COVID-19 and liver diseases, what we know so far.

Coronavirus disease 2019 (COVID-19) pneumonia outbreak started in December 2019. On March 12, 2020, the World Health Organization (WHO) declared that the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) constitutes a pandemic, and as of May 2021, SARS-CoV-2 has infected over 167.3 million patients, including 3.4 million deaths, reported to WHO. In this review, we will focus on the relationship between SARS-CoV-2 infection and the liver. We will discuss how chronic liver diseases affect the COVID-19 disease course and outcomes. We will also discuss the SARS-CoV-2 effects on the liver, mechanisms of acute liver injury, and potential management plans.

Belly Dancer's Dyskinesia: A Rare Condition.

Belly dancer's dyskinesia or diaphragmatic flutter (DF) is a rare condition characterized by repetitive involuntary contractions of the diaphragm. Also known as diaphragmatic myoclonus (DM), this disorder can manifest with involuntary movement of the abdominal wall and contraction of accessory respiratory muscles or respiratory myoclonus. Because of its variable presentation, diagnosis can often be difficult and delayed. This phenomenon is thought to be secondary to abnormal excitation of the phrenic nerve, via the central nervous system or along the nerve.Another possible mechanism is the irritation of the diaphragm itself. Diagnosis can be made with ultrasound, thoracic videofluoroscopy, or electromyography (EMG). Different pharmacologic and surgical therapies have been used in the past, but overall, there are no specific guidelines regarding treatment. In this report, we present a case of DF in a young female patient.

Balloon Retrograde Transvenous Obliteration for Treatment of Persistent Gastric Variceal Bleed in Patient With Hepatocellular Carcinoma.

Gastric varices are often associated with formation of spontaneous portosystemic shunts that arise to relieve portal hypertension. Balloon retrograde transvenous obliteration (BRTO) is a procedure indicated to prevent recurrent gastric variceal bleeding. Its advantage is diverting blood flow towards the liver, but this can also worsen portal pressure and increase risk for ascites or esophageal variceal bleeding. Patients with gastric varices and concomitant hepatocellular carcinoma (HCC) usually have more advanced cirrhosis and lower possibility of treatment of HCC. BRTO is thought to preserve hepatic function from increased blood flow, possibly allowing better chances of treatment and survival in these patients.