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The study aims to summarize the updated evidence regards, epidemiology, causes, clinical manifestations, and management of paralytic ileus. Lower abdominal surgical procedure, particularly big open cuts and increased bowel operations, is linked with an increased hazard of bowel obstruction. Though, numerous risk issues have been revealed to upsurge the probability and resistance of intestinal obstruction, such as prolonged abdominal / pelvic surgery, lower gastrointestinal (GI) surgery, open surgery, retroperitoneal spine surgery, opioid use, cancer peritoneal, intra-abdominal inflammation (sepsis / peritonitis), delayed enteral nutrition or nasogastric (NG) tube placement, and hypokalemia. Signs of intestinal obstruction are tachycardia caused by any interruption of movement, absence of abdominal pain, abdominal distention and tenderness, shortness of breath, and hypovolemia. Bowel sounds disappear and flatulence is not discharged, leading to gastric stasis, which can cause hiccups, discomfort, and easy vomiting. Preventive measures include avoiding unnecessary exposure and over-processing of the intestine or traction of the mesentery. Treatment is conservative, as this condition is mostly self-limited. Pharmacologic Therapy have little place, but there are some exceptions of adequate values.

Introduction:diastolic dysfunction refers to impaired ventricular relaxation or filling regardless of ejection fraction and symptoms. It accounts for 8% and 25% in the hospitalized and general population, respectively. The present study was conducted to determine the prevalence and correlates of diastolic dysfunction in hypertensive patients living in Saudi Arabia. Methods:a multicentric, cross-sectional study was conducted from February 2019 to February 2020 at King Khalid Hospital and Prince Sultan Center for Health Services, Prince Sattam Bin Abdulaziz University hospital in Al Kharj, and Al Kharj Military Industries Corporation hospital, KSA. All patients with hypertension who underwent an echocardiography were included in the study. Logistic regression analysis was performed to determine factors associated with left ventricular diastolic dysfunction (LVDD). Results:the study included a total of 104 participants, where 51.9% were females andthe mean age of the patients was 48.01±12.81 years.Most patients had an abnormal echocardiography finding (64.4%, n = 67). The most common abnormalities were left ventricular (LV) hypertrophy (44.2%, n = 46), and diastolic dysfunction, (35.6%, n = 37). The study revealed that age (aOR: 6.1, 95% CI 1.17-31.3; p = 0.032) and dyslipidemia (aOR: 3.45, 95% CI 1.16-10.24; p = 0.026) have significant association with LVDD in the patients with hypertension. Conclusion:in conclusion, diastolic dysfunction is prevalent among older hypertensive patients and those with dyslipidaemia. Age and dyslipidaemia were non-modifiable and modifiable factors associated with LVDD in hypertensive patients, respectively.

Background: Cerebral palsy (CP) is a heterogeneous disease with different causes and clinical types. It is the leading condition that causes life-long disability in children worldwide. The current study aimed at identifying the prevalence, most common risk factors, and types of CP among infants and children in the city of Medina over 10 years (2009-2018). Methodology: This retrospective descriptive study screened all medical files of children diagnosed with CP at the main neurological center of Medina (Maternity and Children Hospital). Results: The current study showed that the prevalence of CP among children in Medina is 3.5 per 1,000 live births. The most common age of CP diagnosis was between 12 and 24 months, with a percentage of 38.3%. The most common type of CP among children in Medina was spastic (82.05%), followed by ataxic (9.83%), and dyskinetic (8.12%). Regarding the risk factors for CP, mixed risk factors were the most common (38.2%), followed by perinatal (34.3%) and postnatal (17.6%) factors; whereas, antenatal (7.3%) and unknown (2.6%) risk factors were less common. Conclusion: The prevalence of CP in Medina is 3.5 per 1,000 live births. Regarding risk factors, mixed risk factors were most common, followed by perinatal, postnatal, and antenatal factors. The most common type of CP in Medina children was spastic, followed by ataxic and dyskinetic.

Introduction: Chronic paediatric diseases, as bronchial asthma, affect the quality of life, which can be defined as the ability to preserve personal well-being despite sickness. These diseases have a huge impact on the quality of life of both the children, their parents and or caregivers. Methodology: A cross-sectional study using convenient sampling was conducted in the paediatric pulmonology clinics at Hamad General Hospital in Qatar aiming to evaluate the quality of life among caregivers of asthmatic children. The quality of life of caregivers was assessed using the standard Paediatric Asthma Caregiver Quality of Life questionnaire. Depression and asthma control were assessed using the Beck Depression Inventory; second edition and the Paediatric Asthma Control and Communication Instrument, respectively. Results: Total number of the caregivers was 330. Majority of the asthmatic children had controlled or partially controlled asthma (47% and 44%, respectively). Most of the caregivers had either very good or good quality of life (63% and 31%, respectively). Mean quality of life score was 5.55 ± 1.14. Males, married and father caregivers had significantly higher mean quality of life. In addition, gender, getting bothered about child’s asthma, asthma control score and depression score were significant predictors of quality of life among the caregivers. Conclusion: Most of the caregivers had either very good or good quality of life. Being a female, degree of asthma control and depression were important determinants of the quality of life of the caregivers. Provision of needed support to caregivers and effective approach to controlling asthma are recommended to improve the quality of life of caregivers.

Tooth and Nail Syndrome or Nail Dysplasias with Hypodontiaor Witkop´s Syndrome is an autosomal dominant condition present at birth and improves by age. An early diagnosis is essential to avoid future functional, aesthetic, and psychological problems. Here we report two classic cases with brief clinical, radiological and genetic investigation along with a brief review of literature.

Background: asthma is a chronic inflammatory disease with a considerable prevalence and unfavorable impacts on various body systems. The natural history of asthma has been extensively investigated in terms of the varied effects on age and gender. Aim of the study: this study aims to achieve a better understanding of the unclear relationship between bronchial asthma and pubertal delay in the pediatric age group. Methods: we reviewed the scientific literature concerned with studying the effect of asthma and its treatment on the growth of children and the onset of puberty using some international medical databases (Medline, Google scholar, EMBASE). Conclusion: Although there have been some community-based surveys and studies based on young children which failed to find an association between asthma and growth, others revealed that asthma can cause growth retardation through different mechanisms, including hypoxia, impaired lung functions, or endocrine malfunctions. Pubertal delay is also observed in untreated asthmatic boys and girls. In addition, inhaled corticosteroids, the best available treatment of asthma, were found also to have an effect on pubertal delay and this effect is dependent on the dose, duration and the outcome of therapy. When concentrating on pubertal delay, it seems that more longitudinal studies are required to comprehensively investigate the effects of asthma and its treatment on this vital stage of life.

This study was conducted to evaluate the operative time, blood loss, hemoglobin drop, blood transfusion, and length of hospital stay in orthognathic surgery.A 10-year retrospective analysis was performed on patients who underwent bilateral sagittal split osteotomy (with or without genioplasty), Le Fort I osteotomy (with or without genioplasty), or any combination of these procedures. A total of 271 patients were included.The age range was 17 to 49 years, with a mean age of 24.13 ± 4.51 years. Approximately 62% of patients underwent double-jaw surgery. The most common procedure was bilateral sagittal split with Le Fort I (37%). The average operative time was 3.96 ± 1.25 h. The mean estimated blood loss was 345.2 ± 149.74 mL. Approximately 9% of patients received intraoperative blood transfusion. The mean hemoglobin drop in the non-transfusion cases was 2.38 ± 0.89 g/dL. The mean postoperative hospital stay was 1.85 ± 0.83 days. Only one patient was admitted to the ICU for one night.In orthognathic surgery, blood loss is relatively minor, blood transfusion is frequent, and ICU admission is unlikely. Operative time, blood loss, blood transfusion, and the complexity of the surgical procedure can significantly increase the length of hospital stay. Males may bleed more than females in orthognathic surgery. Hemoglobin drop can be overestimated due to hemodilution in orthognathic surgery, which may influence the decision to use blood transfusion.

Background: Wound care is observed to be one of the major challenge in health-care system. Wound infection is one of the major issues in medical treatment. There is limited information regarding knowledge and attitude of patients regarding care of traumatic wound. This study was conducted to assess the knowledge, attitudes, and practices regarding wound care among general population in Aseer Region, Saudi Arabia. Materials and Method: This cross-sectional study was a questionnaire-based study conducted on general population from time period from September 2020 to November 2020. The demographic data collected were age, gender distribution, marital status, residence, job profile, income, education, habit of smoking and any comorbidities. To analyze the knowledge, attitude and practice of general population regarding wound care, 28 well-constructed questions were framed and asked. The response to all these questions was recorded and subjected to statistical analysis. Results: A total of 897 participants were included in the study. In total, 56.74% subjects of age group 41–60 years of age. In around 80% participants, no co-morbidities were observed. Around 29% participants had previous experience of surgical wound, with most common wound site being abdomen. The most common symptom in around 58% participants was excessive bleeding. Use of Alcohol swab and dry gauze were commonly used by participants as wound care measures. Conclusion: We observed that knowledge, attitude and practices followed by patients were not up to the standard. As patients' knowledge, good attitude and practices are important in implementing newer management technique; thus, we advice to take necessary steps to improve the attitude and knowledge of general public.

Objective We report a case of pilomatrixoma of the right cheek in a healthy 4 years old girl. Method Case report and review of the English language literature (using PubMed, Ovid and Proquest databases). Results Case of right cheek pilomatrixoma occurred in a young girl to be reported in the English language literature. Conclusion Pilomatrixoma is a cutaneous neoplasm that is one of most common causes of superficial head and neck masses in children. Although the presurgical diagnosis may be difficult in some cases, pilomatrixoma must be kept in the differential of superficial head and neck masses in children. The present case highlights the importance of considering pilomatrixoma in the clinical and pathologic differential diagnosis of dermal or subcutaneous nodule even in locations other than head and neck region. Surgical excision is almost always curative.

Background. The prevalence of End Stage Renal Disease (ESRD) is increasing in different parts of the Kingdom of Saudi Arabia (KSA), particularly Hail Region. Therefore, the aim of this study was to assess the respiratory complications that associated with ESRD.Methods. In the present study, clinical, imaging and laboratory parameters were identified for 100 ESRD patients with ESRD who were referred to the Pulmonary Medicine Department at King Khalid Hospital.Results. Pulmonary Edema, Pneumonia, and Pleural effusion were identified in 22%, 14%, and 16% of the referred ESRD patients, respectively.Conclusion. Respiratory complications are common among ESRD patients in Hail Region.

Background: obesity is associated with increased mortality and morbidity. The use of bariatric surgery has recently increased dramatically in order to lose weight fast; however, the heavy consequences and the long-term weight loss induced by bariatric surgery has favorable effects on life span remains unclear. Aim of Study: this study was aimed to explore knowledge and beliefs about safety, effectiveness and consequences of bariatric surgeries among community population in Jeddah city and to evaluate the role of demographic factors in shaping those beliefs, and assess possible associations between demographic characteristics with lose weight preventive behavior. Patients and methods: this study was done in 2016 and carried out among a sample of 474 citizens, of them 70.1% women and 29.9% men. The mean age of citizens was 35.77. To assess citizens’ demographic factors, risk factors of obesity and beliefs about bariatric surgeries, consenting citizens responded to an anonymous online questionnaire. The data was entered and analyzed using SPSS version 20. Data were entered into the Statistical Package for Social Sciences (SPSS, version 20) and descriptive analysis conducted. Results: the results of the current study show that among the respondents, (24.5%) were obese, (13.7%) severely obese and (9.3%) were morbid obese. The majority of them believed that the lack of exercise is the cause of their obesity (45.7%), (71% ) of the respondents think that genetics play a role in obesity, (69.3%) of respondents have someone in their family who suffers from obesity and (61.6%) were not keen to exercise. The majority of respondents (77.4%) think that weight loss procedures contribute to weight loss, however (69.8%) are not of favor towards weight loss procedures to get rid of obesity, (63.4%) of them have not undergone any surgery, and (86.6%) of the respondents do not think of surgeries as their first choice to lose weight without exercise or diet, also (71.0%) think that weight loss procedures and its complications may lead to death.The majority of the respondents (74%) have inadequate beliefs about bariatric surgery and (50.8%) of the respondents have good knowledge on prevention behavior of obesity.

Bilateral adrenal abnormalities are not infrequently encountered during routine daily radiology practice. The differential diagnoses of bilateral adrenal abnormalities include neoplastic and non-neoplastic entities. The bilateral adrenal tumors include metastasis, lymphoma, neuroblastoma, pheochromocytoma, adenoma, and myelolipoma. Non-neoplastic bilateral adrenal masses include infectious processes and haematomas. There are different diffuse bilateral adrenal changes such as adrenal atrophy, adrenal enlargement, adrenal calcifications, and altered adrenal enhancement. In this pictorial review article, we will discuss the imaging features of these entities with emphasis on their clinical implications.

Diabetes is one of the most common chronic diseases, usually appears during childhood or adolescence; however, it can also develop in adults. The objective of this study was to evaluate the knowledge and awareness about diabetes among teaching stuff in Taif province of Saudi Arabia. A cross sectional study, using a structured pre-tested questionnaire, was conducted in Taif. Our study involved 50.5% males and 49.5% were females. The age of participants ranged from less than 30 years old to more than 50 years old. Our results showed that he majority of teaching staff in our sample study are aware of diabetes and how to deal in case of low blood glucose level. However, the knowledge of causes, symptoms, risk factors, complications of diabetes and signs of low blood glucose level was not as high as expected. Therefore, training is required for the teaching stuff as more than half of our sample study had taught a diabetic child.

Background: Due to the lack of data and studies concerning about measurement of population awareness about carpal tunnel syndrome (CTS) in Al Majmaah city, this study aims at determining the level of population awareness among Al Majmaah adult population in Saudi Arabia. Aims: To study the awareness of CTS among adult population in Al Majmaah city, Saudi Arabia, and to estimate the overall prevalence of CTS. In addition, to look for the relationship between CTS and chronic disease. Materials and Methods: In this cross-sectional study, 386 individuals were covered, both males and females in the targeted areas. A standardized questionnaire was used to cover 11 different aspects concerning CTS. SPSS package was used to analyze the data collected from the sample. Results: The result of scoring system shows that 54 of participants (14.0%) have CTS. Approximately, 30% of them are thought that the main symptom is pain in wrist. However, 26.7% think that tingling and numbness in fingers is the main manifestation. The most causes that population think that leads to the CTS are trauma, repeated hand physical activities such as using computer, taping, and wrist fracture or dislocation by 33.8%, 29.1%, and 21.4% respectively. There is relationship between patients who had chronic diseases and CTS [sig = 0.000]. CTS cause a strong effect on social life by 79.01% of participant though that CTS could affect patient sleep and job performance. Conclusion: The awareness of community was sufficient among adult population in Al Majmaah city, and the prevalence of CTS is 14%.

Primary non-Hodgkin's lymphoma of the common bile duct is extremely rare. We present a case with history of inflammatory bowel disease and clinical manifestations of obstructive jaundice. Abdominal magnetic resonance imaging with magnetic resonance cholangiopancreatography (MRCP) was done and demonstrated tight stricture at the middle part of common bile duct, and radiological findings were supportive of extra-hepatic cholangiocarcinoma. Whipple's procedure was performed and the case was histopathologically proven to be non-Hodgkin's lymphoma of follicular subtype involving the common bile duct. Lymphoma of the hepatobiliary system is usually present as secondary manifestation of systemic malignant lymphoma. However, primary malignant lymphomas arising from the hepatobiliary tree are extremely rare. The radiological appearance of common bile duct lymphoma is very similar to cholangiocarcinoma, making preoperative diagnosis very difficult, as in our present case. We also compare the imaging findings of our case to those seen in reported cases of follicular lymphoma of the common bile duct.