In hematochezia patients, the PEG group showed a higher diagnostic rate and lower rate of repeated CFS. However, emergent CFS after an enema only seems to be useful in patients with severe hematochezia or if the bleeding focus can be presumed.

Cytomegalovirus (CMV) esophagitis is well-documented in immunocompromised patients. A few studies have described CMV infection in immunocompetent patients diagnosed with a critical illness. However, CMV esophagitis has rarely been documented in immunocompetent hosts. We report a case of CMV esophagitis in an immunocompetent patient who presented with chest pain and dysphagia that was successfully resolved with ganciclovir treatment. Our case supports observations that CMV esophagitis can cause significant morbidity, regardless of immune system status. Keywords: Cytomegalovirus, esophagus, immunocompetent INTRODUCTION Cytomegalovirus (CMV) is a type of herpesvirus and a common viral pathogen in humans. CMV causes various diseases, such as retinitis, hepatitis, encephalitis, pneumonia, and gastrointestinal infection in immunocompromised patients (1,2). CMV-associated gastrointestinal infection has been reported to mainly invade the colon and stomach, but it may also occur in other organs (2).CMV-associated gastrointestinal infections are generally resolved without clinical symptoms in immunocompetent patients, but the infection can be fatal in the immunocompromised (3).There is now growing evidence of CMV infection in immunocompetent patients (3-5). Here, we present a case of CMV esophagitis in an immunocompetent patient, who presented with severe progressive chest pain and dysphagia after severe post-operative ileus (POI). The patient was successfully treated with ganciclovir. This positive outcome has been added to an updated review of the literature regarding CMV esophagitis in immunocompetent hosts. CASE PRESENTATIONA 67-year-old male patient was referred to the gastroenterology department following 3 days of progressive chest pain and dysphagia. The chest pain was localized to the retrosternum and was aggravated by eating. His dysphagia was localized to the retrosternum and neck with associated odynophagia. Ten days before the attack of chest pain and dysphagia, the patient has undergone surgery for a burst fracture of the 12 th thoracic vertebra and left orbital bone fracture caused by a traffic accident. Two days after surgery, he developed abdominal distension, nausea and vomiting. He continued to vomit, and subsequently developed aspiration pneumonitis. He was managed medically for aspiration pneumonitis and POI, and his symptoms subsequently improved.At time of referral, the patient's vital signs were stable with blood pressure, 130/80 mmHg; heart rate, 72 beats/ min; respiration rate, 18/min; and body temperature, 37°C. The physical examination revealed a chronically ill-looking man with mild epigastric tenderness. The complete blood count showed leukocytes, 8,200/μL; hemoglobin, 9.8 g/dL; and platelet count, 414,000/μL. Blood chemistry showed sodium, 137 mmol/L; potassium, 3.5 mmol/L; chloride, 101 mmol/L; aspartate aminotransferase/alanine aminotransferase, 58/34 IU/L; blood urea nitrogen, 14 mg/dL; creatinine, 0.44 mg/dL; albumin, 3.1 g/dL; and C-reactive protein, 6.08 mg/dL. Case ReportTurk ...

Objective: This study examined the effects of working chair that was developed for farmers who work in grapevine's cluster thinning. Background: Agricultural work involves some of the nation's highest occupational risk exposures. Fruit cultivation has been recognized as one of the most hazardous crops in which to work. Grapevine cluster thinning task involve activities related to the main risk factors associated with upper limb work-related musculoskeletal disorders. Method: An experiment was designed to test the working chair. Six healthy male(25.8±4.9years) were selected as the subjects for this study. Electromyography(EMG) was used to monitor the muscles activity, and Electro-goniometer was used to measure the ranges of motions of the elbow, trunk and knee. Subjective test was also carried out to examine discomfort body parts and their pain intensity. A grapevine's working space was built for the experiment and working chair was installed on it. In order to examine the muscle activity and range of motion, subjects used to the working chair for 30 minutes for each experimental condition. Another test without working chair was also performed for comparison. %MVC was used to quantify the level of muscle activity. Results: Decreases of muscle activity was found in all leg muscles and significant decrease of muscle activity was found in left Gastrocnemius. The range of motion of the trunk and knee also decreased when working chair used. Discomfort in lower back, thigh and shank region were reduced significantly. However, in upper limbs muscle activity tended to increase in working chair compared with conventional task. Conclusion: Improvement for cushion in seat back and pan required to reduce discomfort in buttocks. Application: Overall findings verified that the working chair might help to prevent upper limb and lower back MSDs based on the current study. These results can be practically used for work improvement for the grapevine growers to prevent MSDs.

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A 28-year-old male was admitted to our medical center with general myalgia and fever. After a series of tests, he was diagnosed with P. vivax malaria. On the 5th hospital day, the patient complained of tingling sensation on both hands and feet, which acutely progressed to ascending symmetric motor paralysis.Nerve conduction velocity test and cerebrospinal fluid analysis showed albumino-cytologic dissociation, suggesting polyradiculopathy, and thus he was