Prevalence of low vitamin D levels in patients with Hidradenitis suppurativa in Jordan: A comparative cross-sectional study

Hidradenitis suppurativa (HS) is a chronic inflammatory disease of the apocrine gland bearing skin, presenting various stages of flexural skin pain, erythema, painful nodules, abscesses, sinuses, and fistulas. We aimed to assess serum vitamin D levels in patients with (HS) in Jordan. a cross-sectional comparative study conducted among 110 patients with HS and 110 matched controls, who didn’t previously receive vitamin D therapy. Serum vitamin D was measured and classified into normal (>30 ng/ml), insufficient (20–30 ng/ml), and low (<20 ng/ml). The mean age of the cases was 43.1 ± 12.9 years and the mean disease duration was 19.4 months. The mean body mass index among patients with HS was 30 and about 34% of them were smokers. The mean Vitamin D level was 8.4 ng/ml and all HS patients were vitamin D deficient. Patients of HS were more likely to have vitamin D deficiency compared to healthy controls. Most of the study subjects and particularly all of the patients with HS have low vitamin D levels. Smoking and high BMI, were associated with HS. We suggest the implementation standard public dietary recommendations of Vitamin D supplementation, smoking cessation, and weight reduction behaviors with further assessment of disease course among HS patients.

Violet discoloration of urine: A case report and a literature review

BACKGROUND

Purple Urine Bag Syndrome (PUBS) is an uncommon event that can be described as purple discoloration of urine due to a series of chemical reactions induced by Urinary Tract Infections (UTIs). PUBS has been reported in the past but still remains unrecognized by healthcare givers leading to misdiagnosis and inappropriate management. We report our case alongside a literature review of previously published cases.

CASE PRESENTATION

We present the first case report of Purple Urine Bag Syndrome in Jordan of a catheterized 80-year-old wheel-chaired female with a history of type 2 Diabetes Mellitus (DM), stage 5 Chronic Kidney Disease (CDK), Hypertension, and ischemic stroke. Her condition was initially misdiagnosed for hematuria but later on was correctly diagnosed with PUBS. She was treated with a course of appropriate antibiotic and by changing her urinary catheter and bag. The patient returned for a follow up visit and her problem resolved with the color of her urine in the urine bag returning back to normal.

CLINICAL DISCUSSION

PUBS is an uncommon event that occurs in association with UTIs. Such cases are mostly seen in elderly catheterized patients with other risk factors.

CONCLUSION

Purple Urine Bag Syndrome can be managed by changing urinary catheter, and by the administration of appropriate antibiotics. Such event can be easily misdiagnosed thus leading to unnecessary and consuming measures. Creating a better awareness of this condition among physicians and healthcare givers is essential for better patient outcomes.