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Introduction: Oculoplastics is a subspecialty of ophthalmology that focuses on a wide range of disorders affecting the eyelids, lacrimal system, and orbit. Common conditions include ptosis (eyelid drooping), nasolacrimal duct obstruction, thyroid eye disease, orbital fractures, and others. In this review, we explore the spectrum of benign orbital lesions in the pediatric population, with a focus on the most common entities.

Introduction: Nasal fractures are the most prevalent among facial fractures, constituting 40-50% of all such injuries. They can be isolated or accompany multi-system trauma, including damage to soft tissues or other fractures. When addressing a patient with a suspected nasal fracture, anamnesis is paramount. It is crucial to discern the mechanism and timing of the trauma. The latter is essential as the most recent data indicates a 14-day "treatment window" for closed reduction, a procedure that does not require general anesthesia. Contrary to past practices, imaging studies are now deemed unnecessary for diagnosing nasal fractures. After collecting the patient's history, a physical examination ensues. It begins with observing the nose's shape and skin, followed by manually examining the nasal structure, and then an anterior rhinoscopy. Clinicians should keenly observe and note any nasal bone discontinuities, epistaxis, septal displacements or fractures, and septal hematomas. Treatment options can be divided into three main options: 1) observation, 2) closed reduction, and 3) open reduction; each needs to be tailored to the individual case.

Objectives: To explore the circumstances that contributed to the development of neonatology and neonatal units in Israel, and to recognize the key figures who played an essential role in these advancements.

Methods: This qualitative study involves in-depth, semi-structured interviews with a purposively selected group of participants, including pediatrics, NICU managers, managers in the Israel Neonatal Society, and policymakers from Israel's Health Department. Interviews were conducted in a free narrative setting to encourage open sharing of personal experiences and opinions, with all sessions audio-recorded and transcribed verbatim for accuracy. Thematic analysis was applied to the transcripts to identify recurring patterns and themes, providing an in-depth understanding of participant views. Additionally, text analysis of policy documents and guidelines from Israel's Ministry of Health and other relevant organizations was conducted using content analysis to complement and broaden the insights obtained from interviews. The study adheres to strict ethical standards, including obtaining informed consent and maintaining participant confidentiality.

Conclusions: This study was conducted as part of the requirements for MD degree from the Goldman Medical School at the Faculty of Health Sciences, Ben-Gurion University of the Negev.

Introduction: This article describes the case of a middle-aged patient who, following cardiopulmonary resuscitation, was placed on veno-arterial extracorporeal membrane oxygenation (VA-ECMO) with subsequent hemodynamic stabilization. Given a low hemoglobin level and a family request for transfusion, a focused literature review was conducted to assess the appropriateness of blood transfusion in this context. Concurrently, the large language model ChatGPT was evaluated in its Deep Research configuration for its ability to address complex and urgent clinical questions, discussing its advantages and limitations. The case prompted broader consideration of the integration of artificial intelligence into clinical decision-making, the risks of automation bias, and the changing role of physicians in an era where algorithms retrieve information. Nonetheless the clinical responsibility remains on the shoulders of the human clinician.

Introduction: Review for "The Search for Meaning in Disease", a book by Amos M. Yinnon.

Background: The implementation of integrative medicine in an oncology setting (Integrative Oncology, IO) is increasingly taking place in cancer centers across Israel and worldwide, often together with palliative care.

Objectives: To learn about a collaborative treatment setting involving a team of gyneco-oncology, supportive and palliative care and IO healthcare professionals and practitioners.

Methods: This narrative-based study analyzed the treatment of a patient with advanced ovarian cancer from the perspectives of healthcare professionals and practitioners from the three disciplines.

Results: The patient, a young woman from Israel with a diagnosis of ovarian cancer, had always had a strong affinity toward alternative medicine practices. The medical team at the study center accompanied her from the initial diagnosis until her passing. The narratives presented include those from the IO team of practitioners working in the gyneco-oncology department, her gyneco-oncologist and the palliative care nurse. These perspectives addressed the goals of the IO program, and the quality of the interaction in meeting therapeutic challenges, including during end-of-life care.

Conclusions: Clinical collaboration between oncology surgeons, palliative care professionals and IO practitioners may facilitate communication with patients whose health-belief model challenges that of medical and nursing staff. This interaction may create a synergistic process, sharing treatment goals with the patient.

Introduction: Over the past decade, complementary medicine services have been increasingly integrated into departments of obstetrics (i.e., Integrative Obstetrics) throughout Israel. This case report is presented with the goal to learn about a collaborative treatment setting involving a team of obstetric and integrative medicine practitioners. The narrative-qualitative case report analyzed the response of a woman who had been referred to an Integrative Obstetrics service after giving birth. The patient was hospitalized in the postnatal obstetric department, where she was referred by the chief department nurse to an Integrative Obstetrics service treatment with the indication of post-lumbar puncture headache pain, two days following birth. The narratives analyzed for the case study included those from the patient, the referring nurse, the patient, the integrative medicine practitioner, and the patient's obstetrician. This case study was analyzed within the broader context of integrative obstetric programs in Israel. In conclusion, communication between the obstetric and integrative medicine teams is a key factor in providing an informed referral to integrative obstetric care, based on a focused clinical indication (e.g., pain), and in creating a unified and multi-disciplinary therapeutic approach which is then documented in the patient's medical record.

Introduction: This case report presents a 36-year-old woman with a large pericardial effusion secondary to severe hypothyroidism. Notably, despite pronounced echocardiographic findings, the patient displayed minimal clinical symptoms, underscoring the importance of recognizing the association between hypothyroidism and pericardial effusion. Management with thyroid hormone resulted in significant clinical improvement, and no recurrence of the effusion.

Introduction: Varicella Zoster Virus (VZV) is a common cause for acute retinal necrosis (ARN). On the other hand, Epstein-Barr Virus (EBV) is considered a rare cause for viral retinitis. Ocular co-infection with two viruses or more was described in a few isolated cases. In this case report, a 61 year old female with a history of Hodgkin lymphoma presented to the ophthalmic ER because of painless vision loss in her left eye. There was an inflammatory reaction +3 in both eyes. It was a normal fundus examination in the right eye. Fundus examination of the left eye showed 1+ vitreous haze, papillitis, the retina was flat with peripheral foci of retinal necrosis with discrete borders, exudates and perivascular sheathing. Fluorescein angiography of the right eye was normal and in the left eye demonstrated occlusive vasculitis and dye leakage from the peripheral foci. Vitreous tap revealed high titer VZV and lower titer EBV infection. Intravenous acyclovir and intravitreal foscarnet injections and systemic prednisone were started. After one week the patient developed retinal detachment in the lower part. Surgical intervention was performed. An improvement was shown after the surgery and there was a reduction in the retinal lesions, as a result the anti-viral dosage was reduced. In her next visits a further deterioration was observed - that manifested in exudative retinal detachment and retinal hemorrhage as an expression for ARN. Peeling and retinotomy surgery and frequent follow-ups in the uveitis clinic were the following steps. ARN caused by co-infection with VZV and EBV can by treatment-resistant, especially in immunosuppressive patients. Patients can benefit from early detection and intervention and frequent follow-up.

Introduction: Urinary diversion, with or without cystectomy, is a radical option for individuals experiencing end-stage lower urinary tract dysfunction caused by non-malignant bladder conditions. Our aim was to highlight our experience with this procedure, focusing particularly on its safety.

Methods: Demographic, clinical, and surgical data were collected for patients who underwent the procedure. Postoperative complications were examined and classified into short-term (<30 days) and long-term (>30 days) complications.

Results: Twenty-three patients (48% women, median age 60 years (IQR:44-67 years)) underwent urinary diversion for benign indications. Eight (35%) and six (26%) patients, underwent urinary diversion without cystectomy and supra-trigonal cystectomy respectively. The most common indications for surgery were a non-functioning bladder due to, oncological treatments (39%), neurogenic bladder (17%) and refractory interstitial cystitis (13%). Postoperative complications were recorded in 60% of patients, with 87% of these being low-grade complications (Clavien-Dindo ≤2). Two patients experienced late complications, and one patient died three months after surgery due to septic shock. No complications or need for additional cystectomy were documented in patients who underwent urinary diversion alone.

Conclusions: Urinary diversion, with or without cystectomy, is an effective and relatively safe solution for refractory end-stage bladder dysfunction. The surgery improves the quality of life and coping for patients with a non-functioning bladder. Despite the potential surgical complications, it should be considered as a last resort when other conservative treatments have failed. Further studies with larger cohorts are needed to validate these findings.