Netherton syndrome (NS) is a rare autosomal recessive disorder characterized by a triad of congenital ichthyosiform erythroderma (CIE) or ichthyosis linearis circumflexa (ILC), hair shaft abnormalities, and atopic diathesis (elevated serum IgE ). We report a case of a two-year-old boy presented with intractable pruritus, scaling, dry skin and generalized eczematous lesions resistant to atopic dermatitis therapy. Netherton syndrome misdiagnosed as atopic dermatitis due to the presence of eczematous skin lesions and allergic problems. The family counseled about the diagnosis and need of genetic testing for confirmation, but they refused for genetic testing. The patient got treatment with topical corticosteroids and skin moisturizers. There is no cure or satisfactory treatment currently available for NS. Further understanding of the underlying pathophysiology of integumentary changes will lead to more effective treatment. Netherton syndrome should be in the differential diagnosis when characteristic skin manifestation of CIE or ILC, and elevated serum IgE present.

There is a well-established association of Sjogren's syndrome with renal tubular acidosis (RTA). Rarely there is a retrospective diagnosis where the patient presents with RTA and the workup reveals Sjogren's syndrome. Our case report is about a patient who presented with generalized weakness and hypokalemia, which upon further workup turned out to be RTA. Various tests were performed to find out the cause of RTA. A favorable profile for the anti-nuclear antibody, anti-Ro/SSA, and anti-La/SSB was consistent with Sjogren's syndrome. Treatment with corticosteroid improved hypokalemia. The patient did not have typical glandular symptoms of Sjogren's syndrome, and follow-up is needed to see whether the patient develops symptoms in the future and to prevent any possible complication.

Foreign body ingestion is commonly encountered in clinical practice. According to standard guidelines, urgent therapeutic endoscopy should be performed in cases involving sharp objects to prevent complications. Although several extraction methods are available, few cases may still pose a therapeutic challenge. This report describes a novel endoscopic technique utilizing modification of the standard overtube to facilitate the removal of a large razor blade. This technique offers a minimally invasive approach for rapid retrieval of large sharp-edged foreign bodies, obviating the need for a surgical exploration. Additionally, this article compares various imaging modalities for prompt detection of gastrointestinal foreign bodies to avoid unnecessary delays in endoscopic intervention.

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Aim: To compare the radiological and functional result of conservatively treated distant radius fractures (manipulation under anesthesia and plaster of paris) versus percutaneous K- wire fixation Study design: Retrospective Duration and place of study: Department of Orthopedic Surgery, The Indus Hospital, Raiwind campus Lahore from July 2018 to August 2020. Methods: The sample size of 100 patients aged between 18-60 years, closed, isolated distal radius fracture were included, and patients with diabetes mellitus, ischemic heart disease, pathological fractures, chronic renal disease, head injury, chronic liver disease, whose Glasgow coma scale was <14, malignancy were excluded. Patients were randomized as A & B by lottery method. They managed with conservative treatment ( manipulation under anesthesia (MUA) and plaster of paris (POP) cast) and K- wire fixation in groups A & B, respectively. Side of the fractured bone, infection, radiological union, and function outcome were recorded. Results: Amongst the total 100 patients in group-A, 32(63.8%) were males, and 18(36.2%) were females, and 35 (70.2%) were males, and 15 (29.8%) were females in Group-B. in group A patients mean age was 38.86.19 years, while patients mean age of the group B was 39.57.36 years. With the conservative method, 45(95.7%), the union rate was while with the K- wire fixation method, the union rate was 48(96%). In group-A, 35(70%) had excellent, 10 (20%) good, 03 (6%) had an average, and 2(4%) poor and in group-B, 40(80%) had excellent, 04 (08%) good, 04(08%) had an average, and 02 (4%) poor functional outcome. Conclusion: In terms of clinical and radiological evaluation, fixation of a distal radius fracture with K-wires has a better outcome than conservative treatment (MUA and POP cast) with a low infection rate and better union and result. Keywords: closed fracture, distal radius, back slab, K-wires

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Program were included. 4 geographic regions comprised of 18 cancer registries covering approximately 30% of the US population were identified: