Giant Relapse Sigmoid Volvulus: Case Report

Sigmoid volvulus is one of the acute abdomen that requires endoscopic intervention and/or surgery. High recurrence rates after detorsion require patients to be operated under elective conditions. A 32 year oldmental retarded male patient was operated for recurrent sigmoid volvulus. In this study, we aimed to present a giant recurrent sigmoid volvulus case accompanied by diaphragmatic hernia.

Tongue Entrapment in a Plastic Bottleneck

Introduction Oral foreign bodies and perioral injuries are common occurrence among paediatric population. These may range from benign occurrences to those that may threaten the airway. One such injury is tongue entrapment into objects like plastic bottle neck. Tongue entrapment in bottle neck is rare with very few cases reported in literature. Case Report A case of a 9-year old mentally retarded male child with tongue haemangioma who got his tongue tightly entrapped inside a plastic bottle neck is presented. Since such cases are very rare, treatment often requires creative and novel approach to ensure safe removal of constricting object without causing any injury to surrounding structures. When conventional methods using Mayo’s scissors failed to cut open the bottle neck, we used Gigli saw wire in a safe manner to cut it open. It took a few minutes to relieve the entrapment of tongue without traumatising the surrounding structure. Discussion This case highlights the result of careless and often dangerous play and misadventures of children and the challenge of management. It calls for vigilance and close supervision of children by caregivers at home and at school. Early presentation, immediate intervention and treatment can prevent grave consequences.

Fragile X syndrome: a clinico-genetic study of mentally retarded patients in Kuwait

In a prospective study in Kuwait, 182 mentally retarded male patients who fulfilled 5 or more clinical criteria of fragile X syndrome were screened using polymerase chain reaction [PCR] testing. Twenty patients [11%] were highly suspected of having fragile X syndrome due to mutation at the FRAXA locus; none had mutation at the FRAXE locus. Of these, 11 [55%] were confirmed fragile-X-positive by both cytogenetic and PCR techniques. The most frequent clinical features were:prominent forehead, high arched palate, hyperextensible joints, long ears, prominent jaw, height > 10th centile and attention-deficit hyperactivity. Less common were avoidance of eye contact [45%], autism [45%] and seizures [30%]. Large testes were found in 55% of cases. Pre-pubertal and post-pubertal clinical criteria were different