BACKGROUND AND OBJECTIVESData on the epidemiology of traumatic head injuries (THI) is essential for any organized prevention program. Such data are few in the developing world. Our primary goal was to study the causes, descriptive features, and outcomes of THI in adults in Saudi Arabia.DESIGN AND SETTINGSThe present study is a retrospective review.METHODSThis retrospective review included all consecutive cases of adults with THI (>18 years) who were admitted to a major trauma centre in Riyadh, Saudi Arabia, from May 2001 to July 2010. Patients were identified through a trauma database, which includes cases that required hospital admission or died in the emergency department.RESULTSA total of 1870 patients met the inclusion criteria with a mean age of 32.6 years and a male predominance (91.2%). Most injuries were secondary to motor vehicle collisions (MVC; 69.4%). Pedestrian injuries were second (16.8%) and had 40% risk of mortality (odds ratio 0.62, 95% CI 0.48–0.8). Most patients (56.7%) had a severe THI (Glasgow coma score, GCS < 8). The overall mortality rate was 30%. Mortality was significantly associated with older age (P=.0001), lower GCS (P=.0001), and a higher injury severity score (ISS; P=.0001).CONCLUSIONThe most common causes of hospital admission following injury were MVC and pedestrian injuries. Both were also the most common causes for injury-related deaths. Safety on the roads should be the primary target for any organized injury prevention programs to be successful.

Cholecystocolic fistula (CCF) is a rare late complication of gallstones. The clinical features of CCF are nonspecific and variable. No single test is sufficient to diagnose CCF because of the low sensitivity of the tests or the invasive nature of the procedures, and these tests are not routinely requested for asymptomatic patients. Because CCF is rarely diagnosed preoperatively, patient history, laboratory, and radiological data play an important role in alerting surgeons to the possible existence of a CCF. Treatment involves closing the fistula and performing an open or laparoscopic cholecystectomy.

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Objectives:To analyze the clinical and echocardiographic changes in individuals with morbid obesity who underwent bariatric surgery. Methods:In total, 59 obese patients with body mass index >35 kg/m 2 were prospectively enrolled. We assessed baseline pre-operative and a 6-month post-operative lipid profile, hemoglobin A1c, echocardiography, lifetime, and a 10-year risks of atherosclerotic disease for all patients. Results:The mean patients' age was 37±12 years, with 40 (67.8%) women. We found that the pre-operative Original Articletotal cholesterol (4.2±1.1 vs. 4.4±1.1, p=0.014) and triglyceride levels (1.4±0.7 vs. 1.8±0.8, p<0.0001) were significantly lower than post-operative levels, while postoperative high-density lipoprotein levels were significantly higher (1.5±0.5 vs. 1.2±0.3, p<0.0001). The calculated 10-year risk of atherosclerotic cardiovascular disease was significantly lower post-operatively (1.1±1.6% vs. 1.6±1.8%, p<0.0001). Echocardiography follow-up revealed that diastolic dysfunction was more prevalent pre-operatively than that post-operatively (41% vs. 10%, p<0.0001). Post-operative left ventricular (LV) mass was significantly lesser than the pre-operative mass (168±252 g vs. 187±255 g, p=0.019), whereas the post-operative LV diastolic (46.5±7 mm vs. 38.5±18 mm, p=0.002) and systolic dimensions (31±5 mm vs. 25±11 mm, p=0.001) were significantly smaller. Conclusion:Bariatric surgery resulted in a significant amelioration in lipid profile, reduction in LV mass, and LV cavity dimensions.

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