Search

Mohammed Alkhaldi,1– 4 Zeana Hamdonah,5 Lyne El Khatib6 1Department of Public Health, Canadian University Dubai, Dubai, United Arab Emirates; 2Faculty of Medicine, School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada; 3Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, UK; 4The Global Health Network (TGHN), Regional Network of the Middle East and North Africa, Dubai, United Arab Emirates; 5Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ONT, Canada; 6Department of Health Management and Policy, Faculty of Health Sciences, American University of Beirut, Beirut, LebanonCorrespondence: Mohammed Alkhaldi, Email mohammed.alkhaldi@cud.ac.aeAbstract: The interrelationality of health and peace is complex, multifactorial, and imbued with political and economic challenges. Peace and health outcomes reflect shared fundamental values related to the achievement of a balanced holistic condition on the individual and collective level. This causal relationship between social inequity and health requires special attention to be paid to the impact of political instability and structural violence on undermining health systems in conflict zones. The mutual dependency between peace and health means that peace cannot be achieved without the existence of physical, mental, social, and spiritual health, and holistic health cannot be sustained under violent conditions. The interrelationality of peace and health as mutual conditions shapes our understanding of global solidarity and advocacy in relation to health diplomacy and peace promotion if addressed equally across all conflict zones This commentary analyzes the unique interdisciplinary contextual factors that contribute to or undermine the realization of global health and peace in three active conflict zones: Palestine, Ukraine, and Venezuela. Contextual analysis, review of the evidence, and synthesis of the authors’ perspectives were used. The health-peace nexus remains a theoretical approach and lacks real application in most settings under crisis. Peace is a multifaceted phenomenon that necessitates the participation, dedication, and action of all sectors and stakeholders in the global societies, including health policymakers, scientists, professionals, and people. Both the “right to health” and the “right to peace” even at the minimum remains unfulfilled, particually in Palestine, and can be realized through two trajectories: (1) honest, responsible, and fair accountability, transparency, and political commitment empowered by reliable global health diplomacy for maintaining peace, eliminating the roots of injustice, and protecting health systems, and (2) equitable and real implementation of peace-health approaches, policies and actions driven by monitroing mechanims that promote health, well-being, health security and equity for all nations under conflicts.Plain Language Summary: Countries under conflict are facing multiple, (re)emerging and complex crises aggravated by increasing structural social, political, and economic pressures and inequities that mainly impact people’s health and health systems. Global health and politics integration is key for promoting health through building reliable and lasting peace in these countries.The existing global health governance and diplomacy structures of peacebuilding for health are powerless, ineffective, and still polarized, thus global health actors up for failure when it comes to addressing the root causes of the crisis and building/maintaining a reliable and lasting peace in countires under conflict.Crises including political pressures, historic suffering due to coloniality, protracted conflicts, lack of firm enforcement of international laws, including diplomatic, humanitarian, and human rights laws, hypocritical standards of intervention, health inequity and injustice, and absence of impactful and unfied global rights-based advocacy movements from civic, academic, labour, and professional societies, all impede the creation of peaceful societies that promote health and vice versa.Palestine, Ukraine, and Venezuela reflect diverse contexts where clear major disparities are present in terms of global solidarity and advocacy, levels and forms of interventions, global attention, magnitude of losses, and actors’ willingness to promote the health-peace approach and to change realities.Continued impunity, partiality, and injustice undermine health-peace promotion and scale up local and global health disruptions, and the common challenges of suboptimal health status should be sufficiently handled based on equal rights, equity, accountability, and transparency regardless of variations in geography, ethnicity, region, political context.Keywords: global health, peace-health nexus, Palestine, Ukraine, Venezuela

A 63-year-old male patient with a history of hypertension presented to the emergency department with a one-day history of dizziness, nausea, and vomiting.

Mechanical prosthetic valve thrombosis (PVT) is a serious condition that is associated with various life-threatening complications. The utilization of multimodality imaging techniques is critical in identifying this etiology. Its management is complex and often requires repeat surgical valve replacements. Our report describes the case of a 48-year-old female who presented with mechanical mitral valve thrombosis in the setting of subtherapeutic anticoagulation. Due to her complex surgical history, nonsurgical therapeutic options were initially pursued for management. Through shared decision-making and after exhaustion of other alternatives, she was maintained on optimized medical therapy and was scheduled for repeat elective surgery. After compliance with medical therapy and close monitoring, she improved significantly, and her underlying pathology completely resolved, eliminating the need for surgery. This report indicates that the management of mechanical prosthetic valve thrombosis should be individualized and emphasizes the importance of involving a multidisciplinary team of medical and surgical professionals to achieve the best clinical outcomes., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Saeed Al-Asad et al.)

Competing Interests: Competing interests: None declared.

Purpose: Acinetobacter baumannii is an opportunistic pathogen, and is among the most problematic nosocomial infections as well as community-acquired infections. This retrospective study was conducted as an attempt to determine the prevalence of multidrug-resistant A. baumannii (MDRAB) isolates from the north and central Jordan area during 2018., Methods: Patients' records provided by an accredited central private laboratory located in Amman, were examined for A. baumannii isolates identified during this period. The isolates were identified to the species level using the API-10S system and the antimicrobial sensitivity testing was determined using the Kirby-Bauer disc diffusion method., Results: A total of 43 unduplicated isolates were obtained and classified according to clinical sampling source into: Group I (blood), Group II (urine) and Group III (wound, pus, sputum, bedsore and others). Total MDRAB isolates recorded were 29 (67.4 %). Resistance to imipenem was found to be 36% and 94% among groups II and III, respectively, and resistance to meropenem was 60% and 88% among the same groups, respectively., Conclusion: Antimicrobial stewardship programs at a national scale are needed to calculate the actual proportion of MDRAB in the country and to combat its increasing emergence and decrease the magnitude of antibiotic resistance., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Quinidine is one of the oldest antiarrhythmics known. Over the years, its use has decreased along with its side effects. Our case describes a 69-year-old woman with recurrent resistant ventricular tachycardia on Quinidine and Amiodarone who presented with acute liver toxicity. Drug-induced liver toxicity was at the top of our differential diagnosis list. Taking multiple factors into consideration, a decision was made to discontinue Quinidine, the patient's symptoms and lab abnormalities resolved within 1 week, yielding the diagnosis of Quinidine hypersensitivity., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2020. No commercial re-use. See rights and permissions. Published by BMJ.)

Purpose: The purpose of this study was to report crystalline lens deposit formation following ICL implantation for the correction of hyperopia., Observations: A 23-year-old male presented at the American University of Beirut Medical Center in 2008 seeking refractive surgery for hyperopia. His cycloplegic refraction was +7-1.25 × 115° and +7-1.00 × 115° in the right and left eyes, respectively, yielding a vision of 20/20 bilaterally. The patient underwent right eye insertion of a non-toric phakic sulcus-fixated collamer lens 2 weeks after undergoing peripheral iridotomies. The early postoperative course was complicated by anterior chamber inflammation and the appearance of diffuse whitish precipitates on the anterior surface of the crystalline lens, hypotony, and a mid-dilated mildly reactive pupil. With the prompt administration of topical and systemic steroids, the anterior chamber reaction subsided, and the anterior capsular deposits gradually resolved peripherally with some remaining centrally over the course of several weeks. The patient's visual acuity at 6 months was 20/20., Conclusionsand Importance: Adequate viscoelastic removal and minimal iris stimulation seem to be essential to avoid this condition in hyperopic implants that lack a central port. Additionally, prompt treatment can minimize visual impairment and hasten visual recovery., Competing Interests: Shady Awwad is a consultant for STAAR Surgical, the manufacturer of the ICL. All of the other authors have no financial disclosures pertaining to this work., (© 2020 Published by Elsevier Inc.)

Background: Medical education & medical profession are among the most challenging and most stressful ones. Anxiety and depression represents an escalating public health problem among medical students. The objective of the study was to determine the prevalence & predictors of anxiety and depression among female medical students in King Abdulaziz University, Jeddah, Saudi Arabia., Methods: A cross-sectional study was carried out during 2010-2011. A stratified random sample method was used to select 450 medical students. A confidential, anonymous & self administered questionnaire included Standardized Hospital Anxiety & Depression Scale was used., Results: The mean scores for anxiety and depression were 9.32 ± 3.77 & 6.59 ± 3.62, respectively. There is a positive correlation between anxiety & depression scores (r= 0.52, P< 0.001). Prevalence of morbid anxiety and depression were 34.9% and 14.7%, respectively. Logistic regression analysis revealed that the first predictor of morbid anxiety was depression (adjusted Odds Ratio (aOR) = 3.28; 95% Confidence Interval (CI): 1.85-5.82, P < 0.001). Students complained from condensed academic course, had academic and emotional failures during the 6 months preceded the study were about 2 times more prone to anxiety. Predictors of depression were having anxiety, nationality (being non-Saudi) & having emotional failure., Conclusion: Medical students encountered high rates of anxiety & depression compared to others. Academic problems and major life events were the main predictors. Enhancing faculty preventive & curative mental health services is recommended. Initiation of stress management courses & enhancing academic advising services are required since the start of medical education.