Chronic granulomatous invasive fungal sinusitis (CGIFS) is a peculiar disease of the paranasal sinuses due to its rarity, patient subset, and disease course. We describe 7 cases of histopathologically confirmed CGIFS with different treatment plans and varying outcomes. Of particular note was that one of these patients developed allergic fungal rhinosinusitis after complete resolution of his primary invasive disease, a finding that has never been reported in the literature. Another patient had an atypical fungal species ( Aspergillus nidulans) on fungal stain and culture, while one immunodeficient patient had a large intracerebral disease component and died after 2 months of treatment. We also present a review of the pertinent literature investigating this rare disease.

Objectives:To develop a more comprehensive explanation and understanding of the prevalence of and factors associated with burnout for residents of the Saudi Plastic Surgery Residency Program.Methods:This is a cross sectional study. Data was gathered using a survey, which was distributed during April 2015, among all 57 plastic surgery residents enrolled in training programs across all regions of Saudi Arabia, 38 of whom responded (60% response rate). The dependent variable was professional burnout, which was measured by 3 subscales of the validated Maslach Burnout Inventory (MBI). High scores on emotional exhaustion (EE) or depersonalization (DP) or low scores on personal accomplishment (PA) were taken to be indicative of professional burnout. Variables evaluating possible predictors of burnout, such as sociodemographic and professional characteristics, were also included.Results:The validated rate of high burnout status was 18%. Nearly three quarters (71%) of residents scored high in emotional exhaustion, and half (50%) scored high in depersonalization. A third (34%) scored low in personal accomplishment. However, only 5% were dissatisfied with the plastic surgery specialty as a career, and 69% would choose the same specialty again. Workload was not found to play a significant role in the development of burnout (mean 70 hours per week).Conclusion:Approximately half of plastic surgery trainees in the Kingdom of Saudi Arabia have signs of professional burnout.

Introduction. Middle East respiratory syndrome (MERS) outbreaks have had a considerable negative impact on health systems in Saudi Arabia. We aimed to study the psychological impact of a Middle East respiratory syndrome coronavirus (MERS-CoV) outbreak on emergency room resident physicians (ERRPs). Methods. We assessed the MERS-related psychological impact and concerns of ERRPs using a self-report questionnaire. Results. The majority (91%) of the ERRPs agreed that their work put them at risk of infection, but most (65%) did not agree that they should not be looking after patients infected with MERS. Despite that, 54% of ERRPs reported being afraid of contracting the infection from infected patients and only 4.2% of them were willing to change their current job. The majority of the ERRPs (85%) felt that their job would expose their families to risk of infection. Conclusions. Our study demonstrated the considerable psychological impact of MERS outbreaks on ERRPs. The ERRPs' concerns and the psychological impact of MERS outbreaks should be considered in greater detail by hospital policymakers.

To address the gap in knowledge by providing data and analyses of the status of awareness among Saudi adults. Methods: This cross-sectional questionnaire-based study was carried out in Saudi Arabia from August 2018 to August 2019 through social media platforms using SurveyMonkey. The domains of the questionnaire included demographic information, knowledge of types and symptoms of head and neck cancers)HNCs(, and the relation of HNCs to human papillomavirus)HPV(and its vaccine. Results: A total of 3171 respondents completed the questionnaire. The analysis revealed that many of the study respondents)49.3%(were not knowledgeable about HNCs. Almost two-thirds)61.2%(of the study population incorrectly believed that brain Original Article cancer was included in HNCs. Over half)57.8%(did not recognize headaches as a symptom. In terms of the risk factors, males showed higher awareness of tobacco and excessive alcohol as risk factors, while females were more knowledgeable about HPV infection)p<0.05(. Conclusion: This study revealed that there is a lack of knowledge and awareness of the clinical features of and risk factors for HNCs among the Saudi population.

HighlightsBilateral peritonsillar abscess is quite rare.Bilateral peritonsillar abscess present with sore throat, dysphagia, trismus, drooling, a muffled.Bilateral peritonsillar abscess can be easily missed.Bilateral peritonsillar abscess treated with incision and drainage.Most common organism is Streptococcus pyogenes.

Objectives:To determine medical residents’ emotions, attitudes, and knowledge related to Middle East respiratory syndrome (MERS) outbreaks.Methods:In this is a cross sectional study, self-administered questionnaires were distributed and collected before resident education activities in 4 tertiary hospitals in Riyadh, Kingdom of Saudi Arabia, between November 2015 and January 2016. The questionnaire included questions related to residents’ demographic data and their emotions, attitudes, and knowledge related to an MERS outbreak.Results:Of the 228 participants analyzed, 85.5% believed their work put them at risk of infection, and two-thirds believed their family was exposed to a greater risk of infection. However, only 2.6% would change their job. Nearly half of the residents indicated that their hospital had a clear plan, and only 28% considered themselves not well prepared for an MERS outbreak.Conclusions:Our study highlights medical residents’ attitude and emotions related to MERS outbreaks. Residents’ concerns and emotions in relation to MERS should be considered in greater detail by hospital policymakers.

Objectives:To assess Saudi mother’s preferences regarding Saudi children’s physicians’ attire, and its influence on the parents’ level of trust and confidence.Methods:A cross-sectional survey was conducted from January to April 2014. Our sample comprised mothers of pediatric patients in both inpatient and outpatient settings at National Guard Hospital, Riyadh, Kingdom of Saudi Arabia. Mothers answered multiple questions, including their preferences regarding male and female pediatric physicians’ attire, their preferences regarding their children’s physician’s gender, and the impact of physician’s appearance on mothers’ confidence.Results:There were 259 female participants. Of all caregivers, 51.4% were 32-years-old or younger. Of those, 170 (65.6%) were educated (had completed high school or higher). Forty-four percent preferred that male physicians wear scrubs, while 5.4% preferred formal attire (tie, shirt, and trousers) and 27.8% preferred Saudi national attire (Thobe and shemagh). Most caregivers (57.9%) preferred that female physicians wear long skirts. Most caregivers (87.6%) preferred physicians to wear a white coat. Most (89.2%) believed that a physician’s appearance is very important.Conclusion:Gender of the treating physician is insignificant to mothers. However, the level of trust in a physician is related to his/her external appearance. Most mothers prefer their children’s physicians to wear scrubs.

Objectives:To determine the mean nasal skin thickness in the Middle Eastern population and to assess the effect of skin thickness on patients’ satisfaction following rhinoplasty surgeries.Methods:Radiological measurements of skin thickness at the 3 vertical thirds of the nasal dorsum were taken. A total of 154 patients (80 females and 74 males) who were scheduled for computed tomography scan for the paranasal sinuses were included in the study. The patients were then categorized into 3 groups: thick, medium, and thin nasal skin. A scale from 10% to 100% was used to assess patient satisfaction following rhinoplasty. Satisfaction and skin thickness were analyzed using the Kruskal-Wallis test.Results:Nasal skin thickness for males was 6.13, 2.76 millimeter (mm) from the upper and 3.70 mm to the lower third. For females, it was 5.34, 2.13 mm from the upper and 3.21 mm to the lower third. There was no statistically significant difference in patient satisfaction among the 3 skin thickness groups (p=0.089).Conclusion:This study provides baseline results of nasal skin thickness in the Middle Eastern population. The results also show that nasal skin thickness may not be a strong factor affecting patient satisfaction.