Overweight and obesity are the fifth leading cause for global deaths. At least 2.8 million adults die each year as a result of being overweight or obese.Like many countries, obesity is becoming one of the most important public health problems in Saudi Arabia. People are getting fatter in almost every age group. If body weight is not controlled, it may lead to major health complications and unwanted dependence on others. According to the WHO there will be close to 2.3 billion overweight adults on this planet by 2015.In addition to adult obesity, child Obesity is a major problem in many developing countries. Overweight and obesity are the major risk factors for diabetes type 2, heart disease, stroke and some types of cancers. New research has suggested that obesity is more prevalent in children with both parents obese additionally obesity during adolescence is linked to increased mortality rates during adulthood. Our results show that percentage of Saudi overweight or obese children is four fold higher (19% overweight and 29% obese male children) than the world obese and overweight children rate of 10%. Like many countries adult and child obesity is on the rise in Saudi Arabia. In this study we decided to study the percentage of obese people among school aged adolescent children and the adult population of Hail region of Saudi Arabia. Hypothesis: Percentage of overweight and obese people is rising in Saudi Arabia. Method: BMI was measured for all of our subjects additionally questions were asked regarding their family history such as how often they exercise, watch TV, how often they eat red meat, prevalence of colon cancer (due to inadequate vegetable consumption), preference for sweets, etc. Results: Our results show that 48% of male children were obese or overweight, 46% normal and 6% underweight. Among female children 20% were overweight and 13% were found to be obese. Obesity rates were shockingly high (73% Obese) among adult Saudi population. We found 58.4 % adults to be obese and 15.4% were severely obese. 9.9% adults were found to be overweight.

IntroductionSclerosing encapsulating peritonitis (SEP) is a rare cause of intestinal obstruction in which the bowel and internal abdominal organs are wrapped with a fibrocollagenous cocoon-like encapsulating membrane [1,2]. SEP is divided into two entities: abdominal cocoons (AC), also known as idiopathic or primary sclerosing encapsulating peritonitis, which is of extremely rare type, and secondary sclerosing encapsulating peritonitis, which is the more common type.Case presentationTwo male patients from India, a 26 year old and a 36 year old, presented to our hospital complaining about abdominal pain associated with nausea and vomiting without any history of previous surgical interventions; the patients' vitals were stable. Preoperative diagnosis of abdominal cocoon was established by abdominal computed tomography. It showed multiple dilated fluid-filled small bowel loops in the center of the abdominal cavity with thin soft tissue, non-enhancing capsules encasing the small bowel loops with mesenteric congestion involving small and large bowel loops. Both patients underwent complete surgical excision of the sac without intraoperative complications. Patients had a smooth postoperative hospital course and were discharged home in good conditions.ConclusionPatients with abdominal cocoons have a non-specific clinical presentation of intestinal obstruction. A high index of clinical suspicion in combination with the appropriate radiological investigation will increase the chance of preoperative detection of the abdominal cocoon. In patients with complete bowel obstruction, complete excision of the peritoneal sac is the standard of care.

BACKGROUND: Workplace bullying (WPB) is any sort of repeated and unjustified verbal, sexual, or physical intimidation that a person is exposed to by a group or another person in the workplace. In healthcare environments, practitioners are occasionally victims of WPB incidents. Bullying in surgical environments is an important issue that needs attention as it could affect patient care either directly or indirectly. The objective of this study was to assess the prevalence of bullying in surgical environments in multiple regions in Saudi Arabia. MATERIALS AND METHODS: This cross-sectional study was conducted among surgeons, trainees, interns, nurses, and students in surgical specialties in multiple Saudi regions. The survey was designed by Survey Monkey and posted online. The data were analyzed through SPSS Version-21 by computing descriptive statistics as frequency and percentages with graph construction. RESULTS: About two-thirds (65.2%) of the 788 study participants were male and were between the age of 20 and 29 years (67.8%). Consultants came first as perpetrators of bullying in the past 12 months (44.3%) and residents and interns were the major victims. The NAQ-R score ranged from 22.00 to 110.00, with a mean score of 42.47 (SD=17.9). Statistically significant association was found between mean NAQ-R score and age ( P = 0.007), specialty ( P = 0.002), and position ( P < 0.001). CONCLUSION: WPB is a pervasive problem in surgical environments in multiple regions of Saudi Arabia. Consultants and specialists are the primary offenders in bullying, which makes the hospital an environment for bullying behaviors.

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Background: A rare form of hepatocellular cancer is called fibrolamellar hepatocellular carcinoma (FL-HCC) which occurs mostly in young adults who are medically free, regardless of their gender. It usually presents with abdominal pain with right upper quadrant palpable mass, nausea, and weight loss associated with higher Alpha-Fetoprotein (AFP) in some cases. Objective: We report a case of a 15-year-old male patient who was diagnosed with (FL-HCC), successfully treated with surgical resection and is currently free of relapses. Case presentation: A 15-year-old male patient with no previous medical or surgical history, presented with recurrent vomiting for two months, weight loss, and loss of appetite. Patient presented with normal systemic examination except for abdominal examination which revealed a generalized distended abdomen with mild tenderness in the right upper quadrant with the presence of hepatomegaly. Laboratory and radiological investigation showed high level of (AFP). CT and liver MRI showed large right hepatic lobe lesion then TRU-CUT needle biopsy was performed which showed Fibrolamellar hepatocellular carcinoma and patient underwent surgical resection with no postoperative complication followed by multiple cycle of chemotherapy and no signs of relapse with 3 year follow up. Conclusion: Fibrolamellar hepatocellular carcinoma is rear type hepatocellular carcinoma which occurs mostly in young adults who are medically free with vague symptom and to diagnose it need high index of suspicion and variers Laboratory and radiological investigation including biopsy. However, it can be treated successfully by surgical resection followed by chemotherapy in selected cases if diagnosis in timely manner.