Nasal Nosocomial Myiasis Infection Caused by Chrysomya bezziana (Diptera: Calliphoridae) Following the Septicemia: A Case Report.

A 74 yr old woman from Gonabad, southern part of Khorasan Razavi Province of Iran was admitted to a Hospital of Gonabad, because of respiratory distress, exertional dyspnea and fever. Close contact with domestic animals, history of chronic obstructive pulmonary disease (COPD), and completely resolved pulmonary tuberculosis (TB) in remote past, were notable parts of her past medical history. Due to clinical, paraclinical and radiographic findings and because of recent hospitalization, she was admitted to internal medicine ward with the diagnosis of health care associated pneumonia (HCAP). Despite the application of broad-spectrum antibiotics and appropriate supportive care, she had a poor response to the treatment. During the daily visit in Intensive Care Unit (ICU), numerous white larvae were detected in both nostrils. Further investigation of oropharynx and tracheal tube aspiration, showed no more larvae in mentioned parts. An hour later, nasal spontaneous bleeding occurred. Otorhinolaryngology consultation was performed and led to surgical procedure. In ENT examination, there were numerous larvae and massive clot formation in both inferior meatuses and distal nasal septum perforation. Thirty-seven extracted larvae were transferred to Medical Entomology lab by vial 70% ethanol and 5 live larvae for rearing. After precise investigation by aid of light microscopy, the larvae were identified as Chrysomya bezziana. Due to discovered 2nd larvae stage and duration of hospitalization, this infestation was identified as nasal myiasis.

Interaction of Physical Exposures and Occupational Factors on Sickness Absence in Automotive Industry Workers.

INTRODUCTION: Increased sickness absence in recent years has been a trouble making issue in industrial society. Identify the causes of sickness absence and its influencing factors, is an important step to control and reduce its associated complications and costs. The aim of this study was to evaluate main factors associated with the incidence of sickness absence. PROCEDURE: In 2012, a cross-sectional study on 758 employees of a car accessories producing company was applied and relevant information about the number of days and episodes of sickness absence, Disease resulting in absence from work, personal features, occupational factors and physical exposures were collected. To determine risk factors associated with sickness absence, Logistic regression analysis was used. RESULTS: The most common diseases leading to sickness absence in order of frequency were Respiratory diseases, musculoskeletal disorders, gastrointestinal diseases and injuries at work. Musculoskeletal disorders increased the danger of long term absence by 4/33 times. Blue collar and shift works were the most important occupational factors associated with the incidence of sickness absence. The main physical factors that affect incidence of sickness absence were frequent bending-twisting and heavy lifting. CONCLUSION: Identifying controllable factors of sickness absence and trying to prevent and modify them such as compliance of ergonomic principals to decrease physical can be effective in reducing sickness absence.

The Relationship between Disease, Work and Sickness Absence among Psoriasis Patients.

BACKGROUND: The aim of this study was to assess the prevalence of absenteeism in patients with psoriasis and determine the factors influencing the incidence of absenteeism in these patients. METHODS: A cross-sectional study from December 2012 to November of 2013 was conducted on 192 psoriasis patients referred to the Dermatology Clinic of Imam Khomeini Hospital, Tehran, Iran. The number day of absence from work due to psoriasis in the last year was asked from the patients; the absence of 7 days has been considered as short-term and more than 7 days as long-term. Logistic regression was used to data analysis. RESULTS: Sickness absence in 21.4% of patients was positive. The average numbers of days of absence were 10.25 and the duration of absence from work in 48.7% were long-term ≥7 days. 51.3% had short-term absence (<7 days). Among disease factors: moderate to severe disease (SAPASI score >10), palms and soles involvement, joint problems and radiation therapy and among job factors: hazardous physical and chemical exposures in the workplace, non-office work, disability, exacerbations of disease on work days and problem on employment were associated with high incidence of sickness absence. CONCLUSION: Psoriasis with its chronic and recurrent nature especially in higher severities causes disabilities that deeply affect Work performance and can decrease the efficiency. In better management of psoriasis patients, physicians should pay special attention to occupational factors.