Hypersensitivity pneumonitis (HP) is a rarely diagnosed interstitial lung disease with variable manifestations. It results from repeated inhalation of certain antigens, e.g. mold, avian antigen, etc. find more in susceptible patients. The diagnosis is made by exposure history, relevant clinical presentation, and specific radiologic features. It is treated by avoidance of triggers and use of corticosteroids. We report a 7.5-year girl with HP. She was admitted for cough and severe respiratory distress. Key Words Hypersensitivity pneumonitis, Antigen, Allergy, Child.Acute rhabdomyolysis and elevated transaminases during streptococcal pharyngitis are rare presentations. The proposed pathophysiological mechanisms include direct bacterial invasion and toxin generation. Physicians should be aware of the association between these infections and the above-mentioned complications to facilitate optimal treatment of these patients. We present the case of a 18-years-old gentleman with β-haemolytic streptococcal pharyngitis complicated by rhabdomyolysis and elevated liver function tests. Such high levels of creatine phosphokinase of 111856 IU/L and elevated liver function tests with aspartate aminotransferase (AST) of 1862 U/L and alanine aminotransferase (ALT) of 1003 U/L in streptococcal pharyngitis is rare to find in the literature. He was treated with aggressive intravenous hydration, antibiotics and hemodialysis. Key Words Rhabdomyolysis, β-haemolytic Streptococci, Creatine phosphokinase, Liver function tests.Sulphamate drugs, widely prescribed for various systemic conditions, are reported to have rare ocular adverse-effects, usually within weeks of initiation of treatment. Medical and drug history in such cases are of pivotal importance in reaching a proper diagnosis. This study reports three cases, which developed topiramate-induced ocular side effects. In one of the cases, although the angles were narrow in both eyes, yet intra-ocular pressure (IOP) was not high. Also, in the third case, there were no macular striae. Topiramate was immediately withheld and all cases were improved without any permanent ocular damage. Key Words Sulphamate, Topiramate, Angle closure glaucoma, Myopia.To optimise the diagnosis and treatment of primary renal leiomyosarcoma, we present our experience with a similar case and review the literature. A 49-year woman was incidentally found to have a palpable mass in the right kidney. CT scan revealed an enhancing, heterogeneous, 6×7×9 cm right renal mass. On suspicion of renal carcinoma, a right radical nephrectomy was performed. The pathological diagnosis was primary renal leiomyosarcoma. After 40 months of regular follow-up, local recurrence was found, and she had liver metastases. She died of cachexia due to tumor metastasis, and the survival period was just 44 months. With unobvious clinical manifestations, preoperative imaging and postoperative pathological examination might be helpful for an accurate diagnosis. Radical nephrectomy to completely remove the tumor is recommended, and the combination of neoadjuvant or postoperative therapy should also be considered. Key Words Renal neoplasms, Leiomyosarcoma, Diagnosis, Therapy.Spermatocytic tumor is a rare germ cell tumor not related to germ cell neoplasia in situ, and derived from postpubertal-type germ cells. It was previously called “Spermatocytic Seminoma” due to false belief of its origin from germ cell neoplasia in situ. The tumor usually occurs in an older age group and orchidectomy is curative. We present a case of spermatocytic tumor in a 25-year male who presented with right-sided testicular swelling and right-sided varicocele. Radiology revealed a 9.8 × 9 cm testicular mass and the patient underwent right-sided orchidectomy. Microscopic examination showed classic morphology with three characteristic cell types and diagnosis of spermatocytic tumor was made. Key Words Spermatocytic tumor, testis, young.Atypical polypoid adenomyoma (APAM) is a rare polypoidal benign tumor of uterus, which usually presents with irregular vaginal bleeding in women of reproductive age. It has the potential of malignant transformation but does not metastasise. It may coexist with endometrial hyperplasia and adenocarcinoma; and so, is usually misdiagnosed. It is composed of atypical endometrial glands along with bundles of smooth muscle fibres. It has a high incidence of recurrence. We describe a case of APAM, which was managed at a tertiary care hospital. A 25-year woman with irregular vaginal bleeding and abdominal mass had total abdominal hysterectomy (TAH) on suspicion of endometrial sarcoma. Histopathology specimen revealed APAM. On follow-up so far, she is in stable condition and asymptomatic. Key Words Atypical polypoid adenomyosis, Adenosarcoma, Endometrial carcinoma.Mycosis fungoides (MF) is a skin lymphoma characterised by atypical T lymphocyte infiltration, which may present with patches and tumors in advanced stages. Treatment options in MF aim to reduce symptoms, since patients usually do not achieve complete cure. Bexarotene is used for treatment-resistant early stage MF and advanced stages of the disease. It has been suggested that white blood cell (WBC)/absolute lymphocyte count, WBC, absolute lymphocyte and eosinophil counts might be prognostic factors in MF. Therefore, we investigated the changes in complete blood count (CBC) parameters and CBC-derived inflammatory biomarkers in patients with MF treated with bexarotene. The results revealed that neutrophil (NE)%, NE numbers, neutrophil/lymphocyte, derived neutrophil/lymphocyte, (neutrophil × monocytes)/lymphocyte and (neutrophils × monocytes × platelets)/lymphocyte counts decreased in all patients three months after bexarotene treatment. We suggest that these inflammatory biomarkers can be used in the follow-up of patients with MF receiving bexarotene treatment. Moreover, these results indicate that decrease in these inflammatory biomarkers may signify improvement of the disease. Key Words Bexarotene, İnflammatory biomarkers, Mycosis fungoides.

To identify the insights of dentistry students towards a new 3/1 problem-based learning (PBL) and team-based learning (TBL) blended package approach.

Mixed method triangulation design, using validating quantitative data model.

College of Dentistry, Qassim University, KSA, from March to July 2020.

Modified TBL within an existing PBL hybrid curriculum, by strategically designing three modified PBL sessions followed by one modified TBL session was evaluated. There were 241 students enrolled over five academic years of session 2019-2020, and all were included in the study. Feedback of the students regarding novel approach was collected at the culmination of the academic year through an e-questionnaire, utilising closed- and open-ended questions. Descriptive statistics and thematic analysis were used to analyse data.

In total, 124 (51.5%) students filled a questionnaire regarding use of PBL and TBL in the new blended approach. The median perception score of TBL was 3.9 (3.2-4.3) and PBL was 3.9 (3.3-4.3).