Urethrovaginal fistula is an abnormal communication between the urethra and vagina. Urethrovaginal fistula results in urinary incontinence with urine continually leaking from the vagina. In children congenital anomaly may also be the cause. Congenital Urethrovaginal fistula is an extremely rare genitourinary anomaly. The reported five cases in the literature are all associated with urogenital abnormalities like vaginal septum, vaginal agenesis and imperforate hymen. We present a case of a 7-year-old female that was referred from a peripheral hospital for micturating cystourethrography (MCUG) on account of urinary incontinence and passage of urine from vaginal orifice. Following MCUG the urethra, proximal fistula between the urethra and vagina, distended urinary bladder, contrast opacified uterus and a fallopian tube were all demonstrated. We report this case because of its rarity in the literature.

Background: Carbapenem-resistant Klebsiella pneumonia (K. pneumoniae) has been recently identified as the major class of pathogens and the treatment became the biggest challenge in this bacterium. We assessed the antibiotic resistance patterns of K. pneumoniae, the frequency of resistant strains to imipenem, meropenem, and ertapenem, and the frequency of K. pneumoniae carbapenemases (KPC), and Guiana-Extended-Spectrum (GES) metallo-ß-lactamase genes. Methods: The phenotypes of 200 strains of K. pneumonia, collected from 650 clinical samples, were isolating and identified in Qom, Iran. The antibiotic resistance pattern of the strains was analyzed against different antibiotics. The imipenem, meropenem, and ertapenem-resistant strains, were isolated and the frequency of KPC and GES genes were evaluated. Results: K. pneumoniae strains had different resistance patterns against various antibiotics. The isolated strains with the highest and lowest antibiotic resistance were related to ampicillin, and meropenem, respectively. Investigation of the KPC and GES ß lactamase showed that none of 48 imipenem, meropenem, and ertapenem-resistance isolates had the KPC gene. In addition, the GES gene was detected in 3(2.7%) of 110 ceftazidime-resistant specimens. Conclusions: Carbapenem is useful in the treatment of K. pneumoniae infections. Due to the importance of the mechanisms of resistance is by ß-lactamase genes, investigating the prevalence of ß-lactamase genes can help to increase the necessity of choosing the appropriate treatment for K. pneumoniae.

Multilocular cystic renal neoplasm is a rare subtype of clear cell carcinoma with an incidence of 1-2 % of all clear cell carcinomas. Morphologically, it shows numerous cysts surrounded by fibrous capsule and septae containing clear cells. The aim of this case report is that the diagnosis is possible solely by histopathological and immunohistochemical evaluation, which aids in distinguishing it from other cystic clear cell entities, as imaging is inconclusive pre-opeartively. Urologists and radiologists should have an adequate understanding such an entity. Almost all the cases are amenable to partial nephrectomy irrespective of the size and there is no documentation regarding the recurrence and metastasis, which mandates less stringent follow up post – operatively compared to clear cell carcinoma.

Background: Behçets disease (BD) is a chronic inflammatory disease with unknown causes. The geographical distribution is mostly consistent with the historic Silk Road. The role of tumor necrosis factor receptor-associated factor 5 (TRAF5) gene in the inflammation signaling pathway leads more attention to the potency of different polymorphisms of the TRAF5 gene, in the development of BD. Methods: This was a case-control study conducted among the Azeri Turk ethnic group (50 BD patients and 50 persons with no history of autoimmune disease), Tabriz, Iran. Four different TRAF5 gene polymorphisms were assessed via the Polymerase Chain Reaction-Restriction Fragment Length Polymorphism technique. Data were analyzed by SPSS Version 20. Results: Genotypic distributions of four studied Single nucleotide polymorphisms (SNPs) had no significant difference between case and control groups (rs6540679 (p=0.50), rs12569232 (p=0.86), rs10863888 (p=0.14), and rs7514863 (p=0.24). There were also found no significant differences in SNP allelic frequencies between cases and controls.

Tuberculosis of the wrist joints is an uncommon clinical entity that most frequently presents with insidious pain and swelling. Isolated carpal bones involvement due to tuberculosis is a relatively uncommon event. In this report, the authors describe the case of a 36-year-old female patient presenting with fracture of the scaphoid bone. The diagnosis of tuberculosis was suspected based on the ultrasound and magnetic resonance imaging findings of the wrist joint, and confirmed by joint fluid culture. Introducing anti-tuberculous drugs under appropriate supervision resulted in clinical improvement and optimal regain of function. No reactivation of the disease was noted after 2 years of follow-up. This case report describes a rare presentation of wrist joint tuberculosis.