Jellyfish have a worldwide distribution. Their stings can cause different reactions, ranging from cutaneous, localized, and self-limited to serious systemic or fatal ones, depending on the envenoming species. Several first aid treatments are used to manage such stings but few have evidence behind their use. This review of the literature describes and discusses the different related first aid and treatment recommendations, ending with a summarized practical approach. Further randomized controlled trials in this field are needed.
Depression is prevalent across the life span worldwide. It is a common problem encountered in primary care settings. The World Health Organization recommends the integration of mental health into general health care in order to seal the existing gap between the number of patients who need mental health care and those who actually receive it. Addressing the burden of mental health problems in primary care settings has its limitations, particularly because of the time constraints in busy primary care clinics as well as the inadequate training of staff and physicians in mental health disorders. That is why reliable, brief, and easy to administer depression screening instruments are important in helping physicians identify patients at risk. The 2-item Patient Health Questionnaire (PHQ-2) is a suitable primary screening tool for depression. If positive, other tools should be administered, such as the PHQ-9 in adults, the PHQ-9 or Geriatric Depression Scale-15 in older adults, or the Arroll's help question or the Edinburgh Postnatal Depression Scale in ante- or postpartum women. Patients with positive scores ought to be interviewed more thoroughly. Computerized depression screening instruments that are interfaced or integrated into electronic health records seem to be promising steps toward optimizing diagnosis, treatment, and follow-up. The availability of adequate management and follow-up are ethical requirements for the utilization of any screening instrument for depression.
Although family physicians in the Arab world believe in the benefits of insulin therapy, many are reluctant to initiate it themselves. Further studies are needed per country, as well as multiple measures to minimize the physicians' barriers to insulin prescription.
Introduction As the COVID-19 pandemic spread globally, emergency departments (ED) around the world began to report significant drops in volumes and changes in disease patterns. During the early COVID-19 period, Lebanon followed an aggressive containment approach to halt the spread of the disease. Objective This study aims to examine the impact of the different national containment measures and the early COVID-19 outbreak in Lebanon on ED visit volume and disease spectrum in a single center ED in Lebanon. Methods This study is a secondary analysis of ED visit administrative data, comparing ED visits during the three months period prior to the first identified COVID-19 case in Lebanon with the first 3 months post-COVID-19. A time series analysis of ED visit trends in relation to the major lockdown measures was conducted. Statistical analyses were performed using the Statistical Package for Social Sciences (SPSS, version 27) and STATA version 15 (StataCorp LLC., College Station,TX). Statistical significance was set at 0.05. Results The daily ED visit volume significantly decreased in response to the closure of educational institutions (19.96% per day, p -value = 0.04) and the declaration of public mobilization state with border closure (97.11% per day, p -value <0.0001). ED visits decreased by 47.2% post-COVID-19. The drop was highest amongst pediatric patients (66.64%). Patients who presented post-COVID-19, compared to pre-COVID-19 were older (40.39 ± 24.96 vs 33.71 ± 24.83, p -value <0.0001), had higher hospital admission rates (28.8% vs. 22.1%, p-value <0.0001), higher critical care admission rates (5.6% vs. 3.5%, p-value <0.001), and double mortality rate (0.4% vs 0.2%, p-value = 0.006). While visits for most diseases dropped, the odds of presenting to the ED post-COVID19 were higher for bacterial infections and non-communicable disease and lower for injuries and communicable diseases. Conclusion ED visits dropped significantly during the COVID-19 containment period. Understanding the trends of changes in disease entities is important for ED staffing purposes during the pandemic and the varying containment efforts. While stringent lockdown measures were associated with drops in ED visits, understanding the reason behind these drops, specifically whether behavioral or related to true drops in disease prevalence, needs further exploration.
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