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SUMMARYThis is a case of eosinophilic cystitis in a 56-year-old indigenous Australian woman who presented with urosepsis on the background of a urinary tract infection unresponsive to oral antibiotics. After resolution of the urosepsis, she had persisting urinary retention and a cystoscopy/bladder biopsy suggested eosinophilic cystitis. After 1 month of intravesical hydrocortisone and oral loratadine, repeat cystoscopy showed vast improvement in the bladder lesions. This case further strengthens the use of intravesical steroids and oral antihistamines for the management of eosinophilic cystitis. BACKGROUND

The ability of the GOSLON Yardstick, scored at 9 years of age, to predict the need for orthognathic surgery in a cohort of complete Unilateral Cleft Lip and Palate (UCLP) patients treated in the Cleft Lip and Palate Unit, Princess Margaret Hospital for Children, Perth, Western Australia was assessed. Sixty six consecutively treated UCLP patients with dental models at 9 years of age and details on referral for orthognathic surgery were retrieved from medical and dental records. Cephalometric appraisal at 18 year old patients was also conducted. Twenty four of sixty six patients were referred for orthognathic surgery at growth completion (36%). Referral pattern stratified by GOSLON scores at 9 years of age found that four of four patients (100%), with a GOSLON score of 5 were referred for orthognathic surgery. Eleven of fourteen patients (79%) with a GOSLON 4, four of sixteen patients (25%) with a GOSLON 3 and five of thirty two patients (15%) with a GOSLON 2 were referred. No patient recorded a GOSLON 1 at age 9. Cephalometric appraisals conducted on thirty eight subjects at age 18 significantly discriminated the referral group from the non-referral group. Of the seventeen patients referred for surgery eight fulfilled the objective cephalometric criteria for orthognathic surgery, none of the patients who were not referred for orthognathic surgery fulfilled the objective criteria. The GOSLON Yardstick was found to be a good predictor of the need for orthognathic surgery at growth completion in our unit.

A case of a young man who developed heterotopic ossification (HO) in his elbows following an accident where he sustained petrol burns to over 60% of his body. His injuries necessitated intubation, escharotomies and a protracted intensive care unit stay that was complicated by septicaemia. Several weeks after the injury, he was diagnosed with HO in his right elbow, followed by the left elbow a week later. He was commenced on an non-steroidal anti-inflammatory drug, a long-term course of a bisphosphonate and regular physiotherapy. He is now waiting for the HO bone to mature before having definitive excision of his lesions in 12-18 months time.

This is a case of a 56-year-old lady with recent autologous peripheral stem cell transplantation for multiple myeloma. She was presented with a 48 h history of worsening headache, drowsiness, nausea/vomiting and some peripheral neurological symptoms. She developed status epilepticus, was intubated and transferred to intensive care unit. After full investigation with a CT head, CT cerebral angiogram, MRI brain and cerebral angiogram, she was diagnosed with posterior reversible encephalopathy syndrome (PRES) with the help of expert opinion, based on the clinical and radiological evidence. The MRI showed bilateral occipital signal changes suggestive of PRES. She was managed with nimodipine, phenytoin and clonazepam with good effect. Eventually extubated, she made good progress on the ward with no further seizure episodes. Functionally she did not appear to have any evidence of residual damage from the PRES. This case discusses PRES on a background of a haematological malignancy and its clinical features.