Background: Traumatic injury is a leading cause of morbidity and mortality in developed countries worldwide. Recent studies suggest that many deaths are preventable if injuries are recognized and treated in an expeditious manner – the so called 'golden hour' of trauma. Ultrasound revolutionized the care of the trauma patient with the introduction of the FAST (Focused Assessment with Sonography for Trauma) examination; a rapid assessment of the hemodynamically unstable patient to identify the presence of peritoneal and/or pericardial fluid. Since that time the use of ultrasound has expanded to include a rapid assessment of almost every facet of the trauma patient. As a result, ultrasound is not only viewed as a diagnostic test, but actually as an extension of the physical exam. Methods: A review of the medical literature was performed and articles pertaining to ultrasound-assisted assessment of the trauma patient were obtained. The literature selected was based on the preference and clinical expertise of authors. Discussion: In this review we explore the benefits and pitfalls of applying resuscitative ultrasound to every aspect of the initial assessment of the critically injured trauma patient.

Ultrasound guidance during central line insertion has significantly reduced complications associated with this procedure and has led to it being incorporated as standard of care in many institutions. However, inadvertent arterial penetration and dilation remains a problem despite ultrasound guidance and can result in significant morbidity and even mortality. Dynamic ultrasound confirmation of guidewire position within the vein prior to dilation may help to prevent and even eliminate this feared complication.

Comparison of the efficacy of standard bariatric surgical procedures on Saudi population using the bariatric analysis and reporting outcome system

Background: Adults in Saudi Arabia are more likely to be obese, which has negative effects on reproductive health, especially for women. While bariatric surgery (BS) provides a sustainable approach, little is known about how it affects menstrual health and requires a study among the Saudi demographic. Methods: The current investigation is a cross-sectional study conducted in Saudi Arabia. Data were collected using an online questionnaire to assess the impact of BS on menstrual abnormalities in women. Data were cleaned in Excel and analyzed using the Statistical Package for the Social Sciences (IBM SPSS Statistics for Windows, IBM Corp., Version 24.0, Armonk, NY). Results: This study included 516 Saudi women who underwent various BS procedures, with 37.2% aged 18-30 years and 97.9% residing in Saudi Arabia. Approximately 85.9% underwent sleeve gastrectomy (SG), experiencing a mean weight loss of 54.2 kg. Co-morbidities included polycystic ovary syndrome (PCOS) (12.4%), hypothyroidism or hyperthyroidism (11%), uterine fibroids (4.7%), and hormonal imbalances (2.5%). Post-surgery, 18% encountered BS complications from BS, while 8.3% used antidepressants. Moderate sports participation ranged from 12.2% (five or more days) to 36.2% (one to three days). In particular, no significant associations were found between complications and various parameters, except a marginal association with educational level (p=0.071). The number of menstruations per year did not change statistically significantly, remaining constant at 10.6 +/- 4.8 before surgery and 10.6 +/- 4.9 after surgery (p = 0.859). However, there was a mild decrease in the amount and duration of menstruation, reported by 23.3% and 27.3% of the participants preoperatively and post-operatively, respectively. Conclusion: The study demonstrates the impact of BS on menstrual abnormalities in Saudi women. Despite a significant weight reduction, we found mild improvement in the amount and duration of menstruation with no substantial effect observed on the menstrual cycle frequency. Psychological support after surgery is crucial, considering the increased use of antidepressants.