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The Center for Disease Control and Prevention is warning about a new outbreak of meningococcal meningitis among gay, bisexual, and other men that have sex with men (MSM) due to multiple cases reported in Florida. Meningococcal meningitis (MM) is a bacterial infection often spread by direct contact or through respiratory droplet dissemination from an infected person to a host. Meningitis can cause a wide range of complications, from thrombosis to cerebral edema or even septic shocks as the bacteria thrive on colonizing the submucosa of blood vessels adjacent to inflamed meninges. The CDC urged MSM to immediately take the MenACWY vaccine. 200 years ago, several outbreaks have been recorded of the disease throughout history, the first being in Africa in the 1840s. The world cannot afford more outbreaks and serious measures should be taken to contend with and contain such potential threats. In this review, we aim to provide an updated investigation of the bacterial infection relevant to the current global health status and a revision on what governments, policymakers, health providers, and individuals should do to prevent the further spread of this fatal disease.

The Monkeypox virus (MPXV) is a double-stranded DNA virus related to the orthopoxvirus genus in the family of poxviridae. MPXV is endemic in central and Western African countries. There have been several outbreaks of MPXV in non-endemic countries since it was discovered in 1958 in lab monkeys. The current spread of MPXV is different from previous outbreaks, raising concerns about its potential to cause pandemics around the world. In order to reduce the spread of the disease, several countries imposed different preventive measures. The MPXV virus is believed to be transmitted either through wild animals, such as rodents or through infected individuals. Every year, Africa experiences a few thousand cases, mostly in the west and central regions. The number of cases outside Africa has previously been limited to a handful associated with travel to Africa or with the importation of infected animals. In this narrative review, we will discuss the clinical diagnosis, transmission, distribution, treatment, and prevention of the recent monkeypox outbreak around the world.

Multiple sclerosis is a disease that affects the central nervous system, resulting in a variety of symptoms such as vision , physical activity and stability .Central positional vertigo as an initial multiple sclerosis symptoms is a rare case in the literature.

Some studies have suggested that earlier initiation of antibiotics has shown positive outcomes in sepsis patients. We aimed to do a systematic review and meta-analysis to evaluate the effect of prehospital administration of antibiotics on 28 days mortality and length of stay in hospital and intensive care unit for sepsis patients.We formulated a search strategy and used it on search databases PubMed, Scopus, Web of Science, and Embase. We then screened the records for eligibility and included controlled studies, either clinical trials or cohort studies reporting prehospital antibiotic administration for sepsis patients. We excluded duplicates, books, conferences' abstracts, case reports, editorials, letters, author responses, not English studies, and studies with nonavailable full text. Animal and lab studies were also excluded.The total number of studies identified is 1811, 19 were eligible for systematic review and 4 for meta-analysis (three cohort and one clinical trial). The total number of sepsis patients in the four included studies in the 28 days mortality outcome was 3523 (1779 took prehospital antibiotics and 1744 did not take prehospital antibiotics). Of 1779 who took the antibiotics, 190 died, and of 1744 who did not take antibiotics, 292 died (95% confidence interval 0.68-0.97,This meta-analysis reveals that receiving prehospital antibiotics can significantly lower mortality in sepsis patients compared to patients who do not receive prehospital antibiotics. However, more clinical trials and multicenter prospective studies with high sample sizes are needed to get strong evidence supporting our findings.

Takotsubo cardiomyopathy (TCM) mimics acute coronary syndrome and is characterized by reversible left ventricular (LV) apical ballooning in the absence of angiographically substantial coronary artery stenosis.A 31-year-old man with acute dejection, physical stress, and psychological strain from the dread of losing his work arrived at the emergency department with chest pain, and discomfort that had lasted 3 hours.Once the coronary angiography revealed normal epicardial coronaries, the case was retroactively diagnosed, and the levels of cardiac enzymes were increased.The amount of necrotic tissue was so little that the surgeon could only verbally convey it. It is completely closed with the help of a Dacron sheet. The patient received surgical closure of the VSR a few days after having a surgical consultation.No postoperative echocardiogram was required, and the patient was sent home in great general condition.The presence of TCM with a ruptured LV wall was extremely rare because our patient had neither clinical risk indicators nor a family history of coronary artery disease. As a Takotsubo syndrome severe complication, we underline the significance of identifying, diagnosing, and treating it.

Hyperemesis gravidarum is a condition that affects pregnant women (HG),serum levels of human chorionic gonadotropin (hCG) and estradiol are increased than in pregnant women who are not influenced.Objective:This study's major goal was to learn moreabout how elevated human chorionic gonadotropin levels and estradiol affect the intensity of hyper emesis gravidarum during the first trimester.Methods: At El Hussein University Hospital, our prospective study was conducted from May 2020 to Nov. 2020; duration of the study was 7 months. The key sign of severe Hyper Emesis Gravidarum was a lengthy stay in the hospital (HG).The term "extended hospital stay" describedas stay ≥4 days, as this cut-off value demarcates the top quartilef orhospitalization timein our study population. Results: There was a highly significant difference between cases with hospital stay< 4 days and cases with hospital stay ≥ 4 days as regard HCG, cases with longer stay have higher median HCG (300637) compared to cases with

BACKGROUND Men with high-risk non-metastatic prostate cancer are treated with androgen-deprivation therapy (ADT) for 3 years, often combined with radiotherapy. We analysed new data from two randomised controlled phase 3 trials done in a multiarm, multistage platform protocol to assess the efficacy of adding abiraterone and prednisolone alone or with enzalutamide to ADT in this patient population. METHODS These open-label, phase 3 trials were done at 113 sites in the UK and Switzerland. Eligible patients (no age restrictions) had high-risk (defined as node positive or, if node negative, having at least two of the following: tumour stage T3 or T4, Gleason sum score of 8-10, and prostate-specific antigen [PSA] concentration ���40 ng/mL) or relapsing with high-risk features (���12 months of total ADT with an interval of ���12 months without treatment and PSA concentration ���4 ng/mL with a doubling time of

Background Needle stick injuries (NSIs) are preventable hazards that can be avoided with appropriate staff training and safety systems. We assessed the prevalence and awareness of NSIs among health-care workers and cleaners in hospitals in Gaza. Methods We did a cross-sectional study in four hospitals from July 14 to Oct 25, 2018. All cleaners and health-care workers were eligible to participate. Data were gathered via a survey tool designed for the study that covered sociodemographic data, NSI prevalence, and response to possible injuries. The primary outcomes were prevalence and staff awareness of NSIs. Findings 538 staff participated in the survey, among whom the mean age was 28.9 (SD 7.71) years, 331 (62%) were men, 119 (22%) were doctors, 262 (49%) were nurses, 72 (13%) were medical students, and 85 (16%) were cleaners. 289 participants (54%) had had at least one NSI: 59 doctors (50% of all doctors), 142 nurses (54%), 32 students (44%), and 56 cleaners (66%). NSIs were obtained during various activities, including 168 incidents (40%) during drug administration, 82 (20%) while recapping needles, 78 (19%) during wound suturing, 63 (15%) while cleaning, and 27 (6%) during arterial blood gas sampling. Only 94 (33%) of 289 participants with NSIs reported their injuries. Among the 195 (67%) participants who did not report NSIs, 41 (21%) did not know that they should do so, 65 (33%) did not know how to report, 62 (32%) believed that reporting was useless, and 27 (14%) forgot to report. Interpretation More than half the participants had had NSIs, but reporting of injuries was low. The Ministry of Health should provide targeted interventions and training to improve risk awareness and understanding of the importance of reporting for health-care employees. The strengths of this study are the large sample size and recruitment from diverse professional backgrounds. The main limitation was the lack of validation of the study instrument. Funding None.