Acute appendicitis (AA), one of the most common causes of lower abdominal pain, is the most common diagnosis given to young children admitted to the hospital with an acute abdominal pain. According to statistics, the lifetime risk for AA was 9% in USA, 8% in Europe, and 2% in Africa. Over the past 20 years, a rise in interest in the non-operative care of uncomplicated AA care has developed, most likely due to a more accurate analysis of postoperative complications and costs of surgical interventions, which are primarily connected with minimally invasive techniques, which are on the rise. This study aimed to evaluate the current literature on the non-surgical management of acute appendicitis, thus, studies discussing the non-surgical management of acute appendicitis between 2009 and 2022 were included. Initially, the non-operative treatment seemed possible to avoid appendectomy, reducing the need for surgery, surgical risks, and overall costs. Antibiotic therapy has a high success rate and is both feasible and effective; the risk of treatment failure is higher than the risk of appendectomy. Although the conservative treatment had a low overall failure rate, individuals who received upfront surgery had a greater complication risk.

Growing knowledge supports the importance of microRNAs in cell growth regulation, differentiation, apoptosis, and tumorigenesis. We addressed the associations between miRNA variants and risk of urothelial bladder carcinoma (UBCa).Subjects and Methods: Sixty-six cases with UBCa (33 pTa, 13 pT1, 20 pT2) of low and high tumor grade (21 and 45 cases, respectively), and 156 healthy controls were genotyped for miR-196a2 rs11614913(C>T), miR-146a rs2910164(C>G), and miR-499 rs3746444(A>G) using TaqMan genotyping assays. Patients were stratified according to tumor stage, tumor grade, and risk of recurrence for UBCa. We used the SNPStats (https://www.snpstats.net) to choose best interactive model(s) of inheritance in selected miRNAs. Results:The rs3746444 SNP showed a potential association with risk of UBCa (odds ratio [OR]= 1.9; P= 0.012). Significant associations were found for rs3746444 (P= 0.013) in codominant models, and for rs11614913 (P= 0.048) in an additive model. The rs11614913T allele had a protective effect, while homozygotes for the C allele were associated with a significantly increased risk of UBCa compared with controls (χ2= 3.7; P= 0.05). Homozygosity of rs3746444A/A was more frequent in cases than controls (43.9% versus 30.8%). Despite its significant impact in diverse ethnic populations, the rs29101164 SNP did not show clear effects on UBCa. Besides, the presence of rs3746444A/A was associated with tumors of high grade (OR= 2.7; P= 0.046). Conclusion:This study was the first among the Saudi community to present a substantial function of miRNA biomarkers to predict UBCa, identify at-risk patients, and suggest a potential therapeutic target for UBCa.

Primary mesenteric gastrointestinal stromal tumors may give rise to abdominal emergencies like bowel obstruction and should be considered in the differential diagnosis to reduce morbidity and mortality. The present study presents an unusual case of primary mesenteric gastrointestinal stromal tumor presenting with small bowel obstruction. A 44-year-old healthy male presented with abdominal pain for 2 days. Detailed examination revealed presence of a 4 × 4 cm mass in the small bowel mesentery with multiple small bowel loops adherent to it, together with their mesentery. The patient was diagnosed with primary gastrointestinal stromal tumor of the small bowel mesentery. He had an uneventful postoperative course and was discharged on the second postoperative day in a good condition. The case analysis showed that the diagnosis of gastrointestinal stromal tumor is likely with the emergence of CD117, despite of its occurrence at rare sites and it is a vague clinical picture.

The study aims to evaluate the various techniques used to perform circumcision in Saudi Arabia. In September 2018, this cross-sectional survey was performed. A questionnaire was sent to all pediatric surgery units across the Kingdom. The responses to the questionnaire were analyzed and categorized. A total of 176 questionnaires were send and more than half (56.3%) of the practitioners filled the questioners, 62 (63%) were consultants, 19 (19%) were specialists and 19 (19%) were trainee in pediatric surgery fellowship program. Circumcisions were performed in Maternity and Children hospitals (32.3%), tertiary hospitals (32.3%), private hospitals (16%) and in general or academic hospitals (19%). The most commonly used method for circumcision was Gomco clamp (n = 39; 39.6%) followed by Plastibell (n = 30; 30%) and bone cutter (n = 25; 25.4%). The optimal time for circumcision was in neonatal period. Eighty-six percent of the surgeons agree that 2.5 to 5 kg is the optimal weight for the baby to do circumcision. In Saudi Arabia circumcision is a religious practice done for every Muslim male. It should be done by trained medical practitioner and circumcision done by non-medical personal should be avoided. Circumcision should be performed in the neonatal period and attention should be given to analgesia.

The aim of the study was to evaluate the benefits from 4th year surgical course for medical students upon reaching 6th year surgical course. A questionnaire survey was conducted and questions regarding student satisfaction with the 4th year course and the benefits gained from this course in the 6th year were evaluated. Students were questioned regarding their interest in surgery as a career. A total of 67 students were enrolled in the study and the information collected from them was analyzed. The results showed that only 35 students reported in agreement of offering 1 surgery course; whereas, only 32 students reported in agreement of 2 surgery courses. The results also showed that only 26 students were interested in surgery as a career. The study emphasized on spreading awareness among students regarding surgery, and suggested that courses must be introduced in the curriculum to help students in their future decision making.