Mixed corticomedullary adrenal adenoma in a child

We present a three-and-a-half-year-old female with an extremely rare tumor of the adrenal gland. There are less than 20 reported cases worldwide; it is mostly reported in adult females. The child presented with precocious puberty and the investigations revealed an adrenal mass. The tumor was resected. The morphology of the tumor suggested a mixed Corticomedullary adenoma, which was confirmed with immunohistochemistry

Prediction of glucose-6-phosphate dehydrogenase deficiency in newborns

Objective: To evaluate the positive and negative predictive value of the positive family history of G6PD in predicting the actual G6PD of newborns compared to the mean total serum bilirubin [TSB] level for one-week

Design: A Prospective Study

Setting: Salmaniya Medical Complex and Jidhafs Maternity Hospital, Bahrain

Method: The mothers filled a survey, and the newborns underwent serum bilirubin check during the first week of life [day one, day two to four and day five to seven]. The G6PD activity status was tested as part of the newborn screen for all the newborns in Bahrain

Result: Four hundred twenty-seven newborns were included in the study; males were 219 [51.3%]. Two hundred eighty-eight [67.4%] of the newborns had G6PD normal activity and 139 [32.6%] were G6PD deficient. Two hundred fifty-one [58.8%] had a positive family history of G6PD deficiency while 176 [41.2%] did not have a family history of G6PD deficiency. The positive predictive value [PPV] for family history of G6PD deficiency is 47.4%, while the negative predictive value [NPV] is 89.1%. The mean serum bilirubin level for newborns with G6PD reduced activity was 139 +/- 52 micro mol/L. The serum bilirubin level was higher if the previous sibling required phototherapy, 157 micro mol/L +/- 50 micro mol/L [P-value<0.001]

Conclusion: Family history could be helpful for clinicians but it should be considered with caution. The negative predictive value is 89.1%, which means that 20 [4.7%] of the newborns had no family history of G6PD deficiency and still have G6PD deficiency

Chronic constipation leading to sigmoid colon volvulus in an adolescent

We report a case of one of the rare complications of constipation in an adolescent. The patient presented with acute abdominal symptoms and the radiographic images revealed a dilated twisted sigmoid colon. Rectal tube reduction was successful and subsequently, the patient underwent sigmoidectomy and uneventful recovery