Methemoglobinemia is a common complication of dapsone poisoning. Its´ treatment usually relies on methylene blue infusion. The aim of this study was to report a case of an acute dapsone poisoning with methemoglobinemia treated only with ascorbic acid and activated charcoal. A 16-year-old female voluntary ingested 3 grams of dapsone in an attempt of suicide and presented with desaturation and tachypnea. Lab findings were compatible with methemoglobinemia. After two days of treatment with ascorbic acid and activated charcoal, we observed the disappearance of desaturation and tachypnea. Methemoglobinemia can be treated with ascorbic acid and activated charcoal in limited resource settings.

This pilot study aimed to assess the effects of high-fidelity simulation on cardiopulmonary resuscitation (CPR) self-efficacy and knowledge retention compared to case-based learning. A two-group, experimental, longitudinal design was adopted. Fifty-two undergraduate nursing students were invited to participate in the study, which was conducted between March and May 2019. The results show statistically significant differences in favor of the experimental group on both CPR knowledge retention and self-efficacy one month after training. These findings may assist nurse educators to implement high-fidelity simulation in CPR education.

Posterior reversible encephalopathy syndrome is a rare clinical and radiological entity which can lead to seizures. Some of its risk factors are hypertension and vasculitis, as in the case of Takayasu Arteritis, a large vessel arteritis which damages the abdominal vasculature. We report the case of a patient who presented in a generalized convulsive status epilepticus secondary to a PRES, which was induced by a renovascular hypertension secondary to Takayasu Arteritis. The aim of this study is to report the case of a rare association of Takayasu Arteritis and PRES, and discuss the timeline of the assessment of our patients condition, which allowed us to start the treatment as quickly as possible.

Pulmonary air leak syndromes involve dissection of air out of the normal pulmonary airspaces and include pulmonary interstitial emphysema, pneumothorax, pneumomediastinum, pneumopericardium, pneumoperitoneum, subcutaneous emphysema and systemic air embolism. It presents as a spontaneous extension of dissecting air without a history of a procedure or penetrating injury. Pulmonary air leak syndromes are extremely rare complications of systemic autoimmune connective tissue diseases. Few cases were reported in the literature regarding rheumatoid arthritis patients. The purpose of this article is to emphasize on this rare pulmonary complication and discuss the physiopathology of the disease and the different risk factors for a better management of these patients. We report the case of a 45-year-old female, with a history of proven rheumatoid arthritis under methotrexate and steroids, who presented with a spontaneous dissecting subcutaneous emphysema, pneumothorax, pneumomediastinum and pneumoperitoneum. The patient’s condition improved after chest drainage and adjustment of her medical treatment.