Urticaria pigmentosa in a child with sporadic bilateral diffuse conjunctival redness: case report and review of the literature

We present a case of a 2-year-old girl with urticaria pigmentosa. The clinical features indicated disseminated, discrete, non-clustered, reddish-brown macules, papules, and plaques on her body [0.5-1 cm in diameter]. Skin lesions occurred in the second month of life. There was associated sporadic bilateral lid swelling, diffuse conjunctival redness, and watery discharge. Darier's sign was positive. Diagnosis of mastocytosis was confirmed histopathologically. To the best of our knowledge, this information has not been previously reported

Intracoronary reopro during percutaneous coronary intervention in acute and stable patient can influence stent thrombosis formation [IRPASST] study

In patients with acute myocardial infarction or unstable angina undergoing coronary angioplasty, abciximab reduces major adverse cardiac events [MACE]. Most clinical trials have studied mainly intravenous administration. Intracoronary [IC] bolus application of abciximab causes very high local drug concentrations and may be more effective in reducing acute and sub-acute stent thrombosis [ST]. We studied whether IC bolus administration of abciximab is associated with a reduced ST and target vessels revascularization [TVR]; therefore, less MACE rate compared with the standard intravenous IV bolus and infusion application. This was a single-center observational study conducted between June 2007 and 2009. We studied a total of 447 patients admitted with either acute coronary intervention [PCI] and stenting. Patients with bleeding disorder, recent major surgery and high blood pressure were excluded. Patients were divided into two groups: Group I [n =199] patient received IC bolus of abciximab [reopro] 0.25 microg/kg during the PCI in cath lab. Group II [n =248] received the standard dose of reopro-a bolus intravenous 0.25 micro g/kg and maintenance dose of 0.125 micro g/kg over 12 h. There were no differences between the groups with regard to diabetes mellitus, group I [56%] vs. group II [58%], P = 0.613; ACS, group I [38%] vs. group II [44%], P = 0.175; Dietthylstilbestrol Drug eluted stent [DES] in group I [66.5%] vs. [57.6%] group II, P = 0.056; Bare Metal Stent [BMS] in group I [33%] vs. [40.7%] group II, P=0.093; target vessel revascularization [TRV] was seen in 9 patients [4%] in group I vs. 16 patients [6%] in group II. ST elevation was seen in 4 patients [2%] in group I vs. 7 patients [2.8%] in group II, all presented with STEMI. In this study, there was a trend toward less ST and TVR in patients who received IC reopro vs. intravenous route both in ACS and stable CAD. The percentage of DM was high in both groups [56%], especially in Saudi patients. In-stent restenosis [ISR] was less in group I than in group II, this was mainly associated with BMS usage. The percentage of BMS was more than 30% in both groups, either due to STEMI cases or large vessel size. Randomized controlled trials are warranted to further assess IC application of abciximab in reducing ST

outcome of pharmacist counseling at the time of hospital discharge: an observational nonrandomized study

Adverse drug events [ADEs] may occur after discharge from acute care hospitalization because of limited instruction on medications at discharge. The right instructions given to patients may reduce the risk of ADEs. The objective of our study was to assess a program involving comprehensive medication counseling provided by pharmacists at the time of discharge from a tertiary hospital in Riyadh, Saudi Arabia. A prospective, nonrandomized observational study over a period of 3 months in a 1000-bed tertiary hospital. patients discharged from the internal medicine wards with more than three medications received comprehensive pharmacist counseling. The intervention pharmacist counseled patients about their discharge medications and provided written materials as needed. Topics discussed with the patients included the importance of following prescribed medication regimens and the indications, directions, and any potential side effects of discharge medications. The control group included similar patients who received routine discharge counseling by nurses. Two weeks after discharge, the same pharmacist called the patients and assessed the frequency of ADEs. Two independent clinicians reviewed each ADEs and judged its severity and preventability. Out of 200 patients included in the study [100 patients from the intervention group and 100 patients from the control group], 175 patients [87.5%] were successfully contacted two weeks after discharge [88 patients from the intervention group and 87 patients from the control group]. ADEs occurred in 2 patients [2.3%] in the intervention group and in 21 patients [24%; 23 incidents in 21 patients] in the control group [P<.001]. In the control group, 14 ADEs [61%] were judged as preventable, and 9 [39%] were judged as serious. A comprehensive medication counseling program at hospital discharge reduced the incidence of ADEs two weeks after discharge from a tertiary hospital in Riyadh, Saudi Arabia. Further studies assessing the long-term outcomes of such a program are needed

Phthiriasis palpebrum presenting as chronic atypical unilateral blepharitis

To report a case of phthiriasis palpebrum presenting as unilateral blepharitis in a 4-year-old male child. Materials and Observational case report. A 4-year-old child presented to the emergency room of King Khaled Eye Specialist Hospital complaining of persistent redness after he had trivial trauma to his right eye one day earlier. Live crab lice and their nits were found attached to the eyelashes of the right upper lid. They were removed mechanically by jeweler's forceps under slit lamp and topical anesthesia, and treated with application of erythromycin eye ointment for two weeks. Infestation of the right upper eyelid by phthiriasis palpebrum was diagnosed and treated successfully. Meticulous examination of the eye lids may help early diagnosis and treatment of such communicable diseases. Screening of family members for possible sources of infection, and health education are important issues in the prevention of such diseases