Medical Relationship associated with Ms Immunopathologic Subtypes

Albeit, all forms of tuberculosis (TB) are endemic in India, spinal intramedullary TB and tubercular longitudinally extensive transverse myelitis (LETM) is deemed extremely rare. With recent advances in the field of neurology, autoimmune astrocytopathy (neuromyelitis optica spectrum disorders, NMOSD), myelin-oligodendrocyte glycoprotein associated encephalomyelitis (MOG-EM), metabolic myelopathy, connective tissue diseases and viral infections have gained considerable focus in the list of differentials of LETM whereas tubercular association is often forgotten. This report presents a rare case of acute transverse myelopathy which unveiled previously undiagnosed pulmonary tuberculosis in an adult rural Indian male. The patient responded well to anti-tubercular therapy and corticosteroids. Exact pathogenesis of LETM in TB remains elusive. Association of TB with MOG-EM has been one of the recent hot-cakes. However, an ill-defined immune-inflammatory response to the infectious agent is the likely cause of tubercular LETM. Hence, the primary care physicians who are the first medical contacts of acute LETM cases and in most cases due to diagnostic dilemma there is an unavoidable delay in accurate diagnosis and initiation of therapy. Primary care doctors should nurture a high index of suspicion to diagnose this potentially lifetime-debilitating yet absolutely treatable clinical condition i.e. tubercular LETM.Carcinoma penis is a rare malignancy which mostly occurs after the sixth decade of life. It is managed surgically and partial penectomy is the most common procedure done in carcinoma involving the distal penis. Partial penectomy provides the opportunity of preservation of sexual function and enables the patient to micturate in standing position. The conventional technique of neourethra creation in partial penectomy is slitting the urethra dorsally. We propose an alternative approach to neourethra formation. Technique involves ventral slitting of the urethra followed by suturing which begins at the ventral aspect and continued in a parachute fashion toward the dorsal end. This new technique will help primary physicians and surgeons in providing better surgical results in caring for patients with carcinoma penis.Neuropsychiatric manifestations like cognitive dysfunction, peripheral neuropathy, stroke headache, seizures in systemic lupus erythematosus (SLE) are quite common. However, psychosis as the sole presenting manifestation of SLE is rarely encountered clinically. If lupus is not kept as differential among patients with acute psychosis, delay in diagnosis and subsequent mismanagement are likely to happen. Here, we present a case of a young female presenting with acute psychosis as the predominant symptom and was further evaluated and diagnosed as a case of SLE. The patient was managed with immunosuppressive agents and carried an excellent outcome.Follicular thyroid carcinoma (FTC) presenting as an isolated spinal metastasis with features of compression myelopathy is extremely rare with less then 10 cases reported in world literature. FTC is the second most common thyroid cancer with an indolent course. It predominantly occurs in females. The most common route of metastasis is through hematogenous routes to lung, liver, bones, etc., Herein we report a case of 47-year-old female presented with lesion involving sacral vertebrae and biopsy showing metastatic follicular carcinoma with morphology and immunohistochemistry of thyroid gland. The present case highlights the rarity of FTC to present as upfront solitary vertebral metastases with history of prior hemithyroidectomy. selleck chemicals All the cases of spinal mass should be evaluated thoroughly to exclude any metastatic deposits.Though tuberculosis is commonly seen in India, uncommon manifestations like peripheral gangrene is also a possibility. Here we present a case of spinal tuberculosis, with peripheral gangrene.Coronavirus disease (COVID-19) is the newly discovered infectious disease, affecting millions worldwide. Majority of the patients present with mild respiratory syndrome. Some neurological symptoms are reported like anosmia & dysgeusia. We are presenting a case with hiccups as an unusual symptom. An elderly male patient presented to Bapuji teaching hospital attached to JJM medical college, Davangere on 24th July 2020 with intractable hiccups in the last 5 days. There were no other symptoms. Patient's saturation was initially 98% at room air which then dropped to 90%. Based on clinical knowhow, SARS-Cov-2 RNA qualitative RT-PCR test was sent, and the results came positive. Patient improved symptomatically in 2 days and was kept in ward for observation for a total of 7 days. This extremely rare case report brings to light new atypical symptom of COVID-19 are being presented every other day, which shows how the importance being aware of the same.Scleredema diabeticorum is an uncommon skin disorder which is characterized by stiffness and hardening of the subcutaneous tissues located on the upper back and posterior neck. Patients with this skin disease typically experience pain and stiffness on the neck. Scleredema associated with diabetes mellitus may often go unrecognized. We report a case of a 55-year-old female patient with diabetes mellitus type 1, who presented with skin tightness on her upper back and decreased range of motion. Scleredema diabeticorum is rare and its treatment is difficult and tricky, as no specific regimen has been instituted to treat this skin disease.Bupropion is taken as an antidepressant for treatment of major depressive disorders, treatment of sexual side effects of selective serotonin reuptake inhibitors, and as a smoking cessation aid, however, it may result in adverse effects such as nausea, dry mouth, headache, insomnia, dizziness, anxiety, tremor, and constipation. We investigate the case of a 34-year-old woman with bulimia nervosa where acute dystonia was induced by bupropion in 8 months. Following this diagnosis and after normal tests and MRI results, the patient was advised to discontinue bupropion intake. In the follow-up done 2 weeks later, 3 months later, and 6 months later, no signs of acute dystonia was observed. A physician who administers dopamine blocking agents must be aware of the prevalence of and the risk factors for acute dystonia and also the way of prevention and treatment.