[63] Traumatic testicular displacement and torsion: A case report and literature review

Objective: To report on a case of traumatic testicular displacement (TTD) and torsion, which is a rare consequence of pelvic trauma. Methods: A 34-year-old motorcycle rider who presented immediately following a head-on collision with a car. His past surgical history included bilateral inguinal varicocoele repair. The patient recalled that his genitals collided with a part of the motorcycle before coming off the vehicle. He complained of left-sided groin pain and was found to have an empty left hemi-scrotum, a tender palpable lump in the left suprapubic region, and bruising in the area. A contrast-enhanced computed tomography (CT) scan revealed an empty scrotum and an ovoid structure measuring 5 × 3 × 4 cm in the subcutaneous tissue with an adjacent spermatic cord and surrounding fat stranding. He was immediately transferred to the operating theatre for surgical exploration of the lower abdomen. Results: After anaesthesia, the testis was repositioned into the scrotum and then we proceeded with exploration of the scrotum that revealed a torted left testicle. De-torsion, warm fomentation and orchidopexy of a viable left testicle was performed. He made an uneventful recovery. He was then transferred to a tertiary trauma centre for further management of his injuries. TTD is defined as migration of one or both testicle outside the scrotum. The most common mechanism of trauma is a rapid deceleration straddle injury against a motorcycle fuel tank. Predisposing factors include inguinal hernia repair, wide external inguinal ring, and atrophic testes. Radiological examinations of choice include colour-flow Doppler ultrasonography and CT scans of the abdomen and pelvis. Management consists of either closed reduction of the testicle or surgical exploration. Conclusion: Early diagnosis and management of TTD is imperative to preserve the displaced testicle

Knowledge about Epilepsy and Attitudes toward Students with Epilepsy among Middle and High School Teachers in Kuwait

Background and Objectives. Attitudes toward students with epilepsy and epilepsy-related knowledge of teachers are crucial for child’s safety in the school. The aim of this study was to evaluate teachers’ knowledge and attitudes toward epilepsy. Methods. This cross-sectional study included 824 teachers from 24 randomly selected middle and high schools. Scale of Attitudes Toward Persons with Epilepsy (ATPE) was modified to assess teachers’ knowledge about epilepsy and attitudes toward students with epilepsy. Results. Median knowledge score about epilepsy was 5 (out of 13), while median attitude score was 10 (out of 15). Both knowledge and attitude median scores were significantly higher in senior teachers with longer teaching experience and in respondents who dealt with a person with epilepsy. There was significant association between knowledge score and attitude score (p<0.01). Logistic regression showed that significant variables, independently associated with poor knowledge after adjusting for possible confounders, were not having a family member with epilepsy (p=0.009), unawareness of life circumstances of persons with epilepsy (p=0.048), and a poor attitude score (p<0.001). Conclusion. School teachers in Kuwait have relatively poor knowledge about epilepsy but have positive attitudes toward students with epilepsy. A number of historical and stigmatizing ideas about epilepsy still exist. It is recommended to provide teachers with information about handling seizures in the educational setting through development and implementation of epilepsy education programs