Background: Syringomyelia is a rare disorder in which a syrinx is formed in the spinal cord and it expands over the time, damaging the entire spinal cord. It shows low prevalence and is difficult to diagnose. Syringomyelia is a physically disabling condition and its symptoms are profoundly similar to that of spinal cord injury (SCI). Since it is a rare disorder, there is lack of literature about the effects of various physiotherapy techniques in syringomyelia patients.
Objective: The aim is to determine the effects of functional Proprioceptive Neuromuscular Facilitation (PNF) with Mental Practice to improve activities of daily living in syringomyelia patient. Case report: We report the case of a 25 year old female presenting with history of fever and chills for a month followed by convulsions and loss of sensations and muscle power 1/5 in both lower limbs below the trunk. The condition was managed by functional PNF techniques along with mental practice. Conclusion: PNF with Mental Practice is effective to improve activities of daily living in syringomyelia patient.
The varicella zoster virus belongs to the family of alpha herpes viridae which is responsible for both primary and recurring infections. Herpes zoster is a condition caused by the reactivation of the varicella zoster virus. The reactivation follows a suppressed immune system or aging. Herpes zoster mostly affects the aged population; however, it can also occur at any age. Herpes zoster is capable of affecting any sensory ganglia and its cutaneous nerve. The infections mostly affect the dermatomes of T3 to L2, however, about 13% of the patients manifest infections relating any of the three branches of the trigeminal nerve. Prodromal symptoms may include malaise, neuropathic pain, headache and interrupted sleep. Herpes zoster causes pruritic, confined, blisters which usually occur unilaterally in the distribution of either one or more adjacent sensory nerves that comes along with neuropathic pain in the affected dermatome. This case of Herpes zoster is reported on a 32-years-old man who was managed based on the symptoms he presented.
Background: Fetus Papyraceus is a rare condition with the intrauterine death and subsequent retention of one or more fetuses of a multiple gestation. Antepartum diagnosis of fetus papyraceus is infrequent and usually it is a chance finding during investigation of some other pregnancy problem on ultrasonography. I report a case of fetus papyraceus in an unbooked patient diagnosed at second stage of labour.
Case Presentation: A 26-year-old, unbooked primigravida, presented to the Labour Ward at a gestational age of 35 weeks with painful uterine contractions of 6 hours duration. On admission, she had features of mild pre-eclampsia, but had good contractions and was in established labour. She had an obese anterior abdominal wall with marked oedema, which made discerning the fetal presentation and auscultating the fetal heart sounds difficult. She was however delivered of a live baby weighing 3300 g with Apgar scores of 8 in one minute and 10 in 5 minutes. This was followed by the delivery of a fetus papyraceus weighing 200 g, with crown rump length of 85mm. subsequent delivery and examination of the placenta revealed a diamniotic-monochorionic twin gestation. Both the mother and live baby were discharged home in good condition.
Conclusion: The antenatal diagnosis of fetus papyraceus is usually a chance finding on obstetric scan for other problems or routinely. The primary concern for fetus papyraceus is its effect on the surviving fetus. Regular antenatal care and routine ultrasonography in pregnancy is mandatory to diagnose and manage possible complications. However, this patient did not enjoy such benefits. Where this is missed, routine placental examination to search for fetus papyraceus and establish chorionicity is mandatory.
Introduction: Neuroblastoma is an extremely rare pediatric neoplasm whose prognosis becomes poor as the age advances. It can be sporadic or nonfamilial in origin. It is primarily a tumor of abdominal origin from where it metastasis to lymph nodes, liver, intracranial and orbital sites, and central nervous system The purpose of this paper is to report a case in which scalp nodules and inguinal lymph node was the initial presenting sign of disseminated neuroblastoma in a 2 year-old child.
Case Presentation: We report a rare case of metastasis of neuroblastoma in a 2-year-old child presenting complain of fever for several weeks, anorexia, loss of weight , arthralgia and multiple scalp nodules and inguinal lymph node enlargement . Biopsy was receive from the scalp and inguinal lymph nodes showed undifferentiated tumor tissue where medium sized atypical blastoid tumor cells were located in clusters and sheets in an eosinophilic sometimes fibrillary background showing blood vessels. The sinuses were also infiltrated by these tumor cells.
Immunohistochemically, Pan Leucocyte antigen was negative as also myogenin and CD99. However, CD 56 and synaptophysin are strongly positive and the neuroblastoma marker was weakly positive in the neuropil-like structures and the cytoplasm of some tumor cells.
Conclusion: The addition of our case to the literature offers new clinicopathological data useful for better defining the diagnosis. The differential diagnosis of neuroblastoma in a child presenting with multiple scalp nodules and inguinal lymph node enlargement should be consider.
Methemoglobinemia is a potentially fatal condition, can be congenital but mainly acquired after intoxication by certain drugs. To this date there are very few cases associated with use of multiple drugs leading to methemoglobinemia. We report a patient who developed methemoglobinemia secondary to multiple drugs. Our patient had diabetes related micro and macro vascular complication along with non-vascular complication i.e. diabetic gastropares is along with UTI. She was treated with multiple drugs which included metoclopramide, nitrates, paracetamol which led to methemoglobinemia. All three of these drugs can precipitate methemoglobinemia either individually or in combination with each other. This patient was successfully treated with iv methylene blue.
