Rejected

Acute appendicitis is one of the most common surgical presentations seen in the emergency department, usually presenting as a case of fever, anorexia, and abdominal pain. Curative treatment is an appendectomy with histological examination of the surgical specimen to diagnose the subtypes or causes of appendicitis. One of these subtypes, granulomatous appendicitis, is an uncommon form of appendicitis. This condition can be caused by a multitude of mechanisms, including tuberculosis infections, parasitic infections, fungal infections, mechanical obstruction, or systemic diseases such as Crohn's disease, sarcoidosis, among others. Investigations and management should be tailored according to the histologic findings, and patient follow-up should be advised.

Recently, coronavirus disease 2019 (COVID-19, caused by SARS-CoV-2) has posed a challenge for clinicians, particularly extrapulmonary manifestations. These manifestations are often rare and difficult to recognize as research is still underway for the myriad presentations of the disease. A 19-year-old man presented with viral upper respiratory infection (URI) symptoms and received a positive result for SARS-CoV-2 real-time reverse transcription polymerase chain testing. A few days later, he developed abdominal pain and presented to the Emergency Department (ED). He was found to have bradycardia, right lower quadrant pain, fevers, and elevated inflammatory markers. An abdominal computed tomography scan showed appendicitis and an electrocardiogram showed third-degree heart block. He underwent successful implantation of a dual-chamber permanent pacemaker and was scheduled for elective appendectomy. This case illustrates a state of system-wide inflammation that has been described mainly in pediatric patients with SARS-CoV-2 known as multisystem inflammatory syndrome in children (MIS-C). Recognition of this syndrome is crucial as it has potential diagnostic and therapeutic implications that can improve outcomes.

Regional techniques in parotid surgeries include superficial cervical plexus block (SCPB) and auriculotemporal nerve (ATN) block, which can be used as an anesthetic technique for awake parotidectomy. This study aimed to evaluate the efficacy of cervical retrolaminar block (RLB) as an alternative to SCPB both, used in combination with auriculotemporal nerve (ATN) block, in parotid surgery.

Neurological aspect of COVID-19 is less understood compared to its respiratory and systemic effects. We aimed to define subacute neurological sequelae in patients who recovered from mild COVID-19.

Chronic inflammatory back pain (CIBP) occurs in up to one-third of those with chronic back pain. Criteria for diagnosis of inflammatory back pain include an onset below 50 years. Using the US National Health and Nutrition Examination Survey data for 2009-2010, we showed that 3% of adults aged 50-69 years have features of CIBP with onset on or after 50 years. There is little information in the literature on CIBP of late onset. Patients with late onset CIBP may be falling through the cracks.

 The prerequisite for monitoring goal-oriented analgesia and screening for the presence of delirium is the use of validated measuring instruments such as the Richmond Agitation and Sedation Scale as well as an adequate medical and intensive care staffing ratio.

Opioids are commonly used to treat postoperative pain; however, guidelines vary regarding safe opioid use after hip arthroscopy.

We examined the clinical characteristics and outcomes of patients with recurrent trigeminal neuralgia (TN) and assessed the long-term efficacy and safety of microvascular decompression (MVD) to treat typical recurrent TN.

The Enhanced Recovery After Surgery Society published guidelines for bariatric surgery reviewing the evidence and providing specific care recommendations. These guidelines emphasize preoperative nutrition, multimodal analgesia, postoperative nausea and vomiting prophylaxis, anesthetic technique, nutrition, and mobilization. Several studies have since evaluated these pathways, showing them to be safe and effective at decreasing hospital length of stay and postoperative nausea and vomiting. This article emphasizes anesthetic management in the perioperative period and outlines future directions, including the application of Enhanced Recovery After Surgery principles in patients with extreme obesity, diabetes, and metabolic disease and standardization of the pathways to decrease heterogeneity.