Retraction: Acute Omental Infarction Mimicking Acute Appendicitis.

[This retracts the article DOI: 10.7759/cureus.18053.].

Evaluation of patient satisfaction about the use of regional anesthesia for cesarean section in the Kingdom of Saudi Arabia.

Background and Aim: Regional anesthesia for cesarean delivery has become a popular choice due to with its immediate effect and high frequency of effective blockage. However, patient satisfaction is a critical indicator of anesthetic care quality. This research aimed to determine the mothers' satisfaction levels after they had an elective or emergency cesarean section under regional anesthesia. Materials and Methods: This noninterventional, descriptive, cross-sectional questionnaire-based study included 327 participants to evaluate patients' satisfaction with regional anesthesia for cesarean section in Saudi Arabia. The research employed descriptive analysis and a modified Likert scale to assess maternal satisfaction. The study considered a P value of ≤0.05 to decide statistical significance. Results: The respondents' overall satisfaction with regional anesthesia services were rated high, and 198 (60.6%) were satisfied with recommending regional anesthesia to others, while only 28 (8.6%) disagreed with recommending regional anesthesia to others. Most participants scored higher satisfaction rates in all areas of the study. About 233 (71.7%) reported satisfaction concerning the anesthesia staff for patients' privacy; nearly 226 (69.1%) agreed with the level of professionalism of the anesthesia team. Also, 253 (77.4%) were satisfied with the anesthesia team's politeness. Conclusion: Our study concluded that a higher satisfaction rate is associated with regional anesthesia among participants who underwent cesarean section.

Evaluation of the effectiveness of bioactive glass fillers against Candida albicans adhesion to PMMA denture base materials: An in vitro study.

Background: Dentures with antimicrobial properties are desirable for preventing Candida albicans adhesion. This study was to assess the effectiveness of bioactive glass (BAG) on C. albicans adhesion, surface roughness, and hardness of denture base materials. Methods: Heat-polymerized (HP) and autopolymerized (AP) acrylic resins were used to fabricate 240 disk specimens (120/material, 60/C. albicans, 60/surface roughness and hardness). Specimens were divided into five groups (n = 10) based on the BAG concentration: 0.5, 1.5, 3, 5, and 7.5 wt% of the acrylic powder, with a control group comprised of unmodified specimens. Direct culture method was used to assess C. albicans adhesion. A profilometer and Vickers hardness test were used to measure surface roughness and hardness respectively. Analysis of variance (ANOVA) and post hoc Tukey's test were used for data analysis (α = 0.05). Results: BAG addition significantly decreased the C. albicans count when compared with the control group (P < 0.001) for both HP and AP. Regarding surface roughness, there was no change in the HP acrylic resins (P > 0.05), while the AP acrylic resins exhibited significantly higher surface roughness with BAG addition (P < 0.001). The hardness of the HP and AP acrylic resins were significantly higher with the addition of BAG (P < 0.001). Conclusions: The addition of BAG to HP and AP acrylic resins effectively decreases C. albicans adhesion. The roughness of AP acrylic resins increases with the addition of BAG, while the hardness of both HP and AP acrylic resins increase with the addition of BAG.

Normative Values for Corneal Tomography and Comparison of Both Eyes in Young Saudi Males with 20/20 Vision Using Pentacam-HR Scheimpflug Imaging.

Purpose: Anterior segment evaluation using Scheimpflug imaging with the Pentacam scanner allows the acquisition of a plethora of information. It aids in screening and diagnosing corneal pathologies and determining suitability for keratorefractive procedures. This research has significant benefits in terms of establishing normative tomographic values, which is crucial in countries where Keratoconus (KC) is more prevalent, especially among young age group, along with aiding future research in the field of refractive surgery by providing relevant normative data. Methods: A retrospective review of digital corneal tomography images for a group of medically and ophthalmologically free males aged between 18 and 21 years with 20/20 unaided distant visual acuity was performed. Results: A total of 1272 subjects (2544 eyes) were included. Findings revealed a mean maximal corneal curvature (Kmax) of 42.91 ± 1.40D (range 36.90-47.80D). The mean flat keratometry (K1) was 41.87 ± 1.31D (range 36.00-46.40D). The mean steep keratometry (K2) was 42.66 ± 1.35D (range 36.70-47.60D). The mean corneal astigmatism (CA) was 0.79 ± 0.37D (range 0.00D-2.30D). The mean central corneal thickness (CCT) was 558.53 ± 33.84 µm (range 421-677 µm). The mean thinnest corneal location thickness (TCLT) was 551.64 ± 34.08 µm (range 417-669µm). The mean corneal diameter (CD) and anterior chamber depth (ACD) were 12.13 ± 0.39 mm (range 10.50-13.60 mm) and 3.12 ± 0.29 mm (range 2.08-4.08 mm), respectively. The median differences between both eyes of the same subject were as follows: kmax difference of 0.20D (IQR 0.1-0.4); K1, K2 and CA difference of 0.20D (IQR 0.1-0.3) for all 3 parameters; CCT and TCLT difference of 5.00 µm (IQR 3.0-9.0) and 6.00 µm (IQR 3.0-10.0), respectively; CD difference of 0.10 mm (IQR 0.0-0.1); and ACD difference of 0.04 (IQR 0.02-0.06). Conclusion: We believe our data can aid in establishing normative tomographic values and acceptable differences between both eyes. Our data may also help detect subtle corneal pathology and be useful for researchers and innovators in the field of ophthalmology.

Corneal Endothelial Cell Loss Following Airbag Injury.

Purpose: To report a rare incidence of corneal endothelial cell loss following airbag injury. Observation: A 27-year-old female who sustained a motor vehicle accident with airbag deployment presented with hand motion vision in the left eye. Ocular examination demonstrated corneal abrasion, significant corneal stromal edema with descemet folds, and a central pachymetry of 999 µm. The patient was managed with topical steroids and antibiotic drops. One week later, specular microscopy revealed a central endothelial cell count of 2200/mm2 with pleomorphism, polymegathism, and a decreased central corneal thickness of 569 µm. A repeat of specular microscopy 6 months later showed a decreased central endothelial cell count of 1611/mm2 with recovered visual acuity of 20/30. Conclusion: Corneal endothelial loss is a severe complication of ocular airbag injury. Serial ophthalmic assessment is recommended because endothelial cell loss may continue for some time after the initial impact.

Acute Omental Infarction Mimicking Acute Appendicitis.

Acute abdominal pain is a common cause of visits to the emergency department. Acute appendicitis remains the most common indication for abdominal surgical intervention in the pediatric age group. However, several conditions may present with a clinical picture similar to that of acute appendicitis. We report the case of a 7-year-old girl with a history of right lower quadrant abdominal pain of two days in duration. The pain was associated with vomiting and was exacerbated by movement. Abdominal examination revealed a localized tenderness in the right iliac fossa with guarding, giving the impression of acute appendicitis. After a thorough investigation, the patient was diagnosed as having acute omental infarction given the radiological findings seen in the computed tomography scan. The patient was successfully managed conservatively with analgesics and anti-inflammatory drugs. Physicians should keep a high index of suspicion for this condition when encountering a patient presenting with an acute right lower quadrant abdominal pain. Imaging modalities play a pivotal role in making the diagnosis.

The awareness of water intake and its correlation with BMI among students attending national and international secondary schools in Riyadh, Saudi Arabia.

Dehydration is linked to worse cognitive functions and preference for beverages that are linked to obesity and other health conditions. Saudi Arabia's hot climate can exacerbate these effects and it is important to ensure that children in the region understand the benefits of adequate water intake. To evaluate secondary school student perceptions and practices regarding water intake, investigate how water intake is related to BMI and school performance, and compare international schools to national schools. This cross-sectional study surveyed understanding and practices relating to water intake of national and international secondary school students using a questionnaire based on a random selection of schools and students. One-hundred and sixty-two students from international schools (I) and 157 from national schools (N) responded. Most were aged 16 and 17 years old (I:61.1%, N:76.5%, p = .005). The average BMI of all students was 24.9 ± 6.013 (I:23.6 ± 4.658, N:26.1 ± 6.931, p < 0.001). Students understood beverages do not replace water intake (I:80.2%, N:75.8%, p = .337) and preferred water when thirsty (I:77.8%, N:75.2%, p = .549). However, water consumption was low with more than 50% of students drinking less than 1500 ml a day (I:54.3%, N:70.7%, p = .002). A positive correlation between BMI and water intake was observed only among international school students. Students have inadequate water intake despite understanding the importance of hydration. There are some differences between international school students and national school students that can be attributed to the availability and sources of water, though other factors cannot be excluded.

A Novel Use of Fully Absorbable PhasixTM Mesh for Laparoscopic Inguinal Hernia Repair.

BACKGROUND AND OBJECTIVES: An inguinal hernia is usually repaired with synthetic nonabsorbable mesh, resulting in collagen formation, chronic inflammation, and fibrosis, with significantly reduced hernia recurrence. However, chronic pain may affect the quality of life. Poly-4-hydroxybutyrate (P4HB) mesh was introduced to minimize complications, and starts to degrade in 12-18 months. This study assesses the consequences and results of patients undergoing transabdominal preperitoneal (TAPP) inguinal hernia repair using P4HB mesh (PhasixTM, C.R. Bard Inc., Murray Hill, NJ, USA). METHODS: We performed a pilot study of laparoscopic TAPP repair for inguinal hernias using P4HB mesh in 15 patients (14 male and one female) with an average age of 55.8 y, and an average body mass index of 27.4 kg/m2. We assessed the recurrence rate and patients' chronic pain for 30 months, with institutional review board approval (E-19-3735). The study was conducted from January 2016 to July 2017 in Medical City, King Saud University. We measured postoperative pain, reactions, mesh sensation, discomfort, and recurrence. RESULTS: In 15 patients, we encountered no recurrence or mesh sensation, except in one patient, who experienced mild chronic inguinal pain for one year, without activity restrictions. CONCLUSION: Laparoscopic TAPP inguinal hernia repair using P4HB mesh is safe for combined, direct (medial), and indirect (lateral) inguinal hernia, with no recurrence. P4HB absorbable mesh caused less chronic pain and discomfort. Longer follow-up, more patients and 15 patients repaired using synthetic mesh are necessary to assess the utility of P4HB for inguinal hernia repair globally.

Awareness of risk factors and preventive measures for neural tube defects: Perception towards pregnancy termination in the Saudi population.

BACKGROUND: Neural tube defects (NTDs) are among the most common congenital anomalies worldwide with an incidence of 300,000/year. Spina bifida, which is the most prevalent NTD, has an incidence of 1.2/1000 live births in Saudi Arabia. Our study aimed to assess the awareness of NTDs and the implementation of preventative measures against them. In addition, to gauge public opinion regarding abortion following early diagnosis of NTDs. METHODS: This was a cross-sectional study in which questionnaires were distributed using non-probability convenient sampling technique and data was collected in a face-to-face interview. Subjects were approached in an outpatient clinic and in a shopping mall in Jeddah city, Saudi Arabia. RESULTS: Out of 353 subjects, 35.7% were males, 64.3% females (33% pregnant), and the median age was 34 (IQR = 14) years. Of subjects, 66.3% were not aware of NTDs, and regarding folic acid 54% believed that it helps in preventing NTDs, and only 25% agreed on starting it before pregnancy. However, only 19% agreed on all points, which even dropped to 9% after considering planned pregnancies. Gender differences were extremely significant (p-value <0.001) as females were more aware. Interestingly, 62% would abort in early-diagnosed NTD cases. Of pregnant women, only 20% started taking folic acid before pregnancy. CONCLUSIONS: The data shows that the majority of the study's population are in favor of terminating the pregnancy in justified NTD cases. There is a need for increasing public awareness, especially to males, and should be provided through all channels of knowledge.

Bilateral posterior crystalline lens dislocations in an otherwise healthy child.

Introduction: Ectopia lentis is defined as a crystalline lens displacement, either partially or completely, due to zonular abnormalities. It can be a result of trauma, hereditary ocular disease, or part of systemic diseases, like Marfan syndrome and homocystinuria. Case description: We report a case of a medically free 16-year-old girl, who was referred to our hospital complaining of poor vision and a squint in both eyes since childhood. Her history included a traffic accident when she was one-year-old. She was previously diagnosed with alternating esotropia, which was treated with glasses, alternating patching, and bilateral Botox injections. On examination, she had a visual acuity of 6/7.5 with correction in the right eye and 6/6 with correction in the left eye. She had an esotropia of 60 prism diopters, which was partially corrected to 40 prism diopters for near and distance vision. Fundus examination showed myopic changes in each eye and dislocated lenses in the posterior pole at 6 o'clock. Our case was stable, so we used conservative management with contact lenses. Conclusion: Bilateral posterior lens dislocation is very rare. A proper examination is important and early diagnosis can prevent serious complications, such as retinal detachment or pupillary block glaucoma.