Papillon-Lefevre syndrome: a case report

We report the first diagnosed case of Papillon-Lefevre syndrome in Thailand. The patient is the youngest child of consanguinous parents, and she has had symmetrical hyperkeratotic plaques on both plantar surfaces since birth with a history of chronic gingivitis, periodontitis, and premature loss of primary dentition. The histologic study revealed compact hyperkeratosis with epidermal acanthosis. Radiologic studies of the skull were normal. The radiographic panoramic view of the oral cavity revealed generalized severe vertical and horizontal alveolar bone loss. The immunologic analysis of polymorphonuclear leukocyte phagocytic function by nitrobluetetrazolium test (NBT test) showed decreasing response to latex stimulation. Serum parathyroid hormone, calcium, phosphate, and alkaline phosphatase levels were within normal limits. The skin lesions were temporary relieved with topical keratolytic agents. The oral lesions were improved by the extraction of hopeless teeth and conventional periodontal treatments.     

Failure to thrive in children

Optimal nutrition in early infancy is the success behind good health, growth, and development of children. This article presents an overview of failure to thrive in children younger than 2 years of age. This article reviews normal growth, growth indices, common etiology, and an approach to evaluation and management of failure to thrive.     

Rhodotorula minuta: an unusual fungal infection in hip-joint prosthesis

Fungal infections of total joint arthroplasty are uncommon complications, and most cases have been associated with Candida species. In this article, we present a case in which a total hip arthroplasty was infected with Rhodotorula minuta. Intraoperative gram stain showed yeast formsand led to early detection and immediate treatment with amphotericin B and bacitracin. Successful reimplantation was performed 12 months later. To our knowledge, this is the first reported case of arthroplasty infection caused by R minuta.     

Psychosocial aspects of epilepsy

Social attitudes towards epilepsy cause more distress to the patient and his/her near and dear ones, than the disease itself. The major psychosocial issues related to epilepsy are: Quality of medical management, overprotection, education, employment, marriage and pregnancy. Inadequate treatment is the major reason involved in psychosocial issues. Constant overprotection and pampering leads to behavioural pattern which makes epileptic patient dependent for ever. Education is hampered in epileptic persons. Teachers and students should have proper information regarding seizures. If seizures are well controlled, job opportunities increase. Employers and employees need to be educated about epilepsy. Self-employment is the best in epileptic patients. Regarding marriage, each patient is to be judged on individual merits and type of epilepsy. Society needs to be educated about the facts and consequences of epilepsy. Risk of anti-epileptic drug's usage is very insignificant compared to risk of seizures in pregnancy. So girls are advised to seek medical advice before pregnancy and during follow-up. With more and more support from the society, persons with epilepsy will have the courage and confidence to speak about themselves and their illness. It is only then that we will realise that persons with epilepsy are 'normal' or 'near-normal' and this will break the vicious cycle of stigma.