IntroductionOne of the major psychological factors that can affect the outcome of hip arthroplasty is postoperative kinesiophobia, which is defined as a fear of movement. The effect of kinesiophobia and excruciating pain has not been widely explored in hip arthroplasty literature especially in Saudi Arabia. AimThis study aimed to investigate kinesiophobia and pain catastrophizing after total hip arthroplasty (THA) in

Flood syndrome is a spontaneous rupture of an umbilical hernia. It has a high mortality and morbidity and presents many challenges in medical versus surgical management. We present a case of a 23-year-old Yamani woman with complicated umbilical hernia, newly diagnosed hepatitis B infection, and decompensated liver cirrhosis with ascites (Child-Pugh grade B). The patient was undergoing multiple abdominal ascitic tapping that eventually ruptured with an omentum evisceration, causing Flood syndrome. An urgent umbilical hernioplasty with mesh in a sublay technique was conducted.

Malaria presents a challenge to healthcare systems globally. It is associated with severe complications, notably splenic rupture. The prognosis of malaria complicated by splenic rupture is poor and sometimes leads to death even with timely intervention. Here, we report the case of a patient who presented with complicated malaria with spontaneous splenic rupture and coincidental acute appendicitis. A 34-year-old man was successfully treated for a grade IV ruptured spleen and acute appendicitis with splenectomy and appendectomy. Postoperative care took place in the intensive care unit and the patient was shifted to the general floor on the fifth day. Upon discharge the next day, he was prescribed amoxicillin twice daily for one year. Malaria can present with life-threatening complications requiring prompt surgical intervention.

Rectal procidentia is an uncommon perineal disease that is rare in males. There is no specific medical role in treatment of rectal procidentia and surgical intervention is the treatment of choice. Various surgical approaches have been performed, but there is no consensus on which procedure is most effective in terms of patient condition, recurrence rate, bowel function, and risk. This case presentation of a healthy male patient with experience of uncomplicated reducible rectal prolapse and a history of chronic constipation. Presented with complicated rectal prolapse in the presence of incarcerated rectal prolapse after a failed trial with conservative maneuvers, he ended up with abdominal approach sigmoidectomy and posterior mesh rectopexy.

Background Patients with avascular necrosis related to sickle cell disease (SCD) can be severely disabled by the severe degenerative changes of their hip. Total hip arthroplasty (THA) remains the only surgical option for some of these patients. Total hip arthroplasty can be a challenging procedure, and SCD patients demonstrate high percentages of medical, intraoperative, and postoperative complications and implant failure. Furthermore, the need for THA following avascular necrosis in the Eastern Province of Saudi Arabia is high, and the subsequent risk of periprosthetic fracture is prevalent. Therefore, it is crucial to conduct such a study. Aim of the study This cross-sectional retrospective study aimed to assess the prevalence and associated risk factors for periprosthetic fractures during total hip arthroplasty in sickle cell disease patients at King Fahad Hospital Hofuf, Saudi Arabia. Methods We collected the data of all SCD patients who had undergone THA during the study period, January 2015 to September 2020. Forty-nine SCD patients who had undergone THA during the study period were included. Patients who had undergone hip hemiarthroplasty, postoperative fractures, or had an indication of THA other than avascular necrosis were excluded. Surgeon factors, assistant factors, and surgical technique were also excluded. We then analyzed the data according to gender, age, BMI, American Society of Anesthesiologists classification, implant fixation type, avascular necrosis stage, proximal femoral morphology, Vancouver classification type, sickle cell type, preoperative hemoglobin (Hb) level, and the risk of periprosthetic fractures. Descriptive statistics were presented using frequency and percentages for categorical variables, and continuous variables were summarized using means ± standard deviations. Independent t-tests and chi-square tests were used to test for associations between categorical variables. At 0.05, the significance level was set. Results Of the patients, 32.7% were male and 67.3% were female. 32.7% of the patients had advanced degenerative changes due to avascular necrosis. Among the patients, 20.4% had an intraoperative periprosthetic femoral fracture, 90% had a Vancouver classification class A, and 10% had a Vancouver classification class B1. According to Dorr classification, 75.5% were classified as Dorr A and 24.5% as Dorr B. Of the patients, 48 had an uncemented implant, and only 1 had cemented. The mean perioperative Hb was 9.02 + 2.02, with a minimum of 6 and a maximum of 14. No significant associations were found between the incidence of intraoperative femoral fracture and the demographic variables and the operative profile characteristics. However, a significantly higher rate of fracture was observed in patients operated on the right side compared to patients operated on the left side. Conclusion The prevalence of periprosthetic intraoperative fracture among SCD patients at King Fahad H...