Notes

Sectional Anatomy Test -- Mire.
A young male presented with complaints of disturbance of vision and floaters for the past five years with best corrected visual acuity of 6/6 in both eyes. Ophthalmic examination of the anterior segment was normal in both eyes. There was a relative afferent papillary defect in the right eye. Fundoscopic examination of the left eye showed a raised, 3-disc diameter (DD) dark brown lesion arising from the optic disc. Ophthalmic investigations were performed including fundus photos, A-scan, B-scan, Auto-fluorescence, OCT, and FFA. Findings were consistent with those of optic disc melanocytoma. The patient is now kept on close three-monthly follow-up. To the best of our knowledge, there are no published reports from Pakistan so far.Descemet Membrane Detachment is a vision-threatening complication of Cataract Surgery. If not treated promptly it can lead to serious vision impairment with the possible need for corneal transplantation. We present a case report of a 60 years old female who presented with blurry vision post phacoemulsification and lens placement after a cataract in the left eye. She was diagnosed with Descemet membrane detachment on slit-lamp examination that was confirmed on Anterior-segment Optical Coherence Tomography and treated with intracameral 20% SF6 injection. There was a marked improvement in her vision with complete resolution of corneal oedema. Conclusion Anterior Segment OCT can be used as a diagnostic tool to accurately ascertain the site and extent of detachment and monitor disease progress. 20% Sulfur-hexafluoride intracameral injection can be used as a surgical option for large, central detachments.Tuberculosis is very prevalent in countries like Pakistan. It can be a diagnostic challenge when it has extra pulmonary organ involvement. Variation in clinical signs and symptoms, lack of access to a specialist and limited financial resources often result in delayed diagnosis. This leads to an increase in overall morbidity and mortality. We are presenting a case of disseminated tuberculosis with predominant intestinal symptoms in an eleven years old boy. He remained undiagnosed for several years despite frequent visits to multiple general practitioners. After appropriate investigations and initiation of treatment for tuberculosis, he showed an excellent recovery.Meckel's diverticulum is the most common congenital anomaly of the GIT with a low incidence of 2% and the complication rate is even lower with perforation being the rarest. www.selleckchem.com/screening/inhibitor-library.html We report an intriguing case of a 15-year-old male, who presented with one-week history of high-grade fever and diarrhoea followed by acute onset of abdominal pain in the periumbilical region which became generalized. On physical examination his abdomen was distended with guarding and rigidity. A provisional diagnosis of peritonitis secondary to enteric perforation was made and exploratory laparotomy was done which revealed a perforated Meckel's diverticulum and advanced peritonitis. A diverticulectomy with double barrel ileostomy were performed. No heterotopic tissue in the diverticulum was noted on histopathology, nor any other abnormal tissue identified. The patient made an uneventful recovery postoperatively and ileostomy reconstruction was done two months later. This case report is rare case of Meckel's diverticulum complications and highlights the importance of considering Meckel's diverticulum as a differential diagnosis in every patient presenting with acute abdomen, which can aid toward better management through laparoscopy.
Hand-Foot-and-Mouth disease (HFMD) is a viral illness commonly seen in young children, characterized by fever, vomiting, ulcerative lesions in oral mucosa, and vesicles on hands and feet. The early symptoms resolve but sometimes, it leads to more harsh neurological complications and even death. Therefore, the objective of this review was set to provide an overview of the symptoms, pathogenic agents, and treatment of neurological complications associated with HFMD.

We reviewed literature from PubMed and Science Direct covering at least one of our objectives from inception to 4th March 2018.

This review represents 6 countries including China, Vietnam, Cambodia, South Korea, Taiwan, and Australia. Fifteen studies with a total of 1043 patients were included. The majority of HFMD cases with neurological complications were reported in China, predominance in boys as compared to girls, with 97% cases under 15 years of age. Meningoencephalitis and brainstem encephalitis contributed 70% of all neurological complications related to HFMD. Human Enterovirus71 genotype C, especially C4a was a causative agent associated with severe complications. Among symptoms, fever, vomiting, myoclonic jerks or seizure, headache, convulsion, and rashes were reported in almost all neurological complications. The common and supportive treatments were the administration of intravenous immunoglobulin and glucocorticoid therapies.

Early detection and appropriate treatment of severe neurological complications can minimize the risk of adverse health outcomes. Evidence based clinical practice guidelines for early detection and treatment would be significant in the management of these devastating neurological complications.
Early detection and appropriate treatment of severe neurological complications can minimize the risk of adverse health outcomes. Evidence based clinical practice guidelines for early detection and treatment would be significant in the management of these devastating neurological complications.
Leishmaniasis is an endemic disease and a major public health problem throughout the world. Its geographic distribution has been extended over the past few years in Pakistan. The available treatment options of Leishmaniasis are limited and mostly parenteral, and hence a nontoxic oral alternative therapy is urgently needed to overcome the problem. The objective of this study was to evaluate the synergistic effect of Allopurinol as an adjunct therapy along with conventional intra-lesional sodium Stibogluconate in the treatment of cutaneous Leishmaniasis.

This single blinded randomized controlled trial was carried out at the tertiary care hospitals of district Peshawar, Pakistan. A total of one hundred and sixty-four (164) patients of age range from 19-56 years, consisting of both genders were included in this study. All subjects were randomly allocated to Group-1 and Group-2 where each group had 82 patients of comparable age and genders. Group-1 patients were given an intra-lesional injection of sodium Stibogluconate at a dose of 1-5 ml depending on the lesion size, where one ml injection contained 100 mg of the drug.
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