Psoriasis and Metabolic Disorders: A Comprehensive Meta-Analysis of Million Adults Worldwide.

Psoriasis, a chronic inflammatory skin condition, and metabolic disorders, such as obesity, diabetes, and dyslipidemia, have long been recognized as distinct clinical entities. However, emerging evidence suggests a complex bidirectional relationship between these seemingly unrelated conditions. Psoriasis is characterized by an accelerated skin cell turnover, resulting in the formation of erythematous plaques with silvery scales. Metabolic disorders, on the other hand, encompass a range of conditions associated with abnormal metabolic processes, including insulin resistance, dyslipidemia, and chronic low-grade inflammation. It is intriguing to note that psoriasis is commonly associated with several metabolic comorbidities, with a higher prevalence observed in individuals with obesity, type 2 diabetes, and metabolic syndrome. Mounting evidence suggests that chronic inflammation plays a pivotal role in both psoriasis and metabolic disorders. Shared inflammatory mediators, such as tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and C-reactive protein (CRP), have been implicated in the pathogenesis of both conditions. Moreover, adipose tissue-derived hormones, known as adipokines, including leptin and adiponectin, exert modulatory effects on immune responses and may contribute to the link between psoriasis and metabolic abnormalities. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a comprehensive search across databases identified 16 eligible studies (1975-2023), totaling 6,623,379 participants. Inclusion criteria encompassed peer-reviewed observational studies focusing on adults and specified outcomes. Data extraction, quality assessment (Newcastle-Ottawa scale (NOS)), meta-analyses, and heterogeneity evaluations were conducted using rigorous methods. Psoriasis displayed a significant association with diabetes mellitus (DM, 18% increased incidence), hypertension (HTN, 35%), hyperlipidemia (19%), and obesity (25%). Substantial heterogeneity was observed in meta-analyses, particularly for DM. The NOS indicated varied study quality, with some studies categorized as a high or moderate risk of bias.

Clinical outcomes of percutaneous screw fixation of acetabular fracture: A minimally invasive procedure.

Objective: Open reduction with internal fixation is the surgical intervention of choice for acetabular fractures (AFs). Percutaneous screw fixation for AFs is a new procedure that is desirable because of the complex anatomy of the pelvis. In this study, we aimed to assess the functional outcomes, mobility, healing, and distal neurovascular abnormalities in patients who underwent percutaneous retrograde screw fixation. Methods: Our study included 36 patients with AFs treated with percutaneous screw fixation between January 2016 and June 2021. There were 18 cases with anterior column AF, 7 cases with transverse AF, and 11 cases with associated AF, 6 of which had a T-shaped AF. Frequencies and percentages were used to describe characteristics and clinical outcomes. Mean and standard deviation were used for continuous variables. SPSS version 23 (IBM Corporation, Armonk, NY, USA) was used for statistical analysis. Results: The average time to regain full mobility with full weight bearing was 12.9 ± 5.4 weeks, and approximately 11.1 ± 2.8 weeks was required for patients to be pain-free with satisfactory fracture healing. Only a minority (8.3%) of patients had abnormalities affecting the distal neurovascular system, and 11.1% experienced sexual dysfunction. Pain severity was assessed with a visual analogue scale. The average pain severity on the first and third post-operative days was 4 ± 2.4 and 3.8 ± 2.6, respectively. However, the average pain intensity before discharge was 1.7 ± 2.6. Conclusion: Percutaneous screw fixation is the most efficient surgical choice for most pelvic/AFs.

Myxoinflammatory Fibroblastic Sarcoma of the Hand.

Myxoinflammatory fibroblastic sarcoma is an ultra-rare tumor type with a prevalence of fewer than two per 100,000 people. The tumor poses a challenge because it can be misdiagnosed as a benign lesion in clinical and radiological investigations, causing serious morbidity in patients. We present the case of a 33-year-old patient who presented with painless hand swelling that was misdiagnosed as lymphaticovenous malformation based on magnetic resonance imaging. The patient underwent surgical excision, and myxoinflammatory fibroblastic sarcoma was diagnosed postoperatively. All surgical interventions failed to achieve negative margin. A decision to start radiotherapy was made, and tissue convergence was done temporally using acellular dermal matrix and split-thickness skin graft. On patient follow-up, the graft had taken well, and the patient was undergoing radiotherapy sessions with a plan for permanent hand reconstruction after negative margins are achieved. Based on this case report, we identified that magnetic resonance imaging is not yet a reliable method to diagnose myxoinflammatory fibroblastic sarcoma. Therefore, implementing a multidisciplinary team approach, a preoperative core needle biopsy, planned surgical intervention, and early involvement of radiotherapy is recommended to minimize morbidity. We strongly urge establishing a sarcoma specialized treatment center in the region to limit patient morbidity.

Non-Accidental Injuries in Pediatric Primary Care: A Systematic Literature Review of Objective Assessment Tools and Trends in Gulf Cooperation Council Region.

Nonaccidental injuries (NAI) in pediatric primary care in the Gulf Cooperation Council (GCC) region refer to intentional injuries inflicted on children, usually by a caregiver or a family member. The region has seen an increase in nonaccidental injuries in recent years, and healthcare providers have a crucial role in identifying and managing the cases. The aim of research on nonaccidental injuries in pediatric primary care in the GCC region is to identify objective assessment tools and evaluate trends in the region. PubMed, Google Scholar, and EMBASE databases were searched using search string keywords. The search was conducted on 7th February 2023. The keywords included in the search included the search terms: nonaccidental injuries, pediatric, and GCC. All the studies were published between 1990 and 2023. The articles that passed the eligibility criteria were read fully to examine whether they would be relevant to the current systematic literature review. An initial search identified 3059 studies (Google Scholar = 6, EMBASE =12, PubMed = 4732). After the deletion of similar articles, only 3613 articles were left for further screening. The abstracts and titles of the left articles were scanned and screened to decide whether they were included in this systematic review. After deletion, 16 papers were inspected and read fully based on predefined eligibility criteria. Eventually, 11 papers were recognized and identified that passed the eligibility criteria of this systematic review. The studies reviewed in this analysis highlight the significant problem of child abuse in the GCC region, particularly neglect as the most common form of abuse. The studies also suggest that parents are the most frequent perpetrators of abuse. The need for policies and interventions to prevent child abuse and support victims is paramount.

A Rare Case of Painful Hand Swelling.

Many conditions are known to cause chronic wrist pain, one of which is accessory muscles which can be easily overlooked as the cause of pain. Here we present a case of chronic wrist pain in a 33-year-old male who presented with painful dorsal unilateral right-hand swelling associated with increased activity. This patient was referred to the radiology department and was found to have an accessory muscle along the dorsal aspect of the wrist consistent with the extensor digitorum brevis manus muscle. The report includes the clinical presentation, radiologic findings, and management.