Effectiveness of unilateral percutaneous vertebroplasty for acute traumatic non-osteoporotic compression vertebral fractures.

Although vertebroplasty is a well-known treatment for osteoporotic and neoplastic compression fractures, there is limited evidence to support its use in traumatic compression fractures without osteoporotic degeneration. The purpose of this study was to evaluate the correlation of kyphosis and wedge angles with pain relief and functional outcome after percutaneous vertebroplasty. 38 patients who harbored acute traumatic non-osteoporotic compression vertebral fractures without neurological complications refractory to at least 5 days of conservative treatment were included in this study. Follow-up evaluations included pain (assessed with the visual analog scale) and medication use. Functional outcome was measured using Oswestry low back pain disability questionnaire. Cobb angles, Gardner angles and kyphotic angles were measured on the full-spine radiographs preoperatively and postoperatively. The axial pain visual analog scale score (8.05 ±â€…1.23 pre-op vs 1.18 ±â€…1.09 post-op, P < .05) and The Oswestry low back pain disability questionnaire score (33.45 ±â€…6.97 pre-op vs 4.47 ±â€…2.41 post-op, P < .05). The Cobb's angle (19.66° ± 8.68° pre-op vs 15.08° ± 7.51° post-op, P < .05), the Gardner's angle (17.72° ± 6.52° pre-op vs 14.13° ± 7.13° post-op, P < .05) and the kyphotic angle (17.51° ± 5.8° pre-op vs 8.81° ± 4.14°post-op, P < .05) were significantly reduced postoperatively therefore, local kyphosis was markedly restored after vertebroplasty. Our findings show that vertebroplasty for patients with traumatic spinal compression fractures reduces pain, improves mobility, reduces the need for painkillers, and significantly affects kyphotic angles.

Management of necrotizing fasciitis and the use of sealed irrigation system: A case report.

Introduction: Necrotizing fasciitis [NF] is a deep soft tissue infection with high morbidity and mortality. The diagnosis is mainly clinical, and is confirmed during the surgical exploration, which is also the cornerstone of treatment. Case presentation: We report a case of a 16-year-old female who complained of pain, tenderness, and erythema along her abdomen and back after a minor trauma on her left palm. The patient was treated with systemic antibiotics and daily surgical debridement followed by placement of a bilateral suction drainage system. A split-thickness graft was used to cover the defect on the lower back of the patient. Conclusion: Sealed irrigation technique is an effective method to manage NF. Furthermore, it reduces the hospitalization duration by continuously removing the necrotic and infected material that hinder tissue healing.

Factors associated with the intention of Syrian adult population to accept COVID19 vaccination: a cross-sectional study.

BACKGROUND AND OBJECTIVES: With global efforts to develop and deliver a COVID-19 vaccine rapidly, vaccine hesitancy stands as a barrier to these efforts. We aimed to estimate the proportion of Syrian adult population intending to be vaccinated against COVID-19 and, principally, to assess the demographic and attitudinal factors associated with it in order to approach suitable solutions. METHODS: An anonymous online questionnaire was conducted between 23rd December 2020 and 5th January 2021 in various provinces in Syria. A total of 3402 adults were sampled to reflect the population demographic factors. Attitudinal factors included Covid-19 fears, risks, and beliefs on the origin. Vaccination hesitancy and knowledge were also measured. The intention to get vaccinated against COVID-19 was the primary endpoint. RESULTS: According to their statements, 1222 participants (35.92%) will consent to get vaccinated against COVID-19. Our findings indicate that male gender, younger age, rural residence, not having children, smoking, fear about COVID-19, individual perceived severity, believing in the natural origin of the coronavirus, and high vaccination knowledge were positive predictors of embracing COVID-19 vaccine when it is available. CONCLUSION: COVID-19 vaccine acceptance rate is considerably poor across Syrian population compared to populations in developed countries. Vaccine hesitancy is closely bound to the fear of side effects and doubts about vaccine efficacy. Factors such as conspiracy beliefs and myths about the vaccine lower vaccine uptake. Thus, interventional educational campaigns are increasingly required to overcome misinformation and avert low vaccination acceptance rates.

Biliary type-II sphincter of Oddi dysfunction with a pancreatic duct dilation: a case report and review of the literature.

BACKGROUND: The double-duct sign is defined as dilation of both the common bile duct and pancreatic duct, which usually indicates pancreatic malignancy. However, benign causes have also been reported to cause a double-duct sign. CASE PRESENTATION: We present the case of a 59-year-old Caucasian female patient admitted to the Gastroenterology Department with intermittent right epigastric abdominal pain and an intact gallbladder. A double-duct sign was seen on endoscopic ultrasound. The suspicion of pancreatic malignancy was excluded through follow-up investigations. Biliary type II sphincter of Oddi dysfunction was diagnosed with an association of the double-duct sign. Sphincterotomy was performed to reduce pain, and there was no recurrence of symptoms during follow-up. CONCLUSIONS: This is the third reported case in the literature of the double-duct sign associated with sphincter of Oddi dysfunction. This case emphasizes that the double-duct sign is not always caused by a local malignancy. The literature review of the reported cases has been summarized to help in the diagnosis of future similar cases.

Workplace violence toward resident doctors in public hospitals of Syria: prevalence, psychological impact, and prevention strategies: a cross-sectional study.

INTRODUCTION: Workplace violence (WPV) against healthcare workers is a common and daily problem in hospitals worldwide. Studies in different countries indicated that exposure to WPV potentially impacts the psychological status of healthcare workers. However, there is a paucity of studies approaching this issue in the Syrian healthcare system. OBJECTIVES: This study had three objectives: (1) to estimate the prevalence of violence against resident doctors in Syria, (2) to examine the association between WPV and resident doctors' psychological stress, sleep quality, depression, and general health and (3) to suggest approaches to tackle this problem from the resident doctors' perspectives. METHODS: A cross-sectional study was conducted in 8 out of 14 provinces, and covered 17 out of 56 accessible functioning hospitals in Syria. Data were collected using anonymous, self-administered questionnaires during February 2020. A total of 1226 resident doctors volunteered to participate in the study. Finally, 1127 valid questionnaires were used in the final data analysis. The overall response rate was 91.92%. RESULTS: A total of 955 participants (84.74%) reported exposure to WPV in the 12 months prior to the study. In specific, 84.74% exposed to verbal violence and 19.08% to physical violence. Patients' associates were the predominant aggressors in both verbal and physical violence (n = 856; 89.63%, n = 178; 82.79%, respectively). Most resident doctors (87.31%) suggested enacting more legislation to protect doctors as the best solution to reduce WPV. Verbal and physical violence showed a significant positive correlation with each item of depression and stress, and a significant negative correlation with both subjective sleep quality and subjective health. CONCLUSION: Workplace violence against resident doctors in Syria is highly common. Therefore, policymakers, hospital managers, and supervisors should work collaboratively in order to minimize WPV and ensure resident doctors' safety and psychophysical stability.