Quadruplets following cessation of clomiphene citrate. A case of sustained effect

We report a case of quadruplet birth in a young oligomenorrheic woman, who had been prescribed clomiphene citrate for two consecutive cycles. She conceived following cessation of treatment and an intervening menstruation. Ultrasonic follow-up which concurred with the last menstrual period dating indicated multiple ovulation as a sustained effect of clomiphene citrate medication.

Peritonsillar abscess in an infant

Although a common enough condition in the general population, quinsy is rare in children and even rarer in infants. In most cases the diagnosis is easy on the basis of the suggestive clinical picture. A case is presented of a peritonsillar abscess in a 7-month-old baby. Here, the diagnosis was somewhat doubtful, due to the uncharacteristic clinical appearance and the young age of the patient. Some of the dangers of an inadequate antibiotic treatment are briefly discussed.

Permanent tracheostomy

A technique designed to create a permanent, wide open, and stable tracheal stoma is based on two corresponding U-shaped flaps: one from the anterior tracheal wall, the other from the skin in the suprasternal notch. The method described in this article has proved to be efficient, practical, well tolerated, and readily reversible. Its applications when indicated may reduce the side effects and complications associated with tracheostomy. Our clinical experience with this technique covers eight patients who tolerated the procedure well. The follow-up period exceeds 2 years.

Chronic cardiovascular pathology and hearing loss in the aged

With the objective of studying a possible correlation between chronic cardiovascular disturbances and hearing loss in aged people, two groups were compared. The first was composed of apparently healthy subjects and the second, of subjects suffering from clinically evident chronic cardiovascular pathology. All the subjects were submitted to a pure tone audiometry, discrimination test, SISI test and TDT. The results showed a significant difference in pure tone threshold audiometry between the apparently healthy subjects and those presenting cardiovascular symptoms; the discrimination and the TDT were comparable in the two groups.

Rhinoscleroma

Rhinoscleroma may present a diagnostic problem when encountered outside endemic region. Two young men from Gaza with tumor-like masses of scleroma in the nasal cavities and the nasopharynx are described. Histological examination of biopsy material from the nasal lesions showed pathognomonic Mikulicz cells, and cultures grew Klebsiella rhinoscleromatis. Both patients responded well to antibiotic treatment.