Autoimmune oophoritis: a rarely encountered ovarian lesion.

Autoimmune oophoritis is a rare disorder causing ovarian failure clinically characterized by amenorrhea and infertility. It often occurs in a setting of autoimmune polyendocrine syndromes. A 38-year-old female presented with a 3 years history of secondary amenorrhea.

Cytomegalovirus colitis masquerading as rectal malignancy in an immunocompetent patient.

Gastrointestinal tract (GIT) involvement by cytomegalovirus (CMV) infection is well-recognized in immunosuppressed patients but is uncommon in immunocompetent hosts. The colon and esophagus are the most frequently affected sites with punched out ulcers being the characteristic mucosal lesion. CMV-induced pseudotumor is an exceptionally rare presentation, especially in immunocompetent hosts.

Idiopathic sclerosing encapsulating peritonitis (abdominal cocoon) in adult male. A case report.

Introduction: Abdominal cocoon (sclerosing encapsulating peritonitis) (SEP) is a rare condition, mostly affecting adolescent girls living in tropical/subtropical region. Its etiology is unknown. It may cause acute or sub-acute intestinal obstruction.

Benign signet ring cells in pseudomembranous colitis: a diagnostic trap.

A 71-year-old female patient was admitted with intractable diarrhea and abdominal distention following several courses of broad spectrum antibiotic therapy. Colonic biopsy revealed pseudomembranous colitis with foci of signet ring cell (SRC) change. The SRCs possessed bland nuclei and were confined to the basement membranes of the crypts with no infiltration into the lamina propria.

Successful elimination of hemodialysis-related bacteremia and vascular access infection.

Hemodialysis (HD) related bacteremia and dialysis induced infection constitute major risk factors for mortality and morbidity among patients with end stage renal disease. In this retrospective study, we attempted to assess the impact of the infection control protocol introduced in our center on the prevalence of HD related bacteremia and vascular access infection. All the HD sessions performed over 8 years, from January 2004 till the end of December 2011, were included in this study.

Unusual presentation of renal vein thrombosis with pulmonary artery embolism.

A young 23-year-old male patient presented with a two-day history of right flank pain. He had no history of any significant illnesses in the past. His investigations showed nephrotic range proteinuria with hypoalbuminemia.

Thyroid dysfunction in pregnancy.

Timely treatment of thyroid disease during pregnancy is important in preventing adverse maternal and fetal outcomes. Thyroid abnormalities are very often subclinical in nature and not easily recognized without specific screening programs. Even mild maternal thyroid hormone deficiency may lead to neurodevelopment complications in the fetus.

Chronic epididymo-orchitis and scrotal ulcers.

Extrapulmonary tuberculosis (TB) still presents a diagnostic and therapeutic challenge. Genitourinary TB constitutes about 20% of the extrapulmonary cases in regions where TB is endemic. Tuberculous infection of epididymis and testis is difficult to differentiate clinically from pyogenic infection, tumour or infarction.

Arnold-Chiari malformation type 1 complicated by sudden onset anterior spinal artery thrombosis, tetraparesis and respiratory arrest.

Chiari in 1891 described a constellation of anomalies at the base of the brain inherited congenitally, the characteristic of which are (1) extension of a tongue of cerebellar tissue posterior to the medulla and cord that extends into the cervical spinal canal; (2) caudal displacement of the medulla and the inferior part of the fourth ventricle into the cervical canal; and (3) a frequent but not invariable association with syringomyelia or a spinal developmental abnormality. Chiari recognized four types of abnormalities. Presently, the term has come to be restricted to Chiari's types I and II, that is, to cerebellomedullary descent without and with a meningomyelocele, respectively.

Unusual presentation of mixed germ cell tumour from testis in a 45-year-old man.

Testicular cancer is a common neoplasm in young and middle-aged men. Although, the most common presentation is a palpable testicular mass, it can present with atypical symptoms. There is a lack of awareness among primary-care physicians about the less common presentations of testicular tumours.

Fluoxetine-induced pill oesophagitis.

Pill-induced oesophagitis is well reported in people of all ages (range 3-98 years), with females outnumbering males by 1.5:1. Antibiotic pills, cardiac pills and non-steroidal anti-inflammatory drugs and alendronate are the most common culprits.

Aminoglycoside use in renal failure.

Aminoglycosides are the mainstay in the treatment of serious gram negative infections including catheter-associated infections. They are not metabolized and are rapidly excreted as such by glomerular filtration resulting in a plasma t(½) of approximately two hours in those with normal renal function. The t(½), however, can extend to 30-60 hours in patients who are functionally anephric; therefore, dosage reduction or modification is necessary in renal failure patients.

Achieving effective pain relief in patients with chronic kidney disease: a review of analgesics in renal failure.

Increasing evidence in literature shows that chronic pain is a common and disabling symptom in patients with chronic kidney disease (CKD). As the dialysis population all over the world ages and experiences multiple co-morbidities, nephrologists are increasingly faced with the complex task of addressing them effectively to sustain a reasonable health-related quality of life for their patients. The overall symptom burden of these patients is high and is similar to the end-of life cancer population.

Changes in renal cortical and medullary perfusion in a patient with renal vein thrombosis.

Dynamic renal perfusion computerized tomographic (CT) scan was performed to test the cortical and medullary perfusion in a patient with unilateral renal vein thrombosis secondary to idiopathic focal and segmental glomerulosclerosis (FSGS). Forty mL of Iohexol was injected intravenously. Multiple fixed repeated axial renal CT scan cuts at specific intervals, over the mid pole, were recorded over 400 seconds.

Infection-free hemodialysis: can it be achieved?

Infection is the second most common cause of mortality in patients with end stage re-nal disease (ESRD). Following strict aseptic precautions during a hemodialysis (HD) session could reduce dialysis-related infection, thereby reducing mortality and morbidity rates. This retrospective study was undertaken to identify the prevalence of dialysis-related bacteremia, sepsis, and catheter infections during HD at Bahrain Specialist Hospital, Bahrain, after following rigid infection control procedures.