Background: Asthma is a common chronic respiratory disease that affects children and adults and can have a serious impact on their quality of life. Factors contributing to the development of asthma and related exacerbations are multifactorial, with microbial communities colonizing the airways possibly playing a key role. Methods: The study included asthmatic (79) and healthy children (57) aged 5– 16 years. Nasal and throat swabs were collected, and bacterial (16s rRNA) and fungal (18s rRNA) amplicon sequence analysis was performed. Diversity indices and the most abundant microbial genera were estimated accordingly. Results: At the level of the bacteriome in the nasal samples, the asthma group had significantly lower diversity than the control group (p = 0.02). However, the microbiota of the asthma cohort was more evenly distributed, and staphylococci were enriched in the control group. Throat samples collected from the asthma cohort revealed significantly lower diversity (p < 0.0001), with a significant difference in species composition between the two groups (p = 0.005). Enriched bacterial species were different within the asthma subgroups (controlled vs uncontrolled asthma). The fungal microbiome of the nasal and throat samples showed no difference in species richness between the two groups, however, a significant difference in beta diversity (species composition) was detected. The nasal samples from the control group were enriched with Malassezia species, while the asthma cases were enriched with Mucor species. On the other hand, throat specimens of the asthma group were found to be enriched with Candida and Saccharomyces. Conclusion: Our findings suggest that asthmatic samples were less diverse than the control samples with certain microbial genera enriching some study groups. Addressing the biomarkers that influence the progression of asthma could lead to improved care for children suffering from severe asthmatic episodes, possibly by including targeted therapies and prevention strategies.

Developmental coordination disorder (DCD) is a lifelong neurological disorder impairing the coordination and planning of motor and sensory tasks. Its functional manifestation includes difficulties in various aspects of daily living, making early diagnosis and management essential. This cross-sectional, questionnaire-based study targeted healthcare providers in Saudi Arabia’s Eastern Province who work with children under the age of 18. The questionnaire was completed through field visit interviews and electronically via social platforms from October 2023 to March 2024, collecting data on demographics, professional experience, familiarity with related disorders, and awareness of dyspraxia symptoms. Of the participants, 21.2% had previously diagnosed at least one child with dyspraxia, with family physicians comprising 30% of those diagnoses. The overall mean knowledge score was 17%, ranging from 8.3% to 23.1%. The most recognized symptom was motor learning difficulties (22.7%), followed by gross and fine motor skill delays (22.3%). Notably, 65.15% of respondents were unsure about the gender distribution of dyspraxia. The findings align with international studies, showing significant knowledge gaps among healthcare providers in the Eastern Province. These findings also emphasize the need for targeted health promotion programs, promotional activities, and media involvement for enhancing public health outcomes, early identification, and better management of DCD.

Asthma is a chronic respiratory disorder characterized by airway inflammation and narrowing often leading to acute exacerbations that necessitate a visit to the emergency department (ED). Whilst life threatening in sever cases, mild to moderate cases can be treated by the administration of bronchodilators delivered by nebulizers or metered dose inhalers (MDI). Numerous studies have attempted to compare between the two modalities and have drawn similar conclusions in that both are comparable in efficacy with minimal differences. What is evident, however, is that physicians remain inclined to favor nebulizers in the majority of acute asthma exacerbations. In this questionnaire-based study, a survey was distributed to physicians who treat asthma exacerbations to examine demographics, knowledge, beliefs and current practice in regard to bronchodilator therapy. Results found the majority (90.8%) of physicians prefer short-acting beta agonists via nebulizer, with 9.2% favoring MDI + spacer. Participants include consultants, residents, and specialists across various emergency disciplines. While 90.1% find MDI + spacer equally effective as nebulizers, advantages cited include cost-effectiveness (49.6%), shorter ED stays (63.4%), quicker administration (67.9%), and ease of use (58.8%). Challenges include availability (66.4%) and ineffectiveness in younger patients (45%). Despite this, 65.6% are willing to switch to MDI for initial asthma management in the ED, while 34.4% are resistant. Concerns about availability and effectiveness in younger patients remain barriers. However, a significant number are willing to adopt MDIs with spacers, indicating potential for broader use with better availability and training.

Acute suppurative thyroiditis (AST) is a rare, potentially life-threatening bacterial infection of the thyroid gland, and surgical drainage has traditionally been regarded as standard care when an abscess forms. We report a case of a previously healthy 9-year-old boy who presented with fever, odynophagia, hoarseness, and neck stiffness and was found to have a left thyroid lobe abscess with multispatial cervical extension into the visceral, prethyroid, retropharyngeal, and parapharyngeal spaces, accompanied by transient biochemical thyrotoxicosis. Because the airway remained patent and systemic toxicity was absent, the patient was managed conservatively with intravenous antibiotics despite a non-yielding ultrasound-guided aspiration, resulting in rapid clinical improvement and normalization of inflammatory markers without operative drainage or recurrence at follow-up. Flexible laryngoscopy and a barium swallow showed no evidence of a pyriform sinus fistula, and thyroid function normalized without antithyroid therapy. This case highlights that carefully selected children with thyroid abscesses may recover without surgery despite radiological multispatial extension, and that the transient thyrotoxicosis of AST reflects destructive follicular injury, for which thionamides are generally not useful. Finally, it underscores the value of individualized, case-based management guided by airway status and clinical response rather than radiological extent alone.

Background/Objectives: Asthma affects millions of patients worldwide and impacts their quality of life, particularly among children. Colonisation or an imbalance within natural resident microbiota may drive inflammatory responses in asthma; antibiotic resistance genes (ARGs) have also been investigated in asthma microbiome studies. However, research on the association between airway microbiota and ARGs remains limited. Therefore, we elucidated functional-level characterisation at the level of ARGs, virulence factors, and active pathways among a paediatric asthma cohort relative to a healthy control. Methods: Overall, 29 children with asthma and 20 control subjects were enrolled, and 3 swabs (2 nasal and 1 oropharyngeal) were obtained from each participant. Genomic DNA was extracted and sent for shotgun sequencing, after which bioinformatic analysis was conducted to remove human reads and analyse the microbiota pattern in the samples. The abundance of antibiotic resistance genes was evaluated along with the distribution of virulence genetic markers. Functional investigation of the most prevalent metabolic pathways was also performed. Results: Upper airway microbiome functional capacity varied by anatomical location, with oropharyngeal communities exhibiting greater metabolic breadth than nasal communities, suggesting the sample source to be the dominant factor shaping gene content, pathway profiles, and community structure. Asthma-related functional differences were modest, and no biological pathways remained significant following false discovery rate correction. Enrichment of antimicrobial resistance genes was observed, particularly those conferring resistance to β-lactams, macrolides, and tetracyclines. Conclusions: Different anatomical niches exhibit differential activities, and further exploration in this direction could aid in the development of diagnostic and therapeutic biomarkers for asthma.