BACKGROUND: Cholinergic urticaria (CholU) is a condition characterized by small, highly pruritic wheals triggered by sweating. Treatment with histamine H1-receptor antagonists (H1RAs) is often insufficient. CASE PRESENTATION: We report the case of a 20-year-old male who developed CholU following a period of physical inactivity with reduced sweating. Symptoms were reproducibly triggered by exercise or emotional stress and were most severe after prolonged inactivity. The patient undertook a self-directed desensitization approach using weekly dry sauna bathing. Over eight weeks, he experienced progressive improvement, with complete resolution of symptoms that was sustained with continued sessions. CONCLUSION: This case suggests that controlled, repeated sweating may reduce disease activity in selected patients. Sauna bathing may represent a feasible, low-cost, non-pharmacologic adjunct in CholU that warrants further investigation.
BACKGROUND: In September 2020, the home health care program introduced the elastomeric pump Accufuser® to the home parenteral antimicrobial therapy program as a new means of administering medications. We aim to assess the clinical outcomes of this recent addition in comparison to traditional administration methods. METHODS: This is a retrospective cohort study conducted at the Adult Home Health Care Services in King Abdulaziz Medical City, Riyadh. We enrolled all the patients who were accepted at the home parenteral antimicrobial program from January 1, 2019 to May 31, 2022. The outcomes of the group of patients who received therapy through Accufuser® and the group that used other administration methods were compared. RESULTS: We included 285 patients in this study, among whom 167 (58.6%) were females. Eighty-nine (31.2%) patients utilized Accufuser®, while the rest used direct intravenous (IV) (71, 24.9%) and IV piggyback (125, 43.9%). A significant reduction in the duration of visits (P=<0.00) and the number of daily visits (P=<0.00) was observed in the group that used Accufuser®. Both groups had similar rates of therapy completion (P=0.14). No significant difference was noticed in the rates of complications (P=0.57) or the rates of mortality between the two groups (P=0.14). CONCLUSION: The Accufuser® device is a safe administration method that reduces both the duration and the number of daily visits.
BACKGROUND: Echinococcosis is a helminthic disease caused by the development of the larval form of the echinococcal tapeworm in various human organs. The detection of an echinococcal cyst in the pelvic region, especially as a primary localization, is extremely rare, with literature data showing a frequency between 0.2 and 2.25%. Ovarian involvement is often a secondary dissemination of a cyst localized in a different location. CASE REPORT: We present a 17-year-old girl with complaints of mild pain, heaviness in the small pelvis, and a cystic formation was detected by ultrasound examination. CONCLUSION: Diagnosing this disease is extremely important for proper treatment. The possibility of a hydatid cyst should be kept under differential diagnosis while evaluating the cystic diseases of the ovary.
BACKGROUND: Extended-spectrum beta-lactamase (ESBL) producing pathogens are a growing health threat due to their resistance to most of the commonly used antimicrobial agents. AIM: In this paper, we aimed to assess the prevalence of those pathogens among patients who received care in the home parenteral antimicrobial therapy program. We also aimed to examine the burden of those pathogens on the home health care services and discuss the options to minimize this burden. METHODS: This retrospective cohort study was conducted in the Adult Home Health Care Service at King Abdulaziz Medical City in Riyadh, Saudi Arabia. We studied all patients referring to the home health care parenteral antimicrobial program in the period from January 1, 2019 to December 31, 2021. Patients' data were retrieved from their electronic medical records. We classified patients as a patient with ESBL infection and a patient with a non-ESBL infection based on their cultures. RESULTS: A total of 253 patients, of whom 144 (56.9%) were females, were accepted into the home parenteral antimicrobial therapy during the specified period. Of these, 121 (47.8%) were treated with an infection with ESBL-producing bacteria. Escherichia coli (92.76.0%) and Klebsiella pneumoniae (23.19.0%) were the most commonly isolated ESBL pathogens. Female gender, a previous history of UTI or ESBL infection, cognitive impairment and BPH in men were all associated with a higher rate of ESBL infections (P<0.05). Infection caused by ESBL-producing pathogen was not associated with a significantly increased rate of complications, readmission or mortality (P≥0.05). CONCLUSION: Almost half of the patients treated in the home parenteral antimicrobial program are infected with an ESBLproducing pathogens. However, we did not find any significant increase in adverse clinical outcomes associated with those infections in our sample. The burden on the HHC services that comes with these infections is mostly related to the limited choices of antimicrobials and to the high rate of recurrence.
BACKGROUND: In daily pediatric clinical practice, in addition to the standard markers such as PCR. AIM: We aimed to demonstrate the role of Procalcitonin in early detection of bacterial infections of the respiratory tract at pediatric age and to determine the sensitivity, specificity, VPP, PCT VNP (quantitative method VIDAS-B-R-A-H-M-S-PCT) in bacterial respiratory infections. METHODS: The prospective, randomized study, conducted at the Clinical Tetovo Hospital (Neonatology Department - Pediatric, Clinical and Biochemical Laboratory), in the period November 2011-December 2012. It includes 99 children. The study group includes 76 children. With upper respiratory tract infections (tonsil pharyngeal) 35 cases. With respiratory tract infections (bronchopneumonia) 41 cases, control group 23 cases. RESULTS: With tonsil pharyngeal infections, out of 35 cases (28.57% were bacterial by criterion). With respiratory tract infections (bronchopneumonia), from 41s (39.02% were bacterial by criterion). In all 35 studies with bacterial tonsil pharyngeal disease, specificity, sensitivity, PPV, NPV of Procalcitonin, which resulted in the following (88%, 90%, 75%, 95.65%), and P = 0.12. All 41 patients with bacterial bronchopneumonitis were calculated as: Specificity, Sensitivity, PPV, and NPV of Procalcitonin, which resulted in the following (72.73%, 100%, 76%, and 100%). and P = 0.12. CONCLUSION: Procalcitonin may serve as an early marker of upper and lower respiratory infections.
