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Introduction The aim of this study was to compare the number of the Pediatric Emergency Department (PED) visits for young allergic patients with respiratory or cutaneous symptoms during the first wave of the coronavirus disease 19 (COVID-19) pandemic in 2020 with the same period in 2019, evaluating the percentage of positive cases to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). We carried out a retrospective analysis using data from young patients who visited the PED with cutaneous or respiratory symptoms in the period from 20th February to 12th May of the years 2020 and 2019. Data on allergy and COVID-19 nasal swab were also collected. We observed eleven (28.2%) PED visits for allergic patients with respiratory or cutaneous symptoms for the period from 20th February to 12th May of the year 2020 and ninety-three (31.8%) PED visits for the same time frame of the year 2019 (p=0.645). Only a two-month-old child out of 39 patients with non-allergic respiratory or cutaneous symptoms resulted positontagion or the lockdown or a reduction in air pollution that kept children with allergy from visiting the PED. Further studies are needed to better understand the impact of underlying allergies on COVID-19 susceptibility and disease severity.The severe acute respiratory coronavirus 2 (COVID-19) pandemic impacts the health of women at reproductive age in different ways, starting from pregnancy planning to post-delivery. This narrative review summarises the challenges to obstetric practice posed by the severe acute respiratory coronavirus 2 (COVID-19) pandemic. In this paper, we highlight the impacts of COVID-19 to obstetric practice globally and the efforts taken to address these challenges. Further study is critical to investigate the effects of COVID-19 on pregnancy, the outcome of COVID-19 positive pregnant women, and the safety of vaccination during pregnancy and breastfeeding.
Severity of corona virus disease 2019 (COVID19) is presented with respiratory distress.

We present a case of a 29-year-old male who was not presented with typical symptoms of COVID19 at the time of referral but loss of consciousness.

The importance of testing patients without typical symptoms for coronavirus infection and multi-system manifestation of the virus is presented in this case.

Severe drop in oxygen saturation in asymptomatic patients can lead to encephalopathy.
Severe drop in oxygen saturation in asymptomatic patients can lead to encephalopathy.
The trauma of surgery is a neglected area of research. Our aim was to examine the differential expression of genes of stress, metabolism and inflammation in the major organs of a rat following a laparotomy.

Anaesthetised Sprague-Dawley rats were randomised into baseline, 6-hr and 3-day groups (n=6 each), catheterised and laparotomy performed. Animals were sacrificed at each timepoint and tissues collected for gene and protein analysis. Blood stress hormones, cytokines, endothelial injury markers and coagulation were measured.

Stress hormone corticosterone significantly increased and was accompanied by significant increases in inflammatory cytokines, endothelial markers, increased neutrophils (6-hr), higher lactate (3-days), and coagulopathy. In brain, there were significant increases in M1 muscarinic (31-fold) and α-1A-adrenergic (39-fold) receptor expression. Cortical expression of metabolic genes increased ∼3-fold, and IL-1β by 6-fold at 3-days. Cardiac β-1-adrenergic receptor expression increased up ulopathy. The pervasive nature of systemic and tissue inflammation was noteworthy. There is an urgent need for new therapies to prevent hyper-inflammation and restore homeostasis following major surgery.
acute upper gastrointestinal bleeding (UGIB) is a common medical condition that results in substantial morbidity, mortality, and medical care cost. The mortality rate for patients with acute upper gastrointestinal (GI) bleeding is 5-10%, and it has not changed much since 1945, despite the development in medicines, endoscopy, intensive care units (ICU), and surgical management. We conduct this study to observe some of the factors that predict death in these patients.

The Study was conducted at the Internal Medicine Department, Digestive Division, Aleppo University Hospital, between July 2018 and June 2020. The study included all patients with acute upper GI bleeding who were admitted to the digestive division during the study period, or who were admitted by other departments requesting an upper GI endoscopy.

This study involved 234 patients, 137 males (58.55%), 97 females (41.45%).The patients' ages ranged between 17 and 81 years old, and the mean age value±standard deviation was 57.15±22.89 years old.Th had received blood transfusions. Finally, we found a moderate inverse relationship between the arterial blood pressure value at admission and the incidence of death.
Lateral abdominal wall (LAW) defect presents as a rare and unique challenge to the reconstructive surgeons.

We report a huge recurrent right lateral abdominal DFSP with local invasion in a 35-year-old lady. After wide local excision, the reconstruction was done by using pedicled anterolateral thigh fasciocutaneous flap and gluteal fasciocutaneous rotational flap.

The goal of reconstruction of the lateral abdominal wall is similar to that of the anterior abdominal wall, namely to provide a static repair that will not attenuate and form a bulge or hernia over time. Anchoring a mesh to stable fixation points is expected to ensure structural integrity in the LAW defect. However, we selected fascial inset from our flaps which did not lead to hernia formation or a bulge following a 7-month postoperative review. In terms of soft tissue coverage, the pedicled anterolateral thigh fasciocutaneous flap and gluteal fasciocutaneous rotational flap were used. The standard free flap will require more complexity of works, especially if the recipient vessels for microsurgical reconstruction are remotely situated or sometimes not even available.

Huge full-thickness LAW defect following an oncological resection can be reconstructed with combination of simpler locoregional flaps which yield good functional and aesthetic outcome.
Huge full-thickness LAW defect following an oncological resection can be reconstructed with combination of simpler locoregional flaps which yield good functional and aesthetic outcome.
To provide an overview of the types of wound debridement and update the available scientific consensus on the effect of wound debridement.

The articles were searched through CINAHL, PubMed, Cochrane Library, and Medline database for relevant articles on all types of wound debridement. Articles included were all systematic review on the effectiveness of wound debridement-related outcome, published within the year 2017 until Aug 2021, in English.

A total of seven scientific articles had been selected for review out of 318 screened. The authors reviewed a total of 318 titles and abstracts related to wound debridement effectiveness. Seven articles that were selected were narratively reviewed by two authors. The findings of the review were organized into autolytic, enzymatic, sharp, surgical, biological, and mechanical debridement methods and includes the advantages and disadvantages of each. The author further explored on the role of wound debridement according to wound bed preparation model. Articles were ts showed inconclusive findings and the patient safety was not clearly defined. A higher level of review is warranted in the future study.
Bilateral ectopic pregnancy is one of the rarest forms of ectopic pregnancy due to the difficulty of diagnosis and interference before surgery, where ectopic pregnancy cases are clinically indistinguishable from unilateral ectopic pregnancy, and many cases are discovered by chance during surgery.The Importance of this report comes from the history of a patient with four cesarean sections, who developed two-tailed tubal ectopic pregnancy without ovulation induction or any contraception methods.

Our patient after admission to the emergency department was diagnosed with a unilateral GS=9W ectopic pregnancy in the right fallopian tube based on Doppler echography. However, during the surgery, the surgeon discovered a rupture in the left tube, which was discovered to be another left fallopian ectopic pregnancy confirmed by pathology.

Our patient presented with typical symptoms of ectopic pregnancy confirmed by BHCG blood test and Doppler ultra sound but the untypical finding of bilateral ectopic pregnancy witstudy only as an aiding tool to make a diagnosis; nevertheless, the patient could have been better managed and her fertility saved if better capabilities were available.
Colocutaneous fistulas can occur as the result of complications from diverticular colon surgery. Enterocutaneous fistula is a type of fistula that accounts for about 88.2% of all fistulas. In this report, we describe a case reports of the management of colocutaneous fistula with laparoscopic surgery.

In this case reports, both patients complained of increased amount of abdominal discharge after surgery. In Case 1, a 43-year-old female patient complained of a lump in her lower abdomen which had been there for three months. After removal of the lump, there was blood in the drainage tube. After three months, her surgeon advised to close the stoma. In Case 2, a 47-year-old male patient lived with colocutaneous fistula for a year. He had been involved in a traffic accident and underwent laparotomy sigmoidostomy. Both patients experienced pain, and there also were feces and bad odor coming out from the surgical incision. Then, both patients underwent colonoscopy, which revealed coloncutaneous fistulas. Laparoscopic surgery was conducted and there was adhesion between the sigmoid colon and ileum in the ventral abdomen wall. After the laparoscopic procedure, the patients were discharged 3 days later without any complaints.

Laparoscopic colectomy has recently replaced open resection as standard surgery. This procedure is safe, feasible, and effective for diverticular disease.
Laparoscopic colectomy has recently replaced open resection as standard surgery. This procedure is safe, feasible, and effective for diverticular disease.The novel coronavirus pandemic has taken a toll on the global healthcare systems and economy. Safety precautions, along with vaccination, are the most effective preventive measures. The global vaccination program against COVID-19 has dramatically reduced the number of deaths and cases. However, the incidence of thrombotic events and thrombocytopenia post-COVID-19 vaccination known as vaccine-induced thrombotic thrombocytopenia has raised safety concerns. This has led to an element of vaccine hesitancy. The exact mechanism for vaccine-induced thrombotic thrombocytopenia is unknown. Although the incidence of thrombosis associated with COVID-19 vaccination is low, it still requires attention, especially in older people, smokers, and people with preexisting comorbidities. BAY-876 This study aims to review the pathophysiology, diagnosis, and management of vaccine-induced thrombotic thrombocytopenia, to provide a concise and comprehensive update.
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