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were hospitalized, while others were treated either in home isolation (59.7%) or in institutional isolation (25.9%). Recovery was almost uneventful except one healthcare worker who died. Conclusion Most HCP had mild symptoms and a few of them were asymptomatic also. HCP with mild COVID-19 symptoms may be treated in home or institutional isolation. As they are a vulnerable group for infection, providing adequate protection to HCP is absolutely mandatory to safeguard them from this pandemic.Epidural hematoma is a life-threatening complication of head injury, which often occurs as a result of blunt trauma to the skull. Unregulated hematoma expansion in any setting results in elevated intracranial pressure and may contribute to the compression of the oculomotor nerve among several other adversities culminating in various long-lasting complications in the future. In this case report, we present the findings of a rare, insightful case of a 47-year-old Southeast Asian male with no established prior medical history apart from being a victim of blunt trauma attributable to a fall four days before presenting to the emergency department with abrupt onset of diplopia and drooping of the left eyelid. The initial physical examination helped to establish a diagnosis of third nerve palsy. A non-contrast CT of the head was conducted, and its findings revealed the presence of a right temporal-parietal-occipital epidural hemorrhage, with no mass impact on the cerebral hemisphere. The patient later underwent a successful left temporoparietal craniotomy, during which 100-125 ml of blood was drained out. Post-surgery, a near-full reduction of ptosis was recorded at the end of the first week. This case report summarizes this ingenious depiction of a partial third nerve palsy presenting as the sole sign of the epidural hemorrhage in a cognizant patient.Moyamoya disease (MMD) is an unusual vasculopathy in which the blood vessels of the brain are occluded, resulting in thrombosis. When MMD occurs in association with an underlying pathology, it is known as moyamoya syndrome. The association of moyamoya syndrome with sickle cell disease is uncommon. Herein, we report a case of moyamoya syndrome in a 32-year-old male adult patient.Background Corona virus has become a global health pandemic since its origin in Wuhan, China, in December 2019. The present systematic review and meta-analysis aims to assess gastrointestinal symptoms and liver enzymes trend in corona virus infection. Methods Pooled proportions were calculated using both fixed and random effects model. Weighted mean difference and 95% CI were calculated. Results We included 15 relevant articles in the meta-analysis (n = 3762). #link# The pooled proportion of patients with nausea/vomiting was 7.00% (95% CI = 6.00-8.00) while that of diarrhea was 6.00% (95% CI = 5.00-7.00). Weighted mean difference of aspartate aminotransferase (AST), alanine aminotransferase (ALT) in non-severe COVID-19 patients was higher by 20.54 U/liter (95% CI = 19.95-21.13) and 21.38 U/liter (95% CI = 20.92-21.84) while that in severe patients was higher by 22.70 U/liter (95% CI = 19.09-26.45) and by 22.94 U/liter (95% CI = 20.46-25.42) respectively, as compared to general population. Pooled proportions showed ALT levels to be elevated in 16.00% (95% CI = 14.00-18.00) of patients with non-severe and 25.00% (95% CI = 20.00-31.00) of patients with severe COVID-19. Weighted mean difference of albumin and platelet count was found to be lower by 3.28 g/liter (95% CI = 3.05-3.50) and by 14.21 x 109/liter (95% CI = 11.87-16.55) in non-severe patients and by 11.39 g/liter (95% CI = 10.16-12.63) and 40.70 x 109/liter (95% CI = 33.62-47.77) in severe patients. Conclusions Our meta-analysis shows that patients with COVID-19 infection can present with nausea, vomiting and diarrhea in addition to elevated liver enzymes including AST, ALT and a decline in albumin and platelet count which is more marked in severe disease.Nonmelanoma skin cancer (NMSC) is more prevalent than all the other cancers combined together. The most common regions affected by skin cancer are the head and neck, but there is a large proportion of the cases located on the limbs. They could be bulky, very extensive and/or located in specialized regions like the hands or near to a joint. Most of those cases should be amputated, with several compromises of the function and a negative impact on the patients' quality of life. Isolated limb perfusion is a proven alternative to limb salvage on soft tissue sarcomas, but there are just a few reports about its application on non-melanoma skin cancer. The aim of the article is to describe the outcomes and prove the benefits and effectiveness to avoid limb amputation when using isolated limb perfusion on locally advanced non-melanoma skin cancer. We present clinical, retrospective study as a case series report. The study includes four patients with locally advanced non-melanoma skin cancer in the limb - three cases wEffusive-constrictive pericarditis (ECP) is a rare clinical entity resulting from accumulating pericardial fluid within a stiff, non-compliant pericardium. There are a number of etiologies for ECP, which include malignancy, radiation, post-surgical causes, infectious, and collagen disorders. Clinically, ECP often presents as right-sided heart failure, or in advanced cases, cardiac tamponade. Symptoms may persist despite treatment with pericardiocentesis, and may warrant consideration for pericardiectomy for more definitive management. link2 Invasive hemodynamic evaluation with cardiac catheterization remains the gold standard for diagnosis of ECP; however, echocardiography can provide a definitive diagnosis with high sensitivity and specificity. Echocardiographic features suggestive of ECP include ventricular septal motion abnormalities, such as interdependence, accentuated longitudinal motion of the heart, and altered respirophasic ventricular filling. While these features have been well established and can lead to the diagnosis of ECP, they are rarely observed in clinical practice. We present a case of ECP in a 25-year-old active duty male with a history of chest wall myoepithelial carcinoma who clearly demonstrated such echocardiographic findings of ECP.Background Patients with decompensated cirrhosis present with various complications and are associated with increased inpatients mortality. This study aimed to evaluate the complications and mortality in hospitalised patients with decompensated cirrhosis of liver. Methods This descriptive, cross-sectional, hospital-based study included 754 decompensated cirrhotic patients. The primary endpoints were mortality and hospital stay. The data analysis was done using Statistical Product and Service Solutions (SPSS) version 20 (IBM Corp., Armonk, NY). The chi-square test was used to compare the differences between different predictors of mortality with p less then 0.05 considered significant. Results A total of 754 patients (mean age 54±11.51 years; male/female ratio of 3.61) were studied. Ascites was the most common complication (99.2%) followed by upper gastrointestinal (UGI) bleed (42.3%), hepatic encephalopathy (32.5%), rebleeding (33.2%), spontaneous bacterial peritonitis (26%), and hepatorenal syndrome (19.1%). Inpatient mortality was 19.8%. The most common causes of mortality were rebleeding (21.5%) followed by hepatic encephalopathy (HE) (18.7%), hepatorenal syndrome (HRS) (14.7%), and spontaneous bacterial peritonitis (SBP) (12.1%). The presence of Grades IV HE, the presentation with shock, Child Turcotte Pugh (CTP) C, rebleeding, variceal bleed, HRS, hyponatremia ( less then 130 mEq/L), the requirement of ≥3 units of blood and blood products, co-existence of hepatocellular carcinoma (HCC), and multiple comorbidities and complications in a single patient were strong predictors of mortality (p≤0.05). Conclusions Ascites followed by UGI bleed, hepatic encephalopathy, rebleeding, spontaneous bacterial peritonitis, and hepatorenal syndrome were common complications among the admitted decompensated cirrhotic patients. Inpatient mortality was high. The most common cause of mortality was rebleeding followed by hepatic encephalopathy, HRS, and SBP.Introduction The severe acute respiratory syndrome coronavirus 2 (SARS2-CoV-2) induced pandemic (COVID-19 pandemic) has affected healthcare in all aspects, including stroke care. We sought to investigate this effect with analysis of our hospital's stroke treatment protocols as well as stroke volume on state, regional, and national levels. Methods This was a retrospective review of prospectively collected data from our stroke registry to assess the impact of the SARS2-CoV-2 induced pandemic on the volume of stroke patients presenting to our facility. Demographics collected included age, sex, race, National Institute of Health Stroke Scale (NIHSS) on admission, discharge modified Rankin Score (mRS), type of stroke (ischemic, hemorrhagic, or transient ischemic attack), time of symptom onset, and time to initial imaging. Data were also stratified by date and comparison was made between the intra-COVID-period (March and April 2020), pre-COVID period (March and April 2019), and peri-COVID period (January and Februa20 compared to March and April 2019 (p=0.0111, p=0.0215, and p=0.0414, respectively). Conclusion Stroke care has been disrupted by the COVID-19 pandemic worldwide. We identified a delay in LKWT to door as well as time from door to CT in March 2020 compared to March 2019 at our institution. There was a statistically significant decrease in final diagnosis of TIA at our hospital, all California hospitals, and all West Regional hospitals during the March-April 2020 window, suggesting that some patients with minor stroke symptoms may not be presenting to the hospital in the midst of the pandemic. Strategies to minimize delays in care and maximize functional recovery must continue to evolve as new challenges are met during the COVID-19 pandemic.Bacterial meningitis is a fatal infectious disease with an annual incidence of four to six cases per 100,000 adults. The most common pathogens associated with this condition are Streptococcus pneumoniae, Neisseria meningitides, and Hemophilus influenzae. Mortality rates range between 10 and 40% despite the availability of highly effective antibiotic therapy, and severe neurological damage affects 30-52% of survivors. learn more of death in patients with pneumococcal meningitis are multifactorial and involve both neurological complications such as cerebral edema, hydrocephalus, infarction, and septic sinus or venous thrombosis and systemic complications such as septic shock, disseminated intravascular coagulation, and acute respiratory distress syndrome. We present an unfortunate case of a 42-year-old woman with asplenia and sickle cell disease, admitted for pneumococcal meningitis, who developed diffuse cerebral edema leading to tonsillar herniation and aneurysmal subarachnoid hemorrhage (SAH) with a fatal outcome. To the best of our knowledge, this is the only case ever reported of meningitis complicated by both SAH and brain herniation.Background After surgery for degenerative cervical spine problems, most patients hope to return to non-competitive sports and other leisure activities. Limited data are available to counsel patients about return to play (RTP) in non-competitive sports after cervical surgery. link3 Methods Participants had cervical surgery for degenerative diagnoses from April 1, 2007, to April 1, 2018. Demographic data were collected, and participants were asked to complete a survey regarding sports participation before and after cervical surgery. Results Of the 73 participants who responded to the study, the majority (81.1%) were able to return to one or multiple hobby sports after elective spine surgery. RTP rates at 12 months for golf, tennis, and swimming were 67.6%, 31.2%, and 81.6%, respectively. Younger age and lack of preoperative motor deficit were significant predictors of return to swimming after surgery. After surgery, 54.3% of golfers reported similar or improved levels of play. Conclusions After elective cervical spine surgery, the majority of hobby athletes can expect to return to athletics.