Hidradenitis suppurativa complicated with secondary lymphedema and lymphangioma of the scrotum

Hidradenitis suppurativa is a chronic relapsing inflammatory skin condition affecting the apocrine sweat glands. Among the complications of this rare condition are local lymphedema and lymphangioma. A case of scrotal lymphedema and lymphangioma following chronic hidradenitis suppurativa in the genital area is described. Excisional skin biopsy was compatible with secondary lymphangioma. A resection of the scrotal mass was performed with reconstruction of the scrotum, penis and perineum

Frequency of inter-atrial blocks in patients with ischemic stroke

To determine the frequency and association of Interatrial block in hospitalized patients with Ischemic Stroke. A case control study. Department of medicine, Military Hospital, Rawalpindi from 1st Jan 2009 to 30 December 2009. It included 64 patients, 32 cases of diagnosed ischemic stroke and 32 patients were taken as controls not suffering from ischemic stroke or ischemic heart disease. ECG findings of both selected groups were evaluated for presence or absence of interatrial block. Out of 32 ischemic stroke patients, 14 [43.85%] were found to have interatrial block on electrocardiogram [ECG]. Whereas only 6 [18.80%] controls were found to have interatrial block on ECG. Odds ratio was 1.66. Interatrial block is more frequent in ischemic stroke patients and may represent a risk factor for such stroke.

Efficacy of terbinafine vs. griseofulvin in tinea capitis in the Northern areas of Pakistan

Since longtime griseofulvin has been in use to treat tinea capitis. However due to its decreasing efficacy, higher doses and side effects a search is going on to find out a better treatment. alternative. Terbinafine is one such therapeutic option. To compare the efficacy and safety of terbinafine and griseofulvin in tinea capitis in Northern Areas of Pakistan. Children 3 to 12 year-old who were clinically diagnosed for tinea capitis and confirmed by potassium hydroxide microscopy were included in the study. One group was treated with terbinafine at a dose of 62.5mg for children weighing less than 20kg and 125mg for those weighing 20-40kg and other group with griseofulvin at a dose of 15mg/kg body weight. Both groups were treated for a period of 4 weeks. Visits were scheduled at baseline and week 2, 4 and 6 for evaluation of efficacy and safety monitoring. Efficacy was evaluated on the basis of clinical improvement and mycological cure. Terbinafine showed comparatively higher clinical cure in our patients as compared to griseofulvin at week 2 [35% vs. 22%], week 4 [50% vs. 38%] and week 6 [70% vs. 55%] [p<0.05]. Similarly, mycologic cure with terbinafine was better than griseofulvin at week 2 [30% vs. 20%], week 4 [45% vs. 35%] and week 6 [60% vs. 50%] [p<0.05]. Trichophyton tonsurans was the most common organism isolated. There were no major side effects except nausea and abdominal pain in either group. Terbinafine is more effective than griseofulvin in treating tinea capitis in our part of the world

Clinical presentation of non-HIV Kaposi sarcoma

Kaposi Sarcoma [KS] is a rare entity. In the north west of Pakistan and Aghanistan, we mostly come across non-HIV related Kaposi sarcoma as Human Immunedeficiency Virus [HIV]. Infections are rare in this part of the world. Here, we present a case of a non-auto Immunedeficiency Disease [AIDS] related KS. A 45-year-old male, Afghan patient presented to our oncology outpatient's unit with multiple subcutaneous nodules. The sites of involvement were the periorbital region, retro-auricular region, forearms, legs, chest and back. Oral mucosa was spared at the nodules. The patient had no visceromegaly at the time of presentation. A biopsy specimen from the retro-auricular region revealed a KS with dermal lymphatic involvement. His serum was negative for the common types of viral infections including Human Immunodeficiency Virus [HIV] on routine serology. His total B-lymphocytes [CD 19+], total T-lymphocyte [CD3+], total CD4+ lymphocyte [CD3+, CD4+] and total CD8+ [CD3+, CD8+] counts were all normal or borderline high. The patient was under treatment with 3 weekly chemotherapeutic regimens of Adriamycin, Bleomycin, Vincristine [ABV] keeping in view socioeconomical constrains, logistical difficulties in getting proper medical care and side effects of other options like radiotherapy for extended surface areas

Cancrum oris

Cancrum oris [noma] is an orofacial gangrene, which causes progressive and mutilating destruction of the infected tissues. The disease mainly occurs in children having malnutrition, poor oral hygiene and debilitating illness. It is well-documented in literature. In the international statistical classification of WHO, it is mentioned as necrotizing ulcerative stomatitis of children. Noma has disappeared from industrialized countries since the 20[th] century, but still common in third world countries especially in Africa