The May-Hegglin anomaly: a rare cause of a common complaint

May-Hegglin anomaly is the presentation of a qualitative platelet disorder characterised by large platelets, thrombocytopenia and granulocyte inclusions as a result of mutations in the MYH9 gene. Though often overlooked given its rarity, it should be considered in patients who present with epistaxis, bruising, menorrhagia and easy bleeding as it can be mistaken for other diagnoses resulting in unnecessary treatments and tests. Our case study reports one presentation of this anomaly and can help broaden awareness of the presentation of this type of patient.

Ulcerative colitis that developed during radiotherapy for prostate cancer, deteriorated rapidly and required emergency surgery

Background Although there are reports linking ulcerative colitis (UC) to prostate cancer (PC), those reports are of PC patients who were previously diagnosed with UC. There are no reports of the development of UC during radiotherapy. Here we describe the first case of a patient who developed UC during radiotherapy for PC. The UC progressed rapidly and required emergency surgery. Case presentation A 61-year-old Japanese man underwent a prostate biopsy at another hospital due to a high prostate-specific antigen level and was diagnosed with PC. Goserelin and bicalutamide treatment was initiated in 2019, and intensity-modulated radiotherapy (total of 60 Gy/20 Fr) was administered in 2020. Diarrhea began during the radiotherapy and bleeding began post-radiotherapy. He was admitted to another hospital 14 days after the end of the radiotherapy, and colonoscopy revealed a deep ulcer in the colon, which led to the suspicion of UC. He was transferred to our hospital, and colonoscopy showed a widespread map-like ulcer, pseudopolyposis, and very easy bleeding in the colon. We diagnosed severe UC, and it worsened rapidly with uncontrollable bleeding, which we considered an indication for surgery. Emergency surgery (a total colectomy and ileostomy creation) was performed. The specimens confirmed an extensively spreading ulcer throughout the colon. The pathological report was UC in the active phase. The postoperative course was good. Conclusions When a patient exhibits diarrhea while undergoing radiotherapy for PC, clinicians should be aware of the possibility of UC in addition to radiation colitis, and colonoscopy should be considered.

Cremmelin. A case of complete inversion of the uterus, or invesion of the third degree. (Austr. Med. Gaz. May, 1892). A case of complete inversion of the uterus or third degree eversion.

Mrs. N., 33 years old, multipara; 13 Feb urgent labor; as the last was tightly fastened, the uneducated midwife began to pull the umbilical cord, all through which there was an inversion, which passed unnoticed at first. But. when on the next day the woman in labor, who had not urinated for a whole day, got up for this purpose from the bed, a prolapse of the uterus occurred. The author, invited Feb 15 found the uterus protruding from the genital gap by 6-8 inches, partial vaginal inversion, easy bleeding, frequent pulse, severe abdominal pain.

REHABILITASI MEDIK PADA ANAK DENGAN LEUKEMIA LIMFOBLASTIK AKUT

Acute lymphoblastic leukemia (ALL) is oftenly found in children as well as in adolescents. ALL occurs in 3-4 cases of 100,000 children. The specific etiology of ALL is still unknown, but it is related to a multifactorial process associated with genetic, immunology, environment, toxic substances, viral exposures, and ionization radiation. Clinical manifestations of ALL may include fatigue and weakness, palor, infections and febris that are not improved with antibiotics, easy bleeding or bruising, joint or bone pain, loss of appetite, weight loss, enlarged lymph nodes, cough, or difficulty of breathing, enlargement of the liver or spleen, swelling of the face and hands, headaches, and vomiting. Functional improvement is a goal for medical rehabilitation in patient with LLA. In general, cancer rehabilitation management aims to maintain body functions including mobilization and activity, nutrition, social support systems, and pain control. Moreover, the program is implemented in conjunction with specific interventions based on the affected organ systems.Keywords: ALL, medical rehabilitationAbstrak: Leukemia limfoblastik akut (LLA) merupakan kanker yang sering terjadi pada anak-anak dan remaja. LLA terjadi pada 3-4 kasus dari 100.000 anak. Etiologi spesifik LLA belum diketahui, tetapi berhubungan dengan proses multifaktorial yang berkaitan dengan genetik, imunologi, lingkungan, toksik, paparan virus, ionization radiation. Manifestasi klinik leukemia dapat berupa kelelahan dan kelemahan, kulit pucat, infeksi dan demam yang tidak sembuh dengan antibiotik, mudah berdarah atau memar, nyeri sendi atau tulang, hilangnya nafsu makan dan turunnya berat badan, pembesaran kelenjar limfe, batuk atau kesulitan pernafasan, pembesaran hati atau limpa, pembengkakan muka dan tangan, sakit kepala, dan muntah Perbaikan status fungsional merupakan tujuan utama rehabilitasi medik pasien LLA. Penanganan rehabilitasi kanker secara umum ialah untuk memelihara fungsi meliputi mobilisasi, aktivitas, nutrisi, sistem pendukung sosial dan pengendalian rasa nyeri. Keseluruhan program ini diterapkan bersamaan dengan intervensi spesifik berdasarkan sistem organ yang terkena.Kata kunci: LLA, rehabilitasi medik

On Construction Wastes Recycling and its Economy

This paper addresses problems of aggregate concrete of construction wastes, which were featured as large water absorption, quick slump loss, as well as easy bleeding and low strength of concrete. A comparative analysis by experiment between recycled aggregate concrete and ordinary concrete was made on aspects of water absorbability, compressive strength, slump loss, bleeding rate, drying shrinkage and economic efficiency. It has found possible to preparing the recycled aggregate concrete of high performance through the prewetting recycled aggregate. It is concluded that construction wastes can be recycled by obtaining the optimum mole of preparing recycled aggregate concrete of construction wastes and evaluating their reliability on cost-lefficiency and mechanic capability，thus, it also recycled the limited resources and solve some environment problems.

Perawatan Periodontal pada Pasien Lupus Eritematosus Sistemik

Background: Systematic disease is a risk factor in periodontal disease. In contrast, severe generalize periodontal disease may also contribute to the development of certain systemic diseases and has and adverse affect in controlling the systemic disease. The majority of systemic diseases manifest in the oral cavity, one of which is systemic Lupus Erythematosus (SLE)., anautoimmune chronic systemic diseases. To date, the etiology of Lupus Erythematosus is still not clear, but the prognosis can become good if the adequate theraphy is given. SLE have a fairly high incidence, but the dangers of this disease is still not widely understood by the public. Purpose: To demonstrate how to manage the oral manifestations of SLE, as it must be done carefully so that patients ca get appropriate treatment to be successful, and the patients with oral manifestations similar to SLE can have a more thorough axamination. Cases: Two patients with SLE and symptoms of easy bleeding gums, frequent stomatitis, dry mouth, and mobile teeth. In both cases, there is gingival hyperemia, edema, pockets of 3-6 mm (case 1) and 3-4 mm (case 2). Prior to dental treatment, both patients are consulted to an internist. Treatment: Periodontal initial treatment such as DHE, scaling, and tooth restorations. Gradual scaling done in multiple visits, followed by gingival curettage. Conclusion: A good periodontal treatment can reduce gingival inflammation, and relatively improve oral hygiene, so it can be expected to increase body immunity.