SARS-CoV-2 precipitated Kasabach-Merritt syndrome in a child with angioma infantile and acute lymphoblastic leukemia: Case Report

Background: We describe an 8-month-old boy with leukemia and SARS-CoV-2 infection who developed Kasabach-Merritt phenomenon. He had a positive SARS-COV-2 RT-PCR sample. Hematologic tests showed coagulopathy and intestinal involvement. She was managed in emergency receiving transfusion support and in hospitalization with social isolation measures, she started propanolol and corticotherapy as initial treatment of infantile angiomas. She presented with symptoms of intestinal obstruction and underwent surgery and evidence of hemorrhagic infarction with foci of intestinal ischemic necrosis, ending in ileostomy. We tried to understand a pathophysiological explanation of the dermatologic and gastrointestinal tract involvement by the virus and the atypical form of COVID-19. Given the emerging evidence of endothelial and vascular involvement in COVID-19, the development of tests to detect vascular lesions may be critical to guide the use of new therapeutic strategies.

CONGENITAL COLONIC ATRESIA PRESENTING AS PNEUMOPERITONEUM: A RARE CLINICAL ENTITY

Introduction:Colonic Atresia is the least common type of Intestinal Atresia which occurs as a result of ischemic necrosis of a segment of large intestine.It presents with abdominal distention,bilious vomiting and failure to pass meconium.Perforation leads to peritonitis and sepsis Case Report:We describe a 3 day old male baby presenting with Colonic Atresia type IIIa and pneumoperitoneum and his surgical management Conclusion:In conclusion, Colonic Atresia is managed by either by colostomy or primary anastomosis.Terminal ileostomy,as in this case is done when there is Ascending Colon atresia with distal ileal perforation.

THROMBOSIS OF THE SHORT ARTERIES OF THE STOMACH AS A CAUSE OF NECROSIS OF THE STUMP OF THE STOMACH AFTER SUBTOTAL DISTAL RESECTION: A CLINICAL CASE

This article covers the problem of ischemic necrosis of the gastric stump after its distal resection, which is a rare but one of the most formidable complications of surgical treatment.

Can large doses of glucocorticoids lead to Perthes? a case report and review of the literature

Background Perthes disease (Legg-Calvé-Perthes, LCP) is a self-limited and non-systemic disease occurring in the femoral heads of children, which is mainly manifested as an ischemic necrosis of the femoral head epiphysis, leading to subchondral ossification injury of the femoral head. Case presentation Here we report a case of 11-year-old child with long-term use of high-dose glucocorticoids. With MRI examination finding the epiphyseal necrosis of right humeral head, femur and tibia, and X-ray examination finding bilateral femoral head necrosis, the child was diagnosed as Perthes disease based on his clinical and imaging data. Conclusions Long-term and high-dose glucocorticoids may be one of the causes of Perthes disease.

Clinical Observations of a Surgical Method Comprising a Combination of Cross Flap and Autologous Auricular Cartilage Transplantation in the Treatment of Type I to III Congenital Concha-Type Microtia

Objectives: The present study attempted to investigate the clinical efficacy of a surgical method involving a combination of cross flap with autologous auricular cartilage transplantation in the treatment of type I to III congenital concha-type microtia. Methods: The present retrospective study was conducted on the clinical and postoperative data of 50 patients with unilateral type I to III concha-type microtia treated with a combination of cross flap and autologous auricular cartilage transplantation at the Plastic Surgery Hospital of Chinese Academy of Medical Sciences from January 2018 to December 2021. Results: The postoperative perimeters of malformed ears were significantly larger than the preoperative perimeters ( P < .05). Of the total, 2 patients exhibited incision dehiscence, 3 patients exhibited incision infection, 2 patients exhibited flap hematoma, and 1 patient exhibited ischemic necrosis at the flap tip. The satisfaction rate of the patients and their families was 100%. Conclusions: The surgical method involving a combination of cross flap and autogenous auricular cartilage transplantation was effective in treating patients with type I to III congenital concha-type microtia, and therefore, this surgical approach can be applied widely to correct this deformity.

Comparison of Social determinants and Evaluation of Disease Management of diabetic patients attending Rahman Medical Institute and Nahaki Emergency Satellite Hospital, Peshawar

Background: Diabetes mainly depends on social determinants of health. Addressing the social determinants, and attitude toward disease management is an important step toward the prognosis, and control of diabetes. The objective of the study was to determine the contributing role of social Determinants in diabetes development and evaluation of diabetes parameters affecting the prognosis and management among the diabetic patients of NESH and RMI. Methods: This was comparative hospital based case control study carried out from the duration of March to December 2016. A total 174 patients, 87 diabetics and 87 non diabetics were included in the study. After taking written consent, a predesigned questionnaire was filled from each patient. Data were collected and analyzed by using SPSS version 16. Results: A total 174 study subjects, 87 diabetic (Cases) and non-diabetic (control) each from two different hospitals with equal distribution were included in the study. Out of 174 study subjects 59 (34%) were male and 115 (66%) were female. A significant difference was observed in weight and BMI p<0.05 of these two groups case and control. There found no significant difference among diabetics and non-diabetes in reference to their social determinants like gender p=0.1683, education p=0.4358 and income p= 0.4672, however a significant difference between these two groups were observed in marital status p=0.0001. It was found that significant difference was observed in decrease of vision (p=<0.001) and Ischemic necrosis of toes and finger (p=0.007) among diabetics patients of both hospital. Conclusion: The social determinants (age, gender, area, profession etc), carbohydrate and fat intake were not significantly different between diabetics and non-diabetics group. The significantly higher proportion of diabetic’s patients of rural hospital were found with decrease of vision and ischemic necrosis of toes and fingers educational intervention regarding diabetes management is needed in rural areas of Khyber Pakhtunkhwa.