Epithelial-myoepithelial carcinoma [EMC]: uncommon tumor with rare presentation, importance of immuno-histochemistry for the diagnosis

Epithelial myoepithelial carcinomas [EMC] are rare carcinomas of the salivary glands. We report here the 6th case of this tumor which arises at the nasal cavity. In case of any histopathological report shows up a pleomorphic adenoma in an unusual site, we highly recommended the use of immunohistochemistry assay as an important tool for the diagnosis of this tumor

Juvenile systemic lupus erythematosus in Bahrain. A tertiary referral center experience

To analyze the clinical and serological features of children with systemic lupus erythematosus [SLE] in a major referral center in Bahrain and to assess the comorbidity, its morbidity, and mortality. We retrospectively reviewed the medical charts of children with SLE treated in the Pediatric Rheumatology Clinic at Salmaniya Medical Complex, Kingdom of Bahrain from 1998 to 2007. The ethical approval for the study was obtained from the Research Health Committee, Ministry of Health, Kingdom of Bahrain. Thirty-two children with SLE were identified. Thirty-one [96.8%] were Bahrainis. The mean age was 14 +/- 4 years, the mean age of disease onset was 9 +/- 4 years and the mean duration of illness was 7 +/- 5 years. The female to male ratio was 2.5:1. Twenty-five percent of the cases had relatives with SLE. Eight patients [25%] had sickle cell anemia [SCA]. Systems involved were as follows: skin [93%], kidney [81%], musculoskeletal system [65%], blood [56%], gastrointestinal tract [31%], central nervous system [31%], lungs and cardiovascular system [21%]. Serological tests showed: positive antinuclear antibody in 90.6%, and positive anti double-stranded DNA antibody in 65%. The morbidity rate was 21% [n=7] due to complication and 12.5% [n=4] died. Clinical and serological results were comparable with the international studies. Nephritis was the primary cause of morbidity and mortality. Coexistence of SLE with SCA was also reported in other studies and may need further investigation with genetic studies

Morel -lavalle syndrome

Closed degloving injury is a severe traumatic separation of the skin and subcutaneous tissue from the underlying fascia first described by Morel-lavalle in the mid-19th century. He observed the phenomenon in the lower limb of a woman after tangential trauma with separation of the fatty layers. Sporadic cases have been reported in the literature since. We report a case referred for plastic surgery for cosmetic reasons

Preliminary study of antiarrhythmic effect of phenytoin during endotracheal intubation

Preliminary observation of arterial blood pressure, heart rate and cardiac rhythm changes during endotracheal intubation were made in 50 patients divided into three groups. Group [A] the control group and into groups [B] and [C] phenytoin was given as premedication by intravenous and oral route respectively. The procedure of endotracheal intubation caused marked rise in blood pressure and heart rate in all the three groups but in group B and C the fluctuation was significantly less than in the control group, although group B and C were comparable. Endotracheal intubation produced higher percentage of cardiac arrhythmias in the control group [45%] including serious type compared with the other two groups [20%] for each. In group [B] one patient out of ten had ventricular ectopic while none of the patients in group [C] showed such serious arrhythmia. The results of this study can not be overlooked clinically, therefore more experience will be required before its full use can be appreciated