Complete Labial Adhesion in a Post-Pubertal Girl: A Case Report

Labial adhesion usually occurs in the infancy period and in prepubertal girls. It is a rare entity in reproductive age without any hypoestrogenism condition. Voiding dysfunction is a rare manifestation of these conditions. Here, we report a 19-year-old girl with complete labial adhesion presented with urinary retention. A 19-year-old virgin girl was referred to the obstetrics and gynecology department of Ghaem Hospital. She complained of urinary retention. Physical examination was normal except that was moderate hypogastric tenderness and a huge vesical globe. Genital examination revealed complete fusion of the labia minora in the midline, extended from the posterior fourchette to the region of the clitoris covering the entire vaginal introitus, urethral meatus, and clitoris. Despite the use of topical estrogen cream and surgical labial separation, re-adhesion occurred for the third time. Vulvar biopsy confirmed severe inflammation. Finally, topical anti-inflammatory medication improved the symptoms. Although labial adhesion is very rare in the post-pubertal period, it can successfully be managed by medical and surgical treatment.

Anterior ischemic optic neuropathy as a rare manifestation of COVID-19: a case report

Aim: A variety of manifestations in different organs could be associated with severe COVID-19; for example, ocular manifestations. Case report: A 52-year-old male complaining of sudden onset unilateral painless vision loss in the right eye for 1 month (started just 1 week after COVID-19 remission) came to the ophthalmology clinic. On further evaluations, he was diagnosed with anterior ischemic optic neuropathy (AION). Considering his past history and the result of evaluations, the hypothesis of association between AION and COVID-19 was proposed. Results & discussion: Ocular and neurologic manifestations of COVID-19 are more likely to happen in patients with more severe conditions. Complications occur secondary to two basic mechanisms including severe inflammatory response and hypercoagulable state. Conclusion: Our findings indicated that non-arteritic AION is another manifestation of microangiopathic/thrombotic events which may occur in the course of COVID-19.

Chorea Associated with Diabetic Striatopathy in an Elderly Female: A Case Report

Diabetic striatopathy is a rare manifestation of diabetes mellitus. The disease commonly affects individuals of Asian descent, female, and the elderly. Patients usually present with hemiballism-hemichorea caused by hyperosmolar hyperglycemic state. Prompt recognition of a hyperglycemiainduced hemiballism-hemichorea is essential because the symptoms are reversible with correction of hyperglycemia. Diagnosis is possible based on blood reports and neuroimaging findings. J Bangladesh Coll Phys Surg 2022; 40: 65-67

Rapunzel Syndrome – A Case Report: Trichobezoar as a Cause of Gastric Outlet Obstruction and Intestinal Perforation

Rapunzel syndrome is described as a rare manifestation of gastric trichobezoar extending throughout the bowel and is associated with psychiatric disorders. Its incidence in Pakistan is very rare and is found characteristically in adolescent females. Large or complicated trichobezoars are best managed by surgery. Psychiatric follow-up is essential to diminish the frequency of recurrence. We report an unusual case of Rapunzel syndrome causing gastric outlet obstruction and intestinal perforation.

hyperkeratotic uremic stomatitis revealing decompensation of chronic kidney disease

Uremic stomatitis is a rare manifestation associated with longstanding uremia in chronic renal failure patients. Its evolution is favorable with earlier institution of renal replacement therapy. We report a case of hyperkeratotic uremic stomatitis that revealed decompensation of chronic kidney disease.