Navigation systems in maxillofacial surgery and neurosurgery and their potential advantages

Operating microscopes, navigation systems and intraoperative neurophysiological monitoring are essential in modern neurosurgical and maxillofacial procedures. Advances in surgical planning in neurosurgery and maxillofacial surgery led to the more common navigation system that helps surgeons know more information and ultimately do more for their patients. The benefits of a contemporary navigation system in the complicated brain, skull-base, maxillofacial and spine surgery are undeniable. Workflow analyses and cost-benefit evaluations must be carried out to increase the efficiency of neuronavigation systems in the next future.

The impact of COVID-19 and the economic crisis on Lebanese public health: Food insecurity and healthcare disintegration.

Background: The economic crisis in Lebanon, a middle-income eastern Mediterranean country, has been threatening the health of the local population. This review will look at the impact of the economic crisis and COVID-19 on health and healthcare in the country, discussing food insecurity and water shortages, and the hospital crisis for what concerns medications, electricity shortages and workforce issues. Methodology: Peer Reviewed Literature produced between 2015 and 2021, indexed in Pubmed, Scopus and Google Scholar was used to compile this short report. News and governmental reports, alongside reports of NGOs like Médicins sans frontières were also collected; these were analysed for the production of this short report. Results: The challenges and public health consequences caused by the economic crisis and the COVID-19 pandemic in Lebanon were identified and commented upon. From food insecurity and water shortages, to the Beirut port explosion and the 2021 lack of fuel and electricity, it was found that the health and well-being of the Lebanese population is currently being threatened from many points of view. With food inflation rates rapidly escalating in 2020 and peaking at 441% in October, new-born and infant milk being non-existent and 20 hour power cuts daily, the situation in Lebanon does not seem to be improving. The country needs to receive international help to relief the population from these synergetic crises. Conclusion: Long-term economic reforms with an emphasis on employment should be at the forefront of the government's priority list. International help should also be provided to prevent disasters like food insecurity and electricity shortages from posing threats to the lives and the wellbeing of the people in Lebanon again.

Periodontal disease and clinical association with COVID-19 infection

SARS-CoV-2 infection can cause long-standing damage to the immune system characterized by increased inflammatory cytokine activation. Maintaining periodontal health may reduce host susceptibility to COVID-19 and prevent COVID-19 aggravation in infected patients. There is sufficient evidence in the literature to warrant an association between the presence of PDs and the development and course of respiratory illnesses. Optimum oral health, maintaining good systemic health, and elimination of smoking habits may be beneficial for the prevention and management of COVID-19 infections. Future studies on the periodontal status of patients with COVID-19, including from mild to severe forms, could allow the opportune identification of people at risk of severe illness and generate relevant recommendations. The connection, if any, between the oral microbiome and COVID-19 complications is urgently required to establish the importance of oral hygiene and pre-existing oral disease in the severity and mortality risk of COVID-19.

Syncope as the initial presentation of pulmonary embolism in a patient with asymptomatic COVID-19: a case report

Syncope is a common clinical presentation, often may remain unexplained. PE is thought to be an uncommon cause of syncope. Hormone therapy (HT) is a known risk factor for thromboembolic disease (TD). The new coronavirus SARS-CoV-2 (COVID-19)pandemic has emerged in China and spread around the world. A higher prevalence of PE has been described in critically ventilated patients with COVID-19 but few data exist on the prevalence of TD in asymptomatic patients. We present a case of insidious development of PE probably promoted by the COVID19 infection. A previously healthy 51 year old female, obese (BMI 34 kg/m2), was admitted to the emergency department for syncope (third generation assays negative for Covid19). She reported HT for 4 months. She was tachypnoic (22 breaths/min), peripheral oxygen (SpO2) was 94% (room air). EKG: sinus tachycardia (137 beats/min) with S1Q3T3 aspect;arterial blood gases: moderate hypoxemia (PaO2 61.2 mmHg). ETT: dilated and hypocontractile right ventricle, D-shape aspect of the IVS, dilated inferior vena cava (23 mm), estimated PAP65 mmHg. We administered parenteral anticoagulant therapy and O2 therapy. We suspected PE, which was confirmed by contrast chest CT;no lung parenchymal involvement was documented.Later, we found RT-PCR assays positive for Covid19. PE should be suspected in all patients with syncope. The prevalence of TD in Covid19 asymptomatic patients is partially studied. Although current guidelines do not recommend the use of thromboprophylaxis in outpatient COVID-19, we believe that each case must be evaluated individually. More studies are needed to evaluate the risk-benefit ratio.