Chronic epididymo-orchitis and scrotal ulcers.

Extrapulmonary tuberculosis (TB) still presents a diagnostic and therapeutic challenge. Genitourinary TB constitutes about 20% of the extrapulmonary cases in regions where TB is endemic. Tuberculous infection of epididymis and testis is difficult to differentiate clinically from pyogenic infection, tumour or infarction.

Arnold-Chiari malformation type 1 complicated by sudden onset anterior spinal artery thrombosis, tetraparesis and respiratory arrest.

Chiari in 1891 described a constellation of anomalies at the base of the brain inherited congenitally, the characteristic of which are (1) extension of a tongue of cerebellar tissue posterior to the medulla and cord that extends into the cervical spinal canal; (2) caudal displacement of the medulla and the inferior part of the fourth ventricle into the cervical canal; and (3) a frequent but not invariable association with syringomyelia or a spinal developmental abnormality. Chiari recognized four types of abnormalities. Presently, the term has come to be restricted to Chiari's types I and II, that is, to cerebellomedullary descent without and with a meningomyelocele, respectively.

Scoping a perforated bleeding peptic ulcer: learning points.

Peptic ulcer perforation and haemorrhage is not unusual as a complication of peptic ulcer disease. In the older patientspresentation can be dramatic and atypical. The authors are presenting a case of duodenal ulcer perforation and haemorrhage which was misdiagnosed as a gastric malignancy and thus failure to have Helicobacter pylori eradication, recurrence with complication and hesitancy in surgical intervention due to initial label of malignancy.

Fluoxetine-induced pill oesophagitis.

Pill-induced oesophagitis is well reported in people of all ages (range 3-98 years), with females outnumbering males by 1.5:1. Antibiotic pills, cardiac pills and non-steroidal anti-inflammatory drugs and alendronate are the most common culprits.

Practice of symptomatic treatment in the era of evidence-based medicine: report of 2 cases of diagnosis of Sheehan's syndrome delayed till eighth decade.

Sheehan's syndrome, first described in 1937, is characterised by postpartum haemorrhage, pituitary necrosis, lactational failure and hypopitutarism. Presentation is variable and late presentations are not unusual due to partial ischaemic injury of the pituitary and gradual loss of endocrine function. A history of postpartum haemorrhage is usual but in some cases it is not elicited.