Synergistic typhoid and taenia solium intestinal perforation.

Typhoid and intestinal infestation with parasites are common and may co-exist especially in the tropics. Their synergistic acute abdominal presentation is rare. We here report a 38-year-old male who presented with complaints suggestive of enteric fever and signs of peritonitis. Following baseline investigations, laparotomy was performed which proved to be a surgical surprise. A live tape worm was seen pouting out of the terminal ileal perforation. The clinical presentation and the stringent attention to preventive measures are discussed

Jejunal perforation due to single ascaris lumbricoides – a case report.

Ascriasis is a common infection in underdeveloped and developing countries and usually detected incidentally on evaluation of nonspecific pain abdomen. Complications related to ascariasis occur mainly due to heavy worm load. We here report a rare case, in which a single live ascaris worm had caused jejunal perforation

Effects of concurrent physical and cognitive demands on muscle activity and heart rate variability in a repetitive upper-extremity precision task

© 2015, Springer-Verlag Berlin Heidelberg. Purpose: Most previous studies of concurrent physical and cognitive demands have addressed tasks of limited relevance to occupational work, and with dissociated physical and cognitive task components. This study investigated effects on muscle activity and heart rate variability of executing a repetitive occupational task with an added cognitive demand integral to correct task performance. Methods: Thirty-five healthy females performed 7.5 min of standardized repetitive pipetting work in a baseline condition and a concurrent cognitive condition involving a complex instruction for correct performance. Average levels and variabilities of electromyographic activities in the upper trapezius and extensor carpi radialis (ECR) muscles were compared between these two conditions. Heart rate and heart rate variability were also assessed to measure autonomic nervous system activation. Subjects also rated perceived fatigue in the neck–shoulder region, as well as exertion. Results: Concurrent cognitive demands increased trapezius muscle activity from 8.2 % of maximum voluntary exertion (MVE) in baseline to 9.0 % MVE (p = 0.0005), but did not significantly affect ECR muscle activity, heart rate, heart rate variability, perceived fatigue or exertion. Conclusion: Trapezius muscle activity increased by about 10 %, without any accompanying cardiovascular response to indicate increased sympathetic activation. We suggest this slight increase in trapezius muscle activity to be due to changed muscle activation patterns within or among shoulder muscles. The results suggest that it may be possible to introduce modest cognitive demands necessary for correct performance in repetitive precision work without any major physiological effects, at least in the short term