International Journal of Medical Advances and Discoveries

International Journal of Medical Advances and Discovery ISSN 2756-3812 Vol. 2 (11), pp. 001-004, November, 2011. © International Scholars Journals

Case Report

Unilateral tuberculous otitis media

Naeem K Makhdoom

Head of Department, Otolaryngology Department, College of Medicine, Taibah University, Medina PO Box 30001, Kingdom of Saudi Arabia. Email: [email protected]

Accepted 21 June, 2011

Abstract

Tuberculous otitis media (TBOM) is an extremely rare clinical condition worldwide. This may pose a diagnostic challenge even to the most astute and experienced otolaryngologist due to a low index of suspicion; however clinician should be aware of the possibility of tuberculosis (T.B) in patients with unusual aggressive presentation of otitis media with complications such as facial nerve paralysis, rapidly progressive hearing loss and multiple tympanic membrane perforations with scanty hell paje colored ear discharge. The objective of this case report is to raise the awareness of TBOM as a possible differential diagnosis in a patient with chronic otitis media. This is the first case of TBOM being reported from the Kingdom of Saudi Arabia.

Keywords: Tubercolous otitis media, lower motor neuron disease, hearing loss.

International Journal of Medical Advances and Discovery ISSN 2756-3812 Vol. 2 (10), pp. 001-004, October, 2011. © International Scholars Journals

Case Report

Clinical and ultrasonographic correlation of post-coital isolated penile injury with corpus cavernosal haematoma: A case report

¹Erondu Okechukwu Felix, ²Ohuegbe Chyke Ihechikara, ¹Okoro Chinedum Richards and ³Emmanuel Ehiwe

¹Department of Clinical Imaging, Image Diagnostics, Port Harcourt Nigeria

²Ultrasound Unit, In Health, London United Kingdom

³Spire Harpenden Hospital Hertfordshire, United Kingdom

Accepted 21 June, 2011

Abstract

Penile fracture or male coital injury is a relatively uncommon condition. It is primarily the rupture of corpus cavernosum, with or without involvement of corpus spongiosum and the urethra. Using a case study approach, we present ultrasound findings of this rare and underreported urologic emergency suffered by a 32 year old male patient during copulation in a female dominant position. This is a case with the classical presentation of pain, detumescence, rapid penile swelling, right-sided deviation and isolated rupture of one corpus cavernosum with massive haematoma. The urethra and corpus spongiosum were spared. Ultrasound demonstrated the presence of isolated hematoma, integrity of the penile urethra as well as evidence of arterial compromise in this patient. Our study shows the importance of sonography as a readily available and non invasive modality in the management of this urologic emergency.

Keywords: Penile fracture, coital injury, hematoma, corpus cavernosa, tunica albuginea.

International Journal of Medical Advances and Discovery ISSN 2756-3812 Vol. 2 (10), pp. 001-003, October, 2011. © International Scholars Journals

Case report

Primary and confined gist of the prostate: Case report and review of literature

João Paulo Martins de Carvalho^{1, 2}, João Pedro Gaio Meirelles Rozado ², Alexandre Vinícius Guimarães Araújo³, Paulo Cesar Nanci de Carvalho ⁴

¹Brazilian Health Ministry, Federal Hospital Cardoso Fontes, Urology Division

²Urogenital Research Unit, Rio de Janeiro State University, Brazil.

³Brazilian Navy Health Service, Brazil

⁴Hospital da Beneficência Portuguesa de Niterói, Brazil.

Accepted 05 June, 2011

Abstract

The symptoms of prostate hyperplasia, such as tenesmus, nocturia, and urinary retention are common in elderly men. A healthy male patient, 92 years old, in urologic follow up for benign prostatic hyperplasia culminated to acute urinary retention and indication of a retropubic prostatectomy. Exams documented a prostate of 180 grams, PSA 2.45 ng/dl. A digital rectal exam documented grade IV prostate with an adenomatous and fiber elastic aspect, without nodules. Surgery and thorough immunohistochemical studies of the specimen were performed, and primary GIST (gastrointestinal stromal tumor) of the prostate was confirmed. Posterior staging did not document another focus of the illness, and a complete resection of the primary mass was performed. The patient and his family were offered all the treatment options and opted for an exclusive clinical follow up, without adjuvant chemotherapy or radiotherapy. This decision was made based upon all the collateral effects that chemotherapy and radiotherapy would produce with no gain to the patient’s quality of life. In patients with localized disease, contingent on individual analysis of performance status as well as social aspects, exclusive clinical follow up can be offered according to their life expectancy.

Keywords: Prostate sarcomas, gastrointestinal sarcomatoid tumors, pelvic syndrome, imatinib, palliative procedures, clinical follow up.

International Journal of Medical Advances and Discovery ISSN 2756-3812 Vol. 2 (9), pp. 001-003, September, 2011. © International Scholars Journals

Case Report

A case of jaundice associated with hypertrophic pyloric stenosis carrying UGT1A1 polymorphism

Eylem Ulas Saz*, Basak Yildiz *, Asude Alpman *, Huseyin Onay *,Ferda Ozkinay **

* Pediatric Emergency Department, Ege University School of Medicine, 35100 Bornova, Izmir, Turkey

**Medical Genetics Department, Ege University School of Medicine, 35100, Bornova, Izmir, Turkey This work was condcuted at Ege University Hospital School of Medicine.

Accepted 26 April, 2011

Abstract

To demonstrate the UGT1A1 (TA)7 TAA polymorphism in a 45 day old boy with jaundice and recurrent vomiting caused by hypertrophic pyloric stenosis. A 45-day-old boy was brought to the emergency department with vomiting and jaundice. On admission, the baby was icteric and had weight lost. No evidence of infection and hemolysis. His thyroid function tests and all other biochemical tests were normal except for serum total bilirubin level which was measured as 9.82 mg/dl, with an unconjugated fraction as 9.05 mg/dl. DNA analysis was performed and the heterozygous (TA) 7TAA polymorphism was revealed in the bilirubin uridine diphosphate glucuronosyl transferase gene (UGT1A1) of the patient. Sonographic image revealed that hypertrophic pyloric stenosis. Ramsted pyloromyotomy was performed by pediatric surgery department. The jaundice disappeared within two days and the infant was discharged. We recommend that it is crucial step to care in a neonate with jaundice, recurrent vomiting and especially weight loss. Although hypertrophic pyloric stenosis and Gilbert Syndrome seem two different conditions, in selected patients more laboratory test should be obtained for differential diagnosis.

Keywords: Hypertrophic pyloric stenosis (HPS), Gilbert, jaundice, infants.

International Journal of Medical Advances and Discovery ISSN 2756-3812 Vol. 2 (9), pp. 001-006, September, 2011. © International Scholars Journals

Full Length Research Paper

Fluid intake in the first week of life: effect on morbidity and mortality in extremely low birth weight infants (less than 900 grams)

Ram Niwas¹, Stephen Baumgart², Joseph D. DeCristofaro³

¹Division of Neonatology, Department of Pediatrics, University of Iowa, Iowa City, Iowa, USA

²Department of Neonatology, Children’s National Medical Center, Washington, DC, USA

³Division of Neonatology, State University of New York at Stony Brook, Stony Brook, NY, USA

Accepted 26 May, 2011

Abstract

This study was carried out to determine whether lower fluid intake in extremely low birth weight preterm infants < 900 grams birth weight is associated with reduced incidence of PDA and BPD without affecting mortality. Retrospective chart review of two cohorts treated in the same NICU over a 5-year period. The high fluid intake cohort was managed with liberal fluid intakes starting at 155 mL/kg/day. The low fluid cohort was managed starting with 125 mL/kg/day. We compared the rates of mortality and the morbidities of PDA and BPD in these cohorts using ANOVA, chi-square, or the Student t test. One hundred and sixty one infants were admitted during two periods. After exclusion 113 infants were studied; 75 infants in high fluid intake group and 38 in low fluid intake group. The two groups were statistically different in their cumulative weekly fluid intake and the peak daily intake. We found no difference in mortality, PDA, BPD (by either of two definitions), ventilator days, or hospital stay. We were not able to demonstrate any association between fluid intake and mortality or morbidity in this retrospective analysis. The concept of fluid balance may be a more appropriate way to think about fluid intake in ELBW infants rather than absolute fluid intake.

Key words: Patent ductus arteriosus, bronchopulmonary dysplasia, premature infants, fluid balance.

International Journal of Medical Advances and Discovery ISSN 2756-3812 Vol. 2 (8), pp. 001-009, August, 2011. © International Scholars Journals

Keywords: HIV/AIDS, CD4 count, Viral load, markers