Diffuse inflammatory facial swelling secondary to local anesthetic injections in patient with polyalkylimide gel used for cheek augmentation

Nowadays the uses of cosmetic fillers have increased dramatically including those placed in the facial region. Although commercial advertisements claim that injectable fillers are biologically inert and pose no significant health risks, we report a case of a patient with bilateral cheek augmentation using Polyalkylimide gel fillers presented with recurrent episodes of facial swelling following routine dental treatment. The clinical scenario presented here highlighted the significance of the interference of the facial gel fillers with the routine dental treatment

role of perihepatic packing in the treatment of liver injury

The perihepatic packing has become the preferred method to control bleeding associated with liver injuries. All traumatised patients admitted or referred to King Fahad Hofof [KFHH] during the 5 years period from 2004-2008. Underwent Laparatomy for Liver injuries and managed by Hepatic packing to control bleeding. A total of 50 patients with medium age 36 years and male: female ratio was 88: 12 [7.1] all underwent damage control surgery procedures to control liver injuries associated with uncontrolable bleeding. Perihepatic packing results in good outcome in liver trauma patients. The aim of this study is evaluation of the efficacy of perihepatic packing in the trauma patients with liver injury

Patterns and frequency of female breast lesions encountered at secondary level of care: hospital records-based study

To describe the histopathological pattern of female breast lesions encountered at secondary level of care in, Saudi Arabia. It is a retrospective, hospital record-based descriptive study. All histopathology records for patients attended King Fahad Hospital in Hofuf, Al Hassa between January 2001 and December 2006, were revised and compiled using a structured compilation form. nine hundred-fifty four [954] histopathology reports were included Data regarding type of specimens, age, laterality of the lesions and the prominent cellular morphology were analyzed; the Data were expressed in proportions, percentage and other descriptive measures. The Malignant lesions in the form of infiltrating ductal carcinoma were the most dominant lesions where 62% diagnosed before the age of 50 years

Laparoscopic adjustable gastric band for morbid obesity - local experience in Al-Ahsa region of Saudi Arabia

To present our experience of laparoscopic gastric banding [LAGB] for morbid obesity in the Eastern Province of Saudi Arabia Retrospective reviews of patients undergoing surgery for morbid obesity. King Fahad Hospital, Hofuf, Saudi Arabia One-hundred and eighty two [182] patients from January 2000 to December 2006 were included in the study. Laproscopic gastric banding Preoperative age, sex, body mass index [BMI], co-morbidities, operative variables and postoperative hospital stay and complications were recorded. The postoperative weight loss was recorded at three monthly intervals. The mean age was 30.3 years [range 18 - 51 years] and the mean BMI was 52.6 kg per square meter [range 41 - 61.5 kg per square meter]. There were two conversions to open procedure because of dense adhesions from previous surgeries. The mean operative time was 2.7 hours [range 1.25 - 3.5 hours]. The mean postoperative hospital stay was 3.7 days [range 2 - 12 days]. There was no mortality. Three patients had band removal after one year postoperatively. The mean follow up period was 11 months [range 3 - 40 months]. The mean BMI decreased to 50.2, 45.4, 41.2 and 37.7 kg per square meter at 3, 6, 9 and 12 months postoperatively, with an average excess weight loss reduction of 43.5% after one year. Conclusions: Laproscopic gastric banding is an effective and safe procedure for the treatment of morbid obesity in Saudi patients

Accuracy of the triple test in the diagnosis of palpable breast masses in Saudi females

For patients who present to clinicians with palpable breast lesions, the "triple test:" [physical examination, mammography and fine-needle aspiration cytology] can be employed to provide accurate diagnosis. In this study, the sensitivity, specificity and predictive values of triple test components were studied separately and in combination. Material and During the study period [from January 1998 to December 1999], 140 patients with palpable breast masses were subjected to all components of the triple test followed by confirmatory open biopsy. Physical examination showed 82.6% sensitivity, 97.3% specificity and 86.4% positive predictive value. Mammography showed 87.5% sensitivity, 97.3% specificity and 87.5% positive predictive value and fine-needle aspiration cytology [FNAC] showed 91.7% sensitivity, 100% specificity and 100% positive predictive value in concordant cases [elements had either all malignant or all benign results]. The triple test was 100% accurate in the diagnosis of palpable breast lesions when all three elements were concordant. Based on these results, we recommend elimination of the confirmatory open biopsy, which will result in reduced expenses and morbidity compared with open biopsy

Non-Invasive preoperative predictors of choledocholithiasis before laparoscopic cholecystectomy in Saudi patients with symptomatic cholelithiasis

Despite the rapid implementation and application of laparoscopic cholecystectomy [LC], predicting which patient will have common bile duct [CBD] stones can be challenging. It is not clear which is the safest and most accurate form of pre operative detection of CBD stones in patients undergoing LC. Our study demonstrates the value of using preoperative indicators to detect the patients with CBD stones especially in LC era where the surgeon cannot manually palpate the CBD Material And We conducted a prospective preoperative study on 250 patients with symptomatic gallstones who undergone LC from October 1998 till December 1999 at King Fahad Hospital, Hofuf. Clinical history, liver functions tests [LFTs] and ultrasonography [US] were performed in all cases prior to operation. Preoperative endoscopic retrograde cholangio- pancreatography [ERCP] was performed in 34 patients [13.6%] in whom CBD stones were suspected by at least one abnormality on US and/or LFTs or clinical indicator [history of jaundice or pancreatitis]. Prevalence rate of CBD stones in this study was 6.8% as defined by the presence of stones by ERCP. The sensitivity, specificity, positive predictive value [PPV] and negative predictive value [NPV] respectively for each preoperative indicator were calculated: a history of jaundice [34%, 84%, 36%, 82%], a history of pancreatitis [20%, 98%, 75%, 82%], US [80%, 82%, 55%, 94%] and LFTs [any elevation] [94%, 75%, 50%, 98%]. Preoperative US and LFTs together with history of jaundice or pancreatitis are the best predictive factors for the state of CBD. Preoperative ERCPshould be restricted to patients with a high probability of CBD stones as suggested by a combination of history, US and LFTs