The impact of amputation on patients' social and psychological well-being has been demonstrated. However, the experiences and requirements of amputees during the adjustment phase vary between amputees. This study aimed to assess how amputation affects psychosocial life and the quality of life (QOL) in the amputees, the psychosocial processes involved in adjusting to amputation and a prosthesis, and the burden of amputees on caregivers in Saudi Arabia. A cross-sectional study was placed from November 2021 to February 2022, and it included all amputees and caregivers available at the time of the study. A total of 239 amputees and 219 caregivers were included in the study. The average level of the physical component score (PCS) was 63.5% ± 14.6% and 57.3% ± 12.9% for the mental component score (MCS). There is a significant positive correlation between psychological adjustment total and satisfaction with prosthesis with PCS and MCS dimension of QOL. Considering the QOL, PCS mean score was significantly higher among prosthetics users than among non-users (68.2 ± 15.5 vs. 59.9 ± 12.8, respectively; P=.001). Also, the MCS score was significantly higher among prosthetics users than among non-users (59.5 ± 12.4 vs. 55.5 ± 13.0, respectively; P=.001). A total of 15.1% of caregivers experienced a high burden, while 23.3% had a mild to moderate burden, but 61.6% had no or little burden. Our finding shows there are correlations between psychological adjustment total and satisfaction with prosthesis with PCS and MCS dimension of QOL. The findings emphasize the importance of psychological and social support to be considered in caregivers’ health assessments. Also, the physical health of the caregivers should be fundamental in their lives as it minifies the caregiver burden. Further studies should be considered with a larger sample of amputees and longitudinal studies to evaluate the adaptation changes over time, caregiving burden, and family functioning.

Background: Post-inflammatory hyperpigmentation (PIH) is skin hyperpigmentation that occurs due to any inflammatory condition. Triggering the melanocytes by inflammation leads to melanin overproduction and deposition. Tranexamic acid (TXA) is an antifibrinolytic medication prescribed to treat bleeding. Recently, there are some studies about the use of TXA in the treatment of PIH. Objective: The aim of this study is to identify the efficacy and the best mode of delivery for tranexamic acid in the treatment of PIH. Methods: This systematic review is reported in accordance with PRISMA guidance. We included all relevant English-language studies that were published up to September 2022 in the following electronic databases: Cochrane Library, PubMed, Embase, and Google Scholar. The initial search yielded 61 articles, 9 of which were included after applying inclusion and exclusion criteria. Results: The systematic review included a total of 196 patients who were over the age of 16 years old. Tranexamic acid was delivered orally in 4 studies, topically in 2 studies, and both simultaneously in 1 study. In addition, intradermal injection was used in 2 other studies. Almost all studies advocated the use of all routes for accelerating the clearance of hyperpigmentation with more favor towards topical and intradermal routes due to their mild reported side effects when compared to oral routes. Conclusion: Intradermal TXA is considered the best route, which exhibits fewer side effects with less cost and excellent outcomes, while oral TXA is found to be less preferable than other routes due to the incidence of undesirable adverse events.

Cutaneous leishmaniasis (CL) is a vector-borne parasitic disease that is transmitted via the bites of infected female sandflies. CL has been endemic in several countries worldwide for many decades, and numerous cases have been reported in Saudi Arabia, particularly across six regions; one of which is AL-Ahsa. Our research aimed to evaluate the epidemiological situation of CL among the patients in Al-Ahsa, Eastern region, Kingdom of Saudi Arabia, during the period from 2017 to 2023. The data were collected from the patients’ registries and included 245 patients who were diagnosed with CL in Al-Ahsa, Saudi Arabia. Fewer than half of the cases (47.8%) were Saudi patients, with a significant number of them being males (84.5%). Over half of the cases (52.7%) were aged between 21 and 40 years, and about three-quarters (74.7%) of the cases resided in rural areas. Regarding the nature of the lesions, 38.4% of the cases had one lesion, which was mainly distributed on a lower extremity (62.0%) or an upper extremity (52.2%). A high percentage of the lesions (75.2%) were wet lesions and caused by L. major. Concerning risk factors, a greater number of patients (71.4%) had been in rural areas within the last three months. Additionally, more than half of the cases (54.3%) had close contact with rodents, followed by birds (28.2%), sheep (22.0%), dogs (16.3%), and other animals (1.2%). The results showed a low number of reported CL cases in 2020 and 2021, followed by a surge in 2022 and 2023. The study shows that cutaneous leishmaniasis is still a public health problem in Al-Ahsa and is primarily associated with rural areas.

Haemophilus influenzae is a gram-negative pleomorphic coccobacillus associated with many diseases, such as meningitis, pneumonia, septicemia, cellulitis, and otitis media. The most virulent and most common serotype is H. influenzae type b (Hib), which was responsible for the majority of meningitis cases until the development of vaccines that led to a decrease in its incidence worldwide. Here, we report the case of an 11-month-old female infant who was previously healthy and fully vaccinated against Hib and developed sepsis and meningitis. The patient was managed as a case of partially treated bacterial meningitis but failed to respond to a short-duration course of antibiotics and had focal seizures of the left hand. Non-contrast brain MRI revealed multiple and bilateral brain abscesses more evident on the left side. The patient was then followed up with imaging every 10-14 days to monitor the response and resolution of the brain abscesses. She was successfully treated with a full course of intravenous ceftriaxone for six weeks until imaging was clear and the brain abscesses were nearly undetected. Invasive H. influenzae infections are considered emerging cases, and there is a need to consider and suspect the disease even in fully vaccinated patients.

BCC is the most prevalent form of skin cancer; thus, it is important to recognize that it poses a significant global health challenge. Various multifactorial risk factors can contribute to the development of BCC such as having fair skin, aging, chronic sun exposure, and tanning beds. Typically, exposed body parts are the frequent location identified for BCC. Here, we report a case of a 53-year-old Saudi female, who presented with an incidental pigmented lesion over her left axillary fold with features of suspicious of BCC.