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Background Lower respiratory tract infections (LRIs) are the fourth leading cause of death globally, affecting all age groups and leading to over 2 million deaths annually. Saudi Arabia faces a significant burden from LRIs, affecting more than 15% of the population each year. This study aims to provide an overview of LRI mortality, etiologies, and risk factors in Saudi Arabia from 1990 to 2021. Method Data on LRI mortality in Saudi Arabia from 1990 to 2021 were extracted from the 2021 edition of the Global Burden of Disease (GBD) Result Tool. The analysis encompassed mortality rates across all age groups, with particular emphasis on children under five and adults over 70. Four primary etiologies influenza, respiratory syncytial virus (RSV), Streptococcus pneumoniae, and Haemophilus influenzae type b (Hib) were examined, alongside 14 associated risk factors. Results The total LRI deaths in Saudi Arabia decreased by 6% from 1990 to 2021, with a significant reduction observed among children under five years old (96%). In contrast, LRI mortality among adults over 70 increased by 16% during the same period. The age-standardized mortality rate decreased by 47%, with significant reductions in deaths associated with pneumococcus and RSV. However, risk factors, such as smoking and ambient particulate matter pollution, showed minimal declines or even increased mortality rates in older adults. Conclusion Over the past three decades, Saudi Arabia has made significant progress in reducing LRI mortality, particularly among children under five. However, the increasing mortality rates among the elderly highlight the need for targeted interventions to address their unique vulnerabilities. Continued investment in public health infrastructure, vaccination coverage, and environmental health initiatives is essential for further reducing the burden of LRIs in Saudi Arabia.

Background: The rapid development and deployment of coronavirus disease (COVID-19) vaccines have been crucial in mitigating the pandemic’s impact. However, the incidence of side effects following vaccination, especially among healthcare providers, raises concerns that must be addressed to maintain healthcare delivery and vaccine uptake. This study aims to assess the prevalence and nature of post-vaccination side effects among healthcare providers in Saudi Arabia and to explore how speciality influences these reactions. Materials and methods: A cross-sectional survey was conducted among 386 healthcare workers across Saudi Arabia from January to December 2023. Participants included medics and paramedics who had received at least one dose of a COVID-19 vaccine. Data were collected using a structured questionnaire covering demographic information, vaccine type, number of doses, and post-vaccination symptoms. Statistical analysis involved Chi-square tests to explore the associations between demographic factors and the impact of post-vaccination symptoms on work. Results: Most healthcare providers experienced mild to moderate side effects, with the most common being injection site pain, headaches, and fever. A significant proportion of the respondents reported symptoms severe enough to affect their work capacity. No significant differences were observed in post-vaccination symptoms among different ABO blood groups. However, a notable gender difference was observed, with females more likely to report an impact on work capacity. Conclusions: The study highlights the commonality of post-vaccination symptoms among healthcare providers and their impact on their work capacity. It underscores the importance of tailored health communications and interventions that address the specific needs of healthcare providers to manage post-vaccination symptoms effectively. Future research should focus on longitudinal studies to track symptoms’ duration and evolution and explore gender-specific responses to vaccination further.

Background Poorly differentiated thyroid carcinoma (PDTC) is a rare, aggressive thyroid malignancy. While thyroid cancer has been reported in monozygotic twins, the occurrence of PDTC in this context is exceptionally uncommon. Such cases may offer unique insights into the interplay between genetic and environmental factors in thyroid cancer development. Case presentation We report the case of 67-year-old monozygotic twin sisters, both diagnosed with thyroid malignancies with discordant histology. Patient A presented with a 5.5 cm PDTC with local invasion and distant metastases. She underwent total thyroidectomy and lymphadenectomy followed by radioactive iodine (RAI) therapy. Patient B had a history of recurrent papillary thyroid carcinoma (PTC) over several years, managed with multiple surgeries and RAI. Despite their identical genetic background, the twins developed distinct thyroid cancer subtypes, with varying ages of onset and clinical courses. Discussion This case highlights the heterogeneous presentation of thyroid malignancies in genetically identical individuals, suggesting a potential role for environmental or epigenetic factors in tumorigenesis. A review of the literature on thyroid cancer in monozygotic twins indicates a general pattern of similar pathology and age at diagnosis, contrasting with the discordant phenotypes seen in our patients. PDTC poses diagnostic and therapeutic challenges due to its aggressive nature and limited response to conventional therapies. Advances in molecular profiling and targeted treatments may help improve management and outcomes. Conclusion The occurrence of discordant thyroid cancer subtypes in monozygotic twins is exceedingly rare and emphasizes the need for further studies exploring genetic and epigenetic contributions to thyroid cancer. Understanding these factors is critical for developing personalized approaches to diagnosis, treatment, and prevention.

Background Thyroid angiosarcoma is a rare, highly aggressive malignancy of endothelial origin, characterized by rapid growth, invasive behavior, and a high metastatic potential. While most cases are reported from the Alpine regions of Europe, its occurrence elsewhere is exceedingly rare. The aim of our review is to report a case of thyroid angiosarcoma and provide a systematic review of the literature, focusing on clinical presentation, diagnostic strategies, and treatment outcomes. Methods A literature search of thyroid angiosarcoma case reports and series was performed according to PRISMA guidelines. Data on clinical features, diagnostic and treatment methods, and clinical outcomes were retrieved and analyzed. Kaplan-Meier survival curve was constructed to assess overall survival. Results A systematic review of 72 cases of thyroid angiosarcoma reported in 52 articles was conducted. The median patient age was 66 years, with female predominance (4:3). Most patients presented with a rapidly enlarging thyroid mass and compressive symptoms. Diagnosis required a combination of histopathology and radiologic imaging, with Fine Needle Aspiration Cytology as the initial tool in 47% of patients. Total thyroidectomy was performed in 67% of cases, and 42% of patients received adjuvant therapies. The prognosis remains poor, with a median overall survival of 28 months and a 3-year survival rate of 40%. Conclusion This case highlights the aggressive nature of thyroid angiosarcoma, and the challenges associated with its diagnosis and management. The literature review underscores the need for standardized management protocols and further research to improve patient outcomes.