An orthopedic bone bank’s creation and management is a challenging procedure where medical organization and legal requirements interact. There are no formal regulations for the management and organization of an orthopedic bone bank in the Netherlands or any other nation in Europe. The recently revised „law of security and quality for utilizing human materials in the Netherlands establishes guidelines for the technical and administrative elements of using human tissue and cells. The bone bank’s processes involve a rigorous questionnaire for choosing donors, a complete bacteriological, histological, and serological examination, as well as industry-standard, practices for registering, processing, preserving, distributing, and storing bone allografts. This article explains how an approved bone bank is run, and it may be used as a suggestion for formal regulation or as a model for additional orthopedic bone banks in Europe. Osseous graft manufacture, testing, packing, storage, and transportation are all handled by bone banks. Their primary responsibility is to guarantee the transplants‘ biological characteristics and microbial cleanliness by legal and quality criteria. All orthopedic surgeons face the challenge of reconstructing bone defects; to address this issue, there are several methods, including the use of autografts, allografts, and bone substitutes to enhance and speed bone recovery. Although autografts have superior biological qualities, their volume is constrained and they are linked to donor site morbidity. Allografts are readily accessible, however, there are still worries about the possibility of infections, and they lack osteosarcoma qualities.Simultaneous bilateral proximal humerus fractures (PHFs) caused by a single trauma are considered rare. We herein report two patients with bilateral PHFs treated based on our treatment strategy reverse shoulder arthroplasty (RSA) to obtain rigid stability for one shoulder and open reduction with internal fixation (ORIF) to regain the mobility of external and internal rotation for the other. By using Neer’s four-segment fracture classification, patients underwent RSA for one shoulder with the more advanced fracture type and ORIF for the other. In Case 1, a 74-year-old female presented with bilaterally comminuted PHFs and underwent surgical treatment with RSA and ORIF. In Case 2, a 78-year-old female with the comorbidity of rheumatoid arthritis and a history of total elbow arthroplasty for both elbows had bilateral PHFs and underwent surgical treatment with RSA and ORIF. Postoperatively, both patients were instructed to perform exercises including passive range of motion (ROM) for a week, active ROM exercises for two weeks, and muscle strengthening for six weeks after the surgery. At the follow-up, both patients were satisfied with the pain relief and functional recovery. Especially, increased ROM for external and internal rotation was obtained in shoulders with ORIF. Proteasome inhibitor These case reports describe a viable treatment option comprising simultaneous RSA and ORIF, and this surgical approach may restore shoulder functions in cases of bilateral PHFs.The coronavirus disease 2019 (COVID-19) pandemic has resulted in large-scale devastation. Reports of COVID-19 in patients with compromised immunity are available in the literature. The compromised immunity could be due to multiple factors like drug induced as in organ transplant patients, diabetes, HIV, etc. Post-transplant patients with compromised immunity due to immune suppression are vulnerable to many infections (tuberculosis, hepatitis B and C, etc.). Herein a case of an Indian male with a kidney transplant is presented who had concurrent infections of pulmonary and extrapulmonary tuberculosis due to Mycobacterium tuberculosis, hepatitis C virus, and severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2). A detailed history with laboratory workup was done to establish the diagnosis and a prompt treatment was initiated for the three infections. To the best knowledge of the author, no such case has ever been reported in the medical literature to date. The management of this rare case is highlighted in this present write-up.Purpose and research question Cross-sectional imaging with CT scanning is the most commonly performed imaging modality to stage right-sided colon cancers. There is increasing evidence for the use of neo-adjuvant chemotherapy in selected patients and debate about the role of complete mesocolic excision (CME) and central vascular ligation (CVL) in the management of locally advanced colon cancers. Predicted tumour stage and the presence of nodal metastases by CT are often used to select patients for neo-adjuvant chemotherapy and those that may benefit from CME. This study aims to compare predicted radiological T and N staging with final pathological T and N staging in elective patients having potentially curative surgery for right-sided colon cancer. Methods A retrospective analysis was carried out of a prospectively gathered database of all patients who had undergone (true) right hemicolectomy between 02/01/13 and 21/05/20. Sensitivity, specificity, positive predictive value, and negative predictive value for CT scanning with regards to the pathological nodal metastases were calculated and analysed. Results The sensitivity and specificity of radiology staging for predicting nodal status were 76.4% and 65.5% respectively. The positive predictive value of CT staging for correctly identifying nodal metastases was 55.3%, with a negative predictive value of 77.3%. Conclusions This large series adds further evidence that CT, even when reviewed by expert GI radiologists, has limited accuracy at identifying lymph node metastases in colon cancer.Background Coronary artery disease (CAD) remains a significant cause of death and morbidity in people globally despite advances in treatment. Prevention of CAD risk factors is crucial to reducing its prevalence. We conducted this study to determine the incidence of CAD from 2019 to 2020 in King Abdulaziz University Hospital (KAUH), Jeddah, Kingdom of Saudi Arabia (KSA), and its major risk factors among this population. Method This retrospective study involved all patients diagnosed with CAD at KAUH in 2019 and 2020. We analyzed validated hospital data to determine the incidence of CAD and identify the risk factors among participants. The incidence of CAD was calculated based on the total number of patients admitted to KAUH by gender, age group, and nationality (Saudi/non-Saudi). Result The study included 1,364 patients with a mean age of 49 years. Most patients were men (n=1,050; 77%), with fewer women (n=314; 23%), and 71.2% were non-Saudi. The incidence of CAD in 2019 was 220.98 per 10,000, and the incidence in 2020 was 3,030.52 per 10,000. However, the incidence for 2020 was confounded by the coronavirus disease 2019 pandemic-related restrictions affecting hospital admissions. The most common diagnosis was acute transmural myocardial infarction, and patients aged less then 60 years had a significantly high incidence of hypertension, high total cholesterol levels, low low-density lipoprotein levels, and high triglyceride levels. Patients ≥60 years had a significantly high incidence of chronic kidney disease, low hemoglobin levels, history of ischemic heart disease, and intensive care unit or critical care unit admission. Conclusion The study demonstrated a significant rise in CAD incidence associated with advanced age and male sex. Further prevention and control of these risk factors would be essential to decrease the incidence of CAD. A national community-based prevention effort should be implemented to avoid the expected CAD epidemic in KSA.Objective This study aimed to investigate the influence of fibromyalgia syndrome (FMS) on the cardiac conduction system and assess patients‘ palpitation complaints using 24-h ambulatory ECG (Holter Maynard, MA Northeast Monitoring, Inc.) monitoring. Methods Ninety patients with FMS and 70 healthy controls were included in this research. ECG was performed on all participants, and ECG parameters were calculated. Holter monitoring was conducted, and the recordings were analyzed. The results of time-domain heart rate variability (HRV) were evaluated. Results The patient group’s mean age was 38.3±6.3 years. There were no statistically significant differences in demographic or laboratory parameters across the groups (p>0.05). The findings of a 24-h Holter ECG recording did not vary significantly between the groups (p=0.182). In the study group, the values for the standard deviation of R-R intervals (SDNN), low frequency (LF), and low/high frequency (LF/HF), which are known as HRV indicators, were substantially different between the two groups (p less then 0.05). Conclusions The study indicated that the risk of arrhythmias did not increase even though FM patients complained of palpitations.Wide-awake surgery is transforming many areas of hand surgery. We report a distinctive case of an avulsion near total amputation of the right dominant arm, which required emergent shaft humerus fracture fixation and brachial artery repair with a vein graft. Three months post-injury, the patient underwent long segment nerve grafts of the median and ulnar nerves, with pectoralis major to biceps transfer for elbow flexion reconstruction. Since the patient failed to gain any functional movement of the elbow, we explored the transfer under wide-awake local anaesthesia using lignocaine and adrenaline. Four months after the wide-awake release, the patient had gained 70 degrees elbow flexion against gravity and 110 degrees with gravity eliminated. On the Waikakul scale, the result was categorized as ‚Good‘. Wide-awake anaesthesia allowed sufficient release of a large muscle transfer in a prior traumatised zone with a satisfactory result.Introduction Patient experience is essential in the overall care; physicians often receive patient reviews evaluating their consultation encounters. Patient experience surveys can be a helpful tool to identify areas to target for improvement. We sought to evaluate what factors influenced breast surgery patients‘ reviews of their clinic visits. Methods Prospective surveys from 2018-2020 were reviewed from a single institution. Surveys were sent to all patients within 48 hours after visiting one of our breast surgery clinics, and patients were asked their preferred mode of contact for the survey. Patients responded to surveys with scores of 0-10, with 0 as „not likely“ and 10 „extremely likely“ to recommend the provider’s office. Scores 0-6 were considered negative, 7-8 neutral, and 9-10 positive. Positive/Negative comments from patients were reviewed and classified according to mention of surgeon, clinic staff/team, clinic processing, and facility amenities. Results 744 out of 2205 patients contacted responded to the survey, resulting in a 33.7% response rate. Of this cohort, 47.6% (354/744) were new patients, and 52.4% (390/744) were established patients. Interactive voice response (IVR) and email, per patient indicated preferred mode of survey communication, had the highest responses. The average patient score was 9.5. Most ratings were positive (91.3%, 679/744), followed by neutral comments (5.2%, 39/744). There were 3.5% (26/744) which were negative ratings. Of those who responded, 47.7% (355/744) left a comment with their score. Surgeon-specific remarks were often noted in positive comments, followed by clinic staff/team comments. Negative comments most commonly referenced clinic processes. Conclusion Patient satisfaction surveys provide a window into creating the best patient experience. Further efforts to address these factors affecting patient experiences should be made to continue improving patient care.