Nicolau syndrome after intramuscular benzathine penicillin injection

A 3-year-old boy was admitted to the emergency department with right lower limb pain, edema, and livedoid discoloration that occurred immediately after intramuscular injection of benzathine penicillin. The patient was diagnosed with Nicolau syndrome, a rare complication of intramuscular injection presumed to be related to the inadvertent intravascular injection. It was first reported following intramuscular injection of bismuth salt, but it can occur as a complication of various other drugs. Fasciotomy was carried out due to the resultant compartment syndrome and medical therapy with heparin, corticosteroid, and pentoxifyllin was initiated

[Relation between homocysteine and peripheral vascular atherosclorosis: a brief report]

The purpose of this study was evaluation of risk factors of peripheral artery disease [PAD] and effective markers on it. This descriptive-analytical study was done during 2010-2011 in the surgical units of Khorramabad Shohada Hospital. Fifty patients who had symptoms of PAD undergoing CT angiography and biochemical markers for them were measured. The investigated variables were family history, site of arterial obstruction, underlying diseases, smoking history, physical activity and stress level. A control group was considered for the study. The comparison was made between these two groups. Aging showed a significant role in prediction of PAD [70% sensitivity and 64% specificity]. Homocysteine had the highest sensitivity [80%] in prediction of PAD, compared with other biomarkers. CRP [74% sensitivity] was the best marker that had positive predictive value for PAD. Fasting blood sugar [FBS] showed a significant role in prediction of true positive cases of PAD [72% sensitivity and 74% specificity]. HbA1C with68% sensitivity and 64% specificity and TG with 50% sensitivity and 44% specificity could be considered as factors related with PAD. The levels of C-Reacative protein, homocysteine, and FBS were correlated with PAD, HbA1C and TG levels were associated with PAD, but lower than the previously named markers. In this study a significant relationship between lipoprotein levels and PAD was also observed. PAD was associated with sex and age.

Significance of platelet count in esophageal carcinomas

Thrombocytosis is found to be associated with unfavorable prognosis in esophageal carcinoma. Platelets produce thymidine phosphorylase which is a platelet-derived endothelial cell growth factor with angiogenic activity. Increased platelet count may be translated into enhanced tumor growth. We examined the relation between platelet count and several prognostic variables in patients with esophageal cancer. Patients and Three hundred and eighty-one cases with esophageal cancer that underwent esophagectomy in a referral cancer institute during a 5-year period were studied retrospectively. The relation between preoperative platelet count and patient age, gender, site of tumor, presence of multiple cancers and clinicopathological characteristics including histological type, tumor size, depth of penetration [T], lymph node involvement [N], distant metastasis [M], degree of differentiation, presence of vascular, lymphatic and perineural invasion was examined. Squamous cell carcinoma [SCC] constituted 93% and adenocarcinoma 7% of cases. Most of patients were in stage III, followed by stage II. The mean platelet count was 245 +/- 76 [10[9]/L]. There was no statistically significant correlation between platelet counts with prognostic factors except a weak linear correlation between platelet count and and tumor size [P= 0.03, Pearson correlation coefficient: 0.16]. Patients with adenocarcinoma had a higher platelet count than those with SCC [P= 0.003]. Platelet count does not correlate with prognostic factors in esophageal cancer. However, it is significantly different between SCC and adenocarcinoma of esophagus