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Background: Choking is a critical emergency that occurs when foreign objects obstruct the airways. It commonly affects young children, older people, individuals with developmental disabilities, those with acquired or lifelong disability, and those with mental health conditions. Symptoms can vary, ranging from coughing to cyanosis. Aim: Our study aims to evaluate Syrian adults' knowledge of choking and their understanding of first-aid procedures. Specifically, we will assess the prevalence of misconceptions in order to train community members and increase their level of knowledge about first aid for choking. Ultimately, our goal is to reduce deaths resulting from this critical condition. Methods: This cross-sectional study aims to assess the knowledge and attitudes regarding choking among adults in Syria. The targeted population consists of Syrians aged between 18 and 45 years who reside in Syria. Data were collected through an online survey, disseminated via social media platforms from March to July 2022. Scores were computed to quantify levels of knowledge, with participants achieving a score of 16 or higher classified as having a high level of knowledge. The collected data were analyzed using descriptive statistics, Pearson's correlation coefficient, and chi-square tests. Results: A total of 406 responded to the survey, with 246 (60.6%) scoring less than 16 points, indicating a low level of knowledge. Gender and place of residency were not correlated with knowledge level p = 0.249, p = 0.913, respectively). Participants employed in the medical field, those who had received training in first aid, and individuals with higher levels of education exhibited higher levels of knowledge. However, the level of knowledge was below expectations for these groups. Conclusion: There should be an increase in the availability of first-aid courses to the public and improvements in hands-on training for physicians and medical trainees.
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INTRODUCTION AND IMPORTANCE: Drainage tubes are commonly used to remove unwanted fluid after surgery. However, they are not indicated in all situations, and there is no evidence to support their common utilization. CASE PRESENTATION: A 31-year-old woman at 38 weeks of gestation with a history of five cesarean sections presented with lower abdominal pain following a tonic-clonic epileptic seizure. Emergency surgery was performed due to fetal distress, and the uterus was found to be ruptured. After delivering the baby and closing the uterus, a drainage tube was inserted into the pouch of Douglas. Two days after surgery, the right ampulla and infundibulum were eviscerated from the drain site during the drainage tube removal. A second surgery was performed to reduce the herniated uterine tube. CLINICAL DISCUSSION: Drainage tubes are typically easily removed without complications. Some reported complications related to drainage tube removal include herniation, anchoring and suctioning of the uterine tube to the drainage tube, knotting with the colonic epiploica, and fracturing and retraction of the drainage tube due to adhesions. To the best of our knowledge, this is the first reported case of uterine tube evisceration during drainage tube removal. CONCLUSION: Evisceration after drainage tube removal is very rare. We believe that this is the first report of immediate evisceration after the removal process. Such complications can be avoided with more restricted instructions for the use of drainage tubes and more researches on the reasons for these complications.
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Introduction and importance: Amyloidosis is an infiltrative disease caused by the deposition of abnormal proteins. While cardiac amyloidosis is relatively common, gastrointestinal (GI) tract involvement is less frequent. In this case, the authors report a delayed diagnosis of systemic amyloidosis presenting mainly with digestive symptoms. Case presentation: An 81-year-old male presented with the complaint of persistent diarrhoea for over a year and the progressive development of edemas during the last 4 months. Echocardiogram findings revealed the presence of the characteristic sparkling sign. The diagnosis of amyloidosis was confirmed by histopathological biopsies taken from the duodenum. Serum electrophoresis findings strongly suggested the possibility of plasma cell dyscrasia. Clinical discussion: What distinguishes this case is that the suspicion of amyloidosis as the underlying cause of the diarrhoea did not arise until an incidental echocardiogram revealed cardiac hypertrophy and a sparkling appearance. Conclusion: This case reminds us to consider amyloidosis as a possible underlying cause for unexplained gastrointestinal symptoms such as diarrhoea, especially in bad economic situations where the diagnosis of rare diseases may be delayed.
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BACKGROUND: This case report describes a cystic fibrosis case after 7 years of a presumed diagnosis of celiac disease without confirming laboratory tests and biopsies. Both cystic fibrosis and celiac disease cause malnutrition, malabsorption, and failure to thrive. Also, the occurrence of cystic fibrosis in celiac disease patients is higher than in the normal population. Therefore, the differentiation between the two diseases might be challenging. This article highlights the reason for the confusion between cystic fibrosis and celiac disease and emphasizes the importance of not skipping the necessary investigations no matter how difficult it is to perform them. CASE PRESENTATION: This report details the case history of a patient presumed to have celiac disease for 7 years without confirming investigations. He developed multiple respiratory infections and weight loss throughout the 7 years but was only diagnosed with cystic fibrosis after hospitalization for gradual abdominal distension and productive cough. Chest CT showed atelectasis in the right upper lobe, tree-in-bud sign on both sides, and right periumbilical mass with several enlargements in the mediastinal nodes. Ascites paracentesis revealed a high SAAG gradient and low-protein fluid. The sweat chloride test resulted in a chloride level of 90 mEq/L, which confirmed the cystic fibrosis diagnosis. Subsequent genetic testing revealed the rare G85E mutation. CONCLUSION: This report highlights the potential for diagnostic confusion between cystic fibrosis and celiac disease. Also, it reminds physicians about the importance of taking a detailed medical history and performing the essential investigations no matter how difficult it is to do them. Finally, it emphasizes the need to verify the patient's previous medical history in case there is no official documentation of his case. This should be considered particularly in rural areas in low-income countries where the possibility of medical malpractice should not be forgotten.
