Spontaneous retroperitoneal haematoma causing femoral neuropathy

Femoral compression neuropathy is rare but can occur with different conditions, the current case being caused by spontaneous retroperitoneal haematoma in a 70 years old hypertensive patient, who was on antiplatelet treatment for deep venous thrombosis. This case demonstrated the typical manefestations of femoral nerve palsy, and is presented so that clinicians can remember this rare complication in the differential diagnosis

Amyand's hernia: appendix within an inguinal hernia

Hernia containing the vermiform appendix is known as the Amyand's hernia. It is a rare condition that occurs in about one percent of the cases of inguinal hernia. This is the report of a case of Amyand's hernia in a 24 years old male patient. As the appendix was not inflamed, hence it was not removed and replaced in the abdominal cavity. The indirect inguinal hernia was repaired with darning

Unusual pathology presented as neck lump

Neck lump is a common presentation in the outpatient clinics of otolaryngology, Head and Neck Surgery. It can be diagnosed on the basis of history, clinical examination, investigations and categorized according to the age of presentation. We present a case of young adult girl who had rightsided neck lump since four years. On the basis of fine needle aspiration cytology [F.N.A. C], she was diagnosed as a case of cervical chronic granulomatous inflammation consistent with tuberculosis. She was prescribed antituberculous treatment [A.T.T.] for 09 months but the swelling persists without any change. Excisional biopsy of the neck lump was performed and the histopathology revealed Histiocytoma Cutis, a variant of benign fibrous histiocytoma also called Fibrous Xanthoma or Xanthoma Cutis. Extensive English medical literature search on net revealed it to be a rare pathology which, to the best of our knowledge, has never been reported in locoregional literature and very rare over the globe

Deafness in highlanders.

Hearing impairment is a common health problem throughout the world. Over two million human beings on the earth are either deaf or hearing impaired, most of them in the developing countries. Pakistan is a land of multiethnic, multiracial, multilingual and varied anthropological cultures and populations. A substantial number of children and adults are suffering from hearing impairment, mostly provoked by poverty and lack of health facilities. This non-interventional descriptive study was carried out while providing primary ear care and conducting an epidemiological survey in the Northern territories of Baltistan, that covers a large terrain of Himalayan mountains of the Hindukush and Korakoram Range. A total of 1964 patients were examined during 7 camps conducted by IMPACT Pakistan in 1998, out of which 1160 were females and 804 were males. Short history was recorded and meticulous ear examination was performed, which includes otoscopy withpneumatic attachment and tuning fork testing. Tympanometry was performed in selected cases of glue ears having clinical evidence of effusion behind the drum. Common causes of deafness and hearing impairment were drawn from this study. Glue ear was found in 503 patients [25.61%] out of which 353 patients-were selected for tympanometry Impacted hard wax was found in 402 patients [20.46%]. Chronic suppurative otitis media [C.S.O.M] was found in 307 patients [15.61%] with discharging perforations in 178 patients [57.98%], dry perforations in 111 patients [36.15%] and cholesteatoma in 18 patients [5.86%]. Tympanosclerotic patches were found in 231 patients [11.76%]. Sensorineural hearing loss [SNHL] was found in 225 patients [11.43%], majority of them were due to aging process [presbaycusis] in 97 cases [43.11%]. Post-infectious neural loss was found in 55 cases [24.44%]. 39 cases [17.33%] of SNHL were associated with goitre and 7 cases [3.11%] of syndrome associated hearing loss were identified. The final message is that all the causes seen in mountainous areas of Northern territories, as indeed elsewhere in Pakistan are preventable. All we need is public awareness, which can be achieved through the help of the international agencies, particularly the W.H.O.