IntroductionThyroid nodules are very common. However, the majority of thyroid nodules are benign. Ultrasound is the first-line imaging investigation of choice for thyroid nodules. Certain sonographic features are associated with an increased risk of malignancy. Recent studies suggested that the location of the nodule may be associated with the malignancy risk. Hence, this study aims to investigate this association. MethodsAfter obtaining approval from the ethics committee, we conducted a retrospective study that involved all patients who attended our hospital, and who underwent fine-needle aspiration cytology for the evaluation of suspicious thyroid nodules (TR3-5). Electronic medical records were used to obtain data about the ultrasound and cytology reports. A multivariable binary logistic regression analysis model was conducted to identify the independent factors significantly associated with malignant thyroid nodules. ResultsThe study included 366 patients who underwent fine-needle aspiration cytology for suspicious nodules on thyroid ultrasound. In total, 52 (14.2%) nodules were found to be malignant on cytology. By far, the most common thyroid malignancy was papillary carcinoma. The multivariable analysis model revealed that women were 24% less likely to have malignant thyroid nodules compared with men. After adjusting for the age, gender, and Thyroid Imaging Reporting and Data System (TI-RADS) group, the nodules located within the isthmus were four times more likely to be malignant compared to those located in the right or left lobes. ConclusionsThe study demonstrates that the isthmus location of thyroid nodules is associated with a higher risk of malignancy. Physicians should have a lower threshold to biopsy such nodules. Further studies are needed to confirm this interesting finding.

This study aims to investigate the potential association between use of WhatsApp in healthcare settings for work-related purposes and depression, stress, and anxiety levels among a sample of healthcare workers in Saudi Arabia. Methods: This was a cross-sectional study of healthcare employees working in different hospitals in Jazan. The data was collected via a semi-structured, self-administered questionnaire with three components that measured the demographics of the sample; the presence of depression, anxiety, and stress; and their use of WhatsApp in the work environment. A multivariate regression analysis was carried out to estimate the statistical likelihood of depression, anxiety, and stress as a result of using WhatsApp and how these factors affected occupational and social relationships. Results: A total of 294 healthcare workers participated in the current study. The median age of the participants was 32 years, and the gender distribution was almost even. Over 90% of the participants stated that they were members of work-related WhatsApp groups, and nearly 70% agreed that use of WhatsApp in work-related settings could be stressful. Among the recruited sample, 48.6% exhibited abnormal levels of depression, 55.8% had abnormal levels of anxiety, and 63% showed abnormal levels of stress. The findings of the regression analysis (P values <0.05) indicated that the likelihood of these participants suffering with depression, anxiety, and stress was high, with the participants themselves agreeing that using WhatsApp in work settings could be stressful and affect their relationships with colleagues, friends, and family members. Conclusion:The findings suggests the presence of a potential association between use of WhatsApp for work-related purposes and levels of depression, anxiety, and stress, especially among those who perceive its use as a stressor and influencer on occupational and social relationships.

The Saudi Ministry of Health's electronic health (e-health) initiative aims to promote the higher use of electronic medical records and has established multiple health applications to facilitate access to healthcare. The current investigation measured the satisfaction and experience of physicians concerning e-health systems and identified the factors associated with their satisfaction level. Methods: This study was a cross-sectional investigation targeting physicians working in primary healthcare centers and hospitals in the Jazan region of Saudi Arabia. Data were collected via a self-administered questionnaire between July and September 2022, which was distributed via online platforms. The questionnaire included sections measuring the physicians' demographic data and their experiences with e-health systems, including information technology (IT) support, training, software design, workload, physician and patient support, and data quality. Chi-square or Fisher's exact tests were used to assess associations between physicians' satisfaction levels and the measured demographics. Results: A total of 445 physicians participated in the current investigation. The median age of the participants was 27, and more than half (58.4%) were male. The median level of the satisfaction score was 4 and varied between -30 (indicating the lowest satisfaction level) and 23 (indicating the highest satisfaction level). Employment rank and work settings were statistically associated with the level of satisfaction (P values < 0.05). The participating physicians were overall satisfied with the e-health systems' impact on their clinical workflow and ability to reduce their work hours but were less satisfied with the training required to use these systems. Conclusion:A good overall satisfaction level with the established e-health systems in the Jazan region was detected. Senior physicians and physicians working in primary healthcare settings exhibited lower satisfaction levels, indicating a need for further investigations to identify the challenges of using e-health systems in these settings, especially among senior physicians.