ABSTRACT
INTRODUCTION: Several complications have been reported following treatment of developmental dysplasia of the hip (DDH). Local muscular spasm is an extremely rare complication. This case serves to enlighten orthopedists about various and unique presentations of idiopathic local muscular spasm, natural history of such condition, and appropriate treatment. PRESENTATION OF CASE: A two-year-old child presented with bilateral acetabular dysplasia for orthopedic evaluation and treated with bilateral simultaneous Dega osteotomy and postoperative cast for 12 weeks. Full range of motion (ROM) of both hips was regained three months after removal of the postoperative cast. Five months later, the child presented with apparent leg length discrepancy, and severe and painless global limitation of the right hip ROM, which initially was thought to be relapsed hip stiffness. Laboratory and radiological investigations were normal apart from pelvic obliquity on radiographs. Symptoms persisted for one month. Examination under anesthesia (EUA) was then performed and revealed full ROM of the involved hip. Physical therapy was started, and hip ROM fully recovered within 3 months without further intervention. DISCUSSION: Stiffness, which is one of the most reported complications following surgical treatment of DDH, is usually related to lengthy periods of immobilization and/or surgical treatment. Clinically, local muscular spasm of the hip can mimic stiffness. EUA is invaluable to differentiate the common postoperative stiffness from the rare local muscular spasm. CONCLUSION: Idiopathic local muscular spasm of hip might present clinically as stiffness that pose a diagnostic dilemma to the treating physician. Close observation coupled with physical therapy is sufficient.
ABSTRACT
This study aimed to evaluate the awareness of organ transplantation and willingness to donate among Saudi Health Colleges students and the impact of gender, year of study, and field of specialization on this. This is a cross-sectional survey-based study. The survey was distributed to all the students attending the annual national conference of Saudi Health Colleges students held in 2018. The survey had two parts. The first part collected the information about gender, university, college of specialization, and year of study. The second part asked 10 questions, seven of which were about the types, causes, treatment of organ failure (awareness questions), and three of which were about their willingness to donate (altruism questions). The participants had three response options: "Yes", "No" and "I don't know. Descriptive statistics (mean, standard) and the frequencies were generated for each parameter. Categorical data were compared using Chi-square and continuous data using an independent t-test or paired t-test. A total of 821 respondents completed the questionnaire; 58.1% were female, 41.3% studying medicine, 25.1% applied medical sciences, 12.7% pharmacy, 9.6% dentistry, and 4.5% nursing 4.5%. The overall awareness of the correct responses constituted 60.4% while 12.3 % gave incorrect responses and 27.3% did not know what the answers were. The highest awareness score was about the concept of brain death (86.4%). The overall awareness score was significantly higher than the altruism score (62.7% and 45.7% respectively (P = 0.0001). Female respondents proved more aware than the male respondents in all the questions did. However, the differences reached the significant levels in four of the ten questions. If we split and summate the responses into "awareness" questions and "altruism" questions, we find that, although female students score higher in both categories, this reaches the significant level for the altruism score (59.90% vs. 45.60% (P = 0.0001). Final year students were significantly more aware than the freshmen in seven of the 10 questions posed with the biggest gap seen in the awareness that Islamic Sharia permits donating organs after death (82.3% vs. 49.6% (P = 0.0001). When we compare of responses by the college, we find that significant differences between the College of Medicine students and applied medical sciences in two questions with the former having a higher awareness score. The overall awareness score was significantly higher than the altruism score (62.7% and 45.7% respectively). Female students have higher altruistic score than male students. The scores are significantly higher in the senior students than in the junior ones.
