Internal hernias are protrusions of viscera that can cause obstructions such as small bowel obstruction (SBO). Diagnosis can be challenging, as they usually come with an atypical presentation. We report on a case of a woman in her early 40s, with no history of surgery or chronic illnesses, which came with abdominal pain associated with vomiting. CT scan revealed obstructed small bowel. On exploratory laparoscopy, an internal hernia through a peritoneal defect in the vesicouterine space was found, entrapping a limb of the jejunum. The entrapped loop of the small bowel was freed, the ischaemic part was resected, and the defect was closed. Our case presents the second reported case of a congenital vesicouterine defect causing SBO. It is important to consider patients presenting with SBO as a case of congenital peritoneal defect if they had no previous surgeries.

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The study aims to summarize the updated evidence regards, epidemiology, causes, clinical manifestations, and management of paralytic ileus. Lower abdominal surgical procedure, particularly big open cuts and increased bowel operations, is linked with an increased hazard of bowel obstruction. Though, numerous risk issues have been revealed to upsurge the probability and resistance of intestinal obstruction, such as prolonged abdominal / pelvic surgery, lower gastrointestinal (GI) surgery, open surgery, retroperitoneal spine surgery, opioid use, cancer peritoneal, intra-abdominal inflammation (sepsis / peritonitis), delayed enteral nutrition or nasogastric (NG) tube placement, and hypokalemia. Signs of intestinal obstruction are tachycardia caused by any interruption of movement, absence of abdominal pain, abdominal distention and tenderness, shortness of breath, and hypovolemia. Bowel sounds disappear and flatulence is not discharged, leading to gastric stasis, which can cause hiccups, discomfort, and easy vomiting. Preventive measures include avoiding unnecessary exposure and over-processing of the intestine or traction of the mesentery. Treatment is conservative, as this condition is mostly self-limited. Pharmacologic Therapy have little place, but there are some exceptions of adequate values.

The aim of the study was to detect the prevalence of work-related Musculoskeletal Injuries among construction workers, to evaluate injury-related sick leave, and identify factors contributing to injury. the study was conducted and distributed to Saudi construction companies in three cities in the eastern region and 201 workers were approached and 149 were enrolled in the study. Jobs were categorized based on level of impact and jobs with similar levels were grouped together. Multiple Regression was used to evaluate stress categories and a cluster analysis was run on scaled and normalized types of stress and pain to identify factors closely associated with sick days taken. The results showed a response rate of 74.1%. A univariate analysis was used, and it demonstrated a 75.2% pain in upper and lower extremities, 61.7% pain was reported in upper extremities (Shoulder and Neck > Wrists and Hands > Elbow) and 12.8% pain reported in lower extremities (Lower back > Hips > Knees). In conclusion, the prevalence of work-related MSI in this large construction company was 75.2%. stratified multiple regression suggests job categories are good predictors of physical stress exposure and sick leave taken, also, the amount of force exerted, and vibration experienced by workers is closely linked to sick leave taken as well. Medium and high pain levels were linked to keyboard work, pushing / pulling, lifting and use of vibrating tools these workers would benefit from training emphasizing ergonomics and an explanation of proper techniques to handle tools. Lastly, applying new engineering controls would be helpful in the prevention of injuries that can minimize sick leave.

Back pain of different etiology is a common encountered symptoms in daily practice. Several factors were associated with the development of degenerative disease (DDD) of the intervertebral disc (IVD). The intervertebral disc, usually asymptomatic but once became symptomatic it will be presented as a low back pain with is consider the main complain among the patient with IVD.  Both genetic  as well as environmental factors lead to progressive redaction in extracellular matrix (ECM) composition which resulted overtime in weak IVD. Clinically back pain divided into two main categories: Inflammatory versus mechanical back pain,   DDD typically present with mechanical type lower back pain. In patient with compatible history and physical exam findings, diagnosis of DDD can be confirmed by computed tomography (CT) scan, magnetic resonance imaging (MRI), or provocative discography. The DDD can be manage with several treatment strategies such as conservative therapy which aim to relief the pain, on the other hand, surgical approach which aim to definitely treat the DDD. The current study aims to provide a brief review about degenerative disc diseases.