Journal of Acute Disease

244-247

Authors: Azadeh Haghi Navand1 , Saber Soltani2 , Mona Moghadami3 , Parastoo Hosseini2 , Sepideh Nasimzadeh1 , Milad Zandi

Diabetes, as the major cause of hyperglycemia, is a chronic metabolic disease. Immune system disorders caused by diabetes can increase the risk of respiratory diseases. Thus, diabetes is considered to be a major risk factor for viral respiratory infections such as coronavirus infections. Coronaviruses are members of the Coronaviridae, which has caused three outbreaks from 2003 to 2020. Patients with coronavirus infection in the lower and upper respiratory tract could show mild to severe symptoms. In this review, we focus on the relationship between diabetes and three coronaviruses: SARS-CoV, MERS-CoV, and SARS-CoV-2.

253-256

Authors: Shahnaz Armin1 , Abdollah Karimi1 , Fatemeh Fallah1 , Roxana Mansour Ghanaei1 , Sedighe Rafiei Tabatabaei1 , Seyed Alireza Fahimzad1 , Seyedeh Mahsan Hoseini-Alfatemi1 , Maryam Rajabnejad1 , Hamid Eshaghi2 , Gholamreza Soleimani3 , Hosein Heydari

Objectives: To evaluate clinical features, treatment strategies, and outcomes of pleural empyema for children who were treated at referral pediatric hospitals in 8 provinces of Iran. Methods: In this retrospective, multicenter cross sectional study, we retrospectively retrieved patients’ data from 8 teaching hospitals during 2010 and 2017. A questionnaire was applied and filled, and all data were statistically and descriptively analyzed. Results: In total, 191 children (109 males and 82 females) were included. Their mean age was 4.95 years and ranged from 11 months to 16 years. The majority of cases (45.1%) were 1-4 years old. Fever (70.3%), cough (65.6%), tachypnea (53.1%), chest pain (14.6%), and abdominal pain (12%) were the most common manifestations at admission. The mean length of admission in hospital was 16.4 d. Consequently, 27 patients (14.1%) were admitted into the pediatric intensive unit because of severe illness, and 15 patients (7.9%) died. Logistic regression analysis showed that younger age (less than 12 months) and presence of underlying diseases (such as cardiovascular disease, immune deficiencies, malignancies, and neuro-developmental delay) significantly increased the mortality rate of patients with pleural empyema (P=0.004 and P=0.001, respectively). Conclusions: Pleural empyema children of younger age and with underlying diseases are at higher risks of death. In addition, guidelines for treating pleural empyema should be developed.

263-269

Authors: Neeraj Agarwal, Bijit Biswas

Objective: To investigate the risk factors and protective measures of COVID-19 among policemen in an eastern state of India. Methods: This case-control study was conducted in Bihar, located in the eastern part of India. In total, 6 confirmed COVID-19 cases (the case group) and 11 negative contacts of these cases (the control group) of Bihar Military Police participated in the study. Results: All subjects were male with a median age of 51 (range: 23-60) years. Among these 6 confirmed cases, 5 cases were asymptomatic. One third (33.3%) of the case group and the majority (90.9%) of the control group reported maintenance of physical distance of at least 1 meter with others all the time, which was significantly different (P=0.028). There was no other statistically significant difference between the case group and the control group. Conclusions: Physical distancing is the most effective public health measure to control contagious diseases like COVID-19, especially in the absence of an effective vaccine in police settings.

272-274

Authors: Suman Rastogi1 , Anandhi Devendiran1 , Divankur Khanna1 , Nanda Kishore Maroju2 , KNJ Prakash Raju1

Rationale: Colonic barotrauma induced by high-pressure air compressors has been reported more frequently these days due to the widespread use of air compressors in industries. Such enormous pressure into the rectum can lead to devastating injuries. Patient’s concern: A 35-year-old male was referred to our emergency department with an alleged history of directing high pressure compressed air jet towards the anus. There was diffuse subcutaneous emphysema over the neck, chest, abdomen, and extremities, and he presented with hemodynamic instability and respiratory failure. Diagnosis: Rectosigmoid perforation due to exposure to high-pressure air jet causing tension pneumoperitoneum, pneumomediastinum, pneumothorax, and extensive subcutaneous emphysema. Intervention: In view of tension pneumoperitoneum, urgent percutaneous needle decompression was performed using 16 G needle, 5 cm superomedial to the anterior superior iliac spine. The gush of air was released along with reduction in abdominal distension and improvement in hemodynamics. Outcome: The patient succumbed two days later due to septic shock. Lessons: This case highlighted the importance of promoting education about work safety among industrial workers especially in developing countries like India.