This report describes a rare case of bilateral foot burns in a 61-year-old man following a religious firewalking ceremony, an event scarcely documented in the literature. The patient presented with multiple painful foot blisters and ulcers 2 days after the ceremony, accompanied by marked discomfort and impaired mobility. On examination, the right foot showed a large deroofed blister with mild slough, whereas the left foot had an intact, tense bleb. The primary diagnosis was bilateral foot burns complicated by diabetes mellitus. Management included deroofing and dressing the right foot blister, while the left foot blister was aspirated, enabling a direct comparison of two treatment strategies within the same patient. Glycemic control was optimized by adjusting insulin dosages, and wound care was tailored to the clinical condition of each foot. Early multidisciplinary consultation guided infection monitoring and pressure offloading. The outcomes underscored the challenges of burn management in diabetic patients, particularly with regard to delayed wound healing and heightened infection risk. This case highlights the importance of individualized burn blister management and the methodological value of comparing deroofing versus aspiration in a controlled clinical context. The key implication is the need for further research to establish best practices for burn care in high-risk populations, especially following unusual injury mechanisms such as firewalking.

Retroperitoneal fasciitis is a progressive infection involving the retroperitoneal fascial planes and deeper soft tissues, requiring prompt diagnosis. A 20-year-old man in India with a history of perianal abscess presented with fever, swelling, and severe pain in the abdomen and inguinoscrotal region. Local examination revealed extensive necrotic skin changes involving the perineum and right lumbar region, extending to the scrotum. Contrast-enhanced computed tomography demonstrated a large myocutaneous defect with extensive air foci, fat stranding, and fluid collections in the abdominal wall extending into both retroperitoneal spaces. The patient underwent emergency surgery with debridement of the perineum and right lumbar region. Vacuum-assisted closure therapy and local sump application facilitated rapid and effective wound healing, eliminating the need for reconstruction. This case illustrates successful management of a rare but severe condition.

Objective: To describe a unique situation of a sewing needle lodged in the parapharyngeal space and elucidate the problems encountered in its successful removal. Methods: Design: Case Report. Setting: Tertiary Private Hospital. Patient: One. Result: A 24-year-old male tailor accidentally swallowed a sewing needle that pierced the oropharyngeal wall and was wedged in the parapharyngeal space. After a thorough physical examination, 70 degree rod endoscopy, radiography and doppler ultrasonography and intraoperative C-arm X-ray for intraoperative localization and as a guide for extraction all yielded less than optimal guidance. Although an intra-oral approach was initially taken, the transcervical approach provided the best access. Conclusion Removal of a sharp foreign body in the parapharyngeal space should be considered a surgical emergency owing to its close proximity to vital structures and the potential for serious complications. Identifying the exact location may require a variety of imaging modalities, and foreign body extraction may entail multiple surgical approaches.
Foreign Bodies ; Parapharyngeal Space

PURPOSE: To establish the strength of the association between routine tear function tests and conjunctival impression cytology (CIC) and to determine whether they simulate the morphological and cytological changes that occur on the ocular surface in dry eye. What are the sensitivity, specificity and positive predictive values of these tests when CIC is considered the gold standard? METHODS: The tear film profile included tear film break up time (TBUT), Schirmer's-1, Rose Bengal scores (RBS), and impression cytology. CIC samples were obtained from the inferior bulbar conjunctiva and stained with periodic acid-Schiff and counter stained with hematoxylin and eosin. RESULTS: The mean Schirmer's value was 11.66 +/- 5.90 in patients and 17.17 +/- 2.97 in controls (p < 0.001). The mean TBUT in participants was 8.88 +/- 3.54 and 13.53 +/- 2.12 in controls (p < 0.001). Patients had a mean goblet cell density (GCD) of 490 +/- 213, while the value for controls was 1,462 +/- 661 (p < 0.001). Abnormal CIC was observed in 46.7% cases of dry eye and in 32.8% of controls. The correlation coefficient (L) for Schirmer's was 0.2 and 0.24 for participants and controls, respectively, while TBUT values were 0.26 and 0.38, RBS were 0.5 and 0.5, and GCD was 0.8 and 0.6 in cases and controls, respectively. CONCLUSIONS: GCD, RBS, and TBUT were better predictors of morphological and cytological changes in the conjunctiva than Schirmer's in dry eye syndrome. The sensitivity of tear function tests in diagnosing dry eye was TBUT > Schirmer's > RBS, and the specificity was Schirmer's > TBUT > RBS in decreasing order when CIC was considered the gold standard.
Adolescent ; Adult ; Case-Control Studies ; Child ; Conjunctiva/pathology ; Diagnostic Techniques, Ophthalmological/*standards ; Dry Eye Syndromes/*diagnosis/*pathology ; Eosine Yellowish-(YS)/diagnostic use ; Female ; Goblet Cells/pathology ; Hematoxylin/diagnostic use ; Humans ; Male ; Middle Aged ; Ophthalmology/*standards ; Periodic Acid-Schiff Reaction/standards ; Predictive Value of Tests ; Rose Bengal/diagnostic use ; Sensitivity and Specificity ; *Tears ; Young Adult