Rejected

The monkeypox virus, which belongs to the orthopoxy virus family, causes fever, lethargy, headache, lymphadenopathy, myalgia, and rash, as well as various complications such as superimposed infections, sepsis, keratitis, encephalitis, and bronchopneumonia. Following replication at the site of injection, the virus often enters by the oropharynx, nasopharynx, or intradermal pathway, spreading to lymph nodes before viremia, promoting viral dissemination to other organ systems. Monkeypox cases have recently been brought to WHO's notice from 12 presently non-endemic member nations spread over three WHO regions, with 92 laboratory-confirmed cases and 28 cases of suspicion as of May 21, 2022. Monkeypox is presently endemic in the Central African Republic, the Democratic Republic of the Congo, Benin, Cameroon, Gabon, Sierra Leone, and South Sudan. Monkeypox cases have been detected all across the world, posing a challenge to healthcare infrastructure that is still recovering from the COVID-19 outbreak. Close monitoring and exact data collecting, the implementation of successful programs across the world, and public support of preventative measures are some of the strategies being used to cope with the increasing incidence of monkeypox.

We describe splenic infarction (SI), an infrequent condition, in an 82-year-old COVID-19 patient with chronic atrial fibrillation (AF). COVID-19 may cause thrombosis, and AF is a predisposing factor for splenic infarction. Suspicion of SI may be warranted in COVID-19 patients with abdominal pain, especially if a predisposing factor exists.

A 49-year-old highly active man had a direct fall on the left shoulder, causing a chronic locked posterior shoulder dislocation. Radiographic analysis revealed a reverse Hill-Sachs lesion (RHSL) that affected 31% of the articular surface. He was successfully treated with a modified McLaughlin procedure that included a double-row suture anchor as a novel fixation approach to secure the lesser tuberosity transfer and the subscapularis tenodesis.

Every human being has gas in abdomen. But patients try to correlate varieties of symptoms with abdominal gas. So this cross sectional symptom based study was designed to see the patients view regarding abdominal gas and its relation with medically explained symptoms at the out patient department of North East Medical College, Sylhet from January 2017 to December 2019. Consecutive patients presenting with complain of abdominal gas were included in this study. Their demographic information and explanation of symptoms resulting from abdominal gas were recorded on a pre-designed data sheet. Statistical analysis was done using SPSS 20.0 version. Total 346 patients, male 239(69.1%), female 107(30.9%), age varying from 17-83 years (mean 38.27) were enrolled. Common symptoms were bloating (fullness) of abdomen (194, 56.1%), abdominal pain (164, 47.41%), belching or eructation (149, 43.1%), heart burn (137, 39.6%), anorexia (124, 35.8%), nausea (120, 34.7%), noisy bowel (88, 25.4%), chest pain (79, 22.8%), headache (56, 16.2%), whole body pain (58, 16.8%), incomplete bowel evacuation (185, 53.5%), excess flatus (76, 22.4%), movement of gas to different part of body including head 87(25.1%) and expulsion of hot air from ear, nose and head in 69(19.9%) patients. Among them 107(30.9%) patients believed abdominal gas to be a curable disease with treatment and 222(64.2%) believed it to be a relapsing disease even after treatment. And 307(88.7%) patients were taking proton pump inhibitor (PPI) as its remedy regularly. Most of the symptoms of patients can be explained by abdominal gas. Again some patients have a misperception regarding some symptoms like heart burn, noisy bowel and sense of incomplete bowel evacuations are also related with abdominal gas. But in some instances causal relations with patients' symptoms and abdominal gas could not be explained by medical knowledge. These differences in perceptions might be related to their personal thinking and social, cultural, educational, economic condition.

Intraoperative nausea and vomiting (IONV) is a common symptom during cesarean section (CS) delivery causing significant discomfort to patients. Combined spinal and epidural anesthesia (CSEA) can provide both intraoperative anesthesia and postoperative analgesia. During CSEA, it is reasonable to administer local anesthetics to the epidural space before patient complaints to compensate for the diminished effect of spinal anesthesia. Therefore, we hypothesized that intraoperative epidural administration of 2% mepivacaine would reduce the incidence of IONV.

The purpose of the study was to determine if neurofilament light chain (NF-L), a biomarker of neurologic damage in disease states such as ALS, diabetes, and Parkinson's disease increases with neurotoxic chemotherapy.

Gam-COVID-Vac is the world's first registered vector vaccine against COVID-19 based on a combination of two heterologous adenoviruses. It was chosen by the Republic of San Marino as the main tool in its vaccination campaign, which started on 25 February 2021. Our aim was to build up on the ROCCA study, focused on the older population, by describing adverse effects following immunisation (AEFIs) rates and characteristics in all age groups for the first time in a real-world context.

FASTHUG is a mnemonic used by intensive care physicians to ensure the proper management of patients admitted to an Intensive Care Unit (ICU). FASTHUG-MAIDENS is a modified version that incorporates key pharmacotherapeutic elements such as delirium management, drug dosing, and drug interactions for an appropriate medication assessment of critically ill patients. An analytical cross-sectional study of hospitalized patients was carried out to determine aspects related to the pharmacotherapeutic management of critically ill patients that required to be optimized, to design and implement a protocol based on the FASTHUG-MAIDENS mnemonic. A total of 435 evaluations were performed to assess the status of current critical patient management. The main parameters with opportunities to be improved were analgesia, feeding, and sedation. With the implementation of MAIDENS, the parameters of analgesia, sedation, and thromboprophylaxis showed an increase in the percentage of optimal management. Furthermore, 103 drug-related problems were detected, and most of them were associated with feeding (21.3%), glucose control (11.7%), and delirium (9.7%). The FASTHUG MAIDENS protocol implementation allows for the evaluation of more vital aspects in the management of critically ill patients. The daily review of patients admitted to the ICU by a clinical pharmacist (CP) using the FASTHUG-MAIDENS checklist instead of the FASTHUG mnemonic facilitates the identification of DRPs for the performance of possible interventions by the CP to improve the pharmacotherapeutic management.

A recent surge in monkeypox cases in non-endemic countries has been a recent concern in global health. The virus originated in Africa, and the current multi-country outbreak involves various countries in North and South America, Europe, and Australia. The virus spreads through direct contact and presents with fever, headache, muscle aches, later lymphadenopathy, and painful skin rash. The current developments include the detection of the draft genome and the approval of MVA-BN vaccine for the prevention of monkeybox. This letter presents challenges in the detection and recognition of cases along with recommendations for the early phases of the multi-country outbreak. This article is protected by copyright. All rights reserved.

We report the first pediatric disease in which the use of minimally invasive autopsy (MIA) confirmed severe dengue as the cause of death. During the COVID-19 pandemic, a previously healthy 10-year-old girl living in north-eastern Brazil presented fever, headache, diffuse abdominal pain, diarrhoea, and vomiting. On the fourth day, the clinical symptoms worsened and the patient died. An MIA was performed, and cores of brain, lungs, heart, liver, kidneys, and spleen were collected with 14G biopsy needles. Microscopic examination showed diffuse oedema and congestion, pulmonary intra-alveolar haemorrhage, small foci of midzonal necrosis in the liver, and tubular cell necrosis in the kidneys. Dengue virus RNA and NS1 antigen were detected in blood and cerebrospinal fluid samples. Clinical, pathological, and laboratory findings, in combination with the absence of other lesions and microorganisms, allowed concluding that the patient had died from complications of severe dengue.