Background: Obstructive sleep apnea (OSA) is a common, serious, under-recognized and under-diagnosed medical disorder. Polysomnography (PSG) is the gold standard diagnostic test for OSA; however, the cost of testing and the shortage of sleep disorders laboratories limit access to this tool. Therefore, there is a need for a simple and reliable diagnostic tool to screen patients at risk of OSA.Objective: This study was conducted to evaluate the validity and reliability of an Arabic version of the STOP-Bang questionnaire (SBQ) as a screening tool for OSA.Methods: This study was conducted in three steps, as follows: Step 1: the SBQ was translated from English to Arabic (examining both forward and backward translations); Step 2: the test-retest reliability of the questionnaire was investigated; and Step 3: the questionnaire was validated against PSG data prospectively on 100 patients attending a sleep disorders clinic who were subjected to a full-night PSG study after completing the translated version of the SBQ. The validity of the test was tested against the apnea-hypopnea index (AHI).Results:The study group had a mean age of 46.6 ± 14.0 years and a mean AHI of 50.0 ± 37.0/hour. The study demonstrated a high degree of internal consistency and stability over time for the translated SBQ. The Cronbach’s alpha coefficient for the 8-item tool was 0.7. Validation of the SBQ against the AHI at a cut-off of 5 revealed a sensitivity of 98% and positive and negative predictive values of 86% and 67%, respectively.Conclusion:The Arabic version of the SBQ is an easy-to-administer, simple, reliable and valid tool for the identification of OSA in the sleep disorders clinic setting.

Background: Lymphatic malformations (LMs) are rare benign tumors that are at risk of various complications due to their progressive nature and critical locations. Considering the morbidity and mortality of such lesions, different therapeutic methods proposed are surgical excision, sclerotherapy, laser, aspiration, radiotherapy, and most recently sirolimus. Case Reports: We reviewed 3 cases with lymphatic malformation at King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia. Initially placed on various treatment sessions of surgical intervention, sclerotherapy or even both prior to sirolimus, minimal improvement was noted. Sirolimus initiation was associated with significant clinical improvement. However, sirolimus was associated with neutropenia, which was successfully managed by G-CSF. Conclusion: Sirolimus can cause bone marrow suppression due to cumulative effect.

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Hepatocellular carcinoma (HCC) is the sixth most common neoplasm worldwide; HCC metastasis is common affecting 50% of cases. However, metastasis to the oral cavity is extremely infrequent. We present a case of hepatocellular cancer first presenting as a mass lesion at the upper alveolus and review metastatic hepatocellular carcinoma to the oral cavity in 73-year-old male patient.