Left ventricular-right atrial shunts also known as Gerbode defects are rare and can be either congenital or acquired. A case is here presented of an acquired Gerbode defect discovered in a previously healthy young patient after an episode of endocarditis associated with Staphylococcus aureus infection. Gerbode-type defect due to bacterial endocarditis in childhood is even more rare, it has been recorded few times to our knowledge.
Polymorphic Light Eruption is an abnormal cutaneous response which occurs on exposure to sunlight. No such data, however, is available from our country even though the exposure to sunlight is high. Polymorphous light eruption (PLE) is a common form of photodermatosis. The pathogenesis of the disease and the mechanism of the hardening phenomenon, however, have not been clarified. The previous study done by Watanab M et al. said that the hardening phenomenon in their case might be due to immunosuppression by UV exposure supported by the down-regulation of cell adhesion molecule expression and partially due to the depletion of endogenous antigens which cause a delayed-type hypersensitivity reaction. PMLE is commonly observed in females between 21 - 30 years of age. Pruritus is the chief complaint and the time required for the development of rash increases with time of sun exposure. Most common morphological type is papule on the forearm. Papules and plaque type of lesions of PMLE of longer duration clinched the histopathological diagnosis.
The spermatocytic tumour is a rare neoplasm of the testis and classified as a germ cell tumour. The name of the tumour comes from the similarity (under the microscope) between the small cells of the tumour and secondary spermatocytes. It was previously classified as ‘Spermatocytic Seminoma’.
They make up only 1-2% of all testicular germ cell tumours. Men presenting with this tumour are generally 50-60 years old and its occurence is rare in men less than 30 years old. Most of these patients present with slow, painless testicular enlargement, which may involve both testes.
Esthetic management of anterior broken teeth acts as a challenge to the clinician. Broken teeth treated endodontically are quite weak and are prone to fracture due to excessive loss of sound tooth structure. Posts are indicated in endodontically treated teeth which serve as a strength to the insufficient tooth structure. This article describes the esthetic rehabilitation of broken anterior teeth using cast post and core.
Introduction: Aggression is a severe and frequent behavioral consequence of brain injury. Pharmacological interventions are used, though evidence of efficacy is lacking. Behavioral therapies have shown some effect. Electrical aversion therapy (EAT) is a behavioral therapeutic option that might be suitable for brain-injured individuals for whom other therapies are not effective.
The effect of EAT on aggression after brain injury has not been investigated previously.
Case Presentation: Here we report on a single case observational study on the effect of EAT on aggression in a 41-year old male with severe brain injury due to subarachnoid hemorrhage. Restraints, time out of bed, number of staff needed for care and aggressive behavior were measured.
The level of care and the number of restraints were markedly reduced with EAT, without incidents leading to injury to the patient or nursing staff. There was a trend towards decline in the frequency of aggressive behavior over time.
Discussion: The study design was observational but by comparing the first and the second part of the registration period we were able to demonstrate a decline in aggressive behavior after EAT. The large number of measurements was a strong aspect. The lack of control is however a major limitation.
Conclusion: We conclude that EAT was effective in this patient with aggressive behavior due to severe brain injury. EAT can therefore be considered in therapy resistant aggression in brain-injured patients.
