IntroductionRoad traffic accidents (RTAs) are the most frequent cause of traumatic spinal injuries (TSIs), which account for up to 33.6% of all spinal fractures. The Kingdom of Saudi Arabia (KSA) is one of the countries which has high rates of SCIs and bears the economic burden of that situation.Methods120 patients were included in this study, using a stringent set of inclusion and exclusion criteria. The patients were followed-up from the point of triage to admission and discharge. We analysed the clinical notes of the patients to determine the severity of their traumatic spinal injuries, the neurosurgical management carried out, and other prognosticating factors such as blood transfusion and the Glasgow Coma Scale (GCS). The data collected was analysed anonymously, and the confidentiality of all participants was respected.ResultsMost of the patients were young adults and adolescents under the age of 40 (n = 96). There was a male preponderance of 84.1%. With respect to spinal injury stratification, 55 patients had cervical spine fractures, 10 patients had cervical lacerations, 85 patients had thoracolumbar spinal fractures, and 10 patients had thoracolumbar spinal lacerations. 35 patients had other fractures documented. All 120 patients were followed up to assess the management of their traumatic spinal injuries. 66.6% (n= 80) of all patients were managed conservatively, whereas the remaining 33.3% (n=40) were managed surgically.ConclusionTrauma is an important cause of spinal injuries (TSIs), and untreated TSIs may lead to poor clinical outcome, especially if the cervical region is involved.

Abstract. Injuries type and its relation with Glasgow ISS (i.e., head, chest, abdominal, internal organ, pelvic)

Background: The number of patients suffering from diabetes and its complications in the world is doubling every 10-15 years. Apart from development of retinopathy, nephropathy, and diabetic-induced atherosclerotic changes in high caliber arteries. Critical ischemia with gangrenous changes of the lower limb has occurred quite often as a result of micro-angiopathy. Objective: This study aimed to investigate the bacterial spreading and related outcomes of treatment in 81 patients with diabetic foot complicated by infection. Materials and methods: A retrospective study based on the analysis of the patients medical records from the hospital database. The bacteriological analysis of the tissues from infected wounds, obtained during surgical debridement or amputation, were conducted in all patients. Microbiological investigations of the the contents of an aerobic and anaerobic bacterial flora in the wounds were compared and analyzed in all cases considered suitable for this study. Results: Analysis of microbial spreading revealed growth of bacteria in all diabetic foot wounds. Associations of aerobes with anaerobes were found in 89.9 % of the cases. Escherichia coli was the dominating agent among anaerobes (22%), leading to development of infectious process and distributed in a proximal direction along synovial-tendon sheets of the foot. Conclusion: Aggressive debridement of necrotized tissues, including proximal and distal parts of tendons up to 5 cm within the limits of healthy looking tissues may disrupt further spreading of purulent infection and lead to favorable outcome.

Purpose To evaluate functional outcomes of severe traumatic brain injuries after insertion of intracranial pressure (ICP) monitor at King Saud Medical City (KSMC) and their correlation to each other. Patients and Methods A retrospective observational study for all adult patients (age >18 years) who were diagnosed with severe head injury and underwent ICP insertion at KSMC. Patients diagnosed between 2017 and 2019 were included. Data for measured outcomes, Glasgow outcome scale (GOS), Karnofsky Performance Score (KPS) and length of stay (LOS) and prognostic factors, data like: age, gender and primary Glasgow coma score (GCS) was obtained from patients’ files and direct communication with patients or their caregivers. We also compared patients who underwent ICP monitoring alone with those who underwent ICP with decompressive craniectomy (DC). Follow-up period ranged from 6–24 months. Results Seventy-four patients were included in this cohort study. Outcome measurements for patients with decompression and ICP were lower than those with ICP alone. KPS and GOS showed strong correlation ( p <0.01) in whole cohort and in both subgroups (ICP alone and ICP with DC). KPS showed significant correlation with length of stay ( p =0.026). Conclusion ICP monitoring is valid tool in management of severely head injured patients. Patients who underwent DC had a worse outcome. KPS can be used as alternative tool to measure functional outcome in severe traumatic brain injury.