Hirayama's Disease: A Rare Clinical Variant of Amyotrophic Lateral Sclerosis.

Hirayama's disease is a rare clinical variant of amyotrophic lateral sclerosis where distal muscles are involved more compared to proximal muscles and vice-versa occurs only in 10% cases and so it is differentiated from O'Sullivan McLeod syndrome which involves only small muscles of single limb. Here, we present a case of Hirayama's disease where disease achieved a plateau after 3 years with no further progression. His electrophysiological studies, and clinical picture, and magnetic resonance imaging findings were consistent with a diagnosis of Hirayama's disease.

A study of the prevalence of serum vitamin B12 and folic Acid deficiency in Western maharashtra.

Context: This study summarizes the prevalence of vitamin B12 and folic acid deficiency in the population coming to tertiary care center in Western Maharashtra along with the main presenting symptom routinely misinterpreted in daily practice.

Aims And Objectives: 1. To study the prevalence of vitamin B12 and folic acid deficiency in the population of western Maharashtra.

Ischaemic Stroke Following Percutaneous Transluminal Coronary Angioplasty (PTCA): A Rare Complication.

Stroke following coronary interventions is a devastating and most dreaded complication with significant morbidity and mortality. Various factors have been ascribed for this complication including the technical errors. We hereby describe such a patient who presented to us with the diagnosis of acute coronary syndrome and underwent percutaneous coronary intervention (PCI) but unfortunately developed left sided hemiparesis due to ischaemic stroke (right middle cerebral artery).

Reactive thrombocytosis leading to acute myocardial infarction.

Thrombocytosis is defined as platelet count of > 600000. An elevated platelet count may be primarily (essential) or secondary (reactive). Acute myocardial infarction and other vaso-occlusive phenomenon are seen in less than 5% of the patients of reactive thrombocytosis.

A study of the clinical profile of right ventricular infarction in context to inferior wall myocardial infarction in a tertiary care centre.

Introduction: Right ventricular infarction, previously thought to be rare and recently thought to be common, is commonly associated with inferior wall myocardial infarction. We will hereby study the clinical profile of right ventricular infarction (as diagnosed by right precordial electrocardiography) in patients with acute inferior wall myocardial infarction and the clinical course of RV infarction in inferior wall myocardial infarction in terms of complications.

Aims And Objectives: 1.

Delayed cerebellar ataxia: A rare self limiting complication of plasmodium falciparum malaria.

The classic presentation of malaria with paroxysms of fever is seen only in 50-70% of the patients. The development of immunity, the increasing resistance to anti-malarial drugs, and the indiscriminate use of anti-malarial drugs have led to malaria with the presentation of unusual features. Cerebellar ataxia, extrapyramidal rigidity and various psychiatric symptoms have been described either as early manifestations of cerebral malaria or as a part of post malaria neurological syndrome.

Lutembacher's syndrome.

The definition of Lutembacher's syndrome has undergone many changes. It refers to combination of congenital Atrial Septal Defect with acquired mitral stenosis. Lutembacher's syndrome is a very rare disease and in the past, it has been either overdiagnosed or misdiagnosed.

Cardiorenal syndrome: Resistant to diuretics, sensitive to ultraflitration.

Cardiac and renal diseases are becoming increasingly common today, and are seen to frequently coexist, thus causing a significant increase in the mortality rate, morbidity, complexity of treatment and cost of care. Syndromes describing the interaction between heart and kidney have been defined and classified; however, never as a result of a consensus process. Though the incidence of cardiorenal syndrome is increasing, the associated pathophysiology and effective management are still not well understood.