Nonketotic hyperglycinemia is a rare inborn error of glycine metabolism characterized by a severe metabolic encephalopathy with drug-resistant seizures. Here, we report the outcome of nonketotic hyperglycinemia in a cohort of patients diagnosed and followed-up at a tertiary care reference center in Lebanon, between 2000 and 2014.Eight out of 12 patients with nonketotic hyperglycinemia were retrospectively reviewed. The remainders were excluded for incomplete data. The majority of cases presented with seizures and hypsarrhythmia or burst suppression patterns. Half of the patients died. Survival varied between 7 days and 18 years. Seizures remained unresponsive with poor outcome, despite standard supportive care and antiepileptic therapy; however, two patients were responsive to ketogenic diet and one of them became seizure-free.Scarce data on the outcome of nonketotic hyperglycinemia patients from the Middle East and North Africa region are available. The ketogenic diet, in combination with standard therapies, appears to be effective in controlling the seizures in this devastating disorder. Larger multicenter studies are still needed to establish the role of the ketogenic diet in nonketotic hyperglycinemia.

Objectives: Sexual harassment is one of the most common workplace issues that female employees may experience. The issue is especially severe for women working in a healthcare setting due to factors, such as unequal hierarchical power, night shifts, and a significant volume of visitors, etc. This study sought to characterize and categorize responses to and causes of acute sexual harassment. Methods: Thirty-nine hospital employees who had experienced sexual harassment were selected for in-depth interviews as part of a qualitative study designed to collect data. Results: The responses were categorized chronologically as pre-, during-, and post-harassment. Preventive strategies were the most notable pre-harassment responses, whereas, during harassment, diffusion, denial, avoidance, and behavioral changes were the most significant responses. Nonetheless, since diffusion, avoidance, non-disclosure, and non-reporting could result in the persistence of the harassment, the post-harassment strategies shed light on the factors that determined the victims' failure to disclose sexual harassment. Discussion: Although women experience sexual harassment in healthcare settings, they typically refrain from reporting it and respond passively to such situations. Formal and informal organizational support for the harassed women can empower them to resist harassers and report their conduct in hospital settings.

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