Alcoholic hepatitis (AH) is a clinicopathologic illness caused by excessive alcohol abuse and is a precursor of cirrhosis. The leukemoid reaction (LR) is characterized by a strikingly raised granulocyte count of 40,000-50,000 cells/mm3. The LR usually suggests an acute inflammatory reaction. It is usually mistaken for chronic myeloid leukemia. The initial phase of leukocytosis occurs due to the releasing of cells from the bone marrow with more immature cells, causing a left upper shift in the ratio of immature to mature neutrophils and macrophages. The LR is usually seen in cases of leukemia but is rare to present in alcohol hepatitis. Excessive alcohol use causes AH in persons with or without underlying chronic liver disease. In severe AH, leukemoid responses have been associated with very poor prognosis and short-term mortality. We describe a case of a 35-year-old male with severe AH with an LR.

Accidents and emergencies in the workplace account for a significant proportion of emergency calls worldwide. The specificity of these events is often associated with hazards at a given workplace. Patients do not always require hospitalization; therefore, the characteristics of events can only be determined from the perspective of emergency medical services teams. The aim of the study was to analyze calls and the course of emergency ambulance interventions to patients at their workplace.
The study was conducted based on a retrospective analysis of data contained in the medical records of the ambulance service from central Poland from 2015-2018. From all interventions (n = 155,993), 1601 calls to work were selected, and the urgency code, time of day and year, patients\' sex, general condition, as well as diagnoses according to the International Classification of Diseases-ICD-10 and the method of ending the call were considered.
The mean age of patients in the study group was 42.4 years (SD ± 13.5). The majority were men (n = 918; 57.3%). The number of calls increased in the autumn (n = 457; 28.5%) and in the morning (n = 609; 38.0%). The main reasons for the intervention were illnesses (ICD-10 group: R-\'symptoms\') and injuries (ICD-10 group: S, T-\'injuries\'). Calls at workplaces most often ended with the patient being transported to the hospital (78.8%), and least often with his death (0.8%).
The patient profile in the workplace indicates middle-aged men who fall ill in the fall, requiring transport to the hospital and further diagnostics.

UNASSIGNED: Diagnosing bullous eruptions in systemic lupus erythematosus (SLE) patients is challenging because there are so many differential diagnoses, including drug reactions such as Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) and TEN-like cutaneous lupus erythematosus (LE).
UNASSIGNED: An Indonesian female with a SLE history complained of an erythematous rash over the body 2 weeks ago. A pulse dose of methylprednisolone was given, and after 3 days, of getting bullae appeared all over the body and treatment stopped. The patient is treated in collaboration with dermatology, ophthalmology, and allergy consultants to obtain a diagnosis of SJS supporting skin biopsy. The patient was given methylprednisolone 62.5 mg once daily for 7 days, Gentamicin 80 mg twice daily, and the skin lesion was treated with NaCl 0.9% compression. The patient showed improvement and decreased methylprednisolone dose to 16 mg 3 times a day.
UNASSIGNED: Skin biopsy must be obtained to establish the diagnosis between JSJ/TEN and cutaneous LE.
UNASSIGNED: SJS/TEN can occur in SLE patients. The correct diagnosis can reduce the patient\'s mortality and morbidity.

We present a case of inappropriate dexamethasone use in a trekker in the Everest region of Nepal. We aim to increase awareness among health professionals of the possible use of this medication by trekkers and promote knowledge of potential complications. In this case, a previously altitude-naive trekker was prescribed prophylactic dexamethasone by physicians in a Western travel clinic before high-altitude trekking in Nepal. There were no indications for prophylactic medication nor for the use of dexamethasone. The trekker reported that no discussion regarding risks and benefits, alternatives, side effects, contraindications, or dose tapering on completion of the course had occurred before travel. Side effects were temporary, but serious complications may have ensued if it not for timely interventions by doctors at the International Porter Protection Group rescue post. The events leading to inappropriate dexamethasone use in this case cannot be known for certain. However, it is clear that the trekker lacked the knowledge to use the medication safely. Although the efficacy of dexamethasone in the prevention of acute mountain sickness is undisputed, associated side effects and other limitations make acetazolamide the prophylactic drug of choice. Inappropriate use of dexamethasone can lead to severe complications, and such a case has been reported from Mount Everest. Clinicians prescribing dexamethasone must understand the indications and risks, and health professionals at altitude should be aware of its use by trekkers and the potential complications.

Modern clinical case reporting takes the form of problem-solution narratives that redescribe symptoms in terms of disease categories. Authored almost always by those who have played a part in the medical assessment of the patient, reports historicise the salient details of an individual\'s illness as a complex effect of identifiable antecedent causes. Candidate hypotheses linking illness to pathological mechanisms are suggested by the patient\'s experience, and by data that emerge from clinical examination and investigation. Observational and interpretive statements from these considerations are fitted into a temporally inflected account of the patient\'s medical condition, configured from the vantage point of hindsight. Drawing on established forms of deferred telling, readers are invited to follow a story that drip-feeds a mixture of contingent and non-incidental information into the account, which engenders and frustrates curiosity, creates expectations, and challenges powers of reasoning and pattern recognition. Whereas case reporting once favoured memoir, the sentimental tale and eccentric biography as the means by which its historical narrative was cast, the preferred genres of contemporary case reporting include detective fiction, and puzzle and riddle narratives, formats that conceptualise the medical consultation in narrow problem-solution terms.

BACKGROUND: Prevalence rates of child illness according to parents have been found to vary greatly in the general population, with even less known about children of military parents. Mothers are generally considered more informed about their children\'s problems than fathers. This paper aimed to establish the prevalence of serious illness and disability among children from military families, noting the difference between parental reports.
METHODS: Male serving and ex-serving personnel with children aged 3-16 years were invited to take part in an online questionnaire and telephone interview based on their child\'s health. The mothers of their children were invited via post if the father gave permission to make contact. Data were analysed using descriptive statistics and Cohen\'s kappa.
RESULTS: 378 fathers and 383 mothers provided information for 610 children. The vast majority of parents did not perceive their child to have a serious illness or disability; fathers reported problems in 7.7% of their children (respiratory conditions most common), while mothers reported problems in 6.2% (physical health problems rated most prevalent). A moderate agreement was found between parent\'s reports; kappa=0.51 (p<0.001).
CONCLUSIONS: The prevalence of serious illnesses and disabilities is low among military children according to parent reports. Fathers were more likely to disclose a problem in their child, and these differences were visible in the type of problem reported also. This disparity suggests mothers\' and fathers\' views should both be considered when making decisions that involve the child\'s care, in addition to clinical diagnoses.

Some religious reactions to the HIV epidemic in Africa unwittingly contributed to the expansion of the epidemic in its early years. This was because many religious people regarded the emergence of HIV and AIDS as divine punishment for man\'s sins as a result of people\'s sexual promiscuity. Some also opposed public promotion of the use of condoms for HIV prevention. However, religious bodies have made positive contributions to HIV/AIDS responses in many African countries in recent times. Though Christian bodies are taking the lead in faith-based responses to HIV and AIDS in Africa, Islamic bodies have also been major partners in HIV/AIDS interventions in several countries. Against this background, this article examines some Islamic perceptions of HIV and AIDS, and especially the impact of antiretroviral treatment (ART) for people living with HIV in Africa, with particular emphasis on Nigeria. In spite of the emergence of antiretroviral (ARV) drugs in Africa, Islam still emphasises the prevention of new infections and care for people living with HIV or AIDS. The article discusses basic issues associated with ARVs, such as health, sickness, life-prolongation and death, from an Islamic viewpoint, as well as some Islamic measures to prevent HIV-risk-taking behaviours in an era of ARVs. It also looks at the nature and extent of Islamic involvement in the national HIV/AIDS response in Nigeria. The paper concludes that while Islam sees HIV and AIDS and other diseases as \'tests\' from Allah, the religion is not opposed to ART. Thus, efforts need to be intensified by Islamic bodies and Muslim leaders in Nigeria for an improved response to HIV and AIDS in the country.

To test the hypothesis that self-compassion buffers people against the emotional impact of illness and is associated with medical adherence, 187 HIV-infected individuals completed a measure of self-compassion and answered questions about their emotional and behavioral reactions to living with HIV. Self-compassion was related to better adjustment, including lower stress, anxiety, and shame. Participants higher in self-compassion were more likely to disclose their HIV status to others and indicated that shame had less of an effect on their willingness to practice safe sex and seek medical care. In general, self-compassion was associated with notably more adaptive reactions to having HIV.