Multiple syringocystadenoma papilliferum arising from an extensive nevus sebaceous of Jadassohn: Case Report

We present an extensive nevus sebaceous of Jadassohn which was present at birth and had a rapid growth  during puberty. Multiple nodules of syringocystadenoma papilliferum developed on the plaque of nevus  sebaceous. The extensive nature of nevus sebaceous and numerous benign tumours is a therapeutic challenge  on the face. Currently there is no adequate evidence to support prophylactic excision of nevus sebaceous of Jadassohn, especially in people with skin of colo

Management of Patients with Post- Traumatic Exposed Bones at Moi Teaching and Referral Hospital, Eldoret, Kenya

Background: The global frequency for open long bone fracture is at least 11.5 cases per 100,000 personsper year. Precise published research information regarding the characteristics and the management ofpatients with post- traumatic exposed bones for Africa, Kenya and Moi Teaching and Referral Hospital-Eldoret is non- existent. This study will provide the much needed research information.Objective: To assess the characteristics of patients with post- traumatic exposed bones with theirmanagement at Moi Teaching and Referral Hospital, Eldoret.Setting: Moi Teaching and Referral Hospital, Eldoret, Kenya.Design: Hospital based descriptive retrospective study.Subjects: One hundred and ninety six patients managed for post- traumatic exposed bones between 1stJanuary, 2006 and 31st December, 2010.Methods: The medical records (files) were retrieved from the Records Department; data was gathered,recorded in observation checklist, organized, cleaned and analyzed in the statistical package for socialscience software version 19.Results: Males-167, females-29; ratio: 5.76:1. Mean age: 32.51 years (SD=13.26). Referrals were 51%, at least 60% were of low literacy and income earning status. All patients had exposed bones due to open fractures (97%) and degloving injuries (3%). Road traffic accidents were responsible in 49.5% of the patients. Duration of ailment was 0-300 days (median= 1.00). All patients benefited from surgical  interventions. Waiting time for surgery was 0-67 days (median= 1.00); while number of procedures were 1-9 (mean= 2, (SD=1.6)). Survival was 99.5%; length of hospitalization was 2- 177 days (median= 24.00; mean= 36.3 days (SD= 32.8)). The main complication was infection (62 patients). Follow up was adhered to by 59% of the patients.Conclusions and Recommendations: Majority of patients were: referred, males, of low literacy and low income earning status. All patients had exposed bones and benefited from one form or another of thenumerous surgical interventions with satisfactory outcome. Scarcity of resources remained major  challenge. There is need to create awareness and empower people socio-economically; as well as providing resources required in prevention, control and treatment of this disorder.Key words: Exposed bones, Debridement, Fracture stabilization, Coverage procedur

COVID-19 infection in adult patients with hematological malignancies: a European Hematology Association Survey (EPICOVIDEHA)

Background: Patients with hematological malignancies (HM) are at high risk of mortality from SARS-CoV-2 disease 2019 (COVID-19). A better understanding of risk factors for adverse outcomes may improve clinical management in these patients. We therefore studied baseline characteristics of HM patients developing COVID-19 and analyzed predictors of mortality. Methods: The survey was supported by the Scientific Working Group Infection in Hematology of the European Hematology Association (EHA). Eligible for the analysis were adult patients with HM and laboratory-confirmed COVID-19 observed between March and December 2020. Results: The study sample includes 3801 cases, represented by lymphoproliferative (mainly non-Hodgkin lymphoma n = 1084, myeloma n = 684 and chronic lymphoid leukemia n = 474) and myeloproliferative malignancies (mainly acute myeloid leukemia n = 497 and myelodysplastic syndromes n = 279). Severe/critical COVID-19 was observed in 63.8% of patients (n = 2425). Overall, 2778 (73.1%) of the patients were hospitalized, 689 (18.1%) of whom were admitted to intensive care units (ICUs). Overall, 1185 patients (31.2%) died. The primary cause of death was COVID-19 in 688 patients (58.1%), HM in 173 patients (14.6%), and a combination of both COVID-19 and progressing HM in 155 patients (13.1%). Highest mortality was observed in acute myeloid leukemia (199/497, 40%) and myelodysplastic syndromes (118/279, 42.3%). The mortality rate significantly decreased between the first COVID-19 wave (March–May 2020) and the second wave (October–December 2020) (581/1427, 40.7% vs. 439/1773, 24.8%, p value < 0.0001). In the multivariable analysis, age, active malignancy, chronic cardiac disease, liver disease, renal impairment, smoking history, and ICU stay correlated with mortality. Acute myeloid leukemia was a higher mortality risk than lymphoproliferative diseases. Conclusions: This survey confirms that COVID-19 patients with HM are at high risk of lethal complications. However, improved COVID-19 prevention has reduced mortality despite an increase in the number of reported cases.EPICOVIDEHA has received funds from Optics COMMITTM (COVID-19 Unmet Medical Needs and Associated Research Extension) COVID-19 RFP program by GILEAD Science, United States (Project 2020-8223)