Paclitaxel-induced acute myocardial infarction: a case report and literature review.

BACKGROUND: Paclitaxel is a chemotherapeutic agent commonly used for ovarian, lung, breast carcinoma, and Kaposi's sarcoma. Its common side effects include hypersensitivity reaction, bone marrow suppression, and peripheral neuropathy. However, a rare and life-threatening side effect is paclitaxel-induced myocardial infarction. CASE PRESENTATION: A 71-year-old man with type 2 diabetes mellitus, hypertension, heavy smoking history, previous coronary artery disease with percutaneous coronary intervention (PCI) in left anterior descending artery (LAD), and non-small lung cancer presented with non-ST elevation myocardial infarction during infusion of paclitaxel infusion. Coronary angiogram showed de novo three vessel disease with 70% stenosis in ostial to distal left main artery (LM) and 80% in-stent re-stenosis in proximal to mid left anterior descending artery. CONCLUSIONS: Physicians should be keeping this in mind when dealing with patients on paclitaxel, especially if they have previous risk factors for coronary artery disease.

Endogenous Purulent Pericarditis Due to Klebsiella aerogenes in a Patient With Traumatic Chest Injury: A Case Report.

Purulent pericarditis is a rare but serious medical condition caused by an infection that spreads to the pericardial space surrounding the heart. Gram-positive organisms are the most common pathogens associated with purulent pericarditis. However, there has been a shift in recent years toward gram-negative bacteria. Klebsiella aerogenes is a rare pathogen that has never been linked to purulent pericarditis. In this report, we describe the case of a 40-year-old male patient with chronic bronchiectasis who, two months after suffering an injury, developed purulent pericarditis due to an uncommon organism, K. aerogenes. During his stay in the hospital, the patient developed several infections caused by K. aerogenes. These included bacteremia and ventilator-associated pneumonia (VAP). Beta-lactamase-inducible K. aerogenes was grown in pericardial fluid culture following an emergency pericardiocentesis. The organism was resistant to carbapenems in a sputum culture, even though it was sensitive to meropenem in a blood culture. The patient had hypotension, requiring inotropes, and continued persistent bacteremia due to K. aerogenes. The patient had a heart attack with no pulse or electrical activity and died despite getting the best care possible. In light of this example, it is crucial to think about K. aerogenes and other rare organisms as possible pathogens in purulent pericarditis, especially in people who do not normally have known risk factors for this condition. Multidrug resistance patterns can make treatment more complicated, and aggressive care may be necessary in critically ill patients with chronic bacteremia.

Linezolid-Induced Pancreatitis Associated with Lactic Acidosis and Relative Hypoglycemia: A Rare Case Report.

Background: Linezolid is known to cause side effects, including nausea, diarrhea, and headaches of short duration. As extended use of linezolid is becoming more common, additional rare side effects should be considered. Case Presentation: A 68-year-old man hospitalized for osteomyelitis developed severe abdominal pain and altered mental status following five weeks of linezolid therapy. Laboratory studies showed very high lipase levels, lactic acidosis not responding to resuscitation, and relative hypoglycemia. All common causes of pancreatitis were ruled out, and a trial of linezolid withdrawal was done resulting in drastic improvement in the patient's clinical status. Conclusions: For patients on extended course of linezolid who develop abdominal pain, drug-induced pancreatitis should be considered as a side effect, and a trial of withdrawal of linezolid should be undertaken. LEARNING POINTS: Linezolid can be associated with a rare but serious triad of adverse effects of pancreatitis, hypoglycemia, and lactic acidosis.Possible risk factors include a prolonged course of linezolid, renal dysfunction, and sepsis.

Soil Properties Correlate with Microbial Community Structure in Qatari Arid Soils.

This is the first detailed characterization of the microbiota and chemistry of different arid habitats from the State of Qatar. Analysis of bacterial 16S rRNA gene sequences showed that in aggregate, the dominant microbial phyla were Actinobacteria (32.3%), Proteobacteria (24.8%), Firmicutes (20.7%), Bacteroidetes (6.3%), and Chloroflexi (3.6%), though individual soils varied widely in the relative abundances of these and other phyla. Alpha diversity measured using feature richness (operational taxonomic units [OTUs]), Shannon's entropy, and Faith's phylogenetic diversity (PD) varied significantly between habitats (P = 0.016, P = 0.016, and P = 0.015, respectively). Sand, clay, and silt were significantly correlated with microbial diversity. Highly significant negative correlations were also seen at the class level between both classes Actinobacteria and Thermoleophilia (phylum Actinobacteria) and total sodium (R = -0.82 and P = 0.001 and R = -0.86, P = 0.000, respectively) and slowly available sodium (R = -0.81 and P = 0.001 and R = -0.8 and P = 0.002, respectively). Additionally, class Actinobacteria also showed significant negative correlation with sodium/calcium ratio (R = -0.81 and P = 0.001). More work is needed to understand if there is a causal relationship between these soil chemical parameters and the relative abundances of these bacteria. IMPORTANCE Soil microbes perform a multitude of essential biological functions, including organic matter decomposition, nutrient cycling, and soil structure preservation. Qatar is one of the most hostile and fragile arid environments on earth and is expected to face a disproportionate impact of climate change in the coming years. Thus, it is critical to establish a baseline understanding of microbial community composition and to assess how soil edaphic factors correlate with microbial community composition in this region. Although some previous studies have quantified culturable microbes in specific Qatari habitats, this approach has serious limitations, as in environmental samples, approximately only 0.5% of cells are culturable. Hence, this method vastly underestimates natural diversity within these habitats. Our study is the first to systematically characterize the chemistry and total microbiota associated with different habitats present in the State of Qatar.

A Rare Case of Fahr's Syndrome With Bilateral Vocal Cord Paresis.

We will be discussing a very rare neurodegenerative disorder called Fahr's disease, which is characterized by calcifications in the basal ganglia and other brain regions. Our case describes a 54-year-old lady presenting with abnormal aggressive behavior. Interestingly, in our case, the patient later developed vocal cord paresis, of which only one similar case has been reported before. CT was done, which showed typical extensive diffuse calcifications of the basal ganglia and other brain regions. Her labs were significant for normocalcemic hyperparathyroidism. During her stay in the hospital, she developed vocal cord paresis. In this case, she was managed in a multidisciplinary approach by medicine, neurology, psychiatry, and ENT. She improved significantly and was eventually discharged from the hospital. The rarity of Fahr's disease and the atypical involvement of vocal cords made the management challenging; however, the multidisciplinary approach aided in achieving well-rounded patient care and clinical improvement.

Impact of the Coronavirus Disease Pandemic and Related Vaccination in an Orthopedic Clinic in the United Arab Emirates: An Observational Study.

The coronavirus disease (COVID-19) pandemic has influenced hospital visiting patterns. Although vaccination has decreased infection rates and disease severity, hospital visiting patterns and associated treatment changes related to orthopedics remain unexplored in the Middle East. Therefore, this study aimed to examine the impact of the COVID-19 pandemic and vaccination on individual departments dealing with musculoskeletal disorders in the United Arab Emirates. Relationships between publicly available national data on the number of COVID-19 polymerase chain reaction tests and confirmed and recovered cases during May 2020-July 2021 and hospital data on the number of outpatients, inpatients, operations, and physiotherapy consultations were analyzed. In January 2021, the relationship between vaccination rate and orthopedic unit utilization was evaluated after vaccination campaign initiation. Multifactorial analysis revealed that an increased number of COVID-19-related deaths correlated with a decreased number of joint operations. Negative linear relationships were observed among confirmed and death cases with inpatient treatment and joint operation as well as recovered cases with inpatient treatment. Recovered cases with inpatient treatment and joint operation showed a positive linear relationship. Inpatient spine treatment showed a positive relationship with vaccination rates. The COVID-19 pandemic influenced orthopedic treatment in the Middle East, and vaccination campaigns facilitated inpatient spine treatment.