Understanding and addressing β-lactam resistance mechanisms in gram-negative bacteria in Lebanon: A scoping review.

Background: A growing threat to public health is the worldwide problem of antimicrobial resistance (AMR), in which gram-negative organisms are playing a significant role. Antibiotic abuse and misuse, together with inadequate monitoring and control protocols, have contributed to the emergence of resistant strains. This global scenario prepares us to look more closely at the situation in Lebanon.

B-cell Acute Lymphoblastic Leukemia in a Patient With Crohn's Disease After Anti-TNF-Alpha Treatment.

This case report details a patient with Crohn's disease (CD) who developed acute lymphoblastic leukemia (ALL) 16 years after their initial diagnosis. Various immunosuppressive therapies used in the treatment included azathioprine, infliximab and, for a short period, vedolizumab and steroids for CD and hyper-CVAD chemotherapy for leukemia. The association between CD and increased cancer risk, particularly hematological malignancies, emphasizes the importance of regular cancer surveillance, including hematological assessments, for patients on immunosuppressive therapy.

Pediatric Red Ear Syndrome Misdiagnosed as Relapsing Polychondritis: A Case Report and Review of Literature.

Red ear syndrome (RES) is a rare clinical entity presenting with paroxysmal erythema of one or both ears associated with a burning sensation or earache. The onset of symptoms could be either spontaneous or triggered by touch, stress, coughing, sneezing, neck movements, chewing, and combing hair. While most cases are usually described in adults, it can rarely present in children.

Bullous Pemphigoid Induced by Cefixime: A Rare Side Effect.

Bullous pemphigoid (BP) is the most prevalent autoimmune subepidermal blistering disease of the skin and mucous membranes. This disease typically affects the elderly and manifests with pruritus and localized or, most commonly, generalized bullous lesions. Numerous studies have established the association between BP and oral antidiabetic agents, particularly dipeptidyl peptidase 4 (DPP4) inhibitors, diuretics, and certain antibiotics, notably levofloxacin and cephalexin.

Toxic Epidermal Necrolysis Induced by Doxycycline: A Case Report and Literature Review.

Lyell syndrome, also known as toxic epidermal necrolysis (TEN), is a rare but life-threatening skin condition, often triggered by certain medications. Antiepileptics, allopurinol, and some nonsteroidal anti-inflammatory drugs are the most common causes. Some antibiotics are also common culprits, although tetracyclines are rarely linked to this condition.

Ischemic Stroke Revealing Libman-Sacks Endocarditis as the Initial Manifestation of Lupus Erythematosus With Secondary Antiphospholipid Syndrome: A Case Report.

Libman-Sacks endocarditis (LSE), also known as nonbacterial thrombotic endocarditis (NBTE), is a rare condition characterized by noninfectious lesions on the heart valves with the deposition of thrombi. NBTE is most commonly linked to advanced malignancy, systemic lupus erythematosus, and antiphospholipid syndrome (APS). In many cases, NBTE is only diagnosed postmortem during autopsies, with embolization being the most frequent clinical manifestation.

Risk factors associated with multidrug-resistant Klebsiella pneumoniae infections: a multicenter observational study in Lebanese hospitals.

Background: Klebsiella pneumoniae is a significant global public health burden, especially in low-income countries and regions with fragile healthcare infrastructures, due to its ability to cause severe infections, increase mortality rates, and its rising antimicrobial resistance. This study aimed to estimate the proportion of multidrug-resistant (MDR) K. pneumoniae infections and identify associated risk factors.

Autospreader Flaps in Closed Rhinoplasty: Our Technique and Long-Term Results.

Introduction:  Rhinoplasty is a common and complex surgical procedure. Respiratory and aesthetic dissatisfaction are major causes of revision surgeries. Multiple techniques were described to reconstruct the middle nasal vault and improve functional outcomes.

Endoscopic Management of Gastric Volvulus in an Elderly Patient With Multiple Comorbidities: A Case Report.

Gastric volvulus is a rare condition whose incidence remains largely unknown. Unless actively considered by healthcare providers, the diagnosis of gastric volvulus, which can lead to significant morbidity and mortality, may be overlooked. This condition can manifest in either acute or chronic forms, presenting with diverse symptoms.

Identifying the panorama of potential pandemic pathogens and their key characteristics: a systematic scoping review.

The globe has recently seen several terrifying pandemics and outbreaks, underlining the ongoing danger presented by infectious microorganisms. This literature review aims to explore the wide range of infections that have the potential to lead to pandemics in the present and the future and pave the way to the conception of epidemic early warning systems. A systematic review was carried out to identify and compile data on infectious agents known to cause pandemics and those that pose future concerns.

Brucellosis complicated by piriformis myositis and sacroiliitis: A case report and a review of the literature.

Brucellosis remains an endemic zoonosis in the Middle East, particularly in Lebanon, owing to the high consumption of raw meat and unpasteurized cheese. In this report, we present the case of a twenty-one-year-old girl who was diagnosed with brucellosis during the investigation of persistent fever and night sweats that was confirmed by an elevated Brucella agglutination titer at 1/160 for Brucella melitensis species, and an indirect Coombs at 1/1280. Unfortunately, owing to non-adherence to the antibiotic regimen prescribed, her condition progressed, resulting in piriformis myositis with sacroiliitis, an unusual complication of brucellosis.

A Case of Severe Proton Pump Inhibitor-Induced Hypomagnesemia Refractory to Continuous Oral and Intravenous Magnesium Replenishment.

Proton pump inhibitors (PPIs) are frequently used medications to treat a wide variety of gastrointestinal conditions. By irreversibly inhibiting the hydrogen-potassium ATPase pump, they remarkably reduce gastric acid secretion. However, chronic PPI intake can result in serious complications, including severe hypomagnesemia.

The First Documented Ibuprofen-Induced Toxic Epidermal Necrolysis in the Middle East and North Africa Region: A Case Report, Complications, and Management.

Introduction: Stevens-Johnson syndrome (SJS), Stevens-Johnson/toxic epidermal necrolysis overlap syndrome (SJS/TEN) and toxic epidermal necrolysis (TEN) are rare, acute, potentially lethal conditions, considered to be part of the severe cutaneous adverse reactions (SCARs) spectrum, with TEN being the most life-threatening. The distinction between these three entities is based on the extent of total skin surface involvement, with SJS involving < 10%, SJS/TEN involving 10-30% and TEN involving > 30% of total body surface area. These mucocutaneous reactions are most commonly caused by a hypersensitivity reaction to a drug, with infections and vaccines being possible, less common etiologies.

Chemical Meningitis and Syndrome of Inappropriate Antidiuretic Hormone Release (SIADH): A Rare Presentation of Pituitary Adenoma Apoplexy.

Unlabelled: Pituitary apoplexy is an uncommon condition typically resulting from a sudden haemorrhage within a pituitary adenoma. This bleed can present clinically with a wide array of signs and symptoms. This report documents the case of a 62-year-old male who presented to the Lebanese Hospital Geitaoui University Medical Center with signs and symptoms of meningeal irritation.

Efficacy of opioid-free anesthesia in modified radical mastectomy: a cross-sectional observational study.

Introduction: Perioperative management of female patients undergoing breast surgeries differs from other patients due to chronic pain and postoperative nausea and vomiting. The anesthesia could consist of opioid-free general anesthesia (OFA) or non-opioid-free general anesthesia (NOFA). OFA relies on multimodal analgesia preoperatively and postoperatively.

Epidemiology and resistance profiles of Enterobacterales in a tertiary care hospital in Lebanon: a 4-year retrospective study.

Introduction: Antimicrobial resistance (AMR) is a worldwide problem that threatens treatment effectiveness against the most serious bacterial infections. AMR in Enterobacterales is highly prevalent in Lebanon. However, recent reports regarding the distribution of Enterobacterales and related antimicrobial susceptibility are scarce.

Ethnic Rhinoplasty: A Middle East-Centered Patient Satisfaction Survey Using the FACE-Q Questionnaire.

Background Rhinoplasty is a common and complex plastic surgery procedure. The evaluation of surgical success in rhinoplasty is primarily based on patient satisfaction. The purpose of the study is to assess the characteristics of patients who underwent rhinoplasty and their satisfaction using the FACE-Q questionnaire.

Extensive Subcutaneous Emphysema Post-traumatic Tube Thoracostomy.

Bronchocutaneous fistula (BCF) is a pathologic communication between the bronchus and the subcutaneous tissue. Its diagnosis is made mainly by chest imaging, and bronchoscopy can help in accurately localizing the fistula. Treatment options include conservative and non-conservative approaches.

Automated Detection of Patient Harm: Implementation and Prospective Evaluation of a Real-Time Broad-Spectrum Surveillance Application in a Hospital With Limited Resources.

Objectives: This study aimed to prospectively validate an application that automates the detection of broad categories of hospital adverse events (AEs) extracted from a basic hospital information system, and to efficiently mobilize resources to reduce the level of acquired patient harm.

Methods: Data were collected from an internally designed software, extracting results from 14 triggers indicative of patient harm, querying clinical and administrative databases including all inpatient admissions (n = 8760) from October 2019 to June 2020. Representative samples of the triggered cases were clinically validated using chart review by a consensus expert panel.

A case of relapsing chronic eosinophilic pneumonia treated by Omalizumab.

Chronic eosinophilic pneumonia (CEP) is an idiopathic disorder characterized by an abnormal accumulation of eosinophils in the pulmonary interstitial and alveolar spaces. Although many patients respond very well to treatment by steroids, some suffer from disease relapse. There aren't many treatment alternatives for steroid dependent patients or patients who are steroid intolerant because of their side effects.