Le Journal médical libanais. The Lebanese medical journal
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Abdominal apoplexy, the spontaneous hemorrhage into the peritoneal cavity, is usually caused by a rupture of visceral vessels such as short gastric arteries. Several factors such as pregnancy, hypertension and atherosclerosis have been described in association with abdominal apoplexy. ⋯ The patient was treated with blood transfusion, fluids resuscitation, laparotomy, and suture ligation of the bleeder vessel. We also review the medical literature of abdominal apoplexy, a rare etiology of acute abdomen that should be recognized early in the Emergency Department.
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The number of cancer patients in Lebanon is increasing, and patients are living longer due to early detection and enhanced methods of treatment. The purpose of this study was to evaluate the quality of life, symptom management, functional ability, and the quality of palliative care in adult Lebanese cancer patients at the American University of Beirut-Medical Center. A cross sectional survey design was used. ⋯ Inadequate symptom management was reported especially for the psychological symptoms. Participants reported a satisfactory level with the quality of care. Based on these results, providing adequate symptom management and social support to Lebanese cancer patients is highly recommended.
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To measure the magnitude of use of so-called "herbal medications" with or without prescribed drugs and to assess the benefits and adverse effects perceived by herbal users in the Greater Beirut area. ⋯ There is a relatively high prevalence of herbal medicine use in Greater Beirut, with an important rate of self-reported adverse effects, especially among those who suffer chronic conditions, and little exchange of information on this between patients and doctors. Data indicate the need to educate patients about realities associated with abusive use, expected benefits and potential drug-herb interaction. Patients on chronic medications should not be left to actually experience adverse effects in order to discover that herbal medicines are not always effective or innocuous.
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Randomized Controlled Trial
General anaesthesia combined with bilateral paravertebral blockade (T11-T12-L1) vs general anaesthesia for bilateral varicocelectomy. A randomized double-blind clinical trial.
Varicocelectomy is a common operation in urology associated with considerable postoperative pain. The aim of this prospective, randomized, double-blind study was to investigate whether a combination of general anesthesia and bilateral nerve stimulator guided paravertebral nerve blocks could provide better postoperative pain relief compared to general anesthesia in combination with placebo paravertebral nerve block. ⋯ Preoperative paravertebral blockade combined with general anesthesia showed significantly reduced postoperative pain scores and analgesic consumption, earlier return to normal activity and was associated with better patient and surgeon satisfaction during varicocelectomy surgery.
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End-of-life care is an important aspect of medical practice. Individual physicians and the medical community must be committed to the compassionate and competent provision of care to dying patients and their families. Patients rightfully expect their physicians to care for them and provide them with medical assistance as they are dying. ⋯ Care of patients near the end of life, however, has a moral, psychological, and interpersonal intensity that distinguishes it from most other clinical encounters. With appropriate education, physicians can play a key role to improve care for patients and families who are living with advanced life-threatening illness. Although some issues (e.g., the role of physician-assisted death in addressing suffering) remain very controversial, there is much common ground based on the application of the four major principles of medical ethics, nonmaleficence, beneficence, autonomy, and justice.