Spontaneous extradural hematoma in a Sickle cell Beta Thalassemia patient—A rare complication

Abstract Spontaneous extradural hematoma in Sickle cell disease is rare neurological complication with few cases reported in the English literature. We report a case of a 16‐year‐old male patient who was previously diagnosed with Sickle Cell Beta Thalassemia and presented with severe headache and vomiting for 3 days. An emergency CT scan of the head demonstrated right‐sided acute parietal extradural hematoma with mass effect. Patient underwent emergent craniotomy with evacuation of the hematoma. Patient recovered completely. Although calvarial infarction has been associated with extradural hematoma, an absence of it makes our case distinct. A high index of suspicion should be made in SCD patients for possibility of EDH in progressive headache

Genital filariasis presenting as a vaginal wall cystic lesion

Vaginal cystic lesions are rare incidental findings detected during physical examination and imaging. To our knowledge, filariasis as a cause of vaginal cystic lesions has not been previously reported in the English literature. We present vaginal cystic lesion which posed diagnostic dilemma and was confirmed on cytology to being filarial in etiology. The patient was treated with single-dose of oral diethylcarbamazine and the lesion subsided on follow up scans at three months thus avoiding inadvertent surgeries.Vaginal cystic lesions are rare entities and have multiple etiologies. A high degree of suspicion for filariasis as cause of vaginal cystic lesions should be made in individuals hailing from or have history of travel to endemic regions of filariasis. Keywords: Filariasis, Vaginal, Microfilariae, Diethylcarbamazin

Neglected case of recurrent abdominal pain due to a chronically retained and broken double J (DJ) stent following percutaneous nephrolithotomy (PCNL): A case report

Double J (DJ stent) is commonly used in urology practices. Short- and long-term complications of indwelling catheters are increasingly noted resulting in significant morbidity and at times mortality. Retained and broken DJ stent is however rare complication with few cases reported in the literature. We present a case of neglected retained and broken DJ stent in a 55-year-old male who had undergone percutaneous lithotripsy (PCNL) 4 years back presenting with recurrent abdominal pain and was misdiagnosed as peptic ulcer disease at various centers. Radiological investigations including ultrasound, radiographs, and computer tomography helped in identifying the retained and broken DJ stent. Patient improved with conservative management and left against medical advice for definite treatment. Patient education and ensuring proper follow-up can reduce the likelihood of complications associated with DJ stents

Leishmania donovani persistence and circulation causing cutaneous leishmaniasis in unusual-foci of Nepal

Abstract Cutaneous leishmaniasis cases have increased dramatically in recent years in Nepal. The study offers molecular identification of the Leishmania species using 40 patient’s aspiration biopsy samples, targeting markers kinetoplast minicircle DNA (kDNA) and internal transcribed spacer-1 (ITS1). Among molecularly diagnosed 22 cutaneous leishmaniasis cases, L. donovani complex was identified in 13 instances and L. major in 9 cases. The ITS1 PCR was positive in 12 of the positive nested- kDNA PCR cases (12/22), confirming L. donovani complex in seven of the cases and L. major in five of the cases. In addition, the study conclude that concurrent occurrence of atypical cutaneous infections caused by L. donovani parasite in 59.1% of cases and typical cutaneous infections caused by L. major parasite in 40.9% of cases. A Phylogentic analaysis showed that the detected L. donovani species present null genetic distances from seven references of L. donovani, but slight differences between ITS1 sequences and not grouped into a significant monophyletic cluster