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Moreover, inter-phalangeal and metacarpophalangeal joints of thumb showed no deformities in group II in comparison with high level of deformities in group I, owing to early regain of thumb movements.

Immediate (during neurorrhaphy) tendon transfer may offer additional merits over nerve repair only for distal combined ulnar and median injury, as it offers scarless field, no adhesion, and no joint edema, leading to very early return to normal hand functions with a consequent decrease of thumb deformities, better hand grip, and key pinch.

Immediate (during neurorrhaphy) tendon transfer may offer additional merits over nerve repair only for distal combined ulnar and median injury, as it offers scarless field, no adhesion, and no joint edema, leading to very early return to normal hand functions with a consequent decrease of thumb deformities, better hand grip, and key pinch.In the field of plastic and reconstructive surgery, soft tissue reconstruction of Gustilo 3B with peripheral vascular disease or 3C fractures is a complex treatment algorithm. The concomitant issue of soft tissue coverage with vascular reconstruction is the main challenge when opting for free tissue transfer. The flow-through flap offers the surgeon the ability to treat a vascular injury or high-grade stenosis to maintain distal perfusion, while also providing soft tissue coverage. In this study, we present a case series of 3 patients who underwent flow-through anterolateral thigh free flap for lower extremity soft tissue coverage. read more Each patient had a history of trauma and either single vessel runoff or a dominant branch with diminutive secondary blood flow to the foot. All patients successfully underwent free flap reconstruction of lower extremity wounds while concomitantly reconstructing diseased arterial supply. Only 1 patient suffered partial flap loss postoperatively that was treated with debridement and split thickness skin grafting. Flow-through free tissue transfer is a valuable treatment option not only in Gustilo 3C fractures requiring soft tissue coverage, but also in patients with Gustilo 3B fractures with peripheral vascular disease.Renal and hepatic functions are often mingled through both the existence of associated primary organ diseases and hemodynamic co-relationship. The primary objective of this study was to sum up the relationship between autoimmune hepatitis (AIH) on renal tubular acidosis (RTA) and the stages of the disease. A systematic review was performed for 24 trials. A total of 3687 patients were included. The incidence of RTA occurring and short-term mortality reduction was seen in two groups; for an overall effect Z = 2.85 (P = 0.004) a total 95% CI of 0.53 [0.34, 0.82]. Only one patient with alcoholic liver cirrhosis was found to have an incomplete type of RTA. Test for overall effect Z = 2.28 (P = 0.02) 95% CI of 2.83 [1.16, 6.95]. A reduction in fatal infections with dual therapy of corticosteroid plus N-acetylcysteine (NAC) test for overall effect Z = 3.07 (P = 0.002) with 95% CI of 0.45 [0.27, 0.75]. Autoimmune diseases are the most frequent underlying cause of secondary RTA in adults. The primary renal disease must be actively excluded in all patients with hepatic failure by aggressive clinical and laboratory evaluations.Introduction Ocular fluid dynamics are known to improve during hemodialysis, and the improvement of uremia after dialysis may lead to osmotic pressure changes in the retina, which eventually affect retinal edema. Recent studies using optical coherence tomography (OCT) to assess the effect of hemodialysis on macular thickness have shown variable results with a majority of them finding a decrease in retinal thickness. Paradoxical neurosensory retinal detachment (NSD) may be defined as the accumulation of subretinal fluid under the macula in patients who are on continuous HD. The purpose of the study was to find out the incidence of paradoxical neurosensory detachment in diabetic eyes undergoing hemodialysis (HD) and its management. Methods This was a cross-sectional, prospective study involving end-stage renal disease (ESRD) patients secondary to diabetes. This study evaluated the changes in macular thickness in diabetic retinopathy patients with and without diabetic macular edema (DME) by spectral-domain opticn, Ireland) results in early amelioration of such a complication.Objectives Alopecia areata (AA) is a common immune-mediated hair disorder that presents in different clinical patterns. This study aims to find the association between vitamin D and zinc levels with AA phenotypes, to determine the common comorbidities in AA patients, and to assess the influence of age, gender, and body mass index (BMI) on AA phenotypes. Methods This is a cross-sectional study conducted at King Abdulaziz Medical City (KAMC) in Jeddah, Saudi Arabia. Data were collected through retrospective chart review of the electronic medical record system (BestCare) and by utilizing a structured data collection sheet. Results A total of 177 patients were clinically diagnosed with AA with a mean age of 28.37 ± 12.68 years. The mean vitamin D level was 49.14 ± 29.09 nmol/L. Zinc levels were reported in only 22 patients, among which, only one patient had deficient levels. The mean zinc level was 9.8 ± 1.5 µmol/L. Patchy alopecia areata (60.45%) was the most common phenotype followed by universalis (9%) and totalis (7%). Hypothyroidism (11.8%) was the most prevalent comorbidity followed by atopic diseases (10.7%), then both diabetes and mood disorders (6.2%). Conclusion Deficient serum vitamin D levels were present in 62.7% of patients with AA. Nevertheless, no statistically significant relation was detected between vitamin D status and patterns of alopecia areata (P=0.108). A limited number of our sample had records of zinc levels with a mean serum of 9.8 ± 1.5 µmol/L and only one patient was found to be deficient.Introduction Adenoid hypertrophy, a common condition in children, represents one of the common indications for surgery in pediatrics. Medical treatment alone is not effective, and most of the time patients are managed by surgical removal of the adenoid. The aim of this study is to assess the safety and efficacy of intranasal Maxitrol® drops (Novartis Pharmaceuticals, Basel, Switzerland) in pediatric patients with adenoid hypertrophy aged less than two years and to document any side effects during its use. Methods This retrospective cohort study was conducted at King Abdullah Specialist Children’s Hospital (KASCH). We reviewed the charts of 86 pediatric patients aged less than two years who were diagnosed with adenoid hypertrophy between 2015 and 2018. Patients were grouped according to the type of intervention (use of Maxitrol®, and no use). The follow-up time was up to one year. Results Out of 86 patients, 55 (63.9%) patients had adenoid hypertrophy alone and 31 (36.1%) had adenoid hypertrophy plus another disease.