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Introduction and Significance: Ganglion cysts in the thigh area are uncommon, typically occurring in the wrist and ankle. These cysts are usually painless but may compress nearby structures, causing discomfort. Ultrasound is a valuable tool to differentiate ganglion cysts from hematomas and lipomas. It also helps identify the fluid-filled cyst walls. Treatment typically involves surgical removal, with complete resection being the goal., Case Presentation: We present a case of a woman who experienced a gradual increase in size of a lump in her groin area. The lump was later diagnosed and completely removed. Histological analysis revealed the presence of a ganglion cyst., Clinical Discussion: Clinical examination is crucial for diagnosing superficial ganglion cysts. It allows us to assess their separation from the skin and connection to deeper structures. It's important to consider ganglion cysts as part of the differential diagnosis for cystic lesions in the groin area during routine medical practice. This can help avoid unnecessary and expensive tests like MRI scans in some cases., Conclusion: Developing a thorough differential diagnosis for uncommon lesions in specific anatomical areas is essential in clinical practice. This aids in choosing appropriate diagnostic methods and surgical intervention, if necessary, to prevent recurrence of the condition., Competing Interests: Conflict of interest statement The authors declare that they have no competing interests., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

This case report describes the surgical management of a giant left adrenal mass (27 x 26 × 27 cm, 9.370 kg) in a 69-year-old female. We review the multidisciplinary decision-making process for pre-operative preparation, embolization, resection feasibility, and strategies to mitigate intra-operative complications. This is the largest adrenal adenoma removal reported to date. The case highlights the importance of meticulous surgical planning and execution in managing rare and challenging cases, with significant implications for patient outcomes., (© 2024 The Authors.)

Introduction and Significance: The Fulkerson osteotomy, also known as anteromedial tibial tubercle transfer, is a surgical procedure used to address patellar instability. It aims to restore the extensor mechanism of the knee, primarily benefiting patients with recurrent patellar dislocations., Case Presentation: We present a case of a patient with chronic recurrent patellar dislocation. After arthroscopic evaluation of the patellofemoral joint, the Fulkerson osteotomy was performed arthroscopically along with a medial patellar retinacular plication., Clinical Discussion: Selecting the appropriate surgical approach for patellar instability necessitates careful consideration of the patient's history and clinical examination. This is crucial due to the multiple surgical techniques available and the complexities associated with the condition., Conclusion: Patellar instability is a relatively common condition with various causes, including bone deformities. Treatment depends on the severity of the injury and clinical evaluation. In our case, a Fulkerson osteotomy was performed in conjunction with knee arthroscopy and medial plication to address the instability., Competing Interests: Declaration of competing interest The authors declare that they have no competing interests., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background: Congenital Diaphragmatic Hernia (CDH) is a severe congenital anomaly with significant morbidity and mortality. It can be isolated or can be associated with other congenital anomalies, including broncho-pulmonary sequestration (BPS). The association of CDH with BPS (CDH+BPS) is uncommon but has been previously reported, and it can complicate the course of the disease in patients with CDH. We report two cases of CDH+BPS that were recently treated at our CDH-Qatar (CDH-Q) program., Methods: We reviewed CDH-Q program registry to search for CDH+BPS and extracted the data for the identified cases. We also reviewed the previously published literature available on PubMed for similar cases., Results: Out of 53 cases of CDH referred to CDH-Q from January 2018 to December 2022, two cases of CDH+BPS were identified, with an estimated prevalence of 3.8% of this association in our CDH population. Both cases were born at term. Case 1 was diagnosed with CDH+BPS postnatally, while case 2 was diagnosed with CDH antenatally but BPS was diagnosed after birth. Both cases underwent a surgical repair of the CDH with resection of the associated BPS, and the histopathology of the resected lung tissue confirmed the presence of BPS in both. Both cases survived to discharge., Conclusion: The association of CDH+BPS is uncommon; however, it can have significant consequences on the management and the prognosis of patients with CDH. Reporting these cases is important to provide a better understanding of this association and its impact on CDH patients.

Statement of Problem: One of the main challenges facing dental implant success is peri-implantitis. Recent evidence indicates that titanium (Ti) corrosion products and undetected-residual cement are potential risk factors for peri-implantitis. The literature on the impact of various types of dental cement on Ti corrosion is very limited., Purpose: This study aimed to determine the influence of dental cement on Ti corrosion as a function of cement amount and type., Materials and Methods: Thirty commercially pure Ti grade 4 discs (19 × 7mm) were polished to mirror-shine (Ra ≈ 40 nm). Samples were divided into 10 groups (n = 3) as a cement type and amount function. The groups were no-cement as control, TempBond NE (TB3mm, TB5mm, and TB8mm), FujiCEM-II (FC3mm, FC5mm, and FC8mm), and Panavia-F-2.0 (PC3mm, PC5mm, and PC8mm). Tafel's method estimated corrosion rate ( i corr ) and corresponding potential (E corr ) from potentiodynamic curves. Electrochemical Impedance Spectroscopy (EIS) data was utilized to obtain Nyquist and Bode plots. An equivalent electrical circuit estimated polarization resistance (R p ) and double-layer capacitance (C dl ). Inductively coupled plasma mass spectrometry (ICP-MS) analysis was conducted to analyze the electrolyte solution after corrosion. pH measurements of the electrolyte were recorded before and after corrosion tests. Finally, the corroded surface was characterized by a 3D white-light microscope and scanning electron microscope. Statistical analysis was conducted using either one-way ANOVA followed by Tukey's Post Hoc test or Kruskal-Wallis followed by Dunn's test based on data distribution., Results: Based on cement amount, FC and PC significantly increased i corr in higher amounts (FC8mm- i corr  = 8.22 × 10 -8 A/cm 2 , PC8mm- i corr  = 5.61 × 10 -8 A/cm 2 ) compared to control (3.35 × 10 -8 A/cm 2 ). In contrast, TB3mm decreased i corr significantly compared to the control. As a function of cement type, FC increased i corr the most. EIS data agrees with these observations. Finally, corroded surfaces had higher surface roughness (Ra) compared to non-corroded surfaces., Conclusion: The study indicated that cement types FC and PC led to increased Ti-corrosion as a function of a higher amount. Hence, the implant stability could be impacted by the selection, excessive cement, and a potentially increased risk of peri-implantitis., Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:Dr.Valentim Barao is a co-author of this manuscript and he is a co-editor of Heliyon., (© 2023 The Authors. Published by Elsevier Ltd.)

Titanium-based implants utilized in total joint arthroplasties could restore primary musculoskeletal function to patients suffering from osteoarthritis and other conditions. Implants are susceptible to failure stemming from aseptic loosening and infection at the joint site, eventually requiring revision surgery. We hypothesized that there might be a feedback loop by which metal degradation particles and ions released from the implant decrease cell viability and increase immune response, thereby creating biochemical conditions that increase the corrosion rate and release more metal ions. This study focused on the synergistic process through cell viability assays and electrochemical tests. From the results, inflammatory conditions from ion release resulting in cell death would further increase the corrosion rate at the metal implant site. The synergistic interaction in the implant surroundings in which infectious conditions produce Ti ions that contribute to more infection, creating a potential cycle of accelerating corrosion., (© 2023. The Author(s) under exclusive licence to Biomedical Engineering Society.)

Peri-implantitis is a substantially prevailing condition. A potential risk factor for peri-implantitis is Ti implant corrosion. During inflammation, substantial quantities of reactive oxygen species (ROS) secretion and local acidification occur. Little is known about the interaction between the inflammatory and corrosion products on Ti surface corrosion. Therefore, the objective of the current study was to evaluate the synergistic effect of hydrogen peroxide (H 2 O 2 ), lactic acid, and Ti ions on Ti corrosion. Twenty-seven commercially pure Ti samples were polished (Ra ≈ 45 nm) and divided into 9 groups as a function of electrolyte: (1) artificial saliva (AS) as control (C), (2) AS + Ti ions 20 ppm (Ti), (3) AS + lactic acid (pH = 5.5) (L), (4) AS + lactic acid + Ti ions 20 ppm (TiL), (5) AS + H 2 O 2 0.5 mM (HP 0.5 ), (6) AS + H 2 O 2 1.0 mM (HP 1.0 ), (7) AS + H 2 O 2 0.5 mM + Ti ions 20 ppm (HP 0.5 Ti), (8) AS + H 2 O 2 0.5 mM + lactic acid (HP 0.5 L), and (9) AS + H 2 O 2 0.5 mM + Ti ions 20 ppm + lactic acid (HP 0.5 TiL). Electrochemical tests were performed following ASMT guidelines. Based on Tafel's method, current density ( i corr ) and corresponding potential ( E corr ) were acquired from potentiodynamic curves. Using electrochemical intensity spectroscopy (EIS), Nyquist and Bode plots were derived. Using a modified Randles circuit, charge transfer resistance ( R ct ) and capacitance ( C dl ) were estimated. Based on open-circuit potential data, groups C and Ti had the lowest potentials (around -0.3 and -0.4 V vs SCE, respectively), indicating a lower passivation tendency compared to the other groups. From potentiodynamic curves, groups HP 0.5 and HP 1.0 increased i corr the most. From EIS data, groups HP 0.5 and HP 1.0 demonstrated the lowest impedance and phase angle on the Bode plot, indicating the highest corrosion kinetics. Based on EIS modeling, the combination of Ti ions, lactic acid, and H 2 O 2 (group HP 0.5 TiL) significantly decreased R ct ( p < 0.05). In conclusion, the concurrent presence of Ti ions, lactic acid, and H 2 O 2 in the vicinity of the Ti surface increased the corrosion kinetics. High corrosion may produce more Ti products in the peri-implant tissues, which may increase the potential risk of peri-implantitis.

Background: Self-medication is vital to public health because it has an impact on people's health and the current healthcare system, both positively and negatively. During public health catastrophes like the COVID-19 disease, this is particularly true., Aim: This study aimed to examine the behavioral response of the community with regard to self-medication during the COVID-19 pandemic in the eastern region of the Kingdom of Saudi Arabia., Methods: During the COVID-19 outbreak from March to September 2020, a cross-sectional online survey of 398 participants using structured questionnaires was conducted to observe knowledge, prevalence, patterns, and sources of self-medication among the respondents in the eastern region of the Kingdom of Saudi Arabia., Results: The percentage of respondents who had heard about self-medication was 50.5%, and those who practiced self-medication during COVID-19 were 43.7% of the respondents. Regarding knowledge, 60.3% had a low overall knowledge level versus 39.7% who had a high knowledge level. Most of those who practiced self-medication took medication based on their own decision (34.4%). The most frequently used drugs during the outbreak were analgesics (43.5%) and vitamins (24.9%). Only 1% of participants reported using anti-malaria drugs (hydroxychloroquine). The most common reasons for self-medication practices were having a mild illness (30.4%), followed by fear of infection (26.6%). The symptoms for which the respondents took self-medication were headache (29.6%), cough (26.6%), and fever (24.6%)., Conclusion: Our investigation showed a low level of knowledge about self-medication and a considerable level of self-medication practices. Therefore, self-medication may be minimized with ongoing awareness-raising and sensitization., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Almaqhawi et al.)

Ventricular dysfunction may be found in 40% of newborns with CDH, and is not only a predictor of disease severity, but also mortality and need for ECMO. We conducted this study to assess the utility of serial echocardiography in management of newborns with CDH and their survival outcomes. This is a retrospective study, wherein the demographic, clinical and echocardiographic data from our local CDH registry and hospital clinical database were analyzed to study the correlation of timed echocardiographic findings with mortality and other outcomes. Fourty-two newborns with CDH were admitted during the study period (M/F:19/23), with median gestation of 38 weeks (IQR:36-39) and birth weight of 2.83 kg (IQR 2.45-3.17). Thirty-one were left-sided, seven right, one central, and three bilateral hernias. Twelve infants (28%) died in early infancy. Three infants were excluded from analysis due to either palliation at birth or significant cardiac anomaly. A total of 137 echos from 39 infants were analyzed. Seventy percent of newborns who died and had an echo within the first 72 h, were noted to have suffered from moderate to severe PH. Birth weight < 2.8 kg, RVSP > 45.5 in the first 72 h and postoperative VIS > 23.5 and RSS > 4.3 were good predictors of mortality. Markers of elevated pulmonary pressures and cardiac function were useful in guiding therapy. Serial timed functional echocardiography (f-Echo) monitoring allows targeted therapy of patients with CDH. Birth weight, initial severity of pulmonary hypertension and postoperative RSS and VIS may be useful in predicting mortality., (© 2022. The Author(s).)

The aim of this study was to examine the feasibility and effectiveness of telemedicine care provided to osteoporotic patients in Saudi Arabia. Our results show that this service was effective and feasible, and patients had a good rate of satisfaction with it., Purpose: To investigate the efficacy and feasibility of telemedicine care in osteoporotic patients during the COVID-19 lockdown period in Saudi Arabia compared to in-person patients, as well as their satisfaction with this service., Methods: This observational retrospective study was conducted between March 2021 and September 2021 in King Saud University Medical City, Saudi Arabia. A survey was used to compare patients attending telemedicine clinics with in-person patients in terms of access and adherence to medications, occurrence of new fractures, and overall satisfaction with this service., Results: 195 patients attended the telemedicine clinic, while 63 attended the in-person clinic. Exercise frequency was similar in both groups, although exercise intensity was greater in the in-person group. 25(OH)D levels were stable in both groups. The availability and delay of supply of osteoporosis medications were not statistically different between both groups while adherence to treatment did not differ significantly between the two groups. The majority of patients in the telemedicine group were satisfied., Conclusions: Telemedicine care was feasible and effective in managing osteoporotic patients during the COVID-19 epidemic. Such service could be considered in the future for managing disabled patients and those living in remote areas., (© 2022. International Osteoporosis Foundation and Bone Health and Osteoporosis Foundation.)