Amitraz is a triazapentadiene pesticide used predominantly for ectoparasitic infections. The poisoning is usually caused by accidental ingestion. It is a centrally acting alpha-2 adrenergic agonist and leads to depression of the respiratory and central nervous systems, as well as, bradycardia, hypotension, nausea, vomiting, hyperglycemia and hypothermia. There are only limited reports on Amitraz poisoning in children. We report 2 children admitted to us with amitraz poisoning with variable severity of illness to highlight the rarity of life threatening poisoning by amitraz and excellent prognosis with early recognition and supportive management.

Para ganglia is a rare bladder tumor may occur in all of the age groups. It accounts for less than 0.06% of all of the bladder tumors. It is more common in females.Typically they are extra adrenal pheochromocytoma and arise from the ganglion (Chromaffin) cells of the bladder wall. Some of them are functioning and secrets chatecholamines, others are not. Some of them are malignant and can metastasis. However approximately 10% of them possess the capacity to invade despite their lack of mitosis and cellular dissociation which usually associated with malignant tumors. We present this case because its rarity, difficult preoperative diagnosis and the lack of related proper guide lines. Currently their treatment generally is not unified. Hence it is advisable to manage such cases with a multidisciplinary approach.

The novel 2019 coronavirus (SARS-CoV-2) has become an international pandemic. The lack of targeted treatment for SARS-CoV-2 has necessitated the need to evaluate all potential modalities to enhance host immune response. This article reviews the role essential micronutrients play in the risk reduction and treatment of COVID-19. While literature supporting the risk and severity reduction of COVID-19 infections through exogenous supplementation is limited, micronutrient optimization is essential in maintaining host immunocompetence, and deficits may critically impair host defense. The immune supportive mechanisms and physiologic effects of various micronutrients are multifaceted, including the reduction of viral replication, inhibition of polymerase function, augmentation of innate and acquired immune responses, enhancement of anti-inflammatory immune responses, and the reduction of pro-inflammatory responses.

The pelvic endometriosis is considered a relatively common, benign, estrogen-dependent disease associated with complaints of pelvic pain and infertility, affecting 6% to 10% of women of reproductive age. The etiopathogenesis of the disease is based on some theories and hypotheses. Classical theories include the hypothesis of migratory pathogenesis by retrograde menstrual flow, the theory of celomic metaplasia, the theory of embryonic rest or even iatrogenic deposition during abdominal surgical procedures.

Heparin is a major component of glycosaminoglycans (GAGs), which are components of tissues in the interstitial spaces of the body. Heparin is the most important anticoagulant used in clinical settings, especially for hemodialysis (HD).

Meningiomas are the most common intracranial neoplasms [1]. They arise from the meningiothelial cells of the arachnoid villi and present with headache and dizziness as most common symptoms [2]. WHO has classified meningiomas into grade 1 to 3 based on cellularity, nucleocytoplasmic ratio, mitosis and necrosis.

Hemophagocytic lymphohistiocytosis (HLH) is a fatal disease associated with multiple organ dysfunctions and overwhelming inflammation. To date, pulmonary hypertension (PH) coexisting in patients with HLH is rare, and the treatment is unknown. Here we present an interesting case involving a 27-year-old male with dyspnea and irregular fever that eventually certified as PH coexisting with HLH. The patient finally died for severe infection 21-days post hematopoietic stem cell transplantation (HSCT). The necessity and timing of HSCT in this kind of patient need to be more careful.

Primary synchronous breast and renal cancer is very rare. Bladder, prostate, colorectal and lung cancer are the most common synchronous primaries with Renal Cell Carcinoma (RCC) identified till date. We found metachronous tumours of breast with RCC in literature search which included both metastatic tumours as well second primaries. In this study, we represent a case of synchronous ductal breast carcinoma and RCC which is very rare because most of the multiple malignancies reported in the literature are metastatic tumours or metachronous breast malignancy with RCC.

Caplan’s syndrome is seen in patients with rheumatoid arthritis (RA) and chronic silica inhalation. We present a patient with RA who presented with multiple pulmonary nodules. Biopsy of the nodules revealed silica crystals under polarized light. He continued treatment for RA and his pulmonary nodules remained stable. However, he subsequently developed renal failure with nephrotic range proteinuria. We discuss silica and the associated autoimmunity in patients with chronic occupational exposure.

In the era of advanced surgical technique, correction of postburn contracture by serial splinting is often a forgotten art. In this case report we have revisited this old art by applying serial splint and achieving correction of elbow flexion contractures in one patient. Patient considered for this technique had thermal burn injury to the elbow that resulted in flexion contracture deformity. Treatment consisted of serial stretching and elongation of tissue followed by application of a cast in the position of maximal elbow extension. Almost full elbow extension was achieved in multiple sessions and was maintained after follow up period of six weeks. The use of casts in the treatment of elbow flexion contractures appears to be a viable option and can be used for mild contracture.