Rhabdomyosarcoma (RMS) is a common soft tissue tumor in adults, but RMS's causes and risk factors are unknown. We present a case of a 62-year-old man with RMS who presented with feelings of fullness after meals and vomiting for the previous five months with anorexia and weight loss for four months. He reported feeling a rolling mass in his belly that moves from left to right. He was initially diagnosed with gastric outlet obstruction due to stomach carcinoma. During the surgical operation, we noted the gross appearance was unlike typical adenocarcinoma or lymphoma of the stomach. Histopathological evaluation of the specimen confirmed a diagnosis of primary epithelial RMS of the stomach. When treating RMS, expertise in immunohistochemistry, molecular biology, genetics, or ultrastructure may be necessary. Information on the appropriate laboratory investigations and management protocol is limited, but an early diagnosis can change the course of treatment and improve patient outcomes.
Myasthenia gravis (MG) is an autoimmune illness that causes neuromuscular junctions to be damaged by anti-acetylcholine receptor antibodies. It is a very rare condition that is more common among women. Fatigable fluctuating diplopia or ptosis is the characteristic early appearance of this condition. Dysphagia or dysphonia may be present in rare cases. This illness can affect any group of skeletal muscles, including those in the neck and upper limbs. It can also affect the muscles that help you breathe, which can lead to breathing failure.We present a case of a 20-year-old female diagnosed with mixed connective tissue disease presenting with acute respiratory failure as the initial presentation of MG. Clinicians have to have a high index of suspicion for myasthenia when patients arrive with fatigable muscle weakness. This will cut down on the amount of money spent on investigations and the risk of morbidity.
Introduction: Plantar fasciitis is an inflammatory painful condition, one of the most common causes of heel pain. The cause of it is multifactorial; and different treatment modalities are available. Aims:To compare the effectiveness between the stretching exercise and corticosteroid injection. Methods:This study was conducted at Nepalgunj medical college, in the department of orthopedics from September 2019 to September 2020. Patients were equally divided into two groups. In Group A corticosteroid injection was given and in group B stretching exercise was advised. Patients were followed up at two weeks, 8weeks and 16weeks; pretreatment and post-treatment pain level was assessed by Visual Analog Scale (VAS) and Functional outcome was assessed by Foot and Ankle Ability Measure (FAAM) Scale. Results: Both groups were comparable in relation to age and sex. There was significant decrease in pain and improvement of function in steroid group at two weeks and eight weeks follow up; whereas at 16weeks follow up plantar fascia stretching groups improved significantly. Conclusion: For short term relief local corticosteroid injection is superior; but for long term relief in pain and improvement in function plantar fascia stretching exercise is better treatment option.
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