, we found a positive correlation between knowledge and practice scores (Spearman’s rho of 0.451, p< 0.001). We recommend improving AR patients’ knowledge of the proper practices of INCS through health education programs. Furthermore, we recommend an exploratory mixed-method survey on the INCS usage among AR patients that involves other provinces in the KSA.

In recent years, the incidence of thyroid cancer has been increasing globally, with papillary thyroid cancer (PTCa) being the most prevalent pathological type, accounting for approximately 80% of all cases. Although PTCa has been regarded to be slow growing and has a good prognosis, in some cases, PTCa can be aggressive and progress despite surgery and radioactive iodine treatment. In addition, most cancer treatment drugs have been shown to be cytotoxic and nonspecific to cancer cells, as they also affect normal cells and consequently cause harm to the body. Therefore, searching for new targets and therapies is required. Herein, we explored a bioinformatics analysis to identify important theranostic markers for THCA. Interestingly, we identified that the DPP4/CTNNB1/MET gene signature was overexpressed in PTCa, which, according to our analysis, is associated with immuno-invasive phenotypes, cancer progression, metastasis, resistance, and unfavorable clinical outcomes of thyroid cancer cohorts. Since most cancer drugs were shown to exhibit cytotoxicity and to be nonspecific, herein, we evaluated the anticancer effects of the antidiabetic drug sitagliptin, which was recently shown to possess anticancer activities, and is well tolerated and effective. Interestingly, our in silico molecular docking results exhibited putative binding affinities of sitagliptin with DPP4/CTNNB1/MET signatures, even higher than standard inhibitors of these genes. This suggests that sitagliptin is a potential THCA therapeutic, worthy of further investigation both in vitro and in vivo and in clinical settings.

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Background: Single nucleotide polymorphisms provide information on individuals’ potential reactions to environmental factors, infections, diseases, as well as various therapies. A study on SNPs that influence SARS-CoV-2 susceptibility and severity may provide a predictive tool for COVID-19 outcomes and improve the customized coronavirus treatment.Aim: To evaluate the role of human leukocyte antigens DP/DQ and IFNλ4 polymorphisms on COVID-19 outcomes among Egyptian patients.Participants and Methods: The study involved 80 patients with severe COVID-19, 80 patients with mild COVID-19, and 80 non-infected healthy volunteers. Genotyping and allelic discrimination of HLA-DPrs3077 (G/A), HLA-DQrs7453920 (A/G), and IFNλ4 rs73555604 (C/T) SNPs were performed using real-time PCR.Results: Ages were 47.9 ± 8, 44.1 ± 12.1, and 45.8 ± 10 years in severe, mild and non-infected persons. There was a statistically significant association between severe COVID-19 and male gender (p = 0.002). A statistically significant increase in the frequency of HLA-DPrs3077G, HLA-DQrs7453920A, and IFNλ4rs73555604C alleles among severe COVID-19 patients when compared with other groups (p &lt; 0.001). Coexistence of these alleles in the same individual increases the susceptibility to severe COVID-19 by many folds (p &lt; 0.001). Univariate and multivariate logistic regression analysis for the studied parameters showed that old age, male gender, non-vaccination, HLA-DQ rs7453920AG+AA, HLA-DPrs3077GA+GG, and IFNλ4rs73555604CT+CC genotypes are independent risk factors for severe COVID-19 among Egyptian patients.Conclusion: HLA-DQ rs7453920A, HLA-DPrs3077G, and IFNλ4rs73555604C alleles could be used as markers of COVID-19 severity.

Background: Allergic rhinitis (AR) has a major global health impact on all age groups, with a global increase in its annual morbidity and mortality rate. It is common among children and adults in many regions of Saudi Arabia. In spite of its increasing incidence and its great impact on the family, the precise risk factors and the level of awareness on AR in Aljouf region are still unclear. Methodology: This is a questionnaire-based cross-sectional study to identify the common risk factors and their impact on individuals' daily activities. An online questionnaire was disseminated among residents (Saudi and non-Saudi) in Al-Jouf provinces in Saudi Arabia in the period from January to March, 2022. Results: The prevalence of AR among participants was 67.4%, and dust, weather changes, smells, fumes, cold air, perfumes, animal dander, and pollens were the common risk factors. Almost all participants have reported that the manifestations were intermittent (less than 4 weeks, 86.5%), seasonal, and more common during Jumada Al-Thani, Jumada Al-Awwal, Rabi Al-Thani, Rabi Al-Awwal, and Rajab, respectively. Many patients with allergic rhinitis had sleep disturbances, and their daily activities affected. Conclusion: There is high prevalence of AR in Al-jouf region, Saudi Arabia. Thus health education programs are essential to raise community awareness about the risk factors and how to avoid them.

Objective Endoscopic repair of large anterior skull base (ASB) defects has excellent results when using multilayered repairs with a nasoseptal flap. However, in extensive intranasal tumors, a nasoseptal flap may not always be available. One alternative option is a flexible single‐layer ASB repair. Initial studies indicate low cerebrospinal fluid leak rates with a single‐layer repair. However, the level of frontal lobe support, particularly the propensity for a significant inferior displacement of the frontal lobe, is not known. The goal of this study is to determine the frontal lobe position after single‐layer acellular dermal allograft repair in large ASB defects. Study Design Retrospective cohort study. Setting Tertiary care medical center. Subjects and Methods This cohort study compares the frontal lobe position in adults who underwent endoscopic endonasal ASB tumor resection and single‐layer cadaveric dermal matrix repair (ASB cohort) with control subjects without intracranial abnormalities (control cohort). The ASB cohort includes subjects with an ASB defect of ≥5 cm anterior/posterior and ≥1.5 cm wide and who had imaging at least 2 months after surgery. The frontal lobe position is measured on sagittal CT/MRI using a reference line from the base of the sella to the nasion. A value of zero indicates that the inferior‐most aspect of the frontal lobe is at the level of the nasion−sellar line. A positive value indicates that the frontal lobe is inferior to the nasion−sellar line. The ASB cohort frontal lobe position is compared with the control cohort using the Mann−Whitney U test. A priori we set an absolute difference of 5 mm as a clinically significant difference. Results The ASB cohort includes 47 subjects who are 57% male with an average age of 60 years (range: 31−89 years). The most common ASB pathology is esthesioneuroblastoma ( n = 21) and 81% of the ASB cohort had postoperative radiation. The control cohort includes 20 subjects who are 60% male, with a mean age of 45 years (range: 19−74 years). The majority of controls underwent imaging for head trauma ( n = 13). The ASB mean frontal lobe position is −0.2 mm superior to the nasion−sellar line (range: −9.2 to 10.4 mm), while the control's mean frontal lobe position is 1.1 mm inferior to the nasion−sellar line. This difference is not statistically significant ( P = 0.13) and does not reach our a priori definition of clinical significance. The frontal lobe position of ASB subjects who had radiation is closer to the nasion−sellar line as compared with those who did not undergo radiation. Conclusions Single‐layer acellular dermal graft repair maintains frontal lobe support and position in large ASB defects.

Sinusitis is a common condition with various forms and different etiologies. In the era of COVID-19, a large number of studies covered the association between sinusitis and COVID-19, while others reported the impact of COVID-19 on the development of acute invasive fungal rhinosinusitis (AIFR), together with the most commonly associated predisposing factors. Fungal sinusitis, particularly AIFR, can be life-threatening. It is important to dissect this association and improve current evidence and management. Therefore, we conducted this literature review to highlight the association between COVID-19 and sinusitis based on evidence from the available studies in the literature. Evidence shows that chronic sinusitis might have a negative impact on COVID-19 outcomes. However, current results are conflicting, and further studies are needed. On the other hand, COVID-19 can also cause olfactory dysfunction, which is usually temporary. In addition, we found several studies that indicated the association between COVID-19 and AIFR. The condition is usually associated with severe morbidities, as affected patients are usually immunocompromised, including those with uncontrolled diabetes, malignancy, immunosuppression, AIDS, the administration of chemotherapy and other immunosuppressive drugs, and COVID-19.