scholarly journals The First Evidence of Lyme Neuroborreliosis in Southern Bosnia and Herzegovina

2014 ◽  
Vol 2014 ◽  
pp. 1-3
Author(s):  
Jurica Arapovic ◽  
Sinisa Skocibusic ◽  
Svjetlana Grgic ◽  
Jadranka Nikolic
Keyword(s):  
Bosnia And Herzegovina ◽  
Facial Palsy ◽  
Clinical Symptoms ◽  
Neurological Status ◽  
Antimicrobial Treatment ◽  
Lyme Neuroborreliosis ◽  
University Hospital ◽  
First Case ◽  
Dramatic Rise ◽  
The University

Lyme borreliosis (LB) is caused by the spirocheteBorrelia burgdorferi, which is transmitted to humans by ticks of theIxodes ricinuscomplex. It is manifested by a variety of clinical symptoms and affects skin, joints, heart, and nervous system. Neurological manifestations are predictable and usually include meningoencephalitis, facial palsy, or radiculopathy. Recently, a dramatic rise in the number of diagnosed cases of LB has been observed on the global level. Here we show the first case of Lyme neuroborreliosis in southern Bosnia and Herzegovina, which was first presented by erythema chronicum migrans. Unfortunately, it was not recognized or well treated at the primary care medicine. After eight weeks, the patient experienced headache, right facial palsy, and lumbar radiculopathy. After the clinical examination, the neurologist suspected meningoencephalitis and the patient was directed to the Clinic for Infectious Disease of the University Hospital Mostar, where he was admitted. The successful antimicrobial treatment with the 21-day course of ceftriaxone was followed by normalization of neurological status, and then he was discharged from the hospital. This case report represents an alert to all physicians to be aware that LB is present in all parts of Bosnia and Herzegovina, as well as in the neighboring regions.

scholarly journals First Case of Liver Glycogen Documented in the Pediatric Ward of the University Hospital of Treichville (Cote D’Ivoire)

2017 ◽  
Vol 07 (02) ◽  
pp. 72-76
Author(s):  
Jean-Jacques Yao Atteby ◽  
Lassina Cissé ◽  
Jacob Enoh ◽  
Kouadio Richard Azagoh ◽  
Germaine Niamké ◽  
...  
Keyword(s):  
Cote D'ivoire ◽  
Côte D’Ivoire ◽  
Liver Glycogen ◽  
University Hospital ◽  
Cote D’Ivoire ◽  
Pediatric Ward ◽  
Côte D'ivoire ◽  
First Case ◽  
The University

The Prevalence of Rotavirus and Adenovirus in Children 0-5 years old Suffering from Acute Diarrhea in the University Hospital Center of Mother and Child (UHC-MC) in N’Djamena, Chad

2021 ◽  
Vol 2 (6) ◽  
Author(s):  
Fombotioh Ndifor ◽  
Abakar Idriss Lawane ◽  
Nadjioroum Ngam-Asra ◽  
Mouktar Abaya Adoum ◽  
Brahim Boy Otchom ◽  
...  
Keyword(s):  
Viral Infection ◽  
Acute Diarrhea ◽  
Clinical Symptoms ◽  
Public Health Problem ◽  
University Hospital ◽  
Test Kit ◽  
Mother And Child ◽  
Fresh Stool ◽  
The University ◽  
Hospital Center

Acute diarrhea is one of the leading causes of morbidity and mortality in children from 0-5 months old, especially in Africa and many developing countries. Rotavirus and Adenovirus have been recognized as the common pathogens for this public health problem. However, little or no investigation has been carried out on the two viruses in Chad. In view of this fact, we decided to study the prevalence of Rotavirus and Adenovirus in children suffering from acute diarrhea at the University Hospital Center of Mother and Child (UHC-MC). Fresh stool samples were collected from 440 children ages 0-5 years (225 females and 2015 males). They were brought for medical consultation from March 2019- September 2019 at the pediatric department. Specimens were analyzed and Rotavirus and Adenovirus were detected using Rapid Immunochromatographic Test kit (Vikia BioMerieux, France). Out of the 440 children examined, 228 had viral infection with a prevalence of 51.81%. Based on gender infection, females 140 (62.22%) were significantly more infected than males 88(40.93%). Prevalence of mono infection of Rotavirus in children 110 (48.24%) was higher than that of Adenovirus 74(32.45%). More males had Rotavirus infection 60(68.18%) than girls 50 (37.71%). Co-infection was found to be 44 (19.29%). Distribution of viral infection indicated that children between 6-11 months had the highest viral burden 101(77.69%). Among clinical symptoms recorded, dehydration was the highest in children 84(61.76%). Due to the high prevalence of Rotavirus and Adenovirus discovered, we suggest that vaccines for the two viruses should be included in the national immunization program.

scholarly journals SARS-CoV-2 outbreak in a tri-national urban area is dominated by a B.1 lineage variant linked to mass gathering events

2020 ◽  
Author(s):  
Madlen Stange ◽  
Alfredo Mari ◽  
Tim Roloff ◽  
Helena MB Seth-Smith ◽  
Michael Schweitzer ◽  
...  
Keyword(s):  
Epidemiological Data ◽  
University Hospital ◽  
Contact Tracing ◽  
Phylogenetic Study ◽  
Mass Gathering ◽  
Travel History ◽  
First Case ◽  
The University ◽  
The City ◽  
Family Transmission

AbstractBackgroundThe first case of SARS-CoV-2 in Basel, Switzerland was detected on February 26th 2020. We present a phylogenetic study to explore viral introduction and evolution during the exponential early phase of the local COVID-19 outbreak from February 26th until March 23rd.MethodsWe sequenced SARS-CoV-2 naso-oropharyngeal swabs from positive 746 tests that were performed at the University Hospital Basel in the timeframe of our study. We successfully generated 468 high quality genomes from unique patients and called variants with our COVID-19 Pipeline (COVGAP). We analysed viral genetic diversity using PANGOLIN taxonomic lineages. To identify introduction and dissemination events we incorporated global SARS-CoV-2 genomes and inferred a time-calibrated phylogeny. We used epidemiological data to aid interpretation of phylogenetic patterns.FindingsThe early outbreak in Basel was dominated by lineage B.1 (83·6%), detected from March 2nd, although the first lineage identified was B.1.1. Within B.1, a clade defined by the SNP C15324T contains 68·2% of our samples (‘Basel cluster’), including 157 identical sequences at the root of the ‘Basel cluster’, suggesting local spreading events. We infer the origin of the ‘Basel cluster’ defining mutation to mid-February in our tri-national region. The remaining genomes map broadly over the global phylogenetic tree, evidencing several events of introduction from and/or dissemination to other regions of the world via travellers. We also observe family transmission events.InterpretationA single lineage variant dominated the outbreak in the City of Basel while other lineages such as the first (B1.1) did not propagate. We identify mass gathering events and less so travel returners and family transmission as causes for the local outbreak. We highlight the importance of adding specific questions to the epidemiological questionnaires that are collected, to obtain data on attendance of large gathering events and locations as well as travel history to effectively identify routes of transmissions in up-coming outbreaks. This phylogenetic analysis enriches epidemiological and contact tracing data, allowing, even retrospectively, connection of seemingly unconnected events, and can inform public health interventions.

Corynebacterium diphtheriae Infection in Mahajanga, Madagascar: First Case Report

2020 ◽  
Author(s):  
Rivo Solotiana Rakotomalala ◽  
Zo Zafitsara Andrianirina ◽  
Elisoa Ratsima ◽  
Patrick Randrianandraina ◽  
Frédérique Randrianirina ◽  
...  
Keyword(s):  
Heart Failure ◽  
Diphtheria Toxin ◽  
Throat Swab ◽  
Neurological Complications ◽  
Corynebacterium Diphtheriae ◽  
University Hospital ◽  
Rural Municipality ◽  
First Case ◽  
The University ◽  
Hospital Center

Abstract Diphtheria is an infection that has been unreported for more than two decades in Mahajanga. A child, aged 4, presented with a pseudomembranous pharyngitis was associated with a dysphagia. He was from a rural municipality of Ambato Boeny at Mahajanga province and was admitted to the Pediatric Unit of the University Hospital Center. The child was not immunized against diphtheria. A throat swab was performed and cultured, from which Corynebacterium diphtheriae was identified. The strain, of biovar Mitis, was confirmed as diphtheria toxin (DT)-gene positive and produced DT (Elek test). Unfortunately, the child developed cardiac and neurological complications and died of respiratory and heart failure.

scholarly journals SARS-CoV-2 outbreak in a tri-national urban area is dominated by a B.1 lineage variant linked to a mass gathering event

2021 ◽  
Vol 17 (3) ◽  
pp. e1009374 ◽  
Author(s):  
Madlen Stange ◽  
Alfredo Mari ◽  
Tim Roloff ◽  
Helena MB Seth-Smith ◽  
Michael Schweitzer ◽  
...  
Keyword(s):  
Epidemiological Data ◽  
University Hospital ◽  
Contact Tracing ◽  
Phylogenetic Study ◽  
Mass Gathering ◽  
Travel History ◽  
First Case ◽  
Patient Questionnaires ◽  
Initial Source ◽  
The University

The first case of SARS-CoV-2 in Basel, Switzerland was detected on February 26th 2020. We present a phylogenetic study to explore viral introduction and evolution during the exponential early phase of the local COVID-19 outbreak from February 26th until March 23rd. We sequenced SARS-CoV-2 naso-oropharyngeal swabs from 746 positive tests that were performed at the University Hospital Basel during the study period. We successfully generated 468 high quality genomes from unique patients and called variants with our COVID-19 Pipeline (COVGAP), and analysed viral genetic diversity using PANGOLIN taxonomic lineages. To identify introduction and dissemination events we incorporated global SARS-CoV-2 genomes and inferred a time-calibrated phylogeny. Epidemiological data from patient questionnaires was used to facilitate the interpretation of phylogenetic observations. The early outbreak in Basel was dominated by lineage B.1 (83·6%), detected first on March 2nd, although the first sample identified belonged to B.1.1. Within B.1, 68·2% of our samples fall within a clade defined by the SNP C15324T (‘Basel cluster’), including 157 identical sequences at the root of the ‘Basel cluster’, some of which we can specifically trace to regional spreading events. We infer the origin of B.1-C15324T to mid-February in our tri-national region. The other genomes map broadly over the global phylogenetic tree, showing several introduction events from and/or dissemination to other regions of the world via travellers. Family transmissions can also be traced in our data. A single lineage variant dominated the outbreak in the Basel area while other lineages, such as the first (B.1.1), did not propagate. A mass gathering event was the predominant initial source of cases, with travel returners and family transmissions to a lesser extent. We highlight the importance of adding specific questions to epidemiological questionnaires, to obtain data on attendance of large gatherings and their locations, as well as travel history, to effectively identify routes of transmissions in up-coming outbreaks. This phylogenetic analysis in concert with epidemiological and contact tracing data, allows connection and interpretation of events, and can inform public health interventions. Trial Registration: ClinicalTrials.gov NCT04351503.

scholarly journals Diagnostic Accuracy of D-Dimers for Predicting Pulmonary Embolism in COVID-19-Patients

2021 ◽  
Vol 27 ◽  
pp. 107602962110579
Author(s):  
Falmata Laouan Brem ◽  
Boudouh Asmae ◽  
Yassine Amane ◽  
Mohammed-Amine Bouazzaoui ◽  
Miri Chaymae ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Clinical Symptoms ◽  
University Hospital ◽  
The Novel ◽  
Test Results ◽  
Operating Characteristics ◽  
Study Population ◽  
Novel Coronavirus ◽  
The University ◽  
D Dimer

Importance Proinflammatory and hypercoagulable states with marked elevation seen in D-Dimer levels have been accurately described in patients infected by the SARS- Cov2 even without pulmonary embolism (PE). Objectives To compare D-dimers values in patients infected by the novel Coronavirus 2019 (COVID-19) with and without PE and to establish an optimal D-dimer cut-off to predict the occurrence of PE, which guides pulmonary computed tomography angiography (CTPA) indication. Methods We retrospectively enrolled all COVID-19-patients admitted between October first and November 22th, 2020, at the University Hospital Center of Mohammed VI, Oujda (Morocco), suspected to have PE and underwent a CTPA. Demographic characteristics and blood test results were compared between PE-positive and PE-negative. The receiver operating characteristics (ROC) curve was constructed to establish an optimal D-Dimer cut-off to predict the occurrence of PE. Results The study population consisted of 84 confirmed COVID-19-patients. The mean age was 64.93 years (SD 14.19). PE was diagnosed on CTPA in 31 (36.9%) patients. Clinical symptoms and in-hospital outcomes were similar in both groups except that more men had PE ( p = .025). The median value of D-dimers in the group of patients with PE was significantly higher (14 680[IQR 33620-3450]ng/mL compared to the group of patients without PE 2980[IQR 6870-1600]ng/mL [P < .001]. A D-dimer at 2600 ng/mL was the optimal cut-off for predicting PE with a sensitivity of 90.3%, and AUC was .773[CI 95%, .667 −.876). Conclusion A D-dimer cut-off value of 2600 ng/mL is a significant predictor of PE in COVID-19-patients with a sensitivity of 90.3%.

scholarly journals It's Fournier's gangrene still dangerous?

2009 ◽  
Vol 56 (1) ◽  
pp. 77-80
Author(s):  
S. Bilali ◽  
E. Celiku ◽  
V. Bilali
Keyword(s):  
Clinical Symptoms ◽  
Early Recognition ◽  
Fournier’S Gangrene ◽  
University Hospital ◽  
Prognostic Indicators ◽  
Fournier's Gangrene ◽  
Significant Difference ◽  
Radical Debridement ◽  
Aggressive Debridement ◽  
The University

Background: Fournier's gangrene is known to have an impact in the morbidity and despite antibiotics and aggressive debridement, the mortality rate remains high. Objectives: To assess the morbidity and mortality in the treatment of Fournier's gangrene in our experience. Methods: The medical records of 14 patients with Fournier's gangrene who presented at the University Hospital Center 'Mother Teresa' from January 1997 to December 2006 were reviewed retrospectively to analyze the outcome and identify the risk factor and prognostic indicators of mortality. Results: Of the 14 patients, 5 died and 9 survived. Mean age was 54 years (range from 41-61): it was 53 years in the group of survivors and 62 years in deceased group. There was a significant difference in leukocyte count between patients who survived (range 4900-17000/mm3) and those died (range 20.300- 31000/mm3). Mean hospital stay was about 19 days (range 2-57 days). Conclusion: The interval from the onset of clinical symptoms to the initial surgical intervention seems to be the most important prognostic factor with a significant impact on outcome. Despite extensive therapeutic efforts, Fournier's gangrene remains a surgical emergency and early recognition with prompt radical debridement is the mainstays of management.

Benefits of using telemedicine and first results in Bosnia and Herzegovina

1998 ◽  
Vol 4 (1_suppl) ◽  
pp. 91-93 ◽  
Author(s):  
Nurija Bilalović ◽  
Carlo Paties ◽  
Andreas Mason
Keyword(s):  
Bosnia And Herzegovina ◽  
University Hospital ◽  
Small Country ◽  
First Results ◽  
Time Required ◽  
The University ◽  
Consultation Time

In October 1996 the Institute of Pathology with the Radiology and Ophthalmology Clinic of the university hospital of Sarajevo joined the experimental telemedicine project SHARED. Two months after the project began, dermatology, paediatrics and haematology were also included. During the first phase we had 40 teleconsultations that showed us the benefits of using telemedicine. Our opinions and the opinions of the pathologist in Milan were similar for most of the biopsies (78%). The total time required for the consultation for the first 40 cases was 372 min, or 9.3 min each, on average. The longest consultation time was 25 min. The largest number of images was 44 per case, the smallest four. Because of problems of infrastructure and lack of experts, telemedicine will be important to a small country like Bosnia and Herzegovina.

scholarly journals Comparison of antimicrobial prescription patterns in calves in Switzerland before and after the launch of online guidelines for prudent antimicrobial use

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Alina Hubbuch ◽  
Ruth Peter ◽  
Barbara Willi ◽  
Sonja Hartnack ◽  
Cedric Müntener ◽  
...  
Keyword(s):  
Private Practice ◽  
Bacterial Resistance ◽  
Clinical Findings ◽  
Antimicrobial Treatment ◽  
University Hospital ◽  
Antimicrobial Use ◽  
First Line ◽  
Private Practices ◽  
Third Line ◽  
The University

Abstract Background The increasing threat of bacterial resistance promotes the need for antibiotic stewardship programs to foster responsible antimicrobial use. Therefore, guidelines for prudent use supported by an online stewardship tool (AntibioticScout.ch) were introduced in Switzerland in December 2016. They recommend (with decreasing preference) a first, second or third line antimicrobial for treatment. The objective of this study was to evaluate antimicrobial prescriptions for Swiss calves before (2016) and after (2018) the launch of these guidelines. Cases of calves with pneumonia, diarrhea and otitis from a university hospital and eight private practices in Switzerland were included. Data on anamnesis, clinical findings, diagnostic work-up and treatment were collected. Type and percentages [95% confidence interval] of antimicrobial prescriptions were compared between 2016 and 2018. Results Of the total number of calves, 88.2% [85.4–90.6] in 2016 (n = 625) and 88.4% [85.7–90.7] in 2018 (n = 655) were treated with antibiotics. The use of highest priority critically important antimicrobials (HPCIAs) decreased from 52.7% [48.6–56.9] in 2016 to 38.0% [34.2–41.9] in 2018; this decrease was found at the university hospital and in private practice and in cases with pneumonia and diarrhea. Particularly the use of fluoroquinolones decreased (2016: 43.1% [39.2–47.2]; 2018: 31.1% [27.6–34.8]). Overall, the number of first line treatments increased from 12.8% [10.4–15.6] in 2016 to 20.2% [17.3–23.4] in 2018. In cases of pneumonia, first line treatments increased (2016: 15.3% [11.6–19.9]; 2018: 26.5% [21.8–31.9]) and third line treatments decreased (2016: 43.5% [38.0–49.3]; 2018: 27.9% [23.1–33.3]); this was seen at the university hospital, whereas in private practice only a decrease of third line treatments was observed. In cases of diarrhea, more second line at the expense of unlisted antimicrobials were prescribed at the university hospital in 2018. Antimicrobial treatment of calves with otitis did not change from 2016 to 2018. Conclusions After the introduction of AntibioticScout.ch, more prudent use was observed in the treatment of calves with pneumonia and diarrhea as less HPCIAs, particularly fluoroquinolones, and more first line antimicrobials were prescribed. However, the overall frequency of antimicrobial treatment did not change and the use of HPCIAs was still common in 2018, especially in private practices. Therefore, further antimicrobial stewardship activities are necessary.

scholarly journals Miller Fisher syndrome and polyneuritis cranialis in COVID-19

Neurology ◽  
2020 ◽  
Vol 95 (5) ◽  
pp. e601-e605 ◽  
Author(s):  
Consuelo Gutiérrez-Ortiz ◽  
Antonio Méndez-Guerrero ◽  
Sara Rodrigo-Rey ◽  
Eduardo San Pedro-Murillo ◽  
Laura Bermejo-Guerrero ◽  
...  
Keyword(s):  
Miller Fisher Syndrome ◽  
University Hospital ◽  
Low Grade ◽  
Fisher Syndrome ◽  
Neurologic Recovery ◽  
First Case ◽  
Oropharyngeal Swab ◽  
Bilateral Abducens Palsy ◽  
Bilateral Abducens ◽  
The University

ObjectiveTo report 2 patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) who presented acutely with Miller Fisher syndrome and polyneuritis cranialis, respectively.MethodsPatient data were obtained from medical records from the University Hospital “Príncipe de Asturias,” Alcalá de Henares, and the University Hospital “12 de Octubre,” Madrid, Spain.ResultsA 50-year-old man presented with anosmia, ageusia, right internuclear ophthalmoparesis, right fascicular oculomotor palsy, ataxia, areflexia, albuminocytologic dissociation, and positive testing for anti-GD1b–immunoglobulin G antibody. Five days previously, he had developed a cough, malaise, headache, low back pain, and fever. A 39-year-old man presented with ageusia, bilateral abducens palsy, areflexia, and albuminocytologic dissociation. Three days previously, he had developed diarrhea, a low-grade fever, and poor general condition. Oropharyngeal swab test for SARS-CoV-2 by qualitative real-time reverse transcriptase PCR assay was positive in both patients and negative in the CSF. The first patient was treated with IV immunoglobulin and the second with acetaminophen. Two weeks later, both patients made a complete neurologic recovery, except for residual anosmia and ageusia in the first case.ConclusionsOur 2 cases highlight the rare occurrence of Miller Fisher syndrome and polyneuritis cranialis during the coronavirus disease 2019 (COVID-19) pandemic. These neurologic manifestations may occur because of an aberrant immune response to COVID-19. The full clinical spectrum of neurologic symptoms in patients with COVID-19 remains to be characterized.

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