Exploring Community Perspectives on Functional Paediatric Habitual Constipation.

(1) Background: Functional habitual constipation (FC) in children is a common gastrointestinal problem. This study aimed to explore the local community's view on this problem, emphasising the challenges that parents face in managing the condition and its impact on the child's quality of life. (2) Methods: A prospective, cross-sectional, community-based study was conducted between March and July 2023. The survey received 933 responses. The target population was adults over 18 years of age living in the Eastern Province of Saudi Arabia. An electronically distributed questionnaire was designed in the Arabic language. (3) Results: The mean knowledge scores were significantly higher in females than males, with t (931) = -2.701 and p = 0.007. The Bonferroni post hoc test results indicated that participants between 20 and 29 years exhibited significantly higher levels of knowledge scores compared to those between 30 and 39 years. Furthermore, the results revealed that those with three or more children had significantly higher knowledge scores compared to those with only one child. (4) Conclusions: This study demonstrated that parents in the local community have a good perceived knowledge of FC, but it needs to be linked with practice. They tended to report high levels of perception and demonstrated better practices. These results emphasise the importance of exploring the local community's view on constipation among children.

Parents' Perception on Post-tonsillectomy Hemorrhage: A Local Survey.

INTRODUCTION: Tonsillectomy (often combined with adenoidectomy) is one of the oldest and most common surgical procedures performed in otolaryngology. Post-operative complications following tonsillectomy are generally rare and include post-tonsillectomy hemorrhage, dehydration, velopharyngeal insufficiency, and others. Parents play a crucial role in the care and recovery of their children after tonsillectomy. Their perception and understanding of post-tonsillectomy hemorrhage are essential in managing and addressing this potential complication. AIM: The purpose of this study is to assess parents' perception of post-tonsillectomy hemorrhage and factors that would lead to its development. METHODS: A descriptive cross-sectional study was conducted targeting parents of children who had undergone surgical tonsillectomy. Data were collected using a pre-structured online questionnaire, biographical data, tonsillectomy data, child medical and drug history, healthcare staff role, and post-surgical complications and bleeding. RESULTS: A total of 847 parents completed the study questionnaire, and 431 (50.9%) were fathers. As for education, 164 (19.4%) had a university level of education, and 279 (32.9%) had a post-graduate degree. As for child gender, 445 (52.5%) were males, 232 (27.4%) had undergone the surgery in the first five years of their age, 208 (24.6%) at the age of 6-10 years, and 221 (26.1%) undergone the surgery at the age of 16-18 years. The most reported post-surgical complications included headaches and nausea (52.4%), swelling of the roof of the mouth (51.8%), and infection (48.9%). Primary or secondary post-tonsillectomy hemorrhage was reported among 47 (5.5%) of the children, which was during surgery among 12 (25.5%), within 24 hours after surgery among 14 (29.8%), and after 24 hours of surgery among 21 (44.7%). CONCLUSION: The current study revealed a high rate of tonsillectomy-associated bleeding with a shortage regarding the role of healthcare staff in child pre-surgical assessment and also in parents' education regarding expected complications.

Parental perception of nocturnal enuresis in a local region of Saudi Arabia.

Nocturnal enuresis (NE) has been associated with neurodevelopmental disorders such as autism spectrum disorder, attention deficit or hyperactivity disorder, and intellectual disability. This study aimed to assess parents' perception of NE in children in the eastern region of Saudi Arabia. We conducted a cross-sectional study from May to August 2023, including parents aged ≥18 years living in the area. We administered an online questionnaire to assess parents' knowledge and attitudes toward NE and its treatment. A total of 616 parents completed the questionnaire, 71.4% of which were women, 35% were aged between 25 and 35 years, 75% were married, 65% had a university degree, and 49% had three or more children. In total, 70% demonstrated a good overall knowledge about NE and its treatment, and nearly 60% had a positive attitude toward the condition. Univariate and multivariate ordinal logistic regression analyses revealed that female sex, a higher level of education, and having more than one child were associated with a higher score regarding attitude toward treatment. The level of education and the number of children were predictors of knowledge and a positive attitude toward NE in children.

Knowledge, Attitude, and Behavior of Medical Students with Regard to Concussions: A Cross-Sectional Study.

BACKGROUND: Concussions, categorized as mild traumatic brain injuries, result from traumatic events and present a significant concern within the field of traumatic brain injuries. Understanding the multifaceted pathophysiology of concussions, their diverse symptomatology, and their appropriate management strategies is crucial for healthcare professionals. This study explores the knowledge, attitudes, and behaviors of medical students at King Faisal University in the Eastern Province of Saudi Arabia regarding concussions. METHODS: A cross-sectional study design was employed to assess a diverse group of medical students at King Faisal University in the Eastern Province of Saudi Arabia. Participants were surveyed using a questionnaire covering socio-demographic information, knowledge assessment, attitude assessment, and behavior assessment. RESULTS: Of the 315 participants, 68.3% demonstrated good knowledge about concussions. Participants generally recognized concussions as a type of traumatic brain injury (68.9%) and believed it was necessary to report concussion symptoms to a doctor (80.3%). However, certain misconceptions existed, such as the belief that all patients with concussion should rest for seven days (31.7%). Participants primarily obtained information from teachers (100%) and the internet and social media (81.6%). CONCLUSION: While medical students at King Faisal University in the Eastern Province of Saudi Arabia generally exhibited good knowledge about concussions, specific knowledge gaps and misconceptions were seen to exist. To ensure comprehensive understanding and promote appropriate management, continuous education, and awareness campaigns are essential, with healthcare providers playing a pivotal role in knowledge dissemination.

Problem of headache: A cross-sectional study.

Objectives: To assess the medical students, interns, general practitioners, and family physicians' perception of neurological and otolaryngeal causes of headaches. Materials and Methods: A prospective, qualitative, questionnaire-based cross-sectional study took place. Five hundred and seventy-one senior medical students, interns, general practitioners (GPs), and family physicians from different geographical regions in Saudi Arabia were involved in the study. An online questionnaire is used to estimate the respondents' knowledge regarding neurological and otolaryngeal causes of headaches. The obtained data were statistically analyzed using SPSS version 21. Results: Five hundred and seventy-one participants were involved in the study. They were 377 females and 194 males with a female-to-male ratio of 1.9:1. Most of them were medical students (69.9%). However, medical interns, general practitioners, and family physicians' respondents were (17.3%), (7.5%), and (5.3%), respectively. They constituted different geographical regions of Saudi Arabia. An average level of knowledge about headaches was recorded in (55%) of the participants, while (42.7%) had a good level of knowledge about its etiologies. Conclusions: A considerable percentage of the current study population has average knowledge about neurological and otolaryngeal factors of headache. It is advocated that the current national medical curriculum be thoroughly reviewed and clear referral pathways must be established to have better management of these cases.

Artificial intelligence in orthopedics: A qualitative exploration of the surgeon perspective.

Artificial intelligence (AI) is currently integrated into many medical services. AI is utilized in many aspects of orthopedic surgery. The scope ranges from diagnosis to complex surgery. To evaluate the perceptions, attitudes, and interests of Sudanese orthopedic surgeons regarding the different applications of AI in orthopedic surgery. This qualitative questionnaire-based study was conducted through an anonymous electronic survey using Google Forms distributed among Sudanese orthopedic surgeons. The questionnaire entailed 4 sections. The first section included the participants' demographic data. The remaining 3 sections included questions for the assessment of the perception, attitude, and interest of surgeons toward (AI). The validity and reliability of the questionnaire were tested and piloted before the final dissemination. One hundred twenty-nine surgeons responded to the questionnaires. Most respondents needed to be more aware of the basic concepts of AI. However, most respondents were aware of its use in spinal and joint replacement surgeries. Most respondents had doubts regarding the safety of (AI). However, they were highly interested in utilizing (AI) in many orthopedic surgical aspects. Orthopedic surgery is a rapidly evolving branch of surgery that involves adoption of new technologies. Therefore, orthopedic surgeons should be encouraged to enroll in research activities to generate more studies and reviews to assess the usefulness and safety of emerging technologies.

Distal Radius Extra-Articular Fractures: The Impact of Anatomical Alignment on Patient's Perceived Outcome (A Single Center Experience).

PURPOSE: The effects of the anatomical alignment of distal radial extra-articular fractures on the patient's perceived outcome have been drawing much attention recently, and much controversy exists in the literature. The primary purpose of this study was to explore the relationship between the radiological parameters of reduction (radial inclination, radial length, and radial tilt) and the patient's perceived functional outcome, which was quantified using the DASH questionnaire. METHODS: The study included one hundred twenty-four patients with distal radial extra-articular fractures managed by closed reduction and casting. Their radiological (anatomical) outcome was determined by measuring the radial inclination, tilt, and length. Subjective functional outcome was quantified using the DASH score, calculated from the Arabic-translated DASH questionnaire at three months and six months after cast removal. RESULTS: the mean DASH score was 31.56 SD± 9.1 at three months and 29 SD± 3.89 at six months, and the acceptable radiological results for radial tilt, radial inclination, and radial length (according to McDermid's criteria for acceptable reduction) were 77.4%, 88.7% and 74.4%, respectively. There was a significant linear correlation between two radiological parameters (radial tilt and radial length) and the DASH score at three-month follow-up, which was more profound among patients under 70 years old and with diabetes mellitus. At the six-month follow-up, there was no significant relationship between the radiological parameters and the DASH score. CONCLUSION: This study confirmed that radiological outcome affects the early patient-perceived outcome, with a more significant effect among patients under 70 and diabetics. Nonetheless, over time, there will be no significant relationship between the quality of reduction and patients' perceived outcomes. And this phenomenon requires further investigation.

Vision-Related Quality of Life in Patients With Keratoconus: A Nationwide Study in Saudi Arabia.

PURPOSE: To evaluate the impact of keratoconus (KC) on quality of life and assess visual performance via the National Eye Institute Visual Functioning Questionnaire-25 (NEI-VFQ-25) in the Saudi population. PATIENTS AND METHODS: A descriptive cross-sectional study was conducted using the NEI-VFQ-25 to evaluate the vision-related quality of life among previously diagnosed KC patients. An online questionnaire was used to distribute the validated survey through various social media networks. The data were extracted, reviewed, coded, and then analyzed using the Statistical Package for Social Sciences (SPSS) version 26 (IBM Corp., Armonk, NY). RESULTS: A total of 429 patients completed the questionnaire. The overall score of NEI-VFQ-25 was 58.6 (SD: 18.0). The visual performance was worse in females than males (with a score of 55.1), especially in patients aged less than 30 years. Visual function improved with the use of low-vision aids (spectacles and contact lenses) compared with those who did not use them. CONCLUSION: Our study confirms the functional impairment in patients with KC, especially in females, patients aged less than 30 years, and those with no low-vision aids. Moreover, it suggests a significant role of these vision aids (spectacles and contact lenses) in improving the quality of life in patients with KC.

Management of pediatric blunt abdominal trauma with split liver or spleen injuries: a retrospective study.

BACKGROUND: Blunt abdominal trauma is a prevailing cause of pediatric morbidity and mortality. It constitutes the most frequent type of pediatric injuries. Contrast-enhanced sonography (CEUS) and contrast-enhanced computed tomography (CECT) are considered pivotal diagnostic modalities in hemodynamically stable patients. AIM: To report the experience in management of pediatric split liver and spleen injuries using CEUS and CECT. PATIENTS AND METHODS: This study included 246 children who sustained blunt abdominal trauma, and admitted and treated at three tertiary hospitals in the period of 5 years. Primary resuscitation was offered to all children based on the advanced trauma and life support (ATLS) protocol. A special algorithm for decision-making was followed. It incorporated the FAST, baseline ultrasound (US), CEUS, and CECT. Patients were treated according to the imaging findings and hemodynamic stability. RESULTS: All 246 children who sustained a blunt abdominal were studied. Patients' age was 10.5 ± 2.1. Road traffic accidents were the most common cause of trauma; 155 patients (63%). CECT showed the extent of injury in 153 patients' spleen (62%) and 78 patients' liver (32%), while the remaining 15 (6%) patients had both injuries. CEUS detected 142 (57.7%) spleen injury, and 67 (27.2%) liver injury. CONCLUSIONS: CEUS may be a useful diagnostic tool among hemodynamically stable children who sustained low-to-moderate energy isolated blunt abdominal trauma. It may be also helpful for further evaluation of uncertain CECT findings and follow-up of conservatively managed traumatic injuries.

Factors Shaping Medical Students' Intentions Toward Neurosurgery: A Cross-Sectional Study.

Background Choosing a medical specialty poses a significant challenge for students, with initial fascinations often evolving during their academic journey. Despite its inherent appeal, neurosurgery faces hesitancy among undergraduate students, potentially due to perceived difficulties and time demands. This study aims to investigate the factors influencing medical students' intentions toward neurosurgery at two institutions in the eastern province of Saudi Arabia. Methodology A cross-sectional study design was employed, utilizing a validated, anonymous questionnaire distributed electronically to medical students and interns in the eastern province of Saudi Arabia. The questionnaire comprised two sections, namely, demographic and academic profiles, and participants' intentions, knowledge, and attitudes toward neurosurgery. Data analysis involved descriptive statistics, and chi-square tests to explore relationships and identify significant predictors. Results Of the participants, 197 (34.1%) expressed interest in neurosurgery, but only 94 (16.3%) had a comprehensive understanding of the field. Motivations included high income, specialty prestige, and positive impact on patients, while stress and work-life balance were common deterring factors. Age and academic years were associated with a gradual decrease in interest, except for initial medical school students. Participants were attracted to innovative technological aspects, while high competition and neurophobia were deterring factors. Conclusions This study provides a comprehensive analysis of determinants influencing medical students' and interns' interest in neurosurgery. Early exposure, clinical training, and personal motivations play significant roles in shaping career preferences. Challenges, such as perceived difficulties and concerns related to work-life balance, need targeted interventions to enhance neurosurgery's attractiveness. Considerations extend beyond technical and academic facets to encompass personal and lifestyle dimensions.

View of mucormycosis during the era of COVID-19 infection: A cross-sectional study.

Background: During the coronavirus (COVID-19) global pandemic, the diagnosis of mucormycosis co-infection has become challenging as it is sometimes misdiagnosed or even undiagnosed. Many factors contribute to acquiring such infections. These factors vary but their main reason for getting such infections is being immunocompromised. Thus, it results in weak host immunity to fight and prevent such co-infection. Objectives: This study aims to assess the knowledge perception among the general population in Saudi Arabia regarding black fungus and its relationship with the global pandemic COVID-19. Materials and Methods: A prospective, qualitative, questionnaire-based cross-sectional study took place. The obtained data were statistically analyzed using SPSS version 21. Results: The study included 1138 participants, 31.5% from southern region, 27.8% from Eastern region, 22.2% from north region, 12.2% from Western region, and 6.3% from Central region. The participant's mean age was 27.1 ± 11.9 years old. A good knowledge level was detected among 35% of female respondents compared to 28.9% of males with reported statistical significance (P =0.036). All other factors including age, education, and work were insignificantly associated with public knowledge level. Conclusions: A considerable percentage of the current study population had poor knowledge level of perception and awareness regarding mucormycosis in relation to COVID-19.

Food Safety Knowledge and Attitudes: A Cross-Sectional Study among Saudi Consumers from Food Trucks Owned by Productive Families.

Food businesses, such as food trucks (FTs) and family producers have grown rapidly and become popular with people in Saudi Arabia. As foodborne diseases are still a public health concern in the country, consumers should be aware of the safety of foods sold by food trucks. Since there is a dearth of literature, this study aimed to assess the knowledge and attitudes of consumers of food from FTs owned by family producers regarding food safety and foodborne disease. A cross-sectional study was conducted among 921 consumers of food from FTs from two cities in the southern region of Saudi Arabia. Data were collected using an online questionnaire from September to November 2021. Finally, multiple linear regression and a logistic regression model were used to identify the predictors of knowledge and attitude regarding food safety and foodborne illness, respectively. Overall, respondents had moderate knowledge and higher positive attitudes regarding food safety and foodborne illness. Respondents' knowledge about the potential harm and attitudes towards the safety of foods sold by FTs were significantly associated with marital status, education level, and monthly family income. The findings of this study highlight the need to improve the knowledge, awareness, and attitudes of Saudi consumers of food from FTs owned by family producers on food safety and foodborne illness through intervention programs, particularly targeting consumers with lower educational attainments and income status, to control foodborne diseases.

Local Community View of Aesthetic Surgery: Results of a Cross-Sectional Survey.

Background Aesthetic surgery has increased in popularity, reflecting the increased consumer demand. However, the variation in patients' ethnic and cultural beliefs has led to many challenges. Therefore, those who manage aesthetics should always listen and recognize the variability of cultural identities, desires, attitudes, anxieties, and uncertainties of the patient. Emerging from a diversity of cultures and its transforming trends, the scope of cosmetic surgery and its practice reflect not only the individual's personality but also the culture as a whole. When counseling an individual, one has to recognize that even in groups of seemingly identical social or cultural standards, there are subtle differences in attitude. Aim To assess the perception of the local community about aesthetic procedures and to determine the possible factors influencing their level of acceptance through a randomized cross-sectional survey. Methodology A community-based, qualitative, cross-sectional study was performed through an anonymous questionnaire that was randomly distributed among the local population. Questions with regard to the sociodemographic data were implemented, as well as the core questions, to assess the perceptions that are based on the modified Acceptance of Cosmetic Surgery Scale (ACSS). Results A total of 857 participants responded to the study questionnaire. Their age ranged from 18 to more than 55 years, with a mean of 23.1 ± 12.9 years. Out of the total number, 630 (73.5%) were females while the remaining 227 (26.5%) were males. More than half of them were single (53.4%), and the remaining were married. Regarding perception, the highest score in percentage was for the interpersonal subscale (18.7 ± 7.9; 53.4%), followed by the consider subscale (18.2 7.2; 52%) and the social subscale (15.5 ± 7.9; 44.3%). The overall mean score was (52.4 ± 21.1; 49.9%). As for the procedure, the most intended was rhinoplasty (41.1%), followed by liposuction (32.9%), abdominoplasty (31.1%), face-lift (24.4%), reconstructive surgeries (24.4%), and lips filler (20.8%) while the least intended was gluteal flat grafting (8.7%). Conclusions Female patients are more eager to undergo cosmetic and aesthetic surgery compared to their male counterparts. Age did not have a major impact as a motive to look for cosmetic surgery.

Reasons for Hospitalization of Sickle Cell Disease Patients in the Eastern Province of Saudi Arabia: A Single-Center Study.

BACKGROUND: Sickle cell disease (SCD) is among the prevalent chronic diseases in the Eastern Province of Saudi Arabia. To our knowledge, there is no published research that reports the reasons for hospitalization in the Eastern Province of the country. Therefore, this study aimed to fill this gap. DESIGN AND METHODS: This is a retrospective cohort study that was conducted in the period from January 2018 to December 2019. Patients with sickle cell disease who were admitted and treated in the hospital were included in this study. Patients' sociodemographic data and reasons for hospitalization were collected and analyzed using the statistical package for social sciences, version 21 (SPSS, Chicago, IL, USA). RESULTS: There were 103 SCD patients, and the age range was from 18 to 62 years old. The majority of the patients were males (56.3%) and were in the younger age group (≤30 years old; 60.2%). The results showed that the most frequent cause of admission was a vaso-occlusive crisis (VOC) (n=94, 91.3%), followed by acute chest syndrome (ACS) (n=32, 31.1%), and then by hemolytic crisis (27 of the cases; 26.2%). However, we found that a higher number of hip avascular necrosis (AVN) cases were statistically significant in relation to the higher number of hospital admissions (p<0.05), whereas other reasons were not found to have a statistically significant association. CONCLUSION: The most frequent cause of admission was VOC episodes, followed by ACS, and then by hemolytic crises. Also, a higher number of hip AVN episodes were statistically significant with the higher number of hospital admissions.

Plastic and aesthetic surgery among medical students: A cross-sectional study.

OBJECTIVES: The wide variety of operations that a plastic surgeon can deal with creates confusion regarding its proper scope. This confusion was observed in primary physicians as well as medical students. Increasing the perception of medical students toward plastic surgery can aid in career decision-making and early referral patterns. The aim of this study is to gauge a holistic overview of how medical students and interns perceive the plastic and aesthetic surgical specialty in King Faisal University and to suggest a recommended plan. METHODS: An online questionnaire was distributed equally to male and female medical students and interns in a local medical institute. The questionnaire constituted three sections; the first included the biographical data. The second is concerned with the different case scenarios and specialties to be chosen. The third is concerned with the previous clinical exposures. The data were analyzed by SPSS version 21. Between comparison, chi-square tests, Mann-Whitney U-test, and Kruskal-Wallis tests were applied. Normality tests were conducted using the Shapiro-Wilk's test. RESULTS: Two hundred ninety-two students and interns have participated and completed the questionnaire. There were 189 males and 103 females. Plastic surgery was most commonly chosen in the following case scenarios; burn of the hand (74%), broken nose (64.7%), and cosmetic nose reshaping (80.8%). However, plastic surgery was infrequently chosen (selected by <30% of students) in many areas of hands and peripheral neuropathies (severed finger extensor tendon (26.4%), fractured scaphoid (12.7%), carpal tunnel syndrome (14.4%), brachial plexus injury (16.1%)). The most common source of information was the social media, and the least one is meeting with doctors and professors. CONCLUSION: Medical students and interns lack a full view of plastic and reconstructive surgery, especially in hand and peripheral neuropathies. Improving the education of medical students and interns is recommended and needed.

Accuracy of shear wave elastography in characterization of thyroid nodules in children and adolescents.

BACKGROUND: Thyroid nodules are an important health problem in children and adolescents. They possess a higher risk of malignancy in comparison to adults. This fact forms a great dilemma for clinicians. The aim of this study was to evaluate the reliability of shear wave elastography (SWE) as a non-invasive technique in the characterization of thyroid nodules in children and adolescents. METHODS: This prospective study included 56 patients with thyroid nodules. All the patients underwent clinical assessment, laboratory investigations, ultrasound, and Doppler examination, followed by an SWE assessment. Statistical analysis was performed and the best cut-off value to differentiate benign from malignant nodules was determined using the ROC curve and AUC. RESULTS: Seventy-two nodules were detected in the examined patients (ages ranged from 11 to 19 years, with mean age of 14.89 ± 2.3 years). Fifty-eight nodules (80.6%) were benign, and fourteen nodules (19.4%) were malignant (histopathologically proved). Highly suspicious criteria for prediction of malignancy by ultrasound and Doppler were hypoechoic echopattern, internal or internal and peripheral vascularity, microcalcifications, taller-than-wide dimensions, irregular outlines, and absence of halo (p < 0.05). The diagnostic performance for their summation was 70.69% sensitivity, 82.8% specificity, 80.45% accuracy, a 63.79% positive predictive value (PPV), and 87.9% negative predictive values (NPV). Regarding SWE, our results showed that 42.2 kPa was the best cut-off value, with AUC = 0.921 to differentiate malignant from benign nodules; the diagnostic performance was 85.71% sensitivity, 94.83% specificity, 93.06% accuracy, 76.9% PPV, and 93.2% NPV. CONCLUSION: Shear wave elastography is a non-invasive technique that can assist in the diagnosis of malignant thyroid nodules among children and adolescents.

Clinical and Laboratory Predictors of Painful Vaso-Occlusive Crisis Among Sickle Cell Disease Patients: A Single-Center Study in Saudi Arabia.

Introduction Vaso-occlusive crisis (VOC) episodes are considered to be the cause of 95% of hospitalizations for sickle cell disease (SCD) patients. The frequency of VOC is significantly associated with higher or lower lactate dehydrogenase levels, higher hemoglobin concentration, higher white blood cell, and neutrophil count, and lower platelet counts. In this study, we highlighted the association and predictors of VOC episodes in Saudi Arabia. Methods This is a retrospective observational study that was conducted in a period from January 2018 to December 2019 which included patients who were admitted and treated as sickle cell disease patients were included in this study. Retrieved data included patients' age, sex, and other demographic data items as well as the clinical history of SCD. The patients were divided into two groups. Those patients who developed one or two VOC episodes in the period between 2018-2019 were considered mild in severity and patients who developed three or more VOC episodes in the period between 2018-2019 were categorized as moderate to severe. Results A total of ninety-four patients (58 males and 36 females) with a male to female ratio of 1.6 were included in this study. The prevalence of patients who had severe vaso-occlusive crisis was 39.4% while mild-moderate were detected among 60.6% of the patients. It was found that there was no significant difference between the frequency of vaso-occlusive crisis and all the hematological parameters (all p>0.05). It was found that the risk of having vaso-occlusive crisis for those patients who were admitted more than three times was 30 times higher than those patients who were admitted by three times or less [adjusted odds ratio (AOR) = 30.081; 95% confidence interval (CI) = 8.204 - 110.3; p<0.001)]. Conclusion It was found that those patients who had three times VOC episodes in our studied period are more liable to have frequent episodes in the future which might necessitate urgent intervention for these patients.

Reliability of the Mangled Extremity Severity Score in the Management of Peripheral Vascular Injuries in Children: A Retrospective Review.

This study was aimed to evaluate different management modalities for peripheral vascular trauma in children, with the aid of the Mangled Extremity Severity Score (MESS). A single-center retrospective analysis took place between 2010 and 2017 at University Hospitals, having emergencies and critical care centers. Different types of vascular repair were adopted by skillful vascular experts and highly trained pediatric surgeons. Patients were divided into three different age groups. Group I included those children between 5 and 10 years; group II involved pediatrics between 11 and 15 years; while children between 16 and 21 years participated in group III. We recruited 183 children with peripheral vascular injuries. They were 87% males and 13% females, with the mean age of 14.72 ± 04. Arteriorrhaphy was performed in 32%; end-to-end anastomosis and natural vein graft were adopted in 18% and 29% respectively. On the other hand, 20% underwent bypass surgery. The age groups I and II are highly susceptible to penetrating trauma ( p = 0.001), while patients with an extreme age (i.e., group III) are more susceptible to blunt injury ( p = 0.001). The MESS has a significant correlation to both age groups I and II ( p = 0.001). Vein patch angioplasty and end-to-end primary repair should be adopted as the main treatment options for the repair of extremity vascular injuries in children. Moreover, other treatment modalities, such as repair with autologous vein graft/bypass surgery, may be adopted whenever possible. They are cost-effective, reliable, and simple techniques with fewer postoperative complication, especially in poor/limited resources.

Gynecomastia: a study to assess how students perceive this disease.

Background: Gynecomastia is a benign proliferation of the glandular male breast tissue. Gynecomastia etiology might be physiological or non-physiological such as medications, chronic diseases (e.g. hypogonadism), or steroid supplements. Aim: The purpose of this study was to assess the knowledge and understanding of gynecomastia among medical students and which resources were used to gain their understanding regarding the disease. Methods: Data for this qualitative, questionnaire-based cross-sectional study was collected on the basis of our own study objectives and from available questionnaires with similar objectives. The questionnaire was composed of 26 questions divided into many items that were recorded including sociodemographic data, gynecomastia symptoms, and holistic perception of the problem by the students. Exclusion criteria included those who refused to participate in the study and did not complete the questionnaire. Statistical tests were taken significant at p-value ≤0.05. All analyses were performed using SPSS, version 21. Results: A total of 200 medical students participated in this study, among them more males than females (64% vs. 36%). We observed that medical students had significantly more moderate knowledge with teachers as their source of information on gynecomastia (p=0.028) while with books (p=0.005) and internet (p=0.041) as their sources of information they had significantly more a higher level of knowledge. Conclusions: Medical students have overall insufficient knowledge about gynecomastia especially in physical examination and treatment aspects. Therefore, gynecomastia is to be considered more thoroughly in the curriculum.

Erratum to: Reliability of the Mangled Extremity Severity Score in the Management of Peripheral Vascular Injuries in Children: A Retrospective Review.

[This corrects the article DOI: 10.1055/s-0040-1720970.].