The surinfection of the renal graft by multi-resistant germs constitutes a serious complication, which can engage the functional and vital prognosis in renal transplant patients. It is responsible for a problem of therapeutic management and of the benefit/risk ratio between antibiotic therapy at therapeutic doses and the contraindications linked to renal insufficiency and therapeutic impasse. This work reports the case of a kidney transplant recipient who died following complications of a superinfection of the graft by a strain of Klebsiella pneumoniae producing OXA 48. The purpose of this observation is to underline the nosocomial risk in kidney transplant patients and the difficulty of the therapeutic management of these multi-resistant infections.

Background: Potash alum mouth rinse has been well studied with appreciable success in protection against carious lesions and periodontal microbiota with no adverse reactions. While oral lichenoid reactions have been documented as complications of various dental materials and drugs none has been reported as a result of alum use. Case Description: An unusual oral lichenoid reaction to potash alum use in an adult patient who presented at the oral medicine and diagnosis clinic of the dental centre of the Lagos State University Teaching Hospital. He presented with complaints of excessive salivary flow and dark pigmentation of the palate, and a history of potash alum licking for more than a month. On examination a dark pigmentation involving the palatal gingiva related to 24-27, sialometry revealed normal salivary flow Hence a diagnosis of false sialorrhoea was made. The patient was referred to the Periodontology unit of the same institution where an excisional biopsy was carried out, this was diagnosed as a lichenoid reaction by the Oral Pathology unit. The patient was counselled to stop the use of alum and reassured about the normal salivary flow. The patient reported tremendous improvement on review. Conclusion: Many home remedy habits and practices can be harmful, this underscores the role of counseling patients against these unverified remedies.

The Dabska tumor also known as Endovascular papillary angioendothelioma is a rare, low-grade angiosarcoma that often affects the skin and subcutaneous tissues of children is characterized by intraluminal papillary endothelial structures. EPA has an overall favorable prognosis. The malignant potential of this tumor should not be ignored and close follow-up should be maintained.

Introduction: Gastrointestinal infections are one of the leading causes of morbidity and mortality throughout the world, particularly in the immunocompromised. Gastrointestinal PCR appears to be the technique of choice for establishing the molecular diagnosis of pathogenic gastrointestinal agents. The aim of this study was to establish the epidemiological, clinical and evolutionary profile of gastrointestinal infections and to study the impact of molecular diagnosis on the choice of a targeted therapy. Methods: This is a retrospective study carried out in the Microbiology Department of Arrazi Hospital of the Mohamed VI University Hospital Center, including all immunocompromised patients treated for a gastrointestinal infection and needing a hospitalization in the various departments, over a period of 15 months. Results: During the period studied, 124 patients were collected. The average age of the patients was 22 years. Signs of gastrointestinal infection were present in all patients. Of the patients sampled, 95.2% received probabilistic antibiotic therapy. Gastrointestinal infection has been documented in 57.26% of patients. A bacterial etiology was found in 76.81% of patients. A viral etiology was found in 13.04% of the patients and a parasitic etiology was found in 10.15% of the patients. Enteropathogenic E. coli was the most common infectious agent detected (19.53%). Co-infections were found in 29.84% of patients. Following PCR results, management was changed in 70 patients (56.45%), including initiation or modification of antibiotics in 40 patients (32.26%) and discontinuation of antibiotic therapy in 30 patients (24.19%). Conclusion: The diagnosis of gastrointestinal infections by multiplex PCR allowed us to provide optimal patient care with a reduction in the unnecessary use of antibiotics and an improvement in the course of care.

Introduction: Acute leukemia is the most common form of cancer in children, platelet transfusion is needed for the chemotherapy of acute lymphoblastic leukaemia children. Platelets are transfused for therapeutic and prophylactic purposes. Transfusion of stored platelet concentrates (up to 5 days) has been demonstrated to be as effective as transfusion of fresh platelet concentrates (upto 24 hours). Platelet refractory cases were also observed in this study that was detected by Corrected Count Increment (CCI) and Percent Platelet Recovery (PPI) at 1hour and 24 hours. Aim of the study: The aim of this study was to observe the platelet refractory cases after transfusion of fresh and stored platelet in acute lymphoblastic leukemia (ALL) in a tertiary care hospital, Dhaka. Methods: A cross-sectional study was conducted in the Department of Clinical Pathology, Paediatric Haematolo- Oncology and transfusion Medicine BSMMU, Department of Haematology and Paediatric Haemato-Oncology in Dhaka Medical College Hospital from March 2010 to February 2011 where 81 children diagnosed with acute lymphoblastic leukaemia were taken as the study population. Non probability purposive sampling was used by fulfilling the inclusion criteria. Ethical consideration was taken by the BSMMU ethical review committee. A data sheet with two parts (Part A and Part B) was designed with a view to collect data from the patients to be enrolled in the study. Data were analyzed using the SPSS version 25.0. Results: Out of 81 in 47 children with acute lymphoblastic leukemia (ALL), fresh platelet concentrates (FPC) (upto 24 hours) or day-0 platelets were transfused. In 34 children, stored platelet concentrates (SPC) (days 1–5) were transfused. In 27 cases, platelet concentrates were transfused both fresh and stored. In FPC and SPC, the corrected count increment at one hour (CCI 1h) was 20.5×109/L and 18.9×109/L respectively. FPC and SPC values for the mean corrected count increment at 24 hours (CCI 24h) were 15.5×109/L and 13.8×109/L respectively. Platelet refractory cases were 15(18.5%) out of 81 cases transfused. Platelet refractory cases were 7(15%) out of 47 cases transfused with FPC and 8(23%) out of 34 cases transfused with stored platelet concentrate (SPC). There were no significant differences (P<0.05) between FPC and SPC according to platelet refractoriness. Conclusion: In vivo quality of freshly generated platelet (upto 24 hours) versus stored platelet concentrates (up to 5 days) were determined after 1 hour and 24 hours. 1-5 day’s stored PRP-PCs are as effective as fresh PRP-PCs for sufficient platelet increment.

Background: The severe respiratory syndrome coronavirus (COVID-19) pandemic has affected many aspects of life, much vaccine adopted to minimize morbidity and mortality due to COVID-19. Aim: To assess behavior changes after taken second dose of COVID-19 vaccine among students in university of Hail. Methodology: This cross-sectional questionnaire based study involved 350 participants from Hail University, Saudi Arabia. We distributed online questionnaire to determine differences in the protective measures before and after the second dose of COVID-19. Results: We included 350 participants from Hail University in Saudi Arabia in this study. Declines at different levels was detected in all protective measures after the second dose of COVID-19 vaccine that were in the questionnaire compared to before taking the second dose of COVID-19 vaccine. The significance of the behavior changes after receiving second dose of COVID-19 vaccine compared to behavior changes before receiving second dose of COVID-19 vaccine (P<0.0001). Conclusion: the second dose of vaccine resulted noticeable changes in preventive measurement behavior in university of Hail students.

There are many dermatoses that can affect the genital area. These may be isolated genital conditions or signs of a general cutaneous disorder. Genital dermatoses can be classified as physiologic variants, and inflammatory, neoplastic, or infectious in etiology. Psoriasis is a chronic autoimmune disease, which has a prevalence of about 3% with genital involvement, reported in 29% a 40% of patients. Although the diagnosis of genital psoriasis can be aided by the presence of classic psoriatic plaques on the body, the penis may be the only affected region. In uncertain cases, a skin biopsy can lead to diagnosis. Initial management should consist of mild topical corticosteroids with increasing potency titrated to effect or topical calcineurin inhibitors. Systemic therapy with disease modifying small molecules or biologic drugs may be considered when disease is particularly bothersome, widespread, or unresponsive to conservative approache. This article provides a broad overview for dermatologists in addressing the Psoriasis wich is placed on. Recommendations for diagnostic evaluation, treatment, and appropriate follow-up are discussed.