Gasless, endoscopic trans-axillary thyroid surgery: our series of the first 51 human cases

Background The safety of gasless endoscopic trans-axillary thyroid surgery is still undetermined. Methods Clinical findings and postoperative complications of patients who had undergone trans-axillary thyroid surgery due to thyroid cancer and thyroid nodules were retrospectively studied. The sensory change and paralysis results from this technique and patients’ satisfaction with the cosmesis were also studied. Results Fifty-one patients (49 females and 2 males) received operations by gasless, endoscopic trans-axillary approaches with one patient whose operation was converted to open surgery because of internal jugular vein injury. Only two patients developed temporary vocal cord paralysis and no patients developed other severe complications. The alleviation of the discomfort in the anterior neck area and sternocleidomastoid, and the cosmetic effect of gasless endoscopic trans-axillary thyroid surgery were acceptable. No evidence of recurrence was found during the follow-up period. Conclusions Gasless, endoscopic trans-axillary thyroid surgery is a feasible procedure with acceptable safety and better cosmetic results in strictly selected patients.

Does the taste of the plain packaged cigarettes in Saudi Arabia really changed and differ from the branded cigarettes or it is a natural sensory change? Pilot Experimental Study (Preprint)

BACKGROUND Saudi Arabia implemented tobacco plain packaging in August 2019. After few weeks of implementation huge number of smokers complained in various media channels especially social media (Twitter) claiming extreme change of how the cigarette taste, increase the frequency of coughing, and for some hospitalization caused by shortness of breath. OBJECTIVE The main objective is to answer the question: Does the taste of the plain packaged cigarettes recently implemented in Saudi Arabia really changed and differ from the branded cigarettes or it is a natural sensory change? The secondary objective is to observation of frequency of immediate cough or shortness of breath. METHODS This study is a pilot prospective, one-group posttest-only design, which recruited smokers 18 years old and above, who are currently smoking cigarettes and cleared upon physical assessment before the experiment. Participants received 6 sequences of different random exposures (3 puffs) to 3 plain packaged cigarettes (2 from the favorite brand and 1 other brand “control”) and 3 branded cigarettes (2 from the favorite brand and 1 other brand “control”). Participants wore Virtual Reality Goggles (VR) accompany with a special software to alter the visual reality and wore gloves to alter the touch sensation. RESULTS Participants were not able to identify the correct type of cigarettes (plain or branded (Estimate of fixed effect -0.01 p=0.79). Moreover, there were no differences in the ability of the participants to identify their favorite brand t(-0.63) mean=0.47 p = 0.53. In terms of immediate coughing out of the 108 experiments 1 episode of short coughing was observed and it was attributed to the branded cigarette not the plain packaged. CONCLUSIONS After controlling the visual and touch sensation participants were not able to difference between branded and plain packaged cigarettes in terms of taste or inducing immediate shortness of breath or cough. Interestingly, participants were not able to identify their favorite brand.

Does The Taste of The Plain Packaged Cigarettes in Saudi Arabia Really Changed and Differ from The Branded Cigarettes or it is A Natural Sensory Change? Experimental Study

Background: Does the taste of the plain packaged cigarettes recently implemented in Saudi Arabia really changed and differ from the branded cigarettes or it is a natural sensory Methods: 18 adult smokers, who are currently smoking cigarettes and cleared upon physical assessment before the experiment. Participants were excluded if they were planning to quit smoking or in quitting stage or have any respiratory or cardiac disease, any taste related disorder (e.g. hypogeusia / ageusia) or any acute disease that affect taste or smell (e.g. Flu). Participants who shows any abnormal vital signs check before the study (fever, shortness of breath or elevated blood pressure). Participants received 6 sequences of different random exposures (3 puffs) to 3 plain packaged cigarettes (2 from the favorite brand and 1 other brand “control”) and 3 branded cigarettes (2 from the favorite brand and 1 other brand “control”). Participants wore Virtual Reality Goggles (VR) accompany with a special software to alter the visual reality and wore gloves to alter the touch sensation.Results: Participants were not able to identify the correct type of cigarettes (plain or branded (Estimate of fixed effect -0.01 p=0.79). Moreover, there were no differences in the ability of the participants to identify their favorite brand t(-0.63) mean=0.47 p = 0.53. Conclusion: After controlling the visual and touch sensation participants were not able to difference between branded and plain packaged cigarettes in terms of taste or inducing immediate shortness of breath or cough. Interestingly, participants were not able to identify their favorite brand.