Hiccups and Acute Symptomatic Hyponatremia: A Rare Manifestation of COVID-19.

We report a rare case of a patient presenting with a very unusual manifestation of coronavirus disease 2019 (COVID-19). A 62-year-old male presented to the emergency department (ED) with complaints of headache, nausea, vomiting, and intractable hiccups for two days. Laboratory results showed that he had profound hyponatremia (Na+: 103 mEq/L) and hypokalemia (K+: 2.3 mEq/L) with a positive RT-PCR for COVID-19. He was treated with an intravenous (IV) bolus of 3% saline solution followed by continuous infusion. The patient was discharged after eight days when his electrolytes returned to normal, and a significant symptomatic relief was achieved.

Physeal separation and complete resorption of femoral head associated with chronic osteomyelitis of femoral diaphysis in a young child: rare case report.

We report the case of a two and a half-year-old girl who presented with injury to the right thigh along with a discharging sinus in the midthigh region following a nonorthopaedic surgical procedure. Radiographs of the thigh indicated osteomyelitis of the femoral diaphysis with pathological fracture. During follow-up examination, shortening was observed in the affected limb, along with complete separation of the femoral epiphysis with partial resorption of the femoral head. A few cases of physeal separation of the femoral head following osteomyelitis of the femoral diaphysis have been reported in the published literature, but still it may go undiagnosed until late stages because of the lack of awareness among orthopaedicians about this entity. There was no history of any precipitating trauma to the hip. This case is of interest because of the difficulty in making differential diagnosis at the first evaluation; there was an orthopaedic misdiagnosis on the basis of the lack of complete preoperative imaging. Because of the devastating sequelae on immature skeleton including limb shortening, osteomyelitis, epiphyseal separation of proximal epiphysis and pathological fracture of shaft femur, the importance of early diagnosis, complete preoperative imaging and prompt treatment must be overemphasized.

Primary malignant melanoma of female urethra: a rare neoplasm.

Primary malignant melanoma of urethra is an extremely rare entity. It has very poor prognosis. A 62-year-old post-menopausal female presented with complaints of voiding difficulty and a mass projecting from external urethral meatus. External genital examination revealed a growth arising from urethral meatus with blood-stained discharge from its surface. Biopsy from lesion confirmed the diagnosis to be malignant melanoma. Metastatic work up for the malignancy was negative. We describe the surgical management of this pathology at our tertiary care center and discuss the various treatment options possible in this scenario.

Comparative toxicological evaluation of untreated and treated tannery effluent with Nostoc muscorum L. (algal assay) and microtox bioassay.

The relative sensitivity of tannery effluent before and after treatment was compared by employing Nostoc muscorum and microtox assay in laboratory. The effect on chlorophyll, protein and biomass content of Nostoc muscorum was studied with the luminescent property inhibition of Photobacterium phosphorium and compared with algal bioassay. The results of microtox assay after 5, 15 and 30 min of exposure were compared with data obtained from algal bioassay. It was observed that the luminescent property of Photobacterium phosphorium in microtox assay as well as the chlorophyll content of Nostoc muscorum in algal assay were the most sensitive parameters in toxicity evaluation of tannery effluent. The microtox assay produced notably comparable EC50 values with that of algal bioassay. The microtox assay of toxicity showed that EC50 (%) in 30 min was 3.19 and 63.49 for untreated and treated tannery effluent, respectively while in algal bioassay the EC50 for chlorophyll was in between 0-2.5% and 100%, respectively, in untreated and treated effluent. More than 60% reduction of toxicity was noted in treated tannery effluent in both test system.