Subscapularis Z-plasty With Coracoidectomy for Internal Rotation Contracture in Children With Brachial Plexus Birth Injury.

OBJECTIVES: Brachial plexus birth injury (BPBI) is a rare dystocia complication. Although it has a good prognosis, a significant number retain functional impairment to varying degrees. The data concerning shoulder function improvement and complication rates are conflicting due to variations in outcome measures between the studies. Therefore, we report our experience with this approach. METHODS: It was a retrospective study conducted at King Faisal Specialist Hospital and Research Center in Riyadh (FSH&RC), Saudi Arabia. Data such as patient demographics, Mallet scores, and passive external rotation (PER) in adduction and abduction were retrieved from the medical records. RESULTS: In active shoulder function, Mallet score significantly improved (P=0.00). The improvement was most remarkable in active external rotation movement (P=0.00) followed by hand to the neck. However, no significant gain was observed in active abduction and hand-to-back. At the final follow-up, with a mean of 2.9 years, the improvement in PER in adduction and abduction was maintained. Compared to six months postoperative, no significant difference was found in hand-to-neck, hand-to-back, and total Mallet score. CONCLUSION: Subscapularis z-lengthening with coracoidectomy was consistently effective in correcting internal rotation contraction in a patient with BPBI. Significant improvements were observed in the Mallet score and PER in adduction and abduction.

Foot drop in patients with extensive 3rd and 4th degree burn, case series study.

Burn injuries can lead to a variety of short- and long-term complications, peripheral neuropathy has been known as the most common neuromuscular complication. 29% of the burn-related peripheral neuropathy has been found in both the upper and lower limbs. Moreover, literature failed to find the causative factors for specific presentations like foot drop in burn patients. This study reports a series of 10 patients who developed foot drop after burn injury and required occupational therapy follow up at King Abdulaziz Medical City in Riyadh. To assess the effect of different risk factors in the outcome of foot drop. 10 case records were reviewed, 70% among the patients were men and 30% were women with a mean age of 39 and a mean BMI of 28. Most of the patients 70% were burned by flame. The mean Total Body Surface Area (TBSA) was 62%. 4 of the cases (40%) were having comorbidities. There was a significant association between death and high TBSA. All cases were managed without surgical intervention, physiotherapy started immediately after the diagnosis of foot drop. Seventy percent of our patients improved while 3 cases have expired. Higher TBSA showed to be significantly associated with death.

Vaccine hesitancy towards childhood immunizations as a predictor of mothers' intention to vaccinate their children against COVID-19 in Saudi Arabia.

BACKGROUND: Despite the success of childhood immunization in reducing vaccine-preventable diseases, vaccine hesitancy is now a global health threat to this achievement. The current COVID-19 pandemic may change the picture of vaccine hesitancy toward childhood immunizations, which could influence the mothers' intention to vaccinate their children against COVID-19. AIM: To measure the prevalence and related factors of vaccine hesitancy towards childhood immunization during the era of COVID-19 along with the prevalence of mothers' intention to vaccinate their children the future COVID-19 and its association with childhood vaccine hesitancy. METHODS: Cross sectional study was conducted among 270 Saudi mothers attending outpatient clinics at King Abdullah University Hospital (KAAUH) in Riyadh by purposive sampling technique. Data were collected from January to February 2021 using SAGE Group standardized questionnaire. RESULTS: Although most mothers strongly agree on the importance of the vaccine (79%), almost one-fourth of mothers were hesitant towards childhood immunization (24.31%). Similar percentage of mothers' intended to vaccinate their children against COVID-19 in the next 6 months was reported (24%). Vaccine hesitancy was found to be a significant predictor of mothers' intention. Mothers' education level was significantly associated with being hesitant towards childhood immunization as well as the intention to accept the future COVID-19 vaccine (p < 0.05). Main reason that was highly significantly associated with being hesitant is the concerns about the side effect (50%). CONCLUSION: The present study reported a considerable percentage of mothers who are hesitant towards childhood immunization which predicts their intension to vaccinate towards COVID19 and is associated with the level of education.