In Ross patients who require reintervention on the PV homograft, both tPVR and sPVR provide low procedural mortality and comparable midterm outcome with no significant difference in mortality or PV reintervention. However, IE is more common following tPVR. A larger randomized study is needed to determine the role of each procedure in patient management.

Background and Objective: Adolescence is considered to be a pivotal point in which optimum nutrition and eating habits are developed. Although tackling the obesity epidemic has been much discussed, addressing the issue of underweight and body image is often neglected. This study was carried out to get a better understanding of underweight status among adolescents in Saudi Arabia, and exploring self-perceptions of body image and weight loss measures among underweight adolescents. Methods: Data from Jeeluna®, a national cross-sectional school-based survey were utilized. Jeeluna® assessed the health status and health-risk behaviors of adolescents in school through data obtained by a self-administered questionnaire, anthropologic measurements, and laboratory investigations. Results: A total of 12,463 adolescents participated. Eighteen percent of adolescent males and 12.4% of females were found to be underweight, representing 14.9% of adolescents collectively. Forty-five percent of underweight participants were happy with their weight. Underweight females between the age group of 10 and 14 years were the most likely to believe that they still need to lose weight (16.0%) followed by females aged 15–19 years (9.7%). Underweight females aged 10–14 years were also the group most likely to engage in purging (1.6%). Stepwise logistic regression found that the strongest association with being underweight was with having a lower household income (OR 2.0, CI 1.5–2.7) and having more than 5 siblings (OR 1.8, CI 1.5–2.3). Conclusion: Underweight status is prevalent among adolescents in Saudi Arabia and deserves more attention as a public health issue. Distorted body image and disordered eating behaviors exist, necessitating further investigation of underlying causes.

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Key Clinical Message This article reports on the use of Botox preoperatively for the treatment of a complex ventral hernia which would have typically been treated with component separation technique. The case demonstrates that using the recently developed technique can aid in performing a tension‐free hernia repair with potentially lower complication and recurrence rates.

Highlights Intrapancreatic Accessory Spleen (IPAS) is a rare embryological benign abnormality. (IPAS) should be considered in patients with recurrent immune thrombocytopenia (ITP). Although IPAS is a challenging diagnosis, it can be detected by the recent advancement of medical imaging.