Perceptions of testicular cancer and self-examination in the general population of Saudi Arabia.

Background: Although testicular cancer (TC) is the most common malignancy in males between the ages of 18 and 50 years, little effort has been made to increase public awareness about TC and testicular self-examinations (TSEs). Therefore, the aim of this study was to assess the level of awareness of TC and TSEs in the Saudi population. Materials and Methods: This study was conducted using a structured questionnaire distributed online through social media platforms. The questionnaire consisted of 11 questions related to TC and TSE. All relevant data were moved into an Excel sheet, and data analyses were carried out using SPSS. Results: A total of 849 responses were received. The proportion of respondents who knew any information about TC was 26.5%, with media or the Internet being the most common sources of information (16.3%). In addition, 5.5% of respondents knew how to perform a TSE, although only 4% actually performed TSEs. The patient age group was an independent significant predictor of this knowledge, with a P = 0.031. Conclusions: These findings suggest that there is a low level of public awareness and knowledge of TC and TSE in Saudi Arabia, and further efforts should be focused on raising public awareness.

Mixed primary and secondary vaginal calculi: a case report.

Vaginal calculi are classified according to the pathogenesis of calculus formation. Primary and secondary vaginal calculi. In this article, we present an interesting case that we believe to be a mixed primary and secondary vaginal calculi in which both originated as a result of a vesicovaginal fistula (VVF) and stitches found in the vagina. Although vaginal calculi are a rare disease, a high index of suspicion is needed, especially in patients with a history of gynecological procedures. Since the high recurrence rate of VVF along with its complications, more frequent follow-up and physical examination are required to avoid the recurrence of the disease.

Leiomyosarcoma Invading the Vena Cava: A Case Report.

Leiomyosarcoma is an aggressive soft tissue tumor originating from smooth muscle cells typically of the uterus, gastrointestinal, or genitourinary system. The most common site of leiomyosarcoma of soft tissue is the retroperitoneum, accounting for 50% of all cases. The majority of patients are asymptomatic, which may be due to the large retroperitoneal cavity. However, when symptoms do occur, they are vague in nature. The most common growth pattern is an entirely extravascular mass. We are presenting an interesting case of a 65-year-old lady, who was referred to our hospital as a case of large left retroperitoneal mass with left renal vein thrombosis. She was biopsied and diagnosed with leiomyosarcoma with invasion into descending colon and the left renal vein, which led to renal vein thrombus. In the last few decades, there is a lack of studies about leiomyosarcoma invading the renal vein and Inferior Vena Cava (IVC). As far as we know, the leiomyosarcoma of a major blood vessel is extremely rare. Since leiomyosarcoma often has a late presentation with the advanced stage when detected, a high index of suspicion is needed to be detected early and avoid such a complication.

Characteristics and Types of Urolithiasis in the Eastern Region of Saudi Arabia: A Single-Center Retrospective Study.

Introduction Urolithiasis is one of the most common conditions encountered in clinical practice with the prevalence increasing globally in the last few decades. Urolithiasis has been found to be more common in areas with a hot climate, such as Saudi Arabia. The aim of this study was to determine the characteristics and the types of urolithiasis most frequently found in the Eastern Region of Saudi Arabia. Methods This was a single-center retrospective cohort study based on data extracted from an electronic hospital information system (BESTCare) of all patients diagnosed with urolithiasis at King Abdulaziz Hospital, a tertiary care center in Saudi Arabia's Eastern Region. From January 2013 to December 2016, all adult patients aged 18 and up who presented with urinary calculi (renal and ureter) were included in the study. Results A total of 235 patients were reviewed, with a mean age of 48.52 years. Renal calculi were more prevalent in males (74.5%). Calcium oxalate was the predominant type (76%), followed by uric acid calculi (18%) and cystine calculi (4.8%). A small proportion (1.2%) was calcium phosphate calculi. The most frequently associated comorbidity was hypertension (17.9%). The majority (78.5%) had a stone removal through a ureteroscopy and 8.2% by percutaneous nephrolithotomy (PCNL). The mean stone size was 12.2 ± 9.91 mm, with a mean stone Hounsfield unit (HU) of 789.9. The mean urinary PH at stone incident was 6.77, and the mean creatinine level was 92.4mmol. Conclusion This study showed that males were more affected by urolithiasis, compared to females in the Eastern Region. Furthermore, calcium oxalate was the predominant type. These findings are consistent with the literature and they highlighted the necessity for further studies in this area, to provide insight into the pathophysiology and incidence of renal calculi for improving patient care.

Recurrent urethral stricture with dual lumen managed by a single stage dorsal Onlay buccal mucosal graft Urethroplasty: a case report.

Urethral stricture is defined as any abnormal narrowing throughout the entire length of the male urethra. Anterior urethral stricture is the most common site which accounts for more than 90% of cases in developed countries. One of the possible long-term outcomes of urethral stricture treatment is stricture recurrence. Refractory urethral strictures to initial management present surgical challenges to the reconstructive surgeon. It has been reported in the literature that buccal mucosal grafts in complex anterior urethral strictures have lately become a well-established management modality for bulbar and penile urethral strictures. Here, we are presenting an interesting case of a patient with a dual lumen urethra due to recurrent urethral stricture.

Complications of Veress Needle Versus Open Technique in Abdominal Surgeries.

Introduction In any laparoscopic procedure, the first and most important step is abdominal entry. This is followed by the creation of pneumoperitoneum, which is essential for lifting the abdominal wall off of the internal organs and visualizing the entered space. However, the entry and establishment of pneumoperitoneum are not without risks and complications, the most serious of which include vascular injuries and bowel perforations in all the different techniques used. The most commonly used techniques for abdominal entry are the closed (Veress) and open (Hasson) techniques, the choice of which varies according to the surgeon's preference and other regional and local factors. Aim To compare the outcomes between the open technique and the Veress needle for accessing the peritoneum during laparoscopic surgery. Methodology This was a retrospective cohort study that aimed to compare the outcomes between the Veress needle and the open technique for entering the peritoneum in laparoscopic surgeries. A chart review was used as an instrument to collect data. The study was conducted in King Abdul-Aziz Medical City, Riyadh, Saudi Arabia. All patients who underwent abdominal laparoscopic surgery from 2006 to 2016 were included. Results We analyzed 365 patients who underwent laparoscopic abdominal surgery. The mean age of the patients was 32.6 years. The most common postoperative complication occurring during the admission period was abdominal pain (40.5%). Postoperative complications during admission were significantly associated with the type of needle used (χ2=10.641; p=0.001). Conclusion The type of technique used for entry and peritoneal access was associated with the occurrence of postoperative complications in abdominal surgeries. Thus, the choice of open or Veress technique for peritoneal access should be individualized based on factors such as patient sex, clinical diagnosis, and most importantly, the surgeons' experience and preference.

Predictors and clinical outcomes of silent hypoxia in COVID-19 patients, a single-center retrospective cohort study.

BACKGROUND: Patients with COVID-19 usually present with fever and respiratory symptoms such as cough, sputum production, and dyspnea. However, they may suffer from severe hypoxemia without a clinical correlation with the respiratory symptoms, also known as silent or apathetic hypoxia. The aim of the study was to assess the predictors and clinical outcomes of COVID-19 patients without dyspnea. METHODS: A single-center retrospective cohort study, based on data extracted from the electronic hospital information system, with COVID-19 patients over a 10-month period in Riyadh, Saudi Arabia. RESULTS: Of the COVID-19 patients presenting at the Emergency Department with a SpO2 < 90%, 13% had silent hypoxia. The majority of the patients required BiPAP, 34% were intubated and 60% were admitted to an intensive care unit. There was no association between dyspnea and gender, age group, body mass index, or comorbidity. Cough, fever, and chronic cardiac diseases were predictive for dyspnea in a regression analysis. There was no difference in the clinical outcome between patients with silent dyspnea or dyspnea. Age and obesity were significantly associated with a decrease in survival, and an increase in the initial SpO2 increased survival. CONCLUSION: Patients with cardiac disease are more likely to present with silent hypoxia. The SpO2 saturation in COVID-19 may be an independent predictor of survival. Silent hypoxia in COVID-19 patients does not appear to have an association with increase in mortality.