Association Between Voice Handicap Index and Reflux Symptom Index: A cross-sectional study of undiagnosed general and teacher cohorts in Saudi Arabia

Objectives: This study aimed to assess potential associations between self-reported symptoms of laryngopharyngeal reflux (LPR) and voice disorders among two undiagnosed cohorts in Saudi Arabia. Methods: This cross-sectional study was conducted from February to April 2017 in Khobar, Saudi Arabia. Validated Arabic versions of the Reflux Symptom Index (RSI) and 10-item Voice Handicap Index (VHI-10) were distributed to 400 teachers at 13 schools and 300 members of the general population attending an ear, nose and throat clinic in Khobar. Scores of >13 and >11 on the RSI and VHI-10 indicated a potential subjective diagnosis of LPR and voice disorders, respectively. Results: A total of 446 individuals took part in the study, including 260 members of the general population (response rate: 86.7%) and 186 teachers (response rate: 46.5%). The mean age was 32.5 years. In total, 62.2% complained of voice and/or reflux problems, with the remaining 37.8% not reporting/unaware of any problems in this regard. Among the teachers, 30.6% and 18.3% had positive RSI and VHI-10 scores, respectively, while 43.1% and 14.6% of the individuals from the general population had positive RSI and VHI-10 scores, respectively. Overall, VHI-10 scores were significantly associated with RSI scores (P <0.001). Conclusion: A significant association between RSI and VHI-10 scores suggests that there may be an association between LPR and voice disorders. These tools would therefore be a valuable method of monitoring patients; however, they cannot be used to confirm a diagnosis. Thus, more detailed studies are needed to confirm this association using a larger sample size.Keywords: Voice Disorders; Laryngopharyngeal Reflux; Hoarseness; Diagnostic Self Evaluation; School Teachers; Saudi Arabia

Efficacy of photodynamic therapy on candida colonization and clinical symptoms in denture stomatitis: a systematic review and meta-analysis

Background: Photodynamic therapy (PDT) has been recently proposed as a promising alternative therapy for Denture Stomatitis (DS). The present systematic review and meta-analysis investigated the current available evidence regarding the efficacy of PDT in the management of DS. Materials and methods: PubMed, Scopus, Web of Science, Google Scholar, and ProQuest were searched up to June 7, 2023. All relevant clinical trials were included. RevMan software was used for the statistical analyses. Results: Elven randomized clinical trials (460 DS patients) were included. Eight studies assessed the efficacy of PDT vs. topical antifungal therapy, while three studies assessed the adjunctive use of PDT (PDT + antifungal therapy) vs. topical antifungal therapy alone. The results revealed comparable efficacy of PDT and conventional antifungal therapy on candida colonization at 15 days (MD: 0.95, 95% CI: -0.28, 2.19, p = 0.13) and at the end of follow-up (MD: -0.17, 95% CI: -1.33, 0.98, p = 0.77). The pooled two studies revealed relatively better efficacy of adjunctive use of PDT with antifungal therapy on candida colonization compared to antifungal therapy alone at 15 days (MD: -6.67, 95% CI: -15.15, 1.82, p = 0.12), and at the end of follow-up (MD: -7.14, 95% CI: -19.78, 5.50, p = 0.27). Additionally, the results revealed comparable efficacy of PDT and topical antifungal therapy on the clinical outcomes. Conclusions: PDT might be considered a viable option for DS either as an adjunct or as an alternative to the topical antifungal medications. Further studies with adequate sample sizes and standardized PDT parameters are warranted

Risk and diagnostic factors and therapy outcome of neonatal early onset sepsis in ICU patients of Saudi Arabia: a systematic review and meta analysis

BackgroundNeonatal early onset sepsis (NEOS) is a serious and potentially life-threatening condition affecting newborns within the first few days of life. While the diagnosis of NEOS was based on clinical signs and symptoms in the past, recent years have seen growing interest in identifying specific diagnostic factors and optimizing therapy outcomes. This study aims to investigate the diagnostic and risk factors and therapy outcomes of neonatal EOS in ICU patients in Saudi Arabia, with the goal of improving the management of neonatal EOS in the country.MethodsThis method outlines the protocol development, search strategy, study selection, and data collection process for a systematic review on neonatal early onset sepsis in Saudi Arabian ICU patients, following the PRISMA 2020 guidelines. PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) is a well-established guideline that provides a framework for conducting systematic reviews and meta-analyses in a transparent and standardized manner. It aims to improve the quality and reporting of such research by ensuring clear and comprehensive reporting of study methods, results, and interpretations. The search strategy included electronic databases (PubMed, Embase, Google Scholar, Science Direct, and the Cochrane Library) and manual search of relevant studies, and data were extracted using a standardized form.ResultsThe systematic review included 21 studies on neonatal sepsis in Saudi Arabia, with varying study designs, sample sizes, and prevalence rates of sepsis. Group B streptococcus and E. coli were the most commonly isolated pathogens. Various diagnostic factors and risk factors were reported, including hematological parameters, biomarkers, and blood cultures. The quality of the included studies was assessed using the Newcastle-Ottawa Scale and Joanna Briggs Institute critical checklist.ConclusionsThe review identified a number of risk and diagnostic factors and therapy outcomes for neonatal sepsis. However, most of the studies were having small scale cohort groups. Further research with controlled study designs is needed to develop effective prevention and management strategies for neonatal sepsis in Saudi Arabia

Hoarseness among school teachers: A cross-sectional study from Dammam

Background: Voice disorders are known to be a serious occupational hazard for teachers. Compared to the general population, teachers have a greater risk of developing hoarseness of voice. The prevalence of voice disorders in teachers is 20%–50%. To the best of our knowledge, there has been no study in Saudi Arabia (SA) on the prevalence of hoarseness in teachers. Materials and Methods: A cross-sectional survey was conducted in 13 randomly selected schools at different levels of education in Khobar, SA, between February 2016 and March 2016. Data collected included demographic data, comorbidity, smoking, school type, laryngopharyngeal reflux, hearing problems, common cold, family history, number of students, and stress. The study included teachers who were actively teaching. Teachers with laryngeal cancer and those who were not actively teaching as well as those who were on sick leave were all excluded from the study. Data were analyzed using SPSS version 20. Results: Out of 400 surveys distributed, 187 teachers responded; mean age of teachers was 42.5 years and 55.1% were females. The percentage of teachers who subjectively complained of hoarseness was 27%; teachers in public schools had a higher prevalence of hoarseness than teachers in private schools. The greater the number of students per class, the more likely it was for the teacher to develop hoarseness (P = 0.038). The factors statistically significantly associated with hoarseness included smoking, acid reflux, family history of hoarseness, and work-related stress. Conclusion: Prevalence of hoarseness in teachers is high owing to a combination of multiple associated factors, many of which can be controlle