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. Currently, emergency physicians are leaning more towards ultrasound, fellowships and university courses are created around the globe to teach this essential skill. This article highlights the importance of ultrasound in the hands of emergency physicians while presenting a life-threatening diagnosis that could have been easily missed if it wasn't for the use of ultrasound. Cases like these are frequently seen in the emergency departments, and it is when blinded by a tunnel vision, and anchoring bias, that these serious diagnoses can be left undiagnosed. Many individuals in the medical community are against the use of ultrasound by untrained physicians, but it remains highly recommended that emergency physicians get a proper training on the use of this tool for it is of great value in the emergency department.
Androgenetic alopecia (AGA) is a common and benign cause of chronic hair loss that affects both males and females. Platelet-rich plasma (PRP) is a safe and minimally invasive technique with promising ...outcomes in patients with AGA, alongside other therapeutics use. The currently available data in the literature assures that the rate of side effects is low but includes infection and localized reaction (Stevens and Khetarpal, Feb. 2019) 1. This article describes a case of herpes zoster ophthalmicus (HZO) following PRP treatment for androgenic alopecia, while shedding light on the importance of respecting the guidelines when injecting PRP therapy to ensure a safe outcome with no complications.
With the continuous spread and emergence of transmissible diseases, focusing on preventive measures is essential to decrease their incidence and spread. In addition to behavioral measures, ...vaccination is an optimal way to protect the population and eradicate infectious diseases. The majority are aware of children's vaccinations, while many might not know that adult vaccinations are also essential.
This study aims to understand the perception of Lebanese adults towards vaccination and their knowledge and awareness of its importance. This is a national cross-sectional study, conducted between January 2020 and January 2021.
the data were collected from 1023 subjects, the majority being Lebanese, previously healthy, and with a graduate or post-graduate level of education. Out of these participants, 44.9% were advised to take vaccines, half of them by healthcare workers. The most common vaccine received during adult life is the Flu vaccine. Overall, 25.6% of the participants were unaware that they needed vaccines and 27.9% thought it is not indicated. Participants' knowledge about vaccination is variable. In total, 39.4% agree or are uncertain whether vaccines contain harmful chemicals and 48.4% believe that vaccines will trigger diseases. The level of education and occupation significantly enhances knowledge about vaccination. Some participants 27.3% are concerned about the vaccine's side effects. The group of young participants, graduates, and nonsmokers think that the vaccine is a necessity and had a positive attitude towards vaccination.
Many Lebanese lack knowledge about adult vaccination protection and its benefits in the community. It is essential that the country's health ministry department collaborate with the healthcare system to launch awareness campaigns about adult vaccination in the country to overcome the barriers and ensure better coverage.
ObjectivesThis study aims to describe the injury patterns of the Beirut blast victims and assess hospitals’ disaster management and preparedness during the 2020 Beirut port blast.MethodsA ...cross-sectional retrospective multicenter study was conducted in two stages. Data were collected on blast victims presented to participating hospitals from August 4 till August 8, using three designed questionnaires. Stage 1 included all blast patients’ records and stage 2 examined a subset of inpatient and outpatient records. Binary logistic regression was performed to assess the factors associated with death and disability for blast patients.ResultsA total of 3278 records were collected, 83% were treated at emergency departments and 17% were admitted to hospitals. Among those, 61 deaths and 35 long-term disabilities were reported. Extremity operations (63%) were mostly performed. Outpatients (n=410) had a mean age of 40±17.01 years and 40% sustained lacerations (40%). 10% of those patients sustained neurological complications and mental problems, and 8% had eye complications. Inpatients (n=282) had a mean age of 49±20.7 years and a mean length of hospital stay of 6±10.7 days. Secondary (37%) and tertiary (25%) blast injuries were predominant. 49% sustained extremity injuries and 19% head/face injuries. 11 inpatient deaths and 20 long-term disabilities were reported. Death was significantly associated with tertiary concussion and crush syndrome (p<0.05). Of the 16 hospitals, 13 implemented disaster plans (87%), and 14 performed a triage with a mean time of 0.96±0.67 hours. One hospital (6%) performed psychological evaluations, without follow-up.ConclusionBeirut blast victims suffered deaths and disabilities associated with their injuries. They predominantly sustained lacerations caused by shattered glass. Tertiary injuries were associated with death. Triage, disaster plans, and hospital preparedness should be effectively implemented to enhance patients’ clinical outcomes.Level of evidencePrognostic and epidemiological/Level III
Prurigo Nodularis is a skin disease, secondary to a chronic scratching behavior. As multiple etiologies were said to be the cause of this condition, no clear pathophysiology has been described, and ...treatment is still not readily available. An elderly patient presented to the Emergency Department for confusion was found to have multiple excoriating lesions on the abdomen, back and extremities. Multiple treatment regimens were tried to manage this skin disease prior to this admission, with no improvements. This patient was eventually diagnosed with Prurigo Nodularis and treatment was initiated. In this case report we discussed the etiologies, presentation and management of Prurigo Nodularis, while focusing on the case in hand.
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The population around the world is growing in age, and taking care of the elderly has become a medical challenge as new pathologies, risk factors, treatments, and approaches are being ...explored. One of the most important chapters that should be focused on is falls in the elderly, as it is a common reason for, not only fractures but also dependency, morbidity, and mortality in this population. The chapter on fall is vast and can be further categorized. In this article, we aim to focus on one of the complications, which is discitis post-vertebral fracture. The patient studied was a 78-year-old female patient who consulted post-fall and was admitted to the geriatric ward for a vertebral fracture. The hospitalization was complicated by a spinal infection and later on by a rarely-seen pacemaker lead infection. Vertebral fractures are very common in the geriatric population, whether spontaneously or post-trauma. Although treatment can be surgical or conservative, complications are commonly seen and can be fatal. Discitis is a medical challenge as the germs can be difficult to isolate, the pain management is difficult and in frail elderly patients, the infection and inflammation can be fatal. Prevention of falls is important in the elderly population as a simple slip can have drastic outcomes. Understanding the possible complications of falls is essential for better management.
COVID-19 pandemic changed the world. The fight against acquiring this virus went from social distancing, lockdowns and
wearing masks, to mass vaccinations. Several vaccines invaded the market, and ...nations raced towards vaccinating all the
population in order to reach herald immunity. mRNA vaccine is one of the most commonly used vaccine nowadays, and
although it has a very high efficacy rate, many side effects were reported. A previously healthy young woman presented to our hospital, 1 week after receiving her first COVID-19 mRNA vaccine due severe aphthous ulcers, fatigue and fever. The patient was found to have pancytopenia. Although several side effects were reported to all the COVID-19 vaccines, pancytopenia is not one of the most commonly reported side effects in the literature. In this case report, we talk about is mentioned in the literature, the clinical picture of this patient, the evolution during her hospitalization, and the outcome.
BACKGROUND Ethanol intoxication is very common, and several forms of alcohol intoxication can lead to emergency department visits. Excessive alcohol users, when in withdrawal, might seek replacement ...alcoholic beverages; one of the common sources of ethanol is hand sanitizer, which contains 45-95% alcohol. It becomes even more challenging to deal with alcohol use disorder patients when they seek these replacement products inside hospital premises, and medical clinics and hospitals have increased their use of ethanol-based hand sanitizer since the start of the COVID-19 pandemic. CASE REPORT We report the case of a 26-year-old man with alcohol dependence presenting with a fictitious illness leading to hospital admission and consumption of ethanol-based hand sanitizer in the emergency department (ED). The patient initially presented reporting severe abdominal pain that persisted despite medications. The initial laboratory tests and imaging were non-significant. The patient was later caught stealing hand sanitizer bottles, consuming them within 4-6 h. The COVID-19 pandemic has increased alcohol intoxication, especially in EDs. Hand sanitizers, including ethanol, are toxic and hazardous when misused, mostly by adolescents and young adults. Treatments include glucose determination, dextrose infusion, and thiamine perfusion. Strategies to reduce ethanol intoxication include eliminating hand sanitizers, using wall-fixed sanitizers, and using sanitizer wipes. CONCLUSIONS Patients with alcohol use disorder are known to develop alcohol-seeking behaviors. This report has highlighted that healthcare professionals should be aware that the increased availability of ethanol-based hand sanitizers, some of which contain toxic antiviral chemical agents, may be targeted by individuals with alcohol dependency.BACKGROUND Ethanol intoxication is very common, and several forms of alcohol intoxication can lead to emergency department visits. Excessive alcohol users, when in withdrawal, might seek replacement alcoholic beverages; one of the common sources of ethanol is hand sanitizer, which contains 45-95% alcohol. It becomes even more challenging to deal with alcohol use disorder patients when they seek these replacement products inside hospital premises, and medical clinics and hospitals have increased their use of ethanol-based hand sanitizer since the start of the COVID-19 pandemic. CASE REPORT We report the case of a 26-year-old man with alcohol dependence presenting with a fictitious illness leading to hospital admission and consumption of ethanol-based hand sanitizer in the emergency department (ED). The patient initially presented reporting severe abdominal pain that persisted despite medications. The initial laboratory tests and imaging were non-significant. The patient was later caught stealing hand sanitizer bottles, consuming them within 4-6 h. The COVID-19 pandemic has increased alcohol intoxication, especially in EDs. Hand sanitizers, including ethanol, are toxic and hazardous when misused, mostly by adolescents and young adults. Treatments include glucose determination, dextrose infusion, and thiamine perfusion. Strategies to reduce ethanol intoxication include eliminating hand sanitizers, using wall-fixed sanitizers, and using sanitizer wipes. CONCLUSIONS Patients with alcohol use disorder are known to develop alcohol-seeking behaviors. This report has highlighted that healthcare professionals should be aware that the increased availability of ethanol-based hand sanitizers, some of which contain toxic antiviral chemical agents, may be targeted by individuals with alcohol dependency.
BACKGROUND Iodine contrast allergy can cause acute and delayed allergic reactions. Just like any other sensitivity reaction, the severity can vary from mild to moderate skin manifestations such as ...erythematous rash to an even more severe presentation or life-threatening event, such as angioedema and anaphylaxis. CASE REPORT This case report discusses a patient who presented to our institution with a diffuse complex rash 2 days after undergoing CT scan imaging with intravenous iodine contrast injection. The rash started by being maculopapular in nature. Later on, the patient developed a purpuric and petechial pattern, and eventually, an acute exanthematous pustulosis rash was noticed. Several attempts to treat the patient with intravenous corticosteroids failed. Three days after admission (5 days after the rash started), topical steroids were used in place of parenteral steroids. The rash showed remarkable improvement in a very short time. The patient was diagnosed with delayed hypersensitivity IV iodine reaction, resistant to parenteral corticosteroids. The workup of such an extensive rash and odd presentation include several laboratory tests and skin testing to be able to rule out more serious differential diagnoses. CONCLUSIONS This case is unique as it enables us to show the importance of substituting topical management, more specifically, topical steroids that might even replace parenteral steroids, to our management in order to treat allergic reactions, especially in the presence of a rash.
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