Mesenteric Vasculitis as a Rare Initial Presentation of Systemic Lupus Erythematosus: A Case Report.

Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease that can also affect the gastrointestinal tract (GIT). The GIT symptoms are common in SLE patients, occurring in up to 40%-50% of the patients and may involve almost any organ along the GIT. Abdominal pain is the most common symptom, and an important cause of this is lupus mesenteric vasculitis (LMV). LMV is a very rare presentation of SLE, and in some cases, can precede the typical manifestations of SLE. Here, we report such a case where a 30-year-old Saudi woman presented clinically with a 2-week abdominal pain and diarrhea; the patient had not previously been diagnosed with SLE. Laboratory investigations and abdomen computed tomography imaging confirmed the diagnosis of LMV. Early recognition of this condition and its proper management improve the outcome of this serious rare initial presentation of SLE.

A multimodality approach to decreasing ICU infections by hydrogen peroxide, silver cations, and compartmentalization.

PURPOSE: Hospital-acquired infections in the Intensive Care Unit (ICU) account for an increase in morbidity and mortality leading to serious health complications. This study aims to determine the effect of a multimodality approach including disinfection and physical separation on the infections prevailing in ICU. METHODS: The study employed prospective cross-over analysis to assess the 738 individuals (560 males and 178 females) at the ICU, Aseer Central Hospital, Saudi Arabia. The intervention programs were carried out for 3 years (2013-2015). It included the application of hydrogen peroxide and silver cations, physical separation, and compartmentalization of ICU. Acinetobacter spp., E. coli, and staphylococci were isolated, identified, and used to evaluate the efficacy of the intervention program. RESULTS: The results provide endotracheal tube as the main specimen type (34.7%) followed by blood (29.1%), tracheal secretion (7.7%), wound (6%), urine (5.7%), throat swab (5.4%), sputum (3.7%), and other specimens (7.7%). It also showed the infection rate decreased from 14.3% to 4% in the last three months after continuous interventions (R2 = 0.44). There was a decrease in the occurrence of bacteria after an intervention (p = 0.036). CONCLUSION: The outcome of the study revealed that mist and separation measures offered a significant decrease in infections at the ICU as per the measurement of the most hazardous nosocomial pathogens.