A rare complication of ventriculoperitoneal shunting (VPS) is bowel perforation by the peritoneal catheter of the shunt tube. Rarer still is the peroral extrusion of such a perforated shunt. A two-month-old infant with history of neonatal meningitis, presented with a large head, bulging fontanelle, and hydrocephalus. A VPS was inserted. The child was doing well till the age of eight months, whe...

Achalasia is very uncommon, and rarely does achalasia co-exist with esophageal varices. We present a 62-year-old woman who was diagnosed with both achalasia and esophageal varices in December 2014 and had a past history of hematemesis. The patient's achalasia symptoms' Eckardt score was 9, and her hepatic function was Child-Pugh grade A6. After comprehensive assessment of the patient's health a...

Achalasia is characterized by loss of coordinated esophageal peristalsis and failure of the lower esophageal sphincter (LES) to completely relax. High resolution manometry distinguishes three subtypes [1, 2]. The Eckardt score evaluates clinical symptoms, but not quality of life [3]. The treatment aim is to decrease the LES pressure and the integrated relaxation pressure (IRP), in order to impr...

Background: Rheumatoid arthritis (RA) is an autoimmune and inflammatory disease that potentially attacks all parts of the human body. Despite use disease-modifying anti-rheumatic drugs (DMARDs), rate total knee arthroplasty (TKA) remains high. Critical complications such as infection, dislocation, readmission following TKA are also reportedly high therefore, appropriate management during periop...