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Case Report
Case Report: Purple Urine Bag Syndrome with Surprisingly Acidic Urine
Issue:
Volume 4, Issue 3, September 2025
Pages:
42-46
Received:
11 June 2025
Accepted:
25 June 2025
Published:
16 July 2025
Abstract: Purple Urine Bag Syndrome (PUBS) is a rare clinical phenomenon typically seen in elderly female patients. It occurs in patients who have chronic urethral catheterisation and comorbid conditions such as chronic urinary tract infections, immobility (bedridden or wheelchair-bound), dehydration, constipation, and chronic kidney disease. The pathophysiology of PUBS is thought to develop as a result of the complex metabolic pathway of essential amino acid tryptophan in the gastrointestinal system, forming urine metabolites converted by bacterial enzymes, sulphatase and phosphatase, turning urine bag and tubing purple. PUBS can emerge as asymptomatic bacteriuria or symptomatic urinary tract infection in a patient with an indwelling urinary catheter. This case report uniquely describes an elderly patient who had a prolonged urethral catheter and presented with a purple discolouration of the urine collection bag with acidic urine and a startling Klebsiella ozaenae species that has not been reported to cause this phenomenon before. In many literatures, it is noted to be a benign condition; however, it carries a significant morbidity and mortality. Thereupon, it is critical to vigilantly screen chronic catheterised patients and manage them accordingly. Management of PUBS includes: targeted antibiotic therapy, correcting underlying predisposing factors, aseptic changing of urethral catheter, and finally calming patient and caregivers regarding the condition.
Abstract: Purple Urine Bag Syndrome (PUBS) is a rare clinical phenomenon typically seen in elderly female patients. It occurs in patients who have chronic urethral catheterisation and comorbid conditions such as chronic urinary tract infections, immobility (bedridden or wheelchair-bound), dehydration, constipation, and chronic kidney disease. The pathophysio...
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Case Report
Perioperative Analgesia Management for a Chinese Patient with Multiple Traumatic Injuries: A Case Report
Yang Chen
,
Yang Jing*
Issue:
Volume 4, Issue 3, September 2025
Pages:
47-50
Received:
31 July 2025
Accepted:
12 August 2025
Published:
18 August 2025
Abstract: Trauma is a leading global health burden, contributing to substantial morbidity, mortality, and healthcare costs. Polytrauma patients frequently endure severe acute pain, which disrupts physiological recovery, delays rehabilitation, and diminishes quality of life. Effective perioperative analgesia is critical for optimizing outcomes, with anesthesiologists playing a central role in developing individualized, multimodal pain management strategies. This case report details the perioperative care of a patient with multiple injuries—including fractures, pulmonary contusion, hemothorax, and soft tissue trauma—following a motor vehicle accident. The analgesic regimen integrated intravenous opioids, regional nerve block, and non-steroidal anti-inflammatory drugs (NSAIDs) to minimize opioid-related adverse effects, mitigate pulmonary complications, and enhance pain control. Multimodal analgesia has become the cornerstone of perioperative pain management in trauma care. During emergency debridement surgery, this approach facilitated hemodynamic stability and adequate analgesia. Following pulmonary recovery, the patient underwent definitive fracture fixation, with continuation of the multimodal strategy. Postoperatively, the patient experienced no opioid-related complications such as respiratory depression, nausea), reported high satisfaction, and achieved early mobilization. This case highlights the clinical benefits of structured, patient-centered analgesia in trauma care, including improved recovery trajectories, reduced healthcare costs, and enhanced safety. Anesthesiologists’ expertise in balancing analgesic efficacy with safety is indispensable in optimizing perioperative outcomes for polytrauma patients.
Abstract: Trauma is a leading global health burden, contributing to substantial morbidity, mortality, and healthcare costs. Polytrauma patients frequently endure severe acute pain, which disrupts physiological recovery, delays rehabilitation, and diminishes quality of life. Effective perioperative analgesia is critical for optimizing outcomes, with anesthesi...
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Case Report
A Three-rooted Deciduous Second Molar in a 13-year-old Caucasian Female
Daniel Joseph Traub*,
Robert Walsh,
Colleen Ahern
Issue:
Volume 4, Issue 3, September 2025
Pages:
51-54
Received:
19 July 2025
Accepted:
1 August 2025
Published:
20 August 2025
Abstract: Introduction: Several reports have been published highlighting accessory root formation in permanent molars. These studies have shown higher incidence of occurrence of accessory roots in patients of Mongolian, Taiwanese, Korean, Inuit, Native American and Indian descent. Very few reports have been published with a focus on accessory root formation in the primary dentition, in particular in the Caucasian population. Objective: This study was aimed at drawing attention to a rare morphological development in the Caucasian population. Case Presentation: This report presents a case of a 13-year-old Caucasian female with a three-rooted mandibular second molar tooth #T. The tooth was surgically removed, with some degree of difficulty, and upon inspection of the tooth following removal, it was observed that an accessory root was present. Conclusions: The presence of an accessory root may be demonstrated radiographically, but often is only discovered after excavation of the pulp chamber or following removal of the tooth itself. As such, it is important for the astute clinician to consider the potential for the presence of an accessory root, and to appreciate the potential complications an accessory may cause during endodontic or surgical treatment. Appropriate imaging should be obtained preoperatively if an accessory root is suspected, and treatment planning should be adjusted accordingly, in order to optimize successful treatment.
Abstract: Introduction: Several reports have been published highlighting accessory root formation in permanent molars. These studies have shown higher incidence of occurrence of accessory roots in patients of Mongolian, Taiwanese, Korean, Inuit, Native American and Indian descent. Very few reports have been published with a focus on accessory root formation ...
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Case Report
Severe Neonatal Autoimmune Thrombocytopenia in a Mother with Chronic ITP After Splenectomy: Treated Successfully with IVIG, Case Report
Issue:
Volume 4, Issue 3, September 2025
Pages:
55-58
Received:
21 July 2025
Accepted:
6 August 2025
Published:
28 August 2025
Abstract: Neonatal autoimmune thrombocytopenia occurs due to the transplacental passage of maternal antiplatelet antibodies and is seen in approximately 10% of neonates born to mothers with immune thrombocytopenia (ITP) or systemic lupus erythematosus (SLE). Although most cases of neonatal autoimmune thrombocytopenia are asymptomatic in rare instances, neonates might develop severe thrombocytopenia that can lead to life threatening bleeding, including Intracranial hemorrhage. Considering those potential consequences, early platelet number determination and other necessary investigations will be beneficial for better outcomes. Intravenous immunoglobulin is the first line of treatment, with most neonates responding to it without requiring transfusions. We report a case of neonatal autoimmune thrombocytopenia in a term male neonate born to a 25 year old woman with chronic ITP. The mother had a splenectomy for refractory thrombocytopenia despite steroid treatment. The neonate was asymptomatic but had thrombocytopenia with a nadir platelet count of 8,000/µL in routine evaluation prompted by maternal ITP history. He was treated with Intravenous Immunoglobulin at 1 g/kg/day for 5 days, without requiring platelet transfusion or experiencing any clinical complication. In subsequent post treatment followups (fourth month) the platelet count increased gradually, reaching 348,000/µL in the fourth month. This case highlights the importance of early detection and treatment of neonatal autoimmune thrombocytopenia, even in the absence of clinical symptoms.
Abstract: Neonatal autoimmune thrombocytopenia occurs due to the transplacental passage of maternal antiplatelet antibodies and is seen in approximately 10% of neonates born to mothers with immune thrombocytopenia (ITP) or systemic lupus erythematosus (SLE). Although most cases of neonatal autoimmune thrombocytopenia are asymptomatic in rare instances, neona...
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