Background The COVID-19 pandemic and physical distancing have had a significant impact on the conversion of traditional teaching methods to online teaching methods, which although not uncommon in medical schools, has to date only been used for some aspects of the teaching process. Thus, we aimed to measure the effectiveness of e-learning during the COVID-19 pandemic, as well as medical students’ preferences regarding e-learning and classroom teaching, and the possibility of applying it post-pandemic. Methods A cross-sectional online survey of medical students (N = 376) in six medical schools was carried out after their second semester, from August 15 to 20, 2020. Ten parameters were measured for the effectiveness of e-learning based on a 5-point Likert-scale and five parameters were measured for satisfaction. Results e-learning was more or equally effective in four parameters such as assignment submission and meeting individual needs, but less effective in six parameters, including building skills and knowledge, and interaction level. Satisfaction was either high or neutral in all five parameters. Conclusions Our findings have shown that e-learning can assist the teaching process in medical schools in some respects, but cannot be used for the entire teaching process.

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Background Nursing staff play a key role in the bedside management of tracheostomized patients in both intensive care units and general floors. Effective provision of postoperative care to these patients by nurses is critical. This study aimed to assess the readiness of nursing staff to manage tracheostomy-related complications in Riyadh, Saudi Arabia. Methods This cross-sectional study enrolled 395 nurses in Riyadh, Saudi Arabia. A self-administered questionnaire developed by the authors was distributed to nurses via an online survey. The questionnaire assessed nurses’ socio-demographic characteristics and their knowledge and practices regarding tracheostomy indications, postoperative care, and management of its complications. Results Of respondents, approximately 59% (232/395) had poor knowledge regarding tracheostomy-related complications and indications, 39% (154/395) had moderate knowledge, and only 2%(9/395) had good knowledge. Several factors were associated with increased knowledge, including having a higher education degree, working in a tertiary/quaternary hospital, being a government employee, caring for tracheostomized patients, and attending courses or lectures on managing tracheostomized patients. Conclusions Knowledge level and practices regarding tracheostomy-related complications and indications among nurses remain limited. In-service continuous professional development programs for nurses working in all hospital settings are strongly recommended. Further research is warranted to elicit the major factors contributing to inadequate knowledge and practices among nurses in Riyadh.

Introduction: The surgical residency training programs have the nature of long work hours and a stressful environment that might lead to disturbances in the quality of life of the residents. Surgical residents’ performance might be affected by the poor quality of life. This study aimed to assess the quality of life of otolaryngology and head and neck surgery residents, in Saudi Arabia. Subjects and methods This is a cross-sectional study conducted among otolaryngology and head and neck surgery residents in Saudi Arabia. A self-administered questionnaire was distributed among the targeted residents. The questionnaire is primarily composed of the socio-demographic data and the work-related quality of life (WRQoL) questionnaire. The WRQoL was composed of 6 domains as General Well-Being (GWB), Home-Work Interface (HWI), Job and Career Satisfaction (JCS), Control at Work (CAW), Working Conditions Satisfaction (WCS ), and Stress at Work (SAW). Results: The overall work-related quality of life was good among 43.6% of the residents. Among its domains, WCS showed better results with a 55.3% high level while SAW was the least (25.5%). Older age group (30 years) were observed to have a significantly higher mean score in JCS (p=0.040), CAW (p=0.002) and WRQoL (p=0.027). Smoking residents showed a higher mean score in JCS (p=0.023) and HWI (p=0.001). It is interesting to note that increasing residency levels were more associated with increasing CAW scores (p=0.003). Conclusion: The work-related quality of life among otolaryngology, head and neck surgical residents was adequate. Older residents demonstrated a better quality of life than younger residents. ACGME competencies: Medical knowledge, Patient care, Interpersonal skills communication. Keywords: Quality of life, WRQoL, otolaryngology, head and neck surgery, residents

gray to yellow-brown. They are soft, firm, and friable. 1 There are 3 theories in relation to origin of the GCT: neoplastic, inflammatory and traumatic; none of them has been confirmed in the literature. 7 GCTs in the skull are locally aggressive, malignant phenotype exists in only 5 to 10% of cases. 4 As the name implies, GCTs feature giant cells on microscopic analysis, a finding that is not pathognomonic for this type of tumor. It should be noted that GCTs, though benign, may contain histologic features that are often associated with malignancy, such as abundant mitotic figures, areas of tumoral necrosis, and areas of tumoral bone formation. 2,8 No consistent correlation has been observed between histologic features of GCTs and malignant potential. 2,8 This is evidenced by the fact that GCTs have the capability of "benign metastasis" as well as malignant metastasis, as seen in tumors that have undergone sarcomatous degeneration. 2,9 On temporal bone CT, GCTs appear as enhancing expanding lytic and destructive lesions. Sometimes it shows soap bubble appearance which may extend to adjacent soft tissues, dura mater or intracranial extension. 1,7 On MRI, GCTs usually demonstrate low to intermediate signal intensity on T1 sequencing, and hypointense on both T2-and diffusion-weighted images with heterogeneous enhancement after the administration of contrast (gadolinium). 1,2,7 Gross tumor resection without adjuvant radiotherapy is the most effective treatment for localized disease. Furthermore, it avoids the risks associated with radiation exposure including radiation damage to normal surrounding tissues and prevents the chance of sarcomatous degeneration. If gross tumor resection is not feasible, subtotal resection with adjuvant radiation appears to result in acceptable tumor control rates. Although chemotherapy for GTCs has largely been obsolete in the past, new studies examining the effect of Denosumab as an adjuvant to subtotal resection, demonstrate reduction in tumor volume and surgical morbidity. 2 The local recurrence rate is approximately 25% while the ratio increases to 40% to 60% in case of a partial resection. 5,7 In approximately 2% of patients, the tumor may metastasize to the lungs. 5 Malignant transformation is most commonly to fibrosarcoma, osteosarcoma, or malignant fibrous histiocytoma. 5,7 Follow-up of GCT patients is required because 80% to 90% of tumor recurrences arise within 3 years of primary treatment. Therefore, follow-up visits are recommended every 4 months in the first 2 years after surgery and every 6 months thereafter until the fifth year. 5 Preoperative diagnosis by biopsy is critical to help guide the therapy. Complete resection of the tumor is important to reduce the risk of recurrence. It is often difficult to remove the tumor totally in some locations such as the sphenoid bone; therefore bisphosphonates may be useful in patients with recurrent or unresectable GCTs. 4 CONCLUSION GCT of the temporal bone is an uncommon entity with nonspecific clinical and ra...

Background Intranasal corticosteroids (INCSs) are the first-line treatment for patients with moderate to severe conditions of allergic rhinitis (AR) as per current guidelines. However, patients' knowledge and practice towards the safety of such medications remains ambiguous. Therefore, this study was undertaken to identify the awareness of and knowledge about the safety of nasal corticosteroid usage in patients with allergic rhinitis as well as their adherence to taking the medication.

Objective: This study aims to assess the knowledge and deficits of otolaryngology in primary care physicians who work at primary care centers or tertiary hospitals in Riyadh, KSA. Methods: This is a cross-sectional study conducted among residents of primary care specialties and otolaryngology residents in Riyadh, Saudi Arabia. A 10-item question with multiple-choice to assess the knowledge toward otolaryngology was given to the primary care provider by using face to face interview. Further, questions about clinical rotation in otolaryngology during medical school and residency were asked whether they participated or not. Results: A total of 253 primary care physicians took part (92 internal medicines, 79 family medicines, and 82 pediatrics) and 13 otolaryngologists, Primary care physicians who participated in clinical rotations during medical school and residency were 79.7% and 26.3%, respectively. Otolaryngologists' percentage of average correct knowledge score was (89.2%), family medicine (62.9%), pediatrics (55.4%), and internal medicine (52.5%). Primary care providers who participated in a clinical rotation in otolaryngology showed significantly higher knowledge scores than those who did not participate (p<0.001).Conclusion: primary care physicians had unsatisfactory ratings after examinations. Previous otolaryngology clinical rotation during residency had a positive effect on the knowledge of PCPs with their daily practice, which supports adding further clinical training in otolaryngology for primary care specialties.

One of the most prevalent pediatric ailments around the world is voice disorders. Around 5-million children suffer from voice disorders, and three out of five of them suffer from vocal nodule-induced persistent dysphonia. Nineteen out of 20 otolaryngologists recommend voice therapies for the treatment of pediatric vocal fold nodules. However, the benefits of these therapies still remain to be assessed systematically. The objective of this study is to systematically review the impact of voice therapy (direct and indirect) on pediatric patients with vocal nodules. In this systematic review of randomized control trials (RCTs), four electronic databases, PubMed, CENTRAL (Cochrane), Science Direct, and Lancet, were explored for the literature survey. The impact of direct and indirect voice therapies on pediatric cases with vocal nodules was reviewed based on the results of the selected articles. Based on stringent inclusion and exclusion criteria, six articles were selected. All these studies examined the effects of direct and indirect voice therapies on two types of voice disorders, that is, dysphonia and vocal nodules. Only one of the six studies reported significant alleviation of the patient condition post-intervention. However, none of the studies discussed the clinical significance of the interventions. Three of the six included studies used both direct and indirect voice therapies and reported substantial differences in the data collected before and after the interventions. However, overall, the studies reported more significant improvements in patient conditions. More studies in this domain are still warranted, especially to help understand and define the meaning of the term “effectiveness” with respect to voice therapies.