Pilot use of a novel smartphone application to track traveller health behavior and collect infectious disease data during a mass gathering: Hajj pilgrimage 2014

This study examines the feasibility of using a smartphone application [app] to conduct surveys among travellers during the Hajj pilgrimage, where the use of apps has not been evaluated for infectious disease surveillance. A longitudinal study was conducted among pilgrims at the Hajj 2014 using an iPhone app with separate questionnaires for three study phases covering before, during, and after Hajj. Forty-eight pilgrims from 13 countries downloaded the app. Respondents were aged between 21 and 61 [median 36] years and 58.5% [24/41] were male. Of these, 85% [41/48] completed the first phase, 52% [25/41] completed both the second and third phases, and 25 of these reported meningococcal vaccination, with 36% [9/25] receiving other vaccines. All [25] reported hand hygiene use and 64% [16/25] wore a facemask at some point during the pilgrimage. Four [6%] reported close contact with camels. Respiratory symptoms commenced from the 4th day of Hajj, with sore throat [20%] and cough [12%] being the most common. Three participants [12%] reported respiratory symptoms after returning home. Conducting a prospective survey using a smartphone app to collect data on travel-associated infections and traveler compliance to prevention is feasible at mass gatherings and can provide useful data associated with health-related behaviour

Peripheral primitive neuroectodermal tumor of the pleura in a 41-year-old female

Peripheral primitive neuroectodermal tumor [pPNET] is a rare, very aggressive neoplasm that belongs to a small round cell tumor, and most often arises from the chest wall. Here, we report a female case with proven pPNET who was treated in our institution. She presented with a history of left side chest pain, cough, and significant weight loss. Contrast enhanced CT imaging of the chest showed multiple left pleural-based enhancing masses with left diaphragmatic involvement. She underwent chemotherapy followed by tumor debulking through thoracotomy. However, she died of rapid growth from recurrent local tumors 3 months thereafter

Portal hypertension secondary to splenic arteriovenous fistula

Portal hypertension is a common condition in association with chronic liver disease; however, it is rarely caused by vascular shunting from splenic arteriovenous fistula [SAVF]. We are presenting a case of non-cirrhotic portal hypertension due to SAVF. This condition is usually seen in multiparity women; however, other causes like trauma or mycotic infection are reported in the literatures with equal gender prevalence. Most of the patients present with gastric and esophageal varices, splenomegaly or upper abdominal pain. Clinical history and examination are the first step for diagnosis followed by ultrasound or contrast enhanced computer tomography. Splenic arteriovenous fistula must be then confirmed by selective celiac or splenic arteriography which is the gold standard tool. The condition is treatable either surgical ligation or intra-arterial embolization. Due to less invasive procedure, the later one is more favorable in unstable patients. Both procedures have been reported to be equally successful in managing SAVF

Surgical management of colonic volvulus during same hospital admission

To study the local patient profile, diagnostic methods, and treatment outcome in patients with large bowel volvulus to recommend a management plan. A retrospective study of patients record with a final diagnosis of large bowel volvulus treated at King Saud Medical Complex, Riyadh, Saudi Arabia between January 2000 and December 2007 were performed for patient demography, clinical presentations, co-morbidity, diagnostic methods, anatomical types, management, and outcome. Forty-two patients with large bowel volvulus were reviewed. They represented 8.5% of all intestinal obstructions treated. Most had sigmoid volvulus [83%], were less than 60 years of age, and were male. Recognized risk factors were present in 12 [29%] patients. Diagnosis was suspected on plain abdominal x-ray in 28 patients [69%], although the characteristic signs of omega and coffee bean were seen in only 16 patients. Eight patients required emergency surgery. Endoscopic decompression was successful in 34 patients, followed by a definitive surgery in 24 patients. Seven patients refused surgery; 3 of them were readmitted with recurrence and were operated. Three patients were unfit for surgery. There were 3 deaths. Large bowel volvulus is uncommon in this area. Abdominal distension with pain, constipation, and characteristic gas pattern in plain x-ray can help diagnose most cases. Decompression can be achieved in most patients with sigmoid volvulus, followed by surgery during the same hospital admission. Transverse colon and cecal volvulus usually need emergency surgery

Tumor de corpo carotídeo: relato de dois casos / Carotid body tumor: report of two cases

Os autores apresentam dois casos de tumor do corpo carotídeo diagnosticados pelo Serviço de Angiologia e Cirurgia Vascular da Casa de Saúde Santa Marcelina. Aproveitam a oportunidade para comentar o diagnóstico clínico, angiológico e o tratamento desta doença.