No abstract

Introduction: Bird attacks are in general an uncommon event. To our knowledge, this is the first reported case in Bahrain. There have been very few cases reported worldwide. Mainly, birds attack humans as retaliation to threats surrounding their environment. At certain occasions, bird attack frequency increases especially during mating season or in the presence of a threat toward their young. Methods: A 31-year-old male presented with a history of left-eye trauma, loss of vision, pain and tearing for 2 hours. A left corneal penetrating laceration and traumatic cataract were diagnosed. The corneal laceration was closed surgically, the lens was aspirated and anterior vitrectomy performed. Results: After 4 months of follow-up, penetrating keratoplasty and posterior chamber intraocular lens implantation were performed elsewhere. The patient's vision improved from hand motion in his left eye to 20/200 without correction. Conclusion: Corneal perforation secondary to a bird injury can be treated successfully with surgical closure and broad intravenous antibiotic coverage. This rare type of ocular trauma does not require any specific additional measures.

Background/ lntrod uction Hyponatraemia is the most commonly observed electrolyte abnormality in hospitalised patients. The many causes of hyponatraemia may be classified either by volume status or aetiology. Thorough history taking, clinical examination and investigation are necessary in order to accurately determine the cause of hyponatraemia and so formulate the most appropriate management plan. Methods Patienis with serum sodium<131mM were identified by daily automated search of the biochemistry database at Nottingham University Hospitals NHS Trust over a two week period (September 2012). Data regarding clinical history examination of volume status, investigations undertaken, diagnosed aetiology of hyponatraemia, length of hospital stay and treatment were extracted retrospectively from the medical notes using a linked anonymised system. Data analysis was performed using Microsoft Excel@ 2010 and results are given as mean +/-standard deviation.Results 75 patients were identified. Mean age was 76.0 (+/-13.0) and 53% were female. Mean serum sodium was 126.5 mM (+/-4.1), potassium 4.4 mM (+/-1.0), creatinine 1 1 6.8 ;rM (+t1 33), plasma osmolarity 270.1 osmol/Kg (+t 22.4). Mean urinary osmolarity was 362 +/-osmol/Kg (+/-141.7) and spot urinary sodium of 38.1 mM (+/-40.2).The average length of stay was 18.2 days (+l-26.11. 43% had recorded an examination of volume status.The aetiology of hyponatraemia was established in 37.3o/" of patients. 11 patients were recorded as having SIADH but in only two of these were investigations sufficient to substantiate this conclusion.