Children with autism spectrum disorder (ASD) face several challenges in the healthcare setting. This study defines the challenges experienced by children with autism in hospitals in Saudi Arabia. A cross-sectional study was conducted using a questionnaire for guardians of autistic children in outpatient clinics, autism support groups, and rehabilitation centers. A total of 199 participants were included. The medical procedures causing the most anxiety to children were injections and getting their blood drawn (68.3%), vital sign measurement (41.6%), and height and weight measurement (37.8%). Long waiting hours (44.1%), increased sensory stimuli (33.2%), and overcrowding of hospital staff (27.9%) were stress-inducing in the healthcare environment. The guardians recommended that loud noises (44.7%), crowdedness (41.2%), and long waiting hours (42.1%) be avoided. The nonverbal children experienced significantly higher levels (p < 0.001) of agitation, irritability, and outbursts during doctor visits than their verbal counterparts. The children with intellectual disabilities were more tense and unresponsive during doctor visits (33.3%) than their intellectually able counterparts, who more frequently were calm and responsive (44.9%) during visits. Most patients with ASD face hardships during hospital visits. Nonverbal patients and those with intellectual disabilities have a higher tendency for hospital setting anxiety-induced outbursts, which may be eased by avoiding loud noise and overcrowding.

Purpose: This study aimed to report the outcomes of hypospadias repair performed at a tertiary-level hospital during 2018 to 2021. Methods: A retrospective chart review of 119 patients was performed. Results: The most frequent coronal hypospadias cases were distal. However, the most common scrotal hypospadias cases were proximal. The average age at the time of the first surgery was 2.4 years (standard deviation, ± 2.3 years). The tubularised incised plate technique was performed for 57 of these 119 patients. Urethral fistula was the most common complication associated with distal and proximal cases (23.96% and 30.43%, respectively). No significant correlation was observed between any complication and the surgical technique. Based on the logistic regression model, the duration of urethral stenting was statistically significant (p=0.025), indicating that a urinary catheter duration of more than 5 days resulted in a 2.9-times increased risk of postoperative urethral fistula. Conclusion: Prolonged urethral stenting for more than 5 days may result in subsequent urethral fistula development. Neither the severity of hypospadias nor the surgical technique seems to affect postoperative complications.

Introduction: We report an atypical case of gastrointestinal basidiobolomycosis (GIB) presenting with recurrent intussusception. Case presentation: A 5-year-old male presented with abdominal pain and subjective fever for one day and was admitted to our hospital as a case of recurrent intussusception. He was diagnosed with intussusception based on ultrasound and underwent two successful hydrostatic reductions. One day later, he developed abdominal pain and vomiting, a CT scan was done and showed recurrent intussusception. He then developed red-currant jelly stool with right upper quadrant tenderness, and exploratory laparoscopy revealed ilio-colic intussusception to the hepatic flexure, an inflamed appendix, and healthy cecum. Five days after laparoscopic reduction and appendectomy , the abdominal pain and vomiting recurred, he had laboratory findings of marked eosinophilia, and his histopathology report showed basidiobolomycosis. Abdominal ultrasound showed recurrent intussusception. The patient was kept NPO on TPN and intravenous voriconazole and gradually improved to tolerating orally and passing stool regularly. He was discharged on postoperative day 16 on oral voriconazole and CT scan done on 7th month of follow up showed complete resolution of the mass. Conclusion: GIB should be included in the differential diagnosis of recurrent intussusception given the appropriate clinical setting. According to our case, prolonged medical management of the fungal mass can be successful without surgical resection.