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Intussusception in adults is a rare condition. Most frequently, intussusception involves the small intestine and, very rarely, the large intestine. In this report, we present the case of a 79-year-old male who was admitted with symptoms and signs of bowel obstruction due to an incarcerated incisional hernia (a tender irreducible incisional hernia associated with nausea and vomiting). His CT scan confirmed intussusception in his incisional hernia, showing the target sign. An emergency laparotomy, small bowel resection, and anastomosis were done. The histopathology report revealed the cause of intussusception to be a polypoid small bowel B cell lymphoma. It is necessary to excise the affected bowel segment in order to treat adult intussusception because it is commonly associated with malignant organic lesions. Computed tomography is the most sensitive imaging modality for intussusception; thus, we must consider a low threshold for a scan for patients presenting with abdominal pain.
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INTRODUCTION: Insomnia is a common sleep disorder that can have negative impacts on daily functioning and health. However, little is known about the prevalence of insomnia and its associated factors in the general population of Saudi Arabia. This cross-sectional study aimed to investigate the prevalence of insomnia and its associated factors among adults in Saudi Arabia. METHODS: A self-administered electronic questionnaire was distributed to 4818 participants from all 13 regions of Saudi Arabia. The eight-item Sleep Condition Indicator (SCI) based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria was used to assess the prevalence of insomnia. RESULTS: The results showed that 37.6% of participants met all the DSM-5 clinical criteria for insomnia in the past month. The prevalence was higher among females, divorced or widowed individuals, students, unemployed individuals, those living with friends or family, those reporting severe work stress, and those using mobile devices before sleeping. On the other hand, the prevalence was lower among males, married individuals, morning and evening employees, those who practice physical exercise, and those with good health status. CONCLUSION: This study found the prevalence of insomnia to be 37.6% in the general population of Saudi Arabia, which is considerably high. The risk factors associated with insomnia in the Saudi population were found to be age, sex, work stress, and using mobile devices before sleeping, while protective factors included being employed, practicing physical exercise, and having good health status. Further research is needed to explore the impact of insomnia on the quality of life and productivity of individuals in Saudi Arabia.
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PURPOSE: To demonstrate a modified technique of fully automated direct perfluorocarbon liquid (PFCL)-silicone oil (SO) exchange. MATERIALS AND METHODS: This technique is indicated for cases that require direct PFCL-SO exchange as in giant retinal tear or large retinectomies to avoid retinal slippage. Pars plana vitrectomy (PPV) is carried out in standard fashion; then the dual active injection/extrusion mode is activated in the vitrectomy machine. The machine parameters are set at approximately 30-40 psi for SO injection and 150-250 mmHg for active PFCL aspiration. In this method, both the SO injection and the PFCL extrusion are simultaneously controlled by the foot pedal. RESULTS: We used this technique for a total of 24 cases: 6 cases of giant retinal tears and 18 retinectomies. We did not encounter any complications related to significant IOP spike during surgery or complete removal of the PFCL. CONCLUSION: This automated technique for direct PFCL-SO exchange maintains a controlled balance between SO injection and PFCL aspiration, that mitigates the risk of intraoperative IOP spikes. It is safe, quick, and can be performed without the need of an assistant or extra chandelier light or high-pressure viscous tubing.