The Use of Laparoscopy in the Management of Trauma Patients : Brief review

 Laparoscopy is one of the most effective intervention modalities, resulting in improved outcomes for major surgeries. In the past decade, the laparoscopic approach in trauma patients has shown better diagnostic outcomes than traditional laparotomies. Furthermore, this approach is cost-effective, significantly reduces the length of hospital stay and contributes to reduced complication rates. However, the use of laparoscopies in trauma cases is generally restricted to patients with normal haemodynamic parameters and is contraindicated for individuals with head injuries. With advances in knowledge and improved training, laparoscopies can also be used in the treatment of other conditions, such as diaphragmatic injuries and organ lacerations. This article briefly reviews the extent of laparoscopy use and its significance in the management of trauma patients

Use of Prophylactic Inferior Vena Cava Filters in Trauma

Venous thromboembolisms, specifically pulmonary embolisms (PEs), represent a significant burden on healthcare systems worldwide, particularly within the setting of trauma. According to the literature, PEs are the most common cause of in-hospital death; however, this condition can be prevented with a variety of prophylactic and therapeutic measures. This article aimed to examine current evidence on the use, indications for prophylaxis, outcomes and complications of prophylactic inferior vena cava filters in trauma patients

Missed Gastric Injuries in Blunt Abdominal Trauma : Case report with review of literature

Hollow viscus injuries of the digestive tract are an uncommon occurrence in blunt abdominal trauma. We report a 39-year-old male who was hit by a vehicle as a pedestrian and admitted to the Sultan Qaboos University Hospital, Muscat, Oman, in 2015. He underwent an exploratory laparotomy which revealed injuries to the distal stomach, liver and descending colon. Postoperatively, the patient was febrile, tachycardic and hypotensive. Abdominal examination revealed distention and tenderness. The next day, a repeat laparotomy identified a gastric injury which had not been diagnosed during the initial laparotomy. Although the defect was repaired, the patient subsequently died as a result of multiorgan failure. Missed gastric injuries are rare and are associated with a grave prognosis, particularly for trauma patients. Delays in diagnosis, in addition to associated injuries, contribute to a high mortality rate

Leiomyoma of the Round Ligament of the Uterus : Case report and review of literature

Smooth muscle tumours of the round ligament of the uterus are rare and can mimic an inguinal hernia. Preoperative diagnosis can be established by a computed tomography scan of the abdomen or an exploration of the inguinal canal. Surgical excision is the curative treatment

Comparison of Postoperative Drain Insertion versus No Drain Insertion in Thyroidectomies : Retrospective case-control study from the Sultan Qaboos University Hospital, Muscat, Oman

Objectives: A thyroidectomy is a frequently performed surgical procedure which can result in lifethreatening complications. The insertion of a drain after a thyroidectomy has been suggested to prevent such complications. This study aimed to evaluate the use of surgical drains following thyroidectomies in relation to postoperative complications and mass sizes. Methods: This retrospective case-control study included all thyroidectomies conducted at the Sultan Qaboos University Hospital, Muscat, Oman, from January 2011 to December 2013. Length of hospital stay, readmission, postoperative complications and mass size were evaluated. Results: During the study period, 250 surgeries were carried out on 241 patients. The majority of patients were female (87.2%). Drains were inserted postoperatively after 202 surgeries (80.8%) compared to 48 surgeries (19.2%) without drains. A total of 32 surgeries (12.8%) were conducted on patients with thyroid masses <1 cm, 138 (55.2%) on those with masses between 1–4 cm and 80 (32.0%) on those with masses >4 cm. The association between drain use and mass size was not significant (P = 0.439). Although postoperative complications were more prevalent in patients with drains, the relationship between these factors was not significant (P >0.050). Length of hospital stay was significantly longer among patients with postoperative drains (P <0.010). Conclusion: The routine insertion of drains after thyroid surgeries was found to result in longer hospital stays and did not reduce rates of postthyroidectomy complications. Thyroid mass size should not be used as an indicator for the insertion of a drain after thyroidectomy

The Impact of the COVID-19 Pandemic on the Pattern of Trauma Presenting to a Tertiary Care Trauma Center in Oman

Objective: We noticed a change in the pattern of presentation of trauma cases at SQUH, before the pandemic and during the two waves. Our study aimed at studying this observation. Methods: This retrospective study was from January 2019 to October 2021. Data of all trauma patients was collected from the hospital information system after ethics committee approval. The pattern of trauma was divided into pediatric, adult, and geriatric age groups. Location of trauma was described as outdoor, home and roads along with the details of mechanism of trauma was collected. Patients with incomplete data were excluded. Results: Based on the inclusion criteria 589 records were analyzed. The mean age of presentation was 29 years. Majority were male (71%). Adults were (54.2%), pediatrics (34%) and geriatric (11.9%). There was a gradual increase in percentage of pediatric trauma during pre-COVID, COVID wave 1 and COVID wave 2 (29%, 32%, 51%), respectively. A significant decline in the number of geriatric trauma by almost 50% between pre-covid and covid phase II. Increase in trauma at home during COVID phase II (65.9%) as was an increase in penetrating trauma during COVID phase II (16.5%). ICU admissions increased during the first wave of the pandemic (10.5%). Conclusion:  We noted a true change in the pattern of trauma cases before and during the COVID -19 pandemic. Observations made could lead to better safety guidelines for the pediatric age groups and take steps to reduce penetrating trauma. Keywords: Trauma, coronavirus, COVID-19, Oman, Muscat, Epidemiology

Insomnia in chronic renal patients on dialysis in Saudi Arabia

<p>Abstract</p> <p>Background</p> <p>Studies have shown that insomnia is a common sleep disorder among patients with end-stage renal disease (ESRD). This study aimed to assess the prevalence of insomnia in Saudi patients with ESRD who are on maintenance dialysis.</p> <p>Methods</p> <p>This was an observational cross-sectional study carried out over a period of five months in two hemodialysis centers in Saudi Arabia. To assess the prevalence of insomnia, we used the ICSD-2 definition. We also examined the association between insomnia and other sleep disorders, the underlying causes of renal failure, dialysis duration, dialysis shift, and other demographic data.</p> <p>Results</p> <p>Out of 227 enrolled patients, insomnia was reported by 60.8%. The mean patient age was 55.7 ± 17.2 years; 53.7% were male and 46.3% were female. Insomnia was significantly associated with female gender, afternoon hemodialysis, Restless Legs Syndrome, high risk for obstructive Sleep Apnea Syndrome and excessive daytime sleepiness (<it><b>P-values: </b></it>0.05, 0.01, < 0.0001, < 0.0001, and < 0.0001, respectively). No significant association was found between insomnia and other variables, including BMI, smoking habits, underlying etiology of renal failure, dialysis duration, association with hemoglobin, ferritin, and phosphorus or dialysis adequacy as measured by the Kt/V index.</p> <p>Conclusion</p> <p>Insomnia is common in dialysis patients and was significantly associated with other sleep disorders. Greater attention needs to be given to the care of dialysis patients with regard to the diagnosis and management of insomnia and associated sleep disorders.</p

Blunt Cerebrovascular Injuries: A review of the literature

Blunt cerebrovascular injuries (BCVI) have been a topic of interest to many researchers worldwide as evidenced by the vast amount of available literature. The interest in these rare injuries is probably due to the significant possibility of mortality and morbidity amongst patients who sustain them, when the employment of radiological screening methods could prevent such an outcome. Recognition of these injuries is the most important step towards prevention of adverse outcomes. We present a comprehensive review of the literature regarding the mechanism of injury, imaging, management, and complications of BCVI. Articles were identified through a search of MEDLINE and the Cochrane Central Register of Controlled Trials using the keywords Blunt; Vascular; Carotid; Vertebral; Trauma; Stroke; Management, and Endovascular. The search was limited to humans and articles in English