ABSTRACT
Aneurysmal bone cysts (ABCs) are uncommon benign bone lesions that consist of blood-filled vascular spaces surrounded by fibrous tissue septa. Their diagnosis and surgical management are challenging in a war-torn region. In this case report, we present a rare case of a giant aneurysmal bone cyst located around the acetabulum in a 10-year-old female child who presented with an antalgic limp and left hip pain. The lesion was successfully treated with curettage and mixed autologous and synthetic bone grafts, and the follow-up for two years revealed a complete resolution of symptoms and radiological evidence of bone regeneration. This case highlights the successful surgical treatment of a challenging case of ABC in a difficult setting during the Syrian conflict.
ABSTRACT
In conflict zones like Syria, accessing specialized medical care presents significant challenges. Here, we present the case of a 22-year-old female with a giant cell tumor in her distal forearm, exacerbated by limited access to healthcare due to the Syrian conflict. Despite these obstacles, we successfully performed en bloc resection and reconstructed the defect with a proximal non-vascularized fibular graft, restoring arm function. This case underscores the critical importance of adapting to adverse circumstances to deliver essential medical interventions in conflict-affected regions.
ABSTRACT
BACKGROUND: Exposure to lead (Pb) has been associated with endocrine, hematological, gastrointestinal, renal and neurological problems in humans. However, effects on the thyroid gland are controversial. OBJECTIVES: The aim of the present study was to assess thyroid function in foundry workers occupationally exposed to Pb and the mechanism of oxidative-antioxidant imbalance. METHODS: Thyroid function parameters and markers of oxidative stress were examined in 59 adult males who had been occupationally exposed to Pb. The results were then compared to those of 28 male subjects who had no history of Pb exposure or thyroid abnormalities and served as a control group. RESULTS: Mean blood lead levels (16.5±1.74 µg/dl) were significantly higher among the exposed workers compared to those of the control group (12.8±1.16 µg/dl, (p <0.001)). The exposed group had significantly increased free triiodothyronine (FT3), free thyroxine (FT4) and significantly decreased thyroid stimulating hormone (TSH) (1.77±0.44 µIU/ml), whereas the control group had a TSH level of 2.61±0.94 µIU/ml (p< 0.0001). A state of oxidative stress was indicated by the significant increase in mean levels of malondialdehyde (MDA) and significant decrease in glutathione (GSH) (p < 0.0001). There was a significant positive correlation (r=0.358, p <0.05) between blood lead levels (BLL) and duration of employment, while BLL showed a significant negative correlation with TSH (r =-0.486, p <0.001), and GSH (r =-0.336, p <0.05). Of the occupationally exposed workers, 32.76% had elevated thyroid hormones. The results showed a significant positive relationship between GSH and TSH (ß coefficient=0.274, p < 0.05), MDA with FT3 (ß coefficient=0.355, p < 0.05) and FT4 (ß coefficient = 0.491, p < 0.0001) among exposed workers. CONCLUSIONS: Workers exposed to Pb dust proved to be at risk for hyperthyroidism, which was found to have a significant role in oxidative-antioxidant imbalance present among workers with increasing duration of exposure. PARTICIPANT CONSENT: Obtained. ETHICS APPROVAL: This study was approved by the Ethical Committee of the National Research Centre in Egypt (NRC) under the registration number 15225. COMPETING INTERESTS: The authors declare no competing financial interests.
