Molecular Detection of Candidatus Orientia chuto in Wildlife,Saudi Arabia

Scrub typhus is a zoonosis caused by 3 species of Orientia bacteria, including Candidatus Orientia chuto. This species is known only from a human case in Dubai and infections in wildlife in Kenya. We report molecular detection of Candidatus O. chuto in 2 wild rodent species from Saudi Arabia.     

Use of ultrasound guidance to improve the safety of percutaneous dilatational tracheostomy: a literature review

Patients in ICUs frequently require tracheostomy for long-term ventilator support, and the percutaneous dilatational tracheostomy (PDT) method is preferred over surgical tracheostomy. The use of ultrasound (US) imaging to guide ICU procedures and interventions has recently emerged as a simple and noninvasive tool. The current evidence regarding the applications of US in PDT is encouraging; however, the exact role of US-guided dilatational tracheostomy (US-PDT) remains poorly defined. In this review, we describe the best available evidence concerning the safety and efficacy of US-PDT and briefly delineate the general principles of US image generation for the airway and of US-PDT procedures.     

Energy Transfer Studies in Tb3+-Yb3+ Co-Doped Phosphate Glasses

Detailed optical properties of Tb³⁺-Yb³⁺ co-doped phosphate glasses were performed based on their emission spectra and decay measurements. Under blue excitation of Tb³⁺ at 488 nm, the intensity of Yb³⁺ emissions gradually enhanced upon increasing the Yb³⁺ content until 1 mol% indicated an energy transfer from Tb³⁺ to Yb³⁺. Otherwise, under near infrared excitation of Yb³⁺ at 980 nm, these glasses exhibit intense green luminescence, which led to cooperative sensitization of the ⁵D₄ level of Tb³⁺ ions. A cooperative energy transfer mechanism was proposed on the basis of the study on the influence of Yb³⁺ concentration on up-conversion emission intensity, as well as the dependence of this up-conversion intensity on near infrared excitation power. Moreover, the temporal evolution of the up-conversion emissions have been studied, which was in positive agreement with a theoretical model of cooperative up-conversion luminescence that showed a temporal emission curve with rise and decay times of the involved levels.     

Descending necrotizing mediastinitis

Descending necrotizing mediastinitis (DNM) is a rare but severe life threatening complication of oropharyngeal infections. We report a young lady who had severe pharyngitis complicated by anterior neck infection that descended to the mediastinum causing necrotizing mediastinitis. The course of her illness was complicated with septic shock, acute kidney injury, tracheo-esophageal fistula, and critical illness polyneuropathy. There was considerable delay in her diagnosis; however, she survived after aggressive surgical intervention, wide spectrum antibiotics, and appropriate intensive care management. Early and repeated chest imaging using computed tomography was vital for the detection and follow up of this case. There is a need to increase physicians’ awareness of this condition that can complicate odontogentic or pharyngeal infection, procedures, or trauma.Descending necrotizing mediastinitis (DNM) is a rare but severe life threatening complication of infection in the oropharyngeal region that descends to the mediastinum through the connecting deep and superficial cervical fascial planes.1 The primary origin of the infection can be an odontogenic infection, pharyngeal soft tissue infection, sinusitis, or following cervical trauma.2,3 It is associated with high mortality unless it is diagnosed and treated promply.4 Old age and chronic medical conditions are important predisposing factors.2,3 We report a young patient with DNM who survived despite a considerable delay in diagnoses and a complicated course in the intensive care unit (ICU). We report this particular case to draw the clinician’s attention to this rare, but potentially fatal complication of common odontogenic and cervical infections, and emphasize the importance of early recognition and prompt management.     

Alcohol mixed with energy drink (AMED): A critical review and meta‐analysis

The purpose of this systematic review and meta‐analysis was to critically review the (1) prevalence of alcohol mixed with energy drink (AMED) consumption, (2) motives for AMED consumption, (3) correlates of AMED consumption, and (4) whether AMED consumption has an impact on (a) alcohol consumption, (b) subjective intoxication, and (c) risk‐taking behavior. Overall a minority of the population consumes AMED, typically infrequently. Motives for AMED consumption are predominantly hedonistic and social. Meta‐analyses revealed that AMED consumers drink significantly more alcohol than alcohol‐only (AO) consumers. Within‐subject comparisons restricted to AMED consumers revealed that alcohol consumption does not significantly differ between typical AMED and AO occasions. On past month heaviest drinking occasions, AMED users consume significantly less alcohol on AMED occasions when compared to AO occasions. AMED consumers experience significantly fewer negative consequences and risk‐taking behavior on AMED occasions compared with AO occasions. Meta‐analyses of subjective intoxication studies suggest that AMED consumption does not differentially affect subjective intoxication when compared to AO consumption. In conclusion, when compared to AO consumption, mixing alcohol with energy drink does not affect subjective intoxication and seems unlikely to increase total alcohol consumption, associated risk‐taking behavior, nor other negative alcohol‐related consequences. Further research may be necessary to fully reveal the effects of AMED.     

LE SULFATE DE MAGNESIUM : MOLECULE ADJUVANTE DANS LA PREMIERE HEURE DE PRISE EN CHARGE DE LA FIBRILLATION ATRIALE RAPIDE AUX URGENCES.

Introduction:

Rapid Atrial fibrillation (AF) is a common arrhythmia in emergency department (ED) that requires an urgent control of ventricular rate.

Aim:

To evaluate the safety and efficiency of magnesium sulfate as an adjunctive therapy in addition to usual care for rapid AF in emergency department.   

Methods:

This was a prospective, randomized, double-blind study. We included patients who presented to ED with rapid AF >110 batt/min. Group A received 3g of magnesium in 100mL of glucose solution and group B received 100 ml of glucose solution. Primary endpoint was slowing the ventricular rates to less than 110 beats/ min in the first 12 hours of management.   

Results:

One hundred and three patients were included. Fifty-three patients in group A with a mean heart rate of 146 ± 18 beats / min and fifty patients in group B with a mean heart rate of 143 ± 17 beats / min. A significantly greater number of patients slowed down their ventricular rate in group A during the first hour of management (p = 0.02). After 12 hours, mean heart rate was significantly lower in group A (p = 0.04).

Conclusion:

The use of 3 g of magnesium sulfate slowed down the ventricular rate of a larger number of patients with rapid AF in the first hour of management. Only minor adverse effects were registered.