Introduction: Methods: Results: Conclusions
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First Case of an Infant with COVID-19 in the Middle East
Open Access Case Report DOI: 10.7759/cureus.7520 First Case of an Infant with COVID-19 in the Middle East Amani Mansour 1 , Rola Atoui 2 , Kamal Kanso 1 , Rami Mohsen 1 , Youssef Fares 3 , Jawad Fares 4 1. Pediatrics and Adolescent Medicine, Lebanese University Faculty of Medicine, Beirut, LBN 2. Infectious Diseases, Lebanese University Faculty of Medicine, Beirut, LBN 3. Neuroscience Research Center, Lebanese University, Beirut, LBN 4. Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, USA Corresponding author: Jawad Fares, [email protected] Abstract The novel coronavirus (COVID-19) has been declared a worldwide pandemic. It was initially thought to spare children and adolescents as significantly smaller number of cases have been reported in the pediatric population in comparison to adults. Here, we report the case of a 16-month-old female infant from Lebanon who presented with fever and severe diarrhea and tested positive for COVID-19. Her symptoms started six days prior to presentation with no cough, rhinorrhea, or other respiratory manifestations reported. Chest radiography showed lobar consolidation and bronchial infiltrates. Blood culture was positive for Streptococcus pneumoniae. Stool and urine cultures were negative. She was treated with ceftriaxone and metronidazole. Her RT-PCR test was negative after five days of treatment, suggesting that children can clear the virus faster than adults. The patient likely contracted the virus from her parents, who because of the fear of social stigma hide recent history of respiratory illness. These findings serve as a practical reference for the clinical diagnosis and medical treatment of children with COVID-19. -
Cluster Munitions: Military Use and Civilian Health Hazards Jawad Faresa & Youssef Faresa
PerspectivesPerspectives Cluster munitions: military use and civilian health hazards Jawad Faresa & Youssef Faresa Official reports from the Syrian Arab In Lebanon, more than 500 casual- tural and historic monuments.12 Fear of Republic and Yemen indicate the use of ties have been recorded since hostilities cluster munitions forced populations to cluster munitions in civilian areas.1 Clus- ended in 2006, with craniofacial injuries move into subsidiary locations to avoid ter munitions are a form of air-dropped (7%; 29/356), abdominal and thoracic the unexploded ordnances.12 or ground-launched explosive weapons injuries (28%; 101/356) and upper (62%; In 2015, the International Commit- that eject numerous smaller submuni- 220/356) and lower limb (83%; 294/356) tee of the Red Cross signed an agreement tions. These weapons have military amputations due to submunition deto- with the Faculty of Medicine of the value, because of their wide dispersal, nation.6 These injuries cause significant Lebanese University to give a module versatility and effectiveness against disability, and treatment is compli- on the clinical management of the targets that move or do not have precise cated by wound infections caused by war-wounded, but more can be done. locations, such as moving troops or organisms including Pseudomonas (5%; The World Health Organization and vehicles. Submunitions are designed to 18/350), Escherichia coli (5%; 16/350) other health actors such as Médecins explode on impact; however, when they and Candida (3%; 9/350), sometimes Sans Frontières and the International fail to explode as expected, the duds usu- leading to necrosis (5%; 18/350).7 Many Committee of the Red Cross, could ally remain hazardous and will detonate injured people were also diagnosed send health professionals and trauma when touched or disturbed. -
Inflammation and Elevation of Interleukin-12P40 in Patients With
fnmol-09-00016 March 19, 2016 Time: 11:18 # 1 ORIGINAL RESEARCH published: 22 March 2016 doi: 10.3389/fnmol.2016.00016 Inflammation and Elevation of Interleukin-12p40 in Patients with Schizophrenia Nora Bedrossian1,2, Mariam Haidar3, Jawad Fares1,4*, Firas H. Kobeissy5,6* and Youssef Fares1,7* 1 Neuroscience Research Center, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon, 2 Department of Medical Microbiology, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon, 3 Faculty of Science, Lebanese University, Beirut, Lebanon, 4 Faculty of Medicine, American University of Beirut, Beirut, Lebanon, 5 Department of Psychiatry, College of Medicine and McKnight Brain Institute, University of Florida, Gainesville, FL, USA, 6 Department of Biochemistry and Molecular Genetics, American University of Beirut Medical Center, Beirut, Lebanon, 7 Department of Neurosurgery, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon Schizophrenia is a serious mental illness with chronic symptoms and significant impairment in psychosocial functioning, which suggests that it likely has neurodegenerative characteristics. Inflammatory markers such as pro-inflammatory cytokines are well-known etiological contributors for psychiatric disorders, including schizophrenia. Although, the role of inflammation in schizophrenia is becoming evident, the number of studies in this area is relatively scarce, especially in Lebanon, and increased procedural thoroughness is needed. Cytokines play a key role in the activation of the immune system and strongly influence neurotransmission. Previous investigation of plasma levels showed dysregulation of interleukin (IL)-12. However, genotypical variations of this interleukin have not been investigated for patients with Edited by: Nashat Abumaria, schizophrenia yet. Thus, in this paper, we aimed to compute and assess IL-12p40 levels Fudan University, China in the sera of individuals with schizophrenia from different provinces in Lebanon and Reviewed by: compare it to controls. -
Immune Checkpoint Inhibitors: Advances and Impact in Neuro‑Oncology Jawad Fares1,2, Mohamad Y
OPEN ACCESS Editor: Ekkehard Kasper, M.D., SNI: Neuro-Oncology For entire Editorial Board visit : Harvard Medical School, http://www.surgicalneurologyint.com Boston, MA, USA Editorial Immune checkpoint inhibitors: Advances and impact in neuro‑oncology Jawad Fares1,2, Mohamad Y. Fares3, Youssef Fares4 1Department of Neurological Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, 2Cancer Biology and Therapeutics: High‑Impact Cancer Research Program, Harvard Medical School, Boston, MA 02115, USA, 3Faculty of Medicine, American University of Beirut, Beirut, 4Department of Neurosurgery, Neuroscience Research Center, Faculty of Medical Science, Lebanese University, Beirut, Lebanon E‑mail: *Jawad Fares ‑ [email protected], Mohamad Y. Fares ‑ [email protected]; *Youssef Fares ‑ [email protected] *Corresponding author Received: 21 October 18 Accepted: 27 November 18 Published: 25 January 19 Key Words: Immune checkpoint inhibitors, immunotherapy, T-cells, Nobel prize, James P. Allison, Tasuko Honjo, neuro-oncology INTRODUCTION discuss the latest advances targeting CTLA‑4 and PD‑1 in neuro‑oncology. The Nobel Assembly, consisting of 50 professors at the Karolinska Institutet, in Sweden, awarded the 2018 Nobel CTLA‑4 TARGETTED IMMUNOTHERAPY Prize in Physiology or Medicine jointly to James P. Allison and Tasuku Honjo for their discovery of cancer therapy In 1996, James Allison, lead investigator in his by inhibition of negative immune regulation.[29] laboratory at University of California, Berkeley, published in Science his observation that CTLA‑4, Dr. James Allison is an American immunologist who a protein known as a target in the treatment of holds the position of professor and chair of immunology autoimmune diseases, is a negative regulator of T‑cell at the University of Texas M.D. -
First Case of an Infant with COVID-19 in the Middle East
Open Access Case Report DOI: 10.7759/cureus.7520 First Case of an Infant with COVID-19 in the Middle East Amani Mansour 1 , Rola Atoui 2 , Kamal Kanso 1 , Rami Mohsen 1 , Youssef Fares 3 , Jawad Fares 4 1. Pediatrics and Adolescent Medicine, Lebanese University Faculty of Medicine, Beirut, LBN 2. Infectious Disease, Lebanese University Faculty of Medicine, Beirut, LBN 3. Neuroscience Research Center, Lebanese University, Beirut, LBN 4. Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, USA Corresponding author: Jawad Fares, [email protected] Abstract The novel coronavirus (COVID-19) has been declared a worldwide pandemic. It was initially thought to spare children and adolescents as significantly smaller number of cases have been reported in the pediatric population in comparison to adults. Here, we report the case of a 16- month-old female infant from Lebanon who presented with fever and severe diarrhea and tested positive for COVID-19. Her symptoms started six days prior to presentation with no cough, rhinorrhea, or other respiratory manifestations reported. Chest radiography showed lobar consolidation and bronchial infiltrates. Blood culture was positive for Streptococcus pneumoniae. Stool and urine cultures were negative. She was treated with ceftriaxone and metronidazole. Her RT-PCR test was negative after five days of treatment, suggesting that children can clear the virus faster than adults. The patient likely contracted the virus from her parents, who because of the fear of social stigma hide recent history of respiratory illness. These findings serve as a practical reference for the clinical diagnosis and medical treatment of children with COVID-19. -
Coping with Stress and Burnout Associated with Telecommunication and Online Learning
REVIEW published: 11 November 2020 doi: 10.3389/fpubh.2020.574969 Coping With Stress and Burnout Associated With Telecommunication and Online Learning Nour Mheidly 1, Mohamad Y. Fares 2,3,4 and Jawad Fares 5* 1 Faculty of Information, Lebanese University, Beirut, Lebanon, 2 Neuroscience Research Center, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon, 3 Faculty of Medicine, American University of Beirut, Beirut, Lebanon, 4 College of Medical Veterinary & Life Sciences, University of Glasgow, Glasgow, United Kingdom, 5 Department of Neurological Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States The COVID-19 pandemic substantially impacted the field of telecommunication. It increased the use of media applications that enable teleconferencing, telecommuting, Edited by: online learning, and social relations. Prolonged time facing screens, tablets, and Anca Birzescu, Xi’an International Studies smart devices increases stress and anxiety. Mental health stressors associated with University, China telecommunication can add to other stressors related to quarantine time and lockdown Reviewed by: to eventually lead to exhaustion and burnout. In this review, the effects of the COVID-19 Ravi Philip Rajkumar, pandemic on communication and education are explored. In addition, the relationship Jawaharlal Institute of Postgraduate Medical Education and Research between prolonged exposure to digital devices and mental health is studied. Finally, (JIPMER), India coping strategies are offered to help relieve the tele-burdens of pandemics. Hassan Youssef Hotait, Dubai Health Authority, Keywords: COVID-19, SARS-CoV-2, mental health-state of emotional and social well-being, psychology, students, United Arab Emirates education-active learning, e-learning, COVID-19 mental health response *Correspondence: Jawad Fares [email protected] INTRODUCTION Specialty section: The COVID-19 pandemic has led to a major shift in communication. -
Coping Ability to Stress Among Allied Health Sciences Students
Madhumitha & Archana (2020): Ability to cope to stress Dec, 2020 Vol. 23 Issue 23 Coping ability to stress among Allied Health Sciences Students 1 2 Madhumitha B , R. Archana* 1MBBS Student, Saveetha Medical College, Saveetha Institute of Medical and Technical Sciences, Chennai-602105, India 2Professor, Department of Physiology, Saveetha Medical College, Saveetha Institute of Medical and Technical Sciences, Chennai-602105, India *Corresponding author: [email protected] ( Dr Archana) ABSTRACT The vast medical syllabus along with patient interactions, clinical rotations and examinations can cause high levels of stress and anxiety among the medical students. Resilience is the coping ability to stress. Individuals who are more resilient are considered to be able to face stress and adversities with greater ease and thus produce better results academically. They function more optimally than less resilient individuals when faced with external stressors. Therefore, the objective of the study was to assess the resilience of physiotherapy and nursing students in order to understand their ability to handle stressors in life. A cross sectional study to assess resilience using a standard resilience questionnaire was conducted among the first year Physiotherapy and Nursing students of 18-25 years of age after obtaining informed consent and Institutional ethical clearance. All willing students fulfilling the inclusion and exclusion criteria were included in the study. The percentage of students having high, moderate and low resilience was assessed among the physiotherapy and nursing students. Among the 150 Nursing students and 141 Physiotherapy student participants, majority of the students had moderate resilience while only a significantly small percentage of students had high resilience score. -
Effect of Face Masks on Interpersonal Communication During the COVID-19 Pandemic
PERSPECTIVE published: 09 December 2020 doi: 10.3389/fpubh.2020.582191 Effect of Face Masks on Interpersonal Communication During the COVID-19 Pandemic Nour Mheidly 1, Mohamad Y. Fares 2,3,4, Hussein Zalzale 2 and Jawad Fares 5* 1 Department of Communication and Journalism, Autonomous University of Barcelona, Barcelona, Spain, 2 Faculty of Medicine, American University of Beirut, Beirut, Lebanon, 3 College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom, 4 Faculty of Medical Sciences, Neuroscience Research Center, Lebanese University, Beirut, Lebanon, 5 Department of Neurological Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States Interpersonal communication has been severely affected during the COVID-19 pandemic. Protective measures, such as social distancing and face masks, are essential to mitigate efforts against the virus, but pose challenges on daily face-to-face communication. Face masks, particularly, muffle sounds and cover facial expressions that ease comprehension during live communication. Here, we explore the role of facial expressions in communication and we highlight how the face mask can hinder interpersonal connection. In addition, we offer coping strategies and skills that can ease communication with face masks as we navigate the current and any future pandemic. Edited by: Zisis Kozlakidis, Keywords: SARS-CoV-2, coronavirus, communication, social distancing, pandemic (COVID-19), pandemic International Agency for Research on Cancer (IARC), France Reviewed by: INTRODUCTION Hassan Youssef Hotait, Dubai Health Authority, United The COVID-19 pandemic has severely affected the way people communicate with each other. Arab Emirates Muditha Nanayakkara, Precautionary measures to limit the spread of the virus necessitated a shift in the communication The University of Sydney, Australia paradigm when it comes to greetings and handshakes. -
Integrating Conflict Medicine in Medical Education Jawad Fares1, Mohamad Y
www.surgicalneurologyint.com Surgical Neurology International Editor-in-Chief: Nancy E. Epstein, MD, NYU Winthrop Hospital, Mineola, NY, USA. SNI: Socio-Economics, Politics, and Medicine Editor James A. Ausman, MD, PhD University of California at Los Angeles, Los Angeles, CA, USA Open Access Editorial Medical schools in times of war: Integrating conflict medicine in medical education Jawad Fares1, Mohamad Y. Fares2,3, Youssef Fares3 1Department of Neurological Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, 2Faculty of Medicine, American University of Beirut, Riad El-Solh, 3Department of Neurosurgery, Neuroscience Research Center, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon. E-mail: *Jawad Fares - [email protected]; Mohamad Y. Fares - [email protected]; Youssef Fares - [email protected] *Corresponding author: Jawad Fares, MD, MSc, ABSTRACT Department of Neurological Surgery, Feinberg School Amid the rise in conflict and war and their ensuing repercussions, traumatic injuries, psychological distress, and of Medicine, Northwestern communicable diseases spread widely. Today, health-care providers in the Middle East are faced with new and University, Chicago, IL 60611, unfamiliar cases resulting from the use of new and advanced types of weapons. In addition, there has not been enough emphasis on hands-on experiences in medical school, which can be imperative in times of war. Lack of USA. academia is another inadequacy that limits the transmission of knowledge onto the newer generations. Here, we [email protected] will shed light on the inadequacies in medical curricula in the Middle East when it comes to addressing patients of war. We also call for action to advance medical education in war-ridden areas by incorporating “conflict medicine” as an integral module in medical curricula. -
Clinical Presentation and Management of Severe Acute Renal Failure in Mcardle Disease
Clinical Medicine & Research Volume 19, Number 2: 90-93 ©2021 Marshfield Clinic Health System clinmedres.org Case Report Clinical Presentation and Management of Severe Acute Renal Failure in McArdle Disease Majdi Hamadeh, MD; Khalil Nasrallah, MD; Zeinab Ajami, MD; Rahil Zeaiter, MD; Layan Abbas, MD; Samih Hamadeh, BS; and Jawad Fares, MD, MSc McArdle disease, also known as glycogen storage disease type V, is an autosomal recessive disease due to the absence of myophosphorylase activity, leading to the complete disruption of glycogen breakdown in muscles. We present a rare case of a Caucasian male, aged 26 years, who developed rhabdomyolysis-induced acute renal failure and uremic encephalopathy. Neurological examination and histopathological studies supported the diagnosis of McArdle disease. The severity of his symptoms necessitated urgent hemodialysis, upon which the patient reported improvement in status. Acute renal failure in McArdle disease usually resolves with supportive treatment and maintenance of regular physical activity. Nevertheless, in more severe cases, intensive care with urgent hemodialysis may be needed. A multidisciplinary approach is necessary for the adequate management of similar cases. Keywords: McArdle Disease; Glycogen storage disease; Rhabdomyolysis; Acute renal failure; Neurology n 1951, McArdle described a glycogen storage disease associated with generalized myalgia and a dry cough. The that presents mainly as a myopathy.1 McArdle disease is patient, a non-smoker with no history of substance abuse, one of the most common glycogen storage diseases, noted that for the past 4 years he became easily fatigable I 2 affecting approximately 1 per 100,000 people. Patients upon minimal exercise. No other symptoms were noted. -
Natural Killer Cells in the Brain Tumor Microenvironment: Defining a New Era in Neuro-Oncology Jawad Fares1, Mohamad Y
www.surgicalneurologyint.com Surgical Neurology International Editor-in-Chief: Nancy E. Epstein, MD, NYU Winthrop Hospital, Mineola, NY, USA. SNI: Neuro-oncology Editor Ekkehard Kasper, MD McMaster University, Hamilton, ON, Canada Open Access Editorial Natural killer cells in the brain tumor microenvironment: Defining a new era in neuro-oncology Jawad Fares1, Mohamad Y. Fares2, Youssef Fares3 1Department of Neurological Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL - 60611, United States, 2Faculty of Medicine, American University of Beirut, Riad El-Solh, 3Department of Neurosurgery, Neuroscience Research Center, Faculty of Medical Sciences, Lebanese University, Beirut, Beyrouth - 1102 2801, Lebanon. E-mail: Jawad Fares - [email protected]; Mohamad Y. Fares - [email protected]; *Youssef Fares - [email protected] *Corresponding author: INTRODUCTION Youssef Fares, MD, PhD, EMBA, Department of Neurosurgery, Malignant brain tumors cultivate a variety of mechanisms to escape local and systemic immunity. Current Neuroscience Research Center, treatments are restricted to neurosurgical procedures, chemotherapy, and radiotherapy.[34] e major Faculty of Medical Sciences, limitation to effective therapeutic strategies lies in the impermissibility of the blood–brain barrier, which Lebanese University, blocks the access of targeted drugs into tumor sites.[15] For long, it was believed that the lack of lymphatic P.O. Box 6573/14, Beirut, drainage and antigen-presenting cells protects brain tumors from immunity; however, preclinical and Beyrouth - 1102 2801, Lebanon. translational studies in the past decade changed the perception on the role of immune cells in brain [email protected] tumors.[12,32,37] Brain tumor cells are equipped with the ability of secreting numerous chemokines, cytokines, and growth Received : 21 December 18 Accepted : 05 February 19 factors that stimulate the infiltration of various neural cells and a range of immune cells into the tumor. -
Infectious Diseases in the Era of Refugees: Hepatitis a Outbreak in Lebanon
Published online: 2021-08-12 ORIGINAL ARTICLE Infectious diseases in the era of refugees: Hepatitis A outbreak in Lebanon Abdul Rahman Bizri1,2, Jawad Fares3, Umayya Musharrafieh1,4 1Department of Internal Medicine, Division of Infectious Diseases, American University of Beirut Medical Center, 2Conflict Medicine Program, Office of Strategic Health Initiatives, American University of Beirut, 4Department of Family Medicine, American University of Beirut Medical Center, Beirut, Lebanon, 3Department of Neurological Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA Access this article online ABSTRACT Website: www.avicennajmed.com DOI: 10.4103/ajm.AJM_130_18 Background: The Syrian crisis has altered the epidemiology of infectious diseases in countries Quick Response Code: hosting large numbers of refugees. Lebanon witnessed several outbreaks linked to the presence of significant numbers of Syrian refugees, namely, Hepatitis A virus (HAV). We explore the epidemiology of HAV in Lebanon and the impact of the Syrian war during the 2014 outbreak and suggest solutions to prevent and minimize the HAV spread amid the current socioeconomic conditions. Methods: We reviewed all HAV cases reported to the Epidemiologic Surveillance Unit at the Ministry of Public Health between January 2001 and December 2017. Demographics and distribution of Syrian refugees in Lebanon were linked to reports of new HAV cases. Results: A sharp rise in the number of reported HAV cases was observed in Lebanon in 2013, concurrent with the Syrian crisis and influx of refugees. Most cases reported in 2013 and 2014 involved Syrian refugees and their relevant areas of settlement in the Beqaa and North governorates. Conclusion: The influx of refugees strained overburdened sanitary infrastructure and overstretched existing public health services in Lebanon, which led to an increase in the incidence of reported HAV cases.