International journal of clinical research & trials最新文献

{"title":"The Impact of COVID-19 Pandemic, Financial Wellness, and Online Teaching on Schoolteachers’ Mental Health: A Cross-Sectional Study in Lebanon","authors":"Tarek Baroud, Jad El Masri, Hadi Shammaa, Mustafa Saleh, Hani Chanbour, Pascale Salemeh","doi":"10.38179/ijcr.v3i1.169","DOIUrl":"https://doi.org/10.38179/ijcr.v3i1.169","url":null,"abstract":"Background: Teaching is a mentally and physically draining occupation, and due to the SARS-CoV-2 pandemic, the education system shifted to online platforms, which made it even harder. Lebanon is a developing country that is not well prepared for such a daunting outbreak. In addition to its tremendous economic crisis, it will be even harder for teachers to maintain mental stability. The aftermaths of this crisis could, perhaps, impact all the fundamental systems within the country including education\u0000Aim: This study aims to assess stress, anxiety, and depression levels among Lebanese schoolteachers based on the COVID-19 outbreak, the Lebanese economic crisis, and online education.\u0000Methods: A cross-sectional study was carried out, enrolling 300 schoolteachers currently working in Lebanon. An online survey was used, assessing sociodemographic factors, teaching status, financial wellness, fear of COVID-19, and mental health. The IFDFW scale is used to assess financial distress, DASS-21 to assess psychological distress, and the COVID-19 fear scale to measure fear.\u0000Results: Results showed that 23% of teachers had severe depression, 25% had severe anxiety, and 16% had severe stress. Depression was correlated to both fear of COVID-19 and financial wellness (p<0.0001 for both). Anxiety and stress were correlated with online teaching (p<0.05), fear of COVID-19 (p<0.001), and financial wellness (p<0.001).\u0000Conclusion: Lebanese teachers showed severe levels of anxiety and stress as a  consequence of online teaching, associated as well with depression when correlated with fear of COVID-19 and financial wellness. It is urgent to take measures to keep the Lebanese educational system productive, and dynamic, and prevent the storm of the stressful environment from worsening.\u0000Keywords: Anxiety, Depression, Stress, Online teaching, Pandemic, Economic crisis","PeriodicalId":73437,"journal":{"name":"International journal of clinical research & trials","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90473738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Correlation Between Pre and Post ERCP Laboratory Values","authors":"Johny Salem, W. Arja, Jennifer Aoun, Nourhane Obeid, Anna-maria Abi-nehme, N. Gharib, Tala Ghorayeb, Said Farhat","doi":"10.38179/ijcr.v3i1.166","DOIUrl":"https://doi.org/10.38179/ijcr.v3i1.166","url":null,"abstract":"Abstract\u0000 Background: Endoscopic retrograde cholangiopancreatography (ERCP) has evolved from a diagnostic modality to a primarily therapeutic procedure for pancreatic as well as biliary disorders. However, several complications were described post-procedure such as pancreatitis, perforation, cholangitis, post-sphincterotomy bleeding, etc. Data concerning variation in laboratory values before and after ERCP and its clinical significance with respect to endoscopic findings and possible complications is lacking in the literature.\u0000Aim: To analyze the clinical significance of laboratory values in patients before and after ERCP.\u0000Methods: From a total of 723 patients, 363 with different sets of findings on ERCP were eligible to be included in the study and were divided into 8 different groups. Serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), Gamma-glutamyl transferase (GGT), Alkaline phosphatase (ALKP), bilirubin, amylase, lipase, c-reactive protein (CRP), white blood count (WBC), neutrophil, lymphocyte, monocyte, eosinophils, basophils, platelets counts and creatinine were determined preoperatively as well as postoperatively in these patients.\u0000Results: AST and direct bilirubin showed a significant difference in all patients between pre and post-ERCP (p-value<0.01 and p-value<0.05, respectively). Liver tests were significantly higher in the malignant obstruction group than in the bile duct stones group (P <0.05) and decrease more significantly (P <0.05) after the procedure. A significant increase in lipase (p-value<0.05) among all groups was found, and interestingly, the lymphocytic count showed a significant decrease (p-value<0.01).\u0000Conclusion: In conclusion, (1) ERCP significantly decreases AST, direct bilirubin, lymphocytes, and monocytes count post procedure among all stratified groups of obstructive etiology thus proving its therapeutic value for biliary system obstructions. (2) Higher baseline disturbances in laboratory values at T0, especially in liver function tests such as ALT, AST, GGT, and ALKP as well as a bigger decrease in lymphocyte count at T1 are noted to be linked with malignant obstructions (tumor group), rather than benign obstructions (stone, sludge, stone+ sludge, and stricture).  (3) Finally, stone and stricture groups are at the highest risk of post-ERCP pancreatitis owing to those groups having the highest pancreatic enzyme levels post ERCP, and thus should be the best candidates for a pre-ERCP pharmacologic prophylaxis (such as diclofenac, etc) and post ERCP close monitoring.","PeriodicalId":73437,"journal":{"name":"International journal of clinical research & trials","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86011500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hepatic Vein Thrombosis in a COVID-19 Patient with Hereditary Thrombophilia: A Case Report","authors":"Georges Chedid, Rita Khoury, H. Noureldine, Jad Gerges Harb, Esther Tannoury, S. Semaan, Tamina Elias-Rizk, H. Ghanem","doi":"10.38179/ijcr.v3i1.120","DOIUrl":"https://doi.org/10.38179/ijcr.v3i1.120","url":null,"abstract":"Background: COVID-19 is an infection secondary to the novel SARS-COV-2 virus with a well-established increased risk for thrombotic events. However, the interaction between COVID-19 and other patient-specific hereditary or acquired thrombophilias remains a poorly explored area.\u0000Case Presentation: We herein report a case of a 23-year-old Caucasian female with known risk factors for coagulopathy (smoking, oral contraceptives, anti-phospholipid (aPL) antibodies, heterozygous Factor V Leiden mutation, and homozygous methylenetetrahydrofolate reductase (MTHFR) mutation) who developed a Budd-Chiari syndrome after testing positive for COVID-19. To our knowledge, this is the first report of a case of splanchnic vein thrombosis in a COVID-19 patient with the above risk factors.\u0000Conclusion: Such a presentation underscores the additional increased thrombotic risk attributed to COVID-19 infections in the setting of underlying hereditary or acquired thrombophilias.","PeriodicalId":73437,"journal":{"name":"International journal of clinical research & trials","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75853246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Buccal Mucosal Metastasis of Renal Cell Carcinoma: A Case Report and Review of Literature","authors":"Lithika Lavanya M, Pooja Iyer, M. J, Rajeev Vijayakumar","doi":"10.38179/ijcr.v3i1.125","DOIUrl":"https://doi.org/10.38179/ijcr.v3i1.125","url":null,"abstract":"Background: Intraoral metastasis of RCCs are unusual, especially when it comes to buccal mucosal metastases, which are extremely rare, accounting for less than 1% of metastatic RCC. The buccal mucosal metastatic lesion from RCC poses a challenge in diagnosis and treatment. Due to their scarcity, there doesn’t exist any literature primarily concentrating on them.\u0000Case Report: In this work, we describe the case of a 58-year-old man affected and operated on for renal cell cancer, brought to our care for the appearance of a buccal mucosal ulcer. Pathological analysis revealed a metastasis compatible with clear-cell carcinoma. Its renal origin was confirmed by immunohistochemical technique. The patient was evaluated and managed after post multidisciplinary tumor board discussion with palliative radiotherapy for local disease.\u0000Conclusion: There should be no hurry in starting treatment for a buccal mucosal lesion, and it should be histopathologically evaluated keeping in mind a differential of metastasis from the distant primary. Multidisciplinary tumor board discussion plays an important role in such rare scenarios.","PeriodicalId":73437,"journal":{"name":"International journal of clinical research & trials","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78291924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patients’ Characteristics, Clinical Courses, Fatality Rate, Predictors of Severe Diseases, and Deaths in Intensive Care Unit: A Lebanese Retrospective Cohort of COVID-19 Patients","authors":"M. Hachem, Yaacoub Chahine, Elissa Nassif, Georges Haddad","doi":"10.38179/ijcr.v3i1.117","DOIUrl":"https://doi.org/10.38179/ijcr.v3i1.117","url":null,"abstract":"Background: The novel coronavirus 2019 (COVID-19) pandemic is straining Intensive Care Units’ (ICU) capacities worldwide. It was demonstrated that the ICU mortality rate from Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is higher than from other viral pneumonia.\u0000Aim: The goal of this research is to determine ICU COVID-19 patients’ characteristics, clinical courses, fatality rate, as well as risk factors for severe diseases and mortality in Lebanon, a country known to suffer from a deficiency in ICU capacity as well as a high COVID-19 infection rate.\u0000Methods: We conducted a retrospective monocentric cohort study that enrolled COVID-19 patients admitted to the ICU at Baabda Governmental Hospital, between January 1, 2021, and March 31, 2021. Demographics, clinical, radiological, laboratory characteristics, treatments, and medical and infectious complications were gathered and compared between survivor and non-survivor groups, as well as between mild/moderate and severe/septic groups. Parameters were then entered in a multivariate regression analysis to identify predictors of death and disease severity.\u0000Results: A total of 191 patients were included in our study. The fatality rate reached 35.6% in our population with a median ICU length of stay of 8 days. Non-survivors were more likely older (p<0.001), active smokers (p=0.008), and in severe or septic stage at admission (p<0.001). Elevated levels of neutrophils (p=0.013), ferritin (p=0.002), lactate dehydrogenase (p<0.001), and C-reactive protein (p=0.008) were more frequently encountered in non-survivors. The latter were more commonly intubated (p<0.001) and suffered from complications such as ventilator-associated pneumonia, sepsis, cytokine storm, myocardial infarction, and pulmonary embolism (p<0.001). Multivariate analysis showed that older age, intubation, and severe/ septic stage at admission were associated with an increased risk of death.\u0000Conclusion: Older COVID-19 patients who were intubated, and those who were in severe or septic stages at ICU admission","PeriodicalId":73437,"journal":{"name":"International journal of clinical research & trials","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88659912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Simultaneous Occurrence of Acute Appendicitis and Bowel Perforation in Taenia Infection: A Case Report","authors":"M. Farhat, Firas Ibrahim, Kassem Jamoul, Rama Bdeir, Z. Moussawi, Khaled Rida","doi":"10.38179/ijcr.v3i1.154","DOIUrl":"https://doi.org/10.38179/ijcr.v3i1.154","url":null,"abstract":"Background: Appendicitis is most likely due to obstruction of the appendiceal lumen. Parasitosis is an unusual cause of obstruction and in specific, Taenia Saginata is a very rare cause of appendicitis, even more so of small bowel perforation. Teiniosis is usually an asymptomatic process but a greater load or migration of the adult form may complicate some cases. The simultaneous occurrence of acute appendicitis and ileal perforation in the same setting has not been reported in the literature.\u0000Case Presentation: A 60-year-old Lebanese female patient presented to the emergency department with right lower quadrant pain radiating to the left lower abdomen. The patient reported associated fever, chills, and anorexia prior to presentation. On physical examination, she was afebrile and normotensive, abdominal examination revealed diffuse lower abdominal tenderness. A blood workup revealed an elevated c-reactive protein (CRP) value with a normal white blood count (WBC). Computed tomography (CT) scan done with intravenous (IV) and per os (PO) contrast disclosed a leak of PO contrast in the absence of pneumoperitoneum implying a contained perforated appendicitis or colitis. The patient underwent urgent laparoscopic exploration. Intraoperatively patient had gangrenous appendicitis and an inflamed right fallopian tube, as well as small bowel perforation and the presence of a tapeworm. The tapeworm was removed and the patient ended up having an appendectomy, right salpingectomy, and oophorectomy, with the closure of ileal perforation. Her hospital stay was uneventful and she was discharged on ciprofloxacin, mebendazole, and metronidazole. Soon after her discharge from the hospital, the patient resumed her normal daily activities. Histopathological studies revealed mixed inflammatory infiltrates and the worm to be Taenia Saginata.\u0000Conclusion: Patients with teniosis are mostly asymptomatic. In symptomatic patients, the course is usually mild except for some rare occasions including appendicitis or bowel perforation. The diagnosis of Taenia Saginata infection in such cases should be considered in endemic areas such as the Middle East and North Africa (MENA) region where eating raw meat is habitual.","PeriodicalId":73437,"journal":{"name":"International journal of clinical research & trials","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89220841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Manuka Honey Versus Wet to Dry Dressing for Wound Closure Time After Open Pilonidal Sinus Surgery","authors":"H. Abtar, J. Terro, E. El-helou, K. Jammoul, Ryan Said Lakkis, N. Ismail, M. Al-Raishouni, Charbel Aoun","doi":"10.38179/ijcr.v3i1.25","DOIUrl":"https://doi.org/10.38179/ijcr.v3i1.25","url":null,"abstract":"Background: Sacrococcygeal pilonidal sinus disease is a very common chronic inflammation of the natal cleft that presents frequently as an abscess. Management requires the eradication of the sinus tract and postoperative wound care. Manuka honey (Medihoney) was used in acute and chronic wounds. In our study, we sought to investigate the clinical effectiveness of Manuka honey in decreasing wound healing time post excision.\u0000Material and Methods: We describe patients’ characteristics using traditional descriptive statistics. We compared the study endpoint (wound closure time) in patients who received Medihoney versus those who did not by Kaplan-Meier analysis.\u0000Results: A total of 119 patients underwent pilonidal cyst surgery between the years 2017 and 2018. The median time for healing in the Medihoney group was 40 days compared with 39 days in the control group. After adjusting for age, BMI, wound length, wound volume, smoking and operative time, the time to healing in the Medihoney group was significantly less compared to the group not receiving the treatment (Hazard Ratio 1.56, 95% Confidence interval 1.02- 2.49, p= 0.041).\u0000Conclusion: Postoperative use of Manuka honey showed a significant decrease in wound healing time when compared to gauze fabric dressings. Further research would be beneficial to explore optimal treatment protocols for this dressing technique.","PeriodicalId":73437,"journal":{"name":"International journal of clinical research & trials","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75153203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Forestalling Anti-Ergonomics in Plastic Surgery: Challenging the Modus Operandi?","authors":"G. Nicolas, Arbab Mohammad","doi":"10.38179/ijcr.v3i1.216","DOIUrl":"https://doi.org/10.38179/ijcr.v3i1.216","url":null,"abstract":"Despite formidable advances throughout surgical disciplines spanning decades, plastic surgeons, especially microsurgeons, have most certainly ignored the memo to sufficiently recognize the alarming prevalence of musculoskeletal disorders (MSDs), a consequence of anti-ergonomic postures assumed during intricate procedures (eg. microsurgery), capable of physical limitations which can lead to early retirement. Collective ignorance of the aforementioned predicament is reflected in the plastic surgery literature wherein epidemiologically rigorous studies remain non-existent. Anecdotal reports evidencing the crippling effect of anti-ergonomic postures along with rigorous operative practices in plastic surgery procedures that have exaggerated operative durations suggest increased predisposition to occupational disorders like cervical disk disease, distal interphalangeal arthrosis, ligamentous injury, pulmonary embolism secondary to deep vein thrombosis and tendinitis. Remarkably, evidence in the literature highlights the commencement of musculoskeletal discomfort as early as in residency, even though previous studies have documented 35.4 years as the initiation point of musculoskeletal symptoms.\u0000 ","PeriodicalId":73437,"journal":{"name":"International journal of clinical research & trials","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90883457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers and Facilitators for Setting Upper Limb Reconstruction Services.","authors":"L. Troisi, J. Berner, Macarena Vizcay, Georgio Eugenio Pajardi","doi":"10.38179/ijcr.v3i1.215","DOIUrl":"https://doi.org/10.38179/ijcr.v3i1.215","url":null,"abstract":"  \u0000 ","PeriodicalId":73437,"journal":{"name":"International journal of clinical research & trials","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76186914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Listeria Necrotizing Cellulitis: A Case Report","authors":"Emilio Abi Rached, Julian Maamari, A. Al Kotob, J. Mokhbat","doi":"10.38179/ijcr.v3i1.135","DOIUrl":"https://doi.org/10.38179/ijcr.v3i1.135","url":null,"abstract":"Listeria-associated soft tissue infections are exceedingly rare and are typically seen in immunocompromised individuals, with the usual culprit being Listeria monocytogenes. We report the first ever case of a Listeria grayi associated soft tissue infection, in a previously healthy young man 3 months after recovery from COVID-19 infection.","PeriodicalId":73437,"journal":{"name":"International journal of clinical research & trials","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73479288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}