Background and Objectives: Coronavirus disease-19 (COVID-19) led to respiratory failure and is sometimes complicated with barotrauma. The knowledge about risk factors for the development of barotrauma is scarce and conflict. We aimed to examine the incidence and risk factors for the development of barotrauma in COVID-19 patients who followed up in the intensive care unit (ICU). Materials and Methods: Patients who admitted to ICU from March 15, 2020, to March 31, 2022 were included in the study and retrospectively screened for barotrauma. Patients with barotrauma at ICU admission were excluded from the study. A multiple regression analysis was performed to determine the risk factors for the development of barotrauma. Results: A total of 1113 patients were included in the study, 676 (60.7%) of them were COVID-19. During the study period, at least one barotrauma event was observed in 96 (8.6%) patients. Barotrauma was more common in patients with COVID-19 than non-COVID-19 patients (10.9% vs. 5%, P = 0.001). Positive pressure ventilation was found as the strongest independent risk factor for the development of barotrauma (odds ratio [OR] = 8.80, confidence intervals [CI], 3.88–19.98, P < 0.001). Steroid use also increased the development of barotrauma (OR = 3.45, CI, 1.78–6.67, P = 0.005). Patients with barotrauma had longer length of ICU stay and higher mortality rate than patients without barotrauma. Conclusion: Patients with COVID-19 have a higher risk for the development of barotrauma. Barotrauma is associated with longer ICU stay and increased mortality. Positive pressure ventilation and steroid use are the independent risk factors for barotrauma.
Background and Aims: To obtain herd immunity and control the coronavirus disease 2019 (COVID-19) infection, a large proportion of the population must be vaccinated. However, not everyone in Libya believes in the necessity or safety of COVID-19 vaccines. Therefore, understanding the reasons and variables impacting vaccine hesitation in the Libyan population will assist in developing strategies to reduce this hesitation and achieve better vaccination levels in the country. This study aimed to investigate the acceptance, hesitancy, and refusal of the COVID-19 vaccine and the factors that influence COVID-19 vaccine hesitancy and denial in the Libyan population. Methods: A cross-sectional survey using a snowball sampling strategy to collect data was conducted between February and May 2022. Descriptive statistics and the Chi-square test were used for data analysis. Study questionnaires were distributed using social media. Results: The overall COVID-19 vaccine acceptance was 39.7%, vaccine hesitancy was 36.6%, and vaccine refusal was 23.6% among the study participants. The highest refusal rate was among participants aged 12–24 years, 49 out of 91 (53.8%). Vaccine refusal was similar in males and females; however, vaccine acceptance was higher among females than males. Vaccine acceptance was higher in people with a higher graduate degree than those less educated (P = 0001). Conclusion: Our findings show that vaccine hesitancy was 36.6% and vaccine refusal was 23.6% among the study participants. The study identified reasons for vaccine hesitancy and refusal and proposed education programs to address misbeliefs about the COVID-19 vaccine, allowing people to make informed decisions.
Anabolic-androgenic steroids (AAS) are frequently used to treat a wide variety of pathological medical conditions including but not limited to hypogonadism, aplastic anemia, and metastatic breast cancer. Nonetheless, the abuse of AAS continues to rise among professional and recreational athletes despite their deleterious adverse effects. Here, we report a 34-year-old male, with a history of nonmedical use of AAS for 2 months, who had persistent severe retrosternal chest pain. His electrocardiogram was suggestive of acute anteroseptal ST-segment elevation myocardial infarction. He underwent urgent coronary angiography which revealed a thrombotic burden in the left anterior descending artery without underlying atherosclerosis.
Neuroendocrine tumors (NETs) are epithelial neoplasms with predominant neuroendocrine differentiation, potentially arising from anywhere along the alimentary tract. We report a case of NET in a patient living with human immunodeficiency virus (HIV) (PLWH). A 58-year-old gentleman presented to the emergency department with a 2-week history of dry cough, loose motions, and fatigue; he had unintended weight loss ongoing during the past 4 months. Examination is significant for hepatomegaly (20 cm). On evaluation, a diagnosis of both HIV/AIDS and metastatic NET of gastrointestinal origin was confirmed. The chronic antigenic stimulation, cytokine dysregulation, and inflammation observed in PLWH are believed to influence the development of variety of malignancy. Hence, a high index of suspicion for neoplasms in HIV/AIDS (PLWH) regardless of their viral load or immunosuppression status is necessity when presented with red flag malignancies, especially with the overlapping symptoms of AIDS and the constitutional symptoms of cancers.
Background/Aims: Data that compare the effectiveness of methodologies for cryopreservation of human tissue are very limited. Thus, two different biological sample preparation methods, the conventional cryopreservation of human ovarian tissue using either spontaneous or initiated (so-called “seeded”) ice formation, was carefully investigated and compared. Materials and Methods: Biopsies of ovarian tissue were obtained from women with indications for chemotherapy or radiotherapy, and small pieces of experimental tissue (0.5 mm × 1 mm × 1–3 mm) were randomly distributed into three different groups: group 1 immediately after biopsy, experimental pieces after cryopreservation (thawing) with spontaneous ice formation (Group 2) and cryopreservation with initiated ice formation (Group 3). The pieces of tissue were cultured in vitro for 16 days, after which follicle viability and hormonal activity were evaluated. The level of statistical significance was set at P < 0.05. Results: The obtained results indicated that culture supernatants for Groups 1, 2, and 3 showed estradiol 17-ß concentrations of 476, 465, and 459 pg/mL, respectively. Whereas pProgesterone concentrations were 9.68, 5.77, and 5.61 ng/mL, respectively. In addition, the mean primordial follicle density per mm3 for Group 1 was 12.1 ± 3.9, 3.1 ± 1.4 for Group 2 and 6.0 ± 2.3 for Group 3. Moreover, it was recognized that 91%, 16%, and 87% follicles for Groups 1, 2, and 3, respectively, were normal (P2-1, 3 < 0.05; P1-3 > 0.1). Conclusions: The obtained results revealed that for the best results using cryopreservation of human ovarian tissue, the protocol of conventional cryopreservation must include a step of initiated ice formation. Moreover, an advanced analytical detection technique of high sensitivity, mass spectrometry, can further be used in the future for an accurate determination of hormonal levels and other related compounds and for screening of possible biomarkers using the best-obtained sample preparation method.
