Pattern of Cleft Lip and Palate Clefts at a Tertiary Care Hospital in Saudi Arabia.

BACKGROUND: Clefts of the lip and palate (CL/P) and cleft palate (CP) are the most common craniofacial congenital anomalies. Clefts are classified as syndromic and nonsyndromic. Nonsyndromic clefts have no known genetic causes. OBJECTIVES: This study combines prospective and retrospective studies to review the patterns of CL/P and CP and associated syndromes and conditions in patients registered for CL/P surgery at a tertiary care pediatric center in our tertiary care hospital in Saudi Arabia. METHODS: It included patient data from May 2015 through April 2023. Patient record forms and SPSS (IBM version 20.0) were used to collect and analyze data. A significance level of 5% was used, with p ≤ 0.05 considered statistically significant. RESULTS: Of the 319 patients who met our inclusion criteria, 175 were male. Of the total, 99 had a left unilateral isolated cleft lip, 61 had a right unilateral isolated cleft lip, 69 had a bilateral cleft lip, and 90 had an isolated CP. Of the total, 140 had CL/P. Around 242 were nonsyndromic. The Chi-square test revealed a significant association between the prevalence of isolated CP and CLP and gender. The prevalence of left unilateral isolated cleft lip and bilateral and isolated CP was significantly associated with syndromic and nonsyndromic cases. CONCLUSION: Males are more likely to be affected by orofacial clefts, which is consistent with the global trend. Isolated CP was the most common orofacial cleft. Within the sample, syndromes' association with orofacial clefts was significantly weaker than that of isolated and bilateral clefts.

An unusual presentation of pacifier thumb duplication with VACTERL association: Case report and review of literature.

INTRODUCTION AND IMPORTANCE: Polydactyly of the hand is a common anomaly among pediatrics, which can present in conjugation with other syndromes or on its own. Various types can be seen, ranging from the involvement of skin only to a completely formed digit. We report the first case of pacifier type thumb duplication presenting with VACTERL association. Herein, we also summarize the existing literature of the distinctive features and management of pacifier polydactyly. CASE PRESENTATION: A premature male infant with intrauterine growth restriction due to maternal type II diabetes was referred for a soft tissue attachment to the left hand. The infant showed VACTERL association signs, including a single kidney, small atrial septal defect, and ventricular septal defect. Examination revealed preaxial polydactyly with a cystic swelling connected to the palm. CLINICAL DISCUSSION: Preaxial polydactyly is the second most common congenital hand anomaly, and its pathology is thought to involve the disruption of apoptosis during embryonic development. Pacifier-type polydactyly is a unique variation characterized by severe edema of the soft tissue digit, believed to be caused by physical damage in utero. The case presented did not require surgical intervention as the duplicated thumb underwent spontaneous autoamputation as opposed to other cases in the literature. CONCLUSION: This is the first reported case of pacifier-type thumb duplication in a patient with VACTERL association. The presentation of this condition adds to the existing body of literature on VACTERL association. Surgical removal is the treatment of choice for pacifier polydactyly, but spontaneous resolution can occur.

Bilateral greater arc Perilunate injury: A case report.

INTRODUCTION: Perilunate injuries are rare and are frequently missed during initial examinations. These injuries are missed upon primary evaluation in approximately 25 % of cases, which can result in catastrophic outcomes. Early diagnosis is essential to avoid chronic wrist pain and limited range of motion. IMPORTANCE: We reported rare finding & our approach in management which represents a significant contribution to the field and we believe it would be of great interest to your readers. CASE PRESENTATION: We report the case of a 25-year-old man who presented with a bilateral Perilunate fracture-dislocation injury. He underwent bilateral definitive open reduction using a dorsal approach. Headless screws were used for the internal fixation of the bilateral scaphoids, and Kirschner wires were used to secure the left distal radius and for bilateral intercarpal fixation. Aggressive physiotherapy was initiated 8 weeks after the open reduction. After 1 year, the patient showed a satisfactory outcome with an excellent bilateral Mayo wrist score. CLINICAL DISCUSSION: Perilunate dislocations and fracture-dislocations are considered orthopedic emergencies with close reduction being the initial treatment of choice. Early diagnosis and treatment of such injuries are essential to achieve optimal outcomes, which may be achieved with open reduction and internal fixation through a combined volar and dorsal approach. CONCLUSION: Perilunate injuries should be considered as one of the differential diagnoses in wrist injuries. All Perilunate injuries should undergo emergency close reduction, typically followed by open reduction and reconstruction.

Foot drop in patients with extensive 3rd and 4th degree burn, case series study.

Burn injuries can lead to a variety of short- and long-term complications, peripheral neuropathy has been known as the most common neuromuscular complication. 29% of the burn-related peripheral neuropathy has been found in both the upper and lower limbs. Moreover, literature failed to find the causative factors for specific presentations like foot drop in burn patients. This study reports a series of 10 patients who developed foot drop after burn injury and required occupational therapy follow up at King Abdulaziz Medical City in Riyadh. To assess the effect of different risk factors in the outcome of foot drop. 10 case records were reviewed, 70% among the patients were men and 30% were women with a mean age of 39 and a mean BMI of 28. Most of the patients 70% were burned by flame. The mean Total Body Surface Area (TBSA) was 62%. 4 of the cases (40%) were having comorbidities. There was a significant association between death and high TBSA. All cases were managed without surgical intervention, physiotherapy started immediately after the diagnosis of foot drop. Seventy percent of our patients improved while 3 cases have expired. Higher TBSA showed to be significantly associated with death.

Acceptance of Young Saudi Women to Undergo Cosmetic Surgery and Factors Influencing Their Decision.

Background: The cosmetic procedure is a treatment modality for improving the appearance of a person, and it may involve either surgical or nonsurgical interventions. The number of women who undergo cosmetic surgery in Saudi Arabia has increased dramatically. In fact, the reasons for the increase in the number of cosmetic procedures include the growth impact of social media and the pursuit of perfection. The study aimed to determine the level of acceptance of cosmetic surgery among young Saudi women, and the factors influencing their decisions. Methods: This cross-sectional study was conducted among literate Saudi women during March 2023 to April 2023. A self-reported questionnaire was used, which investigated the demographics, acceptance, and information about cosmetic surgery and social media. Results: A total of 1685 female participants were included in this study: 62.6% were students, 73.6% were single, and 65.8% were aged 18-23 years. The levels of acceptance were high among 38.9% of the participants, and the level of acceptance was significantly affected by age (P = 0.0001), social status (P = 0.0001), work (P = 0.0001), education (P = 0.001), and income (P = 0.001). Up to 86.1% of the participants had not undergone cosmetic surgery, and the reasons for undergoing surgery commonly included dissatisfaction with appearance and social media. Conclusions: The acceptance of cosmetic surgery in this study was low, and it was affected by several demographics of the participants. For instance, social media played a crucial role in driving women to undergo such procedures.