Ursodeoxycholic acid induced generalized fixed drug eruption

Fixed drug eruption (FDE) is a rare form of drug allergies that recur at the same cutaneous or mucosal site in every usage of drug. Single or multiple round, sharply demarcated and dusky red plaques appear soon after drug exposure. Ursodeoxycholic acid (UDCA: 3α,7β-dihydroxy-5β-cholanic acid) is used for the treatment of cholestatic liver diseases. Some side effects may be observed, such as diarrhea, dyspepsia, pruritus and headaches. We encountered only three cases of lichenoid reaction regarding the use of UDCA among previous studies. In this article, we reported a generalized FDE case related to UDCA intake in a 59-year-old male patient with cholestasis for the first time in the literature.     

Aortic cusp ablation for premature ventricular contractions and ventricular tachycardia in children: a 5-year single-center experience

Journal of Interventional Cardiac Electrophysiology - Aortic cusps might be the source of supraventricular or ventricular arrhythmias. For many years, aortic cusp ablation has been widely used to...     

Outcomes in spasticity after repetitive transcranial magnetic and transcranial direct current stimulations

Non-invasive brain stimulations mainly consist of repetitive transcranial magnetic stimulation and transcranial direct current stimulation. Repetitive transcranial magnetic stimulation exhib- its satisfactory outcomes in improving multiple sclerosis, stroke, spinal cord injury and cerebral palsy-induced spasticity. By contrast, transcranial direct current stimulation has only been studied in post-stroke spasticity. To better validate the efficacy of non-invasive brain stimulations in im- proving the spasticity post-stroke, more prospective cohort studies involving large sample sizes are needed.     

Chemical composition of the essential oil and n-hexane extract of Stachys tmolea subsp. Tmolea Boiss., an endemic species of Turkey,and their mosquitocidal activity against dengue vector Aesdes aegypti

Stachys tmolea subsp. tmolea Boiss. is endemic to Turkey and is a species of the genus Stachys L. which is one of the largest genera of the family Lamiaceae with about 300 species. The aims of this study were to examine the chemical composition of the essential oil and n-hexane extract of S. tmolea subsp. tmolea as natural sources of insecticidal activity against the dengue vector, Aedes aegypti. Analysis of the essential oil by GC-FID and gas chromatography-mass spectrometry (GC-MS) systems identified hexahydrofarnesyl acetone (15%), viridiflorol (10%), hexadecanoic acid (7%) and 9-geranyl-p-cymene (6%) as major components. The volatile components of the n-hexane extract were extracted using headspace solid-phase microextraction (HS-SPME) and were analyzed using GC-MS. The principal constituents were 3,4-dimethyl decane (16%), 3-methyl-3-pentanol (15%), 2-methyl-2-pentanol (12%), 1,4-bis (1,1-dimethylethyl) benzene (12%), heptanal (10%), acetic acid (6%) and decane (4%). Bioassay of the n-hexane extract, at 5 µg/mosquito, produced 90% mortality against adult Ae. aegypti while the S. tmolea essential oil demonstrated 13% mortality. No larvicidal activity was observed both in essential oil and n-hexane extract. Further studies are needed to assess the adulticidal activity of the responsible compounds in the crude extract.     

Reactive Hemophagocytic Lymphohistiocytosis After Hepatitis A Infection

Hemophagocytic lymphohistiocytosis (HLH) is a clinical condition which result in cytotoxic Tcell and antigen presenting cell overproduction and also their cytokines. Hepatitis A Virus associated HLH is very rare condition among other viruses. This condition is often difficult to diagnose, so treatment is often delayed. Here we present a case of adolescent boy with secondary virus associated HLH diagnosis with Hepatitis A infection and successfull treatment by short course of intravenous immunoglobulin and steroid.     

Misinterpretation of sural nerve conduction studies due to anatomical variation

Objective

Anatomical variation of the sural nerve has been documented in numerous cadaver studies. The sural nerve conduction parameters can potentially be influenced by the sural nerve type A formation formed by the union of the medial sural cutaneous nerve (MSCN) and the peroneal communicating branch (PCB) and the type C formation with the sural nerve formed solely by the PCB.

Methods

In 17 out of 240 prospectively examined subjects referred for polyneuropathy a suspicion of an anatomical variation of the sural nerve was raised due to decreased amplitude or substantial side-to-side variation (>50%) of the sensory nerve action potential (SNAP) in disproportion to the clinical findings. To verify the variation the sural nerve was examined further with surface electrodes and near-nerve technique, including extra lateral and distal needle placements.

Results

In all 17 subjects an anatomical variation affecting the sural SNAP was confirmed as a normal sural SNAP could be obtained by changing the electrode placement. The most frequent variation, seen in 15 subjects, was a type A formation with union of the MSCN and the PCB distally at low calf, while a type C formation was seen in 2 subjects.

Conclusions

In case of a decreased sural SNAP amplitude or substantial side-to-side variation in disproportion to the neurologic evaluation, an anatomical variation instead of pathology could be suspected and a different electrode placement be considered.

Significance

Neurophysiologists should be aware of different types of formations of the sural nerve which may cause misinterpretations of nerve conduction studies, especially when needle electrodes are used.