Background: Medical students have an important role to provide training to other medical students and health workers, and to volunteer when there is a shortage in health care personnel. The aim of the study was to evaluate the knowledge of medical students in six medical colleges in Riyadh, Saudi Arabia, about the coronavirus-19 (COVID-19) pandemic. Materials and Methods: An online survey was distributed to undergraduate medical students from August to October 2021. A total of 261 medical students participated in the study. The survey composed of 26 questions that evaluated students' knowledge about the COVID-19 pandemic in terms of symptoms, modes of transmission, diagnosis, management, and prevention. Results: Two hundred and sixty-one medical students participated in the study with an overall response rate of 31.37%. Around half of the respondents (54%) being from 1^st to 4^rd medical years 81 (31.03%) and 60 (22.99%), respectively. The students' knowledge regarding COVID-19 was investigated in different domains. The mean knowledge score of the protection and prevention of the disease was the highest with a (mean = 79.85%) followed by the knowledge of the ways of the disease transmission (mean 71.31%). 140 (53.64%) of the participants knew how to properly diagnose COVID-19, while (48.35%) were able to identify the different possible symptoms that can be seen in COVID-19-positive individuals (47.32%) knew the different lines of treatment according to the case severity. Conclusions: The results of the present study can be utilized to develop undergraduate medical curricula with the sufficient amount of knowledge about the COVID-19 pandemic.

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Background: Hypothyroidism alone or in combination with other factors has the risk of triggering rhabdomyolysis. In this article, we aim to describe hypothyroidism-associated rhabdomyolysis and its outcomes. Methods: We reported a new case of hypothyroidism-associated rhabdomyolysis and reviewed similar reported cases from the literature for in-depth knowledge. Results: Eighty-one cases, including the one reported in this article, met the inclusion criteria for this review. The mean age of the patients was 45.6 ± 15.8 years. Out of these, 57 (70.4%) patients were males and 24 (29.6%) were females. The precipitating factor was absent in 45 (55.6%) cases. A total of 8 (9.9%) cases had chronic renal failure at time of presentation, while 25 (30.9%) had hypertension, 11 (13.6%) had diabetes mellitus, and 32 (39.5%) had dyslipidemia. The median creatine kinase (CK) level was 5885 U/L (Interquartile range: 3280.5–11550.5 U/L). Electromyography was performed in 12 patients with 10 (12.3%) cases showing myopathic changes including polyphasic potential and fiber necrosis. Muscle biopsy was performed in 7 (8.4%) cases, with Type II fiber atrophy observed in 4 (4.9%) biopsies. Sixty-two cases developed acute kidney injury, of which 14 (17.3%) required hemodialysis. All patients were treated with levothyroxine and most patients (67, 82.7%) were treated by hydration. All the reported patients made good recovery. A statistically nonsignificant correlation was found between CK and thyroid-stimulating hormone (r = 0.218; P = 0.052). Conclusions: Rhabdomyolysis is a recognized complication of hypothyroidism even in the absence of additional risk factors. Clinicians should be aware of the impact of rhabdomyolysis and hypothyroidism on renal function and promptly initiate hormone replacement therapy and vigorous hydration to preserve the renal function.

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Cervical dystonia (CD) is a neurological movement disorder causing awkward head position, affects very few people with unknown clear etiology, and has no full cure. The patient diagnosed with CD can be managed by botulinum toxin therapy and antidystonic agents. Understanding the biomechanics of skull structure used in jaw alignment and raising the vertical dimension of occlusion (VDO) through occlusal stabilization appliance (OSA) therapy to improve the symptoms of the CD. This case report showed significant improvement of CD symptoms by OSA therapy. Vertical distraction of temporomandibular joints and jaw alignment achieved by OSA with gradual increase in VDO. Stabilization occlusal appliance therapy improved the cervical muscles contraction and the skull cervical collapse in case diagnosed with CD.

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