Saudi Med J
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Fournier's gangrene is an aggressive form of necrotizing fasciitis of the perineal, perianal or genital regions, usually caused by a polymicrobial infection that includes virulent organisms. Over the last decades, we have treated 9 patients suffering from Fournier's gangrene using systemic chemotherapy with broad-spectrum antibiotics, and with extensive, sometimes serial surgical debridement. Recently in one case, in addition to treatment, we used locally 100% oxygen in daily doses with promising results in healing wound. Herein, we report this case with a brief review of the literature concerning pathogenesis, risk factors, and treatment approaches.
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Comparative Study
Suspected acute appendicitis in female patients. Trends in diagnosis in emergency department in a University Hospital in Western region of Saudi Arabia.
To determine the negative appendectomy rate; utilization, accuracy of Alvarado scale, ultrasound (US), computed tomography (CT) in diagnosis of acute appendicitis. ⋯ Clinical findings and experience remain of major importance in appendicitis-diagnosis. When appendicitis appears with atypical presentations, it remains a clinical challenge. In such cases, laboratory and imaging investigation may be useful in establishing a correct diagnosis. Alvarado scoring system is easy, simple and cheap complementary aid for supporting the diagnosis of acute appendicitis especially for junior surgeons.
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To assess the pattern of non-traumatic acute abdomen (NTAA) in emergency general surgical admissions in Saudi Arabia (SA) and highlight the implications for education, training and patient care. ⋯ In our setting, NTAA was the most common cause for general surgical admissions, accounting for 30% and 54% of the total surgical and emergency surgical admissions respectively. Most of the patients were young and acute appendicitis was the most common diagnosis. Further National/regional multicenter studies are needed to assess the trend of emergency surgical admissions and their impact on surgical practice, overall health care costs, medical education and training in SA.
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Ant allergy is a rare clinical problem that ranges from local to systemic reaction and life-threatening anaphylaxis. Different types of ants including the imported fire ants, the black (samsum) ants, and others, are considered health hazard in many parts of the world. We report a 32-year-old Saudi female from Hafr-Al-Batin in the Northern region of Saudi Arabia, with history of recurrent anaphylaxis following black (samsum) ant stings and we review the related literature. This is the first report of black (samsum) ant allergy in Saudi Arabia.
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To explore the effect of h(1) calponin mRNA expression on the biliary tract dynamics, and investigate the molecular mechanisms of gallstone formation in pregnancy. ⋯ The h(1) calponin might play an important role in inducing dysfunction of extrahepatic biliary tract, bile stasis in gallbladder and gallstone formation in pregnancy.