The use of extracorporeal shock wave therapy (ESWT) in treating osteonecrosis of the femoral head (AVNFH): a retrospective study.

Purpose: As most of the cases of avascular necrosis (AVN) in Saudi Arabia is seen in young population and as literature showed good effect of extracorporeal shock wave therapy (ESWT) in reducing pain and oedema in avascular necrosis and delaying the need of surgical intervention. Our purpose of this study is to assess the effectiveness of ESWT in reducing pain, improving range of motion (ROM) and delaying the surgical intervention in patient with AVN of femoral head and compare our results to published literature.

Material And Methods: We have treated 24 patients, 13 males and 11 females with a mean age of 29 years (range 14-48) with 34 hips affected.

Canal of Nuck hernia containing the internal reproductive organs of both gender in a neonate with disorder of sex development: a rare case presentation.

The combination of disorder of sex development and canal of Nuck hernia, in which the hernial sac contains the internal reproductive organs (gonads) of both genders, is exceedingly rare. We present a unique case of a neonate who presented with ambiguous genitalia and a lump in the left inguinal region. The child underwent various radiographic procedures and hernial repair.

Renal and mediastinal perivascular epithelioid cell tumors (PEComas) in a young child with tuberous sclerosis; a rare case report.

We describe a unique case of perivascular epithelioid cell tumors occurring as mediastinal and left renal soft tissue masses discovered incidentally in a 5-year-old tuberous sclerosis patient upon presentation to the emergency department for upper respiratory illness. The radiographic features were non-specific. However, the similar CT characteristics of both lesions and background history raised the suspicion of a synchronous mesenchymal tumor, and histopathology confirmed the diagnosis.

Improved simulated ventilation with a novel tidal volume and peak inspiratory pressure controlling bag valve mask: A pilot study.

Introduction: The dangers of hyperventilation during resuscitation are well known. Traditional bag valve mask (BVM) devices rely on end users to control tidal volume (V), rate, and peak inspiratory pressures (PIP) of ventilation. The Butterfly BVM (BBVM) is a novel device intending to give greater control over these parameters.

Peri-Ureteral Abscess Formation Following Ureteroscopic Laser Lithotripsy: A Case Report.

We report the case of a patient with a previous history of obstructive renal calculus disease who initially presented with a symptomatic calculus in her right mid-ureter, requiring ureteroscopy with laser lithotripsy and ureteral stent placement. Shortly after the removal of the stent, the patient was found to have a peri-ureteral abscess, necessitating percutaneous drainage by interventional radiology, and placement of an additional ureteral stent. Adverse reactions to these procedures are rare and, to our knowledge, this is the only documented case of peri-ureteral abscess as a complication of ureteroscopic laser lithotripsy or of ureteral stenting.

Spontaneous Spinal Epidural Hematoma in a 12-Year-Old Child.

Spontaneous spinal epidural hematoma (SSEH) is uncommon, with an estimated incidence of one per million per year in the general population. Since SSEH was first described, only 29 cases have been reported in children. This condition is difficult to diagnose and needs immediate surgical intervention for hematoma evacuation and cord decompression to obtain optimal functional and neurological outcomes.

Comparison of three intraosseous access devices for resuscitation of term neonates: a randomised simulation study.

Objectives: To compare the success rates and ease of use of three intraosseous (IO) access devices used in term neonates.

Design: A three-arm randomised controlled simulation study was conducted.

Setting: A simulation laboratory.

Keeping up with the information explosion: a surge in consumption of data on pediatric SARS-CoV-2 infection by pediatric emergency physicians.

PEM-Database.org is an unaffiliated, not-for-profit website, dedicated to the field's advancement of pediatric emergency medicine. PEM-Database published the first early access pediatric-related SARS-CoV-2 articles on March 13th, two days following the World Health Organization's declaration of a global pandemic.

Idiopathic myositis ossificans of the deltoid muscle: A case report with unique presentation and MRI findings.

Introduction: Myositis ossificans of the deltoid muscle is extremely rare. We present a case with unique presentation and MRI findings.

Case Report: A 21-year-old female presented with a 3-month history of a swelling in lateral aspect of the right arm.

Outcome of Patients With Breast Cancer Treated in a Private Health Care Institution in Brazil.

Purpose: Middle-income countries like Brazil often have a dichotomous health care system in which patients may be treated in either public or private institutions that differ substantially in terms of level of access to diagnostic and therapeutic procedures.

Patients And Methods: This was a prospective, observational study to assess real-world data in 1,230 female patients with breast cancer who were treated in a private health care institution between 2012 and 2016 in Brazil.

Results: Breast cancer in these patients mostly was diagnosed at early (79.

Severe fibrosing mediastinitis with atypical presentation: Effective control with novel therapeutic approach.

Fibrosing mediastinitis (FM), also known as sclerosing mediastinitis, is an uncommon but serious disease involving the mediastinal structures. A high index of suspicion is essential to establish the diagnosis of FM and starting the appropriate therapy for patients. Here, we report a case of a young female who presented with chest symptoms and subsequently underwent different laboratory and radiologic investigations and an excisional biopsy.

A novel pathogenic mutation of the CYP27B1 gene in a patient with vitamin D-dependent rickets type 1: a case report.

Background: Rickets can occur due to Vitamin D deficiency or defects in its metabolism. Three rare genetic types of rickets with different alterations of genes have been reported, including: Vitamin D dependent rickets type 1, Vitamin D dependent rickets type 2 or also known as Vitamin D resistant rickets and 25 hydroxylase deficiency rickets. Vitamin D dependent rickets type 1 is inherited in an autosomal recessive pattern, and is caused by mutations in the CYP27B1 gene encoding the 1α-hydroxylase enzyme.

Extreme light absorption by multiple plasmonic layers on upgraded metallurgical grade silicon solar cells.

We fabricate high-efficiency, ultrathin (∼12 μm), flexible, upgraded metallurgical-grade polycrystalline silicon solar cells with multiple plasmonic layers precisely positioned on top of the cell to dramatically increase light absorption. This scalable approach increases the optical absorptivity of our solar cells over a broad range of wavelengths, and they achieve efficiencies η ≈ 11%. Detailed studies on the electrical and optical properties of the developed solar cells elucidate the light absorption contribution of each individual plasmonic layer.

Outcome of pulmonary embolism and clinico-radiological predictors of mortality: Experience from a university hospital in Saudi Arabia.

Objectives: The objective of this study is to determine the outcome of pulmonary embolism (PE) and the clinico-radiological predictors of mortality in a university hospital setting.

Methods: A Prospective observational study conducted at King Khalid University Hospital, Riyadh Saudi Arabia between January 2009 and 2012. A total of 105 consecutive patients (49.

Managing traumatic brain injury in children: When do we need a computed tomography of the head?

Accidents still represent a major cause of death and disability in children. The resultant traumatic brain injury (TBI) usually needs a multidisciplinary approach of management. Although computed tomographic (CT) head scan is generally a preferred investigation in TBI, however, clear guidelines are required to help decision making by different team members on "when a head CT scan is needed", its limitations, and "when it is likely to be informative".

High efficiency thin upgraded metallurgical-grade silicon solar cells on flexible substrates.

We present a thin film (<20 μm) solar cell based on upgraded metallurgical-grade polycrystalline Si that utilizes silver nanoparticles atop silicon nanopillars created by block copolymer nanolithography to enhance light absorption and increase cell efficiency η > 8%. In addition, the solar cells are flexible and semitransparent so as to reduce balance of systems costs and open new applications for conformable solar cell arrays on a variety of surfaces. Detailed studies on the optical and electrical properties of the resulting solar cells suggest that both antireflective and light-trapping mechanisms are key to the enhanced efficiency.

3M syndrome: an easily recognizable yet underdiagnosed cause of proportionate short stature.

Objective: To characterize, via clinical and molecul criteria, a cohort of patients with 3M syndrome and thereby increase awareness of this syndrome as a recognizable cause of proportionate short stature.

Study Design: We conducted a case series of patients referred to clinical genetics for proportionate short stature. CUL7, OBSL1, and CCDC8 genes were clinically phenotyped and sequenced.

Hyperphosphatasemia in an adult. Clinical, conventional roentgenographic, and CT findings.

A 47-year-old Saudi deaf lady with short stature presented being unable to walk. She had long standing diffuse skeletal deformities, and progressive head enlargement. She had markedly elevated serum alkaline phosphatase.

Unilateral primary pulmonary agenesis and hypoplasia in monozygotic twins.

We describe 10-month-old identical female twin infants, one with primary left-sided pulmonary agenesis and the other with primary left-sided pulmonary hypoplasia. They came to our outpatient clinic complaining of persistent dry cough. The clinical examination revealed decreased air entry over the left hemithorax.

Normal knee angles in the adult Saudi population.

Objective: To study knee angles in the adult Saudi population and compare their values to the published data from other populations.

Methods: Antero-posterior bilateral radiographs of 333 normal knees of 120 males and 213 females, with age range of 18-65 years, were studied retrospectively at King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia, from January 2009 to December 2009. Tibiofemoral (TFA), lateral distal femoral (LDFA), and lateral proximal tibial (LPTA) angles were measured and the mean of each angle was calculated.

Prevalence of adult paraumbilical hernia. Assessment by high-resolution sonography: a hospital-based study.

Background: Abdominal wall hernias are a common imaging finding in the abdomen. Ultrasonography (US) is noninvasive and allows the examination of the patient in a physiological manner. High-frequency annular US probes have become an increasingly important diagnostic tool for detecting pathological lesions in superficial organs.

Prediction of pulmonary hypertension in patients with or without interstitial lung disease: reliability of CT findings.

Purpose: To study the reliability of pulmonary vascular measurements based on computed tomography (CT) in the prediction of pulmonary hypertension (PH) in patients with advanced interstitial lung disease (ILD) compared with those without ILD.

Materials And Methods: The study was approved by the Institutional Review Board. All patients gave written informed consent.

Pictorial Essay: Infants of diabetic mothers.

About 3 to 10% of pregnancies are complicated by glycemic control abnormalities. Maternal diabetes results in significantly greater risk for antenatal, perinatal, and neonatal morbidity and mortality, as well as congenital malformations. The number of diabetic mothers is expected to rise, as more and more of the obese pediatric female population in developed and some developing countries progresses to childbearing age.

Unilateral breast mass in an infant: a rare presentation of spontaneously regressing myofibromatosis.

Breast tumors are very rare in infants. We describe a 4-month-old female infant who presented with a firm and painless right breast mass. It was first noticed at the age of 1 month and then gradually increased in size.