Valve replacement surgeries holds risks of morbidity and mortality. The study cohort included 346 patients who underwent different types of valve surgery, excluding redo and Bentall operations. All operations were performed through a median sternotomy using cardiopulmonary bypass. Mean patient age was 51.6±16.1 years, and 51% were male. Approximately 21% had diabetes, and 44.6% were hypertensive. Aortic valve replacement (AVR) was performed in 125 patients (37%), mitral valve replacement (MVR) in 95 (28%), combined AVR and MVR in 42 (13%), AVR plus coronary artery bypass grafting (CABG) in 19 (6%), and MVR plus CABG in 32 (10%). Operative mortality was 5.8% (n=20). In the bivariate-level analysis, older age, operation type, hypertension, emergency surgery, use of a biological valve in the aortic or mitral position, pump time greater than 120min, and aortic clamp time greater than 60min were significant predictors of 30-day mortality. Use of medications stratified by duration (less than or more than a moo be independent predictors of mortality in patients undergoing valve surgery. Further prospective multicenter studies may be needed to provide a comprehensive assessment of mortality in patients undergoing valve surgery in Jordan. and importance Conjunctival melanoma (CM) is a rare and potentially lethal ocular tumor. As with any oncologic disease, early diagnosis and appropriate treatment of CM is paramount to limit morbidity and increase life expectancy. However, patients with severe mental disability with social isolation are usually presented in late-stage disease. This report presents a case of a 55-year-old man with paranoid schizophrenic man with an extraordinarily large CM due to neglect. The patient suffered from complete left eye blindness with no clinical and radiological evidence of metastasis. Clinicians must bear in mind the limited patient compliance and family support of mentally-ill patients that restricts treatment modalities that would have otherwise been applicable for cooperative patients. The importance multidisciplinary approach, choosing the simpler but effective surgical technique should be prioritized. Left exenteration and tumor wide excision was performed. The left orbital defect was reconstructed using forehead flap and split-thickness skin graft (STSG). The uncooperative nature of the patient posed early post-operative challenges that necessitates subsequent operation to drain seroma. The patient was discharged 16-days after operation with acceptable cosmetic and clinical results. However, the patient failed to return to the clinic for longer post-operative evaluation. A multidisciplinary approach is mandatory to treat complex cases such as this report. Surgeons are advised to adopt simpler surgical approach that will require minimal self-care and should encourage family members to continuously support the patient. A multidisciplinary approach is mandatory to treat complex cases such as this report. Surgeons are advised to adopt simpler surgical approach that will require minimal self-care and should encourage family members to continuously support the patient. Perforated or pT4 colonic tumors have a bad prognosis with a high rate of relapse, including peritoneal relapse (20-30%). Our aim is to analyze the effectiveness of Second Look surgery (SLS)+hyperthermic intraperitoneal chemotherapy (HIPEC) in these patients for early treatment of peritoneal relapse (PR) or for preventing it. Patients previously operated for colon cancer, either pT4 or perforated (M0), with no evidence of disease at any level after adjuvant chemotherapy, who undergo systematic SLS+HIPEC (Oxaliplatin 30min) one year after the initial surgery. Since February 2014 to July 2018, we performed SLS+HIPEC in 42 patients with M0, either pT4 (n=33) or perforated (n=9) colon cancer. Although during SLS there were suspicious lesions in 15 cases (37.5%), they were histologically confirmed in only 4 (9.5%). Histologically confirmed peritoneal relapse (PR) rate at SLS was 6% in pT4 (2/33) and 22.2% in perforated tumors (2/9). Prophylactic HIPEC was performed in all the cases. There was no postoperative mortality. Grade III-IV morbidity occurred in 19% (8/42). With a median follow-up of 33.8 months after primary tumor surgery, 6/42 patients (14.3%) presented peritoneal relapse (PR). 3-year peritoneal disease free survival was 86%, with 3-year disease free survival of 78.6% and 5-year overall survival (OS) of 97.4%. Peritoneal relapse and survival rates are remarkable in these groups of, a priori, very bad prognosis, which could suggest a beneficial effect of HIPEC. Peritoneal relapse and survival rates are remarkable in these groups of, a priori, very bad prognosis, which could suggest a beneficial effect of HIPEC. Varicella zona infection is a rare condition in immunocompetent adults. It can lead to severe and lethal complications including Varicella pneumonia that can rapidly progress to acute respiratory distress syndrome a rare and life-threatening situation. A 63 years old man was admitted to the intensive care unit for pneumonia with generalized papulovesicular lesions. After investigations, the diagnosis of Varicella pneumonia complicated with acute respiratory distress syndrome was maintained and the patient was put on mechanical ventilation, and despite proper management (antiviral treatment; protective ventilation and prone position) the patient died 48 hours after his admission. Despite its rarity, Varicella pneumonia can be a life-threatening situation in immunocompetent adults. The diagnosis must be evoked when the patient presented with respiratory manifestations with dermatologic lesions. Despite its rarity, Varicella pneumonia can be a life-threatening situation in immunocompetent adults. The diagnosis must be evoked when the patient presented with respiratory manifestations with dermatologic lesions. The COVID-19 pandemic has imposed significant challenges on medical education worldwide, particularly in experience- and resource-limited regions of the world. Collaborative efforts of educators and academic institutions are necessary to facilitate the adaptation to the new educational reality. In this study, challenges and outcomes of a newly implemented distance education curriculum are examined to share findings and provide recommendations. An alternative distance education curriculum with online resources and virtual lectures was developed and implemented in February 2020at the Wasit University College of Medicine in Iraq. https://www.selleckchem.com/products/procyanidin-c1.html A post-implementation survey was developed for both faculty instructors and students to evaluate the program's effectiveness and perception. Results were compared between both groups. The study was approved by the University's Dean and exempted by the research committee for anonymity. A total of 636 students and 81 instructors were surveyed. Approximately 33% of students and 51% of instructors found online education equivalent or superior to traditional face-to-face teaching methods.