Rejected

Children are one of the most important groups at risk of catching the influenza infection. The consequences of influenza in some children, especially children with chronic and underlying diseases, can be very severe and lead to hospitalization.

We report a case of unilateral varicella-zoster virus (VZV) related keratouveitis and papillitis. A 54-year-old male presented with headache, left forehead rash, and decreased vision in the left eye. Examination of the left eye showed visual acuity (VA) of 0.15, relative afferent pupillary defect, anterior stromal corneal edema, nongranulomatous keratic precipitates, a swollen and hyperemic optic disc. The patient could read 6/12 of the Ishihara plates in the left eye. Optical coherence tomography (OCT) showed optic disc edema and OCT angiography (OCTA) revealed increased peripapillary vascularity. Computerized visual field testing demonstrated an enlarged blind spot and lower altitudinal defect. Serum anti-varicella-zoster IgM antibody level was elevated. The patient was put on oral acyclovir and prednisone treatment. At 1-month follow-up visit, VA increased to 0.9 and color vision was 11/12 Ishihara plates. OCT showed resolution of optic disc edema and OCTA demonstrated normalization of the increased peripapillary vascularity. Computerized visual field test demonstrated improvement in the lower altitudinal visual field defect and normalization of the enlarged blind spot. Optic nerve involvement in VZV infection occurs rarely, especially in immunocompetent patients as in our case.

Nerve block is a key technique in postoperative analgesia for total hip arthroplasty (THA). This study aimed to compare ultrasound-guided suprainguinal fascia iliaca block (SFIB) and anterior quadratus lumborum block (AQLB) in patients undergoing primary THA.

The epidemiology features and clinical symptoms associated with 121 cases of snakebite requiring admission to 24 hospitals in Jordan, during 2018-2020, are discussed. Ninety-six of them (79%) brought with them to the hospital the snake that bit them or a photograph of it. Echis coloratus was responsible for 68 of the bites and 6 fatalities. Sex ratio was 3.2 males: 1 female, with an overall average age of 27 ± 14.36 years. The highest incidence of bites was reported in September. Bites were most common on hands and legs. The period of hospitalization ranged from 1 to 36 days. Irbid and Karak governorates had the highest number of snakebites, most cases being reported from agricultural areas and among farmers. Clinical symptoms associated with five species of venomous snakes are described along with illustrative case histories. Symptoms associated with Echis coloratus bites included local swelling and necrosis, coagulopathy and bleeding, microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney injury (AKI) and chronic renal failure. Daboia palaestinae victims exhibited ecchymoses, local swelling and necrosis, with one case of angioedema. Other symptoms included thrombocytopenia, coagulopathy, microangiopathic hemolysis and local and systemic bleeding, as well as AKI. A single case of envenoming by Macrovipera lebetinus developed the following symptoms; swelling, severe pain, extensive ecchymoses, neutrophil leukocytosis, normochromic normocytic anemia and aggregated platelets with thrombocytopenia. Symptoms associated with two cases of Pseudocerastes fieldi included swelling that spread from bitten hands, and mild abnormalities of platelet count and bleeding time. Four cases of envenoming by Atractaspis engaddensis exhibited severe pain, local swelling, erythema, numbness and tissue necrosis. One of them developed acute systemic symptoms. The only antivenom currently available in Jordan, is VINS "Snake venom antitoxin (Biosnake)", manufactured in India using venoms of three African snakes that do not occur in Jordan. It proved clinically ineffective against envenoming by Jordanian Viperidae, failing to correct coagulopathy and life-threatening hemorrhage, and to prevent AKI.

Osteoporosis is a common metabolic bone disease, and treatment is required for the pre-vention of low bone mass, deterioration of microstructural bone tissue, and fragility fractures. Osteoporosis therapy includes calcium, vitamin D, and drugs with antiresorptive or anabolic action on the bone. Therapy for osteoporosis does not include taking non-steroidal anti-inflammatory drugs (NSAID), but pain associated with osteoporotic fractures can be treated by taking non-steroidal anti-inflammatory drugs (NSAID). Recently, polysaccharides extracted from medicinal herbs and edible substances (PsMHES) have attracted attention on account of their safety and promising anti-osteoporosis effects, whereas a systematic review about their potential in anti-osteoporosis is vacant to date. Herein, we reviewed the recent progress of PsMHES with anti-osteoporosis activities, looking to introduce the advances in the various pharmacological mechanisms and targets involved in the anti-osteoporosis effects, extraction methods, main mechanism involved in Wnt/β-catenin pathways and pathways and RANKL (Receptor Activator for NFκB ligand or TNFSF25) pathways, and Structure-Activity elationships (SAR) analysis of PsMHES. Typical herbs like and used for the treatment of osteoporosis are introduced; their traditional uses in traditional Chinese medicine (TCM) are discussed in this paper as well. This review will help to the recognition of the value of PsMHES in anti-osteoporosis and provide guidance for the research and development of new anti-osteoporosis agents in clinic.

() commonly known as 'Kiswara' is used as infusions for stomach and joint pain. This study aims to evaluate the and anti-inflammatory and anti-arthritic activity was evaluated by measuring inflammatory parameters (TNF-, C-reactive protein and Fibrinogen) in murine models of the aqueous extract and isolated compounds of . A bio-guided phytochemical analysis based on NMR/MS was performed identifying three (-) compounds of the aqueous extract. All compounds inhibited the production of TNF- in RAW 264.7 cell line, with IC of 13.44 (), 1.13 () and 0.57 μM (), respectively. In addition, compounds and decreased the levels of TNF-, C-reactive protein and fibrinogen at a concentration of 5 mg/kg in murine models. Our research shows that the compounds isolated from have anti-inflammatory and anti-arthritic properties, providing scientific evidence for the traditional use of this plant species.

Combining local anesthetics with dexmedetomidine (DEX) for nerve blocks has been tested and confirmed as an alternative technique to strengthen analgesia in adults, but the evidence supported this proposal in pediatrics was not convincing enough. Thus, we intend to conduct a meta-analysis to make an appraisal of the effects of DEX as a local anesthetic adjuvant on peripheral nerve blocks in children.

To evaluate the outcomes of Trans Rectus Sheath Extra-Peritoneal Procedure (TREPP) in patients undergoing elective inguinal hernia repair.

Cranial nerve (CN) disorders are the foremost symptoms in cerebellopontine angle (CPA) and petroclival area (PCA) epidermoid cysts (EC).The aim of this work was to  assess the long-term surgical results on CN function and tumor control in these patients EC. We performed a retrospective cohort study about 56 consecutive patients operated on for a CPA or PCA EC between January 2001 and July 2019 in six participating French cranial base referral centers. Sixteen patients (29%) presented a PCA EC and 40 a CPA EC (71%). The median clinical and radiological follow-up was 46 months (range 0-409). Preoperative CN disorders were present in 84% of patients (n = 47), 72% of them experienced CN deficits improvement at the last follow-up consultation (n = 34): 60% of cochlear and vestibular deficits (n = 9/15 in both groups), 67% of trigeminal neuralgia (n = 10/15), 53% of trigeminal hypoesthesia (n = 8/15), 44% of lower cranial nerve disorders (n = 4/9), 38% of facial nerve deficits (n = 5/8) and 43% of oculomotor deficits (n = 3/7) improved or were cured after surgery. New postoperative CN deficits occurred in 48% of patients (n = 27). Most of them resolved at the last follow-up, except for cochlear deficits which improved in only 14% of cases (n = 1/7). Twenty-six patients (46%) showed evidence of tumor progression after a median duration of 63 months (range 7-210). The extent of resection, tumor location, and tumor size was not associated with the occurrence of new postoperative CN deficit or tumor progression. A functional nerve-sparing resection of posterior fossa EC is an effective strategy to optimize the results on preexisting CN deficits and reduce the risk of permanent de novo deficits.

Despite development of new therapies, migraine remains an undertreated illness. It is important to understand patients' preferences and perceptions of using a certain therapy. We present data from a nationwide Lithuanian survey of patients' experience using erenumab for the treatment of high frequency episodic and chronic migraine.