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Introduction: Aneurysmal bone cysts (ABCs) are aggressive and benign tumors that primarily affect children and adolescents. The standard course of treatment for ABCs involves surgical excision or curettage with a bone transplant or cement to repair the deficiency. Denosumab, a monoclonal antibody that inhibits receptor activator of nuclear kappa B ligand, is used to treat osteoporosis, skeletal metastasis, and giant cell tumors of the bones. Case Report: This case study details the therapeutic treatment of a female patient, age 22, who had a recurring aggressive ABC of the distal tibia. The patient was initially treated using curettage and lesion filling. However, recurrence of the osteolysis was observed 9 months later that led to subsequent interventions involving absolute alcohol sclerotherapy in multiple sessions. However, these interventions failed to achieve ossification. Following unsuccessful surgical and sclerotherapy treatments, the patient was administered denosumab, which led to a positive response. Regular radiographic and clinical follow-up demonstrated significant improvements in ossification and pain reduction. During the course of the 12-month treatment, the frequency of visits was gradually reduced. Further, follow-up and monitoring revealed the effectiveness of the local control and long-term treatment. Conclusion: This case report highlights the ability of denosumab to manage recurrent aggressive ABCs after surgical or sclerotherapy failure.
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This study presents a rare case of hydatid cyst (HC) located in the left thigh, an atypical site for this parasitic infection, which typically affects the liver and lungs. A 22-year-old female presented with a gradually increasing swelling in the anterior aspect of her left thigh over a period of six months. The diagnosis of the thigh HC was established through a combination of imaging techniques, including ultrasonography and magnetic resonance imaging (MRI), and serological tests. The patient underwent surgical removal of the cyst. We also highlight a management strategy for perioperative accidental rupture of the cyst to minimize the risk of dissemination and reduce the likelihood of recurrence. This report emphasizes the need for a careful multidisciplinary approach to ensure effective diagnosis and successful management of HC, particularly when they occur in atypical locations.
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Introduction Prolonged sun exposure has been linked with the development of numerous medical and dermatological complications, such as skin cancer. Photoprotection can help reduce ultraviolet radiation (UVR)-induced skin damage and skin cancer. This study aims to assess the knowledge about and attitude toward the use of sun protection to prevent laser adverse events among the general population in Saudi Arabia. Methodology This is a cross-sectional, analytical, community-based study carried out among the general population (sunscreen users) in Saudi Arabia. A total of 600 participants were enrolled in the study. Data were collected using a validated online self-administered questionnaire using Google Forms. Data were analyzed using IBM SPSS Statistics for Windows, Version 21.0 (IBM Corp., Armonk, NY). Results A total of 600 sunscreen users were enrolled in this study, with an overall poor knowledge rate of 471 (78.5%) regarding the use of sun protection methods. Their ages ranged from 18 years to >55 years. The majority of them were females (537, 89.5%), had Saudi Nationality (533, 88.8%), and had skin type III (313, 52.2%). Almost all the participants (491, 81.9%) had undergone laser treatment before; the most reported reason was hair removal (522, 87%). In addition, 267 (44.5%) participants used sunscreens five to six times a week, with 440 (73.3%) also using sunglasses. Notably, only 91 (15.2%) of the study participants were aware that sunscreen covers UVA and UVB, and 34 (5.7%) knew that PA+++ is used in sunscreen. A total of 149 (24.8%) reported that sunscreen should be applied 20 to 30 minutes before sun exposure, while 153 (25.5%) stated that it should be reapplied every two hours. Moreover, 484 (80.7%) participants reported using topical steroid application after laser treatment. The results also showed that young participants (P = 0.001), single participants (P = 0.001), post-graduate participants (P = 0.010), students rather than the unemployed group (P = 0.002), and those who used sunscreens five to six times per week compared to those who never used sunscreens (P = 0.001) demonstrated an overall good knowledge about sunscreens and laser treatment. Conclusions The study showed poor knowledge among the participants regarding the use of sun protection to prevent adverse laser events. Therefore, an increase in awareness among the general public about the protection through campaigns is highly recommended.
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Osteogenesis imperfecta is a rare genetic disorder of type 1 collagen which primarily affects children and leads to recurrent bone fractures. In addition, spinal abnormalities can also occur. We report a case of a 13-year-old male with osteogenesis imperfecta type III, associated with severe femur deformity and thoracic kyphoscoliosis, who developed neurological injury after lower extremity surgery. The patient was in a supine position when general anesthesia was administered. The operation lasted for approximately 250 minutes, and anesthesia for 310 minutes, with an estimated blood loss of 600 cc. Apart from a low mean arterial pressure value (45 mm Hg) intraoperatively, the procedure was uneventful. Early postoperatively, he developed spinal paralysis at the level of T4-T7, and an MRI of the spine demonstrated high signal intensity within the spinal cord from level T3 to T7. Subsequently, he was admitted to the pediatric intensive care unit for further assessment and management. Follow-up revealed recovery of paralysis after 12 months.
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Vogt-Koyanagi-Harada disease (VKHD) is a rare multisystemic granulomatous disorder that mainly affects the central nervous system, eyes, inner ears, and skin, basically organs rich with melanocytes. This case report describes an 11-year-old Saudi Arabian female who presented with a six-month history of decrease in vision in both eyes associated with neck pain, right ankle pain, fatigability, and skin depigmentation. Her ophthalmological examination showed visual acuity of 6/30 oculus dextrus (OD) and 6/60 oculus sinister (OS), and her fundoscopic examination revealed vitreous opacity mainly in the right eye. Optical coherence tomography (OCT) demonstrated macular edema along with infiltration and optic edema. She was initially diagnosed as having posterior uveitis and treated with oral prednisone and steroid eye drops. A month later, her ophthalmological examination revealed a rebound of macular edema. Dosages of steroid and adalimumab injection were raised, and azathioprine was added. Her left macular edema was not resolved; therefore, an aflibercept injection was added. A differential diagnosis of VKHD needs to be considered. Any patient who presents with posterior uveitis should be screened for VKHD. Physicians and ophthalmologists need to be more aware of VKHD, as it can cause serious complications.