Multiple Venous Malformations as a Cause of Pulsatile Tinnitus.

INTRODUCTION: Pulsatile tinnitus is a relatively common presentation in otolaryngology clinics, most cases of which have a treatable cause. This presentation warrants a thorough workup to identify treatable, and rule out life-threatening, etiologies. We present a case of a patient with pulsatile tinnitus arising from multiple dilated venous channels in the head and neck. Case Presentation. We present the case of a 65-year-old Caucasian female with a two-year history of progressive, bilateral pulsatile tinnitus, which had become debilitating. Computed-tomographic angiography (CTA) studies ruled out an intracranial vascular cause for her symptoms. However, computed tomography (CT) scanning and magnetic resonance imaging (MRI) revealed multiple dilated bilateral, low-flow, venous channels throughout the head and neck. The proximity of such dilated venous channels to the temporal bone provides a route for sound to be transmitted to the inner ear. CONCLUSION: Arterial, venous, and systemic etiologies can cause pulsatile tinnitus. Arteriovenous malformations (AVMs) of the head and neck represent less than 1% of cases. In our patient, dilated low-flow venous malformations are the likely source of her symptoms, which is the first reported case in the literature.Peer Reviewe

Characteristics of dental fear among Arabic-speaking children: a descriptive study

BACKGROUND: Dental fear has not only been linked to poor dental health in children but also persists across the lifespan, if unaddressed, and can continue to affect oral, systemic, and psychological health. The aim of this study was to assess the factor structure of the Arabic version of the Children’s Fear Survey Schedule-Dental Subscale (CFSS-DS), and to assess the difference in factor structure between boys and girls. METHODS: Participants were 220 consecutive paediatric dental patients 6–12 years old seeking dental care at the Faculty of Dentistry, King Abdulaziz University, Saudi Arabia. Participants completed the 15-item Arabic version of the CFSS-DS questionnaire at the end of the visit. Internal consistency was assessed using Cronbach’s alpha. Factor analysis (principal components, varimax rotation) was employed to assess the factor structure of the scale. RESULTS: The Cronbach’s alpha was 0.86. Four factors with eigenvalues above 1.00 were identified, which collectively explained 64.45% of the variance. These factors were as follows: Factor 1, ‘fear of usual dental procedures’ consisted of 8 items such as ‘drilling’ and ‘having to open the mouth’, Factor 2, ‘fear of health care personnel and injections’ consisted of three items, Factor 3, ‘fear of strangers’, consisted of 2 items. Factor 4, ‘fear of general medical aspects of treatment’, consisted of 2 items. Notably, four factors of dental fear were found in girls, while five were found in boys. CONCLUSIONS: Four factors of different strength pertaining to dental fear were identified in Arabic-speaking children, indicating a simple structure. Most items loaded high on the factor related to fear of usual dental procedures. The fear-provoking aspects of dental procedures differed in boys and girls. Use of the scale may enable dentists to determine the item/s of dental treatment that a given child finds most fear-provoking and guide the child’s behaviour accordingly. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/1472-6831-14-118) contains supplementary material, which is available to authorized users

Revealing the mechanical and microstructural performance of multiphase steels during tensile, forming and flanging operations

The mechanical performance of Dual Phase (DP) and Complex Phase (CP) steels was investigated by SEM analysis, tensile testing, Forming Limit Curve investigation and flange formability testing. The alloys of interest were Dual Phase (DP) untempered, Dual Phase (DP) tempered and Complex Phase (CP) steels. Phase content analysis showed that the distribution of the ferrite and martensite phases was the same for the two DP alloys, but the grain size and condition (tempered/untempered) for the martensite islands was much different in the two alloys. In the tempered DP steel, the smaller grain size for the martensite and the tempering process resulted in increased elongation, more formability and ability to form a flange (flangeability). In CP steels the soft ferrite phase is replaced by harder bainite, yielding a bainitic-martensitic microstructure. Bainite reduced the total elongation of the alloy during tensile testing, reduced the formability (especially under plane strain conditions) of the alloy but improved the flangeability of the alloy. Under flanging conditions, CP steels deformed to higher strains, at tighter radii with minimum springback. Microstructural inspections at the outer radius of the flanged specimens revealed that in CP steels bainite deforms similarly to martensite, therefore the strain partitioning is smaller in CP steels in comparison to DP steels. Plastic deformation in CP steels upon flanging occurs with the formation of strong slip bands in both martensite and bainite. In contrast, the martensite and ferrite grains in DP steels deform quite differently leading to strong strain localisations. Void nucleation and cracking occurred at the martensite islands or within the soft ferrite phase next to the martensite islands. In CP steels no voids or damage was observed within the matrix. A special case study was done with a thicker and stronger alloy, a Martensitic 1400 steel to reveal the flangeability limits for advanced high strength steels. Neither cracks nor damage were observed visually on the flanged specimens. However SEM observations at the outer radius of the flanged samples revealed significant void growth at inclusion sites and cracks nucleating within the matrix adjacent to the inclusions.Publisher Statement: This is an open access article under the CC BY license (http://creativecommons.org/licenses/BY/4.0/)</p

Practices and complications of pubic hair removal among Saudi women

Source at: http://doi.org/10.1186/s12905-018-0661-6Background: Pubic hair grooming, including the complete removal of pubic hair, has become an increasingly common practice, particularly among young women. Although widespread, there is limited data regarding the methods, products, reasons, and complications of pubic hair removal, particularly among Saudi women. The objective was to examine pubic hair removal practices and the prevalence of its complications among Saudi women living in Jeddah, Saudi Arabia. Methods: In this cross-sectional study conducted at King Abdulaziz University Hospital, Jeddah, Saudi Arabia, Saudi women between 16 and 60 years of age who had the ability to read and speak Arabic, were eligible to complete an anonymous and self-administered survey on pubic hair removal practices and its complications. Results: Between December 2015 and September 2016, 400 Saudi women completed the survey. The age was 26. 3 ± 6.9, 16–58 (mean ± SD, range) years. About three quarters (77.0%) self-removed their pubic hair, while the remainder made use of professional personnel in medical clinics (15.5%), beauty salons (5.3%), and professional services at home (2.2%). Many women (41.8%) used a combination of hair removal methods, with non-electric razor as the most common single method used (33.5%), followed by laser (8.7%), sugaring (6.0%), waxing (4.5%), trimming (2.0%), electric razor (2.0%), and cream (1.5%). Three-quarters of women (75.5%) reported complications, and although they were mostly minor injuries, treatment had to be sought for 17.9% of complications. Multivariable analyses showed that no variables remained correlated with the occurrence of complications (age of starting hair removal, income, BMI, level of education, mode of removal, advice on removal). Conclusions: Saudi women initiate pubic hair removal in early adolescence. While most complications are minor, close to one in five women experience complications

Knowledge about anesthesia and the role of anesthesiologists among Jeddah citizens

Background: The anesthesiologist has a vital role in the operating theatres. Awareness of the role of the anesthesiologist and the types of anesthesia is essential for every person. This study was made to estimate how much information the general population have about the anesthesiologist and the different types of anesthesia.Methods: This research was a cross sectional non-interventional study. The research team conducted a questionnaire in which each participant in the study was interviewed by the research team. The sample size was 159 participants.Results: From the participants,99 (62.2%) recognized the anesthesiologist as a specialized doctor who administers the anesthetics,62 (38.9%) know that the anesthesiologist has a role in resuscitating the patient with the team if crises occurred. However, 85 (53.4%) believe that the surgeon has the responsibility of postoperative pain management. Physicians were the source of knowledge for most participant’s information.Conclusions: A reasonable percentage of people appreciated the role of the anesthesiologist in administrating the anesthesia, however there is a lack of information about the role of the anesthesiologist intra and postoperatively. The need for more education for people about anesthesia is essential as the amount of information about anesthesia in general is rather low

Evaluation of preparedness of healthcare student volunteers against Middle East respiratory syndrome coronavirus (MERS-CoV) in Makkah, Saudi Arabia : a cross-sectional study

Aim: To assess the knowledge and attitude of senior medical, dental, nursing and pharmacy students toward Middle East respiratory syndrome-corona virus (MERS-CoV) in Saudi Arabia. Subjects and methods: A cross-sectional survey using a 21-item questionnaire was conducted for a 3-month period from November 2015–January 2016 in Makkah, Saudi Arabia. The questionnaire was designed to evaluate students’ understanding and perception of MERS-CoV. An ANOVA test was used to determine the association of study discipline and academic year with the student knowledge score on MERS. Results: A total of 364 students were assessed during the study. The majority (62%) of the participants were in the 20–22-year age group. More than half (53%) were pharmacy students followed by (22%) medical students. More than two thirds (71%) of the participants were aware that MERS is caused by the coronavirus. More than half (59%) of the participants believed that MERS can be transmitted through direct or indirect contact with infected camels. A statistically significant association was reported between the study discipline and mean knowledge score (p < 0.0001) with medical students achieving an overall better knowledge score compared with students from other study disciplines. Conclusion: Overall, students had good knowledge about MERS epidemiology, transmission and the recommended protective measures. However, students expressed their reluctance to work in healthcare facilities with inadequate MERS infection control isolation policies

The association between hypertension and other cardiovascular risk factors among non-diabetic Saudis adults-A cross sectional study

Population specific associations between cardiovascular disease with various risk factors including pre-hypertension and hypertension were reported. We aimed to investigate the association of higher than optimal blood pressure with measures of dysglycemia, dyslipidemia, and markers of inflammation in non-diabetic Saudi adults hoping to improve current Saudi guidelines to prevent cardiovascular disease. Volunteers were recruited randomly from public healthcare centers in Jeddah. Demographic information, blood pressure (BP), and anthropometric measurements were taken. Fasting blood samples were drawn, then again following 1-hour oral glucose tolerance test. Glycated hemoglobin, fasting plasma glucose (FPG), lipid profile, highly sensitive C- reactive protein, gamma glutamyl transferase, and 1-hour plasma glucose were measured. Complete data was found for 742 men and 592 women. Pre-hypertension was found in 47.2% of men, and 24.7% of women, while 15.1% of men, and 14.6% of women were hypertensive. Means of measured variables differed significantly between normotensive, pre-hypertensive, and hypertensive groups of men and women in gender specific manner. Association between measured variables and elevated BP, and hypertension were assessed using logistic regression models. After adjustment for age, body mass index and waist circumference, elevated blood pressure was associated with elevated triglycerides in men, while hypertension was significantly associated with elevated fasting plasma glucose, total cholesterol, triglycerides, low density lipoprotein- cholesterol, and low high density lipoprotein- cholesterol in men, and elevated triglycerides, and total cholesterol in women. Therefore, it is strongly recommended to measure lipid profile, specifically TG, for all diagnosed pre-hypertensive and hypertensive patients in addition to FPG for men.Peer reviewe

Dynamical Viscosity of Nucleating Bubbles

We study the viscosity corrections to the growth rate of nucleating bubbles in a first order phase transition in scalar field theory. We obtain the non-equilibrium equation of motion of the coordinate that describes small departures from the critical bubble and extract the growth rate consistently in weak coupling and in the thin wall limit. Viscosity effects arise from the interaction of this coordinate with the stable quantum and thermal fluctuations around a critical bubble. In the case of 1+1 dimensions we provide an estimate for the growth rate that depends on the details of the free energy functional. In 3+1 dimensions we recognize robust features that are a direct consequence of the thin wall approximation and give the leading viscosity corrections.These are long-wavelength hydrodynamic fluctuations that describe surface waves, quasi-Goldstone modes which are related to ripples on interfaces in phase ordered Ising-like systems. We discuss the applicability of our results to describe the growth rate of hadron bubbles in a quark-hadron first order transition.Comment: 40 pages, 4 figures, revtex, minor changes, to be published in Phys. Rev.