Acanthamoeba, one of free-living amoebae (FLA), remains a high risk of direct contact with this protozoan parasite which is ubiquitous in nature and man-made environment. This pathogenic FLA can cause sight-threatening amoebic keratitis (AK) and fatal granulomatous amoebic encephalitis (GAE) though these cases may not commonly be reported in our clinical settings. Acanthamoeba has been detected from different environmental sources namely; soil, water, hot-spring, swimming pool, air-conditioner, or contact lens storage cases. The identification of Acanthamoeba is based on morphological appearance and molecular techniques using PCR and DNA sequencing for clinico-epidemiological purposes. Recent treatments have long been ineffective against Acanthamoeba cyst, novel anti-Acanthamoeba agents have therefore been extensively investigated. There are efforts to utilize synthetic chemicals, lead compounds from medicinal plant extracts, and animal products to combat Acanthamoeba infection. Applied nanotechnology, an advanced technology, has shown to enhance the anti-Acanthamoeba activity in the encapsulated nanoparticles leading to new therapeutic options. This review attempts to provide an overview of the available data and studies on the occurrence of pathogenic Acanthamoeba among the Association of Southeast Asian Nations (ASEAN) members with the aim of identifying some potential contributing factors such as distribution, demographic profile of the patients, possible source of the parasite, mode of transmission and treatment. Further, this review attempts to provide future direction for prevention and control of the Acanthamoeba infection.
Acanthamoeba ; Amoeba ; Animals ; Asia, Southeastern ; Asian Continental Ancestry Group ; Encephalitis ; Humans ; Keratitis ; Nanoparticles ; Nanotechnology ; Parasites ; Plants, Medicinal ; Polymerase Chain Reaction ; Sequence Analysis, DNA ; Soil ; Swimming Pools ; Water

Waterborne parasitic protozoa, particularly Giardia lamblia and Cryptosporidium spp., are common causes of diarrhea and gastroenteritis worldwide. The most frequently identified source of infestation is water, and exposure involves either drinking water or recreation in swimming pools or natural bodies of water. In practice, studies on Cryptosporidium oocysts and Giardia cysts in surface water are challenging owing to the low concentrations of these microorganisms because of dilution. In this study, a 3-year monitoring of Cryptosporidium parvum, Giardia lamblia, and Naegleria fowleri was conducted from August 2014 to June 2016 at 5 surface water sites including 2 lakes, 1 river, and 2 water intake plants. A total of 50 water samples of 40 L were examined. Cryptosporidium oocysts were detected in 22% of samples and Giardia cysts in 32%. Water at the 5 sampling sites was all contaminated with Cryptosporidium oocysts (0–36/L), Giardia cysts (0–39/L), or both. The geometric mean concentrations of Cryptosporidium and Giardia were 1.14 oocysts/L and 4.62 cysts/L, respectively. Thus, effective monitoring plans must take into account the spatial and temporal parameters of contamination because they affect the prevalence and distribution of these protozoan cysts in local water resources.
Cryptosporidium ; Cryptosporidium parvum ; Diarrhea ; Drinking ; Drinking Water ; Gastroenteritis ; Giardia ; Giardia lamblia ; Lakes ; Naegleria fowleri ; Oocysts ; Prevalence ; Recreation ; Rivers ; Swimming Pools ; Water Resources ; Water

A report of a 79 year old male patient suffering from acute myocardial infarction with Mallory-Weiss tear after successful cardiopulmonary resuscitation(CPR) by emergency medical technician in the swimming pool is presented. Successful percutaneous coronary intervention(PCI) was done after appropriate transfusion. The patient survived and discharged without major complications after admitting 11days in the hospital. Importance of CPR in AMI patient is reiterated as complication such as Mallory-Weiss tear may arise.
Cardiopulmonary Resuscitation* ; Emergency Medical Technicians ; Humans ; Male ; Mallory-Weiss Syndrome* ; Myocardial Infarction* ; Swimming Pools

A total of 60 samples were collected from 35 swimming pools in Beijing, China, and the presence of Cryptosporidium and Giardia were investigated. The results showed that 16.7% and 15.0% of samples were positive for Cryptosporidium oocyst and Giardia cysts, respectively, with a mean concentration of 0.30 oocysts/10 L and 0.27 cysts/10 L. The oocysts and cysts were found to have higher rates of occurrence in August than in May. Genotyping confirmed the presence of Cryptosporidium hominis, C. parvum, and Giardia assemblages A and B, all of which were associated with human infections. The predominant species/assemblages were C. hominis and Giardia assemblage A. Analyses of the relationships between parasite oocysts/cysts, indicator bacteria, and physical-chemical parameters revealed that there was no correlation between 2 parasites and fecal bacterial indicators, whilst there was a significant correlation between protozoa and urea concentration, which indicates that urea concentration rather than fecal bacterial indicators might be an appropriate index for chlorine-resistant protozoa in swimming pools. This study provides useful information to improve the safety of swimming pool water and deduce the risk of protozoan infections.
Bacteria ; Beijing ; China ; Cryptosporidium* ; Giardia* ; Humans ; Oocysts ; Parasites ; Protozoan Infections ; Swimming Pools* ; Swimming* ; Urea ; Water Quality* ; Water*

This clinical report presents the clinical appearance and treatment approach in a case of excessive anterior teeth erosion resulted from swimming in a poorly-chlorinated swimming pool. Clinical findings revealed tooth sensitivity, severe enamel erosion resembling veneer preparations, and the presence of anterior open bite. A novel hybrid ceramic (Vita Enamic) was chosen for fabricating full-coverage crowns for this patient. After 6-months follow-up, the tooth sensitivity disappeared and the patient was satisfied with esthetic outcome. The hybrid ceramic restorations can be recommended with no complications.
Ceramics* ; Crowns ; Dental Enamel ; Follow-Up Studies ; Humans ; Open Bite ; Swimming Pools ; Swimming* ; Tooth ; Tooth Erosion*

BACKGROUND: Patients with atopic dermatitis (AD) have increased susceptibility to irritants. Some patients have questions about types of water for bathing or skin cleansing. OBJECTIVE: We studied the pH of water from various sources to give an overview for physicians to recommend patients with AD. METHODS: Water from various sources was collected for measurement of the pH using a pH meter and pH-indicator strips. RESULTS: Bottled drinking still water had pH between 6.9 and 7.5 while the sparkling type had pH between 4.9 and 5.5. Water derived from home water filters had an approximate pH of 7.5 as same as tap water. Swimming pool water had had pH between 7.2 and 7.5 while seawater had a pH of 8. Normal saline and distilled water had pH of 5.4 and 5.7, respectively. Facial mineral water had pH between 7.5 and 8, while facial makeup removing water had an acidic pH. CONCLUSION: Normal saline, distilled water, bottled sparkling water and facial makeup removing water had similar pH to that of normal skin of normal people. However, other factors including benefits of mineral substances in the water in terms of bacteriostatic and anti-inflammation should be considered in the selection of cleansing water.
Baths ; Carbonated Water ; Dermatitis, Atopic ; Drinking ; Drinking Water ; Humans ; Hydrogen-Ion Concentration ; Irritants ; Mineral Waters ; Miners ; Seawater ; Skin ; Swimming Pools ; Thiram ; Water

Aquagenic urticaria is a rare form of physical urticaria, in which contact with water evokes wheals. A 19-year-old man and a 4-year-old boy complained of recurrent episodes of urticaria. Urticaria appeared while taking a bath or a shower, in the rain, or in a swimming pool. Well-defined pin head to small pea-sized wheals surrounded by variable sized erythema were provoked by contact with water on the face, neck, and trunk, regardless of its temperature or source. Results from a physical examination and a baseline laboratory evaluation were within normal limits. Treatment of the 19-year-old man with 180 mg fexofenadine daily was successful to prevent the wheals and erythema. Treatment with 5 ml ketotifen syrup bid per day resulted in improvement of symptoms in the 4-year-old boy.
Baths ; Erythema ; Head ; Humans ; Ketotifen ; Neck ; Physical Examination ; Preschool Child ; Rain ; Swimming Pools ; Terfenadine ; Urticaria ; Water ; Young Adult

OBJECTIVE:To describe the knowledge, attitudes and practices of parents in an urban coastal community on drowning prevention.
METHODS: A descriptive cross-sectional study design was used in the study. Systematic random sampling was used and 431 parents were included as respondents in the study. A questionnaire that was developed and pre-tested was used to determine the knowledge, attitudes and practices on drowning prevention among parents in households with at least one child.
RESULTS: The respondents' knowledge on general aspects of drowning such as its preventability and to whom and where it could happen seems to be sufficient (67-99%). Awareness of drowning prevention programs and activities in the barangay is quite low, and awareness of any legislation is even lower. The respondents seem to have positive attitudes toward supervising children while swimming or playing in high risk areas, in buying and wearing flotation devices, and participating in drowning prevention measures. Although 60 % claimed to have supervised their children while swimming in the sea, river, lake or swimming pools, more respondents (67 % - 88%) had admitted that their children had never worn flotation devices when they swim or play in most bodies of water. More than 93% of the parents have not participated in any program or activity on drowning prevention.
CONCLUSIONS: The study seems to show that, in the surveyed coastal community, there is a high level of knowledge in terms of the general aspects of drowning and there are positive attitudes in terms of measures and activities to prevent drowning. However, this has not translated to similarly appropriate levels of drowning prevention practices.

Human ; Male ; Female ; Aged ; Middle Aged ; Adult ; Attitude ; Awareness ; Child ; Cross-sectional Studies ; Drowning ; Family Characteristics ; Lakes ; Parents ; Rivers ; Surveys And Questionnaires ; Swimming ; Swimming Pools ; Water ; Knowledge ; Attitude

BACKGROUNDNontuberculous mycobacterium (NTM) had been reported to cause cutaneous infections which are difficult to interpret due to the variability of the clinical manifestations. Among NTM infections, Mycobacterium marinum (M. marinum) are mostly seen to cause skin infection. It is therefore important to establish a rapid approach for detection and identification of M. marinum from lesions of patients with suspected M. marinum infections.

METHODSSpecimens were obtained from 5 patients with swimming pool granuloma. DNA was extracted and polymerase chain reaction (PCR) was performed. PCR products were digested with Hae III and BstE II, then analysed by pattern restriction analysis to detect heat shock protein (hsp) 65 kD gene.

RESULTSThe 65 kD hsp gene was found in all specimens from patients with swimming pool granuloma. PCR restriction analysis (PRA) identified all 5 samples to be M. marinum infections, and the result was consistent with that of routine bacteriological identification. The lesions subsided or markedly improved upon treatment.

CONCLUSIONSPRA is a sensitive, specific and rapid method in identification of mycobacteria. Application of this method will be helpful for early diagnosis of mycobacterial skin infections.

Adolescent ; Adult ; Bacterial Proteins ; genetics ; Chaperonin 60 ; Chaperonins ; genetics ; Female ; Granuloma ; microbiology ; Humans ; Male ; Mycobacterium marinum ; genetics ; isolation & purification ; Polymerase Chain Reaction ; methods ; Skin Diseases, Bacterial ; diagnosis ; Staining and Labeling ; Swimming Pools

Of all toxic inhalant exposures, chlorine is one of the most common toxic chemical inhalants. When acutely inhaled, it can be responsible for symptoms ranging from upper air way irritation to more serious respiratory effects. It can also deteriorate lung function and lead to death. Chlorine and its compounds such as chlorinated cyanurates and hypochlorites are commonly used in water disinfection. The chemical agents discussed in this article are sodium dichloroiso cyanurate and calcium hypochlorite which are the two most popular products for swimming pool chlorination. They are both strong oxidizing agents which are soluble in water. Between the above two alkali agents, acid-base interaction occurred and generated heat. And the acid drove the combination of hypochlorous and chloride ions to form chlorine gas. We have experienced, two boys who had inhalation injuries caused by an accidental explosion which occurred in a swimming pool by mixing two different chlorinating agents : sodium dichloroiso cyanurate and calcium hypochlorite. The children suffered from respiratory difficulties after the exposure. They both required intensive care management and one needed the support of mechanical ventilation
Alkalies ; Calcium* ; Child ; Chlorine ; Disinfection ; Explosions* ; Halogenation ; Hot Temperature ; Humans ; Hypochlorous Acid ; Inhalation* ; Critical Care ; Ions ; Lung ; Oxidants ; Respiration, Artificial ; Sodium ; Swimming Pools* ; Swimming* ; Water