Headache Prevalence and Its Associated Factors in Makkah, Saudi Arabia.

Primary headaches are more prevalent and associated with several risk factors, such as chronic diseases, unhealthy lifestyles, smoking, caffeine intake, work, and stress. However, these factors are not associated with specific headache disorders. We investigated the prevalence of primary headache disorders and the associated risk factors in Makkah. This cross-sectional study, conducted over a 6-month period, used an anonymous survey disseminated through online platforms. The questionnaire was a modified version of a validated questionnaire used to assess headaches in relation to modifiable and non-modifiable risk factors. In total, 1177 participants aged 18-65 (mean, 31.5 ± 12.6) years were included. Headaches were diagnosed among 44.2% of participants aged 20-59 years, with a high prevalence among young adults; additionally, 71.5% of participants with headaches reported experiencing headaches for <15 days per month. Chronic headaches were found in 28.5% of participants. Age, chronic diseases, work, caffeine consumption, and smoking were associated with having a significant effect on headache prevalence. The prevalence of headaches in Makkah has increased in comparison to that reported in previous studies. Certain modifiable and non-modifiable risk factors have been associated with headaches. Headaches impact all life aspects of individuals and communities. An educational program for professionals and patients can improve patient outcomes.

Risk Models to Predict Mortality in Burn Patients: A Systematic Review and Meta-analysis.

The predictive capability of various risk assessment models (RAMs) in evaluating the risk of mortality in burn patients is not well established. It is also unclear which RAM provides the highest discriminative ability and presents the highest clinical utility. We pooled all available studies to establish this validity and compare the predictive capability of the various RAMs. Methods: We reviewed PubMed, MEDLINE, and Embase from their inception up until December 2021 for studies evaluating risk of mortality in burn patients as stratified by RAMs. Data were pooled using random-effect models and presented as area under the receiver operating characteristic (AUROC) curve. Results: Thirty-four studies, comprising of a total of 98,610 patients, were included in our analysis. Most studies were found to have a low risk of bias and a good measure of applicability. Nine RAMs were evaluated. We discovered that the classic Baux; the revised Baux; and the Fatality by Longevity, APACHE II score, Measured Extent of burn, and Sex (FLAMES) scores presented with the highest discriminative power with there being no significant difference between the results presented by them [AUROCs (95% CI), 0.92 (0.90-0.95), 0.92 (0.90-0.93), 0.94 (0.91-0.97), respectively, with P < 0.00001 for all]. Conclusions: Many RAMs exist with no consensus on the optimal model to utilize and assess risk of mortality for burn patients. This study is the first systematic review and meta-analysis to compare the current RAMs' discriminative ability to predict mortality in patients with burn injuries. This meta-analysis demonstrated that RAMs designed for assessing mortality in individuals with burns have acceptable to great discriminative capacity, with the classic Baux, revised Baux, and FLAMES demonstrating superior discriminative performance in predicting death. FLAMES exhibited the highest discriminative ability among the RAMs studied.

Application of Negative Pressure Therapy on Skin Grafts after Soft-Tissue Reconstruction: A Prospective Observational Study.

A split-thickness skin graft (STSG) is one of the main tools used in the reconstruction of skin defects. Negative-pressure wound therapy (NPWT) has been widely used as adjunct therapy for wound healing for decades. Few studies have conducted the outcomes of NPWT use as a postoperative dressing for STSGs. This study aimed to compare the outcomes of the application of NPWT versus conventional dressing on STSGs after soft-tissue reconstruction. A prospective observational study was performed at the King Abdullah Medical City. A total of 18 patients with STSGs for acute or chronic skin defects were recruited. Patients from the two groups­10 patients in the NPWT group and 8 in the No-NPWT group­were postoperatively evaluated for three weeks. Assessment included the STSG take rate, wound healing, pain, infection, hematoma formation, and the need to re-graft the same recipient area. Our data demonstrated a higher mean skin graft take rate in the second and third weeks of the No-NPWT group compared to the NPWT group, but it was not statistically significant (p > 0.05). No significant differences between the two groups in terms of wound healing, pain, infection, hematoma formation, and the need to re-graft (p > 0.05) were found. Our study showed that the conventional dressing of STSGs is not inferior to NPWT. In addition, conventional dressing was shown to be easier to use and less expensive to apply, as well as having a higher skin graft take rate and lower infection rate.

Management of Neurofibromatosis of the Nipple-Areolar Complex.

Neurofibromatosis type 1 is an autosomal dominant disease having an incidence of 1 in 3000 individuals. It primarily involves the peripheral nervous system and usually presents with many neurofibromas. On rare occasions, NF1 can affect the breast and manifests as nipple-areolar complex extranipple (pseudopolythelia) like neurofibromas which can be disfiguring and sometimes cause pain and therefore need to be addressed surgically. We present a case of a 31-year-old female, who had multiple pedunculated neurofibromas around the nipple on both breasts for 3 years. These lesions were associated with mild pain and were increasing in size. Surgical excision was done while preserving the nipples bilaterally. NF1 primarily involves the peripheral nervous system and usually presents with a large number of neurofibromas. Several case series of patients with NF1 have been reported, but there are only a few published reports on neurofibromas of the nipple-areolar complexes. These lesions can be painful and cause cosmetic deformity. In our case, these lesions were approached by circumferentially excising the redundant nipple-areolar skin containing the neurofibromas, while isolating the nipple on a central ductal and vascular pedicle. In conclusion, the redundant nipple-areolar skin containing the neurofibromas can simply be approached by circumferential excision while preserving the nipple. This technique is simple, easy to perform, while it allows duct preservation and preserves cosmesis.

Abdominoplasty: An Easy Approach to Giant Abdominal Lipomas.

Introduction. Giant lipomas, which are greater than 10 cm, are rare, cosmetically unacceptable, and deteriorate the quality of daily living. Removal of giant abdominal lipomas either by liposuction, excision, or both, can lead to the formation of a loose, pendulous drooping abdomen, and abdominal wall laxity, which is aesthetically displeasing. The objective of this case report is to highlight an easy approach to treat giant abdominal lipoma through therapeutic abdominoplasty. Case History. In this case, a 29-year-old man with a known case of hypothyroidism and HCV was in remission but had a huge abdominal mass on his lower left side; it progressed for 7 years and increased in size and caused discomfort. His BMI was 29.53 and the mass measured about 15 × 13 cm. All other investigations were normal and showed no malignancies. He underwent excision of the giant abdominal lipoma using a standard abdominoplasty approach. Conclusion. In conclusion, in selected patients, giant abdominal lipomas can be successfully excised along with the redundant abdominal skin.