Introduction: Retroperitoneal abscess is a rare condition which is difficult to diagnose and treat because of its insidious onset and nonspecific clinical manifestations. Case Report: 55 years old male, underlying DM, Hypertension, Gouty arthritis. Referred to us for right Hypochondriac pain with persistent fever for past 2 days duration. Abdominal examination showed soft, tender over right side of abdomen, localized guarding. An abdominal CT scan showed right pyonephrosis complicated by a large right perirenal collection.Right Nephrostomy was performed. 1 week later, patient had fever and persistent right sided abdominal pain with increasing septic parameters. CT abdomen performed and showed Right pyonephrosis complicated by a large right perinephric abscess extending into the pelvic and inguinal region. Right Perinephric drainage performed. Patient developed worsening sepsis, repeated CT abdomen revealed residual multiloculated right perinephric collection. Open retroperitoneal drainage was performed, noted retroperitoneal abscsess, caccon right kidney and peritoneal, slough ,unhealthy tissue and necrotic debris over right psoas muscles.1 week after surgery, patient still not improving, repeated CT Abdomen showed features of D2 ischemia with focal retroperitoneal perforation causing large and recurrent right perinephric inflammation with increasing intraabdominal free fluid and enlarging right perinephric collection. Laparotomy done shiwed 1L clear ascites intraperitoneally, no pus collection seen. Cocoon inflammatory mass involving hepatic flexure and duodenum to the retroperitoneum, hepatic flexure appeared normal with no intraluminal mass.Right retroperitoneal exploration done, noted adhesion between hepatic flexure to Gerota's fascia, pus ~30ml at upper part of Gerota's fascia. Repeated CT abdomen showed slightly larger right paracolic gutter collection with similar right perinephric collection. Discussion: Retroperitoneal abscess is very rare. Retroperitoneal abscess may result from a variety of causes, such as pyelonephritis, pancreatitis, retroperitoneal appendicitis, diverticulitis, peptic ulcer disease, perforated cancer, infammatory bowel disease, spinal infection, trauma, and post instrumentation. For our patient ,the exact aetiology of retroperitoneal collection and peri renal collection are still unknown.

Grisel syndrome is a rare cause of torticollis resulting from subluxation of the atlanto-axial joint (C1-C2 vertebra) joint from surrounding soft tissue inflammation. Atlanto-axial joint injuries typically occur in the setting of trauma. However, here we report a case of a non-traumatic cause of atlanto-axial joint subluxation in a child. The child initially presented to our centre with 5 days history of torticollis preceded by a few days of upper respiratory tract symptoms. The initial radiograph of the cervical spine did not demonstrate any obvious abnormality. However, due to a high index of suspicion by the attending physician, a CT of the cervical spine was performed, which indeed revealed an atlanto-axial subluxation. The patient was put on cervical traction for a few days, and discharged well with soft collar and analgesia.

tinnitus. However, functional abnormalities in tinnitus patients are not limited to the centra METHODS: Some 32 patients were randomized in order to obtain either temporal rTMS (10 sessions, 1Hz, left auditory cortex, 2000 pulses/d, 110% motor threshold) or a combination of temporal and prefrontal rTMS (10 sessions, at each session 20 Hz rTMS, left dorsolateral prefrontal cortex, 1,000 pulses/d, 110% motor threshold; followed by 1Hz, left auditory cortex, 1,000 pulses/d, 110% motor threshold). Tinnitus Severity was assessed before and after treatment and after a follow-up period of three months by using a standardized tinnitus questionnaire (TQ). RESULTS: Assessment of TQ score directly after therapy showed an improvement of the score for both groups but no differences between the two groups. Evaluation after three months revealed a remarkable advantage for the group of patients who received combined prefrontal and temporal rTMS. CONCLUSIONS: These results support recent data suggesting that auditory and nonauditory brain areas are involved in tinnitus pathophysiology. This should be considered in the development of future treatment strategies.

The healthcare staff in interventional fluoroscopy room are exposed to the scattered-radiation from the patient during the procedures. Excessive occupational radiation exposures to their eyes are associated with the formation of radiation-induced cataracts. Therefore, recommendations are set-up to reduce the occupation eye exposure but are often overlooked. Thus, there is a need to incorporate additional value into the recommendations. This review is conducted to incorporate the Islamic perspectives into the recommendations on the eye protection from occupational radiation exposures. Common themes were derived from the recommendations as stated in several guidelines and articles. The relevant Islamic perspective were then identified and linked. The main themes are the responsibilities of the staff in protecting their eyes and the responsibilities of the employers to ensure that their staff are protected. There were several subthemes identified for each main theme. The relevant Islamic perspectives which are related to the identified themes, eyes and concept of radiation protection were discussed in this review. The incorporation of Islamic perspective is an effort to motivate the Muslim staff and employers to see additional values and thus follow the recommendations on the eye lens protection.