Inguinal hernia is described as protrusion of abdominal structures into inguinal canal, such as intestinal loop and abdominal fascia. Appendix rarely bulges into inguinal canal which is called Amyand’s hernia. A 55-year-old diabetic male presented to an outpatient clinic with right inguinal bulging since 2 years ago which was non-tender, without erythema and became non reducible since 2 days ago. Also bulging worsened by physical activity. The patient went through operation and an inflamed appendix was found stuck in hernia sac. Non incarcerated inguinal hernia can be diagnosed with physical examination and there is no need of further imaging which makes it hard to diagnose the nature of protrusion. Amyand’s hernia usually presents with pain due to appendicitis which mimics incarcerated hernia and makes it easier to suspect the etiology and request for further investigation. However in this case, pain was suppressed and this patient was candidate for elective inguinal herniotomy.
Background: Nosocomial infections are associated with increased morbidity, mortality, and medical burdens. Pseudomonas aeruginosa and Acinetobacter baumannii are not-fermentative gram-negative bacteria that considered as the most important nosocomial infection. In the current study, we have aimed to evaluate the sensitivity of Acinetobacter baumannii and Pseudomonas aeruginosa microorganisms to the colistin antibiotic. Methods: In this descriptive cross-sectional study, patients admitted to the ICU ward of Firoozgar Hospital from July 2018 to March 2019 were evaluated, and 169 Patients infected with Acinetobacter baumannii, and Pseudomonas aeruginosa were included. Acinetobacter baumannii and Pseudomonas aeruginosa were isolated, and antibiotic sensitivity was determined by the disk diffusion method according to Clinical & Laboratory Standards Institute (CLSI) criteria. E test was also used to determine MIC-50 and MIC-90 of colistin. Results: Acinetobacter baumannii was around 8 times more frequent than Pseudomonas aeruginosa. Colistin resistance was detected in only 4(2.4%). The mean age of patients infected by Acinetobacter baumannii was significantly higher than those infected with Pseudomonas aeruginosa. Moreover, the mean time of the hospitalization period did not show any significant differences in the different groups. Conclusion: Our findings indicated that the majority of isolated Pseudomonas aeruginosa and Acinetobacter baumannii were sensitive to Colistin. Therefore, it could be effectively used for patients with a confirmed diagnosis of Pseudomonas aeruginosa and Acinetobacter baumannii.
Background: Recombinant tissue plasminogen activator (rTPA) is the gold standard therapy for ischemic stroke patients within the appropriate time interval. In addition to its undoubtedly benefits, recognizing its possible adverse effects is of utmost importance. This study aims to investigate the possible correlation between rTPA administration and the risk of post-stroke epilepsy. Methods: In a retrospective cohort study, we enrolled subjects identified to have an ischemic stroke event without prior history of epilepsy based on their medical records. Then, followed them retrospectively regarding any subsequent seizure or epilepsy syndromes. Results: rTPA therapy showed no correlations with seizures during the first week after stroke or with the epilepsy syndromes. Positive history of prior ischemic stroke, cortical localization of stroke, cardio embolic source of the stroke, and positive hemorrhagic complication were predictors of post-stroke seizure during the first week following the stroke event. Higher final Modified Rankin Scale (MRS) and cortical localization of stroke were predictors of post-stroke epilepsy (PSE). Conclusion rTPA is a safe therapeutic measure for patients with ischemic stroke with no concerns of subsequent development of post-stroke seizure or epilepsy.
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