Panorama of Emergency Medicine
type: channel
description: Panorama of Emergency Medicine PoEM is an international peer-reviewed independent journal dedicated to advancing knowledge and practice in emergency medicine.
publisher: New Health Concept
language: en
publication name: Panorama of Emergency Medicine
issn: 3006-0966
items: Seroprevalence of the General Lebanese Population to COVID-19 Between 2023 and 2024
items: Rethinking Anticoagulation in Kidney Disease and Kidney Transplantation
items: Beyond the Checklist: A Scaffolded, Experiential Learning Framework for Medical Rescue Simulation (Part 1 of 2)
items: Emergency Staff Perceptions of Mass Casualty Management Effectiveness in Lebanese Hospitals: A Cross-Sectional Study
items: The Burden of Road Traffic Injuries: A Global Perspective
items: Knowledge and Stigma Regarding HIV and Homosexuality: An Exploratory Survey of Responding Physicians in Lebanon
items: A Near-Fatal Anaphylactic Reaction to Biliary Contrast: A Cautionary Case During Laparoscopic Cholecystectomy
items: Suggestions for the Study of Ethics of Simulation in Healthcare
items: The Assessment of Lebanese Hospital Nurses’ Qualifications in The Fight Against COVID-19: Are They Well Prepared?
items: The Digital Stethoscope: Harnessing Artificial Intelligence in Pediatric Emergency Medicine
items: Proceedings of the Qatar Paediatric Emergency Medicine 2026 Conference - Selected Abstracts
items: Literature review of the use of simulation for the training of paramedics in relation to caring for pediatric patients
items: Diagnostic accuracy of ultrasound findings for distinguishing complicated appendicitis from simple appendicitis in pediatric patients: A systematic review and meta-analysis
items: Development and Implementation of a Prehospital Paediatric Sepsis Screening Tool: Enhancing Early Recognition, Resuscitation, and Referral
items: Impact of Interprofessional Simulation-Based Training on Enhancing Non-Technical Skills and Team Readiness in Pediatric Resuscitation
items: Enhancing Paediatric & Adult Resuscitation Performance Through Flowchart Driven Targeted Training in the Critical First Five Minutes
items: Risk Factors of Peri-intubation Cardiac Arrest in Critically Ill Pediatric Patients Presenting to the Emergency Department of a Low-Middle-Income Country: A Case-Control Study
items: The Emergence of Excellence: Proposing the Paediatric Transport Reflective Improvement and Simulation-based Education (PaeTRISE) Framework for the Western Cape, South Africa
items: Reversal of Bradycardia through Nutritional Rehabilitation in Paediatric Anorexia Nervosa: A Retrospective Study from Qatar
items: Non-invasive positive pressure ventilation for acute asthma in children: Very uncertain results
items: Therapeutic hypothermia may improve neurological outcome of cardiac arrest in adults
items: All for one and one for all: Scaling mountains for a good cause. SDG 4: quality education awareness campaign
items: Unilateral optic disc swelling: an atypical presentation for a large frontal meningioma
items: Peritoneal carcinomatosis presenting as a mimic for DVT
items: Elderly patient with late diagnosed metastatic bone lytic lesions
items: The Killer Wound; Early Diagnosis and Management of Necrotizing Fasciitis Utilizing Point-of-Care Ultrasound: A Case Repor
items: Assessment of Relatives’ Satisfaction in the Emergency Department
items: Admission Criteria and Successful Care of Adults in a Tertiary Care Pediatric Hospital During the COVID-19 Pandemic
items: Adherence to Screening Recommendations for Diabetic Nephropathy in Lebanese Patients With Diabetes
items: Spinal Rosai-Dorfman Disease with Isolated Severe Neuropathic Pain: A Case Report

Seroprevalence of the General Lebanese Population to COVID-19 Between 2023 and 2024
type: item
description: Background Understanding population immunity to SARS-CoV-2 is crucial for public health planning, especially Lebanon where unique healthcare challenges exist. This study aimed to assess the seroprevalence of SARS-CoV-2 antibodies and identify predictors of serostatus in a sample of the Lebanese population in 2023. Methods We conducted an observational study of 350 adult patients presenting to two emergency departments in Lebanon. Participants were tested using a ZEKMED COVID-19 IgG/IgM rapid test, a qualitative rapid SARS-CoV-2 anti-E antibody kit. A comprehensive statistical analysis including logistic regression, Bayesian modeling, and a Random Forest classifier was performed to identify predictors of IgG seropositivity. Results Our results showed high IgG seroprevalence of 95.1% (n=333), suggesting prevalent natural infection. While vaccination status and self-reported prior infection were not significant predictors of serostatus in standard analyses, both Bayesian and Random Forest models identified increased age as a potential predictor associated with a negative IgG antibody response (94% HDI: [-1.531, -0.000]; importance score: 0.61). Conclusion Our findings indicate high exposure to natural SARS-CoV-2 infection in this Lebanese cohort. However, the association of advanced age with a negative antibody response suggests that older populations may remain more vulnerable. This highlights the need for continued targeted public health surveillance and strategies despite high overall seroprevalence from past infections. Introduction Covid-19 infection is a recent pandemic, known to cause severe respiratory illness. Since the Coronavirus Infectious Disease 19 (COVID-19) pandemic hit, vaccination, infection control and immunity became a major interest for healthcare [1]. People were infected in groups, sometimes whole communities, which while overwhelming, contributed to population-level seroprevalence after resolution [2]. However, not everyone had the same COVID-19…
subject: Original Article
  topic: section
subject: Core discipline & systems
  topic: category
subject: Disaster & Crisis Management
  topic: category
subject: Public Health Emergencies
  topic: category
subject: Covid-19
  topic: keywords
subject: IgG
  topic: keywords
subject: Antibodies
  topic: keywords
subject: Anti-E
  topic: keywords
subject: Immunity
  topic: keywords
creator: Hilal Abdessamad
creator: Elsy Jabbour
creator: Danielle Abou Khater
creator: Mariana Helou
rights: Copyright (c) 2026 Hilal Abdessamad, Elsy Jabbour, Danielle Abou Khater, Mariana Helou (Author) https://creativecommons.org/licenses/by/4.0
date: 2026-05-01
publication date: 2026-05-01
doi: 10.26738/poem.v4i1.7

Rethinking Anticoagulation in Kidney Disease and Kidney Transplantation
type: item
description: Background A clinical dilemma exists in patients with CKD, ESKD, and after kidney transplantation, as they face concurrent risks of both thromboembolic and hemorrhagic complications. Objective To review the literature on anticoagulant treatments in CKD, hemodialysis, and transplantation, with particular emphasis on pharmacology, safety, and clinical implementation. Methods Narrative review of scientific articles from PubMed, EMBASE, and Cochrane databases up to July 2025 inclusive using predefined search strategy. Observational studies, randomized trials, and major guidelines (KDIGO, AHA/ACC, ESC) were included. Results Despite its widespread use, warfarin has the disadvantage of bleeding and vascular calcification. Apixaban has the best data available among DOACs for use in CKD stage 5. The use of UFH is preferred in dialysis patients due to its reversibility properties. Other new drugs like factor XI inhibitors and LAAO are also very promising. Conclusion Anticoagulant therapy in patients with renal diseases needs personal risk assessment, proper selection of medications, and good management, especially during emergencies. Introduction An intriguing hemostatic paradox exists in patients with CKD: both thrombotic and hemorrhagic complications arise from uremic changes affecting platelet function, coagulation pathways, endothelial cells, and vascular calcification [1–3]. This challenge is further magnified among ESKD patients on dialysis and in those receiving kidney transplantations, where additional variables — including extracorporeal circuits, perioperative stress, altered pharmacokinetics, and extensive drug-drug interactions attributable to immunosuppressant medications — complicate anticoagulation management [2, 3]. Within this context, this review critically analyzes the current literature on anticoagulation therapy in patients with CKD, on dialysis, and after kidney transplantation. This topic is clinically significant due to the increasing incidence of chr…
subject: Narrative Review
  topic: section
subject: Emergency Medicine
  topic: category
subject: Anticoagulants, Warfarin, Chronic Renal Insufficiency, Renal Dialysis, Kidney Transplantation
  topic: keywords
creator: Antoine Zgheib
rights: Copyright (c) 2026 Dr. Antoine J. Zgheib (Author) https://creativecommons.org/licenses/by/4.0
date: 2026-05-20
publication date: 2026-05-20
doi: 10.26738/poem.v4i1.12

Beyond the Checklist: A Scaffolded, Experiential Learning Framework for Medical Rescue Simulation (Part 1 of 2)
type: item
description: The effective training of Technical Rescue Specialists (TRS) for high-stakes dynamic environments requires a sophisticated pedagogical approach. This article introduces a comprehensive framework for Simulation-based Education (SBE) designed to elevate Medical Rescue Simulation (MRS). The framework is built upon four interconnected pillars: Foundational Learning Theory, Systematic Skill Scaffolding, Integrated Physical Preparedness, and Stringent Safety Protocols. This article will concentrate specifically on Kolb's learning cycles and the principles of scaffolding. Grounded in Kolb's Experiential Learning Cycle, the framework ensures that learning moves beyond rote memorisation to foster deep understanding and adaptive expertise. The core pedagogical strategy involves scaffolding complex medical rescue procedures, by deconstructing them into isolated, manageable skills. Students’ progress through scenarios of increasing fidelity and complexity, from low-fidelity drills and Visually Enhanced Mental Rescue Simulations (VEMRS) to immersive, high-fidelity exercises, that mirror real-world pressures. This structured progression manages cognitive load, and is designed to cultivate the "emergence" of proficient practice by ensuring foundational competencies are robustly established, thereby preventing the "absence" of critical skills in high-stakes situations. Introduction The effective training of Technical Rescue Specialists (TRS) within higher education institutions, particularly in the demanding and high-stakes context of medical rescue operations, requires a pedagogically sound and integrated approach. These environments are characterised by dynamic, unpredictable scenarios that demand not only technical proficiency but also rapid decision-making, physical endurance, and cohesive teamwork [1]. In response to these challenges, Simulation-based Education (SBE) has emerged as a cornerstone methodology, offering a controlled yet realistic platform for the development of c…
subject: Original Article
  topic: section
subject: Core discipline & systems
  topic: category
subject: Emergency Medicine
  topic: category
subject: Rescue
  topic: keywords
subject: Simulation-based Education
  topic: keywords
subject: Kolb’s Cycle
  topic: keywords
subject: Experiential Learning
  topic: keywords
subject: High Angle
  topic: keywords
subject: Medical Rescue Simulation
  topic: keywords
subject: Scaffolding
  topic: keywords
subject: Technical Rescue Specialist
  topic: keywords
subject: Visually Enhanced Mental Rescue Simulation
  topic: keywords
creator: Athenkosi Sobada
creator: John Meyer
creator: Elroy Cameron
creator: Glenhael Carolus
rights: Copyright (c) 2026 Athenkosi Sobada, John Meyer, Elroy Cameron, Glenhael Carolus (Author) https://creativecommons.org/licenses/by/4.0
date: 2026-04-19
publication date: 2026-04-19
doi: 10.26738/poem.v4i1.3

Emergency Staff Perceptions of Mass Casualty Management Effectiveness in Lebanese Hospitals: A Cross-Sectional Study
type: item
description: Introduction Mass Casualty Incidents (MCIs) present significant challenges to hospitals, often overwhelming available resources and requiring rapid, coordinated responses. Effective casualty management plans are essential to ensure optimal patient care during such crises. Key components include staff training, interdepartmental communication, resource allocation, psychological support, and post-disaster evaluation. Objective This study aimed to evaluate the perceived effectiveness of disaster management plans in Lebanese hospitals from the perspective of emergency staff responsible for implementing Mass Casualty Management (MCM) plans. Materials and Methods A cross-sectional quantitative study was conducted with 71 emergency staff members, including chiefs and personnel directly involved in MCM, from 12 public and private hospitals across Lebanon. Data were collected via a structured questionnaire covering demographics, overall plan effectiveness, specific plan components (triage, communication, coordination, resource allocation), and open-ended suggestions. Results Significant positive correlations were observed between staff training and perceived plan effectiveness (r = 0.528, p < 0.01), perceived triage efficiency and the staff’s perception of reduced mortality and morbidity (r = 0.505, p < 0.01), resource allocation and perceived plan effectiveness (r = 0.572, p < 0.01), communication and team coordination (r = 0.481, p < 0.01), and psychological support and staff satisfaction (r = 0.541, p < 0.01). Conclusion Emergency staff perceive continuous training, effective communication, optimized resource allocation, and psychological support as critical to improving the effectiveness of MCM plans. Hospitals should adopt an integrated approach that combines these elements with systematic post-disaster evaluation to strengthen preparedness, staff resilience, and patient care during mass casualty incidents. Introduction Context Lebanon has faced repeated crises in recen…
subject: Original Article
  topic: section
subject: Disaster Medicine
  topic: category
subject: Disaster & Crisis Management
  topic: category
subject: Mass Casualty Management
  topic: keywords
subject: Emergency Staff Perceptions
  topic: keywords
subject: Hospital Preparedness
  topic: keywords
subject: Psychological Support
  topic: keywords
subject: Resource Allocation
  topic: keywords
creator: Eliana Ghazal
creator: Dunya Nohra
creator: Hilda Chelala
creator: Maha Nehme
rights: Copyright (c) 2026 Eliana Ghazal, Dunya Nohra, Hilda Chelala, Maha Nehme (Author) https://creativecommons.org/licenses/by/4.0
date: 2026-05-16
publication date: 2026-05-16
doi: 10.26738/poem.v4i1.10

The Burden of Road Traffic Injuries: A Global Perspective
type: item
description: Introduction Road Traffic Injury (RTI) pose a significant health challenge. It represents the eighth leading cause of death globally, prompting the UN to designate 2011-2020 as the “Decade of Action for Road Safety”. This study aims to determine the global and regional burden of RTIs, and the impact of drink-driving and seatbelt-wearing on RTIs in 2017, while also assessing the UN Action Plan outcomes and forecasting the RTI rate for 2029. Methods Data on the global and regional RTI rates (2000-2019), regional seatbelt use (2017), and regional drink-driving (2017) were compiled from the Global Health Observatory Estimates. The investigated key metrics are global and regional RTI rate per 100,000 population in 2000-2019, percentage of regional seatbelt-wearing, drink-driving RTIs, and enforced seatbelt and drink-driving laws in 2017. Results This study reveals a heterogenous regional distribution of road traffic injuries in 2017. Africa sustained the highest RTI rate (27.6/100,000 population), while Europe reported the lowest rate (10.98/100,000 population). Regional variation in seatbelt laws exists, with the highest legalization in Europe (100%), and the lowest in Western Pacific (80.95%). Eastern Mediterranean (87.43%) and South-East Asia (46.8%) reported the highest and lowest driver seatbelt-wearing rates, respectively. All countries, except the Maldives, legislated drink-driving laws. Western Pacific (29.98%) and Eastern Mediterranean (1.65%) suffer from the highest and lowest burden of drink-driving RTI, respectively. Conclusion Despite a relatively stable global RTI rate from 2011-2020 and a steady decline till 2029, the future trajectory remains uncertain in developing countries bearing the highest burden, due to slow national law enforcement, rendering the UN Action Plan insufficient in curbing the burden of RTIs. INTRODUCTION Road traffic injury (RTI) is a major global health challenge, impacting millions of individuals worldwide [1]. With approximately 20…
subject: Original Article
  topic: section
subject: Core discipline & systems
  topic: category
subject: Triage & First Response
  topic: category
subject: Trauma & injury
  topic: category
subject: Wounds and Injuries
  topic: category
subject: Multiple and Poly- Trauma
  topic: category
subject: Public Health Emergencies
  topic: category
subject: Policy Shaping
  topic: category
subject: Road Safety
  topic: category
subject: General Public Health Education
  topic: category
subject: Road Traffic Injury
  topic: keywords
subject: Health Policy
  topic: keywords
subject: Epidemiology
  topic: keywords
subject: Global Health
  topic: keywords
subject: UN Decade of Action Plan
  topic: keywords
creator: Johny El-Achkar
creator: Maya El-Gharib
creator: Nesrine Ahmad
creator: Samar Al-Hajj
rights: Copyright (c) 2026 Johny El-Achkar, Maya El-Gharib, Nesrine Ahmad, Samar Al-Hajj (Author) https://creativecommons.org/licenses/by/4.0
date: 2026-04-06
publication date: 2026-04-06
doi: 10.26738/poem.v4i1.2

Knowledge and Stigma Regarding HIV and Homosexuality: An Exploratory Survey of Responding Physicians in Lebanon
type: item
description: Background HIV remains a major public health challenge in the Middle East and North Africa (MENA), where stigma against people with HIV (PWH) and men who have sex with men (MSM) hinders access to care. In Lebanon, little is known about physicians’ current knowledge, attitudes, and willingness to provide care for PWH. Methods We conducted an exploratory online survey of all Lebanese physicians registered with the Ministry of Public Health, distributed in four waves between 2023 and 2025. The 58-item questionnaire assessed HIV knowledge, attitudes toward PWH and homosexual colleagues, willingness to provide medical care, and practices related to sexual history and pre-exposure prophylaxis (PrEP). Out of 4,331 emails, 760 were invalid and 127 physicians responded (3.2%). Results Interpretation is limited by a low response rate, and findings should be considered for hypothesis generation rather than prevalence estimates. Respondents were mostly male (63%), with varied specialties and practice settings. Knowledge of HIV transmission was generally high, though gaps were identified: 54% did not recognize breastmilk as a transmission route, 20% were unaware of confidential testing facilities, and only 64% knew that PrEP prevents transmission. While 86% were willing to medically examine PWH and over 90% would perform minor or major procedures, 29% believed physicians have the right to refuse care due to fear of infection. Stigmatizing attitudes were also noted, where 13% would not buy food from PWH, 33% would not allow their child to play with PWH, and 39% would not accept surgery from a surgeon living with HIV. Regarding homosexuality, 10–12% opposed accepting homosexual applicants to medical training or granting them practicing privileges. Most respondents (61%) did not routinely take sexual histories, and 84% had never prescribed PrEP, while 96% agreed on the need for further education. Conclusion In this exploratory sample, respondents had adequate HIV knowledge, but sig…
subject: Original Article
  topic: section
subject: Core discipline & systems
  topic: category
subject: Emergency Medicine
  topic: category
subject: Specific Needs Patients & Elderlies
  topic: category
creator: Hilal Abdessamad
creator: Zeinab Roumieh
creator: Jacques E. Mokhbat
rights: Copyright (c) 2026 The Authors https://creativecommons.org/licenses/by/4.0
date: 2026-04-06
publication date: 2026-04-06
doi: 10.26738/poem.v4i1.6

A Near-Fatal Anaphylactic Reaction to Biliary Contrast: A Cautionary Case During Laparoscopic Cholecystectomy
type: item
description: Anaphylactic reactions to iodinated contrast agents during intraoperative cholangiography (IOC) are extremely rare, although such reactions are well documented with intravenous (IV) administration. We present the case of a 71-year-old female with a known allergy to iodinated contrast, who experienced a life threatening anaphylactic reaction immediately after intraoperative cholangiography (IOC) during laparoscopic cholecystectomy. Shortly after the administration of iodinated contrast into the biliary duct, the patient developed supraventricular tachycardia and profound hypotension. This case underscores the risk of systemic absorption and hypersensitivity reactions from biliary-administered contrast agents, even in the absence of intravenous exposure. It highlights the need for a comprehensive preoperative allergy evaluation in high-risk patients undergoing biliary procedures and the importance of considering alternative imaging methods to avoid serious complications. Introduction Cholecystitis, inflammation of the gallbladder mostly due to obstruction of the cystic duct by a gallstone, is considered one of the most frequent indications for laparoscopic cholecystectomy [1]. Intraoperative cholangiography (IOC) is performed during cholecystectomy to visualize the biliary anatomy and identify any residual obstruction [2]. The technique involves inserting a catheter into the cystic duct and injecting an iodinated contrast agent to highlight the biliary tree under fluoroscopy. While this contrast agent is generally safe and plays a crucial role in optimizing surgical outcomes, its use carries a very low risk of hypersensitivity reactions [3]. Although contrast is administered directly into the biliary tree rather than intravenously, iodinated agents can still be absorbed into the systemic circulation, potentially triggering hypersensitivity reactions, including anaphylaxis [4]. While such events are rare during intraoperative cholangiography (IOC), they are clinically …
subject: Case Report
  topic: section
subject: Emergency Medicine
  topic: category
creator: Hiba Hamdar
creator: Aktham Abdelhadi
creator: Dareen Al Ayash
creator: Yaser Harb
creator: Nadim Chaarani
creator: Abbas Al Bazzal
creator: Nazim Matta
creator: Mirna Fares
rights: Copyright (c) 2026 Hiba Hamdar, Aktham Abdelhadi, Dareen Al Ayash, Yaser Harb, Nadim Chaarani, Abbas Al Bazzal, Nazim Matta, Mirna Fares (Author) https://creativecommons.org/licenses/by/4.0
date: 2026-05-12
publication date: 2026-05-12
doi: 10.26738/poem.v4i1.11

Suggestions for the Study of Ethics of Simulation in Healthcare
type: item
description: Simulation can be used in healthcare education to provide learners with the opportunity to develop the knowledge and skills needed to manage complex situations and provide patient care, however one aspect easily overlooked and which has many ramifications, is that of ethical practice. Simulation-based education is a moral and ethical imperative. “Never the first time on the patient!” is displayed at the entrance of some clinical simulation centres, but the rest of the ethical obligations, besides the professional code of ethics, are either not mentioned or only sporadically. By using an interpretive framework based upon the 4 bioethics principles used for patients (autonomy, beneficence, nonmaleficence, and distributive justice), we propose, as a conceptual framework, an analysis on the stakeholders of simulation-based education (SBE) - educators, learners, and simulated participants - to broaden and explore in depth the conventional views of ethics in simulation. This article also discusses specific features in simulation which sometimes pose an ethical dilemma such as facing simulated death, breaking bad news, research, the use of biological tissue, teaching ethics, and computer simulation. This proposal to explore ethics in healthcare simulation is intended to stimulate reflection rather than serve as a model seeking external validation. Foreword Before embarking on exploring ethics in healthcare simulation as a conceptual framework, we believe it is important to clarify the relationship between a practice, its ethical aspects, and its legal aspects. The relationship between biomedical practice, ethics, and legislation is closely tied to a society’s historical, cultural, political, and religious context [1, 2]. More specifically, the relationship between ethics and the law regarding a given action evolves according to dynamics shaped by this context. Two examples related to simulation illustrate this point: 1. In France, donating a body to science has been legal …
subject: Original Article
  topic: section
subject: Emergency Medicine
  topic: category
subject: Policy Shaping
  topic: category
creator: Denis Oriot
creator: Guillaume Alinier
creator: Zineb Messarat-Haddouche
creator: Hervé Thomazeau
creator: Laetitia May-Michelangeli
creator: Marie-Christine Moll
creator: Jean-Claude Granry
rights: Copyright (c) 2026 Denis Oriot, Guillaume Alinier, Zineb Messarat-Haddouche, Hervé Thomazeau, Laetitia May-Michelangeli, Marie-Christine Moll, Jean-Claude Granry (Author) https://creativecommons.org/licenses/by/4.0
date: 2026-05-19
publication date: 2026-05-19
doi: 10.26738/poem.v4i1.9

The Assessment of Lebanese Hospital Nurses’ Qualifications in The Fight Against COVID-19: Are They Well Prepared?
type: item
description: Background On December 31, 2019 China reported multiple cases of a novel coronavirus, This rapid and unexpected increase in cases caused a shortage of testing kits, personal protective equipment (PPE), medical treatments, ventilators, and other medical supplies. Therefore, nurses and physicians needed to feel safe, protected and confident while treating ill patients. It is the responsibility of the healthcare system's to wisely use the skills and available resources for an effective response and ensure the safety of the personnel. Our primary objective is to assess the preparedness of nurses against the coronavirus and then to evaluate the impact of the outbreak on the nurses and their attitude towards the pandemic. Methods An anonymous online survey was conducted among nurses across Lebanon. It consisted of 24 multiple-choice, closed-ended questions related to knowledge, attitude and practice. Results A total of 370 registered nurses completed the survey. Analysis showed that age had no effect on knowledge; males were more trained than females for triage, hand hygiene and working in isolation units, while females were more trained for handling PPE. Additionally, females attended national lectures more than males, while males received information from media and brochures. The training for PPE use and working in isolation unit was better conducted in university hospitals as compared to non-university ones. 50% of nurses in both hospital types did not attend any lectures. The nurses in all Lebanese districts had training about hand hygiene and working in isolation unit before the pandemic while they had the triage training mostly after the pandemic started. Analysis also showed that the nurse-to-patient ratio was higher for older nurses and in peripheral areas. For both genders, 66.3% had never undergone an N95 fit test. Lastly, almost half of the nurses thought about quitting their job. Conclusion The study showed that there is some lack of nurses’ knowledge towards …
subject: Narrative Review
  topic: section
subject: Emergency Nursing & Midwives
  topic: category
subject: Practical Nursing
  topic: category
subject: Critical illness & sedation
  topic: category
subject: Public Health Emergencies
  topic: category
creator: Cima Hamieh
creator: Mahmoud El-Hussein
creator: Alicia Djoundourian
creator: Rachelle Riachy
creator: Ghinwa Hayek
creator: Rania Sakr
rights: Copyright (c) 2026 Cima Hamieh, Mahmoud El-Hussein, Alicia Djoundourian, Rachelle Riachy, Ghinwa Hayek, Rania Sakr (Author) https://creativecommons.org/licenses/by/4.0
date: 2026-04-25
publication date: 2026-04-25
doi: 10.26738/poem.v4i1.8

The Digital Stethoscope: Harnessing Artificial Intelligence in Pediatric Emergency Medicine
type: item
description: Dear Editor, Artificial Intelligence (AI) is increasingly recognized as a transformative force in healthcare, with Pediatric Emergency Medicine (PEM) standing to benefit significantly from its adoption. Children often present with subtle, atypical signs, making timely recognition of critical illness challenging. AI-driven tools are being applied in triage, predictive monitoring, diagnostic imaging, and resuscitation support, while also enhancing education through simulation and personalized learning. For global health, AI offers opportunities to reduce disparities by extending decision support to resource-limited settings. However, challenges such as data bias, ethical oversight, and the need for clinician training remain critical considerations. AI should be viewed not as a replacement for pediatric emergency physicians but as an augmentation of human expertise, amplifying decision-making, enhancing safety, and expanding access to quality care. This letter to the editor reflects on the promise, pitfalls, and potential of AI in PEM, advocating for its thoughtful and equitable integration into practice and education. Why AI matters in pediatrics emergencies Children are unique individuals with dynamic physiology. Their developmental stages influence clinical presentations, and emergencies can quickly become critical. Traditional triage and diagnostic tools, primarily designed for adults, often fail to meet the specific needs of pediatric care [1]. AI offers a transformative solution by providing rapid risk stratification and pattern recognition that surpasses human intuition, all while maintaining clinician oversight. Just as pulse oximetry revolutionized patient monitoring decades ago, AI is poised to become an indispensable tool in pediatric triage. Diagnostics and resuscitation : AI as an ally Machine learning systems are already making strides in predicting sepsis, respiratory failure, and unrecognized deterioration [2, 3]. In the realm of cardiac arrest, AI-driv…
subject: Letter to the Editor
  topic: section
subject: Pediatric Emergency Medicine
  topic: keywords
subject: Artificial Intelligence
  topic: keywords
subject: Simulation
  topic: keywords
subject: Clinical Reasoning
  topic: keywords
subject: Global Health
  topic: keywords
creator: Jabeen Fayyaz
creator: Nordia Thompson-Newell
rights: Copyright (c) 2026 https://creativecommons.org/licenses/by/4.0
date: 2026-03-14
publication date: 2026-03-14
doi: 10.26738/poem.v4i1.1

Proceedings of the Qatar Paediatric Emergency Medicine 2026 Conference - Selected Abstracts
type: item
description: Welcome to this issue of Panorama of Emergency Medicine (POEM) dedicated to the 10th Qatar Paediatric Emergency Medicine (Q-PEM) International Conference which was organised and hosted by Sidra Medicine (Doha, Qatar) and held online from January 16 to 18, 2026. Since its first iteration in 2017, Q-PEM has steadily evolved into an international forum for clinicians, educators, and researchers involved in the acute care of children to exchange knowledge, reflect on clinical practice, and share emerging research in paediatric emergency medicine. In 2025, the conference welcomed 2,000 online delegates from 22 countries and the programme included over 55 speakers [1]. Adopting a similar format, with 3 parallel sessions covering different important and contemporary topics, the event proved as popular in its 2026 edition with nearly identical numbers, yet we marked an important milestone for the Q-PEM community. Building on the success of previous years, the meeting again attracted a large international audience with multidisciplinary participation from physicians, nurses, pharmacists, allied health professionals, and trainees involved in paediatric emergency care. Similar to previous editions, the scientific programme combined plenary sessions, focused tracks, and research presentations to provide practical, evidence-based updates relevant to frontline emergency care. The conference was designed to enhance recognition and management of serious illness and injury in children, promote patient safety, and facilitate the translation of evidence into everyday clinical practice. Emergency Medicine is still a relatively young specialty, yet it is important to recognise that it includes a number of subspecialisations with clinicians of different professions each with their specific skill sets and knowledge to match the needs of the distinctive patient groups they care for [2]. Emergency Medicine continues to expand into highly specialized domains requiring multidisciplinary exper…
subject: Editorial
  topic: section
subject: Emergency Medicine
  topic: keywords
subject: Paediatrics
  topic: keywords
subject: Qatar
  topic: keywords
subject: Conference
  topic: keywords
subject: Call for abstracts
  topic: keywords
creator: Guillaume Alinier
creator: Muthukumar Sakthivel
creator: Syed Haris Huda
rights: Copyright (c) 2026 https://creativecommons.org/licenses/by/4.0
date: 2026-03-14
publication date: 2026-03-14
doi: 10.26738/poem.v4i2.9

Literature review of the use of simulation for the training of paramedics in relation to caring for pediatric patients
type: item
description: Background Paramedics face unique challenges when managing paediatric emergencies due to limited clinical exposure, insufficient training, the unpredictable prehospital environment, and scarce resources [1]. These factors increase anxiety and medical error risk, especially during rare, high-stakes events [2]. Simulation-based education (SBE) provides a safe, controlled environment that bridges the gap between knowledge and practice by allowing learners to rehearse decision-making and technical skills. Aim This review assesses the current state of paediatric simulation literature, evaluates the effectiveness of SBE in paramedic training using the Kirkpatrick evaluation framework, and identifies directions for future research. Methods A comprehensive search was conducted across PubMed, PsycINFO, CINAHL, ERIC, and Scopus for studies published between 2003 and 2023, using keywords and MeSH terms related to paramedics, prehospital care, paediatrics, and simulation. The review followed PRISMA 2020 guidelines, and methodological quality was appraised using the Joanna Briggs Institute checklists. Studies were categorised according to the four Kirkpatrick levels. Findings A total of 227 articles were identified, and upon removing duplicates, 184 were screened, and 60 were assessed for eligibility, following which 46 were excluded. In the remaining 14 studies, the use of SBE was generally reported to have had a positive impact on paramedics’ confidence and competence in performing several procedures (Table 1). Several studies reported that paramedics often felt uncomfortable providing care to children, made fewer errors, and wished they had more such training opportunities. No studies reported on how the training interventions contributed to improving actual patient care to fulfil the criteria of Kirkpatrick level 4. The full details of the findings have recently been reported [3]. Conclusion Simulation shows promise in improving paramedics' readiness for paediatric emergenci…
subject: Abstract
  topic: section
subject: Simulation
  topic: keywords
subject: Paediatrics
  topic: keywords
subject: Pre-hospital
  topic: keywords
subject: Paramedic
  topic: keywords
subject: Emergency Medical Service
  topic: keywords
creator: Anan K Al Badawi
creator: Bahaeddin Tomeh
creator: Nandini Alinier
creator: Guillaume Alinier
rights: Copyright (c) 2026 https://creativecommons.org/licenses/by/4.0
date: 2026-03-14
publication date: 2026-03-14
doi: 10.26738/poem.v4i2.6

Diagnostic accuracy of ultrasound findings for distinguishing complicated appendicitis from simple appendicitis in pediatric patients: A systematic review and meta-analysis
type: item
description: Background Acute appendicitis is the most common surgical emergency in children. While up to 85% of pediatric appendicitis cases are uncomplicated, the rate of complicated appendicitis can be significant, ranging from approximately 30% overall to as high as 50–75% in certain cohorts [1]. Ultrasound (US) is a first-line imaging modality, yet its diagnostic performance in accurately identifying these complications remains uncertain [2]. Methods Following PRISMA [3], we searched PubMed, Embase, Web of Science, and Scopus from inception. Risk of bias was assessed with QUADAS-2. Bivariate random effect model pooled sensitivity and specificity; heterogeneity was summarized using I² and Q; small-study effects were evaluated using Deeks’ test. Clinical utility was illustrated using a Fagan nomogram, and overall accuracy was assessed using a summary receiver-operating characteristic (SROC) curve. Results Twenty-one studies met the inclusion criteria. Nearly all procedures were conducted by specialists or residents in radiology. The age range for the pediatric population was between 0 to 18 years old. Pooled US sensitivity for identifying complicated appendicitis was 0.52 (95% CI 0.41–0.62), and specificity was 0.90 (0.84–0.94) (Figure 1). The area under the curve was 0.80 (0.76–0.83) (Figure 2), and the summary operating point mirrored the pooled estimates. Deeks’ test suggested no significant asymmetry (p=0.08). Assuming a pre-test probability of 25%, a positive US result (LR+ = 5) increased the post-test probability to ~64%, whereas a negative result (LR–=0.54) reduced it to ~15%. Conclusion In pediatric appendicitis, US demonstrates high specificity but moderate sensitivity for discriminating complicated from simple disease. A positive scan can “rule in” complication and support expedited, targeted management; a negative scan cannot exclude complication and should be interpreted alongside clinical findings, laboratory data, and, when indicated, adjunct imaging. Future stu…
subject: Abstract
  topic: section
subject: Pediatrics
  topic: keywords
subject: Complicated appendicitis
  topic: keywords
subject: Ultrasound
  topic: keywords
subject: Diagnostic accuracy
  topic: keywords
creator: Mansoureh Fatahi
creator: Ramin Shahidi
rights: Copyright (c) 2026 https://creativecommons.org/licenses/by/4.0
date: 2026-03-14
publication date: 2026-03-14
doi: 10.26738/poem.v4i2.8

Development and Implementation of a Prehospital Paediatric Sepsis Screening Tool: Enhancing Early Recognition, Resuscitation, and Referral
type: item
description: Background Paediatric sepsis remains a leading cause of preventable morbidity and mortality, contributing to 11 million deaths annually, including 1.2 million children [1, 2]. Early recognition is critical, yet prehospital identification is hindered by subtle presentations, age-related physiological variability, and limited diagnostic capability [1, 3]. Currently, no validated prehospital paediatric sepsis screening tool exists. The aim of this project was to develop and implement an evidence-based prehospital paediatric sepsis screening tool for paramedics. Methods The development process included a targeted literature review and formal stakeholder engagement with Hamad Medical Corporation Ambulance Service (HMCAS) and Sidra Medicine. The iterative tool refinement was informed by international guidelines, aligned with Sidra Medicine pathways, and adapted to support HMCAS clinical practice guidelines. Age-specific physiological thresholds were calibrated using Advanced Paediatrc Life Support vital-sign parameters within the sepsis context. Implementation was supported by a blended educational model comprising 4 hours of online preparatory modules, 7 hours of face-to-face workshops, and simulation-enhanced active learning sessions. Results The final screening tool integrated infection-risk assessment, high-risk clinical criteria, age-specific vital-sign thresholds, and key physiological indicators, supported by an algorithm (Figure 1). A corresponding prehospital sepsis care bundle (Figure 2) was incorporated to standardise timely recognition, intervention, and escalation, aligned with the “Sepsis Golden Hour” and “Sepsis 6” principles [1, 3]. Clinical validation and alignment were provided through expert review by paediatric sepsis specialists from Sidra Medicine. Case-based learning, deliberate practice, and simulations supported the application of the tool for operational practice. Conclusion The Prehospital Paediatric Sepsis Screening Tool was successfully develo…
subject: Abstract
  topic: section
subject: Paediatric sepsis
  topic: keywords
subject: Screening tool
  topic: keywords
subject: Early Recognition
  topic: keywords
subject: Prehospital Sepsis Care
  topic: keywords
subject: Paramedic Education
  topic: keywords
creator: Vernon Naidoo
creator: Rasha Ashour
creator: Ahmed Gueddes
rights: Copyright (c) 2026 https://creativecommons.org/licenses/by/4.0
date: 2026-03-14
publication date: 2026-03-14
doi: 10.26738/poem.v4i2.7

Impact of Interprofessional Simulation-Based Training on Enhancing Non-Technical Skills and Team Readiness in Pediatric Resuscitation
type: item
description: Background Effective pediatric resuscitation relies on both technical proficiency and non-technical skills, including leadership, communication, and teamwork [1]. These skills enhance role clarity, situational awareness, and coordinated interprofessional responses under pressure [2]. Combined with technical performance, they improve outcomes, build confidence, and foster collaboration. Simulation-based training provides a structured environment to strengthen decision-making, task delegation, and closed-loop communication [3]. This study assessed the impact of interprofessional simulation-based pediatric resuscitation training on non-technical skills and team readiness. Methods A pre/post interventional study was conducted at Al Wakra Hospital over 10 months starting December 2024, included 75 participants, comprising physicians and pediatric nurses, who were randomized into 12 teams with a designated leader for each team. 2.5-3 hours program following Advanced Life Support Group (ALSG) Guidelines, included a 1-hour interactive presentation and 1.5-2 hours of simulation scenarios, with 2–3 leaders trained per session with their teams. Each leader led a 10-15-minute pediatric resuscitation scenario with structured debriefing and faculty feedback. Pre-training scores were collected immediately before, and post-training scores after completion of entire mass training. Outcomes were measured using a validated 30-item non-technical skills checklist scored by independent observers with each item rated as 1 if demonstrated and 0 if not demonstrated (maximum possible score = 30), covering leadership, teamwork, and communication. Team readiness was assessed by post-training self-reported survey. Pre–post differences were analyzed with Wilcoxon signed-rank test. Results Descriptive and inferential data analysis of normalized mean scores (0–1 scale, with 1 representing the maximum possible score: leadership = 10, teamwork = 14, communication = 6) demonstrated significant improv…
subject: Abstract
  topic: section
subject: Pediatric Resuscitation
  topic: keywords
subject: Interprofessional Simulation
  topic: keywords
subject: Simulation-based Training
  topic: keywords
subject: Non-technical Skills
  topic: keywords
subject: Teamwork and Communication
  topic: keywords
creator: Mohamed Elsayed Saad Aboudonya
creator: Fatma Serag Elayouti
creator: Aseel Abujubbeh
creator: Khaled Sayed El Shafey
creator: Ghadeer Mraweh Mohammad Mustafa
creator: Shihab M. Ameen
creator: Emad Ali Hamad Almomani
creator: Princess Mary Sebastian
creator: Lorna Cynthia Lorenzo
creator: John Tobin
creator: Nina Rachel Reyes-Arbo
rights: Copyright (c) 2026 https://creativecommons.org/licenses/by/4.0
date: 2026-03-14
publication date: 2026-03-14
doi: 10.26738/poem.v4i2.5

Enhancing Paediatric & Adult Resuscitation Performance Through Flowchart Driven Targeted Training in the Critical First Five Minutes
type: item
description: Background Early recognition of cardiac arrest and delivery of high-quality early resuscitation are critical for survival [1]. Performance during this phase remains inconsistent in healthcare settings [2]. Simulation-based multidisciplinary team (MDT) training has shown superior outcomes compared to traditional lecturing, especially when monitored by measurable key performance indicators (KPIs) [3]. Data collected by Resuscitation Officers from the Hamad International Training Centre revealed KPIs not being met (Table 1), prompting a revised training method at Hamad Medical Corporation’s (HMC) hospitals, in Qatar. This study aimed to evaluate the introduction of a MDT training program integrating response algorithms emphasizing the first five minutes on resuscitation KPIs in simulated clinical settings. Methods A pre-/post-intervention study was conducted with 80 participants randomly allocated from newly formed MDT as per the shift roster at a newly opened HMC hospital providing diverse services. Each MDT consisted of two physicians and six nurses with defined roles, all with over 5 years of post-registration experience and qualified in Immediate Life Support or Paediatric Life Support. (European Resuscitation Committee 2021 guidelines). Performance was evaluated before and after the introduction of the revised training model. The initial sessions were skills-based (90 minutes of Basic Life Support airway and defibrillation) followed by a cardiac arrest simulation (30 minutes), latter sessions of the same duration were entirely simulation-based with coaching and emphasis on rapid assessment, timely recognition, and prompt initiation of interventions within the first five minutes of collapse, reinforced by the implementation of response algorithms (Figure 1). Data collection focused on six KPIs (Table 1). Results Implementation of the MDT training program and response pathway algorithms replacing solely skills training, resulted in improvements across all KPIs (Tabl…
subject: Abstract
  topic: section
subject: Resuscitation
  topic: keywords
subject: Training
  topic: keywords
subject: Simulation
  topic: keywords
subject: Qatar
  topic: keywords
subject: First 5 minutes
  topic: keywords
creator: Peter Arrowsmith
creator: Mohamed Elsayed Saad Aboudonya
creator: Khalid Abdulnoor Saifeldeen
creator: John Tobin
rights: Copyright (c) 2026 https://creativecommons.org/licenses/by/4.0
date: 2026-03-14
publication date: 2026-03-14
doi: 10.26738/poem.v4i2.4

Risk Factors of Peri-intubation Cardiac Arrest in Critically Ill Pediatric Patients Presenting to the Emergency Department of a Low-Middle-Income Country: A Case-Control Study
type: item
description: Background Peri-intubation cardiac arrest is defined as cardiac arrest that occurs within 20 minutes of airway management [1]. Incidence in the pediatric population ranges from 0.7% to 1.7% [2, 3]. Identifying pre-intubation risk factors may improve preparedness and outcomes during emergency intubations. This study aims to identify clinical and physiological predictors associated with peri-intubation cardiac arrest in pediatric patients undergoing emergency airway management in a tertiary care emergency department. Methods A retrospective case-control study was conducted at the emergency department of a tertiary care hospital in Karachi, Pakistan, from January 2019 to June 2023. Pediatric patients (<18years) who experienced cardiac arrest within 20 minutes of intubation were included as cases. For each case, four controls were randomly selected from the same cohort who were intubated without arrest. Pre-intubation clinical data, laboratory parameters, and vital signs were analyzed. Multivariable logistic regression was used to identify independent predictors of peri-intubation cardiac arrest. Results A total of 125 pediatric patients were included, 25 cases and 100 controls. Multivariate analysis identified several independent predictors of peri-intubation cardiac arrest. Age less than one year (aOR:10.97; p=0.028), hypoxemia (SpO₂<92%) (aOR:5.48; p=0.047), elevated heart rate (aOR:2.88; p=0.029), low systolic blood pressure (aOR:6.16; p=0.043), elevated shock index (≥1.2) (aOR:5.52; p=0.046), modified shock index ≥1.3 (aOR:11.11; p=0.048), lactate ≥2 mmol/L (aOR:15.64; p=0.023), and capillary refill time >3 seconds (aOR:7.55; p=0.042), were found to be independent predictors of peri-intubation cardiac arrest (Table 1). Conclusion Pre-intubation physiological instability is strongly associated with peri-intubation cardiac arrest in pediatric patients. Early recognition of high-risk features such as hypoxemia, tachycardia, hypotension, elevated lactate levels, delaye…
subject: Abstract
  topic: section
subject: Peri-intubation
  topic: keywords
subject: Cardiac arrest
  topic: keywords
subject: Emergency Department
  topic: keywords
subject: Pediatric
  topic: keywords
subject: Risk factors
  topic: keywords
creator: Noman Ali
creator: Erum Shakeel
creator: Ahmed Raheem
creator: Hania Ather
creator: Surriya Bano
rights: Copyright (c) 2026 https://creativecommons.org/licenses/by/4.0
date: 2026-03-14
publication date: 2026-03-14
doi: 10.26738/poem.v4i2.3

The Emergence of Excellence: Proposing the Paediatric Transport Reflective Improvement and Simulation-based Education (PaeTRISE) Framework for the Western Cape, South Africa
type: item
description: Background: Inter-facility transport of critically ill children in the Western Cape, in South Africa, poses significant risks, often contributing to preventable morbidity.1 While specialised teams exist, many transfers are undertaken by non-specialist personnel. South African literature confirms this gap, noting that paediatric critical care retrieval is often absent as a formal, stand-alone course in tertiary curricula and that transfers are handled by personnel with variable baseline training.2 This lack of standardised, continuous professional development creates a gap between theoretical knowledge and clinical application. Methods: We developed the Paediatric Transport Reflective Improvement and Simulation-based Education (PaeTRISE) framework, informed by literature on simulation, reflective practice, and transport medicine. PaeTRISE is founded on two pillars: Reflective Improvement (structured debriefing to critically analyse clinical experiences) and Simulation-based Education (safe practice of high-acuity, low-occurrence events.3 The framework integrates these pillars into a continuous cycle of learning, reflection, and adaptation, tailored to the geo-historical and socio-cultural realities of the Western Cape healthcare system. Results: PaeTRISE has the potential to cultivate emergent excellence. By coupling simulation with reflective practice, it transcends procedural training to enhance adaptive decision-making, teamwork, and resilience. From a critical realist perspective, PaeTRISE functions as a causal mechanism to activate practitioners’ latent capacity. Crucially, it directly addresses the documented absence of a formalised, standardised learning structure for this high-risk activity, proposing a scalable, contextually relevant model for continuous professional development. The explicit integration of reflection and simulation represents a novel contribution to standardising paediatric transport education in South Africa. Conclusion: PaeTRISE offers a …
subject: Abstract
  topic: section
subject: Paediatric Emergency Care
  topic: keywords
subject: Simulation Based Education
  topic: keywords
subject: Reflective Improvement
  topic: keywords
subject: Paediatric Critical Care Transport
  topic: keywords
subject: Inter-facility transport
  topic: keywords
creator: Athenkosi Sobada
creator: John Thomas Meyer
rights: Copyright (c) 2026 https://creativecommons.org/licenses/by/4.0
date: 2026-03-14
publication date: 2026-03-14
doi: 10.26738/poem.v4i2.2

Reversal of Bradycardia through Nutritional Rehabilitation in Paediatric Anorexia Nervosa: A Retrospective Study from Qatar
type: item
description: Background Anorexia nervosa (AN) is a severe mental health disorder characterized by persistent energy intake restriction, intense fear of weight gain, and a distorted body image. AN affects nearly every organ system, with the cardiovascular system being affected in up to 80% of cases [1]. AN carries the highest mortality among psychiatric disorders, with sudden cardiac death as a major cause [2]. Bradycardia is the most common cardiovascular manifestation in AN.1 Nutritional rehabilitation reverses these abnormalities, but rapid weight gain can pose risks such as electrolyte imbalance and arrhythmias. Early detection and monitoring of bradycardia are therefore crucial [3]. Methods We conducted a retrospective cohort study using data from Sidra Medicine and Hamad General Hospital in Qatar. Patients admitted between December 2016 and June 2024 with AN and bradycardia (Heart Rate (HR) <60 beats per minute (bpm)) were included. Patientswith incomplete records were excluded. Ethical approval was obtained from the institutional review board of Sidra Medicine (IRB 1929504). Data were extracted and analyzed by independent reviewers. Results Of 222 screened patients (aged 10–18 years), 46 met the inclusion criteria. The majority were female (91.3%), with a mean age of onset at 14 years and a percentile of median BMI for age (%mBMI) of 9.1% (z-score -2.36) (Table 1). The average admission HR was 49.96bpm, confirming bradycardia as a frequent complication. All patients underwent nutritional rehabilitation with caloric intake starting from around 1200kCal/day and increasing by 200kCal/day/day. At 1–2 weeks follow-up, the mean HR improved significantly to 78.63bpm (Table 1). Figure 1 shows the correlation between %mBMI and the change in HR (R2=0.07, p=0.133). Conclusion This study highlights the burden of bradycardia among adolescents with AN in Qatar. Nutritional rehabilitation was effective in restoring HR, emphasizing the need for early recognition and careful monitoring. Fu…
subject: Abstract
  topic: section
subject: Anorexia Nervosa
  topic: keywords
subject: Bradycardia
  topic: keywords
subject: Nutritional Rehabilitation
  topic: keywords
subject: Eating Disorder(s)
  topic: keywords
subject: Qatar
  topic: keywords
creator: Abdulla Fahmi
creator: Sara Al-Kuwari
creator: Abdurahman Al-Ansari
creator: Sheema Hashem
creator: Madeeha Kamal
rights: Copyright (c) 2026 https://creativecommons.org/licenses/by/4.0
date: 2026-03-04
publication date: 2026-03-04
doi: 10.26738/poem.v4i2.1

Non-invasive positive pressure ventilation for acute asthma in children: Very uncertain results
type: item
description: Source: Korang SK, Baker M, Feinberg J et al. (2024) Non-invasive positive pressure ventilation for acute asthma in children. Cochrane Database Syst Rev. 2024 Oct 2;10(10):CD012067 http://doi.org/10.1002/14651858.CD012067.pub3 Clinical Question Asthma is the most common chronic disease in children and accounts for 2.3% of pediatric hospitalizations. This condition has a major medico-economic impact, affecting both children’s quality of life and healthcare costs. In 10–12% of cases, intensive conventional treatment based on bronchodilators and corticosteroids is insufficient, and management must be escalated to endotracheal intubation and invasive mechanical ventilation. Some observational studies suggest that non-invasive positive pressure ventilation (NPPV) could reduce the need for intubation. Bottom Line To assess the effects of NPPV combined with conventional treatments compared with conventional treatments alone in children with moderate to severe acute asthma, in terms of mortality, occurrence of serious adverse events (SAEs), length of stay in intensive care, and asthma symptom scores during the acute phase. Main Results No all-cause mortality was reported in either group. Only one randomized study assessed SAEs, namely the intubation rate. Bilevel positive airway pressure (BiPAP) may substantially reduce the intubation rate and appears to shorten the length of stay in intensive care, but these results are very uncertain (very low level of evidence). Acute asthma symptoms score was evaluated in only two studies using different outcome measures, which did not allow meta-analysis. BiPAP may have a beneficial effect on the score, but this result is also very uncertain (very low level of evidence). Caveats Current data are limited, with small sample sizes, resulting in very uncertain evidence and preventing a comprehensive evaluation of the benefits and risks of NPPV in children with acute asthma. Large, well-designed randomized controlled trials with low risk of…
subject: Editorial
  topic: section
subject: Airway & resuscitation
  topic: category
subject: asthma
  topic: keywords
creator: Yannick Auffret
creator: Tania Marx
creator: Patricia Jabre
creator: Cochrane Pre-hospital and Emergency Care Group
rights: Copyright (c) 2026 Yannick Auffret, Tania Marx, Patricia Jabre, Cochrane Pre-hospital and Emergency Care Group (Author) https://creativecommons.org/licenses/by/4.0
date: 2026-04-27
publication date: 2026-04-27
doi: 10.26738/poem.v4i1.5

Therapeutic hypothermia may improve neurological outcome of cardiac arrest in adults
type: item
description: Source: Arrich J, Schütz N, Oppenauer J et al. (2023) Hypothermia for neuroprotection in adults after cardiac arrest. Cochrane Database Syst Rev. 2023 May 22;5(5):CD004128. http://doi.org/10.1002/14651858.CD004128.pub5 Context Neurological prognosis after resuscitated cardiac arrest is challenging to determine. Early resuscitation is essential for a favorable outcome. Experimental studies suggest that therapeutic hypothermia (TH) may have beneficial effects, and several clinical trials have investigated this intervention. Clinical question What are the benefits and harms of TH (target temperature 32–34 °C) in adults after resuscitated cardiac arrest, compared with standard treatment? Bottom Line TH may be associated with better neurological outcome than standard treatment, even at a maintained temperature of 36 °C (low level of evidence). Subgroup analyses indicate that TH offers better chances of neurological recovery than no cooling or fever prevention (temperature >36 °C) (low level of evidence). In contrast, data do not suggest a difference between TH and fever control or temperature management at 36 °C (low level of evidence). Regarding survival at short, medium, and long-term follow-up, TH shows little or no difference compared with standard treatment, with or without active cooling to 36 °C (low level of evidence). Concerning adverse effects, TH may lead to a slight increase in the incidence of pneumonia and severe arrhythmia (low level of evidence). Evidence is very uncertain regarding the effect of TH on the risk of hypokalaemia (very low level of evidence). Two studies assessed quality of life at six months, but the evidence was insufficient to draw conclusions. Caveats Several sources of bias were identified in the included studies; two studies were considered at high risk of bias. Standard cooling methods were employed in all studies, such as ice packs or cooling pads. Only one study used hemofiltration, but its data could not be pooled with the others. …
subject: Editorial
  topic: section
subject: Defibrillation & Cardiac Arrest
  topic: category
creator: Nordine Nekhili
creator: Daniel Meyran
creator: Patricia Jabre
creator: Cochrane Pre-hospital and Emergency Care Group
rights: Copyright (c) 2026 Nordine Nekhili, Daniel Meyran, Patricia Jabre, Cochrane Pre-hospital and Emergency Care Group (Author) https://creativecommons.org/licenses/by/4.0
date: 2026-04-27
publication date: 2026-04-27
doi: 10.26738/poem.v4i1.4

All for one and one for all: Scaling mountains for a good cause. SDG 4: quality education awareness campaign
type: item
description: How it all started? In the mountains, I discover a profound inner tranquility, revitalizing my mind and fortifying myself to confront life’s obstacles. Hiking has deeply transformed my life, igniting a passion to push the boundaries of my physical capabilities, enabling me to venture further and ascend higher. In 2017, during my inaugural hiking expedition, I seized the opportunity to spotlight the issue of burnout, a struggle I was personally overcoming. Amidst inquiries about how I managed time for training and hiking, I found a platform to raise awareness and advocate for self-care amidst life’s demands.In July 2023, fueled by a Law school course on the significance of international organizations and inspired by the UAE’s designation of 2023 as the year of sustainability, I resolved to amplify awareness around Sustainable Development Goal (SDG) 3: Health. In the four days leading up to my departure, I delved into research, crafted social media campaigns, and hand-painted banners bearing meaningful messages, each destined to be showcasing varying altitudes throughout my journey. Remarkably, this preparatory work alleviated the stress that typically accompanies summit preparations. It transformed the purpose of my expedition from a solitary pursuit of reaching the peak to a collective endeavor of championing a noble cause. This shift not only mitigated stress but also infused each hiking day with embedded purpose, as I ascended to new altitudes, unveiling campaign banners—a tangible representation of progress and a triumph in itself. Why SDG 4: Quality Education? In January 2024, I proudly attained my Law degree, a decision not taken lightly, especially after completing medical school, obtaining board certification in two demanding specialties, and earning three master’s degrees, all while juggling numerous professional commitments such as speaking engagements, research endeavors, and educational pursuits. The four years spent as a Law student profoundly transforme…
subject: Letter to the Editor
  topic: section
subject: Core discipline & systems
  topic: category
subject: Sustainable development goal
  topic: keywords
subject: quality education
  topic: keywords
subject: good cause
  topic: keywords
subject: emergency medicine
  topic: keywords
subject: burnout
  topic: keywords
subject: mountaineering
  topic: keywords
creator: Ayesha Almemari
rights: Copyright (c) 2025 https://creativecommons.org/licenses/by/4.0
date: 2025-07-01
publication date: 2025-07-01
doi: 10.26738/poem.v3i1.36

Unilateral optic disc swelling: an atypical presentation for a large frontal meningioma
type: item
description: Intracranial masses pose frequent diagnostic dilemmas for community facing physicians especially in patients presenting with neurological or ophthalmological signs. We describe a case of a large meningioma in a 47-year-old man presenting with left sided optic disc swelling and right visual field disturbance alongside atypical headaches, and mild behavioural disturbance. Neuroimaging demonstrated a large mass with signs of raised intracranial pressure (ICP) and parenchymal herniation. He underwent surgical debulking and biopsy, confirming the suspected diagnosis. Post-operative course was complicated by day one hemiparesis due to venous strokes, with full subsequent motor recovery. Whilst raised ICP is classically thought to cause bilateral optic disc swelling, unilaterality does not exclude this. Careful assessment and use of red flag indicators are therefore needed in determining need for neuroimaging. Declining utility of fundoscopy in non-specialists creates an additional barrier to diagnosis in these presentations and warrants increased research or training to bridge this gap. Introduction Primary brain tumours (BT) are common cancers in those under 65 but are uncommon when pooled across cancers in all ages. Despite this, they demonstrate disproportionately higher morbidity and mortality rates, even among non-malignant cases. Meningiomas represent the commonest non-malignant primary BT, with data from the United States demonstrating that they account for 53% of cases 1. Symptoms associated with intracranial masses include headaches, new focal neurology, visual acuity (VA) changes, persistent vomiting, new onset seizures or behavioural changes (including reduced energy, apathy, executive dysfunction and disinhibition) (2– 4). Symptoms such as these are commonplace, but as BT remain a rare cause each symptom, correctly diagnosing a brain tumour from such symptoms can be troublesome 3. For instance, at least 50% of headaches are attributed to primary causes: tensio…
subject: Case Report
  topic: section
subject: Critical illness & sedation
  topic: category
subject: Meningioma
  topic: keywords
subject: Optic disc swelling
  topic: keywords
subject: Raised intracranial pressure
  topic: keywords
subject: Neuroimaging
  topic: keywords
creator: Pourya Pouryahya
creator: Benjamin Chrisp
creator: Meyer Alastair
rights: Copyright (c) 2025 https://creativecommons.org/licenses/by/4.0
date: 2025-05-16
publication date: 2025-05-16
doi: 10.26738/poem.v3i1.53

Peritoneal carcinomatosis presenting as a mimic for DVT
type: item
description: Unilateral leg swelling poses a diagnostic challenge with a myriad of potential differential diagnosis, including deep vein thrombosis (DVT), Baker's cyst, and cellulitis. As some of these causes can be benign and easily treatable, other causes may be more severe and even life threatening. This article highlights the critical need for healthcare professionals to expand their differential diagnosis when common causes have been excluded, recognizing that some rare etiologies may signify severe underlying conditions. We present the case of a 55-year-old female with a two-month history of right leg swelling, initially attributed to erysipelas due to negative DVT findings. Upon closer examination, an abdomino-pelvic CT scan revealed diffuse peritoneal carcinomatosis, obstructing the right external iliac vein and elucidating the unilateral lower limb edema. This case focuses the importance of considering atypical causes, especially in patients with a history of cancer, and the potential life-threatening nature of rare etiologies. The article emphasizes the significance of a multidisciplinary approach, comprehensive laboratory assessments, and advanced imaging techniques in achieving accurate and timely diagnoses, ultimately guiding effective patient management. Introduction Unilateral leg swelling can be attributed to various factors, with deep vein thrombosis (DVT), Baker's cyst, and cellulitis being the most prevalent causes. It is particularly crucial for healthcare professionals to promptly diagnose DVT, due to its potential life-threatening complication of pulmonary embolism (1). When ruling out these more common etiologies, it is important to recognize that numerous less common causes of unilateral leg swelling exist, spanning a spectrum from benign to potentially serious conditions. Therefore, clinicians should be mindful of rare etiologies, such as arterial insufficiency, lymphatic or venous obstruction, or systemic diseases like vasculitis (2). Conditions like po…
subject: Case Report
  topic: section
subject: Critical illness & sedation
  topic: category
subject: Unilateral leg swelling
  topic: keywords
subject: Differential diagnosis
  topic: keywords
subject: Peritoneal carcinomatosis
  topic: keywords
subject: Imaging
  topic: keywords
creator: Mahmoud El-Hussein
creator: Cima Hamieh
creator: Patrick Nasrallah
creator: Yara Mouawad
creator: Eric Revue
rights: Copyright (c) 2025 https://creativecommons.org/licenses/by/4.0
date: 2025-04-08
publication date: 2025-04-08
doi: 10.26738/poem.v3i1.45

Elderly patient with late diagnosed metastatic bone lytic lesions
type: item
description: Low back pain is a frequent reason for emergency department visits, pain management and screening for red flags should be considered for every patient, especially in elderly even with reassuring physical exam. In this case report, we discuss a case of an elderly patient who visited the emergency department many times with low back pain. His physical exam was reassuring. A low suspicion threshold, and a prompt history taking were the keys for diagnosis of bone-destroying lesions with multiple fractures and metastases. The patient had history of liver cirrhosis post hepatitis B, Alpha foetoprotein was high and he was diagnosed with metastatic hepatocarcinoma with extensive bone metastasis. Persistent pain, especially in older adults with progressive back pain, should be thoroughly investigated for serious conditions like bone metastases. Remember the "red flags" for lower back pain and note that physical exams may appear normal even with advanced bone issues. Introduction Acute back pain is one of the main reasons for emergency department (ED) presentations, and constitutes 4.4% of emergency department applications worldwide [1]. Advanced age places the patient at higher risk and requires further investigation [4]. Malignancies and related metastatic bone lesions form a small part of people who present to the emergency department with low back pain [4]. However, it should not be forgotten in elderly people with low back pain [3]. Emergency physicians should utilize red flag screening methods to detect those with serious diseases and, thus, patients who need to be investigated [2,3]. History of malignancy and cancer risk factors are considered among the serious red flags, since bone tissue appears as a frequent region in terms of metastasis. The presence of bone metastases is an indicator of poor prognosis in cancer patients. Prostate and breast cancers frequently metastasize to the skeletal system. Bone metastases occur much more often than primary bone cancers, espec…
subject: Case Report
  topic: section
subject: Critical illness & sedation
  topic: category
subject: Low back pain
  topic: keywords
subject: Metastases
  topic: keywords
subject: Hepatocarcinoma
  topic: keywords
subject: Redflags
  topic: keywords
creator: Mohammed Al-Amri
creator: Kamal Majed
creator: Deena Kodakatill
creator: Guru T. Arun
creator: Mohamed M. Baumy
creator: Adel N. Al-Hariri
creator: Aftab Azad
rights: Copyright (c) 2025 https://creativecommons.org/licenses/by/4.0
date: 2025-11-21
publication date: 2025-11-21
doi: 10.26738/poem.v3i1.44

The Killer Wound; Early Diagnosis and Management of Necrotizing Fasciitis Utilizing Point-of-Care Ultrasound: A Case Repor
type: item
description: Background: Necrotizing fasciitis (NF) is a rapidly progressive and life-threatening infection of the fascia and subcutaneous tissues. Early diagnosis and prompt surgical intervention are critical to reducing morbidity and mortality. This case report highlights the importance of point-of-care ultrasound (PoCUS) in the rapid diagnosis of NF. Case Presentation: A 34-year-old male carpenter presented to the Emergency Department of Casey Hospital, with a 48-hour history of increasing swelling and pain in his right arm and chest. Two weeks prior, he sustained an open wound to his right wrist from a rusty nail. Initial management by his family doctor focused on musculoskeletal injury without antibiotics. On ED presentation, the patient exhibited signs of systemic infection and gross swelling of the right upper limb and chest. PoCUS demonstrated characteristic findings of NF, including cobble stoning and subcutaneous air with dirty shadowing, leading to an expedited surgical consultation and immediate intervention. Management and Outcome: The patient underwent multiple debridements, antibiotic therapy, and hyperbaric oxygen therapy. Post-surgical rehabilitation showed substantial gains in function and mobility. Discussion: This case underscores the crucial role of PoCUS in the early diagnosis and management of NF. PoCUS allows for rapid bedside imaging, enabling timely surgical consultation and intervention, thereby improving patient outcomes. The multidisciplinary approach, involving emergency physicians, surgeons, and intensivists, is essential for optimal management of NF. Conclusion: Early recognition and treatment, facilitated by PoCUS, are key to reducing the high morbidity and mortality. Key Messages * Early surgical intervention and antibiotic therapy are crucial in reducing morbidity and mortality in Necrotizing Fasciitis. * Multidisciplinary coordination is required for patient stabilization and rapid transfer from the Emergency Department to the operating theatr…
subject: Case Report
  topic: section
subject: Critical illness & sedation
  topic: category
subject: Emergency Medicine
  topic: keywords
subject: bacteria
  topic: keywords
subject: Point of Care Ultrasound
  topic: keywords
creator: Pourya Pouryahya
creator: Mikhar Haripersad
creator: Alastair Meyer
rights: Copyright (c) 2025 https://creativecommons.org/licenses/by/4.0
date: 2025-02-11
publication date: 2025-02-11
doi: 10.26738/poem.v3i1.43

Assessment of Relatives’ Satisfaction in the Emergency Department
type: item
description: Introduction: Emergency departments (EDs) are high-pressure environments where both patients and their relatives face numerous challenges. While patient satisfaction has been widely studied, the satisfaction of relatives remains underexplored, despite their crucial role in supporting patient care and decision-making. Recognizing relatives as key actors in the care process helps improve communication and reduce stress. This study aimed to assess the satisfaction of relatives of patients treated in the ED. Methods: A prospective, descriptive study was conducted at the ED of the Mahmoud Yaacoub Center for Urgent Medical Assistance in Tunis from October 2023 to January 2024. Satisfaction was assessed using a 25-item structured questionnaire. Included participants were adult relatives directly involved in patient care who gave informed consent. Assessed dimensions included reception and management, information provided and overall satisfaction. Results: The study included 165 relatives (mean age 41 ± 13 years, 52.1% female). Relationships included parents (26%), offspring (18.9%), and siblings (14.8%). Overall satisfaction was high: 78% were satisfied with the overall care, 82% with the initial reception, 74% with waiting times, 80% with accessibility, and 77% with information clarity. No significant associations were found between age or education and overall satisfaction. However, relatives from healthcare or paramedical backgrounds showed significantly higher satisfaction (85%) with the registration process compared to non-healthcare relatives (62%) (p = 0.043). Conclusion: The study supports strengthening the involvement of relatives in strategies aimed at improving ED care quality Introduction Emergency Departments (EDs) are high-pressure, overcrowded environments where skilled professionals provide care for critically ill patients [1,2]. The fast-paced, overcrowded, and unfamiliar ED environment can cause stress and frustration for patients and families, often lead…
subject: Original Article
  topic: section
subject: Core discipline & systems
  topic: category
subject: Emergency department
  topic: keywords
subject: Health care surveys
  topic: keywords
subject: Family satisfaction
  topic: keywords
creator: Camillia Jeddi
creator: Jihen Sebai
creator: Mohamed Kilani
creator: Hafedh Thabet
rights: Copyright (c) 2025 https://creativecommons.org/licenses/by/4.0
date: 2025-09-30
publication date: 2025-09-30
doi: 10.26738/poem.v3i1.106

Admission Criteria and Successful Care of Adults in a Tertiary Care Pediatric Hospital During the COVID-19 Pandemic
type: item
description: Objective The study assessed the health outcomes of adult patients admitted on Pediatric Wards and Intensive Care Unit (PICU) of the Montreal Children’s Hospital (MCH) in Canada during the first and second waves of the COVID-19 pandemic. Methods This retrospective chart review analyzed data regarding all adult patients hospitalized at the MCH on pediatric units between March 14, 2020 and March 31, 2021. Results Forty (40) adults were admitted to MCH pediatric units. The median age was 28.5 years. There were 26 females and 14 males. The average length of stay (LOS) at the MCH was 6.3 days. There were 32 consultations from adult medical consultants performed at the MCH. Seventeen (17) incident reports were completed. There were no in-hospital deaths, but 6 in-hospital incidents were reported. Within the first seven days post discharge from the pediatric units, 1/24 (4%) patients returned to the adult emergency room and an additional 4 patients (16,6%) returned within 30 days. Conclusion With clear admission criteria, careful planning, and well-planned supportive resources treating adult patients within a pediatric care facility by pediatric care teams, also caring for pediatric patients in the same units, could be considered as a safe contingency plan in a time of crisis. Furthermore, admitting and treating adult patients on several pediatric units (PICU) may provide a larger variety of options for admission of adult patients. Introduction The COVID-19 pandemic put a significant stress on the healthcare systems leading to a shortage of hospital beds and equipment, disproportionally affecting older adults compared to the pediatric population1. In response to the critical rise in adult care demands, and considering that very few children required hospitalization due to COVID-19, innovative collaborations were developed to expand adult care capacity. Pediatric medical staff from children’s hospitals and pediatric centres worldwide stepped up to support their adult collea…
subject: Original Article
  topic: section
subject: ED operations, triage & diagnostics
  topic: category
subject: disaster medicine
  topic: keywords
subject: pediatrics
  topic: keywords
subject: pandemic
  topic: keywords
subject: admission criteria
  topic: keywords
subject: adult patients
  topic: keywords
subject: Emergency Medicine
  topic: keywords
subject: healthcare planning
  topic: keywords
subject: emergency preparedness
  topic: keywords
subject: PICU
  topic: keywords
subject: pediatric ward
  topic: keywords
creator: Valerie Homier
creator: Mylène Dandavino
creator: Tanya Di Genova
creator: Megan Traversy-Drolet
creator: Michael Ferrante
rights: Copyright (c) 2025 https://creativecommons.org/licenses/by/4.0
date: 2025-09-02
publication date: 2025-09-02
doi: 10.26738/poem.v3i1.96

Adherence to Screening Recommendations for Diabetic Nephropathy in Lebanese Patients With Diabetes
type: item
description: Background: Diabetic nephropathy (DN) is a debilitating microvascular complication of diabetes mellitus that often progresses before becoming symptomatic, highlighting the importance of screening during comprehensive diabetes management. Therefore, we captured a snapshot of DN screening in a country caught in the whirlwind of a pandemic and a severe economic crisis limiting access to healthcare facilities and adherence to screening schedules. Methods: We conducted a cross-sectional study that assessed the adherence of 258 Lebanese patients with diabetes to the recommended DN screening guidelines in a tertiary medical center. Medical records were analyzed for patient demographics, medication profile and laboratory indicators of glycemic control, e.g. glycated hemoglobin (HbA1c), and kidney function. Results: Less than half of patients in our cohort screened for DN with almost two-thirds recording abnormal markers of kidney function. Only half of the screened cohort underwent follow-up testing. Multivariate analysis revealed that lower HbA1c, lower age, outpatient status and year of first abnormal HbA1c were independently associated with DN screening. Conclusion: National-scale interventions through funding an annual screening and awareness campaign, while institutional-level interventions by implementing a quality improvement process to detect and address gaps in practice, are needed to increase adherence to screening recommendations. Key Messages · What is already known on this topic– Diabetic Nephropathy (DN) is a rapidly progressive condition often detected at late stages, due to limited screening practices. Screening for DN has never been investigated in Lebanon, and the impact of the country’s multifaceted crisis on regular check-ups and screening practices remains unaddressed. · What this study adds – This study is the first to describe DN screening practices in Lebanon across times of crisis. · How this study might affect research, practice or policy- Both nat…
subject: Original Article
  topic: section
subject: Public Health Emergencies
  topic: category
subject: Diabetic Nephropathies
  topic: keywords
subject: Diabetes Mellitus
  topic: keywords
subject: Mass Screening
  topic: keywords
subject: Compliance
  topic: keywords
creator: Elio Issa
creator: Zeina Al Achkar
creator: Pascale Salameh
creator: Francesca El Choueiry
creator: Ramy Touma Sawaya
creator: Khodor Shbaklo
creator: Maryline Alhajj
creator: Ali Choaib
creator: Madona Azar
rights: Copyright (c) 2025 https://creativecommons.org/licenses/by/4.0
date: 2025-07-01
publication date: 2025-07-01
doi: 10.26738/poem.v3i1.58

Spinal Rosai-Dorfman Disease with Isolated Severe Neuropathic Pain: A Case Report
type: item
description: Introduction: Rosia-Dorfman disease is a rare histiocytic disorder that presents as generalized lymphadenopathy. Rarely, patients experience atypical extra-nodal manifestations which can mimic other diseases. Case Presentation: We report a challenging diagnosis of Rosai-Dorfman disease in a 52-year-old female presenting with isolated symptomatic neuropathic pain. After excluding common diseases, a challenging diagnosis was made based on imaging, CSF studies and clinical progression that showed thoracic spine involvement and emperipolesis confirming RDD diagnosis and with a great clinical response to corticosteroids. Discussion: Clinical, laboratory and radiologic manifestations of the disease can vary a lot depending on the areas involved and patient progression. This can lead to challenges in establishing the diagnosis and deciding on treatment. Then unusual, first reported manifestations in our patient made the diagnosis exceptionally challenging, highlighting the importance of this report. Conclusion: This disease can have an atypical presentation that should be detected early to avoid any delay in diagnosis or treatment. Unusual cases must be reported to aid in such a difficult diagnosis in future similar cases. Introduction Rosai-Dorfman disease (RDD) is a rare non-neoplastic histiocytic disorder, also known as sinus histiocytosis with massive lymphadenopathy. Histopathologically, RDD emperipolesis is seen as the phagocytosis of erythrocytes and lymphocytes without their destruction.<!-- [if supportFields]> ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"ngf2xvTk","properties":{"formattedCitation":"\\super 1\\nosupersub{}","plainCitation":"1","noteIndex":0},"citationItems":[{"id":2597,"uris":["http://zotero.org/users/11334842/items/W5NWWSQL"],"itemData":{"id":2597,"type":"article-journal","container-title":"Pediatric Radiology","note":"publisher-place: Washington","page":"425–432","title":"Sinus Histiocytosis with Massive Lymphadenopathy (Rosai-Dorfman Disease)",…
subject: Case Report
  topic: section
subject: Critical illness & sedation
  topic: category
subject: Rosai-Dorfman
  topic: keywords
subject: spinal
  topic: keywords
subject: neuropathic
  topic: keywords
subject: pain
  topic: keywords
subject: inflammation
  topic: keywords
subject: histiocyte
  topic: keywords
creator: Omar El Tarras
creator: Hilal Abdessamad
creator: Jonathan Mina
creator: Hussein Farhat
creator: Wassim Serhal
creator: Rola Husni
creator: Rima Moghnieh
creator: Jacques E. Mokhbat
rights: Copyright (c) 2024 https://creativecommons.org/licenses/by/4.0
date: 2024-09-13
publication date: 2024-09-13
doi: 10.26738/poem.v2i1.37