Physical signs in pyomyositis presenting as a painful hip in children: a case report and review of the literature

The incidence of pyomyositis is on the increase worldwide among children and adults. When it involves muscles about the hip it needs to be differentiated from septic arthritis and transient synovitis among other diseases. Lack of awareness of the condition frequently leads to delay in correct diagnosis. We present one case of pyomyositis of the gluteus maximus and another rarer case of obturator internus pyomyositis that posed difficulties in initial diagnosis. While magnetic resonance imaging remains the imaging method of choice, we highlight important physical signs in the examination of patients presenting with a painful hip, which should raise suspicion of pyomyositis.     

Reduction in lung functions in type-2 diabetes in Indian population: correlation with glycemic status

The purpose of this study was to evaluate pulmonary functions in patients with Type-2 diabetes mellitus and to determine their correlation with glycemic status of diabetes in Indian population. Forty Type-2 diabetic patients, aged 30-60 years, with diabetic duration of 1-20 years, were included in the study. FVC, FEV1, & FEV1% are recorded by Benedict's Roth spirometer. PEFR and MEP were recorded by Wright's Peak flow meter & Modified Black's apparatus. Glycemic status of subjects was determined by FBS & PPBS by Glucose oxidase & peroxidase methods. And results were analyzed by calculating Mean +/- SD, using Student's t test, and Pearson correlation. All the respiratory parameters are reduced in Type-2 diabetic patients compared to control of which FEV1, FEV1%, & MEP show very highly significant reduction (P=0.000). Lung functions are negatively correlated with glycemic status & duration of diabetes. (r = -0.390, & -0.342) Reduction in dynamic lung functions and its negative correlation to glycemic status might be due to respiratory muscle weakness as indicated by highly significant reduction in MEP. Hence strict glycemic control and breathing exercises to strengthen the respiratory muscles may improve lung function in diabetics.     

Differences in allele frequencies of autosomal dominant hypercholesterolemia SNPs in the Malaysian population

Hypercholesterolemia is caused by different interactions of lifestyle and genetic determinants. At the genetic level, it can be attributed to the interactions of multiple polymorphisms, or as in the example of familial hypercholesterolemia (FH), it can be the result of a single mutation. A large number of genetic markers, mostly single nucleotide polymorphisms (SNP) or mutations in three genes, implicated in autosomal dominant hypercholesterolemia (ADH), viz APOB (apolipoprotein B), LDLR (low density lipoprotein receptor) and PCSK9 (proprotein convertase subtilisin/kexin type-9), have been identified and characterized. However, such studies have been insufficiently undertaken specifically in Malaysia and Southeast Asia in general. The main objective of this study was to identify ADH variants, specifically ADH-causing mutations and hypercholesterolemia-associated polymorphisms in multiethnic Malaysian population. We aimed to evaluate published SNPs in ADH causing genes, in this population and to report any unusual trends. We examined a large number of selected SNPs from previous studies of APOB, LDLR, PCSK9 and other genes, in clinically diagnosed ADH patients (n=141) and healthy control subjects (n=111). Selection of SNPs was initiated by searching within genes reported to be associated with ADH from known databases. The important finding was 137 mono-allelic markers (44.1%) and 173 polymorphic markers (55.8%) in both subject groups. By comparing to publicly available data, out of the 137 mono-allelic markers, 23 markers showed significant differences in allele frequency among Malaysians, European Whites, Han Chinese, Yoruba and Gujarati Indians. Our data can serve as reference for others in related fields of study during the planning of their experiments.     

Coitus induced vaginal evisceration in a premenopausal woman: a case report

Vaginal evisceration in premenopausal women after trans-abdominal hysterectomy is extremely rare in occurrence and only few cases have been documented in worldwide literature. Here we report a premenopausal woman with coitus induced trans-vaginal evisceration who had undergone trans-abdominal hysterectomy two years ago.