Reviews, Research Articles, and Cases

Welcome back to the second issue of Volume 16. This issue includes three reviews, two original articles, and two case reports.

The review by Rajkapoor Balasubramanian et al provides an overview of tendinopathy, peripheral neuropathy, aortic aneurysm, and hypoglycemia caused by fluoroquinolones. The authors examined the serious side effects of this class of drugs. Fluoroquinolones are widely used to treat urinary tract infections and upper respiratory infections. Physicians and patients are familiar with the common side effects, such as nausea and vomiting. However, serious side effects are less known but more dangerous. In their review, as mentioned in the title, tendinitis and tendon rupture are among the side effects that have been reported, especially for people over the age of 60. Peripheral neuropathy and nerve damage are also known to be among the severe side effects. The side effects may be in different nerve locations, and the pathogenesis is unknown. Several other serious side effects, such as hypoglycemia, aortic aneurysm, and retinal detachment, have been reviewed in this article. The physician needs to be aware of the consequences and be ready to stop the medical when suspecting the appearance of side effects.

Angeliki Mina et al present a narrative, nonsystematic review of the challenges and solutions concerning fertility and pregnancy after bariatric surgery. Obesity has become a common disorder internationally. The review discusses the issue of bariatric surgery and fertility. They concluded that bariatric surgery enhances pregnancy. However, bariatric surgery may result in certain metabolic deficiencies that need attention during pregnancy. There is no clear optimal pregnancy timing following bariatric surgery.

The last review is a synoptic review of the global re-emergence of monkeypox. Monkeypox is primarily found in Central and West African countries, particularly in remote regions where there is close contact between humans and infected animals, such as rodents and monkeys. The virus can be transmitted to humans through direct contact with infected animals, contaminated meat consumption, or respiratory droplets from infected individuals. In this review, Memariani et al concluded that the new spread of this viral illness is of major concern and that preventive measures are the most important steps to halt the spread.

We included two original articles in the issue: The first by Jamal Qaddumi et al on the effect of the National Early Warning Scoring System (NEWS2) implementation on identifying the risk of clinical deterioration and outcomes among coronavirus disease 2019 hospitalized patients. The system is a general tool that aims to identify patients at risk of deterioration. However, it does not provide specific diagnoses or determine the underlying cause of a patient's deterioration. The authors studied nearly 400 patients in their healthcare system and concluded that the validation of the NEWS2 system predicted the decline of patients with high scores. The next original article is a knowledge, attitudes and practices (KAP) analysis of obstetric doctors toward gestational diabetes (GDM) in Benghazi, Libya (Mohamed et al). GDM affects approximately 2 to 10% of pregnant women, usually occurring in the second or third trimester when hormonal changes can interfere with insulin function. The condition is usually temporary and resolves after delivery. However, women with GDM have a higher risk of developing type 2 diabetes in the future. The authors reviewed their center's experience with GDM. They examined their physicians' attitudes and knowledge about GDM by a cross-sectional descriptive study; surprisingly, only 38.2% of respondents correctly defined GDM.

Two case reports/case series are presented in this issue. First, Abdul Rasak Aravessery reminds us to expect the unexpected by reporting schistosomal appendicitis in a nonendemic area. Schistosomiasis is a parasitic infection caused by several species of flatworms. The infection is commonly acquired through contact with contaminated freshwater where infected snails release the parasite's larvae. While schistosomiasis primarily affects the liver and intestines, it can lead to complications involving other organs, including the appendix. In rare cases, the schistosome eggs can migrate to the appendix and rarely may cause acute appendicitis. The authors report a case of a 37-year-old male who presented with the clinical picture of acute appendicitis and was treated with laparoscopic appendectomy. The pathology report showed the presence of bilharzia in the specimen. Second, Etatrhuni et al reported a case series of congenital myopathy-1B due to Ryr 1 gene mutation in three Libyan families. Congenital myopathy-1B (CMYP1B) is a specific subtype of congenital myopathy, a group of genetic muscle disorders present from birth. Congenital myopathies are characterized by muscle weakness and low muscle tone (hypotonia) that typically manifest in infancy or early childhood. Their case report discussed CMYP1B, which refers to a subtype of congenital myopathy caused by mutations in the gene encoding skeletal muscle to Ryr 1 gene mutation. The symptoms of CMYP1B can vary widely, even among affected individuals within the same family. Common features may include muscle weakness, hypotonia, delayed motor milestones (such as sitting, standing, and walking), and respiratory difficulties. Genetic testing helps identify mutations in the Ryr 1 gene, confirming the diagnosis. The RYR1 gene provides instructions for producing the ryanodine receptor 1 protein, which is primarily found in skeletal muscle cells. In one case, they reported a unique presentation of hypertonia that has not been reported in the past. Currently, there is no cure for CMYP1B, but early counseling is very important. Certain RYR1 mutations can predispose individuals to malignant hyperthermia (MH), a potentially life-threatening reaction to certain anesthetics. A rapid rise in body temperature, muscle rigidity, and metabolic disturbances characterizes MH.

We hope the bouquet of articles of different types will interest our readers.

Conflict of Interest

None declared.

Compliance with Ethical Principles

Not applicable.

Authorship

Single author.

Publication History

Article published online:
06 June 2024