Most patients with asthma were treated via primary care; however, those receiving secondary or tertiary care exhibited substantial utilization of medical facilities with high costs. Diagnostic measures and the prescription of inhalants containing corticosteroids in primary care require urgent attention.

Objective: The aim of this work was to report a case of left hepatic artery pseudoaneurysm due to acute pancreatitis following endoscopic papillectomy. Clinical Presentation and Intervention: A 74-year-old female with an ampullary adenoma underwent papillectomy, which was complicated by acute pancreatitis. Computed tomography showed aneurysmal dilatation of the proximal left hepatic artery. An angiography with coli embolization was performed and was successful. The patient was doing well at the 1-year follow-up. Conclusion: This patient with left hepatic artery pseudoaneurysm following severe acute pancreatitis was successfully treated with coil embolization.

Selective intestinal decontamination (SID) with norfloxacin has been widely used for the prophylaxis of spontaneous bacterial peritonitis (SBP) because of a high recurrence rate and preventive effect of SID for SBP. However, it does select resistant gut flora and may lead to SBP caused by unusual pathogens such as quinolone-resistant gram-negative bacilli or gram-positive cocci. Enterococcus hirae is known to cause infections mainly in animals, but is rarely encountered in humans. We report the first case of SBP by E. hirae in a cirrhotic patient who have previously received an oral administration of norfloxacin against SBP caused by Klebsiella pneumoniae and presented in septic shock.

Leuconostoc species (L. species) is Gram-positive, anaerobic, catalase-negative, or oxidase-negative coccus or coccobacillus. It has similar biochemical characteristics to that of enterococcus or streptococcus viridians and therefore there is a risk of it being identified with either one. 1 It is a natural resident existing in humans' and animals' mucous layers, large intestines, dairy products, beans, and vegetables. In the past it was thought that it did not infect humans, but recently its occurrence in patients with major diseases and immunocompromised patients has been continuously reported and it has been reported that it has infected humans in the form of bacteremia, encephalomeningitis, peritonitis, or pneumonia. 2