Ahood Mahjari

This systematic review and meta-analysis evaluated the efficacy and safety of intratympanic (IT) corticosteroid therapy compared with that of standard management of patients with treatment-resistant otitis media with effusion (OME). PubMed, Scopus, Web of Science, and the Cochrane Library were searched from inception to March 2026. Randomized controlled trials and observational studies comparing IT corticosteroid therapy with standard treatment were included. The primary outcomes were changes in pure-tone average (PTA) hearing thresholds and Type A tympanogram normalization. Secondary outcomes included air-bone gap improvement, OME recurrence, tympanosclerosis, otorrhea, and tympanic membrane perforation. Pooled effect estimates were calculated using random-effects models. Six studies involving 312 patients and 417 evaluated ears were included. Overall, IT corticosteroid therapy significantly improved the PTA hearing thresholds compared with the standard treatment (mean differences [MD]=-5.57 dB; 95% confidence interval [CI], -8.15 to -2.99; p<0.001; I²=71.88%). Stratified analyses showed significant improvements in both pediatric patients receiving IT methylprednisolone plus ventilation tube insertion (VTI) (MD=-4.03 dB; 95% CI, -4.98 to -3.07) and in adult patients receiving IT dexamethasone without VTI (MD=-13.68 dB; 95% CI, -19.52 to -7.84). IT corticosteroid therapy also significantly improved the air-bone gap (MD=-7.06 dB; 95% CI, -10.94 to -3.17), reduced the OME recurrence (risk ratios [RR]=0.27), and reduced tympanosclerosis (RR=0.21). No significant differences were observed in Type A tympanogram normalization, otorrhea, or tympanic membrane perforation. IT corticosteroid therapy may improve hearing outcomes and reduce recurrence in patients with persistent or treatment-resistant OME with no statistically significant increase in treatment-related adverse events detected. However, larger size trials with patient-level analyses, standardized protocols, and clinically meaningful hearing outcomes are required.

Meningiomas are the most common primary intracranial tumors, but the role of traumatic brain injury (TBI) as a risk factor remains unclear. This study aimed to systematically review and quantitatively synthesize the available observational evidence on the association between TBI and subsequent meningioma risk. We conducted a systematic review and meta-analysis of observational studies following PRISMA guidelines. PubMed, Scopus, Web of Science, and Cochrane databases were searched through December 5, 2025. Studies comparing meningioma incidence in individuals with and without a history of TBI were included. Risk of bias was assessed using the Newcastle-Ottawa scale. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using a random-effects models. Heterogeneity and sensitivity analyses were performed. In results, 10 observational studies (seven case-control and three cohort studies) were included in the systematic review, with eight contributing to the quantitative synthesis. The pooled analysis demonstrated a statistically significant association between TBI and meningioma (OR, 1.96; 95% CI, 1.31 to 2.95; p=0.0012) with moderate heterogeneity (I2=65.6%). Sensitivity analyses confirmed the robustness of the findings, although funnel plot asymmetry suggested potential publication bias. We concluded that although a statistical association between prior TBI and meningioma diagnosis was observed, the current evidence does not support a clear causal relationship. The pooled effect appears to be driven mainly by retrospective case-control studies, which are particularly vulnerable to recall and detection bias, whereas cohort studies provide less consistent support for a direct etiological link. Further largescale prospective studies with long-term follow-up are needed to clarify this relationship.

Background: Meningiomas are the most common primary intracranial tumors, but the role of traumatic brain injury (TBI) as a risk factor remains unclear. This study aimed to systematically evaluate and quantify the association between TBI and meningioma risk. Methods: We conducted a systematic review and meta-analysis of observational studies and Mendelian randomization analyses following PRISMA guidelines. PubMed, Scopus, Web of Science, Embase, and Cochrane databases were searched through December 5, 2025. Studies comparing meningioma incidence in individuals with and without a history of TBI were included. Risk of bias was assessed using the Newcastle-Ottawa Scale and ROBINS-MR tool. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using random-effects models. Heterogeneity and sensitivity analyses were performed. Results: Eleven studies (seven case-control, three cohort, one Mendelian randomization) were included, with eight contributing to the quantitative synthesis. The pooled analysis demonstrated a statistically significant association between TBI and meningioma (OR = 1.96; 95% CI [1.31 to 2.95]; p = 0.0012) with moderate heterogeneity (I² = 65.6%). Sensitivity analyses confirmed the robustness of the findings, although funnel plot asymmetry suggested potential publication bias. Conclusion: While a statistical association exists between TBI and meningioma, current evidence suggests it is unlikely to be causal. The association is primarily driven by retrospective case-control studies prone to bias, whereas prospective and genetic studies do not support a direct etiological link. Further long-term prospective studies are warranted to fully elucidate this relationship.

Background: Organ donation is a critical global health concern, with disparities in knowledge, attitudes, and willingness (KAW) observed across different populations. Understanding these factors in specific contexts is essential for improving donation rates. Objective: Study aimed to explore the correlations between levels of KAW toward organ donation and demographic variables among adults in the Yemen. Method: A quantitative, cross-sectional, correlational design was employed. A convenience sample of 507 participants from seven Governorates completed a self-administered questionnaire measuring KAW using a validated bilingual scale. Data was analyzed using descriptive and inferential statistics, including regression analysis, via SPSS version 28. Results: Participants demonstrated moderate knowledge levels (mean = 4.21), with 52.5% expressing willingness to donate. Knowledge scores were higher among females, participants with higher education, and those from Sana'a. Logistic regression showed no significant predictive relationship between knowledge (OR = 0.992, p = 0.35) or attitude (OR = 1.07, p = 0.11) and willingness to donate. Socio-demographic factors, including education, gender, income, and religion, significantly influenced KAW scores. Misconceptions about brain death and religious permissibility persisted among many respondents. Conclusions: This study highlights the complex interplay between KAW and socio-demographic factors in the Yemen. Moderate willingness to donate, with no significant predictive power of knowledge or attitudes, underscores the dominant role of cultural and religious factors. Targeted education, culturally tailored outreach, and policy reforms are crucial to dispel misconceptions and enhance organ donation acceptance in the Yemen.

BackgroundCerebrospinal fluid (CSF) leak is a known complication of spine surgery, and an effective protocol for prevention, recognition, and treatment of postoperative CSF leak is essential to avoid a cascade of associated adverse outcomes, such as durocutaneous fistula, wound infection, and intracranial hemorrhage. We aim to identify the incidence of CSF leak post spinal surgeries and to obtain the factors that could predict the risks of having a CSF leak following spine surgeries. MethodsThis study was conducted as a retrospective cohort study on patients who had CSF leaks post spinal surgery in King Abdul-Aziz Medical City, Jeddah, from June 2016 to January 2024. ResultsThe occurrence of cerebrospinal fluid (CSF) leak post-surgery was relatively low (2.6%), and more than 97% of the participants studied had no CSF leak. There is a statistically insignificant relation with age, gender, DM, BMI, hypertension, malignancy, and cardiovascular diseases. Still, there is a statistically significant relation with the attempt to watertight closure, and type of surgery (P value ≤ 0.05). ConclusionPostoperative CSF leak following spinal surgery is associated with morbidity and can lead to re-operation and infection. The incidence of CSF leaks among our study participants was about 2.6%, which is relatively low. Identifying predictors for CSF leaks can assist in counseling patients concerning surgical risk and expected postoperative recovery.

Vertebral disease is a main source of morbidity (MM) in individuals with multiple myeloma. The effects of associated osteolytic lesions and vertebral fractures on severe pain, functional limits, spinal deformity, and cord compression are well recognized. Systemic therapy, radiation, cementoplasty (vertebroplasty/kyphoplasty), and radiofrequency ablation are now available therapeutic options for severe MM spinal pain. We here reported a case of a 45-year-old male who had complained of progressive symptoms of pathological spine fractures. He had been examined and investigated for the cause of lytic lesions and found to have multiple fractures in the spine. A computed tomography (CT) revealed multiple osteolytic lesions noted in the thoracolumbar spine, ribs (bilaterally), and pelvic bones. Magnetic resonance imaging (MRI) showed a compression fracture of the T8 vertebral body with evidence of retro-bulging and a spinal canal narrowing. However, there was no evidence of spinal cord abnormal signal intensity. T2 weighted image (T2WI) keeping with edema is noted. A surgical intervention fixed the fracture and improved the quality of life. Vertebroplasty, a minimally invasive procedure, as a treatment option for vertebral lesions and pathologic fractures in the MM, showed good clinical improvement in the patient.

Background: Coronary artery disease (CAD) is responsible for significant mortality and morbidity among patients. Many factors are associated with the increasing prevalence of CAD in a population, including diet and lifestyle, physical inactivity, high cholesterol levels, and others. Objectives: The purpose of this study is to assess the awareness level and knowledge about CAD risk factors and its prevalence among the general population in Taif city, Saudi Arabia. Methods: This study was a community-based cross-sectional descriptive study carried out from August 2022 to September 2022 by an online questionnaire previously validated in published studies and then distributed via different social media platforms to assess participants' knowledge of risk factors for CAD. The survey included questions about socio-demographic data and risk factors of cardiovascular diseases and their prevalence. Results: A total of 2439 participants met the inclusion criteria and finally enrolled in the current study. About 1671 (68.5%) were found to have good awareness levels, 718 (29.4%) of the participants were considered to be having fair awareness levels, and only 50 (2.1%) of the participants were with poor awareness levels. Conclusion: Most participants have a good level of knowledge and awareness about CAD. Few knowledge gaps were regarding certain factors, including age, gender, and family history of CAD. High educational level and age were found to be linked with a higher level of knowledge regarding CAD.