Malaria cases among Jordanian medical team on prophylactic mefloquine in Sierra Leone

To describe malaria outbreak among medical Jordanian team members participating in Peacekeeping Forces in Sierra Leone. This is a retrospective review of 119 Military Jordanian males 32 of them [26%] were officers and the rest were enlisted. The mission started in January 2002 and ended in July 2002. Strict regulations were taken to ensure that prophylactic mefloquine was taken on time and the measures against the vector were applied rigorously. Thick and thin blood smears for malaria were adopted whenever a case of malaria was suspected. In many cases, the test was repeated several times. Due to the nature of the mission, which included internist physicians available 24 hours, the members were supervised continuously for any complication. Out of the 119 members of the team, 18 [15.1%] had malaria during this mission period. The species was Plasmodium falciparum. All patients responded to treatment except one case, which was labeled as multi-drug resistant and subsequently was repatriated. Compliance was nealy complete with melfloquine chemoprophylaxis. The number of cases declined remarkably after revising and improving the measures against the malaria vector [15 vs. 3]. In malarious area, chemoprophylaxis with melfoquine is not enough to prevent infection, but it may ameliorate the clinical course. Drastic measthe against the vector must be deployed to reduce the incidence of this disease

Exercise testing of chest pain patients in emergency department at prince hashem military hospital

To describe patients with chest pain and their triage in the emergency department after using treadmill exercise testing when needed. This study was conducted during the period between 15th of August 1999 and 15 th of July 2000 as indicated by clinical and electrocardiographical ceiteria in a large heterogeneous group, which excluded patients with proven coronary artery disease. During the study period, a total of 450 patients with chest pain [[287[63.8%] males, 163 [36.2%] females]] presented to the emergency department underwent treadmill testing. Fifty patients [11.1%] had positive results on exercise electrocardiography, 42 of the latter the further evaluation that revealed evidence of coronary artery disease in 31 [73.8%] patients. There hundred sixty nine [82%] patients had negative exercise test results and 31 [6.9]% had non-diagnostic tests. No adverse events were recorded. A 30-day follow-up achieved in 425 [94.4%] patients and revealed no mortality in any of the patients. The results in the study population support the safety and utility of exercise testing in low-risk chest pain patients who presented to the emergency department

Analysis of malaria cases among united nations troops in Sierraleone

To analyze malaria case presentation admitted to the United Nations hospital in Freetown, Sierra Leone named Choithram Memorial Hospital, a Jordanian Medical Level III Hospital. All data from patients admitted to the Choithram Memorial Hospital, Freetown, Sierra Leone, over a 6-month period, 21st January through to 21st July 2002 were tabulated and later analyzed according to clinical presentation. Data such as age, sex, most common complaints, malaria smear and history of malaria prophylaxis together with other variables were recorded. A total of 101 cases were included in this study. Males accounted for the majority of cases n=90 [89.1%], females n=11 [11.9%]. Mean age was 34.4+/= 9 and mean stay in hospital was 4.5+/=2 days. Malaria thick smear was positive from the first time in 71.3%, n=72, while in 16.8%, n=17 from the second time, 4%, 5%, 3% were positive from the third, fourth and fifth time. Most common complaints were fever and headache [79.2%, n=80], chills [74.3%, n=75], sweating [72.3%, n=73], arthralgias [56.4%, n=57] and vomiting [43.6%, n=44]. Those who were taking anti-malarial prophylaxis were 34.6% [n=35], while the rest were on no prophylaxis. Complicated cases were: 5 cases presented with cerebral malaria, one of them succumbed while the rest recovered completely; 4 presented with uremia and were referred for dialysis, one of them passed away after the first dialysis session. Other clinical presentations were seen such as: upper gastro-intestinal bleeding, diarrhea, pneumonia, pericarditis, angina pectoris, black water fever and abdominal pain. Four consultations were received from the dermatologist on cases of chicken pox not responding to treatment and turned out to be malaria falciparum. In an endemic area, malaria falciparum may present in very bizarre and variable clinical pictures. Fever is not necessarily a cardinal sign. High suspicion index must be exerted in unusual presentations. Prophylaxis against malaria must not alter the clinical decision away from the diagnosis. Prompt treatment on presumptive diagnosis will save many patients from the complications of this killing disease