Outcome of complicated osteoarticular brucellosis in a tertiary care center in Saudi Arabia.

OBJECTIVE: To evaluate the outcome of complicated osteoarticular brucellosis. METHODS: A retrospective chart review was conducted at King Abdulaziz Medical City (KAMC), in Riyadh, Saudi Arabia. All patients aged more than 14 who have been diagnosed with complicated brucellosis with osteoarticular disease between July 2016 and December 2022 were included. RESULTS: A total of 82 (10.7%) patients met the criteria, with a male predominance of 66 (80.4%), and their mean age was 56.4 ± 19.3 years. A positive blood culture was found in 33 (40.2%). The most common clinical presentation was fever (57.3%). All patients received a doxycycline-based regimen except one. 62 (75.60%) patients were treated with three or more medication regimens, while 20 (24.40%) patients received two drug regimens. The mean duration of therapy was 94.2 days for two-drug therapy and 116.4 days for three-drug therapy. A total of 78 out of 82 (95.1%) cases were cured at the end of treatment. Unfavorable outcomes were documented in four cases (two relapses and two treatment failures). Neither using three drugs regimen nor longer duration of therapy was associated with better outcome. CONCLUSIONS: Unfavorable outcomes have been noticed to be minimal in our cohort of patients with osteoarticular brucellosis, treated mainly with a three-drug regimen and a longer duration of therapy.

Disseminated Intra-abdominal Actinomycosis Mimicking Colorectal Carcinoma With Diffuse Intra-abdominal Carcinomatosis: A Case Report.

Actinomycosis is a rare opportunistic bacterial infection. It most commonly affects the cervicofacial area and is less common in the gastrointestinal area. Because of the ambiguous clinical pictures, there is a low preoperative diagnosis rate and a high rate of misdiagnoses. In this case report, we have an unusual presentation of disseminated abdominal actinomycosis in a diabetic male patient with no previous history of surgery or trauma. He presented with abdominal pain for two years. Abdominal imaging showed rectal wall thickening with adhesion and attachment to the bladder, and small bowel with omental and peritoneal deposits, mimicking colorectal cancer with abdominal carcinomatosis. Histopathological examination, however, revealed actinomyces infection with no evidence of malignancy. In such cases, the recovery rate with antibiotic therapy is very high in conjunction with surgical resection.

Complex fracture pattern involving ipsilateral intertrochanteric fracture associated with ipsilateral posterior hip dislocation and posterior acetabular wall fracture: A rare combination of injuries.

Introduction: High-energy trauma has increased the incidence of traumatic hip dislocation. In most cases, dislocation of the hip is associated with fractures of the acetabulum. However, its association with ipsilateral intertrochanteric fracture is very rare. Case Report: We present a case of a 54-year-old male who had uncommon fracture pattern involving ipsilateral intertrochanteric femur fracture associated with ipsilateral posterior fracture dislocation of hip following a road traffic accident. He underwent closed reduction of the dislocation followed by an open reduction and internal fixation of the fractures. Through Kocher-Langenbeck approach, the intertrochanteric fracture was reduced and fixed with dynamic hip screw and derotation anti-rotation screw. Acetabulum fractures then fixed after reduction with two reconstruction plates. Conclusion: Early recognition and orthopedic intervention constitute the cornerstones of satisfactory outcomes in cases with such complex injuries.

Attitudes towards depression among non-psychiatric physicians in four tertiary centres in Riyadh.

Depression is a common mental illness that has a profound impact on an estimated number of 300 million people worldwide. Depression is stigmatised in communities and even physicians, especially, non-psychiatric physicians, which affects depressed patients' care. This study aims to investigate non-psychiatric physicians' attitudes towards depression in Riyadh, Saudi Arabia. The study surveyed 380 participants using Revised Depression Attitude Questionnaire. Non-psychiatric physicians in Riyadh are optimistic and have a positive perspective towards depression. Yet, the majority preferred dealing with physical rather than mental illness. Understanding the attitudes of medical practitioners is important to shape service delivery and assess training needs.