BackgroundThe global incidence of thyroid cancer (TC) has increased significantly over the past decades. In Saudi Arabia, it is the third most common cancer among adults. This study aims to review the clinical and histopathological characteristics of TC in Saudi Arabia and analyze the size trend over the years. MethodsWe conducted a retrospective chart review of all differentiated and poorly differentiated TC patients following up at a tertiary care center in the Western region of Saudi Arabia. All patients 11 years and older, diagnosed between 2004 -2018, and with sufficient histopathological data were included.

Background: Proliferation markers, especially Ki67, are increasingly important in diagnosis and prognosis. The best method for calculating Ki67 is still the subject of debate. Materials and Methods: We evaluated an image analysis tool for quantitative interpretation of Ki67 in neuroendocrine tumors and compared it to manual counts. We expanded a primary digital pathology platform to include the Leica Biosystems image analysis nuclear algorithm. Slides were digitized using a Leica Aperio AT2 Scanner and accessed through the Cerner CoPath LIS interfaced with Aperio eSlideManager through Aperio ImageScope. Selected regions of interest (ROIs) were manually defined and annotated to include tumor cells only; they were then analyzed with the algorithm and by four pathologists counting on printed images. After validation, the algorithm was used to examine the impact of the size and number of areas selected as ROIs. Results: The algorithm provided reproducible results that were obtained within seconds, compared to up to 55 min of manual counting that varied between users. Benefits of image analysis identified by users included accuracy, time savings, and ease of viewing. Access to the algorithm allowed rapid comparisons of Ki67 counts in ROIs that varied in numbers of cells and selection of fields, the outputs demonstrated that the results vary around defined cutoffs that provide tumor grade depending on the number of cells and ROIs counted. Conclusions: Digital image analysis provides accurate and reproducible quantitative data faster than manual counts. However, access to this tool allows multiple analyses of a single sample to use variable numbers of cells and selection of variable ROIs that can alter the result in clinically significant ways. This study highlights the potential risk of hard cutoffs of continuous variables and indicates that standardization of number of cells and number of regions selected for analysis should be incorporated into guidelines for Ki67 calculations.

Aim: Children's oral health maintenance is influenced by their parents' knowledge and behaviors. Therefore, the aim of this study was to assess the knowledge and practices among parents for prevention of early childhood caries (ECC) in children. Materials and methods: This cross-sectional study interviewed the parents visiting the Pediatric Dental Clinic in King Abdulaziz University, Faculty of Dentistry (KAUFD), from January 1, 2018 to December 31, 2018. The questionnaire was drafted based on the recommendations on strategies for ECC prevention by the American Academy of Pediatric Dentistry in 2018. Results: Of the 549 parents, 283 responded. The mean knowledge score for caries prevention was 2.29 (standard deviation = 1.26) out of 10. In addition, 13.8% of participants scored zero. Knowledge questions that showed the highest correct responses were those associated with fluoride application. However, only 96 (24.4%) participants were aware of fissure sealants, 48 (17%) participants knew that fissure sealants are applied to sound teeth, 35 (12.4%) participants knew the correct age of the first dental visit, and 157 (55.5%) participants practiced snacking between meals. Mothers showed significantly higher mean knowledge score compared with fathers (p < 0.001). In addition, the number of dental visits significantly correlated with the mean parental knowledge score (p < 0.05). Conclusion:Parental dental knowledge and practices were not satisfactory. Anticipatory guidance should be reinforced by oral healthcare providers on each dental visit. In addition, pediatricians and physicians could be involved in improving parental dental knowledge. Clinical significance: This study reported the level of knowledge and awareness of parents visiting the Pediatric Dental Clinic in KAUFD. It could be used as a reference for future community services and caries prevention programs conducted by oral healthcare services for children to prevent ECC.

This cross-sectional study aimed to determine the degree of visibility of maxillary and mandibular anterior teeth at rest in different age groups and to evaluate the smile line, smile arc, and number of maxillary teeth displayed during smiling among the Saudi population visiting King Abdulaziz University Dental Hospital, Jeddah, Saudi Arabia. A total of 157 participants (77 males and 80 females) were included in this study with an age range of 19 to 69 years. All participants had maxillary and mandibular anterior teeth without restorations. Crown length and visible portions of anterior teeth at rest were measured using a Fowler Electronic Digital Caliper. Three measurements of each variable were recorded by two independent dental interns and calibrating their measurements was performed. Smile line, smile arc, and number of teeth displayed during smiling were examined. The collected data were statistically analyzed using SPSS software. It was found that the average clinical crown lengths in the maxillary lateral incisor, mandibular central incisor, and canine were significantly higher in males than females. At rest position, females displayed more maxillary central and lateral incisors. The displayed length of maxillary teeth at rest is inversely proportional to increasing age; the reverse occurs in mandibular teeth. The common visibility of maxillary teeth during smiling was from the second bicuspid to its counterpart. Average smile line and consonant smile arc were the most common characteristics. It was concluded that both age and gender affect the characteristics of tooth display at rest and in smiling. These effects should be considered during treatment planning and restoration of anterior teeth to obtain a more predictable esthetic outcome.

Objectives: To assess the quality of the meta-analyses (MAs) and systematic reviews (SRs) in Saudi journals indexed in PubMed using 2 scales: A MeaSurement tool to assess systematic reviews (AMSTAR) and the overview quality assessment questionnaire (OQAQ). Methods: This study focused on SRs/MAs published in 8 Saudi journals. We investigated, screened, and extracted the data, which included recording the main topic of each SRs/MAs and the date of publication. Furthermore, we assessed the quality of each included SRs/MAs using the AMSTAR and the OQAQ. The reviews concluded in January 2018. Results: The search uncovered 201 unique articles; of these, the researchers screened 110 full texts and included 103 in this review. Most of the included studies were published in Saudi Medical Journal (50 articles, 48.5%), followed by Saudi Journal of Gastroenterology (21 articles, 20.4%), and Annals of Saudi Medicine (16 articles, 15.5%). The main topics in these published articles were gastroenterology (20 articles, 19.5%), followed by oncology (14 articles, 13.7%), and pharmacology (9 articles, 8.7%). The AMSTAR and the OQAQ scales showed that most SRs/MAs were of medium quality. Conclusion: Quality of SRs and MAs published in Saudi journals was distributed in all categories (low, medium, and high) and it can be improved using critical evaluation by authors, journal editors, and readers. PROSPERO REG. NO. CRD: 42018102210