Extramedullary hematopoiesis is a compensatory response in patients with thalassemia and other chronic anemia and can result in compressive myelopathy, if untreated. Two young adults with history of thalassemia presented with symptoms of spinal cord compression. Presence of extramedullary hematopoiesis was confirmed by magnetic resonance imaging. Both the patients were treated with blood hypertransfusion and showed improvement clinically and radiologically. Although there are various options in the management of such condition, including decompression surgery and radiation treatment, hypertransfusion can be very effective even in severe compression of the spinal cord. Hypertransfusion should be tried as the first line of management in patients with thalassemia presenting with compressive myelopathy to decrease the bulk of extramedullary hematopoietic tissue.
Crigler-Najjar syndrome (CNS) has been rarely described during pregnancy with only few case reports available in literature, CNS is expressed in two forms, CNS type I and CNS type II; Type I CNS results in severe unconjugated hyperbilirubinemia and neurological impairment in newborn and is fatal. Type II CNS results in milder unconjugated hyperbilirubinemia responding to Phenobarbital treatment with better outcome.
A 50-year-old female came with a history of chronic lower back pain radiating to right leg for which she received an epidural steroid injection. Two hours later, she was found to in a delirious state with bilateral ptosis. Magnetic resonance imaging of the brain was suggestive of ventricular pneumocephalus in frontal and temporal horns of right lateral ventricles. She was managed conservatively with oxygen inhalation. Patient’s sensorium improved after 72 h.
Perphenazine in doses of 10--50 mg kg-1 day-1 given at the early stages of pregnancy delayed nidation up to day 8 of pregnancy. Once nidation had occurred the length of the rest of the gestation period was normal. Doses of up to 20 mg perphenazine kg-1 day-1, injected on days 1--7, prolonged gestation but the mothers and young were apparently normal; lower doses were effective only when treatment commenced soon after copulation. The delay in implantation of the ovum caused by perphenazine was corrected and and implantation was brought about immediately, by injection of 0.1 microgram oestradiol together with perphenazine. It is suggested that perphenazine delays and prevents implantation in rats by counteracting oestrogen release from the ovaries.
Ischemic monogenic neuropathy (IMN) reported mostly in diabetics with peripheral neuropathy or peripheral vascular disease is a rare condition .Usually seen after AV fistula for haemodialysis, it is a preventable entity. We describe a rare case of ischemic monomelic neuropathy (IMN) in a young girl with involvement of all three nerves developing after preventive tourniquet application in a presumed snake bite.
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