Synchronous Nasopharyngeal and Thyroid Malignancies: A Case Report

This report presents a case of primary non-keratinizing, undifferentiated nasopharyngeal cancer and an oncocytic (Hurthle cell) thyroid carcinoma developing simultaneously. The patient was diagnosed in August 2022 with nasopharyngeal carcinoma. After the staging process and before starting treatment for the patient, he was diagnosed with oncocytic (Hurthle cell) thyroid carcinoma on October 2022. Synchronous primary head and neck malignancies are well-known in the medical field. However, this is a rare case of two primary tumors of mucosal and non-mucosal carcinomas, highlighting the importance of discussing head and neck malignant cases in the multidisciplinary team meeting and performing frequent imaging and endoscopic examination for suspicious cases, especially in elderly patients. This case report describes the cases, the management modalities, and the outcomes, informing clinicians of the importance of considering the possibility of multiple primary malignancies when evaluating patients with head and neck tumors and a better approach to this rare and challenging case to ensure successful management.

Patterns of Inpatient Admissions during Hajj: Clinical conditions, length of stay and patient outcomes at an advanced care centre in Makkah, Saudi Arabia

Objectives:

This study aimed to describe inpatient clinical conditions at an advanced care facility in Saudi Arabia during the annual Hajj pilgrimage and to determine factors correlating with length of stay (LOS).

Methods:

This retrospective study was conducted at the King Abdullah Medical City (KAMC), Makkah, Saudi Arabia, and included all inpatients admitted during the annual Hajj pilgrimage between August and October 2015. Demographic, administrative and clinical data were collected from patient charts and analysed.

Results:

A total of 296 inpatients were included in the study, of which the majority were male (73.6%) and ≥55 years old (77%). Walk-in admissions occurred less frequently than referrals (38.9% versus 61.1%). Most patients (41.6%) were admitted during the peak Hajj period (the 8-13^th days of Dhu al-Hijjah). Acute coronary syndrome was the most prevalent provisional diagnosis (65.2%). In terms of outcomes, 89.2% of the inpatients were discharged in a stable condition, with 37.5% discharged within ≤24 hours of admission. However, 39.9% required admission to the Intensive Care Unit (ICU). Overall, LOS was significantly associated with various factors, including the mode of admission, admission period, admitting department, number of comorbidities and ICU admission (P <0.050 each).

Conclusion:

Most of admissions were referrals, and the main Hajj period witnessed the majority of admissions. The vast majority of inpatients eventually discharged in a stable condition. Determinants of the length of hospital stay were the mode of admission, admission period, admitting department, number of comorbidities and ICU admission.