Journal of Acute Disease

133-141

Authors: Mohammad Hossein Feiz Haddad1, Azar Shokri2, Habib Habibpour3, Seyede Manizhe Heidar Nejadi4

Acanthamoeba keratitis, a vision-threatening disease, is caused by a free-living amoeba of genus Acanthamoeba. Amoeba is widely distributed all around the world. Several cases of Acanthamoeba keratitis have been reported from the Middle East and Iran as well. The infection is mainly caused by inappropriate use of contact lens; therefore, it is more common among lens wearers. The number of reported cases worldwide is increasing annually due to the increasing number of contact lens wearers for medical or cosmetic reasons. It is known that early diagnosis and treatment can reduce consequent damages, while the delay in these processes will deteriorate the vision. Nowadays contact lens wearing, surgery and use of corticosteroids are known to predispose to Acanthamoeba keratitis, and it was also believed that trauma was the main cause. Increasing public knowledge about Acanthamoeba infection, inquiring the history of patients, clinical signs and laboratory findings can be helpful to early diagnosis and better treatment. Regardless of the increasing knowledge of diagnosis and treatment, this disease is still a challenge. Considering the long curative time, and insufficient efficacy of available treatments, it seems that the prevention is more important than the treatment. This review aimed to explain Acanthamoeba keratitis in the Middle East and Iran from the aspects of epidemiology, diagnosis, and therapeutic treatment.

146-152

Authors: Eman Hussein Hussein Elfeky, Maii Atef Shams Eldeen, Amel Abd El-Tawab Hashish, Azza Mahmoud Hassan

Objective: To compare the inhibitory effect between DL-tryptophan and bovine lactoferrin on biofilm formed by isolated Pseudomonas aeruginosa strains. Methods: The study was carried out on 40 patients suffering from surgical site infection. Wound pus was collected using sterile swabs after isolation, and identified by common bacteriological methods. Isolated Pseudomonas aeruginosa strains were grown on biofilm enhancing materials, and then the inhibitory effects of different concentrations of DL-tryptophan and lactoferrin were tested using scanning electron microscopy and microtitre plate methods. Results: There was no significant difference in the inhibitory effect between DL-tryptophan and lactoferrin at 0.5 mg/mL. While in concentration of 1 mg/mL and 2 mg/mL, tryptophan showed more significant inhibitory effect than lactoferrin. Conclusions: Both DL-tryptophan and bovine lactoferrin have inhibitory effect on Pseudomonas aeruginosa biofilm formation in a dose dependent manner, and the inhibitory effect of DL- tryptophan is stronger.

160-164

Authors: Ibrahim Aliyu1, Godpower Chinedu Michael2, Haliru Ibrahim3, Zainab F Ibrahim4, Umma Idris5, Bashir Mariat Zubayr6, Halima Umar Ibrahim

Objectives: To assess the basic knowledge of cardiopulmonary resuscitation (CPR) among health workers in a tertiary health facility in a semi-rural county. Methods: A questionnaire based, cross sectional study involving health care professionals was performed in Federal Medical Centre, Birnin Kudu, Jigawa State, Nigeria from April to July 2017. A purposive sampling method was adopted for subject selection. A pretested self-administered questionnaire was distributed; this included knowledge on basic life support; participation in basic life supportand outcomes. It was adopted from the American Heart Association guidelines for CPR and emergency cardiac care. Results: One hundred and two respondents were recruited (40 doctors and 62 nurses). There were 50 males (49%) and 52 females (51%). Their age ranged from 23 to 54 years with mean of (34.9± 7.4) years. Only 20% of the respondents were aware of circulation, airway and circulation in adult resuscitation; however, 61.0% of all respondents were aware of airway, breathing and circulation of resuscitation in children. Furthermore, only 10% of the respondents were aware of the correct steps of single rescuer resuscitation. Their knowledge was poor about chest compression and ventilation for both adult and children resuscitation. The overall knowledge score ranged from 0.0% to 100% with mean knowledge score of (21.2±18.6)%. The date of last training about CPR had no relationship with the knowledge scores (χ2=2.951, P=0.300). The cadre of the respondents (doctors and nurses) had no relationship with their knowledge score (χ2=0.100, P=0.633 for doctors and nurses; ,χ2=7.074, P=0.225 for doctors cadre; XX2=3.868, P=0.677 for nurses cadre) respectively. Conclusions: The knowledge about CPR among health workers is poor; furthermore, the last date of training about CPR and the cadre of staffs have no relationship with knowledge of CPR.

170-172

Authors: Keyvan Kiakojuri1, Mojtaba Taghizadeh Armaki2, Ramazan Rajabnia3, Abazar Pournajaf3, Mohsen Karami2, Saeid Mahdavi Omran2

Rationale: Stevens-Johnson syndrome is a disorder mostly attributed to drug use, which can cause different skin problems. Patient concerns: A 31-year-old woman presented with severe pain and pounding in the left ear. Diagnosis: Fluconazole-induced Stevens-Johnson syndrome with fungal infection in ear. Intervention: Surgical and systemic antibiotic therapy. Outcomes: The patient recovered and resumed her normal life. Lessons: The prescription of fluconazole for patients with underlying conditions should be done with caution.

176-178

Authors: Morteza Dehnokhalaji1, Mahnaz Abavisani2, Zohreh Sarchahi2

Rationale: Necrotizing fasciitis is a rare infection of fascia tissues. It progresses quickly and has high morbidity and mortality. In this study, we aimed to explore a case of necrotizing fasciitis in a diabetic patient. Patient concerns: A 46-year-old woman presented with severe pain and inflammation in the left leg, and with fever and chills. Diagnosis: Necrotizing fasciitis in the left leg. Intervention: Broad debridement of infectious tissues and broad-spectrum venous antibiotics. Outcomes: The patient was discharged without pain, inflation, or fever. Lesson: This disease is a surgical emergency, therefore, early diagnosis and quick and invasive treatment could significantly decrease morbidity and mortality.