Panorama of Emergency Medicine https://panoramaoem.com/index.php/poem <p>Panorama of Emergency Medicine (PoEM) journal is an interdisciplinary peer-reviewed open access scientific journal, with an access to Cochrane summary. The journal is owned by <a href="https://newhealthconcept.net" target="_blank" rel="noopener">New Health Concept (NHC)</a>, a company that provides consultancy, training and publication services related to healthcare. PoEM publishes continuously and is freely available for readers and researchers.</p> en-US poem@panoramaoem.com (Panorama Of Emergency Medicine) support@panoramaoem.com (Panorama Of Emergency Medicine IT) Wed, 03 Jul 2024 12:02:33 -0400 OJS 3.3.0.13 http://blogs.law.harvard.edu/tech/rss 60 Subarachnoid hemorrhage associated with ecstasy abuse in a young adult: a case report https://panoramaoem.com/index.php/poem/article/view/26 <p>3,4-Methyl​enedioxy​methamphetamine (MDMA), is a synthetic amphetamine derivative. Its usage can be complicated by intracerebral or subarachnoid hemorrhage. Drug-related intracranial hemorrhage (ICH) is a relatively uncommon occurrence, often associated with an underlying vascular anomaly,</p> <p>We report the case of a 28-year-old male with a history of Ecstasy abuse prior to the onset of a sever holocranial headache. Cerebral computed tomography angiography revealed a right sided sub-arachnoid hemorrhage and blood within all four ventricles, as well as a right sided pontine hematoma and an arteriovenous malformation.</p> <p>As the drug epidemic continues to worsen, it is important to take a full drug history in patients presenting with a severe headache, and to not overlook ICH as a potential complication of recreational drug abuse.</p> camillia Jeddi Copyright (c) 2024 camillia Jeddi https://creativecommons.org/licenses/by/4.0 https://panoramaoem.com/index.php/poem/article/view/26 Tue, 11 Jun 2024 00:00:00 -0400 Hippocampus infarct following a posterior cerebral artery occlusion. https://panoramaoem.com/index.php/poem/article/view/29 <p style="font-weight: 400;">A 64-year-old gentleman, presented for subacute onset of short-term memory problem, preceded by headache, right arm numbness and visual disturbances. On neurological exam, he had anterograde amnesia, decreased pinprick sensation on his right arm and right homonymous hemianopsia.</p> <p style="font-weight: 400;">Brain Magnetic Resonance imaging (MRI) and Magnetic Resonance Angiography (MRA) showed subacute ischemic lesions in the left occipital lobe, hippocampus and thalamus, caused by a distal occlusion of the left Posterior Cerebral Artery (PCA). A distal occlusion of the PCA led to multiple infarcts in different anatomical structures, causing a constellation of variant neurological signs.</p> <p style="font-weight: 400;">Our case demonstrates an anterior hippocampus predominantly irrigated by the PCA.</p> Cima Hamieh, Mahmoud El-Hussein, Eric Revue Copyright (c) 2024 Cima Hamieh, Mahmoud El-Hussein, Eric Revue https://creativecommons.org/licenses/by/4.0 https://panoramaoem.com/index.php/poem/article/view/29 Tue, 23 Jul 2024 00:00:00 -0400 Post-COVID-19 Kawasaki-Like Vasculitis and Endocarditis: A Case Report https://panoramaoem.com/index.php/poem/article/view/30 <p><strong>Background:</strong> Coronavirus Disease of 2019 (COVID-19) can cause mild to severe infection, but with a combination of inflammatory complications that target virtually anywhere in the body. Cardiac complications remain of utmost importance as they have the highest association with mortality.</p> <p><strong>Case presentation: </strong>A 32-year-old male presents with a fever of unknown origin for a period of 3 months post SARS-CoV-2 infection. He was found to have endocarditis and underwent an aortic valve replacement that was complicated by an aortic aneurysm, needing another surgery. The fever and aneurysm remitted after a new COVID-19 infection and the patient underwent a Bentall procedure with reimplantation of the coronary arteries.&nbsp;</p> <p><strong>Discussion: </strong>Cardiac complications of COVID-19 can range from small to large arteritis, valvopathy and aortic aneurysms, which can have significant morbidity and mortality, leading to the need of surgery and prolonged treatment. The scarcity of such cases makes reporting imperative so that clearer guidelines of management can be established.</p> <p><strong>Conclusion:</strong> Cardiovascular complications of COVID-19 remain the scariest and the least reported, which necessitates the presence of more evidence of their management, which can be lifesaving.</p> Hilal Abdessamad, Charbel Saad, Tarek Abou Saad, Shaza Mortada, Sarkis Ejbeh, Richard Zalloum, Rola Husni, Jacques E. Mokhbat Copyright (c) 2024 Hilal Abdessamad, Charbel Saad, Tarek Abou Saad, Shaza Mortada, Sarkis Ejbeh, Richard Zalloum, Rola Husni, Jacques E. Mokhbat https://creativecommons.org/licenses/by/4.0 https://panoramaoem.com/index.php/poem/article/view/30 Wed, 11 Sep 2024 00:00:00 -0400 Spinal Rosai-Dorfman Disease with Isolated Severe Neuropathic Pain: A Case Report https://panoramaoem.com/index.php/poem/article/view/37 <p><strong>Introduction:</strong> Rosia-Dorfman disease is a rare histiocytic disorder that presents as generalized lymphadenopathy. Rarely, patients experience atypical extra-nodal manifestations which can mimic other diseases.&nbsp; <br><strong>Case Presentation: </strong>We report a challenging diagnosis of Rosai-Dorfman disease in a 52-year-old female presenting with isolated symptomatic neuropathic pain. After excluding common diseases, a challenging diagnosis was made based on imaging, CSF studies and clinical progression that showed thoracic spine involvement and emperipolesis confirming RDD diagnosis and with a great clinical response to corticosteroids.</p> <p><strong>Discussion: </strong>Clinical, laboratory and radiologic manifestations of the disease can vary a lot depending on the areas involved and patient progression. This can lead to challenges in establishing the diagnosis and deciding on treatment. Then unusual, first reported manifestations in our patient made the diagnosis exceptionally challenging, highlighting the importance of this report.</p> <p><strong>Conclusion: </strong>This disease can have an atypical presentation that should be detected early to avoid any delay in diagnosis or treatment. Unusual cases must be reported to aid in such a difficult diagnosis in future similar cases.</p> Omar El Tarras, Hilal Abdessamad, Jonathan Mina, Hussein Farhat, Wassim Serhal, Rola Husni, Rima Moghnieh, Jacques E. Mokhbat Copyright (c) 2024 Omar El Tarras, Hilal Abdessamad, Jonathan Mina, Hussein Farhat, Wassim Serhal, Rola Husni, Rima Moghnieh, Jacques E. Mokhbat https://creativecommons.org/licenses/by/4.0 https://panoramaoem.com/index.php/poem/article/view/37 Fri, 13 Sep 2024 00:00:00 -0400 Influenza Associated Pulmonary Aspergillosis: A Retrospective Study from a Tertiary Care Center in Lebanon https://panoramaoem.com/index.php/poem/article/view/28 <p><u>Introduction</u></p> <p>Influenza-associated pulmonary aspergillosis (IAPA) has been reported in multiple cohort studies, typically in the immunocompromised host. Limited data is available from the Middle Eastern region.</p> <p><u>Methods</u></p> <p>This is a retrospective study conducted at the American University of Beirut Medical Center (AUBMC) between January 1 2014 and March 1 2019, to describe the clinical characteristics, risk factors and outcomes of patients with influenza and invasive pulmonary aspergillosis (IPA). Six hundred fifty six patients were admitted with influenza pneumonia. Data about positive cultures for <em>Aspergillus</em> sp. isolated from sputum, deep tracheal aspirates (DTA) or bronchoalveolar lavage (BAL) or a positive aspergillus galactomannan test (GM) in serum or BAL was collected. Cases were identified based on the definitions and criteria for influenza and invasive aspergillosis suggested by the European Organization for Research and Treatment of Cancer/Mycoses study Group (EORTC/MSG), EORTC/MSG intensive care unit (EORTC/MSGERC ICU) Working Group, and IAPA definition.</p> <p><u>Results</u></p> <p>Nine patients had a positive result for <em>Aspergillus</em> sp. in culture or GM. Based on the EORTC/MSG criteria, 7 patients were classified as probable cases of IPA, and one as a possible case. On the other hand, only 2 patients were classified as probable cases of invasive fungal infection (IFI) based on the IAPA criteria. Only 1 out of 9 patients died. There was a preponderance of aspergillosis among immunocompromised patients.</p> <p><u>Conclusion</u></p> <p>Our study showed that the incidence of IPA in influenza patients was low compared to the data reported from European countries. This calls for national and regional surveillance to better understand the epidemiological variation in the regions.</p> <p> </p> Fatima Allaw, Rozana El Eid, Michel Almardini, Nabih Habib, Imad Bou Akl, Aline El Zakhem, Souha S. Kanj Copyright (c) 2024 Fatima Allaw, Rozana El Eid, Michel Almardini, Nabih Habib, Imad Bou Akl, Aline El Zakhem, Souha S. Kanj https://creativecommons.org/licenses/by/4.0 https://panoramaoem.com/index.php/poem/article/view/28 Thu, 18 Jul 2024 00:00:00 -0400 Quality of life following Covid-19 vaccination in Lebanese adults https://panoramaoem.com/index.php/poem/article/view/34 <p><strong>Background:</strong> This study investigates the quality of life (QoL) among individuals in Lebanon post-COVID-19 vaccination, focusing on various demographic and lifestyle factors influencing physical, psychological, social, and environmental health domains.</p> <p><strong>Objective:</strong> To explore the associations between COVID-19 vaccination status and QoL across four sub-scales: physical health, psychological health, social relationships, and environmental quality, examining the impact of gender, tobacco and alcohol consumption, chronic diseases, physical activity, employment status, education level, geographic location, and marital status.</p> <p><strong>Methods:</strong> A cross-sectional study was conducted involving 507 Lebanese adults who completed a structured questionnaire. The questionnaire collected data on demographics, lifestyle factors, and QoL using a standardized measurement tool. Statistical analysis, including bivariate analysis, was performed to determine significant associations between independent variables and QoL scores across the four domains.</p> <p><strong>Results:</strong> The majority of participants were female (71.6%), non-smokers (83%), and non-drinkers (76.7%). Most had no chronic diseases (83%), and 42.4% engaged in regular physical activity. High educational attainment (80.5% with graduate or professional degrees) and full-time employment (77%) were prevalent. Significant associations were found between gender and all QoL domains, with males reporting higher scores. Physical health scores were higher among non-drinkers, the physically active, independent workers, and vaccinated individuals. Psychological health was better in males, the physically active, and independent workers. Social relationships were stronger among males, independent workers, and those in relationships. Environmental quality was higher among males, non-drinkers, independent workers, and those with no formal education. Vaccination status positively influenced physical health and showed near-significant effects on social relationships and environmental quality.</p> <p><strong>Conclusion:</strong> COVID-19 vaccination is associated with improved QoL in Lebanon, particularly in physical health. The findings highlight the importance of considering socio-economic factors and lifestyle choices in public health strategies to enhance overall well-being. Future research should explore longitudinal impacts and address the specific needs of diverse populations.</p> Dunya Nohra Copyright (c) 2024 Dunya Nohra https://creativecommons.org/licenses/by/4.0 https://panoramaoem.com/index.php/poem/article/view/34 Thu, 19 Sep 2024 00:00:00 -0400 Bacteriophage-Based Treatment in Infectious Diseases: What Do We Know So Far? A Narrative Review https://panoramaoem.com/index.php/poem/article/view/38 <p><u>Purpose</u>: To summarize the literature on bacteriophage use in human infection</p> <p><u>Methods</u>: Using the MeSH terms “Phage” “Therapy”, “Treatment” “Outcome”, a search was performed in ScienceDirect, Scopus and Pubmed databases, including narrative review, systematic reviews and clinical trials, dating from 2020 till June 2023. A total of 191 articles and 389 articles were retrieved respectively from each database, which after duplication removal, added up to 505. After the primary screen, 131 texts were collected. Following that, a secondary ended up with 56 articles included.</p> <p><u>Conclusion</u>: With the constant increase in antibiotic resistance, there is a need for newer antimicrobial agents, which led to the revival of bacteriophages. Due to advances in molecular microbiology, phages became a possibility that has proven itself promising. More studies and funding are needed towards this field, that offers us a promising salvation from the antimicrobial resistance pandemic.</p> Hilal Abdessamad, Ahmad Afyouni, Amarelle Chamoun, Lara Dalal, Macram Wakim, Ali Toufaily Copyright (c) 2024 Hilal Abdessamad, Ahmad Afyouni, Amarelle Chamoun, Lara Dalal, Macram Wakim, Ali Toufaily https://creativecommons.org/licenses/by/4.0 https://panoramaoem.com/index.php/poem/article/view/38 Thu, 18 Jul 2024 00:00:00 -0400 The Epidemiology of Syphilis and Co-infection with HIV in a Tertiary Care Center in Lebanon: A Retrospective Review https://panoramaoem.com/index.php/poem/article/view/40 <p><u>Introduction:</u> Syphilis is an ancient STI causing a new worldwide outbreak in general and in Lebanon specifically.</p> <p><u>Methods:</u> We conducted a retrospective chart review to assess the rate of syphilis increase in an infectious diseases clinic in Lebanon from 2006 to 2023. We studied the epidemiology of these cases, stage and treatment response and their association to HIV infection and its control.</p> <p><u>Results:</u> There was an 862% increase in syphilis cases from 2006 to 2019.Most of our cases were middle aged men living with HIV. Most of them had well-controlled HIV infection with good CD4 counts. Most of the diagnosed cases of syphilis were primary and secondary, responding to penicillin G.</p> <p><u>Discussion:</u> Our data mostly parallels international data, except for gender distribution. Despite successful treatment of most cases in our clinic, the alarming rise of new cases highlights the urgent need for public health measures to mitigate this epidemic.</p> <p><u>Conclusion:</u> Inclusive awareness is needed to stop syphilis spread in Lebanon, and more screening is key in identifying new cases early for a successful eradication.</p> Hilal Abdessamad, Dalida El Khatib, Moussa Hojeij, Rana Asmar, Julien Maamari, Hicham Baba, Ghazirabih@gmail.com, Wael T Azzam, Rola Husni, Jacques E. Mokhbat Copyright (c) 2024 Hilal Abdessamad, Dalida El Khatib, Moussa Hojeij, Rana Asmar, Julien Maamari, Hicham Baba, Ghazirabih@gmail.com, Wael T Azzam, Rola Husni, Jacques E. Mokhbat https://creativecommons.org/licenses/by/4.0 https://panoramaoem.com/index.php/poem/article/view/40 Thu, 19 Sep 2024 00:00:00 -0400