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We present a case of an iatrogenic complete left proximal ureteric injury after a lumbar 1 laminectomy and intradural tumour excision and lumbar 4/5 transforaminal lumbar interbody fusion. Initial management included a percutaneous nephrostomy for urinary diversion followed by definitive urinary reconstruction with an ileal ureter.Several refractive techniques are available for the treatment of hyperopia. Conductive keratoplasty (CK) is a safe and non-ablative procedure suitable for the treatment of low hyperopia and presbyopia. Due to the high rate of regression, it is not a commonly used technique. There is minimal literature about the use of refractive procedures for the treatment of hyperopic regression after CK. We report a case of a 49-year-old man who had undergone bilateral CK 15 years before for the correction of his hyperopia. He experienced a regression, with sph +2.75 cyl -0.50(20) in the right eye and sph +2.50 cyl -0.75(170) in the left eye. Transepithelial photorefractive keratectomy (tPRK) was performed with Schwind Amaris 750 s. After 12 months, his best-corrected visual acuity was 20/20, with -0.25 sph in both eyes. To the best of our knowledge, this is the first reported case of tPRK performed after CK.A 52-year-old man with a history of urolithiasis presents to the emergency department with a sudden, sharp, continuous right flank colicky pain. Laboratory workup demonstrates acute kidney injury with a mild hyperkalaemia. During the observation period, the patient develops an atypical broad complex sinus bradycardia and eventually short asystolic periods. This was caused by a severe therapy-resistant hyperkalaemia, wherefore emergency haemodialysis was necessary. Radiographic results showed a giant hydronephrosis with a blowout of the right kidney and an obstructing calculi of 21 mm in the distal ureter. We will discuss the mechanism of reversed intraperitoneal dialysis causing the refractory hyperkalaemia and the need of close ECG monitoring in patients where kidney blowout is considered.Tongue trauma with active bleed is most commonly due to the ruptured lingual artery and its branches, whereas delayed haemorrhage is usually secondary to pseudoaneurysm formation. This case is a unique presentation of traumatic tongue bleeds with early formation of pseudoaneurysm of a lingual artery branch. We present our experience in its management. A contrast-enhanced CT (CECT) with angiography detected right deep lingual artery pseudoaneurysm, which was managed by endovascular gelfoam embolisation followed by tongue laceration repair. Tongue bleed stopped immediately post embolisation; tongue viability and functions restored on postoperative day 1 of repair. No complications like secondary haemorrhage or tongue necrosis were noted at 1-month follow-up. High index of suspicion for lingual artery and/or its branch pseudoaneurysm is crucial in acute and uncontrollable traumatic tongue bleed. A CECT is a minimum norm in early diagnosis. Choice of management is the cornerstone of a successful outcome.This report describes a novel technique of steroid infiltration of the wrist to treat symptomatic carpal tunnel syndrome. Our approach potentially reduces direct trauma to the median nerve when compared with current conventional techniques. The use of a cannula allows infiltration directly into the carpal tunnel and advancement of the blunt tip minimises the risk of sharp trauma to the median nerve and adjacent tendons. This avoids the unpleasant, shooting pain frequently experienced by patients using traditional needle infiltration. We anticipate this would be of particular benefit in reducing pain associated with the procedure.Rivaroxaban is a commonly used anticoagulant agent for treatment and prevention of thromboembolism. There are case reports demonstrating an association between its use and drug-induced liver injury. However, this has not been reported in a patient who previously tolerated apixaban. An 88-year-old man presented to hospital with worsening lethargy, jaundice and vomiting. He had severely elevated liver transaminases, an abnormal coagulation profile and elevated bilirubin in keeping with acute liver injury. This is in the context of having had his anticoagulation medication switched from apixaban to rivaroxaban 2 weeks prior. The patient recovered well after cessation of rivaroxaban, suggesting that it was the likely offending agent. The mechanism of rivaroxaban-induced liver injury remains to be investigated. Drug-induced liver injury should be discussed and monitored for as a potential adverse reaction when commencing rivaroxaban, even if a patient has previously tolerated a drug of the same class.Small-cell lung cancer (SCLC) is a very fast growing form of cancer and is characterised by early metastasis. As a result, chemotherapy is the mainstay of treatment. Platinum-containing combination regimens are the current treatment of choice for limited stage-SCLC and extensive stage SCLC. Various adverse effects after cisplatin and etoposide chemotherapy include nausea, nephrotoxicity, cardiotoxicity, hepatotoxicity, neurotoxicity, alopecia, gastrointestinal toxicity and myelosuppression. However, severe headache has not been reported yet. Here, we report one such case of severe refractory headache postcisplatin and etoposide chemotherapy which responded only to change in chemotherapy regime. selleck products All pertinent causes of headache were ruled out prior to changing the chemotherapy regimen.Malignant melanoma of the anal canal is a rare and aggressive tumour associated with significant mortality. Early diagnosis and early curative surgical resection have shown to offer a survival advantage. We present a case of 53-year-old woman, who was accidentally diagnosed to have a localised lesion of malignant melanoma of the anal canal on histopathology report of the specimen of haemorrhoidectomy done for thrombosed external haemorrhoids. She refused any form of treatment and did not return for follow-up. Two years after the initial diagnosis, she presented with intestinal obstruction. The malignant melanoma had become advanced with multiple metastases to the lungs, the liver, the peritoneum and the spine. The patient underwent a diverting loop ileostomy. At the time of surgery, it was found that the primary malignant melanoma of anal canal had contiguously involved the entire large intestine up to the ileocaecal junction and hence transverse colostomy could not be done.