Hypokalemic quadriparesis in Sjogren syndrome.

We report a 58-year-old woman who presented with acute quadriparesis, bulbar weakness, atrial fibrillation, ventricular ectopics, and distal renal tubular acidosis with severe hypokalemia. She recovered completely on potassium and alkali supplementation. The patient also had hypergammaglobulinemia with probable primary Sjogren syndrome.

Prospective randomized controlled study using polyethylene mesh for inguinal hernia meshplasty as a safe and cost-effective alternative to polypropylene mesh.

Most patients who come to a general hospital in a developing country are poor. The most important prohibiting factor for use of polypropylene mesh in hernia repair is its exorbitant cost. Hence, research workers have been on the lookout for an equally effective but economically affordable mesh.

Sodium artesunate-induced diuresis in a patient with malaria.

Sodium artesunate is used in the treatment of malaria. We report a case of sodium artesunate induced diuresis and natriuresis in a patient with malaria. Following artesunate administration there was polyuria accompanied by natriuresis that was reversed after discontinuation of artesunate treatment.

Acute hepatic failure due to yellow phosphorus ingestion.

We report a case of three year old girl, who was brought to hospital for accidental consumption of rat-poison (3% phosphorus). The patient was asymptomatic for first 48 hours. Later on she developed the symptoms of hepatic failure.

Acute glomerulonephritis: an unusual manifestation of Plasmodium vivax malaria.

Long considered a benign infection, Plasmodium vivax is now increasingly recognised as a cause of severe and fatal malaria. Various atypical presentations of vivax malaria have been reported. This report highlights the occurrence of acute glomerulonephritis in a 7-year-old girl who presented with fever and vomiting.

Paradoxical response to anti-tubercular treatment.

We report a 5-year-old boy who developed optic neuritis as a paradoxical reaction to anti-tuberculous therapy. Steroids were re-started in the patient with gradual recovery of his vision. The case emphasizes the importance of recognizing paradoxical reactions in patients on anti-tuberculous therapy.

Experience with patients with anti-MUSK antibody positive myasthenia gravis.

The association of muscle tyrosine kinase (Musk) antibody with recurrent bulbar weakness in acetylcholine receptor antibody (Ach-R Ab) negative myasthenia gravis (MG) has been well documented. We describe 2 patients, a middle aged man and a 9-year-old girl, both seronegative for Ach R antibody who had recurrent bulbar weakness and MUSK antibody positivity. Patients made a full recovery from the acute episode with intravenous immunoglobulin (IV Ig) therapy.

Monocular blindness during therapy for cerebral neurocysticercosis.

Neurocysticercosis is endemic in India, cerebral and ocular manifestations being common. A 32 yr old man on treatment with Albendazole for cerebral neurocysticercosis for 10 days presented with 3 days of painful uniocular blindness. He had only light perception in the left eye, left pupil was non-reactive to light and left disc was edematous.

Acute acalculous cholecystitis causing gall bladder perforation in children.

We report two cases of children who presented with acute abdomen due to gall bladder perforation and biliary peritonitis. Cholecystectomy with peritoneal lavage proved curative.

Modified technique of percutaneous cystolithotripsy using a new instrument--combined single-step trocar-dilator with self-retaining adjustable access sheath.

Objectives: To evaluate a new instrument and technique for access that overcomes the difficulties with percutaneous cystolithotripsy (PCCL). PCCL is a safe and established minimally invasive surgical option for large vesical calculi. It is commonly performed using a guidewire, serial dilation, and an Amplatz sheath.

Gitelman's syndrome presenting as recurrent paralytic ileus due to chronic renal tubular K+ wasting.

Gitelman' syndrome, although a relatively frequent cause of chronic hypokalemia in adults, is rarely diagnosed correctly. It is frequently confused with overt diuretic abuse or Bartter's syndrome. We describe a 60 year man with 2 year history of recurrent paralytic ileus attributed to recurrent hypokalemia.