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  • ISSN: 2373-9819
    Volume 9, Issue 1
    Case Report
    Kathuria PC*, Manisha Rai and Devinder Rai
    Allergen Immunotherapy is a unique and effective therapeutic option in patients allergic to molds. Alternaria alternata is known to be a significant source of fungi aeroallergens. Sensitization to A. alternata is a risk factor for development and persistence of Chronic Rhinosinusitis with (CRSwNP) or without (CRSsNP) nasal polyps Co-morbid Asthma. The role of Allergen Immunotherapy (AIT) by Alternaria alternata allergen extract combined with Omalizumab has been evaluated in very few studies. In our five cases, the combined effect of Alternaria alternata Subcutaneous Immunotherapy (SCIT) with Omalizumab was safe, effective, and synergistic, sustained and achieved the maintenance dose faster. Our conclusion was based on significant reduction in symptom and medication scoring by Asthma Control Test (ACT), Rhinitis Control Assessment Test (RCAT), Sino-nasal Outcome Test (SNOT-22), Improvement in Peak Expiratory Flow Rate (PEFR) variability, Immunological (Ratio of Specific IgE to Total IgE for Alternaria alternata), Endoscopic and Radiographic parameters after 1 year of treatment. We suggest a causative role of Alternaria alternata allergen in the pathogenesis of Chronic Rhinosinusitis with or without nasal polyps Co-morbid Asthma.
    Nana Anim-Addo*
    We describe a case of Mycoplasma genitalium infection in a male presenting with purulent urethral discharge that mimicked the presentation of Gonorrhoea. A recent study estimated the prevalence of M. genitalium in those aged between 16 - 44 to be similar to that of Chlamydia trachomatis [1]. Despite considerable prevalence, provisions for testing are not routinely available in all UK Sexual Health clinics.
    An Unusual case of Osteopetro-rickets presenting as Neonatal Hypocalcemic Seizures and Dilated Cardiomyopathy
    Shreya Sharma*
    Background: Osteopetrosis is a rare genetic condition of reduced osteoclastic bone resorption. Excessive calcium sequestration in bone may lead to an abnormal Ca/P balance resulting in hypocalcemia and poor mineralization of the osteoid ( rickets).
    Case Characteristics: We report the case of a one month old boy with late onset neonatal hypocalcemia and rickets that was later diagnosed as Osteopetro-rickets.
    Message: Osteopetrosis should be kept in mind as a rare cause of neonatal hypocalcemia and rickets.
    Lyme Neuroborreliosis Presenting with Symptoms of Night Terrors: A Case Report
    Julie Brix Bindslev and Malene Landbo Boerresen
    This case describes an unusual presentation of Lyme neuroborreliosis in a child presenting with nightly episodes of screaming and crying followed by amnesia for the event.
    Long Term Outcome of Extraskeletal Ewing’s Sarcoma of the Thigh after Multimodal Treatment including Limb Salvage Surgery Plus Interstitial Brachytherapy: A Case Report
    Tai-Sheng Tan, Hao-Wei Lu, Hui-Ling Yeh*
    Extraskeletal Ewing Sarcoma (EES) is a rare type of Ewing’s Sarcoma (ES) that arises in soft tissue with high local recurrence rate and distant metastasis rate. Here we report a case of locally advanced EES of the thigh in a middle-aged male Asian adult diagnosed 15 years ago. It was a local disease initially and the patient underwent limb salvage surgery plus postoperative interstitial brachytherapy and adjuvant chemotherapy as his first treatment. Multiple episodes of lung metastasis over the patient’s left lung were discovered during the first seven years of diagnosis in spite of multiple surgical resections, as well as adjuvant chemotherapy. The disease has been under control for eight years after the last local radiotherapy to the lung metastasis at the lower lobe of left lung (LLL). The patient continued follow up at our outpatient department (OPD) with no local recurrence or distant metastasis being recorded since his last radiotherapy treatment was completed. Our review suggests that interstitial brachytherapy after a wide excision with a free margin may be an alternative treatment for preserving the limb in patients diagnosed with locally advanced soft tissue sarcoma. Although EES has an aggressive disease process, multimodal treatment may help to control the disease progression.
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