RESUMO
Malaria infection, which results due to the parasitic protozoan Plasmodium, has several known etiologies of hemolytic anemia as a possible complication in cases such as concurrent G6PD deficiency, severe parasitemia, or use of parenteral antimalarials. Although artemisinin-based antimalarial therapies are generally well-tolerated, several cases of severe post-artemisinin delayed hemolysis (PADH) have been recently reported, which present a diagnostic challenge, and affect morbidity and mortality in patients with malarial infection. We highlight the case of a young lady with Plasmodium falciparum severe parasitemia who developed hemolytic anemia after parenteral artesunate therapy.
RESUMO
Scalp angiosarcoma is a malignant tumor of the vascular endothelial cells. We present the case of an elderly male patient with a history of urinary bladder transitional cell cancer and trauma (falling on his head) who came to the emergency department with scalp swelling, which was found on brain imaging to infiltrate into the skull, reaching the dural matter. A biopsy was done, which showed angiosarcoma, which is rare for that area. Further studies are recommended to establish if there is a possible genetic association between both cancers (urinary bladder transitional cell cancer and scalp angiosarcoma) as both arise from endothelial cells.
RESUMO
OBJECTIVES: We aimed to identify the prevalence of depression and anxiety among physicians working in the emergency departments of nine tertiary care centres in Libya. DESIGN: This was a cross-sectional study. SETTING: Nine main tertiary centres in Libya PARTICIPANTS: Emergency department doctors were surveyed between December 2018 and February 2019. INTERVENTION: The standardised Hospital Anxiety and Depression Scale (HADS) was selected as a measurement tool for analysing anxiety and depression symptoms; a HADS score of 8 indicated anxiety as well as depression symptoms. The primary outcomes were anxiety and depression, which were tabulated with independent sociodemographic variables. χ2 tests were conducted to compare the prevalence of anxiety and depression between the groups. Statistical analysis was performed using SPSS V.25. RESULTS: A total of 108 out of 150 (72%) emergency physicians from all levels participated in the study and took the survey. The emergency physicians had a mean±SD age of 31.2±4.5 years, and were predominantly males (74 out of 108, 68.5%). Overall, 49 (45.4%) physicians reached the cut-off score to define both depression and anxiety (ie, a score ≥8). In terms of violence, 71 (65.7%) reported incidents of verbal violence, while 26 (24.1%) reported physical violence or abuse by militias. In addition, 28 reported being threatened by militias. CONCLUSION: The high prevalence rate of anxiety and depression is of concern, and the high rate of physical and verbal abuse highlights the range of abuse endured by doctors in Libya. Therefore, screening for anxiety and depression at regular intervals is needed to avoid the deterioration of mental health, which can increase the risk of suicide and dropping out, and decrease the level of healthcare for patients.
