ABO, Rh, and Kell Blood Group Antigen Frequencies in Blood Donors of Taif City, Saudi Arabia.

BACKGROUND: The ABO, Rh, and Kell blood group antigens are clinically significant. Knowledge of antigen frequencies is important to assess the risk of alloimmunization and to guide the probability of finding antigen-negative donor blood. Patients that lack such antigens may produce antibodies that may cause transfusion reaction. The frequencies of ABO, Rh, and Kell antigens in Taif city, Saudi Arabia have not yet been determined. This study aims to assess the frequencies of ABO, Rh, and Kell blood group antigens among Saudi donors in Taif city, Saudi Arabia. METHODS: A retrospective study was conducted on 2,073 Saudi blood donors of both genders from May 2016 to May 2019. The data were collected, and calculations were done to determine the frequencies of ABO, Rh, and Kell blood group antigens. RESULTS: Of the 2,073 donors, the ABO blood groups of the donors were O (53.8%), A (24.9%), B (16.4%), and AB (4.6%). Rh-positive samples were (87.8%) and (12.1%) were Rh-negative. The most common Rh antigen was e (95.8%), followed by the c and C antigens (81.7% and 62.3%, respectively). The lowest Rh antigen frequency was E (31.3%). DCce was the most prevalent phenotype (29.5%). The KEL1 (K) antigen was determined in (22.1%) of the donors. CONCLUSIONS: This is the first study conducted in Taif city to assess the frequency of ABO, Rh, and Kell antigens among Saudi blood donors. This study provides the first step to create a regional donor database to obtain negative antigen blood units for patients with unexpected antibodies and to offer compatible bloods for multi-transfused cases by designing red cell panels.

Multi-disciplinary surgical management of ocular and maxillofacial ballistic injury: A case report.

INTRODUCTION AND IMPORTANCE: Injury to the maxillofacial region is of great importance due to the highly sensitive area, and the vital structures it carries. Special surgical wounding techniques must be used due to the significant tissue destruction. We report a unique case of a ballistic blast injury in a pregnant woman in a civilian setting. CASE PRESENTATION: A 35-year-old pregnant female, in the third trimester, presented at our hospital after ballistic ocular and maxillofacial injuries. Due to the complex nature of her injury, a multi-disciplinary team consisting of otolaryngologists, neurosurgeons, ophthalmologists, and radiologists was formed to manage the patient. She was managed by performing an evisceration followed by an enucleation and a spherical implant, then underwent mandibulo-maxillary fixation due to a foreign body medial to the left ramus. This initial management plan proved to be effective until two (2) years later, she presented with new onset meningocele and active CSF rhinorrhea and meningitis, due to a left anterior skull base defect. The patient was then managed by reconstructive orbital and ethmoidal roof surgery. In addition, her pregnancy had favorable outcomes after an uneventful delivery. CLINICAL DISCUSSION: Civilian setting injuries are specifically sensitive due to the lack of proper protection, such as in this case. This patient, a pregnant victim of a ballistic blast injury, was managed successfully by a multidisciplinary team through multiple reconstructive surgeries yet presented with a late life-threatening complication. CONCLUSION: Long-term follow-up for such complex cases is recommended due to the possibility of late complications, despite adequate surgical management.

Effect of Pegylated Interferon and Mitomycin C on Ocular Surface Squamous Neoplasia in Xeroderma Pigmentosum: A Case Series.

BACKGROUND Xeroderma pigmentosum (XP) is an autosomal recessive disease caused by mutations in DNA repair genes. Clinical manifestations include extreme sensitivity to ultraviolet (UV) rays, freckle-like pigmentation, ocular abnormalities, and an increased risk of developing neoplasms in sun-exposed areas of the skin, mucous membranes, and eyes. This paper describes the clinical outcome of pegylated interferon alpha 2b (PEG-IFN-alpha-2b) subconjunctival injections and topical mitomycin C (MMC) in the treatment of ocular surface squamous neoplasia (OSSN) in patients with XP. CASE REPORT A series of 3 patients with histopathologically-proven biopsy specimens of XP-associated neoplasia of the eyelids and ocular surface underwent subconjunctival injections of PEG-IFN-alpha-2 band topical cycles of MMC. There was a noticeable decrease in the size and severity of ocular surface squamous neoplasia, with minimal adverse effects of flu-like symptoms with mild fever and generalized malaise. Transient mental depression was reported in 2 of our patients, and only 1 patient developed autoimmune diabetes mellitus, which required insulin therapy after the discontinuation of the PEG-IFN-alpha-2b. CONCLUSIONS The literature on the specifics of ocular care using PEG-IFN-alpha-2b for XP-associated OSSN is sparse. However, according to our clinical experience, the combination of PEG-IFN-alpha-2b subconjunctival injection and the topical cycles of MMC is a promising long-term medical therapy to minimize the development and recurrence of OSSN in XP patients.

Transorbital craniocerebral occult penetrating injury with cerebral abscess complication.

Transorbital intracranial penetrating injury is an uncommon mechanism of head injury. These injuries can be occult during the initial clinical presentation. Certain patients develop an intracranial cerebral infection. Herein, we report a 5-year-old child with an occult transorbital intracranial penetrating injury caused by a pen. A retained pen tip was found at the superior orbital roof and was not noticed at initial presentation. This was complicated by a right frontal lobe cerebral abscess. This paper emphasizes the importance of orbitocranial imaging in any penetrating orbital injury. A review of the literature on intracranial infection locations in relation to the route and mechanism of injury is included to complement this report.