Background: Lateral internal sphincterotomy (LIS) has been the gold standard for treating chronic anal fissure (CAF) that persists despite other measures. The authors aim to evaluate the effects of the close method (CLIS) of performing LIS as compared to the open method (OLIS). Methods: Databases were searched for relevant studies and results were screened to identify eligible articles, and all concerned outcomes were pooled as odd ratio (OR) or mean difference (MD) with 95% CI in the meta-analysis models using RevMan 5.4. Results: Pooled data from 16 trials with 1,711 patients with idiopathic CAF showed that the CLIS has significant lower risk of delayed fissure healing [OR: 0.28, 95% CI (0.10, 0.77), P = 0.01], duration of hospital stay [MD: -0.82 with 95% CI (−1.07, −0.57), P < 0.00001] and postoperative visual analogue pain score (VAPS) at 24 h [MD: −0.30 with 95% CI (−0.39, −0.21), P < 0.00001]. Also, the risk of overall complications [OR: 0.33 with 95% CI (0.19, 0.55), P < 0.0001], incontinence [OR: 0.28 with 95% CI (0.20, 0.38), P < 0.00001], and postoperative pain [OR: 0.56 with 95% CI (0.35, 0.91), P = 0.02] was significantly lower with CLIS. Conclusion: CLIS is a safer option than OLIS for treating anal fissure. The risk of delayed fissure healing, incontinence, post-op pain and overall complication was significantly lower. However, the risk of surgical site infection, postoperative bleeding and recurrence did not differ. Future research with more prolonged follow-up is necessary to document recurrence reliably.

Spinal cord injury (SCI) is a serious condition accompanied by severe adverse events that affect several aspects of the patient’s life, such as motor, sensory, and functional impairment. Despite its severe consequences, definitive treatment for these injuries is still missing. Therefore, researchers have focused on developing treatment strategies aimed at ensuring full recovery post-SCI. Accordingly, attention has been drawn toward cellular therapy using mesenchymal stem cells. Considering their wide availability, decreased immunogenicity, wide expansion capacity, and impressive effectiveness in many therapeutic approaches, adipose-derived stem cell (ADSC) injections in SCI cases have been investigated and showed promising results. In this review, SCI pathophysiology and ADSC transplantation benefits are discussed independently, together with SCI animal models and adipose stem cell preparation and application techniques. The mechanisms of healing in an SCI post-ADSC injection, the outcomes of this therapeutic approach, and current clinical trials are also deliberated, in addition to the challenges and future perspectives, aiming to encourage further research in this field.

Background: Environmental surroundings reduce the rate of several diseases, especially those related to stressful events. Ischemic stroke can be affected by such events, either directly or through its risk factors. Therefore, the present study evaluates the effects of green spaces and noise exposure on the risk of ischemic stroke. Methods: A case–control study was carried out, including 200 ischemic stroke cases within the first 48 h of diagnosis and 200 controls, divided equally into hospitalized and non-hospitalized participants. Controls were matched to cases based on age and gender. Socio-demographic characteristics were assessed, in addition to environmental surroundings and noise exposure at home and at workplaces. Results: Living in a house, having a house garden, and taking care of the garden were associated with a lower risk of suffering an ischemic stroke (p < 0.001, p < 0.001, and p = 0.009, respectively). However, having buildings as the view from home led to a higher stroke rate (p < 0.001). Working in an urban area, the workplace being surrounded by buildings, and the workplace not being surrounded by green spaces were also associated with a higher risk of suffering an ischemic stroke (p = 0.002, p = 0.001, and p = 0.03, respectively). As for noise exposure, being exposed to traffic noise, human noise, and other types of noise was significantly associated with a higher risk of ischemic stroke, while being exposed to higher levels of natural noise was significantly associated with a lower risk of ischemic stroke. Higher levels of noise were also associated with higher risks of ischemic stroke in homes and workplaces (p < 0.001 and p = 0.008, respectively). Conclusions: Environmental surroundings and noise exposure were found to affect the risk of ischemic stroke. Greater green spaces and lower noise exposure play a protective role against ischemic stroke, suggesting a possible prevention strategy through environmental modifications at home and workplaces.

Background: Stroke is the third most common cause of death in Lebanon. With many preventive strategies identified, stroke remains a national burden, especially in developing countries, where risk factors and epidemiological states are understudied. This study aims to investigate the association of sociodemographic factors and health-related risk factors with age at first ischemic stroke and its recurrence in the Lebanese population. Methods: A retrospective study including 214 ischemic stroke cases was carried out. Sociodemographic characteristics and health-related risk factors were assessed, in addition to disability levels (modified Rankin score (mRS)), age at first ischemic stroke incidence, and number of ischemic strokes. Data were analyzed using SPSS software version 25, including descriptive, bivariate, and multivariate analyses. Results: This study showed that stressful factors were significantly associated with a younger age at first ischemic stroke, such as having no partner (p < 0.001), having employment (p < 0.001), and having migraines (p < 0.001). However, metabolic risk factors were associated with an older age of ischemic stroke, such as hypertension (p < 0.001) and hyperlipidemia (p < 0.001). Moreover, having a partner (OR: 2.136), having a family history of stroke (OR: 2.873), having hyperlipidemia (OR: 3.71), and having atrial fibrillation (OR: 2.521) were associated with ischemic stroke recurrence. Conclusions: Many modifiable factors are associated with age at first ischemic stroke and its recurrence. This study sheds light on the necessity of increasing knowledge and awareness of well-known risk factors in the Lebanese population. These results suggest implementing targeted preventive strategies and highlight the importance of complying with early detection and follow-up measures.