Diphallus: A Rare Urological Anomaly- What to Do Next? Case Report and Literature Review

Diphallus is a very rare congenital anomaly usually accompanied by various congenital anomalies and can be classified according to the anatomical structure in which the anomaly develops. Generally, in cases with diphallus the surgical approach is preferred, in that the hypoplastic structure has been excised for esthetic and functional purposes and penile reconstruction is performed. In addition, urethroplasties have been also performed in the presence of any accompanying urethral abnormality. In the current case, we report a two-year-old boy who was diagnosed as having glandular diphallus

A novel modified PAIR technique using a trocar catheter for percutaneous treatment of liver hydatid cysts: a six-year experience

PURPOSEWe aimed to demonstrate the success and reliability of a novel puncture, aspiration, injection, and reaspiration (PAIR) technique in liver hydatid cysts.METHODSPercutaneous treatment with ultrasonographic guidance was performed in 493 hepatic hydatid cysts in 374 patients. Patients were treated with a new PAIR technique by single puncture method using a 6F trocar catheter. The results of this novel technique were evaluated with regards to efficacy and safety of the procedure and complication rates.RESULTSOut of 493 cysts, 317 were Gharbi type I (WHO CE 1) and 176 were Gharbi type II (WHO CE 3A). Of all cysts, 13 were referred to surgery because of cystobiliary fistulization. Recurrence was observed in 11 cysts one month later. Therefore, the success rate of the PAIR technique was 97.7% (469/480). Minor complications (fever, urticaria-like reactions, biliary fistula) were seen in 44 treated patients (12%, 44/374); the only major complication was reversible anaphylactic shock which was observed in two patients (0.5%, 2/374).CONCLUSIONThis novel modified PAIR technique may be superior to catheterization by Seldinger technique due to its efficiency, easier application, lower severe complication rate, and lower cost. Further comparative studies are required to confirm our observations

Epidemiology of pemphigus in Turkey: One-year prospective study of 220 cases

Pemphigus is a group of rare and life-threatening autoimmune blistering diseases of the skin and mucous membranes. Although they occur worldwide, their incidence shows wide geographical variation, and prospective data on the epidemiology of pemphigus are very limited. Objective of this work is to evaluate the incidence and epidemiological and clinical features of patients with pemphigus in Turkey. All patients newly diagnosed with pemphigus between June 2013 and June 2014 were prospectively enrolled in 33 dermatology departments in 20 different provinces from all seven regions of Turkey. Disease parameters including demography and clinical findings were recorded. A total of 220 patients were diagnosed with pemphigus during the 1-year period, with an annual incidence of 4.7 per million people in Turkey. Patients were predominantly women, with a male to female ratio of 1:1.41. The mean age at onset was 48.9 years. Pemphigus vulgaris (PV) was the commonest clinical subtype (n=192; 87.3%), followed by pemphigus foliaceus (n=21; 9.6%). The most common clinical subtype of PV was the mucocutaneous type (n=83; 43.2%). The mean Pemphigus Disease Area Index was 28.14±22.21 (mean ± Standard Deviation).  The incidence rate of pemphigus in Turkey is similar to the countries of South-East Europe, higher than those reported for the Central and Northern European countries and lower than the countries around the Mediterranean Sea and Iran. Pemphigus is more frequent in middle-aged people and is more common in women. The most frequent subtype was PV, with a 9-fold higher incidence than pemphigus foliaceus.   </p

Exploring the effectiveness of the Tree of Life in promoting the therapeutic growth of refugee women living with HIV

The current study aimed to understand the experiences of refugee women living with HIV as they participated in the Tree of Life (ToL), a group-based narrative technique. A qualitative case study methodology was used. Five African refugee women took part in the study. The ToL consisted of seven two-hourly sessions conducted on weekly basis. Further, participants completed a feedback form after each session, and they were individually interviewed on completion of the ToL. The researchers kept detailed field notes. The data indicated that participants were motivated to attend the intervention in order to overcome their psychological distress, isolation and negative thoughts associated with their situation. Participants found the intervention beneficial. In a safe and supportive setting, and through the art making process, they were able to reflect on their painful past and current issues associated with their migratory stressors and with living with HIV. They identified personal strengths and qualities that enabled them to cope and build their resilience. The art making process and the discussion of the tree empowered them to re-author their life narratives. Finally, they related to each other and they developed a sense of connectedness. The findings indicate the Tree of Life as a promising technique for use with refugees living with HIV. Implications and future directions are discussed