Avicenna Journal of Medicine

Decolonizing epidemiological research is a crucial endeavor. Historically, colonial and imperialistic ideologies have pervaded epidemiology, leading to an emphasis on Western perspectives and the neglect of indigenous and other marginalized communities' needs and experiences. To effectively address health disparities and promote justice and equality, acknowledging and addressing these power imbalances are imperative. In this article, I highlight the need of decolonizing epidemiological research and make recommendations...

Background  Posttraumatic stress disorder (PTSD) is associated with disturbed sleep. However, the impact of sleep disturbances and PTSD symptomology in refugee populations is not well known. This study examined how PTSD-related sleep symptoms and overall sleep quality were impacted by previous and current traumatic and stressful experiences. Methods  Adult Syrian refugees living in Southeast Michigan were assessed via scheduled in-home interviews. Overall sleep quality was measured using the Pittsburgh Sleep Quality Index...

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Background  Pulmonary arterial hypertension (PAH) is a rare disease of cardiopulmonary circulation characterized by elevated pressure in the pulmonary artery. The right-heart catheter is the gold standard for diagnosis, but there is interest in identifying additional prognostic indicators. The aim of this study was to examine the importance of the rate of pressure change of the pulmonary artery (dP/dt mean PA) in patients with PAH. Methods  We retrospectively analyzed data from 142 patients with PAH (exclusively clinical group 1) and examined the statistical correlation of dP/dt mean PA with vascular, right ventricular, and clinical parameters...

Background  Medical students' career choices determine the prospects of the future medical workforce, thus influencing the delivery of medical care. This study aims to identify and provide information about factors affecting the selection of future specialties among medical students. Methods  A cross-sectional study was conducted on students in both preclerkship and clerkship phases at a single institution in the United Arab Emirates. A self-administered questionnaire included questions about demographic data, most preferred specialties, and influential factors...

Idiopathic isolated right ventricular cardiomyopathy is an extremely rare cause of right ventricular failure. Here, we report a case of 65-year-old male presented with chief complaints of dyspnea, fatigue, and bilateral pedal edema for the last 6 months. On clinical evaluation, grade II/III pansystolic murmur was present in left parasternal area. Investigations and imaging revealed dilated right atrium and ventricle with normal pulmonary artery pressure without any etiology. Magnetic resonance imaging ruled out other common causes of right ventricular cardiomyopathy; thus, the patient was diagnosed as a case of idiopathic isolated right ventricular cardiomyopathy that is a diagnosis of exclusion...

The 2019 coronavirus disease (COVID-19) has been a major dilemma all over the world since December 2019. Several types of COVID-19 vaccines were developed for public utilization to halt the widespread of the disease; however, vaccine hesitancy is one major factor that prevents a successful control of this pandemic. This study aimed to summarize the different kinds of available COVID-19 vaccines and their effectiveness, and to assess the associated factors regarding vaccine hesitancy of the general population to bridge the gap existing between the two factors...

Pneumocystis jirovecii pneumonia is an opportunistic fungal infection that was mainly associated with pneumonia in patients with advanced human immunodeficiency virus (HIV) disease. There has been a decline in Pneumocystis jirovecii pneumonia incidence in HIV since the introduction of antiretroviral medications. However, its incidence is increasing in non-HIV immunocompromised patients including those with solid organ transplantation, hematopoietic stem cell transplantation, solid organ tumors, autoimmune deficiencies, and primary immunodeficiency disorders...

Background  Antibiotic resistance is a global problem, and the World Health Organization has made this problem one of its priorities for solving. Therefore, a survey was carried out to investigate the knowledge, attitude, awareness, and perceptions of antibiotic resistance among physicians and to assess the correlation between the knowledge of antibiotic resistance and their years of experience in some Palestinian hospitals. Methods  This was a cross-sectional study that targeted physicians who are working in different healthcare facilities in Hebron and Bethlehem governorates...

Anorexia nervosa (AN) is a type of eating disorder that has been increasing in incidence and has been encountered more commonly by physicians in their daily practice. Both environmental and genetic risk factors paired along with a more susceptible neurobiology are at play in the emerging resistance to treatment in AN. Preoccupations with intense fear of weight gain, dietary restrictions, excessive exercise, and how the individual is perceived by society mixed with underlying psychopathology all further add to the issue...

Background  Telemedicine is widely used in neonatal services in developed countries, though its outcomes in low- and middle-income countries are controversial. Lack of expertise and/or facilities, however, has limited its use in developing countries and around areas of military conflicts. We aim to study the implementation and management of therapeutic hypothermia (TH) in infants with hypoxic-ischemic encephalopathy (HIE) with the help of telemedicine in a resource-limited country. Methodology  This is a retrospective study, evaluating patients who received TH, guided by telemedicine, through a mobile app (Telegram), an application that allows sharing and archiving of information with other beneficial features...

The coronavirus disease 2019 (COVID-19) pandemic has underscored social and racial discrimination in global health, showing that health equity is still a goal to be achieved. Understanding the impact of COVID-19 on public health potential is vital to present a fair opportunity for people of different backgrounds to be as healthy as possible. As such, this communication discusses the emerging health disparities in light of the COVID-19 pandemic and analyzes their implications. Original research, effective health communication, and promotion strategies ought to be leveraged to step closer toward national and international health equity...

Background  Hematological parameters and their ratios are the most studied biomarkers for prediction of mortality or severe illness in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. This study aims to compare the power of the blood urea nitrogen (BUN)/albumin ratio, lactate/albumin ratio, and C-reactive protein (CRP)/albumin ratio, measured at the time of admission, in predicting 30-day mortality in SARS-CoV-2-infected patients presenting to the emergency department (ED). Materials and Methods  This retrospectively designed, single-center, observational study was performed in the ED of a tertiary education health care center...

Background  Multiparametric magnetic resonance imaging (mp-MRI) of urinary bladder (UB) is a novel imaging to predict detrusor muscle invasion in Bladder cancer (BC). The Vesical Imaging-Reporting and Data System (VI-RADS) was introduced in 2018 to standardize the reporting of BC with mp-MRI and to diagnose muscle invasion. This study was performed to evaluate the role of mp-MRI using VI-RADS to predict muscle invasive BC. Methods  This prospective study was carried from June 2020 to May 2021 in a tertiary care institute...

Background  Vulnerable communities around the world, such as Syrian refugees, faced increased social and financial strain due to coronavirus disease 2019 (COVID-19). We evaluated the underlying issues and inequities of Arabic-speaking refugees during the pandemic. Methods  Data were collected from Arabic-speaking refugees ( N  = 20) in July 2020, using an online 97-item questionnaire, in short response and multiple-choice formats. Results  Participants' reports indicate adequate knowledge about COVID-19 symptoms and preventative measures, but experienced linguistic, financial, and cultural challenges during the pandemic...

Background  It is not clear if the increase in the number of esophagogastroduodenoscopies (EGDs) performed has any significant effect on the rate of lymphocytic duodenosis (LD) reporting in children and adolescents and whether it correlates with abnormal gastric and/or esophageal pathology." Methods  We performed a single-center retrospective study using the Mayo Clinic electronic health record and pathology database. We reviewed all EGD procedures performed in children and adolescents (<18 years) between January 1, 2000, and December 31, 2018, and identified two groups, the LD group and matched age and sex control group (normal duodenal biopsies)...

Background  Protracted conflict has destroyed Syria's health system with severe impacts on the diagnosis and treatment of chronic and high-cost diseases including cancer. Here, we review the type and (where possible) the stage of cancers diagnosed in a pathology laboratory serving Northwest Syria. Methods  We retrospectively reviewed all pathology reports which reported a diagnosis of cancer from a pathology department in Northwest Syria from January to December 2020. Results  A total of 397 new cancers were diagnosed during 2020 of which 191 were among males (48...

B-acute lymphoblastic leukemia (B-ALL) is commonly encountered in clinical practice. Patients present with increased percentage of lymphoblasts in bone marrow and/or peripheral blood. Immunophenotypic study by flow cytometry or immunohistochemistry is essential to establish the diagnosis. Paired box-5 (PAX5) is a B cell lineage protein and terminal deoxynucleotidyl transferase (TDT) is an immature marker, both of which are routinely tested in the pathologic workup of acute leukemia. In this report, we describe a case of B-ALL in a 37-year-old woman in which both PAX5 and TDT were negative...

Adrenal oncocytomas are rare tumors that are mostly benign and non-functional although they may be hormonally active and can exhibit a borderline or malignant potential. We present a case of a 40-year-old female patient with known hypertension who presented with abdominal discomfort. Radiologic investigations showed a large mass on the left adrenal gland. In the hormonal study, an aldosterone-secreting tumor was identified. After laparoscopic resection, the histological assessment of the 12-cm mass showed an oncocytic neoplasm with borderline characteristics...

Background  Subcutaneous lidocaine injection and topical EMLA cream are both used to control lumbar puncture (LP) pain; however, local analgesia usage is not standardized. Methods  We conducted a prospective, single-blinded, randomized-controlled crossover trial comparing the two modalities in reducing LP pain. Pediatric patients requiring serial LPs were randomly assigned to receive EMLA cream or lidocaine injection prior to LP. On the subsequent LP, analgesia was defaulted to the other agent...