The Prevalence and Associated Risk Factors for Neonatal Thrombocytopenia Among Newborns Admitted to the Neonatal Intensive Care Unit.

Background Thrombocytopenia is the most prevalent hematological condition in neonates that develops in the neonatal intensive care unit (NICU). This set of illnesses is caused by either decreased platelet production due to placental insufficiency, increased platelet breakdown (consumption), or a combination of the two causes. Based on platelet count, it is defined as mild, moderate, or severe thrombocytopenia, with early and late onset. Purpose The purpose of this study is to determine the prevalence of thrombocytopenia and the factors that contribute to it in newborns hospitalized in the neonatal critical care unit at the Maternity and Children Hospital in Al Ahsa, Saudi Arabia. Methods This descriptive retrospective cross-sectional study was carried out at the NICU of the Maternity and Children Hospital in Al Ahsa, Saudi Arabia, over the span of one year (August 2022 to August 2023) among hospitalized neonates with thrombocytopenia. Thrombocytopenia is defined as a platelet count of 150,000 or less. These patients were monitored until they recovered or died. Results The inclusion criteria were met by a total of 242 newborns with thrombocytopenia. Half of the neonates (57%) were full-term, with Apgar scores greater than 5 at the first (84%) and fifth (93%) minutes, respectively. The great majority of individuals (84%) experienced early-onset thrombocytopenia of mild severity (62%) and were asymptomatic (93%). The majority of the cases resolved spontaneously, with only 21% requiring platelet transfusion. There was a significant relationship discovered between gestational age and the severity of thrombocytopenia, with very preterm infants having moderate to severe thrombocytopenia, as well as birth weight (p=0.001). Furthermore, neonates with severe thrombocytopenia had a considerably higher mortality rate (p=0.001). Conclusion The mortality and morbidity of newborns with perinatal risk for neonatal thrombocytopenia can be reduced with timely detection of the cause and development of thrombocytopenia, as well as adequate and early care.

Factors Influencing Visits to the Pediatric Emergency Department.

Introduction Overcrowding in emergency departments (EDs) is still a national and international issue. Among the variables contributing to this crisis are an increase in patient numbers and the severity of sickness. One significant issue that has not yet been addressed and is burdening healthcare facilities is the use of EDs by parents of children who have mild illnesses. Developing successful interventions requires an understanding of the factors that lead to nonurgent visits to pediatric EDs (PEDs). Our objective was to assess the variables that could influence parental visits to PEDs. Methodology In the Eastern Region of Saudi Arabia, between September and November 2023, a descriptive cross-sectional survey was conducted among parents who had previously visited a PED. The survey had 21 questions. Along with parental viewpoints and healthcare utilization, parents' evaluations of their child's emergency state were investigated. In addition to gathering and evaluating demographic data, the survey evaluated respondents' impressions of the severity of a disease or injury. Results A total of 776 participants were included in the study. The mean parental age was 32.1 ± 12.7 years, and approximately 32.1% of the participants' children were between the ages of 1 and 5. Nearly half of the children, 44.7%, visited the ED during the evening shift. The most common reasons for presenting were fever (50.5%) and upper respiratory tract symptoms (37.1%). Among these visits, parents perceived 48.5% as nonurgent and 30.2% as urgent. The majority of respondents (54.9%) had received advice before going to the ED. In most cases (47.9%), this was from a relative or a healthcare provider (16.7%). Conclusion This analysis identified some of the reasons parents bring their children to the ED for mild illnesses. The results emphasized the varied nature of the problem. Understanding the reasons for parental ED visits may help us better design targeted interventions to decrease unnecessary visits and lessen the burden on healthcare systems.

Retraction: Retroperitoneal Lipoma: An Unusual Etiology of Urge Incontinence.

[This retracts the article DOI: 10.7759/cureus.19878.].

Knowledge and Attitudes Regarding Clinical Trial Participation: A Cross-Sectional Study in the Eastern Province, Saudi Arabia.

Objective This study aims to assess the knowledge and attitudes toward clinical trial (CT) participation among the adult population in the Eastern Province of Saudi Arabia. Material and methods This cross-sectional study was conducted among the population of the Eastern Province of Saudi Arabia. A self-administered questionnaire was distributed among the general population using an online survey. Results A total of 334 participants completed the questionnaire. Participants' ages ranged from 18 to 65 years, with a mean age of 31.2 ± 13.9 years, 56.6% of whom were males, 42.2% were employed, 29.6% were students, and 23.1% were unemployed. Surprisingly, only a small percentage of respondents (7.5%) were requested to participate in a randomized controlled trial (RCT), of which the majority did partake. Additionally, 25.4% of participants believe CTs are used to evaluate new drugs; others believe that CTs are used to understand diseases and human behavior. The data show that most participants believe that CTs improve patient care, welfare, and society. Also, participants were more likely to take part if they were aware of the study's purpose and findings and were given more time to consider their options. Conclusion Participants believed that the biggest obstacle was a lack of knowledge of CTs. It is crucial to educate patients more about CTs. Multimodal strategies such as improved patient-provider communication and online information for trial information sharing may be effective in boosting knowledge and CT recruitment.

Severity of SARS-CoV-2 infection in children with inborn errors of immunity (primary immunodeficiencies): a systematic review.

BACKGROUND: Inborn errors of immunity (IEIs) are considered significant challenges for children with IEIs, their families, and their medical providers. Infections are the most common complication of IEIs and children can acquire coronavirus disease 2019 (COVID-19) even when protective measures are taken. OBJECTIVES: To estimate the incidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in children with IEIs and analyse the demographic parameters, clinical characteristics and treatment outcomes in children with IEIs with COVID-19 illness. METHODS: For this systematic review, we searched ProQuest, Medline, Embase, PubMed, CINAHL, Wiley online library, Scopus and Nature through the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) guideline for studies on the development of COVID-19 in children with IEIs, published from December 1, 2019 to February 28, 2023, with English language restriction. RESULTS: Of the 1095 papers that were identified, 116 articles were included in the systematic review (73 case report, 38 cohort 4 case-series and 1 case-control studies). Studies involving 710 children with IEIs with confirmed COVID-19 were analyzed. Among all 710 IEIs pediatric cases who acquired SARS-CoV-2, some children were documented to be admitted to the intensive care unit (ICU) (n = 119, 16.8%), intubated and placed on mechanical ventilation (n = 87, 12.2%), suffered acute respiratory distress syndrome (n = 98, 13.8%) or died (n = 60, 8.4%). Overall, COVID-19 in children with different IEIs patents resulted in no or low severity of disease in more than 76% of all included cases (COVID-19 severity: asymptomatic = 105, mild = 351, or moderate = 88). The majority of children with IEIs received treatment for COVID-19 (n = 579, 81.5%). Multisystem inflammatory syndrome in children (MIS-C) due to COVID-19 in children with IEIs occurred in 103 (14.5%). Fatality in children with IEIs with COVID-19 was reported in any of the included IEIs categories for cellular and humoral immunodeficiencies (n = 19, 18.6%), immune dysregulatory diseases (n = 17, 17.9%), innate immunodeficiencies (n = 5, 10%), bone marrow failure (n = 1, 14.3%), complement deficiencies (n = 1, 9.1%), combined immunodeficiencies with associated or syndromic features (n = 7, 5.5%), phagocytic diseases (n = 3, 5.5%), autoinflammatory diseases (n = 2, 3%) and predominantly antibody deficiencies (n = 5, 2.5%). Mortality was COVID-19-related in a considerable number of children with IEIs (29/60, 48.3%). The highest ICU admission and fatality rates were observed in cases belonging to cellular and humoral immunodeficiencies (26.5% and 18.6%) and immune dysregulatory diseases (35.8% and 17.9%) groups, especially in children infected with SARS-CoV-2 who suffered severe combined immunodeficiency (28.6% and 23.8%), combined immunodeficiency (25% and 15%), familial hemophagocytic lymphohistiocytosis (40% and 20%), X-linked lymphoproliferative diseases-1 (75% and 75%) and X-linked lymphoproliferative diseases-2 (50% and 50%) compared to the other IEIs cases. CONCLUSION: Children with IEIs infected with SARS-CoV-2 may experience higher rates of ICU admission and mortality in comparison with the immunocompetent pediatric populations. Underlying immune defects does seem to be independent risk factors for severe SARS-CoV-2 infection in children with IEIs, a number of children with SCID and CID were reported to have prolonged infections-though the number of patients is small-but especially immune dysregulation diseases (XLP1 and XLP2) and innate immunodeficiencies impairing type I interferon signalling (IFNAR1, IFNAR2 and TBK1).

An Overview of Emphysematous Epididymo-Orchitis: A Systematic Review of Case Reports.

Emphysematous epididymo-orchitis (EEO) is a rare but serious condition that involves the presence of gas within the tissues of the testicle and/or the epididymis. It is a medical emergency that can be life-threatening if left untreated. Management of this condition may involve a combination of antibiotics, surgical drainage, and supportive care. In March 2023, A systematic review of case reports was conducted to identify and examine cases of EEO. We used PubMed, ScienceDirect, and Google Scholar for a methodical search. Only seven out of 136 studies met our criteria for this review of case reports. However, this review discusses symptom presentation, imaging findings, complications, and possible management of EEO.

Urolithiasis Symptoms and Risk Factors Among the General Population of Alahsa, Saudi Arabia.

OBJECTIVE: This study aims to assess the awareness and attitudes about urolithiasis among the general population of Alahsa, Saudi Arabia. METHODOLOGY: A cross-sectional study was conducted in September 2022 in Alahsa, Saudi Arabia, using a validated questionnaire that was distributed to the general population. Inclusion criteria include male and female citizens of Saudi Arabia who were living in Alahsa, older than 18 years old, and willing to participate in the study. Exclusion criteria include non-Saudi citizens or Saudi citizens who did not live in Alahsa. Data were analyzed using SPSS Statistics. RESULT: The results showed there were 1023 participants. The results showed the awareness level of symptoms associated with kidney stones at 29%, complications at 34%, diagnosis at 51%, and treatment at 16%. The results showed there was a significant association between a history of kidney stones and having no complications (p-value = 0.002) or inflammation (p-value = 0.009). However, there was no significant association between kidney stone symptoms and the participants' comorbidities. CONCLUSION: According to our findings, there was a low level of knowledge about the condition and the methods to prevent it, like dietary and lifestyle modifications. Regardless of the low level of general knowledge, there was some awareness of urolithiasis in some elements. Therefore, it is advised to increase health awareness campaigns.

Comparing Gastroesophageal Reflux Disease (GERD) and Non-GERD Patients Based on Knowledge Level of Acute Myocardial Infarction Symptoms, Risk Factors and Immediate Action Taken in Eastern Province, Saudi Arabia.

INTRODUCTION: A major cause of death globally is cardiovascular disease (CVD). Chest pain, nausea, vomiting, and heartburn are common symptoms of acute myocardial infarction (AMI). Chest pain is also the main symptom of gastroesophageal reflux disease (GERD). Therefore, the differential diagnosis of chest pain can become more challenging when GERD and AMI coincide. This study evaluated and compared the knowledge of the signs, symptoms, and immediate action that must be taken regarding AMI among GERD and non-GERD patients. METHODOLOGY: An observational cross-sectional study using an online questionnaire was created and published between October and November 2022 to collect data from Saudi males and females 18 or older willing to participate in the study. Participants who were not Saudi had declined to complete the survey or had not fully completed it was excluded. The questionnaire contained three sections; after collecting informed consent, it made inquiries regarding respondents' GERD status, demographic information, and knowledge and attitudes regarding GERD. RESULTS: This study included 691 responses from 300 non-GERD participants and 391 GERD participants. The study showed a high level of awareness (75.5%) of GERD, with significant differences in the level of awareness according to marital status, education levels, and occupation status. There was no significant difference in the level of awareness according to gender and GERD diagnosis, where the p-value > 0.05. The most common source of information about AMI was the Internet, followed by health care professionals. The most commonly known symptoms of AMI were sudden pain or discomfort in the chest, followed by a sudden shortness of breath. Additionally, there was no significant association between the diagnosis of GERD and known risk factors. The association between GERD and other diseases (chi-square = 46.94, p-value 0.01). Obesity and smoking were the two main risk factors for heart attacks. CONCLUSION: This study demonstrated that there was no significant difference between GERD and non-GERD participants regarding the knowledge and awareness level of AMI. Moreover, it showed that there was a lack of general knowledge and awareness of AMI in Saudi Arabia. The authors recommend initiating more awareness programs in Saudi Arabia to inform people about AMI and cardiovascular disease. More research is required to determine whether other patients are aware of AMI.

Thermoresponsive Conductivity of Graphene-Based Fibers.

Smart materials are versatile material systems which exhibit a measurable response to external stimuli. Recently, smart material systems have been developed which incorporate graphene in order to share on its various advantageous properties, such as mechanical strength, electrical conductivity, and thermal conductivity as well as to achieve unique stimuli-dependent responses. Here, a graphene fiber-based smart material that exhibits reversible electrical conductivity switching at a relatively low temperature (60 °C), is reported. Using molecular dynamics (MD) simulation and density functional theory-based non-equilibrium Green's function (DFT-NEGF) approach, it is revealed that this thermo-response behavior is due to the change in configuration of amphiphilic triblock dispersant molecules occurring in the graphene fiber during heating or cooling. These conformational changes alter the total number of graphene-graphene contacts within the composite material system, and thus the electrical conductivity as well. Additionally, this graphene fiber fabrication approach uses a scalable, facile, water-based method, that makes it easy to modify material composition ratios. In all, this work represents an important step forward to enable complete functional tuning of graphene-based smart materials at the nanoscale while increasing commercialization viability.

Cerebral, ocular, dental, auricular, skeletal anomalies (CODAS) syndrome: First case reported in Saudi Arabia.

CODAS syndrome (cerebral, ocular, dental, auricular, skeletal anomalies) is a rare autosomal recessive inherited multisystemic disease that carries an incidence rate of less than 1 in 1,000,000 children worldwide. It has an infancy, neonatal age of onset, characterized by deformities of the central nervous system, eyes, ears, teeth, and skeleton. A 1-year-old female of non-consanguineous parents, first time presented to our pediatrics clinic on November 6, 2021 when she was 4 months of age with developmental delay, as the patient could not support her head and made no eye contact on examination. Microcephaly was observed. She had a positive family history; her sister died at the age of 3 days with microcephaly and diaphragmatic hernia. We recommend that a wider range of centers to get encouraged to report cases of CODAS they might encounter due to the lack of sufficient amounts if solid literature on the topic. To our knowledge, this is the first case to be reported in the literature from Saudi Arabia.

Prevalence, frequency, and disability of migraine headaches and tension headaches among the general population in the Eastern Region of Saudi Arabia.

A tension-type headache (TTH) is a recurrent headache that is mild to moderate in intensity, unlike migraine (MH), which is accompanied by crippling effects of nausea, vomiting, photophobia, or phonophobia. TTH is more frequent than migraine, but it is less likely to cause severe pain and physical dysfunction. TTHs account for more lost workdays due to their prevalence. The study aimed to evaluate the prevalence, frequency, and disability of MHs and TTHs among the general population in the Eastern Region of Saudi Arabia. A cross-sectional study was employed using a validated questionnaire. The questionnaire implemented the HARDSHIP algorithm to diagnose MH and TTH and questions to correlate their prevalence to socio-demographic data, measurement of the level of disability, headache management, and treatment effectiveness using the chi-square test. The study reviewed 877 subjects (46.6% males vs. 53.4% females). 52.9% of the participants experienced headaches during the previous three months, and 35.6% experienced headaches recently. The most common type of headache was a probable MH (32.1%), followed by a TTH (26.9%), probable TTH (19.5%), and MH (15%). It was reported that some disability was attributed to 47% of MHs and 26% of TTHs. The most commonly used headache medication was paracetamol (53.5%). This study revealed that TTH and MH are common illnesses in Saudi Arabia's Eastern Region. TTH and MH are correlated with significant individual and social burdens, particularly for MH. Headache sufferers mostly manage their headaches using conventional over-the-counter methods.

Heterozygous Mutation of Sodium Voltage-Gated Channel Alpha Subunit 2 and Pumilio Homolog 1 Genes in a Pediatric Patient: A Case Report.

Epilepsy is a neurological condition brought on by recurrent and spontaneous seizures in patients with hypersynchronous neuronal ensemble activity. These spontaneous seizures appear to be brought on by increased neuronal excitability and synaptic synchronization. The development of neuronal hyperexcitability and acquiring epilepsy is still poorly understood. Cell differentiation and development might be related to the pumilio RNA-binding family member 1 (Pumilio 1 (PUM1)). Complete deficiency of this gene causes misregulation of the proteins involved in the control of neuronal excitability. Furthermore, the voltage-gated sodium channels alpha subunit 2 (SCN2A) triggers action potentials in brain neurons, and a variety of severe hereditary epilepsy syndromes are caused by their mutation. Here, we present a rare case of a seven-year-old female with co-occurrence of two genetic mutations in the pumilio homolog 1 (PUM1) and sodium voltage-gated channel alpha subunit 2 (SCN2A).

Combined Methylprednisolone Pulse Therapy plus Rituximab for Treating a Rare Juvenile Steroid-Resistant Nephrotic Syndrome with Cerebral Venous Sinus Thrombosis: A Case Report.

Background: Cerebral venous sinus thrombosis (CVST) secondary to nephrotic syndrome (NS) is rarely reported. Additionally, treating steroid-sensitive nephrotic syndrome (SSNS) that changes to steroid resistance (SRNS) is difficult, with many relapses and side effects. Case presentation: A 32-month-old SSNS male child turned into SRNS and developed cerebral venous sinus thrombosis (CVST), a rare complication of NS. As a result of the administration of combined pulse methylprednisolone and IV Rituximab (RTX) therapy, the patient showed marked improvement, the results of urine analysis were remarkably improved, and the child started to respond to treatment. Conclusion: Successful treatment of a rare case of juvenile SSNS behaving as SRNS with the development of CVST could be established using combined steroid pulse therapy, Enoxaparin, and the B lymphocytes monoclonal antibodies RTX.

Co-occurrence of Glycogen Storage Disease Type 2 and Congenital Myasthenic Syndrome Type 5 in a Pediatric Patient: A Case Report.

Glycogen storage disease type 2 (also known as Pompe disease) is a metabolic disorder characterized by an accumulation of glycogen within lysosomes. Pathophysiologically, this condition is caused by an autosomal recessive deficiency of the lysosomal acid alpha-glucosidase enzyme, resulting in defects in lysosomal metabolism. Glycogen accumulation causes advanced muscle weakness (myopathy) throughout the body, including the heart, skeletal muscles, liver, and the neurological system. Currently, there is no definitive treatment for Pompe disease. However, recent studies have indicated that enzyme replacement therapy (ERT) can be effective. Myasthenia gravis (MG) is an autoimmune illness that affects the postsynaptic acetylcholine receptors and causes fatigue that can be eased by rest. MG is frequently accompanied by a thymoma. Dyspnea and/or bulbar symptoms can indicate an imminent crisis requiring immediate intervention. Here, we present a rare case of a four-year-old female patient who initially presented at the age of one month with the infantile form of Pompe disease and congenital myasthenia syndrome type 5. The patient presented with bradycardia, poor suckling, respiratory distress, and respiratory failure requiring assisted ventilation, subglottic stenosis, and tachypnea. Whole exome sequencing was used for definitive diagnosis. ERT (Myozyme) was administered with good results. We propose that early identification and management of Pompe disease with Myozyme can improve patients' condition and ultimately increase the possibility of survival.

Surgical outcome of Yasui procedure for preserving biventricular function: single centre experience.

BACKGROUND: Yasui procedure is surgical repair intended to preserve biventricular function for patients with left ventricle outflow tract obstruction associated with aortic arch lesions and ventricular septal defect. METHODS: Retrospective chart review analysis of all patients who had Yasui procedure (2008-2020) comparing midterm outcome of one versus two stage repair. RESULTS: Twenty patients (70% female) underwent Yasui procedure in our center. Eight patients (40%) had left ventricle outflow tract obstruction /interrupted aortic arch, 7 patients (35%) had left ventricle outflow tract obstruction /coarctation of aorta, 3 patients (15%) had double outlet ventricle and ventricular septal defect that were unattainable for tunneling to one of the semilunar valves without creating obstruction, and 2 patients (10%) had aortic atresia with hypoplastic aortic arch. All patients had associated ventricular septal defect. Fifteen patients (75%) had one-stage repair and 5 patients (25%) had two-stage repair. Means age and weight for one and two-stage repair were 1.3 ± 2 months, 13.4 ± 11.5 months and 3.3 ± 0.6 kg, 7.8 ± 3.4 kg, respectively. During follow up, 8 patients (40%) required re- intervention, mainly for right ventricle-pulmonary artery conduit either dilation or replacement. The average duration of follow up was 5 years with nil mortality. CONCLUSION: Yasui procedure is effective approach for children who have left ventricle outflow tract obstruction associated with aortic arch anomalies and ventricular septal defect. Survival rate with single or staged repair is comparably good. During the first 5 year of follow up, nearly 40% of operated patients required re-intervention.

Tuberculosis presenting as metastatic lung cancer.

Mycobacterium tuberculosis infection (TB) masquerading as lung tumor is well reported, but its mimicry as metastatic thoracic cancer is rare. We report the case of a young male who presented with clinical and radiological picture of lung cancer but investigations confirmed it as TB. A 35-year-old male, with 18-pack year of smoking history, presented with dry cough, anorexia, weight loss, and lower back and left hip pain. Chest imaging showed right upper lobe speculated mass with mediastinal and hilar lymphadenopathy and a lytic lesion in the left sacral area. Magnetic resonance imaging of the spine and pelvis revealed lytic lesion in the left sacrum. Fluorodeoxyglucose positron emission tomography computed tomography scan of the whole body showed hypermetabolic lung lesion with ipsilateral mediastinal, supraclavicular, splenic, and bone metastasis in the left aspect of the sacrum. Computed tomography (CT)-guided biopsy of the lung lesion showed necrotizing granuloma and tissue culture was positive for pan-susceptible M. tuberculosis. Follow-up CT scan showed complete resolution of the lung lesion and lymph nodes after anti-TB treatment with significant reduction in the sacral lesion. Mycobacterial infection may mimic metastatic lung cancer and should always be considered a differential diagnosis.

Pregnancy-Related Anxiety and Impact of Social Media Among Pregnant Women Attending Primary Health Care.

Background Pregnant women go through physiological as well as psychological changes during pregnancy. Antenatal anxiety disorders are common, with proven adverse maternal and fetal outcomes. Anxiety increases the risks for prematurity and neurodevelopmental disorders. This study aimed to estimate the prevalence of pregnancy-related anxiety and the impact of social media among pregnant women in Al-Ahsa, Saudi Arabia. Materials and methods This observational cross-sectional study included pregnant women who were attending antenatal care (ANC) in primary healthcare centers between May and October of 2021 in Al-Ahsa, Saudi Arabia. For data collection, a structured self-administered questionnaire was distributed randomly to eligible pregnant women. The presence of pregnancy-related anxiety was assessed by using the 10-item Pregnancy-Related Anxiety Questionnaire-Revised (PRAQ-R), Arabic version. The impact of social media was measured through Social Media Engagement Questionnaire (SMEQ). Results Out of 823 pregnant women, 382 were eligible. Their mean age was 26.1 ± 10.9 years. Most of them (70.4%) had adhered to ANC. However, 32.1% had a history of miscarriage, and 6.7% had previous birth with congenital anomalies. The mean scores of pregnancy-related anxiety domains were 10.6 out of 15 for fear of giving birth, 8.7 for concern of own appearance, and 6.4 out of 12 for worries about bearing a handicapped child. More than half of the participants scored 28 out of 50 for pregnancy-related anxiety. The factors that were significantly associated with pregnancy-related anxiety were healthcare workers, first trimester, and unplanned pregnancy (P < 0.05). Social media engagement showed no correlation with anxiety. Conclusions The pregnancy-related anxiety level was average among pregnant women in Al-Ahsa, and fear of giving birth was the most common reason. Its predictors included early pregnancy, being a healthcare provider, and unplanned pregnancy. Pregnancy-related anxiety should be diagnosed early during routine ANC for better maternal and fetal outcomes.

Mental Stigma Among Al-Ahsa Population in Saudi Arabia.

Introduction Mental stigma is when patients of mental illness are labeled by their disorders, viewed negatively, and discriminated against due to their illness. This has a big impact on people's attitudes and behaviors toward the mentally ill. Moreover, mental stigma leads people to avoid patients with mental health issues, blame them for their conditions, and associate them with negative features like being dangerous, unpredictable, and hard to communicate with. The primary objective of this study is to assess the mental stigma among the population of the Al-Ahsa region in Saudi Arabia. Methods This is a cross-sectional study conducted in Al-Ahsa, Saudi Arabia, between June and August 2021. The target population of the study was people aged 18-65 years old whose place of residency during the time of the study was Al-Ahsa. The questionnaire used in this study contained a mental stigma scale called community attitudes toward mental illness (CAMI). Results A total of 758 participants were enrolled in the study. The mean of the stigma score was 99.24 ± 15.622, with a minimum of 53 and a maximum of 176. The means of the subscales were as follows: authoritarianism (26.18 ± 4.420), benevolence (23.26 ± 4.762), community mental health ideology (24.66 ± 5.896), and social restrictiveness (25.13 ± 4.6). There was a positive relationship between age and stigma score. Healthcare workers were found to have a lower level of stigma, as were those who spoke more languages. Also, being diagnosed with a mental illness and knowing someone who is diagnosed with a mental illness were associated with a lower level of stigma. Conclusion Most of the population (91.96%) had a low to medium-low level of stigma. The variables found to affect the level of stigma were age, career, number of spoken languages, being diagnosed with a mental illness, and knowing someone who is diagnosed with a mental illness. Mental stigma has a great impact on the person, as it can prevent the patient from seeking help, lead to isolation, and suicidal ideation. Future stigma-targeted campaigns are recommended.

Retroperitoneal Lipoma: An Unusual Etiology of Urge Incontinence.

Urge incontinence is the most frequent type of urinary incontinence that can be due to bladder outlet obstruction or overactive bladder. A focused history is crucial to identify the type of urinary incontinence and the possible etiology. We report the case of a 67-year-old man with urinary frequency, urgency, and nocturia. However, his urine stream is normal with no history of an intermittent stream, hesitancy, or postvoid dribbling. Digital rectal examination revealed normal prostatic size. Urinalysis results were normal. Urine culture showed no growth. The patient was prescribed symptomatic treatment in the form of anticholinergic medication but failed to provide any clinical improvement. Urodynamic studies suggested the diagnosis of detrusor instability. A computed tomography (CT) scan of the abdomen was performed and demonstrated the presence of a large retroperitoneal lipoma exerting a mass effect on the bladder. The mass was successfully resected by laparotomy operation. Following the operation, the patient had complete resolution of his symptoms. The retroperitoneal region is an extremely rare site for lipoma. Patients with urinary urgency should be carefully evaluated for any structural lesion causing a compressive effect on the bladder.