Locating the danger zone to avoid injury to the sural nerve during Achilles calcaneal tendon repair. A systematic review of cadaveric studies with clinical implications.

Introduction: Although iatrogenic injuries to the sural nerve (SN) are commonly encountered in calcaneal (Achilles) tendon (CaT) repair surgeries, the relationship between both structures have anatomical variations. A quantitative evidence synthesis has not been yet conducted. Our systematic review aims to better define the safe zone where the SN crosses the lateral border of CaT.

The Urogenital System's Role in Diseases: A Synopsis.

The human microbiota contains ten times more microbial cells than human cells contained by the human body, constituting a larger genetic material than the human genome itself. Emerging studies have shown that these microorganisms represent a critical determinant in human health and disease, and the use of probiotic products as potential therapeutic interventions to modulate homeostasis and treat disease is being explored. The gut is a niche for the largest proportion of the human microbiota with myriad studies suggesting a strong link between the gut microbiota composition and disease development throughout the body.

Beirut Explosion: Challenge of Hospital Emergency Preparedness.

On August 4, 2020, a major explosion took place in Beirut, the capital of Lebanon. Some hospitals in Beirut were destroyed and became nonfunctional, and others were overwhelmed with casualties, with 8643 casualties admitted to emergency departments on that night. The Lebanese American University Medical Center-Rizk Hospital, 2.

Managing endothelial dysfunction in COVID-19 with statins, beta blockers, nicorandil, and oral supplements: A pilot, double-blind, placebo-controlled, randomized clinical trial.

Coronavirus disease 2019 (COVID-19) is associated with endothelial dysfunction. Pharmacologically targeting the different mechanisms of endothelial dysfunction may improve clinical outcomes and lead to reduced morbidity and mortality. In this pilot, double-blind, placebo-controlled, randomized clinical trial, we assigned patients who were admitted to the hospital with mild, moderate, or severe COVID-19 infection to receive, on top of optimal medical therapy, either an endothelial protocol consisting of (Nicorandil, L-arginine, folate, Nebivolol, and atorvastatin) or placebo for up to 14 days.

Digital tools in allergy and respiratory care.

Patient care in the allergy and respiratory fields is advancing rapidly, offering the possibility of the inclusion of a variety of digital tools that aim to improve outcomes of care. Impaired access to several health care facilities during the COVID-19 pandemic has considerably increased the appetite and need for the inclusion of e-health tools amongst end-users. Consequently, a multitude of different e-health tools have been launched worldwide with various registration and access options, and with a wide range of offered benefits.

The Lebanese Healthcare Crisis: An Infinite Calamity.

In the past, a number of events rocked Lebanon, a small region of the previously prestigious Phoenician civilization. Whether it was mandates, wars, or economic compromises, the country always seemed to rise up again to a prominent stature in the Middle East. Once known as Switzerland of the East, Lebanon was torn apart by the works of sectarian battles during the civil war from 1975 to 1990.

Transcatheter tricuspid valve intervention techniques and procedural steps for the treatment of tricuspid regurgitation: a review of the literature.

Severe tricuspid regurgitation (TR) is an undertreated common pathology associated with significant morbidity and mortality. Classically, surgical repair or valve replacement were the only therapeutic options and are associated with up to 10% postprocedural mortality. Transcatheter tricuspid valve interventions are a novel and effective therapeutic option for the treatment of significant TR.

Challenges and recommendations for the management of asthma in the Middle East and Africa.

Clinical presentation of asthma is variable, and its diagnosis can be a major challenge in routine health-care practice, especially in low-and-middle-income countries. The aim of asthma management is to achieve optimal asthma control and to reduce the risk of asthma exacerbations and mortality. In the Middle East and in Africa (MEA), several patient- and physician-related factors lead to misdiagnosis and suboptimal management of asthma.

Early infantile epileptic encephalopathy related to NECAP1: Clinical delineation of the disease and review.

Background And Purpose: Epileptic encephalopathy (EE) refers to a heterogeneous group of epilepsy syndromes characterized by seizures as well as encephalopathies, leading to cognitive and behavioral disturbances. These conditions vary in their age at onset, their severity, and their electroencephalographic patterns. Whereas genetic factors are involved in approximately 40% of all epilepsy cases, they contribute to 80% of early infantile EEs (EIEEs), with approximately 125 genes previously linked to this disease.

How point-of-care Ultrasound became an essential part of the assessment in the Emergency Department.

From its first use in medicine, ultrasonography has been an excellent non-invasive diagnostic tool. The use of ultrasound increased dramatically especially in the last decade, as it is a painless, safe, and widely accessible, especially with the development of pocket ultrasound machines. In addition, it is crucial in promptly diagnosing unstable patients in emergency settings.

Emergency Department Management of COVID-19 Suspected Patients. An International Perspective.

In December 2019, an invasive viral outbreak, the Corona Virus Disease 19 spread to the whole world. An international cross-sectional study was conducted to evaluate how healthcare workers in Emergency departments dealt with this pandemic. A questionnaire was sent to 180 healthcare workers around the world during May and June of the year 2020.

The Effects of the COVID-19 Confinement on Screen Time, Headaches, Stress and Sleep Disorders among Adolescents: A Cross Sectional Study.

Background: Headache is a common symptom affecting children and adolescents. The medical literature over the last three decades reveals a variable prevalence and triggers in different countries, regions, circumstances and times. This study aims to assess the prevalence, frequency and quality of headaches in the Lebanese adolescent population under the COVID-19 confinement and study its triggers and relationship to screen time, self-reported anxiety, and sleep.

An unusual presentation of convergence insufficiency in a patient with Parkinson's disease stimulated by deep brain stimulation.

Purpose: To report convergence insufficiency in a patient with Parkinson's' disease stimulated by turning on the deep brain stimulator.

Observations: 72-year-old male with Parkinson's disease and hypertension presenting for the evaluation of blurry vision at near and mid distance that started after activation of an implanted Deep brain stimulator.Baseline ophthalmologic evaluation prior to deep brain stimulator implantation surgery and with the deep brain stimulator turned off demonstrated a full motility, centered eyes for distance and near and a best corrected visual acuity of 20/20, normal pupil exam, confrontational visual fields and dilated fundus exam.

The efficacy of force of stream assessment for post-operative catheter management: a retrospective cohort study.

Introduction And Hypothesis: Postoperative urinary retention is common after urogynecologic procedures. Our objective is to determine the efficacy of force of stream (FOS) assessment without a visual analog scale for postoperative catheter management.

Methods: We conducted a retrospective cohort study of 110 women undergoing an inpatient gynecologic procedure.

Raine syndrome: Report of a novel mutation and review of the different antenatal imaging modalities used to diagnose this disease.

Introduction: Raine syndrome is an autosomal recessive disorder characterized mainly by the presence of exophthalmos, choanal atresia or stenosis, osteosclerosis, and cerebral calcifications. There are around 50 cases described in the literature with a prevalence of less than 1/1,000,000. It is secondary to pathogenic variants in the FAM20 C gene, located on chromosome 7p22.

Tarsal tunnel syndrome secondary to accessory or variant muscles: a clinical and anatomical systematic review.

Purpose: Many etiologies are known to lead to a tarsal tunnel syndrome (TTS). One rare cause is mass-occupying lesions, and particularly accessory or variant muscles (AVM). This study aimed to systematically collect published clinical cases of TTS caused by AVM.

Measurements of The Pediatric Cartilaginous Eustachian Tube: Implications for Balloon Dilation.

Objectives: (1) Measure the cartilaginous Eustachian tube (ET) length using a computed tomography (CT) scan and (2) develop a prediction model to measure this length without the need of a CT scan.

Study Design: CT measurements in children.

Setting: Children's Hospital.

The gracilis and semitendinosus muscles: a morphometric study on 18 specimens with clinical implications.

Introduction: The pes anserinus consists of the sartorius, semitendinosus, and gracilis muscles. They coalesce together with the leg fascia to form the anserine plate. The semitendinosus and gracilis both form the deep layer of this plate and are clinically relevant for ligament reconstruction.

Obstructive sleep apnea in a case of ehlers-danlos syndrome.

Ehlers-Danlos Syndrome (EDS) is a group of rare connective tissue disorders characterized by genetic defects in collagen and connective tissue synthesis and structure, with manifestations ranging from asymptomatic or mild skin and joint hyperlaxity to severe physical disability. Mild asymptomatic forms of Ehlers-Danlos syndrome seems to be under diagnosed and may have severe systemic complications mainly cardio vascular. Cartilaginous defects in the head and neck region increase the risk of Sleep-Disordered Breathing (SDB) especially Obstructive Sleep Apnea (OSA).

The evolution of mature cystic teratomas of the ovary into squamous cell carcinoma: two case reports and review of the literature.

Mature Cystic Teratomas (MCT) of the ovary or Dermoid Cysts are common benign tumours found in 10-20% of women. However, 0.2-2% of those cysts underwent malignant transformation.

Telemedicine and diabetic foot ulcer outcomes. A meta-analysis of controlled trials.

Telemedicine (TM) has been advanced as an effective approach to wound care management. In this era of COVID-19 pandemic, it is paramount to assess the evidence behind the use of TM in treating diabetic foot ulcers (DFU). This meta-analysis aims at evaluating the efficacy of TM versus face-to-face attendance in managing DFU.

Respiratory Adverse Events After LMA® Mask Removal in Children: A Randomized Trial Comparing Propofol to Sevoflurane.

Background: The removal of the laryngeal mask airway (LMA®) in children may be associated with respiratory adverse events. The rate of occurrence of these adverse events may be influenced by the type of anesthesia. Studies comparing total intravenous anesthesia (TIVA) with propofol and sevoflurane are limited with conflicting data whether propofol is associated with a lower incidence of respiratory events upon removal of LMA as compared to induction and maintenance with sevoflurane.