A Case Report of Proximal Palm Giant Lipoma Leading to Double Nerve Compression, with a Brief Literature Review.

Lipomas are frequently found as benign neoplasms in humans, mainly in the head, neck, and upper limb regions. Because of their rare occurrence in hands and digits, such cases attract researchers' attention. A case description of a 28-year-old Saudi male patient is presented with a large-size lipoma at the distal forearm, carpal tunnel, and Guyon canal area, with numbness of the central three digits and grip strength weakness of his left hand. The nature of the lesion was a benign, subcutaneous, multilobulated lipoma, removed surgically to prevent malignant transformation and deterioration in neuropathy.

Retraction: Posterior Reversible Encephalopathy Syndrome: A Rare Complication in COVID-19.

[This retracts the article DOI: 10.7759/cureus.18426.].

Retraction: Amyand Hernia With Acute Appendicitis: A Rare Type of Hernia.

[This retracts the article DOI: 10.7759/cureus.18720.].

Spiral Wrap-Around Technique in the Reverse Radial Artery Fasciocutaneous Forearm Flap for Thumb Reconstruction: A Report of An Innovative Technique.

For amputation of the thumb in any age group, microsurgical replantation is the gold standard over other osteoplastic thumb reconstruction methods as it restores the form, function, and cosmesis of the thumb better. In the osteoplastic reconstruction of the thumb, usually, a pedicled groin flap or a reverse radial artery forearm flap is used to provide the soft tissue cover, and each of these flaps has its own set of merits and demerits. The reverse radial artery forearm flap can be used as a fascial or fasciocutaneous flap in an islanded or peninsular form. Using it as a fasciocutaneous forearm flap creates a donor site secondary defect that needs skin grafting, leading to an unsightly permanent cosmetic deformity in the forearm. We report a case of a 25-year-old male patient who underwent post-traumatic near-total thumb amputation following a crush avulsion injury in whom revascularization failed, and we successfully performed osteoplastic thumb reconstruction using the same phalanges as skeletal support and the reverse radial forearm flap as soft tissue cover. We devised a novel but simple spiral wrap-around technique in the reverse pedicled fasciocutaneous flap by rearranging the dimensions, changing the length-to-width ratio to 5:1, and then wrapping this strip of flap spiraling around the bony skeleton with primary closure of the donor site.

Online Health (Mis)Information: The Role of Medical Students.

The public perceive social media as a convenient source of health information. Some physicians might use this to enhance their visibility and market value. In this study, we aimed to assess medical students' awareness of regulations for dispersion of health-related information on social media and physicians' online self-promotional activities. A cross-sectional study was conducted among undergraduate medical students from the 3 largest administrative regions of Saudi Arabia: Central, Western, and Eastern regions. Data was collected between February-July 2020 via online distribution of a self-administered questionnaire. Results showed that: (a) a total of 730 medical students participated; (b) about half of respondents were unsure or unaware of guidelines of both, online posting of medical information and physicians' online self-promotional activities (343/47% and 385/52.7%, respectively); (c) 610 (83.6%) students supported that healthcare providers report accounts sharing unreliable health information. Physicians' online promotional activities, and posting about successful cases, might shift physicians' focus from patient care to becoming more popular online. Care should be taken not to breach essential professional and ethical principles, such as protecting the confidentiality and privacy of patients. Raising awareness among patients and physicians, current and future ones, of the regulations governing these online health related interactions is imperative.

Physicians' Perspective of Telemedicine Regulating Guidelines and Ethical Aspects: A Saudi Experience.

Methods: This was an observational cross-sectional study conducted among physicians working at the College of Medicine, Imam Abdulrahman Bin Faisal University (IAU), and its affiliated academic tertiary hospital, King Fahad Hospital of the University (KFHU), Eastern province-KSA. Data were collected between August 2019 and March 2020 via a structured, pretested, self-administered questionnaire distributed to 220 eligible physicians at KFHU. A final sample of 101 physicians completed our survey. Collected data was coded and analysed using SPSS, and the results presented as frequencies, percentages, and summary statistics. Results: Among our respondents, 62 (61.4%) were males, 46 (45.5%) were in the age group of 35 to 44 years, and 62 (61.3%) were Saudi. Two-thirds of physicians (58 (57.4%)) use smart devices in healthcare delivery, and 51 (50.5%) are satisfied with this use. A minority (21 (20.8%)) knew about telemedicine guidelines, 8 (7.9%) had encountered legal issues related to telemedicine use, and 52 (51.5%) were doubtful about patients' readiness for virtual care. Regarding physicians' awareness of the ethical aspects regulating the use of social media and medical apps in patient care, only 44 (45.3%) were aware of the proper reporting system if they found accounts sharing unreliable information. Nevertheless, the majority (91 (92.9%)) agreed it is essential for healthcare providers to report such accounts. Concerning physicians' awareness of the rules and regulations of online self-promotion, the majority of our respondents were unsure or unaware of such regulations (46 (45.6%) and 18 (17.8%)), respectively. Nonetheless, 67 (66.3%) of the physicians would not pay SM influencers to advertise for them. Conclusion: Two-thirds of our physicians use smart devices in healthcare delivery, with 1 in 13 having encountered related legal issues. Nonetheless, only a minority was aware of telemedicine use regulating guidelines, including physicians' online self-promotion regulations. These results highlight the necessity of targeted physicians' training on telemedicine use related guidelines, thereby ensuring the safety of both patients and healthcare professionals and the optimum utilization of online health-related interactions.

Posterior Reversible Encephalopathy Syndrome: A Rare Complication in COVID-19.

The coronavirus disease 2019 (COVID-19) has a broad spectrum of manifestations. Neurological complications are not uncommon in patients with COVID-19. We report the case of a middle-aged man who presented with a cough and fever. He had a decreased oxygen saturation and required supplementary oxygen therapy. During his stay, he developed an unexplained seizure. Computed tomography of the brain revealed vasogenic edema located posteriorly. Subsequently, magnetic resonance imaging demonstrated subcortical white-matter hyperdensities, in keeping with the diagnosis of posterior reversible encephalopathy syndrome, an exceedingly rare manifestation in COVID-19. This condition should be kept in mind when encountering unexplained neurological manifestations that developed in patients with COVID-19.

Amyand Hernia With Acute Appendicitis: A Rare Type of Hernia.

A hernia is an abnormal protrusion of an organ or tissue from its containing cavity. Inguinal hernia is the most common type of abdominal hernias. The presence of the appendix within the inguinal hernial sac is a rare occurrence. We present the case of a 41-year-old man, with no previous surgical history, who presented to the emergency department with a right-sided painful groin swelling. The swelling was associated with nausea, vomiting, anorexia, and fever. Initial laboratory investigation revealed leukocytosis and elevated C-reactive protein and erythrocyte sedimentation rate. A computed tomography (CT) scan demonstrated the presence of an inflamed appendix with an inguinal hernia. The patient underwent laparoscopic repair of the hernia with appendectomy. The patient tolerated the procedure without any complications. Amyand hernia with acute appendicitis is a very rare surgical condition. Clinicians should have a high index of suspicion for Amyand hernia with appendicitis when they encounter a patient with groin mass with laboratory markers indicating an inflammatory process.