Prevalence and Clinical Characteristics of Sleeping Paralysis: A Systematic Review and Meta-Analysis.

Sleep paralysis (SP) is a mixed state of consciousness and sleep, combining features of rapid eye movement (REM) sleep with those of wakefulness. The exact cause of SP is unknown, and its prevalence varies among the studies. We aim to identify SP's global prevalence, the affected population's characteristics, and the SP's clinical picture. We searched three databases (PubMed, Scopus, and Web of Science (WoS)) using a unique search strategy to identify eligible studies. All observational studies identifying the prevalence or frequency of sleeping paralysis were included. No exclusions are made based on country, race, or questionnaire. The analysis was performed using the latest version of R software (R Core Team, Vienna, Austria). The analysis included 76 studies from 25 countries with 167,133 participants. The global prevalence of SP was 30% (95% CI (22%, 39%)). There were similar frequencies of isolated SP and SP (33%, 95% CI (26%, 42%), I2 = 97%, P <0.01; 31%, 95% CI (21%, 43%), I2 = 100%, P = 0, respectively). A subgroup analysis showed that the majority of those who experienced SP were psychiatric patients (35%, 95% CI (20%, 55%), I2 = 96%, P <0.01). The prevalence among non-psychiatric patients was among students (34%, 95% CI (23%, 47%), I2 = 100%, P = 0). Auditory and visual hallucinations were reported in 24.25% of patients. Around 4% had only visual hallucinations. Meta-regression showed no association between the frequency of SP and sex. Publication bias was detected among the included studies through visual inspection of funnel plot asymmetry. Our findings revealed that 30% of the population suffered from SP, especially psychiatric patients and students. The majority of SP cases lacked associated hallucinations, while a noteworthy proportion experienced combined visual and auditory hallucinations.

Incidental Prenatal Diagnosis of Congenital Inguinal Hernia: A Case Report.

Prenatal congenital inguinal hernia is a rare condition, with limited cases reported in the literature. Accurate prenatal diagnosis is crucial for appropriate management and outcomes. We report a case of a 44-year-old woman at 36 weeks of gestation with well-controlled gestational diabetes diagnosed with prenatal congenital inguinal hernia. The patient's antenatal history included abnormal first-trimester screening tests for Down syndrome, but subsequent amniocentesis revealed no chromosomal abnormalities. Ultrasonography at 36 weeks showed an enlarged right scrotum with heterogeneous consistency and visible bowel peristaltic waves without signs of bowel obstruction, strangulation, or incarceration. At 39 weeks, oligohydramnios was diagnosed, leading to a decision for labor induction. However, the patient underwent a cesarean section upon her desire, giving birth to a male infant with congenital inguinal hernia. Both mother and child had a normal six-month postpartum follow-up. This case underscores the significance of detailed third-trimester ultrasonography in diagnosing prenatal congenital inguinal hernia. Early detection allows for better planning and management, highlighting the value of routine prenatal assessments for fetal organ status and early identification of malformations.

A Huge Hemangioma of the Urinary Bladder: A Case Report and Literature Review.

Cavernous hemangioma of the bladder is a benign and very rare vascular tumor. It can be isolated or part of a syndrome. Neither clinical symptoms nor imaging modalities lead to a definitive diagnosis as there are no specific findings on imaging studies or specific symptoms. Painless gross hematuria is the most common chief complaint and presentation and should never be underestimated. Here, we report a case of a large hemangioma of the urinary bladder in a young man who presented with recurrent recent episodes of painless gross hematuria and, surprisingly, with a previous episode of painless hematuria 15 years ago, which was treated successfully with partial cystectomy. We discuss the clinical features, evaluation, diagnosis, biopsy, management, the challenges encountered in treatment, and assert the value of tissue diagnosis and follow-up pattern and period. Due to the rarity of the tumor and lack of trials and evidence-based guidelines for management, treatment modalities vary and the risk for recurrence is questionable and not known.

Energy drinks and waterpipe smoking associated with disordered eating habits among male Palestinian refugees.

This cross-sectional study highlights the concerning relationship between stimulants, alcohol use, and weight-related problems among Palestinian refugee men in the West Bank. Self-administered questionnaires were used to gather data on stimulants and alcohol use and eating attitudes and behaviors (EAT-26). The findings revealed that many refugee men were daily cigarette (61.4%) and waterpipe smokers (15.5%), while 30.6% and 2.3% were daily energy drink and alcohol users, respectively. Moreover, most refugee men (67.3%) were obese, and 23.5% were terrified about being obese. They had disordered eating habits, including the impulse to vomit after meals (63.3%). Moreover, 30.7% scored ≥20 using EAT-26 scale, and 44.4% scored at least one positive behavior, including binge eating (40.4%), purging (10.0%), using laxatives or diet pills (8.3%), excessive exercise (30.9%), and losing weight (24.6%). The results of the adjusted binary logistic regression indicated that risk factors associated with self-induced vomiting were daily (OR = 2.71, p-value = 0.004) and weekly energy drink intake (OR = 2.41, p-value = 0.023), weekly alcohol intake (OR = 10.83, p-value = 0.036), and obesity (OR = 2.57, p-value = 0.002), while inversely associated with weekly waterpipe smoking (OR = 0.297, p-value = 0.007). Obesity was inversely associated with daily (OR = 0.146, p-value < 0.01) and weekly waterpipe smoking (OR = 0.259, p-value = 0.002), and weekly cigarette smoking (OR = 0.251, p-value < 0.01). The study underscores the urgent need for community awareness, professional evaluation, and treatment for obesity and disordered eating habits among Palestinian refugee men. It is essential to address the detrimental effects of alcohol and energy drink intake and tobacco smoking to improve the health outcomes of this vulnerable population.

Basic Life Support (BLS) Knowledge Among General Population; a Multinational Study in Nine Arab Countries.

Introduction: Basic Life Support (BLS) is a medical treatment used in life-threatening emergencies until the sufferer can be properly cared for by a team of paramedics or in a hospital. This study aimed to assess the level of knowledge regarding BLS and the contributing factors among the Arab non-medical population. Methods: An online survey-based cross-sectional study was conducted among non-medical populations in nine Arab countries between April 13, 2022, and June 30, 2022. The utilized questionnaire consisted of two parts: part one included socio-demographic characteristics and part two measured knowledge of BLS through an online survey. Results: The research included a total of 4465 participants. 2540 (56.89%) of the participants were knowledgeable about BLS. The mean basic life support knowledge scores of participants who received training were higher than those who had not (20.11 ± 4.20 vs. 16.96 ± 5.27; p< 0.01). According to the nations, Yemen scored the highest, while Morocco had the lowest levels of BLS knowledge (19.86 ± 4.71 vs. 14.15 ± 5.10, respectively; p< 0.01). Additionally, individuals who resided in urban areas scored on average higher than those who did in rural areas (17.86 ± 5.19 vs. 17.13 ± 5.24, p= 0.032) in understanding basic life support. Age, information sources, and previous training with theoretical and practical classes were significant predictors of BLS knowledge. Conclusion: The level of BLS knowledge among non-medical people in Arab nations is moderate but insufficient to handle the urgent crises that we face everywhere. In addition to physicians being required to learn the BLS principles, non-medical people should also be knowledgeable of the necessary actions to take in emergency events.

Myocarditis Following COVID-19 Vaccination: A Systematic Review.

COVID-19 vaccination has significantly reduced both the morbidity and mortality rates associated with SARS-CoV-2 infection. Vaccines, especially mRNA vaccines, have been proposed in several studies to complicate viral myocarditis. Thus, our systematic and meta-analysis review aims to further investigate the possibility of an association between COVID-19 vaccines and myocarditis. We systematically searched PubMed, Web of Science, Scopus, Ovid, and Google Scholar and did a gray search of other databases using the following keywords and terms: "Myocarditis ("Myocarditis" Mesh) OR "Chagas Cardiomyopathy" Mesh) AND "COVID-19 Vaccines" Mesh. The studies were limited to only English articles that reported myocardial inflammation or myocarditis associated with COVID-19 vaccines. Pooled risk ratio with its 95% confidence interval was analyzed by RevMan software (5.4) to perform the meta-analysis. Our study included 671 patients from 44 studies with a mean age of 14-40 years. Nevertheless, myocarditis was noted in a mean of (3.227) days, and 4.19 per million vaccination recipients experienced myocarditis. Most cases were clinically presented with manifestations of cough, chest pain, and fever. Laboratory tests revealed increased C-reactive protein, and troponin with all other cardiac markers in most patients. Cardiac magnetic resonance imaging (MRI) revealed late gadolinium enhancement with myocardial edema and cardiomegaly. Also, electrocardiograms revealed ST-segment elevation in most patients. Furthermore, the incidence of myocarditis was statistically significantly lower in the COVID-19 vaccine group as compared with the control group (RR = 0.15, 95% CI = 0.10-0.23, p-value < 0.00001). No significant association was found between COVID-19 vaccines and the incidence of myocarditis. The study's findings highlight the importance of implementing evidence-based COVID-19 prevention strategies, such as vaccination, to reduce the public health impact of COVID-19 and its associated complications.

Pyeloplasty for a Child With a Retrocaval Ureter: A Case Report.

Retrocaval ureter, also known as a circumcaval ureter or pre-ureteral vena cava, is a rare entity in which the patient's ureter passes backward to the inferior vena cava (IVC). The IVC compresses the upper portion of the ureter resulting in varying degrees of hydroureteronephrosis. We report a case of a child with retrocaval ureter malformation that was incidentally diagnosed while investigating for intermittent right renal colic, which was successfully treated by subcostal pyeloplasty. This case highlights the importance of radiographic imaging to diagnose retrocaval ureter, with computed tomography as a definitive method, but other modalities, including magnetic resonance imaging, ultrasound, and pyelography, are also helpful.

A Review of Diagnosis and Management: Persistent Cloaca Treated by a Posterior Sagittal Approach With a Normal Functional Outcome.

Cloacal malformation (CM) is a severe, complex, and extremely rare category of anorectal and urogenital tract malformations. Prenatal diagnosis is illusory and vague; therefore, magnetic resonance imaging (MRI) is the most effective test point toward an accurate diagnosis. Thus, careful investigation and evaluation are mandatory since they could be associated with syndromes and other anomalies, including urogenital tract, vertebral, and cord abnormalities. Despite the severity and complexity of the deformity, CM cases are curable, not desperate, and can have an excellent prognosis with great surgical correction. However, managing persistent cloaca necessitates a careful assessment because corrective surgeries require inclusive surgical planning, multidisciplinary, expert, and highly specialized medical center. In surgically repaired malformations, fecal and urinary incontinence has been a major issue, which was resolved when Dr. Pena Alberto suggested safer dissection and less harmful techniques for neurovascular structures and great functional corrected anomaly to ensure fertility and less incontinence. For improved results and prognosis on quality of life, patients should be scheduled for extended bowel training along with the clinical evaluation follow-up. In this article, we present a case successfully treated with the posterior sagittal approach, Pena operation, and anorecto-vagino-urethroplasty with feminizing clitoroplasty and highlight the value and impact of prenatal evaluation, diagnosis, and management. The rarity of the case and excellent results, including fair to normal bowel and urinary control, prompted us to report it and assert the significance of assessment, surgical management and technique, challenges, postoperative bowel training, and clinical investigation and examination.