Penile erection at the time of urological surgery is a rare but problematic event which can delay, complicate or even lead to the cancellation of planned surgery. Erection may occur irrespective of the type of anesthetic method employed. Several techniques for treatment of this troublesome complication have been described in the literature, all with varying levels of success and potential adverse effects. In our experience over the last 25 years, we have found that intracavernous injection of ephedrine into the penis has a 100% success rate in safely producing detumescence with minimum side effects and should therefore be considered early among the treatment options for this condition.
IntroductionRenal involvement in POEMS (polyneuropathy, organomegaly, endocrinopathy, M-band, skin changes) syndrome is considered to be an under-diagnosed phenomenon with no clear treatment path. The limited literature suggests steroids to be the drug of choice, although improvements are limited and usually reverse on withdrawal of the drug.Case presentationA 52-year-old Caucasian woman presenting with features consistent with POEMS syndrome developed progressive renal impairment with proteinuria. Renal biopsy revealed a membranoproliferative glomerulonephritis. She was treated with relatively low dose oral mycophenolate mofetil and prednisolone which stabilised her nephropathy and neuropathy.ConclusionWe describe an alternative therapeutic option in patients with this serious but poorly understood condition.
IntroductionMyocardial infarction and coronary artery disease in people under 40 years of age are relatively uncommon. To establish a diagnosis, physicians need a high degree of clinical suspicion.Case presentationWe report the case of a 33-year-old Caucasian man presenting with classical signs and symptoms of acute pulmonary embolism. Subsequent investigations interestingly revealed right ventricular mural thrombus with no obvious underlying pathology triggering it. On cardiac magnetic resonance imaging, he was found to have a right ventricular infarct with secondary thrombus formation. Coronary angiography confirmed ostial occlusion of the right coronary artery.ConclusionThis is an unusual case of premature myocardial infarction presenting primarily with secondary complications.
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