Retraction: Abdominal Cocoon: A Rare Complication of Peritoneal Dialysis in Chronic Kidney Disease.

[This retracts the article DOI: 10.7759/cureus.20341.].

Endocrine Complications and the Effect of Compliance with Chelation Therapy in Patients with Beta Thalassemia Major in Eastern Province of Saudi Arabia.

Background: Endocrinopathies and metabolic complications are common in beta thalassemia major patients receiving blood transfusions. Chelation therapy has a role in preventing or delaying such complications. However, patients may face difficulties adhering to chelation therapy for several reasons. Aim: To evaluate endocrine complications in beta thalassemia major patients (2-30 years) in the Eastern Province of Saudi Arabia and compare the onset of endocrine complications among compliant and noncompliant patients. Moreover, we assessed the barriers that hinder compliance with chelating therapy. Methods: A cross-sectional study was conducted on 89 patients (43 males and 46 females) aged 2 to 30 years attending different hospitals in the Eastern Province of Saudi Arabia. A semi-structured questionnaire was used to collect demographic data and medical histories. The questionnaires were completed by face-to-face interviews with the patients or their caregivers, and the required laboratory data were retrieved from the medical records of patients. Results: The most prevalent abnormality was underweight detected in (40.9%) of patients, followed by subclinical hypothyroidism (37.7%), short stature (35.2%), hypothyroidism in (17.0%) and diabetes mellitus in (13.6%). A significant difference between those who were compliant with iron chelation therapy and those who were not in terms of the prevalence of short stature (P value=0.05) and hypothyroidism (P value=0.05). The percentage of patients who were not compliant with chelation therapy was 21.6% and 9.1% of patients were not taking them at all. Conclusion: Despite the role of chelation therapy in the management of iron overload, the risk of secondary endocrine and metabolic complications remained considerable. Subclinical hypothyroidism and short stature were the most frequent endocrine complications encountered in this study.

Attitude and Perception Toward Taking Selfies and Using Filters and Their Relationship With Blepharoplasty.

BACKGROUND: Due to the general increase in the use of social media, the increasing popularity of taking selfies and using filters, we found it essential to examine the effect of these behaviors on the perception and attitude toward blepharoplasty. AIM: This article was conducted to assess participants' attitudes and perceptions toward taking selfies and using filters and their relation to blepharoplasty. METHODS: This study was an observational cross-sectional study undertaken in Saudi Arabia. The study targeted all adults in Saudi Arabia. The study subjects are adults living in Saudi Arabia who consented to participate in the study and have filled out the questionnaire fully between January and April 2022 while meeting the inclusion and exclusion criteria. A convenient sampling technique was used for data collection. The Chi-square test was used to test for association. RESULTS: A total of 466 participants were included in the study. (94.6%) of the participants reported taking selfies, with varying frequencies, with Snapchat being the most commonly used application (82.5%). Moreover, 87.05% of the participants reported using filters, and 96.08% of those who use filters used them from Snapchat. 45.5% of the participants reported comparing their eyelids with others' when seeing their selfies, 50.6% reported thinking that taking a selfie has a role in making a decision to undergo blepharoplasty, and 47.6% reported thinking that using filters has a role in making a decision to undergo blepharoplasty.  Conclusion: This study reflected a notably high rate of taking selfies and using photo filters. The participants' assessment toward the impact of taking selfies and using filters on the decision to undergo blepharoplasty was observed to be moderate. Females were observed to have significantly higher rates of thinking that taking pictures and using filters influence the decision to undergo blepharoplasty compared to males.

Can Thyrotropin, Tri-Iodothyronine, and Thyroxine Hormones be Predictors of Cancer in Thyroid Lesions?

Background Thyroid nodules are a common medical problem worldwide. This study aims to investigate and elucidate the relationship between thyroid-stimulating hormone (TSH), thyroxine (T4), and triiodothyronine (T3), and malignant thyroid nodules. Methods This prospective cross-sectional study was conducted at a public specialist hospital in Saudi Arabia from February 2020 to February 2021. All thyroid nodules were scanned using ultrasound imaging, and the largest diameter was measured for each and classified according to the American College of Radiology (ACR) Thyroid Imaging Reporting and Data System (TIRADS) classification system. Thyroid function tests TSH, T3, and T4 were measured. Definitive diagnoses of thyroid nodules were given based on cytology. A one-way analysis of variance (ANOVA) test was used to compare means, and cross-tabulation was used to correlate the variables in the study. Results A total of 222 patients participated in this study; 23.42% were male and 76.57% were females. The mean age was 44.73 ± 13.31 years (range: 18 to 85 years). The percentage of malignancy was 20.6%, 36.3%, and 91.2% in TIRADS 3, TIRADS 4, and TIRADS 5, respectively. A weak positive linear relationship was noted between nodule size and TSH (R2= 0.012). The study demonstrates that TSH increases in malignant nodules more than in benign nodules, while T4 and T3 are decreased in malignant nodules. Conclusion The level of TSH increases in patients with malignant thyroid nodules more than in benign nodules, which can be used as a predictor of malignancy, while T4 and T3 reduced in malignant nodules with an ambiguous relationship.

Abdominal Cocoon: A Rare Complication of Peritoneal Dialysis in Chronic Kidney Disease.

The abdominal cocoon is a rare clinical entity characterized by a thick fibrocollagenous membrane encasing the intestinal loops. Despite its rarity, the abdominal cocoon is one of the most serious complications of peritoneal dialysis. We report the case of a 45-year-old man, with end-stage renal disease on peritoneal dialysis resulting from systemic lupus erythematosus, who presented to the emergency department with progressive abdominal pain for the last two weeks. The pain was associated with nausea, vomiting, abdominal distension, and decreased bowel motion. Upon examination, the vital signs were within the normal limits. Abdominal examination revealed a distended abdomen with generalized tenderness. There was evidence of ascites as indicated by the positive shifting dullness test. The bowel sounds were of increased frequency and intensity. The laboratory findings were non-contributory. The patient underwent an abdominal computed tomography scan that demonstrated a cluster of small intestinal loops in the middle of the abdomen with a surrounding thick and calcified membrane. This made the diagnosis of the abdominal cocoon. The patient underwent an operation to resect the fibrocollagenous membrane. The patient reported improvement after the operation. No recurrence was noted after three months of follow-up. Abdominal cocoon is a very rare complication of peritoneal dialysis. The diagnosis of abdominal cocoon should be kept in mind when the physician encounters a patient with peritoneal dialysis who presented with non-specific and unexplained gastrointestinal symptoms.

Epidemiology of type 1 diabetes mellitus in Basrah, Southern Iraq: A retrospective study.

AIMS: To investigate the epidemiology of type 1 diabetes mellitus (T1DM) in Basrah city, Southern Iraq, between 2012 and 2016 among people 0-40year old. METHODS: This was a retrospective data analysis of electronic archives for patients with T1DM registered in Faiha Specialized Diabetes, Endocrine, and Metabolism Center (FDEMC), which is a tertiary referring Center in Basrah. The data include electronic database from August 2008 to February 2016. Incidence and prevalence rates are expressed per 100,000. Population of Basrah estimates were derived from official data of The Ministry of Planning of Iraq. RESULTS: There were 2536 people registered at FDEMC. Of them 53.5% were males. The overall mean age at first diagnosis was 15.3±9years and it was significantly higher in males; p value 0.0005. The prevalence rate of T1DM in people 40years old and younger in 2016 was 87 per 100,000. Between 1 January 2012 and 31 December 2016, there were 818 identified new cases of T1DM. Of these, 417 (50%) were males. The average annual incidence rate of T1DM was 7.4 per 100,000 (95% CI, 7.1-8.1). CONCLUSIONS: The incidence of T1DM in Basrah lies in the "intermediate group" according to DIAMOND project group classification. The incidence was increasing over the last three years. The data produced by this study provide a baseline for assessing future changes in the epidemiology of T1DM in Iraq.