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A short nose is a common esthetic problem faced by facial plastic surgeons. Rhinoplasty of the short nose has been recognized as a complex procedure to perform for achieving satisfactory results. The authors presented 4 cases of short nose in 4 Saudi men who underwent rhinoplasty using septal extension graft and closure the skin with secondary intention as an option to control skin tension after graft placement and to increase nose skin volume to prevent skin retraction, which may occur postoperatively during the healing process. Furthermore, the authors have also discussed the surgical outcomes of these 4 cases and overall satisfaction. Finally, the authors reviewed the literature to identify published papers on correcting the short nose technique.

To investigate the indication, site, techniques, and complications at the donor and recipient sites of temporalis fascia grafting in rhinoplasty, and patients' satisfaction with the surgical outcomes.This retrospective cohort study was performed at King Abdulaziz University Hospital, Saudi Arabia, between January 2015 and January 2020. The predictor variable was the temporalis fascia in different forms. Reported variables comprised individuals' satisfaction, dorsal nasal irregularities, and contour definitions. Moreover, further variables were considered, including age, gender, the reason behind surgery, surgical type, and graft size and site. A rhinoplasty doctor, other than a surgeon, has assessed the dorsal augmentation findings by inspecting and palpating the dorsum. Data analyses were achieved through SPSS.A total of 69 patients were enrolled in this study; 44.9% of them underwent rhinoplasty with the temporalis fascia in cartilage wrapped by the temporalis fascia form, 43.5% in a blanket form, and 11.6% in a ball form. The average subject satisfaction outcome score was 10.44 preoperatively and 19.72 postoperatively ( P = 0.001).No dorsal irregularities were detected by inspection in all forms of the temporalis fascia, whereas 3 patients with the blanket and 2 patients with the cartilage wrapped by the temporalis fascia had irregularities, which were detected on palpation.In rhinoplasty, the temporalis fascia is a favorable choice for nasal reconstruction since it is simple in harvesting and can be made in different forms and shapes for many purposes.

Anemia is defined as a drop in haemoglobin (Hb), hematocrit (HCT), or red blood cell (RBC) count. Anemia is a widespread issue in primary care, and primary care physicians are generally the first to notice its symptoms. Anaemia is a prevalent clinical concern among the adolescents. It is widely known that haemoglobin levels drop with age increase. Anemia has been linked to a variety of negative effects, including higher mortality, hospitalisation, and a worse quality of life. epidemiological reporting of anaemia is fragmented. Anemia is diagnosed in part by symptoms reported in general practice/family medicine (GP/FM). Management of anemia relies on the type of anemia and underlying cause, in this review we will be looking at Prevalence, etiology, classification and management of Anemia.

The purpose of this study is to determine the average values of the angular nasal anthropometric variables in Arabian women seeking rhinoplasty and compare them with the normal values. A total of 150 female patients, who underwent rhinoplasty between January 2018 and November 2021, were enrolled in this study. The exclusion criteria were a history of nasal trauma, previous rhinoplasty, and a cleft nose. Data were obtained from standardized digital photographic images. Lateral and basal views were analyzed using landmarks defined by a single observer and measurements were performed using Adobe Photoshop Software SC6. All data were analyzed using SPSS version 21 software (IBM) and compared with the normal values obtained from a previous study. All facial angles, except for the nasofrontal angles, were significantly different between the surgical and nonsurgical normal groups. The values (means±SDs) in the surgical group were as follows: nasofacial angle, 29.7±3.4 degrees; nasofrontal angle, 146.2±2.8 degrees; glabella-nasal angle, 169.8±5.8 degrees; nasolabial angle, 113.5±11 degrees; nasomental angle, 130.6±6 degrees; nasal tip angle, 102.3±8 degrees; ala-slope angle, 95.4±13.6 degrees. The nose characteristics of Arabian women seeking rhinoplasty were as follows: (1) shallow radix, (2) under the projected tip, and (3) normal tip rotation. Surgical planning is important upon consideration of any procedure or modification of the nose among Arabian women.

Objectives Skin quality plays a major role in aesthetics, particularly in determining the success of rhinoplasty. Efficient preoperative estimation of nasal skin thickness can improve postoperative results and patient satisfaction. This study aimed to report on the relationship between nasal skin thickness and body mass index (BMI) as a possible tool to measure skin thickness preoperatively among rhinoplasty patients. Methods This prospective cross-sectional study targeted patients who visited a rhinoplasty clinic at King Abdul-Aziz University Hospital, Riyadh, Saudi Arabia, between January 2021 and November 2021, and agreed to participate in the study. Data on age, sex, height, weight, and Fitzpatrick skin types were collected. The participant visited the radiology department and underwent ultrasound nasal skin thickness measurement for the five different nasal points. Results The study included 43 participants (16 males and 27 females). The average skin thickness of the supratip area and the tip was significantly higher in males than in females ( P < 0.05). The average BMI of the participants was 25.8 ± 5.26 Kg/m2. Participants with a normal BMI or less represented 50% of the study sample, whereas overweight and obese represented one-quarter (27.9%) and one-fifth (21%), respectively. Conclusion BMI was not associated with nasal skin thickness. Differences in nasal skin thickness were found between the sexes.

We describe our novel modified spreader flap, which involves keeping the large cartilaginous septal T hump attached to the upper lateral cartilages to increase the thickness and length of the flap. Our objectives were to assess hump reduction and recurrence, nasal axis deviation, dorsal width, internal nasal valve grade, and Rhinoplasty Outcome Evaluation (ROE) score preoperatively and one year postoperatively.In a prospective study that included 21 patients who met the criteria, patients were followed up for 1 year after surgery, with an assessment of the dorsal projection, tip projection, axis deviation, dorsal width, and internal nasal valve grade. In addition, the modified Cottle maneuver and Rhinoplasty Outcome Evaluation score were also performed and obtained, respectively.Our novel technique was performed in 20 patients (95.2%). In 1 additional patient, we added a regular auto-spreader flap on the contralateral side. One year postoperatively, the axis was found in the midline in all patients (100%). Assessment of internal valve collapse showed that collapse was reduced to grade 0 in 13 patients (61.9%) and grade 1 in 8 patients (38.1%). There were no hump recurrences or visible irregularities. The results showed a statistically significant difference between the pre- and postoperative values in dorsal projection, dorsal width, and rhinoplasty outcome evaluation score.This novel technique shows promising statistically significant results in reducing dorsal hump projection and width, correcting axis deviation, and improving internal nasal valve and rhinoplasty outcome evaluation score, while being less cartilage and time-consuming.

Chronic granulomatous invasive fungal sinusitis (CGIFS) is a peculiar disease of the paranasal sinuses due to its rarity, patient subset, and disease course. We describe 7 cases of histopathologically confirmed CGIFS with different treatment plans and varying outcomes. Of particular note was that one of these patients developed allergic fungal rhinosinusitis after complete resolution of his primary invasive disease, a finding that has never been reported in the literature. Another patient had an atypical fungal species ( Aspergillus nidulans) on fungal stain and culture, while one immunodeficient patient had a large intracerebral disease component and died after 2 months of treatment. We also present a review of the pertinent literature investigating this rare disease.

Foreign body (FB) aspiration in maxillofacial injuries is a life-threatening event. A long-time interval between the aspiration and retrieval results in the formation of granulation tissue and mucosal inflammation around the FB, which could restrict the visual field of bronchoscopy and its retrieval. In addition, it can affect the lung structure with fatal complications. Herein, we present a case of unique FB retrieval (2 joined crown teeth – measuring 19 mm) within 8 h following aspiration in a 24-year-old male polytrauma victim. Further, we discuss our successful modified retrieval technique accordingly without resulting in any complications.

Total knee arthroplasty is an effective way to manage osteoarthritis patients surgically. However, patients may encounter post-surgical complications, such as quadriceps rupture in rare instances, in addition to surgical complications. In our clinical practice, we encountered a 67-year-old Saudi male patient with a rare bilateral quadriceps rupture two weeks post-total knee arthroplasty. The cause of the bilateral rupture was a history of falls in both knees. The patient was reported to our clinic with clinical features like pain in the knee joint, immobility, and bilateral swelling in the knees. The X-ray did not show any periprosthetic fracture, but an ultrasound of the anterior thigh revealed a complete cut of the quadriceps tendon on both sides. The repair of the bilateral quadriceps tendon was done by direct repair using the Kessler technique and was reinforced with fiber tape. Following knee immobilization for six weeks, the patient began intensive physical therapy management to decrease pain, enhance muscle strength, and increase range of motion. After rehabilitation, the patient regained a complete range of motion in the knee and improved functionality, and he could walk independently without crutches.

Coins are among the most common foreign bodies ingested by children, especially those below 5 years of age. Early endoscopic retrieval of esophageal coins minimizes the risk of serious complications. However, significant morbidity and mortality are reported when coins are retained in the gastrointestinal tract for prolonged periods of time. We report a case in which a coin was retained in the upper esophagus for 4 years and presented a distinctive clinical course. An esophageal coin retained for a prolonged period may place the patient at a risk of complications such as tracheoesophageal fistulas. The management of patients with complicated aerodigestive tract foreign bodies is challenging. To avoid a delayed diagnosis and to improve the patients’ safety, the quality of medical care in rural areas should be monitored by implementing continuous educational programs for primary physicians.

Ergonomics in dentistry poses some challenges to dentists and may require considerable concentration and attention to detail. This research enables early recognition and prevention of common ergonomic-related conditions, such as carpel tunnel syndrome, back pain and neck pain. The purpose of this study was to determine the prevalence of ergonomic-related problems concerning carpel tunnel syndrome (CTS) and to know the efficacy of independent and combined clinical tests used in diagnosing it.Initially the participants were instructed to complete a self-administered questionnaire regarding the severity of symptoms of their hands on a hand-wrist diagram and a visual analogue scale. The principle investigator evaluated all questionnaires independently and four clinical tests were used on both hands in a systematic (non-randomised) order for subjects who had symptoms. Those with residual symptoms that exceeded beyond 1 min interval were identified and controlled for the statistical analyses.The most common symptom noted in the study group was tingling and numbness of fingers (66.46%) followed by neck pain (66.34%). 29.26% of subjects reported moderate difficulty in typing and driving vehicles, whereas 26.82% subjects felt moderate difficulty in grasping and carrying shopping bags. 61.94% of subjects with symptoms spent more than 1 h daily of their free time on mobile phones or other smart devices. Individually, in our study the Tinsel's sign stood out as ineffective in ruling out CTS when compared with Phalen's test. Combination tests like Phalen's test and compression tests are confirmatory to CTS diagnosis and 66.34 % of the research group were hence diagnosed for CTS.A positive criteria for CTS, neck and shoulder pain is identified in our study as being due to long-term use of mobile devices. Further, combination tests like Phalen's with pressure provocation tests proved accurate in conforming CTS. Future research is needed to confirm the diagnostic utility of these independent and combined clinical tests in less prevalent settings, including general dental practitioners and occupational worksites.The current study is registered in King Khalid University, College of dentistry ethical committee SRC/REG/2016-17/107.

Background: Dental X-ray is a fundamental part of dentistry. It contributes to the establishment of a definitive diagnosis and the proposed treatment plan. Several modalities are used, ranging from conventional to cone-beam computed tomography with varieties of doses absorbed by the living tissue. Methods: Self-structured questionnaire was established and distributed among 119 dental practitioners working in private and government hospitals through Google® forms. Final-year graduate students of King Khalid University in Abha, Aseer region, Saudi Arabia, were involved as well. Results: A total of 119 participants were included in this prospective survey with a mean ±S.D.ageof 33.30 ± 3.6. There is a significant difference (P

Introduction: Molar Incisor Hypomineralisation (MIH) is a qualitative defect of enamel which is more prone to posteruptive enamel breakdown resulting in the early invasion of dental caries compared to a normal enamel tooth structure. Aim: To assess the differences in the enamel permeability of permanent teeth with and without MIH using Scanning Electron Microscopy. Materials and Methods: Out of the sixteen children, eight children with and eight without MIH were randomly selected. Fully erupted maxillary anterior teeth were subjected for evaluation in this study. Vinyl Polysiloxane impression material was used to make impressions for SEM evaluation. The teeth surfaces were divided, into 9 different morphological areas for assessment. Negative replicas representing enamel droplets were assessed. Odd’s ratio was calculated by Logistic Regression Analysis. Results: Presence of enamel droplets was noticed in both the groups, more predominantly in teeth with MIH. On comparing the individual regions, presence of enamel droplets in the hypomineralised areas had significant difference compared to normal enamel, with p-value 0.0012, which was statistically significant, with an odds ratio of 3.4. Conclusion: This study demonstrated a high presence of droplets in MIH teeth compared to teeth without MIH, suggesting a possible high enamel permeability which in turn can be a predisposing factor for dental caries in teeth with MIH.

Neck emphysema after tonsillectomy surgery is very rare. We present a case documenting the conservative management of a post-tonsillectomy neck swelling, accompanied by crepitus. Computed tomography revealed a large air density at the region of the right masticator space and the masseter muscle, proximal to other deep neck spaces and muscles. Further investigations of her associated symptoms resulted in an additional diagnosis of systemic lupus erythematosus. We have also explored the signs and symptoms associated with such cases, along with a discussion of the literature published on surgical emphysema post-tonsillectomy.

Objectives: The aim of this study was to address the diagnostic efficacy of cone beam computed tomographic (CBCT) imaging in periodontics based on a systematic search and analysis of the literature using the hierarchical efficacy model.Methods: A systematic search of the electronic databases such as PubMed, Scopus, Web of Science, and Cochrane was conducted until February 2019 to identify studies addressing the efficacy of CBCT imaging in Periodontics. The identified studies were subjected to pre-identified inclusion criteria followed by an analysis using a hierarchical model of efficacy (model) designed for an appraisal of the literature on a diagnostic imaging modality. Two examiners performed the eligibility and quality assessment of relevant studies, and consensus was reached where disagreement was found.Results: The search resulted in 64 studies. Of these, 35 publications were allocated to the relevant level of efficacy and quality assessments wherever applicable. The overall diagnostic accuracy studies showed the risk of bias and applicability concerns in the use of CBCT to be low to moderate. In addition, CBCT is accurate in identifying periodontal defects when compared to other modalities. The studies on the level of patient outcomes agreed that CBCT is a reliable tool for the assessment of the outcomes after the treatment of periodontal defects.Conclusion: CBCT was found to be beneficial and accurate in cases of infra-bony defects and furcation involvements.

Estimates show that asthma is highly prevalent across the different communities, and recent reports showed that by 2015, 300 million patients will be affected by asthma, and projections show that additional 100 million individuals will furtherly be affected by 2025. Many factors can attribute to the development of asthma, including genetic, environmental, and allergic causes. They have essential roles in the pathogenesis and development of the condition. Exposure to the different environmental factors has been an area of research for a long time to identify the potential factors that can cause sensitization and asthma development, especially among children that are more exposed to these factors because of their physical structure and daily outdoor activities. In the present literature review, we aim to provide a thorough discussion about the allergic and environmental causes of asthma in children. Our evidence indicates that exposure to different environmental factors including indoor and outdoor pollutants can significantly increase the risk of asthma. Furthermore, maternal exposure to certain pollutants in the prenatal period was also reported to be significantly associated with developing asthma in children around the age of 5 years old. Exposure to these substances increases the inflammatory and airway reactions leading to the development of asthma. Accordingly, healthcare authorities should plan for adequate interventions to reduce the exposure to these compounds among children and reduce the risk of developing asthma and respiratory tract morbidities.

Background:The post-operative hospital stay is considered economic, psychologic and stressful event on the patient. In laparoscopic sleeve gastrectomy, there is not many studies in literature assessed the cause of prolonged hospital stay in LSG, so necessary preventive measures would be applied to decrease this Methods: A retrospective cohort study was conducted in Saudi Arabia on all patients undergone the LSG. Correlation analysis and Wilcoxon rank test was conducted on continuous and categorical variables respectively to understand the relation between length of operation and other risk factors. Multivariate linear regression analysis was conducted to understand the significant relation. Results: BMI, age, sex, operative complications or operative time was associated with prolonged hospital stay. the associated risk factors for long post-operative stay was post-operative serum lipase (P-value Conclusion: The serum lipase level and post-operative complications was the only risk factors for prolonged hospital stay. More studies are needed to assess the risk factors related to prolonged hospital stay in LSG Keywords: Laparoscopic sleeve gastrectomy, obesity, bariatric surgery, hospital stay, postoperative stay

Pleomorphic hyalinizing angiectatic tumor (PHAT) is a rare soft tissue tumor of uncertain histogenesis that was initially described in 1996. The tumor has a strong predilection for the subcutaneous soft tissue of the distal extremities with handful number of cases reported in other locations. Here, we report a case of PHAT involving the breast soft tissue of a 61-year-old man, who presented with a painless left breast mass slowly growing over the period of 4 years. Core needle biopsy was performed to rule out malignancy. The biopsy showed several ectatic hyalinized blood vessels, surrounded by mitotically inactive spindled to pleomorphic cells embedded in a fibromyxoid stroma. The tumor had strong immunohistochemical expression of CD34, CD99 and Bcl2, while being negative for S100, cytokeratin, actin and desmin. The features were consistent with PHAT. This was followed by a wide local excision with no documented recurrence or metastasis 36 months after surgery. This case is reported to increase the awareness of this entity to be considered in the differential diagnosis of pleomorphic and spindle cell tumors of the breast seen on core biopsies to avoid misdiagnosis and unnecessary radical surgical procedures.