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Deficiency in interleukin-12 (IL-12) can result in susceptibility to opportunistic infection, with IL-12 deficiency being a rare genetic cause. Nocardia farcinica is a gram-positive aerobic actinomycete that can cause disseminated and potentially lethal nocardiosis in immunocompromised patients. This report describes a 16-year-old male adolescent with IL-12 deficiency presenting with generalized lymphadenopathy due to disseminated Nocardia farcinica. The subject of our study is a male adolescent who exhibited clinical manifestations consistent with cholestasis. He underwent extensive workup for malignancy, suspecting cholangiocarcinoma initially. The workup turned out unremarkable, and later during his hospital stay, he deteriorated and required intensive care unit (ICU) admission, as he developed superior vena cava (SVC) syndrome from massive enlargement of mediastinal and cervical lymph nodes. During the patient's admission, it was found that he had a deficiency of interleukin-12 (IL-12). Later on, a blood culture revealed the presence of Nocardia farcinica species. Subsequently, the patient was initiated and improved drastically on an empirical antibiotic regimen consisting of amikacin, co-trimoxazole, meropenem, and moxifloxacin. Following that, the susceptibility results came out, and he was switched to oral co-trimoxazole and oral moxifloxacin as he no longer required inpatient care. This report highlights the importance of accurate diagnosis of causes of immunosuppression and early investigation, diagnosis, and management of potentially fatal opportunistic infections such as disseminated Nocardia farcinica.
RESUMO
BACKGROUND: Intermittent exotropia (IXT) is one of the most common forms of strabismus usually seen in the pediatric age group, the prevalence of IXT is higher in Africa and the Middle East. IXT treatment strategies include both surgical and non-surgical methods, non-surgical management is preferred in general as it is less invasive and avoids the risks associated with surgery and anesthesia. AIMS: This study aims to determine the effectiveness of patching therapy for the treatment of IXT in different age groups and to compare the success of patching therapy in preventing surgery in IXT patients in different age groups. METHODOLOGY: A retrospective chart review was conducted from September 2022 until February 2023 at King Abdulaziz University Hospital in Riyadh. The data was collected retrospectively from electronic medical records from 2016 to 2021 of all patients diagnosed with IXT and were managed by patching therapy fitting the inclusion criteria. RESULTS: A total of 76 patients with IXT enrolled in the study with 56.5% of the participants were older than 7 years old. Overall, there was no improvement in the angle of deviation but 34% of patients had improved control over the follow-up period. 55.3% of the participants didn't require surgery. Younger age, longer duration of patching per month, and good compliance were significantly associated with treatment success. CONCLUSION: Younger age groups were more likely to benefit from patching therapy than older age groups, and good compliance to patching therapy is an important factor in preventing the need for surgery.
RESUMO
Objectives: This study aims to determine the sociodemographic characteristics of pet owners and their sources of information regarding pet-related health risks. It also assesses pet owners' perception of pet-related health risks and evaluates their attitudes and practices regarding preventative measures toward pet-related health risks. Methods: A cross-sectional study was conducted in Riyadh, Saudi Arabia from September 2020 to February 2021. The target population was pet owners visiting pet stores. The city was divided into five equal sectors and data were collected from each sector using a questionnaire. Results: A total of 508 participants were engaged in the study. Of these, 402 participants fit the inclusion criteria. The mean age of the participants was 25.5 years. Gender was almost equally distributed, and the majority of participants were single, however most of the participants lived with four or more family members. Around 49.5% of participants had household members at a higher risk for pet-related diseases. The most common pet types were cats (77.4%), followed by birds (24.6%) and dogs (9.7%). Most participants were satisfied with their understanding of pet-related health risks and were not concerned about getting sick because of contact with pets. Physical harm was the most common pet-related health risk that the participants were satisfied with their level of understanding about, on the other hand their satisfaction with their understanding about gastrointestinal infections from pet contact was the lowest. Most participants had good pet husbandry and hygiene practices. Social media and veterinarians were the most common sources of information regarding pet-related health risks. Conclusion: Although most pet owners reported having good pet husbandry practices, further education is needed to raise awareness about pet-related health risks. Since most pet owners receive their information about this topic from social media and veterinarians, further education through these platforms might be beneficial.
