Percutaneous retrieval of a dislodged guide wire by dormia basket in a 98-year-old patient, still a safe and feasible approach

Since the first report of percutaneous retrieval of intravascular foreign body in 1964, it has been accepted as a favorite approach for intravascular foreign body removal. Various instruments such as snares, biopsy forceps, dormia basket or tip deflecting wires are available for this approach. Herein, we report percutaneous retrieval of a dislodged guide-wire by dormia basket. The Patient was a 98-year-old female who was admitted in the Intensive care unit due to confusional state. The physian incharge left the guide-wire in her subclavian vein during central venous catheter insertion. He realized his fault immediately, so he started anti-coagulation therapy and requested surgical consult. Because of the patient's high risk of surgery, the surgeon referred the patient to cardiologist for non-invasive guide wire removal. The guide wire was apprpached through femoral vein by a dormia basket [4/6 F] and it was removed without any difficulties or complications. Utilization of baskets for intravascular foreign body removal is frequently reported and has been successful with low complication rates; In addition, the low cost of the device makes it less of a burden to the patient and the hospital

Superior vena cava syndrome following central venous cannulation

Superior vena cava syndrome caused by blockage of the vein that carried blood from the head, neck, chest, and arms to the heart may occur due to various etiologies including thrombosis, occlusion and pressure on the superior vena cava. Foreign instruments in the vein, infections and also intimae injuries can lead to venacaval thrombosis. One of the most common causes of caval thrombosis is central venous catheterization for fluid administration and hemodialysis. This report presents an 8 years-old girls with chronic benign superior vena cava syndrome related to the long-term use of central venous catheters for hemodialysis. Treatment included resection of the obstructed segment and repair of the superior vena cava with an autologous pericardial patch. Reconstruction with an autologous pericardial patch without bypass of superior vena cava to right atrium is a safe and simple method but more importantly it is preferable and easier to prevent these events by simple nursing care in dialysis unit to secure the dialysis access

[Effect of lactobacillus acidophilus on adults habitual constipation in gastrointestinal clinic of Ghaem Hospital in Mashhad: a pilot study]

Constipation is a common problem in elderly subjects. Probiotics have been suggested to improve intestinal motility and to reduce fecal enzyme activity. In this study, the effect of lactobacillus acidophilus tablets on elderly subjects was compared with placebo. Elderly subjects [n = 48] with chief complaint of constipation were enrolled in a randomly double-blind study. The subjects were divided into 2 groups: control group, receiving placebo every 8 hours for one month, and study group, receiving lactobacillus acidophilus tablet every 8 hours for one month. Subjects with lactose intolerance and other pathologic conditions were omitted. At the end of 4 weeks, all subjects were questioned on the relief of constipation and other symptoms. Response to treatment and complications were compared between the two groups. In subjects receiving lactobacillus acidophilus, 50%[13 subjects] responded well and had relief of constipation, 23.1%[6 subjects] showed relative response and 26.9%[7 subjects] did not respond. In subjects receiving placebo, 40% [6 subjects] had relief of constipation, 13.3% [2 subjects] responded relatively well and in 46.7% [7 subjects] no response was seen [p=0.388]. New signs were observed in 5 subjects [19.2%] receiving lactobacillus acidophilus and 1 subject [6.7%] receiving placebo. After 4 weeks, 2 subjects [7.7%] receiving lactobacillus acidophilus and 1 subject [6.7%] receiving placebo re-experienced constipation. Some relief of constipation could be observed with lactobacillus acidophilus tablets, but there was no significant difference between the two groups

Mycoflora of human external auditory canal in Shiraz, southern Iran

Otomycosis is a superficial mycotic infection of the outer ear canal caused by many saprophytic fungi that could be considered as causative agents. Detection of the fungal agents in the external auditory canal could be valuable to determine the potential risk of otomycosis. The aim of this study was to identify the mycoflora of the human auditory canal in healthy individuals in Shiraz, southern Iran. During three months, a total of 486 ear samples of 243 healthy individuals [100 females and 143 males] were randomly collected by sterile swabs and cultivated on Mycosel and Sabouraud dextrose agar supplemented with antibiotics. Fungal isolates were identified using conventional methods and chromogenic media. Ten point twenty eight percent of the individuals were positive for ear fungal infections. Fungal species belonged to eight genera including Penicillium, Cladosporium, Candida, Aspergillus, Alternaria, Rodotorula, Exophiala and Dematiaceous fungi. In this study, Aspergillus niger, the major cause of otomycosis, was not isolated. Our findings suggest that the normal fungal otic infections in the presence of predisposing factors could be a potential cause for otomycosis