Meningiomas are the most common primary intracranial tumors that often remain clinically silent and may be discovered incidentally during medicolegal autopsy. Such findings can present diagnostic and forensic challenges, particularly in cases of sudden or unexplained death. Here, we describe a case of incidental detection of a meningioma in a 60-year-old male during a routine medicolegal autopsy. Gross examination revealed a well-circumscribed extra-axial intracranial mass, and histopathological evaluation confirmed the diagnosis of meningioma. No evidence of acute tumor-related complications such as hemorrhage, significant mass effect, or brain herniation was identified. The lesion was therefore considered incidental. This case highlights the importance of meticulous intracranial examination and cautious interpretation of incidental pathology in determining the cause and manner of death in medicolegal practice.
We describe a 2-day-old term female neonate with esophageal atresia (EA) and a distal tracheoesophageal fistula (TEF), situs inversus totalis (SIT), right aortic arch, and aberrant vessels. The baby underwent a right posterolateral thoracotomy with muscle sparing extrapleural approach. The azygous vein was spared; ligation of the tracheoesophageal fistula and primary esophageal anastomosis was performed. There were no postoperative complications, and the infant was gaining weight on follow-up at 5 months. SIT is rare and predominantly associated with abdominal malformations, which include polysplenia, asplenia, malrotation, duodenal atresia, and biliary atresia. The association of EA/TEF with SIT is extremely rare, with only 11 cases reported in the literature. An abdominal ultrasound for comprehensive evaluation of abdominal organs and preoperative evaluation of aortic arch abnormality with echocardiogram is necessary in patients with SIT associated with EA. A right-sided approach is preferable, and outcomes are favorable. We are the first to present successful management of this rare association using the muscle-sparing thoracotomy technique.
Saudi Arabia has pursued systematic digital health transformation in emergency medicine as a core component of Vision 2030, deploying telemedicine platforms and artificial intelligence (AI) applications to address emergency department overcrowding, geographical access barriers, and increasing service demand. A narrative literature review was conducted using PubMed, Google Scholar, and institutional databases (2020–2025). Search terms included “telemedicine Saudi Arabia,” “emergency medicine digital health,” “AI healthcare Saudi Arabia,” and “Vision 2030 emergency care.” Peer-reviewed articles, government health reports, and institutional policy documents were prioritized. As a narrative review, formal quality appraisal and systematic risk-of-bias assessment were not performed; findings should be interpreted in light of this methodological limitation. Telemedicine expanded substantially during the coronavirus disease 2019 pandemic, with the national Seha Virtual Hospital network growing to serve over 400,000 patients annually across 200+ connected hospitals by 2024. A multicenter study reported patient satisfaction of 88.82% and mean response times of 2.54 min during the pandemic period. AI integration has included triage algorithms, diagnostic imaging support, and the launch of the world’s first fully autonomous AI clinic in Al-Ahsa in April 2025. Challenges remain in infrastructure standardization, equitable digital access, data governance, and algorithmic oversight. Saudi Arabia’s digital health initiatives in emergency medicine reflect meaningful progress under Vision 2030; however, the evidence base is predominantly descriptive and derived from gray literature and single-setting studies. Rigorous prospective evaluation, standardized outcome reporting, and robust ethical frameworks for AI governance are urgently needed before broad policy conclusions can be drawn.
Minimal intervention dentistry (MID) is a biologically oriented approach to managing dental caries that emphasizes early detection, caries risk assessment, remineralization, and preservation of dental hard tissues. Advances in cariology have shifted caries management from traditional surgically driven treatment toward disease-centered strategies focused on controlling the caries process and maintaining tooth vitality. This narrative review examines the biological foundations and contemporary clinical applications of MID through a focused review of the literature, with an emphasis on systematic reviews, meta-analyses, consensus statements, and clinically relevant studies. Evidence supports minimally invasive approaches that preserve tooth structure and maintain pulp vitality, including selective and stepwise caries removal, atraumatic restorative treatment, silver diamine fluoride, pit and fissure sealants, resin infiltration, and repair of existing restorations. These strategies can effectively prevent, arrest, or control carious lesions while reducing unnecessary removal of healthy dental tissues. By integrating biological understanding with conservative treatment principles, MID provides a comprehensive framework for contemporary caries management that supports preservation of tooth structure, maintenance of pulp vitality, and improved long-term oral health outcomes.
Background: Voice and swallowing problems are frequently reported after thyroid surgery, even in the absence of laryngeal nerve injury. These complications may affect patients’ quality of life in both the short and long term. The objective of this study was to evaluate the prevalence of voice-and swallowing-related symptoms among patients who underwent total thyroidectomy at King Abdulaziz University Hospital (KAUH) in Jeddah. Methodology: This cross-sectional study was conducted in Jeddah, Saudi Arabia, from July 2023 to April 2024. Data were collected via telephone surveys from 184 adult patients who underwent total thyroidectomy at KAUH. Swallowing and voice impairments were assessed using the validated Swallowing Impairment Index (SIS-6) and Voice Handicap Index (VHI-10) questionnaires, respectively. Results: Among the 184 patients studied, most were female (79.7%) and Saudi nationals (79.3%). Postoperative complications were common, with 52.7% experiencing at least one swallowing-related symptom and 67.2% reporting symptoms immediately after surgery. The most frequent swallowing issues were pharyngeal discomfort during bolus transit (37.5%) and difficulty swallowing (35.3%). Voice-related symptoms were also prevalent, particularly difficulty being heard (37%) and being understood in noisy environments (33.2%). A significant positive correlation was observed between SIS-6 and VHI-10 scores ( P < 0.05). Numerous factors may contribute to voice and swallowing change, including modifications to the laryngeal vascular supply, postoperative adhesions, decreased pressure of the upper esophageal sphincter, or position changes after the surgery, laryngeal trauma post intubation, and strap muscle injury. Conclusion: Even in the absence of laryngeal nerve injury after total thyroidectomy, subjective dysphonia and swallowing-related problems are more prevalent than previously thought and can last for months after a complete thyroidectomy.
