To evaluates the management and outcome of non-iatrogenic pediatric and adolescence extremity arterial injuries in a resource-challenged setting. A retrospective study of the surgical management for non-iatrogenic extremity arterial trauma in pediatric and adolescence during the period from January 2008 to December 2015. This study was performed in two different countries at tertiary referral university and teaching hospitals having a specialized emergency and trauma centers. A thorough study of each patient record was collected from these centers including, the original demographic data and their clinical presentations. Operative data of each patient was also reported. During the 8-year period of the study, 149 pediatric and adolescent extremity arterial trauma patients were treated. They were 93.3% male, and 6.7% female, respectively. The age ranged from 2 to 18 years with a mean of 10.25 ± 4.05 years. Lower extremity arterial trauma was recorded in 51%, while 49% were having upper extremity injuries. Primary repair with end-to-end vascular anastomosis was performed in 51.7%, while an interposition reversed saphenous vein graft was performed in 48.3%. The operative procedures were performed by an experienced vascular surgeon and well-trained pediatric surgeons and general surgeons. Pseudoaneurysms was recorded in 9% of cases. Fasciotomy was performed in 15% of cases. Treatment of pediatric and adolescent extremity arterial injuries with primary end-to-end vascular anastomoses or with the use of an interposition reversed saphenous vein graft is a reliable, feasible, and more cost-effectiveness technique with good results. Moreover, it should be adopted for all vascular trauma patients, whenever possible.

Objectives: To assess the prevalence of burnout among emergency and surgical residents and explore the associated factors. Methods: This study was carried out at King Faisal University, Al Hofuf, Saudi Arabia, through the period from January to march 2024. A cross-sectional survey design was employed, utilizing the Maslach burnout inventory-human services survey and the resilience scale-14 to measure burnout and resilience. The survey included demographic information, health-related questions, and specific burnout-related items. Descriptive statistics, frequency distributions, and inferential analyses were carried out to explore the relationships between burnout, demographic factors, and resilience. Results: The study revealed a diverse representation across demographic factors, with variations in burnout prevalence. Approximately 63% of participants reported experiencing burnout, with high levels of emotional exhaustion (55%) and depersonalization (28%). Resilience levels varied across different demographic characteristics. Significant associations were found between burnout and factors such as gender, marital status, having children, specialty, length of experience, and enrollment in postgraduate programs. Conclusion: The findings underscore the urgent need for targeted interventions to address burnout in healthcare professionals. The nuanced relationships between burnout, resilience, and demographic factors highlight the importance of tailored strategies to mitigate burnout effectively. Addressing burnout is crucial not only for the well-being of healthcare professionals but also for maintaining high-quality patient care.

Introduction: Hypoglossal nerve palsy (HNP) is a rare complication of airway management. Multiple factors have been postulated to contribute to its occurrence. Herein, we present a case of ipsilateral HNP following left hemithyroidectomy. Case presentation: A 47-year-old women presented complaining of left thyroid swelling for 1 year with no symptoms of compression or hormonal impairment. Ultrasound of the neck showed a 3 × 2 cm nodule in the left thyroid lobe without lymphadenopathy. Fine-needle aspiration revealed a follicular neoplasm. Left hemithyroidectomy was carried out uneventfully. Three hours postoperatively, the patient started to complaint of dysarthria, dysphagia and odynophagia with clinical sign of tongue deviation to the left side. Head and neck CT ruled out mass effect or ischemic event, and the diagnosis of left HNP was established. Four months postoperatively, the palsy was completely resolved. Histopathology examination of the thyroid nodule showed follicular adenoma, and no further intervention was provided. Discussion: Few cases of HNP are reported in the literature following oropharyngeal manipulation. Factors such as the type of surgery, position changes, and intubation characteristics have been linked to the incidence of HNP. Most of the cases recovered spontaneously, indicating a neuro-paxic type of injury. One case of HNP was reported following robotic total thyroidectomy, which was referred to as iatrogenic complication, and resulted in permanent paralysis. We believe that our case is the only reported case of transient ipsilateral HNP following a conventional left hemithyroidectomy. Conclusion: Strap muscles retraction and neck extension during thyroidectomy could predispose to HNP. Highlights:

Introduction: Graves' disease characteristically presents with a diffuse goiter secondary to the autoantibodies that target the thyrotropin receptors of the thyroid gland. Few cases have been reported of only one of the two lobes being affected. The cause of this phenomenon is still uncertain. Here we report on another case of unilateral Graves' disease. Case presentation: A 43-year-old female patient presented with a history of weight loss, palpitations and right sided neck swelling for 4 months. Clinical examination showed an enlarged right thyroid lobe. Laboratory investigations yielded evidence of thyrotoxicosis with suppressed thyroid stimulating hormone. In addition, anti-TSH receptor and anti-thyroperoxidase antibodies were positive. Neck Ultrasound showed an enlarged right thyroid lobe with increased vascularization. The isthmus and left lobe were both normal in size. A Tc ^99m pertechnetate thyroid scan demonstrated enlargement of the right thyroid lobe with diffuse intense uptake, whereas the left lobe was suppressed. A diagnosis of unilateral Graves' disease was made. The thyrotoxicosis was treated and maintained with methimazole. Discussion: Unilateral Graves' disease is a rare manifestation of Graves' disease, sharing the same autoimmune background and the symptoms of thyrotoxicosis. Enlargement of only one lobe was evident on clinical examination. The distinctive feature was unilateral uptake during thyroid scintigraphy. The exact pathophysiology of this condition has yet to be elucidated. Management options and responses are similar to those of classical Graves' disease. Conclusion: Unilateral uptake during thyroid scintigraphy and/or unilateral lobar goiter in the setting of hyperthyroidism can be the presentation of unilateral Graves' disease. Highlights:

Background and Objectives: On a local and national scale, genitourinary malformations (GUMs) are the second most encountered congenital anomaly in children. GUMs are linked to several risk factors, including maternal co-morbidities and insufficient folic acid. They may also be related to maternal health and care during pregnancy. Expanding our knowledge about these factors is necessary for the development of preventative measures, which could reduce GUM incidence. This study evaluated the local youth’s understanding and perceptions of genitourinary anomalies. Materials and Methods: This cross-sectional, qualitative, anonymous, questionnaire-based study involved members of the local population, aged 18 years or over. Based on a 5% type I error rate (α = 0.05) and an 80% response rate, a sample size of 481 was determined. The questionnaire was completed by 902 people. The data were analyzed using SPSS version 25 (IBM). Results: Over half (57%) of respondents believed that hormonal therapy during pregnancy could increase GUM risk. Moreover, 46% thought that maternal chronic diseases could be another risk factor, while 43% believed that pregnancy-related conditions, such as pre-eclampsia, increased GUM risk. Women had higher odds of high perception scores than men, according to the univariate and multivariate analyses. Most participants (74%) strongly agreed that proper and ongoing prenatal follow-ups are necessary, 69% agreed that premarital medical check-ups are necessary, and 67% believed that optimal nutrition throughout pregnancy is necessary to reduce GUM risk. Conclusions: The results emphasize the necessity of developing healthcare strategies specifically designed to increase knowledge about GUMs and overcome incorrect community perceptions of risk factors that could also help improve attitudes towards prevention and ultimately reduce the incidence of GUMs.