Parvovirus B19 infection in a patient of juvenile arthritis: A case report

Parvovirus B19 infection, or fifth disease or erythema infectiosum, is a self-limiting viral exanthem and can occur along with other connective tissue disorders. Occasionally, children may have preceding chronic joint complaints suggestive of juvenile idiopathic arthritis. A 7-year-old female patient presented to the outpatient department with a rash over her face, upper and lower limbs, and trunk, which was preceded by fever. The patient is a known case of juvenile arthritis. On examination, there were multiple erythematous and skin-colored plaques over cheeks; few pustules over lips; multiple erythematous papules over upper limbs, lower limbs, and trunk; multiple erythematous macules over palms; and swelling over interphalangeal joints of bilateral hands, elbow and knee joints with genu valgum deformity of limbs. The patient was given topical antibiotic and steroid combination cream and oral antihistaminic for her cutaneous complaints.

Therapeutic potential of silver in Unani system of medicine: an overview

Metals play important roles in human body, the deficiency of which may lead to various disorders. Earlier there was a perception that metals are not compatible with human body at all, but now it has been reported that number of metallic compounds are essential for body and some are in the category of essential elements. Metals are present in human body in different concentration and combination at various sites and help the respective body tissues to perform their required activities. Perfect health is attributed to the state of equilibrium of these metals in body tissues. Any imbalance in their concentration or inactive states disturbs the body metabolism. Silver is one of the metals known since antiquity. It was used for medicinal purpose since time immemorial. The first recorded use of silver for medicinal purposes dates back to 8th century A.D. where Ibn Sina used silver filings for palpitation of the heart. In Unani system of medicine it is used in the form of kushta [calcined-oxidized herbo-metallic form] and warq [thin foils]. It is highly recommended in fever, chest affections, impotency, seminal weakness, painful and irritable conditions of the stomach, heart burn, chronic diarrhoea and nervous affections. This review is an effort to summarize the detailed prospects of ancient literature on silver along with recent pharmacological studies

Management of ureteric calculus renal failure: a cost effective and decision making analysis with and without percutaneous nephrostomy

Background: Calculus acute renal failure is a urological emergency. Prompt treatment in the form of either temporary urinary diversion, or definite treatment can save the patients from developing chronic renal failure

Objectives: To compare the management of patients with obstructive uropathy with and without percutaneous nephrostomy

Patients and methods: A prospective interventional study conducted at SIMS/ SZMC, 2007-10. Twenty patients of ureteric calculus presenting with acute renal failure were included in our study. Patients were divided into two groups. Age, sex, duration of anuria and biochemical profile like serum creatinine and serum potassium levels were noted in both groups. In group A, a preliminary percutaneous nephrostomy tube was placed as a temporary diversion. On normalization of clinical and biochemical profile, definite treatment in the form of ureterorenoscopy/ lithoclast was performed. In group B, all the patients underwent definite treatment in the form of ureterorenoscopy/ lithoclast without preliminary temporary urinary diversion. The duration of normalization of renal function test, efficacy of URS lithoclast, hospital stay and cost effectiveness in both the groups were noted

Results: A total of 20 patients with 75% male and 25% female were included. Duration of anuria in group A was one day in 1 patients and 2-3 days in 6 patients. The duration of anuria in group B was 102 days in 8 patients. Mean normalization of serum creatinine level in group A was 5.9 days while it was 5.2 days in group B. The mean hospital stay was 10 days in group A while it was 4.7 days in group B. The mean cost of treatment in group A was Rs. 12300 and Rs. 4800 in group B

Conclusion: In patients with deranged renal functions but otherwise clinically normal can be offered definite treatment without temporary diversion in the form of PCN. This not only decreases the morbidity associated with PCN but also comforts the patients in term of shorter hospital stay and cost effectiveness

Causes of ureteric injures and outcome of different surgical procedures for the repair of ureter

Background: iatrogenic ureteric injuries have long been recognized as a potential complication of any abdominal or pelvic surgery. The present descriptive study was conducted at the Department of Urology Services Hospital, Lahore and Sheikh Zayed Medical College Rahim Yar Khan

Objectives: the specific objective of the study was to determine causes of ureteric injures and outcome of various treatment options

Patients and Methods: a total of 40 patients included in the study were presented either in the emergency ward or referred from other wards. Detailed History and thorough general and physical examination was done. Routine investigations were done in all cases while ultrasonography, intravenous urography, retrograde urography, ante grade urography and Computed Tomography [CT] scan were done in selected cases. Various procedures for ureteral repair were performed according to the site and extent of injury. Ureteral repair was done over a DJ stent

Results: in our study out of 40 patients 33 [82.5%] were female and 7 [17 .5%] males. Mean age of patients was 36 years. Maximum number of patients had lower ureteric injuries i.e 29 [72.5%] while 8 [17.5%] had upper ureteric injuries and 3 [7.5%] presented with mid ureteric injuries. 38 [95%] patients presented with iatrogenic injuries and 2 [ 5%] patients with firearm injury. Abdominal hysterectomy was the main cause in lower ureteric injuries. In case of upper and mid ureteric injures pyeloplasties and ureterouretrostomy was performed while in case of lower ureteric injuries 27 patients underwent extra vesical and intra vesical ureteroneocystostomy. Boari flap with psoas hitch was performed in two patients. Patients were followed at fourth week, three months and six months interval. Success rate in upper and mid ureteric injuries were 100% while in case of lower ureteric injuries it was [93 .1 % ]

Conclusion: ureteric injury causes a considerable morbidity for the patients. Detail understanding of anatomical relations of ureter and meticulous surgery will prevent iatrogenic injuries. The most common lower ureteric injuries can be best managed with Modified Liche [taguchi] technique

Case series of unusual intravesical foreign bodies and review of literature

Foreign bodies in urinary bladder are not uncommon. However, very little published series are available. Although, not being a fatal disease can lead to serious complications like acute or chronic cystitis, stone formation or fistula formation. We present 3 cases of different foreign bodies with different etiology which were removed successfully

Biochemical basis of secondary injury following neurotrauma

Primary trauma to the nervous tissue initiates a cascade of cellular and molecular events that promote continued tissue damage for an extended period following the initial injury. Oxidative stress mediated injury is an important component of secondary neuronal damage. In an attempt to explore the biochemical origin of oxidative stress associated with secondary injury we studied certain markers of oxidative stress and antioxidants in animal models of head, spinal cord and sciatic nerve injuries. Adult Wistar rats weighing 180-200g were subjected to concussive head injury, compression-induced spinal cord injury and crush injury to the sciatic nerve. Animals in the different groups were killed at various time intervals and the injured tissues [brain, spinal cord and sciatic nerve] were collected. Tissues were analyzed for markers of oxidative stress malondialdehyde, lipid hydroperoxides, conjugated dienes and myeloperoxidase] and level of antioxidants [glutathione and vitamin E]. Results of this study clearly showed a significant increase in the markers of oxidative stress and depletion of antioxidants following neurotrauma. In conclusion, this study clearly demonstrates a role of oxidative stress in the process of neurodegeneration following neurotrauma