Common Presentation of an Uncommon DiseaseStrongyloidiasis could be Devastating in an Immunocompromised Host

Strongyloidiasis is a chronic self-limited parasitic infection associated with mostly nonspecific sign symptoms. But in immunocompromised patient’s morbidity and mortality is high due to hyperinfection syndrome and disseminated disease. So early diagnosis is very important. Here we report a case of hyperinfection with Strongyloides stercoralis in an elderly immunocompromised patient diagnosed by endoscopic biopsy who was treated successfully later on. Keywords: Strongyloidiasis; parasitic infection; Immunocompromised host, Hyperinfection Disseminated disease

Retinal involvement in acute thrombotic thrombocytopenic purpura: a case report

Background Thrombotic thrombocytopenic purpura (TTP) is a life-threatening hematological condition associated with deficiency in ADAMTS13. Ocular manifestations associated with TTP are uncommon. Case presentation Here we report a case where a 44 year old female patient with a history of symptomatic anemia and cotton wool appearance in retina during ophthalmological examination and subsequently, she was diagnosed to have TTP. The proper management with Therapeutic Plasma Exchange (TPE) and IV methylprednisolone improved the condition of the patient markedly. Conclusion It concludes that even though the presence of cotton wool appearance in retina is a nonspecific sign it needs to be properly evaluated as there can be underlying serious illnesses as in our patient. Cotton wool spots can be an early sign of underlying retinal compromise and it should be identified early.

Addisonian crisis complicated by rhabdomyolysis and acute kidney injury

Addisonian Crisis is an endocrine emergency requiring hospitalization and urgent management. The diagnosis is usually complicated by nonspecific sign and symptoms of primary adrenal insufficiency. A high degree of suspicion Is required in such cases. Rhabdomyolysis caused by addisonian crisis is a rare complication which was seen in our patient.

A Case Report of Tubercular Constrictive Pericarditis

Diagnosis of Constrictive pericarditis is sometimes become difficult because that requires a high degree of clinical suspicion due to nonspecific sign and symptoms. But in endemic area like our country the presentation of tubercular constrictive pericarditis is common. Here we report a case of 28 year Bangladeshi male with tubercular constrictive pericarditis presenting with progressive exertional dyspnea, ankle edema, puffyness of face, dry nonproductive caugh. After physical examination and investigation, the patient was diagnosed as constrictive pericarditis. Patient was previously diagnosed as a tubercular patient and still now on antitubercular cat-1 chemotherapy. So finally diagnosis becomes tubercular constrictive pericarditis. After improvement of the symptoms with medical treatment, the definitive surgical intervention, pericardiectomy done. Then removed pericardial tissue was sent for histopathological examination and histopathological report confirmed the diagnosis of tubercular pericarditis. This case is a late presentation of extrapulmonary manifestation of pulmonary tuberculosis, which is present as a consequence or, complication of pulmonary tuberculosis. So, early diagnosis and treatment is very much important in this case to prevent late consequence like tubercular constrictive pericarditis.University Heart Journal Vol. 10, No. 1, January 2014; 42-44

The Role of Inflammation in the Pathogenesis of Macular Edema Secondary to Retinal Vascular Diseases

Macular edema (ME) is a nonspecific sign of numerous retinal vascular diseases. This paper is an updated overview about the role of inflammatory processes in the genesis of both diabetic macular edema (DME) and ME secondary to retinal vein occlusion (RVO). We focus on the inflammatory mediators implicated, the effect of the different intravitreal therapies, the recruitment of leukocytes mediated by adhesion molecules, and the role of retinal Müller glial (RMG) cells.

Retrorectal tumors: report of two cases

Retrorectal tumor is uncommon identity presenting with nonspecific sign and symptoms making difficulty in diagnosis. Benign tumors are more common than malignant. The lesion may be malignant or progress to malignancy from benign state. Retrorectal masses in young women may continue to grow and result in dystocia. Cystic lesions are also at risk of becoming infected, which renders subsequent excision more difficult and increase the risk of recurrence. Cross-sectional imaging is required to determine the extent of resection and the appropriate surgical approach. Surgical removal leads to favorable outcomes for patients with benign purely cystic retrorectal tumors. We report two such benign rectal lesions. ] Journal of College of Medical Sciences-Nepal, 2012, Vol-8, No-4, 46-50 DOI: http://dx.doi.org/10.3126/jcmsn.v8i4.8701

Behavioral and Psychological Symptoms of Dementia (BPSD) and Delirium

Delirium is a valuable nonspecific sign of physical illness or intoxication and, as clinical teachers, we impress on our students the importance of its prompt recognition and treatment. However, several practical and conceptual difficulties impede the reliable distinction of delirium from dementia.