ABSTRACT
BACKGROUND: Outbreaks of methanol poisoning have been described in the medical literature in different regions around the world. Even though in Saudi Arabia a few outbreaks of methanol poisoning have occurred, they remain undocumented. Herein, we describe several cases of methanol poisoning in Saudi Arabia with the goal of increasing awareness about the dangers of methanol poisoning among healthcare staff. CASE PRESENTATION: Nine middle-aged Saudi patients (five men aged 24, 26, 27, 36, and 49 years and four females aged 19, 20, 24, and 25 years) were admitted to our emergency department after alcohol consumption. All patients presented with severe metabolic acidosis and some visual impairment. Treatment was initiated based on the clinical suspicion of methanol intoxication because of laboratory test limitations and time constraints. Patients showed improvement and favorable hospital outcomes after aggressive empirical treatment. CONCLUSIONS: Many social and cultural factors influence the lack of reporting of methanol poisoning cases in Saudi Arabia. We believe it is important to document these outbreaks to increase the knowledge among healthcare providers and promote public health awareness. A high index of suspicion and the development of local public health networks to monitor, survey, follow-up, and facilitate data exchange can help healthcare providers recognize and aggressively treat affected individuals. Early empiric and aggressive management can greatly decrease morbidity and mortality despite challenges and limited resources.
Subject(s)
Disease Outbreaks , Methanol , Adult , Emergency Service, Hospital , Female , Hospitalization , Humans , Male , Middle Aged , Saudi Arabia/epidemiology , Young AdultABSTRACT
Arterial access is therapeutically and diagnostically useful. Its clinical utility is vast, and associated complications are infrequent. However, some unfortunate patients progress to disastrous outcomes. Luckily, ischemic hand complications are rare. Hand ischemia threatens independence and quality of life, thus warranting vigilance. We present a case of index digit necrosis as a complication of arterial cannulation in a 30-year-old patient with end-stage renal disease admitted to an intensive care unit.
ABSTRACT
Hand amputation is known to be one of the most debilitating injuries. Its impact on the patient results in multiple diverse outcomes and affects daily life activities and career. With that in mind, we understand how devastating upper limb amputations can be. In this case, we report a middle-aged male who suffered an amputation at the level of the distal forearm and underwent replantation at King Saud Medical City in Riyadh, Saudi Arabia. Dealing with an amputated limb requires knowledge and awareness, starting with the patient and moving on to all healthcare providers involved.
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Lipomas are the most common type of soft tissue tumor, and 95% of them are benign. While lipomas can present anywhere on the body, 1% of them are found in the fingers. The ultimate goal of management is surgical excision of the mass with preservation of the neurovascular surroundings. Here, we present the case of a 24-year-old, morbidly obese Saudi female patient complaining of large non-tender lumps in the index and middle fingers involving the palmar and dorsal surfaces of the left non-dominant hand. The lumps were associated with paresthesia and tingling sensations. The article aims to report and highlight the satisfactory outcomes after total excision of such lipomas and restoring the function as well as the cosmetic results of the hand.
ABSTRACT
We present a case of thumb reconstruction free of microsurgical technique or free tissue transfer producing satisfactory function. The patient who underwent reconstruction is a 40-year-old right-handed male mechanic, medically free, non-smoker. After unsuccessful microsurgical replantation of the amputated thumb, we elected to pursue regional reconstruction options using a reverse radial forearm flap and the skeletonized phalanges obtained from the amputated thumb as a bony scaffold.
ABSTRACT
Background A wide array of diseases can lead to skin defects of the male genitalia. Although reconstructive options have been debated in the literature, no study has compared the effectiveness of a meshed split-thickness skin graft (STSG) and a sheet STSG in perineal and scrotal wound coverage. In this study, we report our experience in a tertiary trauma center. Methodology In this retrospective study, we included cases with a skin defect of the male genitalia, for which genital reconstruction with a skin graft was performed at our hospital from December 2017 to February 2020. This study was approved by the institutional review board. The analysis was performed at 95% confidence interval using the Statistical Package for Social Science (SPSS) version 23.0 (IBM Corp., Armonk, NY, USA). Results A total of 27 patients were included in the study. The most common indication for genital reconstruction was Fournier's gangrene (59.3%). In 15 (55.6%) patients, a meshed skin graft was utilized to cover the defect, whereas a sheet graft was utilized in 12 (44.4%) patients. Out of the 15 patients who underwent genital reconstruction with a meshed graft, 10 (66.6%) had complete graft take. On the other hand, out of the 12 (44.4%) patients who underwent genital reconstruction using a sheet graft, five (41.6%) had complete graft take. A statistically significant relationship was found between aesthetic and functional outcomes and the type of skin graft used. The satisfaction rate was higher among meshed skin graft recipients (86.2%) compared to sheet skin graft recipients (41.7%) (p = 0.014). Conclusions Based on our observational experience, we found that meshed STSG to cover male genital skin defects is safe with satisfactory cosmetic outcomes. Further prospective randomized studies are needed.
