Flexor Pollicis Longus Weakness Post-proximal Radius Shaft Open Reduction and Internal Fixation: A Case Report.

We report the case of a patient who sustained a right proximal radial shaft fracture. He experienced isolated flexor pollicis longus weakness as a result of a partial anterior interosseous nerve (AIN) injury. The incidence of AIN injury is recognized as an exceptional postoperative complication for this particular type of fracture. It might be helpful to do electrodiagnostic investigations to confirm the diagnosis. A complete clinical recovery of the nerve occurred 16 weeks following the surgical operation.

A Systemic Review of Adolescent Supracondylar Fractures: What Is the Surgical Treatment, Open Reduction With Internal Fixation (ORIF) or Closed Reduction With Percutaneous Pinning (CRPP)?

Supracondylar humerus (SCH) fractures represent the most frequent elbow injury in young children. These fractures can be treated through either closed reduction with percutaneous pinning (CRPP) or open reduction with internal fixation (ORIF). Yet, the optimal treatment option for adolescents remains unclear. This research contrasts the results of CRPP and ORIF treatments for distal humerus fractures in adolescents. In June 2023, we conducted a comprehensive search of PUBMED, OVID MEDLINE, Web of Science, Cochrane Central Register of Controlled Trials, and various trial registries without any time restrictions. We evaluated the quality of qualifying studies using the Methodological Index for Non-randomized Studies (MINORS) and Cochrane risk measures for bias. We extracted data particularly related to patient demographics, fracture details, medical procedures followed, complications encountered, and the resulting outcomes. Out of the 488 studies identified, only four satisfied the inclusion criteria. Both methods illustrated comparable outcomes in terms of range of motion, averaging approximately 118 degrees in the ORIF group versus a span of 114 to 128 degrees in the CRPP group. The immobilization period varied, spanning 10 to 13 days for ORIF versus 24 to 29 days for CRPP. Despite this, CRPP displayed a decreased necessity for additional surgery. Notably, one study indicated a higher frequency of heterotopic ossification within the ORIF group. This review indicates that both CRPP and ORIF are effective for treating supracondylar fractures in adolescents, yielding similar results. However, CRPP has a lower need for follow-up surgery. Future studies with larger sample sizes are needed to solidify these findings, providing stronger guidance for treatment.

Optimal positive airway pressure requirement and polysomnography indices of obstructive sleep apnea severity in the Saudi population.

CONTEXT: Positive airway pressure (PAP) is the first-line therapy for obstructive sleep apnea (OSA). Overnight PAP titration for determining optimal PAP requirements is expensive and often inconvenient. Prediction of optimal PAP requirements from diagnostic polysomnography via mathematical equations is possible but variable across populations. AIMS: We aimed to (1) determine the optimal PAP requirement, (2) determine differences in optimal PAP requirements across OSA severity groups, (3) determine the relationship between optimal PAP requirement and diagnostic polysomnography measurements of OSA severity, and (4) develop a pilot equation to predict the optimal PAP requirement from diagnostic polysomnography in a sample from the Saudi population. METHODS: We analyzed records pertaining to adult OSA patients (n = 215; 63% of males) who underwent standardized diagnostic and titration polysomnography in our sleep laboratory between 2015 and 2019. Demographic, anthropometric, and clinical information were also collected for the analysis. Inferential statistics were performed for comparisons between diagnostic and titration studies and between OSA severity groups. Regression analyses were also performed to determine the potential predictors of optimal PAP requirements. Data were presented as the mean (± standard deviation) or median (25th-75th quartiles) according to normality. RESULTS: The median optimal PAP requirement was 13 (9-17) cmH2O. The optimal PAP requirement was significantly greater for male versus female participants (14 [10-17] vs. 12 [8-16] cmH2O) and for participants with severe OSA (16 [12-20] cmH2O, n = 119) versus those with moderate (11 [8-14] cmH2O, n = 63) or mild (9 [7-12] cmH2O, n = 33) OSA. When combined, nadir oxygen saturation, oxygen desaturation index, and arousal index could be used to predict the optimal PAP requirement (R 2= 0.39, F = 34.0, P < 0.001). CONCLUSIONS: The optimal PAP requirement in the Saudi population is relatively high and directly correlated with OSA severity. Diagnostic polysomnography measurements of OSA severity predicted the optimal PAP requirement in this sample. Prospective validation is warranted.

Multiple Small Intestinal Neuroendocrine Tumors With Findings of Intestinal Obstruction.

Carcinoid tumors are one of the most common types of small intestinal neuroendocrine tumors (SI-NETs). However, SI-NETs that manifest as subacute intestinal obstruction are extremely rare. The annual occurrence rate of jejuno-ileal NETs is 0.28-0.8 per 100,000 people. In this report, we describe a case of subacute intestinal obstruction due to a mid-ileal stricture. The patient underwent laparotomy after evaluation and investigation. Mid-ileal growth was noted, and small bowel resection was performed with primary end-to-end anastomosis. Postoperative histopathology revealed the growth to be a well-differentiated NET.

Positron Emission Tomography With Fluorodeoxyglucose Incidental Detection of Colon Cancer in a Patient's Follow-Up for Nasopharyngeal Carcinoma During the COVID-19 Pandemic: A Case Report.

Colorectal cancer (CRC) is a type of widespread, deadly malignancy that took thousands of lives around the globe. In the last two decades, CRC represented the most common cancer among men and ranked third among women in Saudi Arabia. Positron emission tomography with fluorodeoxyglucose (FDG-PET), can incidentally detect malignancy, as in our case, FDG-PET disclosed high abnormal FDG far away from the first primary malignancy. The current case is of a 65-year-old female who was following up on her nasopharyngeal carcinoma (first primary). During her last management, FDG-PET was requested to find any FDG uptake in the nasopharyngeal region; stunning FDG uptake was incidentally found at the ascending colon diagnosed as early-stage (pT2N0) colon cancer. Colonoscopy was done and India Ink was injected to facilitate localizing the mass during the laparoscopic removal of the tumor, which was delayed due to the pandemic of COVID-19. This took place in March 2020 at King Abdul-Aziz University Hospital in Jeddah.