Introduction: The Cyclooxygenase-2 (COX-2) enzyme is responsible for the synthesis of prostaglandin which is responsible for inflammation and pain. Celecoxib a cyclooxygenase-2 inhibitor was first used as a non-steroidal anti-inflammatory drug in 1999. Celecoxib is as effective as NSAIDs but causes less ulceration of the gastrointestinal tract, hence it is commonly used. It has been widely used in patients with osteoarthritis and rheumatoid arthritis. We present 3 cases of temporary psychiatric disorders associated with consumption of celecoxib,two of the patients presented with auditory hallucinations while one was diagnosed to be having depression. None had pre-existing psychiatric disorders or consumed alcohol or substance of abuse. All 3 patients recovered from their temporary psychiatric disorders after stopping celecoxib.Discussion: It is important to be aware of the psychiatric side effects when prescribing the drug for prolonged periods

Thymoma, a rare epithelial neoplasm, is the most common anterior-superior mediastinal tumour. Thymoma can occur sporadically or in association with other conditions, such as myasthenia gravis, pure red cell aplasia (PRCA), and hypogammaglobulinemia. Only 5% of thymoma cases develop PRCA; however, 10–50% of patients presenting with PRCA have an associated spindle cell type thymoma. Thymoma complicated by PRCA is associated with a poor outcome. We report the case of a 38-year-old female who presented with chest pain, and was diagnosed with an anterior mediastinal mass. A thymectomy was performed, and histopathological examination revealed mixed thymoma; two months later, the patient developed PRCA. The present case reinforces the need for clinicians to be vigilant with thymoma patients, even following thymectomy.
Erythropoiesis ; Mediastinum ; Red-Cell Aplasia, Pure ; Thymoma

Pain in specific areas of the body (including the lower back, neck, and shoulders) due to extended periods of sitting and inactivity is the most widespread musculoskeletal disorder worldwide and has consequences that are both socio-economic and personal. This condition is particularly prevalent in industrialised countries, affecting roughly 70% to 80% of adults at some point in their lives; approximately 1% of the U.S. population is chronically disabled by this type of pain disorder. A practical way to reduce the prevalence of musculoskeletal pain among office workers would have a significant positive impact. More work is required to develop a package of exercises designed to prevent and treat musculoskeletal pain in office workers. Such a package would be preferable to pharmacological treatments, which can have undesirable side effects. The main objective of this package would be to increase the flexibility and strength of trunk muscles in order to decrease the soreness, pain, and degree of discomfort. In this article, we introduce our proposed package of exercises, which are based on guidelines issued bythe American College of Sports Medicine.

Paroxysmal non-kinesigenic dyskinesia is a very rare movement disorder. Few cases have been reported in the literature so far. We present a 40-year-old man with non-kinesigenic paroxysmal dyskinesia, which was initially diagnosed as a psychogenic disorder. This case highlights the varied presentation of this condition and an excellent response to clonazepam.
Adult ; Chorea ; diagnosis ; Humans ; Male

INTRODUCTIONNeonatal priapism is known to be associated with a wide range of aetiologies, but an association with spontaneous purulent cavernositis has not been reported in the paediatric literature. We report the first of such case.

CLINICAL PICTUREA 24-day-old neonate was brought with the history of persistent erection of penis since day 4 of life and swollen penis of 4 days' duration, which revealed frank pus on cavernosal aspiration bilaterally.

TREATMENTThe child was treated with closed aspiration drainage; cross-irrigation with antibiotic solution under systemic antibiotic cover helped in achieving complete detumescence.

OUTCOMEOn follow-up, child demonstrated normal full bladder tumescence and colour doppler revealed bilateral normal corporo-cavernosal appearance and blood flow, indicating good functional and anatomical recovery.

CONCLUSIONThis case report describes the presentation, successful management and excellent functional and anatomical outcome, on follow-up, of this rare association of neonatal priapism with spontaneous bilateral pyocavernositis. An attempt has been made to describe the underlying pathophysiology.

Algorithms ; Humans ; Infant, Newborn ; Inflammation ; complications ; Male ; Penile Diseases ; complications ; Priapism ; complications ; therapy ; Suppuration

BACKGROUND: Needle guides have recently come into use for ultrasound-guided percutaneous renal biopsies; however, it is not yet clear if the use of needle guides leads to decreased post-biopsy complication rates and improved tissue yields. Thus, we conducted a retrospective single center study comparing biopsy yield, adequacy, and rates of complications before and after utilization of a needle guide device. METHODS: A retrospective analysis was performed on all native kidney biopsies performed before and after June 2015 corresponding to the start of needle guide use. All biopsies in the latter period of the study were performed by a single operator. We compared clinical characteristics, indications, type of investigation, tissue yield, adequacy of procedure, and rates of major and minor complications. RESULTS: A total of 343 biopsies were analyzed, 140 in the pre-needle guide use period (Period I) and 203 in the needle guide use period (Period II). Biopsy yields were similar, irrespective of the use of needle guides. Tissue adequacy was better in Period II (93.7% vs. 84%, P < 0.001, with respect to pathologist-reported inconclusive biopsies. There were no differences in terms of major complications (1.7%) for the two periods; however, the rate of minor complications (8.4%) was significantly reduced in Period II (P = 0.006). According to multiple logistic regression analysis, not using a needle guide (odds ratio, 3.70; P < 0.001) along with low hemoglobin level, higher pre-dialysis serum creatinine level, and high urinary red blood cell count were significant predictors of biopsy complications. CONCLUSION: Use of a needle guide improves biopsy adequacy and is associated with reduced rates of minor complications in native renal biopsies. Therefore, needle guides may be recommended in percutaneous renal biopsies, especially when transitioning to single-operator performed procedures.
Biopsy* ; Biopsy, Needle ; Creatinine ; Erythrocyte Count ; Image-Guided Biopsy ; Kidney ; Logistic Models ; Needles* ; Renal Insufficiency ; Retrospective Studies ; Ultrasonography, Interventional

BACKGROUND AND OBJECTIVES: Facial nerve stimulation (FNS) is a complication of cochlear implantation (CI). This study compared the thickness and density of the bone separating the upper basal turn of the cochlea (UBTC) and the labyrinthine segment of the facial nerve (LSFN) on preoperative computed tomography (CT) in patients with and without FNS after CI. SUBJECTS AND METHODS: Adult patients who underwent CI from January 2011 to February 2017 with preoperative CT at a tertiary referral hospital were considered for this retrospective case–control study. Patients were divided into two groups: with FNS (n=4) and without FNS (n=53). The density and thickness of the bone between the LSFN and UBTC were measured on preoperative CT. Charts were reviewed for other parameters. RESULTS: A statistically significant difference was seen in the thickness (p=0.007) but not in the density (p=0.125) of the bone between the UBTC and LSFN. Four patients had FNS at the mid-range electrode arrays, and one of them additionally had FNS at the basal arrays. CONCLUSIONS: Decreased thickness of the bone between the UBTC and LSFN can explain postoperative FNS, confirming the histologic and radiologic findings in previous studies, which indicated that the thickness of the temporal bone between the LSFN and UBTC is less in patients who experience FNS. While the density in this region was also less, it was not statistically significant.
Adult ; Cochlea ; Cochlear Implantation ; Cochlear Implants ; Electric Stimulation ; Electrodes ; Facial Nerve ; Humans ; Retrospective Studies ; Temporal Bone ; Tertiary Care Centers