No abstract

No abstract

Between 1983 and 1989, 41 patients were admitted to King Fahad Hospital (KFH) in Al-Baha, Saudi Arabia with airgun injuries. Of the patients admitted, 83% were under 18 years of age. The majority of injuries (80.5%) were trivial. However, 19.5% had serious injuries that required major surgery. These injuries were considered potentially lethal. Public education via the media will probably be effective in reducing the number of injuries caused by these weapons.A Merdad, M Rawas, M Al-Garni, Airgun Injuries: A National Health Hazard. 1992; 12(1): 43-46 Numerous reports have outlined the seriousness of airgun pellet injuries, but they mainly concern eye and other soft tissue injuries [1,2]. Few case reports have been published showing serious and rare complications of these pellet injuries [3][4]. Other reports have highlighted the potentially lethal injuries, the poor supervision of children who use the guns and the inadequacies of the law relating to these weapons [4]. To the best of our knowledge, there has been no report about this problem from the Kingdom of Saudi Arabia. The aim of this article is to survey airgun injuries seen at KFH in Al-Baha and to show the magnitude and seriousness of this health hazard. Material and MethodsThis retrospective study was carried out at King Fahad Hospital in Al-Baha. The medical files of patients admitted between March 1983 and March 1989 with firearm injuries were reviewed. This study included airguns only. All patients with injuries not requiring admission to the hospital were excluded. All the data available were evaluated regarding circumstances of the accident, course of management in the hospital and the details of their surgical procedures. ResultsA total of 63 patients suffering from firearm injuries were admitted to King Fahad Hospital in Al-Baha. Fortyone of these patients were admitted for airgun injuries. Of these 41 patients, 33 (80.5%) were, male and eight (19.5%) were female. The youngest patient was three-years-old and oldest, 35-years. The mean age for all patients was 12.93 years. There were 34 patients (82.93%) ≤ 18 years old, while seven patients were more than 18-years-old. Only one of the 41 patients (2.44%) was non-Saudi. Thirty-seven patients (90.24%) were shot by another person while four patients (9.76%) had accidentally shot themselves. Thirteen patients (31.7%) had injuries to the head and neck, two (4.9%) chest, seven (17.1%) abdomen, nine (21.9%) upper extremities, and ten (24.4%) had injuries in the lower extremities (Table 1).There was no record that any case was reported to the police. The patients were classified according to type of surgery performed. Thirty-three patients (80.49%) had minor surgery (removal of the pellet under general or local anesthesia and dealing with the wound), while eight patients had major surgery.

HM Ali Farsi, HA Mosli, MM Rawas, TN Rehami, SA Hemdi, Persistent Mullerian Duct Syndrome in an Adult: A Case Report. 1990; 10(3): 330-332 Persistent mullerian duct syndrome is a rare form of male pseudohermaphroditism. It is characterized by the presence of well-developed mullerian structures in a male who possesses normally developed external genitalia. 1The classic presentation occurs in children and comprises unilateral cryptorchidism and contralateral inguinal hernia that contains the mullerian structures.2 Recently we encountered the syndrome in a middle-aged man and this influenced the clinical picture as well as management. Case ReportA 40-year-old Saudi man was first seen at our andrology clinic because of primary infertility. He also complained of erectile dysfunction of 10 years' duration. He had been married for 15 years without producing pregnancy. His past medical history included surgical repair of a right inguinal hernia.Examination revealed a healthy man with scanty facial hair. There was no gynecomastia, but his pubic hair was somewhat feminine in distribution. The phallus was normal but the scrotum was empty and underdeveloped. No testicles could be palpated in either inguinal region. There was a right inguinal scar remaining from the hernia repair. Rectal findings were unremarkable.A spermogram on three occasions revealed azoospermia, and the semen was positive for fructose. The serum testosterone level was less than 1 nmol/L (reference interval, 10.4-31); luteinizing hormone, 40 IU/L (reference interval, 3-18); and follicle stimulating hormone, 80 IU/L (reference interval, 3-16). Pelvic ultrasound examination showed a solid mass on the right side. The left testicle was not identifiable. Computed tomogram showed a 6 × 4 × 3 cm soft tissue mass in the right paravesical region that projected posterior to the urinary bladder and could not be differentiated from the right seminal vesicle (Figure 1). The radiological diagnosis was undescended testis, with malignant transformation.On surgical exploration through a lower abdominal incision, the left testis was found to be soft, small, and grossly dysplastic. The epididymis was cystic and separated from the testis. Attached to the epididymis was a mass that extended from the left internal inguinal ring to the right one and descended behind the bladder (Figure 2). The gross appearance was that of the broad ligament and uterus. It was excised and found to consist of a uterus, cervix and vagina, broad ligament, two fallopian tubes, and a dysplastic left testicle (Figure 3). No testicle was found on the right side. Subsequent buccal smear was chromatin-negative. Postoperatively he was started on testosterone replacement therapy.