Smokeless tobacco (ST) products vary significantly in their oral carcinogenicity. Much is known about the differences in the chemical, but not the bacterial, constituents of these products. In this study, we explored the composition and function of the bacteriome in ST products from four countries using quantitative polymerase chain reaction (qPCR) and 16S rRNA-based next generation sequencing. The bacterial load (16S rRNA copies/gram) was lowest in Swedish snus (3.4 × 10⁶) and highest in Yemeni shammah (6.6 × 10¹¹). A total of 491 species-level taxa, many of which are potentially novel, belonging to 178 genera and 11 phyla were identified. Species richness and diversity were highest for Swedish snus and lowest for Yemeni shammah. Bacillus, Paenibacillus, and Oceanobacillus spp. were the most abundant in American snuff; species of Pseudomonas, Massilia, Propionibacterium, Puniceispirillum, and Gloeothece predominated in Swedish snus. In Sudanese toombak, Facklamia, Desemzia, Atopostipes, and Lysinibacillus spp. accounted for the majority of the bacteriome. Yemeni shammah exclusively contained Bacillus spp. Functional prediction by phylogenetic investigation of communities by reconstruction of unobserved states (PICRUSt) showed that genes encoding cadmium/zinc and nickel transport systems were enriched in the presumptively “high carcinogenicity” products. The bacteriome of ST products thus differed qualitatively, quantitatively, and functionally. The relevance of these differences, particularly with respect to nickel and cadmium, to oral carcinogenesis warrants further investigation.

Background: Benign multinodular goiter (BMNG) is a common disease of the thyroid gland with palpable thyroid nodules that may be detected in 0.8%-1.5% of men and 5.3%-6.4% of women. Three major complications could be detected after total thyroidectomy: hemorrhage, recurrent laryngeal paralysis, and hypoparathyroidism. Aims: The aim of this study was to review and assess the experience of total thyroidectomy in patients with BMNG at tertiary referral centers in Jazan Hospitals, Saudi Arabia. Methods: A retrospective study was conducted on 320 patients diagnosed with BMNG and subjected to primary total thyroidectomy. Operative mortality and major complications [bleeding, recurrent laryngeal nerve (RLN) injury, and hypoparathyroidism] were recorded. Results: Postoperative hemorrhage was reported in four patients (1.25%). Bilateral RLN injuries occurred in two patients (0.6%), whereas unilateral RLN injuries occurred in nine patients (2.8%). Permanent hypoparathyroidism was diagnosed in three patients (0.9%), while transient hypoparathyroidism occurred in eight patients (2.5%) and improved after 4 months. Conclusions: Total thyroidectomy represents today the treatment of choice for BMNG. Proper preoperative preparations, meticulous surgical dissection with careful follow-up of patients will improve the surgical results and reduce postoperative complications.

Introduction: Hearing loss among kindergarten children is considered as a major health problem especially when there is a deficiency in routine hearing screening during the clinical examination. The aim of the study was to detect any pattern of hearing loss among kindergarten children in Jazan (Kingdom of Saudi Arabia). Methods: A total of 1220 kindergarten students in Jazan (Kingdom of Saudi Arabia) were subjected to meticulous hearing evaluation using otological examination, Tuning fork tests, pure tone audiometry (PTA), speech audiometry, and tympanometry. Results: We found that 18 kindergarten students had type C tympanogram (Eustachian tube dysfunction), 28 had type B tympanogram (secretory otitis media with conductive hearing loss), 4 had chronic otitis media with conductive hearing loss, and 6 had mild sensorineural hearing loss. Conclusions: Early detection and eradication of hearing loss improves quality of life outcomes of children which reduces the incidence of social burden from unrecognized hearing loss.

Smokeless tobacco (ST) products vary significantly in their oral carcinogenicity. Much is known about the differences in chemical, but not bacterial, constituents of these products. In this study, we explore the composition and function of the bacteriome in ST products from 4 countries using q-PCR and 16S rRNA-based next generation sequencing. The bacterial load (16S rRNA copies/gram) was lowest in Swedish snus (3.4E+6) and highest in Yemeni shammah (6.6E+11). A total of 491 species-level taxa, many of which are potentially novel, belonging to 178 genera and 11 phyla were identified. Species richness and diversity were highest for Swedish snus and lowest for Yemeni shammah. Bacillus, Paenibacillus, and Oceanobacillus spp. were the most abundant in American snuff; species of Pseudomonas, Massilia, Propionibacterium, Puniceispirillum and Gloeothece predominated in Swedish snus. In Sudanese toombak, Facklamia, Desemzia, Atopostipes and Lysinibacillus spp. accounted for the majority of the bacteriome. Yemeni shammah exclusively contained Bacillus spp. PICRUSt functional prediction showed that genes encoding cadmium/zinc and nickel transport systems were enriched in the presumptively “high carcinogenicity” products. The bacteriome of ST products thus differed qualitatively, quantitatively and functionally. The relevance of these differences, particularly with respect to nickel and cadmium, to oral carcinogenesis warrants further investigation.

Objective: To assess the use of powered instrumentation and endoscopes to evaluate the efficacy and safety of this procedure in comparison to classic adenoidectomy using an adenoid curette. Patients and Methods: A prospective study performed at the Department of Otolaryngology, Head and Neck Surgery in Jazan General Hospital, Kingdom of Saudi Arabia. It includes 70 patients subjected to adenoidectomy who were divided into two equal groups: conventional curette adenoidectomy (CCA) group and microdebrider-assisted powered adenoidectomy (MPA) group. Both groups were assessed for operative time, average operative blood loss, duration of postoperative pain, return to normal diet and activities. Results: There was no statistical significance between two groups regarding the operative time: the mean operative time in the CCA group was 13.7±3.5 min, while 12.9±4.3 min in the MPA group. The mean operative blood loss in the CCA group was 14.2±3.4 ml, while it was 13.5±2.9 in MPA group without any statically significant difference between the two groups. Conclusion: MPA proved to be a good alternative to CCA technique as both techniques provide complete adenoid resection with fewer traumas to the adjacent tissue. Level of Evidence: 3b.