Most Viewed Articles

Hypertension is a risk factor for the development of heart failure and has a negative impact on the survival of these patients. Although patients with these two conditions usually take different antihypertensive medications, some patients do not achieve adequate blood pressure control and their hypertension becomes resistant or refractory. In this scenario, percutaneous renal denervation has emerged in recent years as an alternative to achieve blood pressure control goals. We present the case of a 53-year-old woman with a medical history of essential hypertension, hypercholesterolemia, unipolar depression, and diabetes, who was diagnosed with dilated cardiomyopathy with reduced left ventricular ejection fraction (33%). Despite the initiation of multiple antihypertensive medications and placement of a cardiac resynchronization therapy pacemaker, the patient remained hypertensive with a left ventricular ejection fraction of 40%. At that time, percutaneous renal denervation was performed without complications, and one year after the procedure, the patient had improved better blood pressure control and the left ventricular ejection fraction increased to 51%. This case illustrates one of the clinical scenarios in which it has been suggested that renal denervation may be more beneficial, as in the situation of patients with refractory hypertension and heart failure.

Vitamin A is a fat-soluble discovered in 1913. Hypo-vitaminosis A can cause blindness by various mechanisms. The aim of this case report is to emphasize the severity of Vitamin A deficiency and its local consequences on the eyes causing corneal ulcerations, abscess and even blindness.

Background: Despite its negative effects, approximately 23% of Palestinians (≥ 18 years) smoke cigarettes. Studies have shown physicians to be an important channel for smoking cessation intervention. This investigation examines physicians’ smoking-related knowledge, attitudes, and behaviors in the Gaza strip (Palestinian Territories). Methods and findings: A convenience sample of 154 physicians in medical and surgical units took part in this investigation (87.7% response rate). The data show that 37.8% of physicians in Gaza smoke, and most of them about 72% smoke in the hospital’s public spaces, thereby implicitly giving public approval for smoking. While 82.4% reported that they advise patients who smoke to stop, the majority (59%) also believe that their own smoking habits negatively influence the impact of that advice. Unfortunately, our survey showed that physicians’ knowledge levels towards smoking addiction and management were lower than expected (e.g. only 34% knew that nicotine dependence is a psychiatric disorder that necessitates treatment). The physicians in this study believed that the primary barriers to failure of their patients’ smoking cessation were the perceived lack of will (81.3%), and the strength of patients’ addiction (67.9%). Moreover, (61%) of physicians did not spend enough time to convince their patients to quit smoking. Conclusion: Smoking is common among Gaza-strip physicians, and unfortunately, most of them smoke in the hospital’s public spaces. Many obstacles face the smoking cessation program that some physicians linked it to patients, and others linked it to the health-care system. Furthermore, smokers in Gaza receive poor care regarding assessment, referral, and management of their smoking habit.

For the millions of patients experiencing chronic pain despite pharmacotherapy, deep brain stimulation (DBS) provides a beacon of hope. Over the past decade the field has shifted away from DBS towards other forms of neuromodulation, particularly spinal cord stimulation (SCS). DBS for pain is still performed, albeit off-label in US and UK, and experiences variable success rates. SCS is an extremely useful tool for the modulation of pain but is limited in its application to specific pain aetiologies. We advocate use of DBS for pain, for patients for whom pharmacology has failed and for whom spinal cord stimulation is inadequate. DBS for chronic pain is at risk of premature neglect. Here we outline how this has come to pass, and in the process argue for the untapped potential for this procedure.

Sarcoidosis is a multisystem disease of unknown origin that is characterized by non-caseating epithelioid granuloma formation within various organs, mainly the lungs [1]. The objective of this study is the analysis of sarcoidosis patients affected by pulmonary manifestation alone or extrapulmonary expression.

The epidemic of COVID-19 was reported in Wuhan, China in December 2019 and turned into a national crisis, with infected individuals diagnosed all over China [1-3]. In early March 2020, the World Health Organization (WHO) declared that the Wuhan epidemic has turned into a global pandemic. Many European countries have started to know several cases affected by this coronavirus, which is known to be highly contagious. The WHO has launched several recommendations to curb the spread of this virus and to call the general confinement establishment in the affected countries. 

A 78-year-old man, known case of, diabetes mellitus, and hypertension presented with fever, dry cough and dyspnea of five-day duration. He tested positive for SARS-CoV-2 infection and was admitted to the intensive care unit as a case of severe COVID -19 pneumonia. Evaluation revealed raised inflammatory markers CRP: 92.2 mg/ml, LDH: 556 IU/L, Ferritin: 286 ng/ml, D-dimer: 3716 ng/ml. On day 9 of illness, he developed numbness, pain and discoloration of right hand.

Zinc induced pediatric preventing respiratory 2019-nCoV is required that supplementation with zinc gluconate 20 mg in Zn deficient children resulted in a nearly twofold reduction of acute lower respiratory infections as well as the time to recovery. Zinc supplementation in children is associated with a reduction in the incidence and prevalence of pneumonia. Preventing 2019-nCoV pneumonia is required that zinc supplementation alone (10 to 20 mg) for more than 3 months significantly reduces in the rate of pneumonia. zinc pediatric intake may be required to be effective range 10～20 mg/d for 2019-CoV prevention, 10～30 mg/d for reduction of COVID-19 bronchitis, and 20～30 mg/d for recovery from COVID-19 pneumonia, in which Zn2+ could bind with viral surface proteins by Zn2+ions-centered tetrahedrally coordination pattern. On the other hand, for aults, the zinc-homeostatic immune concentration may provide a protective role against the COVID-19 pandemic, likely by improving the host’s resistance against viral infection. 50 mg of zinc per day might provide an additional shield against the COVID-19 pandemic, possibly by increasing the host resistance to viral infection to minimize the burden of the disease. In order to prevent that an outbreak of respiratory sickness caused by a novel coronavirus (COVID-19) has become a serious public threat and disrupted many lives,assessing the efficacy of FDA-approved Zn-ejector drugs such as disulfiram combined with interferon to treat COVID-19 infected patients has been proposed. The key strategies for preventing lung damages include avoiding direct lung infection, altering host-virus interactions, promoting immune responses, diluting virus concentrations in lung tissues by promoting viral migration to the rest of the body, maintaining waste removal balance, protecting heart function and renal function, avoiding other infections, reducing allergic reactions and anti-inflammatory. The interactions had been found on the binding specificity by Zn2+ ions-centered tetrahedral geometric coordination of the inhibitors against 3C and 3C-like proteases. In addition, transient zinc chelation TPEN and EPDTC have been noted as preventing virus replication. Zinc-induced ROS production in COVID-19 respiratory ailment and pneumonia occurs both in children and adults. In children. ROS production in zinc (Ⅱ)-immune pediatric patient with COVID-19 bronchitis and pneumonia cannot be elucidated yet. In adults, zinc induced ROS generation in pulmonary COVID-19 infected cells is that alterations of ROS-producing and scavenging pathways that are caused by respiratory viral infections are implicated in inflammation, lung epithelial disruption, and tissue damage, and, in some cases, even pulmonary fibrosis. The involvement of oxidative stress in cell deaths caused during RNA virus infection and ROS production is correlated with host cell death.

Background: Osteopoikilosis (OPK) is a rare osteosclerotic dysplasia. It is usually asymptomatic and diagnosis is made incidentally by radiographic findings. It has a unique radiographic presentation with multiple small, well-defined, circular, or ovoid radiodensities which are distributed symmetrically in the epiphysis and metaphysis of long bones.Aim of the work: In this case report, a 38-year-old man with mild joint discomfort was diagnosed with OPK according to his radiographic findings and literature review.Conclusion: It is important to diagnose OPK and to distinguish it from other medical conditions to calm the patient and to reduce unnecessary investigation.

Objectives: The sural nerve is the most tested sensory nerve in the lower extremities in the electrodiagnostic assessment of peripheral neuropathies. This study presents the reference values of the sural nerve conduction study (NCS) from a significant sample of the Algerian population. Methods: This is a prospective study of right sural NCS in healthy subjects based on the later recommendations of AANEM-NDTF. The nature of the distribution of each electrophysiological parameter was therefore determined. The lower and upper limits were calculated by using the 5th and 95th percentiles respectively and a logarithmic transformation was performed for Sensory Nerve Action Potential (SNAP) amplitude distribution. Results: 115 subjects aged between 20 and 60 years were selected, including 58 women and 57 men. Unlike Sensory Nerve Conduction Velocity (SNCV), the distribution of SNAP amplitude is not Gaussian. The lower limit of SNAP amplitude was 7.70 µV when using the 5th percentile and 6.80 µV by using the Standard Deviation (SD) method after log transformation. Similarly, the lower limit of SNCV was 43 m/s. The SNAP amplitude was greater in women and decreased with age, height and BMI. Conclusion: The values found in this study are comparable to those published in the literature. It may be more appropriate to determine the reference values using percentiles as recently recommended by several authors.