Amer Alghamdi

To measure the prevalence of dry eye disease (DED) and study the relationship between screen time and dry eye symptoms in the pediatric population during the coronavirus disease 2019 (COVID-19) pandemic using the Ocular Surface Disease Index (OSDI) questionnaire. In this descriptive, observational, cross-sectional study, our survey included the pediatric population, ages 1 to 18 years, of both genders, who attended outpatient clinics of two main hospitals in Jeddah, Saudi Arabia. Collected data included age, gender, dry eye symptoms, and common DED risk factors, followed by the Ocular Surface Disease Index (OSDI) questionnaire, which consists of 12 items graded on a five-point scale (0 = never to 4 = all the time). A total of 329 pediatric participants were included, with more than half of the participants (56.1%) males and 58.5% aged 12-18 years. The most frequently reported symptoms (reported as often or always) were decreased vision (23.0%) and itchy eyes (22.1%). Environmental factors have an effect on developing DED symptoms, as some participants (21.8%) have reported being uncomfortable in windy weather and 15.8% have reported this in places with air conditioners. Based on the OSDI diagnostic criteria, 250 (76.1%) participants had DED. Furthermore, in terms of severity, 44 (13.3%) participants had mild DED, 62 (18.8%) participants had moderate DED, and 145 (43.9%) participants had severe DED. We found that prolonged exposure to mobile screens for two to three hours or four hours or more was associated with a higher DED incidence compared to those exposed for shorter periods. Older age categories were more likely to experience DED (80.8% and 78.2% in age categories 12-18 and 7-12, respectively, versus 57.6% in the youngest age category (p = 0.001)). Additionally, DED was independently associated with participants with a previous history of eyeglasses prescription and those experiencing dry eyes while using electronic devices. Since many children use electronic devices for education and entertainment, we found that symptoms of DED due to prolonged screen time have increased among the pediatric population during the COVID-19 pandemic. Therefore, awareness efforts should be directed to reduce the rate of controllable risk factors like personal computer use. In addition, educational campaigns are warranted to provide all possible preventive measures against DED, especially to children with uncontrollable risk factors for developing DED.

Retrograde jejuno-jejunal intussusception is a rare complication of bariatric surgeries. It causes acute sudden symptoms that require immediate surgical intervention. We report a case of a 46-year-old female who underwent Roux-en-Y gastric bypass (REYGP) 3 years prior. The patient presented to the emergency department with acute sudden abdominal pain, nausea and vomiting. Laparoscopically, intussuscepting small bowel segment was found gangrenous, and it was resected and end-to-end anastomoses were fashioned. The postoperative course was uneventful, and the patient remained asymptomatic for the 12 months of follow-up. Patients with retrograde intussusception experience an intolerable severe pain that necessitates surgical intervention. The etiology of intussusception as a complication after REYGP is unclear, yet theoretically some possible etiologies exist. The initial diagnosis of retrograde intussusception is made based on abdominal computed tomography. Early intervention significantly reduces morbidity and mortality.