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Introduction Although links between meteorological conditions and primary spontaneous pneumothorax have been proposed, the reports are controversial. The aim of the study is to correlate between climatic changes and the development of this condition. Materials and methods A retrospective chart review included all patient presenting with primary spontaneous pneumothorax to King Fahd Hospital, Imam Abdulrahman Bin Faisal University, Alkhobar, Saudi Arabia, from 1 January 2005 to 31 December 2016. Meteorological data were collected from King Abdulaziz airbase station using an online source for the same time interval. The data were analysed to determine differences in weather conditions between days on which primary spontaneous pneumothorax occurred and those in which it did not. Logistic regression model was used to obtain predicted risks for the onset of primary spontaneous pneumothorax with respect to weather conditions. Result Two hundred and eighty-nine patients were found to have primary spontaneous pneumothorax in the 281 days included in the study. Among the meteorological parameters, significant differences were found in average temperature and atmospheric pressure difference between day of admission and two days before the admission, between days with primary spontaneous pneumothorax and days without. There was no significant difference in the other meteorological factors between days with primary spontaneous pneumothorax and days without. Conclusion Two hundred and eighty-nine patients were found to have primary spontaneous pneumothorax in the 281 days included in the study. Among the meteorological parameters, significant differences were found in average temperature and atmospheric pressure difference between day of admission and two days before the admission, between days with primary spontaneous pneumothorax and days without. There was no significant difference in the other meteorological factors between days with primary spontaneous pneumothorax and days without.
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Brucellosis is still endemic in certain parts of the world including the Mediterranean, the Middle East, Latin America, and African regions. Osteoarticular manifestations are common presenting features. Brucellosis presenting as prepatellar bursitis has already been reported. We present a case of seronegative olecranon bursitis with positive blood and aspirate cultures. The patient improved remarkably by treatment with streptomycin and doxycycline with no evidence or relapse.
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In many parts of the world the commonest serious opportunistic infection that occurs in HIV-1 infected persons is tuberculosis (TB). HIV-1 co-infection modifies the natural history and clinical presentation, and adversely affects the outcome of TB. Severe disseminated disease is well-recognised but it is increasingly appreciated that early disease characterised by very few or no symptoms is also common. Immunodiagnostic methods to ascertain latent TB in HIV-1 infected persons are compromised in sensitivity. Chemoprevention of HIV-1-associated TB is effective, its benefits are restricted to those which have evidence of immune sensitisation and appear short-lived in areas of high TB burden. Although promising advances in the microbiological diagnosis of TB have recently occurred, the diagnosis of HIV-1-associated TB remains difficult because of more frequent presentation as sputum negative or extrapulmonary disease. Management of co-infected patients can be complex because of overlapping drug toxicities and interactions. Nevertheless consensus is developing that antiretroviral therapy should be provided as soon as practicable after starting TB treatment in HIV-1 co-infected persons. This has the consequence of increasing the frequency of immune reconstitution inflammatory syndrome, the pathogenesis and management of which is poorly defined.