Description of Occupational Contact Dermatitis Related to the Use of Personal Protective Equipment with a History of Atopy in Health Workers at Prof. DR. Chairuddin Panusunan Lubis Universitas Sumatera Utara and H. Adam Malik Hospital.

Introduction: Coronavirus disease 2019 was declared a pandemic by WHO in March 2020. The Indonesian Ministry of Health has recommended many prevention strategies including the use of hand sanitizers (HSs) and the use of personal protective equipment (PPE), especially for healthcare workers. Previous research reported that the increase in the use of HS and PPE is directly proportional to the increase in the incidence of occupational skin diseases. Aims: To find out the prevalence of work-related contact dermatitis patients related to the use of PPE in healthcare workers at Prof. DR. Chairuddin Panusunan Lubis Universitas Sumatera Utara and H. Adam Malik Hospital, Medan, with a history of atopy dermatitis. Materials and Methods: This was a descriptive study including 104 healthcare workers. The results of the study were analysed using prevalence and frequency data distribution. Results: In this study, we found that the majority of occupational skin diseases in healthcare workers are female (n = 64; 62.5%), and the most common age group was 31-33 years old (44.2%). The incidence of contact dermatitis due to the use of PPE in healthcare workers at Prof. DR. Chairuddin Panusunan Lubis Universitas Sumatera Utara and H. Adam Malik Hospital, Medan, was found only in 15 subjects (14.4%), and only 5 (33.3%) of them had a history of suffering from atopy dermatitis. Conclusion: There is high prevalence of contact dermatitis due to PPE at Prof. DR. Chairuddin Panusunan Lubis Universitas Sumatera Utara and H. Adam Malik Hospital, Medan; in 104 research subjects, only 15 people (14.4%) suffered from work-related contact dermatitis with a history of atopy in 5 people (33.3%).

Norwegian scabies in human immunodeficiency virus and tuberculosis-infected child: A case report.

Norwegian scabies is a rare scabies with the manifestation of thick crusts of the extremities of the skin that contain eggs and mites. Several conditions in which scabies infection is easily transmitted include immunocompromised, home nursing, and severe neurological disorder. The aim of this case report was to present a thorough analysis of a comprehensive resource for the management of Norwegian scabies patients, with a specific focus on individuals who also have HIV or other immunocompromising diseases. A 1-year-and-7-month-old boy was presented to the hospital with a chief complaint of a thick crust that he had experienced for four months. It began as a red papule in the lower extremity, then crusted and spread to the whole body. The patient kept scratching due to itching, had a recurrent fever and diarrhea for three months, and cough for one month. The patient was diagnosed with human immunodeficiency virus (HIV) and pulmonary tuberculosis at three months, suspected to get the infection from the parents. Sarcoptes scabiei was found from microscopy examination of skin scraping. The patient received holistic treatment, including antiretroviral drugs, antituberculosis medication, scabies treatment, and malnutrition treatment. Appropriate scabies treatment aimed at peeling crusted skin, relieving itching, and increasing the patient ability to use the extremities. Comorbidity conditions caused by HIV and pulmonary tuberculosis should also be treated to optimize the outcome. The patient was discharged in good condition with sanitation education and regular follow-up at the outpatient clinic. This case highlights that Sarcoptes scabiei infestation may be a clue to an immunocompromised condition. Holistic therapy aiming to cure underlying infection, infestation and underlying nutrition and psychosocial problems must be addressed to fully cure this high-burden case.

The temporal effect of a wild blueberry (Vaccinium angustifolium)-enriched diet on vasomotor tone in the Sprague-Dawley rat.

BACKGROUND AND AIMS: We have previously reported that wild blueberry (Vaccinium angustifolium)-enriched diets (WB) attenuate aortic adrenergic response through endothelial-mediated pathways. The duration of dietary intervention necessary to induce the positive changes on vasomotor tone has not been studied to date. Thus, our objective was to investigate the temporal effect of WB consumption on vascular function and reactivity in Sprague-Dawley (SD) rat aorta after 4 and 7 weeks of dietary treatment. METHODS AND RESULTS: Forty male SD rats were randomly assigned to a control (AIN-93) (C) or a WB diet for 4 or 7 weeks. Vascular ring studies were conducted in 3-mm isolated rat aortic rings to investigate vasoconstriction induced by six doses of the α(1)-adrenergic agonist, L-phenylephrine (Phe, 10(-8)-3×10(-6) M) alone or in the presence of the NOS inhibitor, L-N(G)-monomethyl-arginine (L-NMMA, 10(-4)M). The maximum force of contraction (F(max)) and vessel sensitivity (pD(2)) were determined. Analysis of variance revealed no significant differences on F(max) after 4 weeks of the WB diet but only a significant increase in pD(2) in the absence of L-NMMA. Seven week WB consumption significantly attenuated contraction in response to L-Phe and resulted in lower pD(2). Inhibition of NOS induced a significant increase in the constrictor response in both diet groups at both time periods, with the WB group fed for 7 weeks having the greater response. CONCLUSION: Thus wild blueberries incorporated into the diet at 8% w/w positively affect vascular smooth muscle contractility and sensitivity but these effects are evident only after 7 weeks of WB consumption.

Recurrent acute otitis media detracts from health-related quality of life.

OBJECTIVE: Acute otitis media causes discomfort to children and inconvenience to their parents. This study evaluated the quality of life in children with recurrent acute otitis media aged less than 24 months. METHODS: Quality of life was evaluated in 149 children aged 10 to 24 months who were referred to the Oulu University Hospital on account of recurrent acute otitis media. The children were treated with or without surgery. Age-matched controls were selected randomly from the general child population. Parents completed the Child Health Questionnaire. RESULTS: The children with recurrent acute otitis media had a significantly poorer quality of life than control children. The control children with a history of a few acute otitis media episodes had a significantly poorer quality of life than those without any such history. The quality of life of the children with recurrent acute otitis media improved during the one-year follow up, regardless of the treatment, but did not reach the same level as healthy children. CONCLUSION: Acute otitis media detracted from quality of life when a generic measure was used. The mode of treatment used to prevent further recurrences of acute otitis media did not influence quality of life improvement.

Intraductal papilloma as a cause of a parotid duct cyst. A case report.

A case is presented of a rare intraductal papilloma being found simultaneously with a parotid duct cyst, which is a relatively common parotid disorder. The papilloma most probably played a significant role in the obstruction of the duct and thus caused the ductal cyst. Intraductal papillomas have been mostly described in minor salivary glands, but are rare in the parotid gland.

Milk containing probiotic Lactobacillus rhamnosus GG and respiratory illness in children: a randomized, double-blind, placebo-controlled trial.

BACKGROUND/OBJECTIVES: To determine whether long-term daily consumption of milk containing probiotic Lactobacillus rhamnosus GG (GG) decreases respiratory illness in children. SUBJECTS/METHODS: A randomized, double-blind, placebo-controlled trial was conducted with 523 children aged 2-6 years attending day care centers in Finland. Subjects received either normal milk or the same milk with GG on three daily meals for 28 weeks. Daily recording of children' symptoms was done by parents. Primary outcome data from 501 subjects were available for analysis, and data from 128 subjects were analyzed as completed cases in terms of recovery of GG in fecal samples. RESULTS: Number of days with at least one respiratory symptom in all subjects was 5.03/month (95% confidence interval (CI): 4.92-5.15) in the GG group and 5.17/month (95% CI: 5.05-5.29) in the placebo group incidence rate ratio (IRR) 0.97; 95% CI: 0.94-1.00; P=0.098). In the completed cases, the figures were 4.71 days/month (95% CI: 4.52-4.90) in the GG group and 5.67 days/month (95% CI: 5.40-5.94) in the placebo group (IRR 0.83; 95% CI: 0.78-0.88; P<0.001). CONCLUSIONS: Consumption of GG reduced the occurrence of respiratory illness in children attending day care centers in the completed cases subgroup, but not in the total population. Thus, future clinical trials are warranted to clarify the association between fecal recovery of a probiotic and the symptom prevalence.

Nasopharyngeal dimensions in magnetic resonance imaging and the risk of acute otitis media.

BACKGROUND: We have previously found by lateral cephalometry an association between nasopharyngeal anatomy and the risk of acute otitis media (AOM). We evaluate here the association of nasopharyngeal dimensions in magnetic resonance imaging (MRI) with the occurrence of AOM in otherwise healthy children. METHODS: Sixty-one healthy children (mean age 5.7 years, range 3.9-6.9) were recruited from child care centres. The parents filled in a questionnaire on the child's history of ear infections and adenoidectomy. MRI was performed with a 4 mm slice thickness during an upper respiratory infection. Five dimensions and two angles expressing the structure of the bony nasopharynx were measured in sagittal images. RESULTS: The dimension from the caudal edge of the septum to the midpoint of the sella, reflecting the height of the nasopharynx, was on average 2.2 mm smaller in the children who had had AOM attacks during the last 12 months than those without attacks (95% confidence interval (CI) 0.9 to 3.4, p=0.001) and the nasal base angle was on average 2.1 degrees smaller (95% CI 0.7 to 3.5, p=0.004). These differences remained significant after adjustment for age, sex and previous adenoidectomy in the logistic modelling. A history of adenoidectomy did not have any effect on the dimensions. CONCLUSIONS: The nasopharynx was smaller in the children with AOM attacks during the last year. The value of this finding for predicting susceptibility to recurrent AOM and directing preventive procedures should be evaluated.

Cross-sectional survey of paranasal sinus magnetic resonance imaging findings in schoolchildren.

AIM: Sinus image abnormalities are common among children examined for indications other than sinus disease. The purpose of this study was to determine the frequency of sinus abnormalities among otherwise healthy children attending school. METHODS: Magnetic resonance imaging (MRI) was performed on 24 children aged 8-9 y, 18 of whom were re-examined after 6-7 mo. RESULTS: Sinus abnormalities were common. An abnormality was seen in 12 of the children [50%, 95% confidence interval (95% CI) 29-71%], and 9 (38%, 95% CI 19-59%) had abnormalities in the maxillary sinuses. As many as 8 (42%, 95% CI 20-67%) of the asymptomatic children (lacking clinical symptoms or findings) had abnormalities in the maxillary or ethmoidal sinuses. The follow-up examination showed that about half of the abnormal sinus MRI findings had resolved or improved without any intervention. CONCLUSION: Abnormal sinus MRI findings are common both among otherwise healthy children attending school and in totally asymptomatic children. As incidental findings, these should be interpreted as normal and do not indicate any need for treatment in children imaged for purposes other than sinus disease.