Rapid Improvement in Guillain-Barré Syndrome With Demyelinating and Secondary Axonal Involvement: A Case Report.

Guillain-Barré syndrome (GBS) is a major cause of acute neuropathy worldwide. The accurate classification of GBS subtypes is essential for diagnosis and prognosis, with acute inflammatory demyelinating polyneuropathy generally linked to more favorable outcomes. This case report examines a 65-year-old Sudanese man who experienced a six-day progression of symmetrical lower limb weakness and numbness, which rapidly escalated to significant motor impairment. Clinical evaluations and diagnostic tests identified primary demyelinating polyradiculoneuropathy with secondary axonal damage. Despite severe initial weakness and hypoxia, the patient showed significant recovery. Follow-up assessments confirmed full motor recovery and independent mobility. This case report aims to fill the gap in local data and provide valuable insights into the clinical features and outcomes of GBS in the Saudi Arabian context.

Retraction: Inguinal Hernia Containing an Inflamed Appendix: A Case of Amyand Hernia.

[This retracts the article DOI: 10.7759/cureus.21121.].

Incidence and risk factors of contrast-induced nephropathy in acute stroke patients undergoing computed tomography angiography: A single-center study.

OBJECTIVES: To investigate the prevalence and risk factors linked to contrast-induced nephropathy in this specific patient population, aiming to ensure the highest quality of clinical care. METHODS: In a retrospective analysis, all patients who presented with an acute stroke to King Fahad Hospital, Jeddah, Emergency Department from March until November 2022 and underwent Computed Tomography Angiography (CTA) brain, Inclusion criteria were as follows: a baseline creatinine results and CTA examination performed within 24 hours of symptom onset and an available early (<5 days after CTA) follow-up creatinine result. RESULTS: Among 246 stroke patients in the emergency, 182 underwent brain CTA and 8.24% had Contrast-Induced Nephropathy (CIN). intracerebral hemorrhage (ICH) increased CIN risk 7-fold (OR=6.7; 95% CI: 1.23-33.3). Abnormal baseline raised CIN risk 8-fold (OR=7.8; 95% CI: 1.74-35.1). hypertension doubled the risk for CIN (OR=2.1; 95% CI: 1.26-6.98) CONCLUSION: The incidence of CIN was 8.2%, particularly elevated in patients with ICH, hypertension, tissue plasminogen administration, and abnormal baseline, necessitating vigilance in managing acute stroke cases.

Inguinal Hernia Containing an Inflamed Appendix: A Case of Amyand Hernia.

Inguinal hernia is a prevalent surgical condition worldwide. The hernia sac typically contains the omentum and small intestine. However, it has been reported that some other organs might be seen, including the ovary, fallopian tube, bladder, and colon. We report the case of a 23-year-old man who presented to our emergency department with the complaint of scrotal pain for the last six days. The pain was mainly in the right side. There was no history of preceding trauma, and the pain developed gradually. He described the pain as having a sharp nature and was constant. He reported having a low-grade fever that resolved with the use of over-the-counter analgesics. There was no change in the urine or bowel habits. No penile discharge was reported. On examination, the patient had a low-grade fever and tachycardia. The patient appeared in pain and was not cooperative to have a complete genitalia examination. However, there was a positive cough impulse in the right inguinal region. The laboratory findings suggested the presence of inflammatory or infectious processes with elevated leukocytes, C-reactive protein, and erythrocyte sedimentation rate. The patient was prepared for emergency laparotomy for reduction of the hernia and resection of the appendix. During exploration, the appendix was reduced from the hernia sac. The appendix appeared edematous, with marked erythema representing acute appendicitis. The appendix was resected and the hernia sac was closed. The presence of an appendix in the inguinal hernia sac is very rare. The preoperative diagnosis of Amyand hernia, the inguinal hernia containing the appendix, can be difficult based on the clinical presentation. Early diagnosis is crucial to avoid the potential complications of Amyand hernia, including perforation and abscess formation. Imaging studies can establish the diagnosis of Amyand hernia with high accuracy and confidence.

Scholarly Activity of Radiation Oncologists in High-Income Developing Countries: Saudi Arabia as an Example.

PURPOSE: To examine the trends and quality metrics of publications by radiation oncologists in Saudi Arabia. METHODS: PubMed was searched using names of all Saudi radiation oncologists to retrieve published articles between January 2010 and December 2019. International collaboration, journal impact factor and country of origin, and number of citations were collected. Each article was assessed for epidemiologic type and independently assigned a level of evidence (LOE) by two authors. The trend in publications was examined and compared in the first and second 5-year periods (2010-2014 and 2015-2019) using relevant parameters. RESULTS: A total of 186 publications were found and included. The most common type of research was cohort studies followed by case reports and case series in 24%, 14%, and 13% of all publications, respectively. Dosimetry, clinical, and preclinical studies formed 7%, 8.6%, and 7.5% of the total publications, respectively. The LOE was I, II, III, IV, and not applicable in 8.6%, 22%, 25.8%, 29%, and 14.5% of the included publications, respectively. Comparing the first and second 5-year periods, there was an increase in international collaboration (P < .001) in the second period. The number of citations (P < .001) and journal impact factor (P = .028) were lower in the second period. LOE and publications in international journals were not statistically different between the two periods. CONCLUSION: Although radiation oncology research activity in Saudi Arabia has gained momentum in terms of volume and international collaboration over time, the LOE has not improved. This calls for a national effort to make the contribution to the literature a priority, allocate adequate resources, and apply appropriate measures to enhance research productivity and quality.