Delays in diagnosis and treatment are widely considered to be threats to outpatient safety. However, few studies have identified and described what factors contribute to delays that might result in patient harm in the outpatient setting. We analyzed 111 root cause analysis reports that investigated such delays and were submitted to the Veterans Affairs National Center for Patient Safety in the ...

Although the incidence of microperforated hymen (MH) is unclear, this hymenal subocclusive anomaly is considered a rare entity. Differently from imperforated hymen, MH may be asymptomatic until puberty when the women's quality of life is jeopardized. Depending on the size of the microperforation, MH's clinical features me be very similar to those found in imperforated hymen cases. However, MH m...

Delayed ejaculation (DE) is a poorly defined and uncommon form of male sexual dysfunction, characterized by a marked delay in ejaculation or an inability to achieve ejaculation. It is often quite concerning to patients and their partners, and sometimes frustrates couples' attempts to conceive. This article aims to review the pathophysiology of DE and anejaculation (AE), to explore our current u...

Fifteen cases of juvenile myoclonic epilepsy (JME) were identified from one hundred and eighty consecutive patients referred to a new epilepsy clinic at St Thomas' Hospital between April 1989 and December 1990, a prevalence of 8.3%. Of these, only one was referred with a putative diagnosis of JME. Diagnosis of the other patients on referral included "epilepsy", "grand mal", "temporal lobe epile...

Hydrocephalus is but one of the several sequelae of neonatal meningitis (NM). Other common sequelae include mental retardation, seizures, and sensorineural hearing loss(2). Therefore, studying cases of hydrocephalus alone may not reflect a true picture of unrecognized NM and figures thus obtained may under-estimate the proportion of missed cases. In fact, in the present series too, 4/13 infants...

The authors present the case of a male patient misdiagnosed with right upper lobe tuberculosis and repeatedly treated for this in the last two years, without response. In our institution, the source of the hemoptysis proved to be a pulmonary carcinoma, which in its evolution involved the carina and the last tracheal ring. Right carenal pneumonectomy with two tracheal ring resection is performed...

This is a retrospective review of congenital cholesteatoma cases that were managed surgically. There were 5 cases. The age of presentation ranged from 5 to 18 year old. Three patients presented with complication of the disease. Three patients had intact tympanic membrane, two had perforation at the anterior superior quadrant. All patients had cholesteatoma medial to tympanic membrane. Four case...

The San Francisco Declaration on Research Assessment (DORA) appeared in Dec 2012, initiated by the American Society for Cell Biology together with a group of editors and publishers of scholarly journals. 397 individual legendries and 87 institutional signatories signed the declaration. However, a towering name in science, Nature did not sign it. DORA emphasized to stop the use of “journal impac...

Mediastinal teratomas are rarely reported in children. We report a 12-year-old child, diagnosed and treated as empyema thoracis in a peripheral setting for 18 months. In our centre, CT scan performed revealed a well circumscribed multiloculated cystic lesion containing fat, bone and teeth, suggestive of a teratoma. The mass was excised and found to be an infected posterior mediastinal teratoma,...