Goldberg Shprintzen syndrome is an autosomal recessive mental and growth retardation syndrome associated with distinctive facial dysmorphism, Hirschsprung disease, and a variety of neurologic abnormalities, and abnormalities on brain imaging studies. Thirty three cases of Goldberg Shprintzen syndrome was reported from many countries (Canada, Pakistan, Japan, United Kingdom, Morocco, The Netherlands, Italy, Israel, France, Iran) including 2 patients reported by Goldberg and Shprintzen (1981), one patient reported by Brunoni et al (1983), two patients reported by Hurst et al (1988), two patients reported by Kumasaka and Clarren (1988), one patient reported by Halal and Morel (1990), two patients reported by Yomo , Taira , and Kondo (1991), one patient reported by Tanaka et al (1993), one patient reported by Ohnuma et al (1997), two patients reported by Fryer AE (1998), four patients reported by Brooks et al (1999), One patient reported by Imaizumi (2001), one patient reported by Silengo et al (2003), two patients reported by Shahar and Shinawi (2003), two patients reported by Brooks et al (2005), two patients reported by Murphy et al (2006), five patients reported by Drévillon , Megarbane , and Demeer (2013), one patient reported by Dafsari et al (2015), and one patient reported by Salehpour et al (2017). The aim of this paper is to report the thirty fourth and thirty fifth cases of the syndrome which occurred in Iraqi brother and was associated with right hemiplegia in one patient.

Introduction: Amyloidosis represents an alteration secondary to the extracellular deposit of low molecular weight protein with an fibrillar structure. Intradural spinal amyloidoma is unusual, with only two cases previously reported. Case report: A female 53 years old patient with story of progressive paraparesis and successfully operated of an intradural extramedullary amyloidoma is presented. Conclusions: Although extremely unusual, the spinal amyloidoma should be considered in the differential diagnosis of any patient with an intradural extramedullary tumor. In this scenario, the laminectomy constitutes a good therapeutic modality which not only afford to stablish the positive diagnosis, also helps to improve the neurological condition of the patient.

Skull base osteomyelitis is a very rare and life-threatening disease. It has significant mortality and morbidity though appropriate antibiotherapy. Here we report a case of atypical skull base osteomyelitis, which is rarely seen in infectious disease practice, caused by E.coli and Candida albicans in a patient with GAPO syndrome.

Introduction: Accuracy of pre-operative templating using radiographs or joint replacement programmes is variable. Implant modularity has increased the number of sizes available and trays used per procedure. Multiple intra-operative implant size trials lead to longer surgery time and greater instrument maintenance costs. It was hypothesised that patient factors could predict the size of implant and tray required, thereby increasing efficiency and reducing operative time. This study aims to identify correlation between implant size and body height to improve efficiency and reduce costs. Method: This prospective cohort study includes patients who underwent primary total knee replacement using the DePuy ATTUNE® Primary Total Knee System between 1st January 2016 to 7th August 2017 performed by a single surgeon, at a single hospital. Post-operative x-rays were reviewed for appropriate implant sizing. The DePuy ATTUNE® Primary Total Knee System has five sets, split into sizes 1-2, 3-5, 6-8 and 9-10. Results: 188 patients (205 knees) were included, 66 male and 122 female. Male height was 174.6cm (152-194.3) with average implant size 8. Female height was 158.7cm (145-177.8) with average implant size 5. The Spearman rank correlation between body height, femoral and tibial size were 0.793 and 0.837 respectively. All men <170cm and >185cm used the 6-8 and 9-10 set respectively. All women <150cm and >170cm used the 3-5 and 6-8 set respectively. Conclusion: The positive correlation identified coincides with existing literature. Using extremes of height and gender, surgeons and theatre staff could predict the likely trial set required, improve theatre efficiency and reduce costs.

Syphilis is a sexuality transmitted disease caused by Treponema pallidum. Its incidence has started to increase in the world, especially in hiv-infected patients. Liver involvement in syphilis is a very rare condition and usually occurs in the second phase of the disease where the brain, skin and genital organs are involved. This liver damage refered to syphilitic hepatitis generally is mild clinical condition that presents with disproportionately increased alkaline phosphatase and slightly high transaminase. Elevated liver enzymes levels are a common encountering problem in clinical practice. Generally diagosing the disease is very diffucult and time-consuming. A variety of diseases has been identified the etiology of the cause of this elevation. Secondary syphilis, rarely developed acute hepatitis is one of these diseases. Therefore, It should be included in the early differential diagnosis if the patients has liver dysfunction of uncertain etiology and high risk sexual behaviors.