use of recombinant nag protein in spinal cord crush injury in a rat model

Objective: To evaluate the therapeutic properties of nAG protein during the recovery following acute spinal cord injuries in the rat

Study Design: An experimental study

Place and Duration of Study: King Saud University, Riyadh, Saudi Arabia, from September 2014 to September 2015

Methodology: Eight rats were studied [4 control rats and 4 experimental rats; and hence 50% were controls and 50% were experimental]

All rats were subjected to an acute spinal cord injury using the aneurysmal clip injury model. Immediately after the injury, a single intra-dural injection of either normal saline [in the control group] or the nAG protein [in the experimental group] was done. Assessment [if both groups was done over a 6-week period with regard to weight maintenance, motor recovery scores, MRI and histopathology of the injury site

Results: Weight maintenance was seen in the experimental and not in the control rats. Starting at 3 weeks after injury, the motor recovery was significantly [p<0.05] better in the experimental group

MRI assessment at 6 weeks showed better maintenance of cord continuity and less fluid accumulation at the injury site in the nAG-treated group. Just proximal to the injury site, there was less gliosis in the experimental group compared to the control group. At the crush injury site, there was less tissue architecture distortion, less vacuole formation, and less granulation tissue formation in the experimental group

Conclusion: The local injection nAG protein enhances neuro-restoration, reduces gliosis, and reduces vacuole/ granulation tissue formation following acute spinal cord crush injury in the rat aneurysmal clip animal model

Histological changes in the proximal and distal tendon stumps following transection of achilles tendon in the rabbits

Objective: To determine tendon stump changes following unrepaired Achilles tendon lacerations in an animal model

Study Design: An experimental study

Place and Duration of Study: King Saud University, Riyadh, Saudi Arabia, from October 2013 to January 2014

Methodology: A rabbit model was developed and studied tendon retraction and histological changes in the proximal and distal stumps following transection of the Achilles tendon

Results: Over a period of 12 weeks, retraction of the distal tendon stump was minimal [2 - 3 mm]. In contrast, retraction of the proximal tendon stump peaked to reach 6 mm at 4 weeks post-injury and plateaued to reach 7 - 8 mm at the 12-week interval

Conclusion: Following complete transection of the Achilles tendon, tendon retraction correlated with the density of myofibroblast expression within the tendon stump. Further research is needed to investigate the pathophysiology of these findings

solitary fibrous tumor of the upper limb

Solitary fibrous tumors [SFT] of the upper limb are extremely rare, and we report this tumor in the arm of a 30-year-old male. He is presented with a 22 cm painless mass. Complete surgical excision was performed. The histological diagnosis of SFT was based on the presence of ectatic blood vessels and positive staining for CD34 and vimentin. He remains disease-free at the 3-year follow-up interval. The report aims to increase the awareness of the criteria for the histological diagnosis of SFT, as well as the principles of their surgical excision and follow-up

use of forehead flaps in the management of large basal cell carcinomas of the medial canthus/medial lower eyelid in Saudi patients

Basal cell carcinoma [BCC] is the most common skin cancer worldwide. BCC represents 90-95% of all malignant eyelid tumors with lower eyelid/medial canthus lesions being more common than lower eyelid/lateral canthus lesions. Although various local flaps have been used for the reconstruction of medial canthus/adjacent eyelid defects, we find the forehead flap to be the most suited for these cases. We are reporting a clinical series of BCC involving the medial canthus and adjacent medial lower eyelid through a retrospective review of 18 patients who underwent surgical excision of the lesion followed by primary reconstruction using forehead flaps. Patients who underwent reconstruction without forehead flaps were excluded. All cases were Saudis and underwent this type of reconstruction. Indications, results, and complications were reviewed with special emphasis on the acceptance of the obvious forehead donor site scar in Saudi patients. All flaps survived completely Follow-up ranged from 2 to 10 years [mean of 5 years]. Tumor recurrence was not seen in any of the patients. Functionally, there was no ectropion and the eyelid margin was well aligned and stable. However, epiphora was evident since lacrimal system reconstruction was not performed. We are presenting the first Saudi series of large medical canthus/lower eyelid defects that underwent reconstruction using forehead flaps. The outcome was satisfactory and there were no cases of tumor recurrence. The only disadvantage is the donor scar which seems to be acceptable in the Saudi population because of their traditional head cover

Height as a risk factor in Saudi Arabian obstetric practice

Short maternal stature as an obstetric risk factor in Saudi Arabia is reviewed. Short stature dose not influence the number of breech, forceps or ventouse deliveries nor dose it influence the perinatal mortality or prematurity rate but it dose increase the Caesarean section rate. The risk of Caesarian section in the 3.3% of Saudi women who are shorter than 145 cm is 3.2 time greater than in taller women. The average birthweight decreases with height. The conclusion is, that for Saudi Arabia, the risk figure is less than 145 cm as opposed to the Western figure of less than 152.4 cm [5 ft]