Background Post-acute COVID-19 syndrome (PACS) is a syndrome characterized by a wide spectrum of symptoms emerging after clearance of coronavirus 2019 (COVID-19) infection. These symptoms include fatigue, myalgia, arthralgia, cognitive dysfunction, and many other psychiatric symptoms. Given that fibromyalgia patients have similar symptoms, we conducted a web-based cross-sectional study to investigate the prevalence and predictors of fibromyalgia patients who recovered from COVID-19. Methods Data were collected between the 9th and 19th of March 2022 using a web-based survey. The questionnaire consisted of 25 questions gathering sociodemographic information, comorbid diseases and features of acute COVID-19 infection. Lastly, the American College of Rheumatology (ACR) survey criteria completed the questionnaire. Results A final sample of 404 individuals (75% women) filled out the form. Of these, 80 (19.8%) satisfied the ACR survey criteria for fibromyalgia (93.8% women). A multivariate logistic regression model including demographic and clinical factors showed that female gender (OR: 6.557, 95% CI: 2.376 - 18.093, p = 0.001) and dyspnea (OR: 1.980, 95% CI: 1.146 - 3.420, p = 0.014) were the strongest predictors of being classified as having post-COVID-19 fibromyalgia. Bivariate correlation revealed that age (r = 0.200, p = 0.001) and duration of COVID-19 infection (r = 0.121, p = 0.015) were directly correlated with fibromyalgia symptom (FS) score. Conclusion Our data suggest that clinical features of fibromyalgia are common in patients who recovered from COVID-19 and that dyspnea and female gender increase the risk of developing post-COVID-19 fibromyalgia.

Introduction Clinical audits have become essential instruments for evaluating and improving the standard of patient care in healthcare services. While individual clinical audits focus on particular aspects of care, multiple clinical audits across various domains, specialties, or departments provide a more comprehensive understanding of clinical practice and encourage systemic improvements. Methodology This study employed a mixed -methods approach to review and assess various clinical audits and quality improvement initiatives conducted at Al-Karak Governmental Hospital in southern Jordan. The study aimed to identify obstacles and possibilities of conducting clinical audits and provide suggestions for enhancing audit procedures and results. Data were collected from both retrospective and prospective sources and analyzed using descriptive and inferential statistics. Results The study comprised 11 audits conducted in three medical departments, namely surgery, obstetrics and gynecology (OB/GYN), and pediatrics, with a total of 618 participants. The improvements in adherence to guidelines after the second loop of all the audits were significant and showed significant improvements in adherence to guidelines, demonstrating the efficacy of clinical audits in improving clinical practice and outcomes. Conclusions Clinical audits are essential for maintaining and improving quality and safety in healthcare services, particularly in developing nations where emergency obstetric care is lacking. Multiple clinical audits provide a comprehensive understanding of clinical practice and encourage systemic improvements. The findings of our study suggest that clinical audits can lead to significant improvements in adherence to guidelines and better clinical outcomes. Future research should focus on identifying best practices for conducting clinical audits and evaluating their long-term viability and expandability.

Background: Abdominal solid organ transplant (SOT) programs have been hit hard by the COVID‐19 pandemic, which was officially declared as such on March 11, 2020. Over two years, the tightening and softening of limitations in response to the “waves” of infection and COVID‐19 fluctuations have provided distinct issues for waitlisted patients, transplant recipients, and transplant organizations.Method: We searched Scopus using the terms “transplant” and “transplantation,” and organ‐related phrases like “intestin*,” “liver,” “kidney,” “hepatic,” “renal,” and “pancrea*,” as well as COVID‐19 terms such as “COVID‐19,” “coronavirus,” and “SARS‐CoV‐2.” We included articles, reviews, conference papers, letters, notes, editorials, brief surveys, book chapters, and errata and studied nations, institutions, authors, journals, keywords, and articles. VOSviewer 1.6.18 and Excel were used to create tables and figures.Results: We included 1,251 of 1,256 studies. Among them, 289 (23.1%), 489 (39.1%), and 473 (37.8%) papers were published in 2020, 2021, and 2022, with mean (SD) citations of 30.3 (53.3), 14.3 (26.8), and 4.79 (6.38), respectively. Compared to other abdominal organs, the field of kidney transplants had the highest number of articles describing the impact of COVID‐19. The United States contributed the most articles, and the American Journal of Transplantation published the most articles.Conclusion: To our knowledge, this is the first bibliometric investigation of the impact of COVID‐19 on SOT. This report provides an overview of the research conducted on SOT and COVID‐19. There is potential for this bibliometric analysis to serve as a beneficial and practical resource for ongoing and future research. image

Medial Hoffa Fracture: A Case Report and Literature Review of Approach and Management - Article abstract #943136

BACKGROUND Situs inversus totalis (SIT) is an uncommon condition characterized as a congenital disorder in which the visceral organs are inverted relative to their typical anatomical position. SIT with double superior vena cava (SVC) is an even rarer presentation. Due to the underlying anatomical difference, the diagnosis and treatment of gallbladder stones in patients with SIT are challenging. CASE REPORT We report the case of a 24-year-old male patient who presented with an intermittent history of epigastric pain for 2 weeks. Clinical assessment and radiological investigations confirmed gall bladder stones with evidence of SIT and double superior vena cava (SVC). The patient underwent elective laparoscopic cholecystectomy (LC) with an inverted laparoscopic approach. The recovery from the operation went smoothly, the patient was discharged from the hospital the following day, and the drain was removed on the third postoperative day. CONCLUSIONS Because anatomical variations in the SIT can affect localization of symptoms in patients with complicated gallbladder stones, the diagnosis of patients who have abdominal pain and SIT necessitates both a high index of suspicion and a thorough assessment. Although LC is considered to be a technically challenging surgery and calls for modification of the standard protocol, it is nevertheless feasible to perform the procedure effectively. To the best of our knowledge, this is the first time that LC has been documented in a patient who has SIT and double SVC.

Acute appendicitis due to a foreign body is a very rare condition with an incidence of 0.0005% of all appendicitis cases and among all age groups. It is one of the atypical cases of appendicitis, and it is a rare condition commonly asymptomatic; there is a period of time between ingestion of the body and appendicitis. A 14-year-old female patient presented to the emergency room with right lower quadrant colicky pain. Moreover, it was progressive with six hours duration, preceded by loss of appetite. It was associated with nausea, non-projectile vomiting, and diarrhea. By taking the past medical history, the patient had a history of multiple times of foreign ingestions when she was younger. On examination, the patient appeared ill, and was vitally stable. On palpation, the patient had a right lower quadrant tenderness. The patient had positive pointing, rebound, Rovsing, and psoas signs. Full labs were done. Abdominal x-ray revealed a radiopaque metallic body in the right lower quadrant. By ultrasound, there was a minimal free fluid collection in the pelvis. Intraoperatively, the appendix looked hyperemic. Appendectomy was performed, and a needle was extracted from the appendix. Furthermore, the histopathology revealed an early inflamed appendix. Foreign body-causing appendicitis is a rare condition. We need to investigate suspected cases carefully because the presentation is atypical, and sometimes the patients are asymptomatic.