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Esophageal melanosis is the proliferation of melanocytes in the squamous epithelium of the esophagus and the accumulation of melanin in the walls of the esophagus. Normal esophageal mucosa does not contain melanocytes. It is a rare disease of the digestive system, and its significance has yet to be fully understood.Various studies have attributed it to gastroesophageal reflux disease, but hard evidence supporting such a claim is lacking. Some studies also point towards it being a pre-malignant condition, and further evaluation is warranted for earlier detection and treatment. We hereby present a case of chronic iron deficiency anemia incidentally found to have esophageal melanosis, confirmed with histopathological examination.

Cysticercosis is a major public health problem, particularly in developing countries. It is caused by the larvae of the cestode Taenia solium (pork tapeworm). It usually presents as a solitary lesion in the muscle or brain (neurocysticercosis). Disseminated cysticercosis is an uncommon manifestation, especially in an immunocompetent individual. We hereby report the case of a 31-year-old male who presented with new-onset generalized tonic–clonic seizures and who also had multiple soft-tissue swellings all over his body. Imaging studies revealed multiple cysticerci in the brain parenchyma, extraocular muscles, and muscles of all the four limbs, which was subsequently established by histopathology also. The patient was started on anticonvulsants, steroids, and albendazole following which he made a complete recovery.

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IntroductionDiabetic cheiroarthropathy (DCA), also known as the syndrome of limited joint mobility (LJM), is among the most underdiagnosed complications of diabetes mellitus (DM). Although not severe, it can hamper the dayto-day activities of the patient and significantly reduce the quality of life. It is hypothesized to be due to increased glycation of collagen around joints. The objective of our study was to examine the association of diabetic cheiroarthropathy with microvascular complications of type 2 diabetes mellitus. MethodsThe study was conducted on 251 previously diagnosed cases of type 2 DM. Patients with previous contractures due to any other cause, who are diagnosed cases of rheumatoid arthritis and scleroderma, and other risk factors such as cardiac or renal disease were excluded from the study. All subjects were subjected to a detailed clinical history including a past history, thorough physical examination, prayer test, tabletop sign, and passive extension of fingers. Patients who are diagnosed with diabetic cheiroarthropathy were then screened for microalbuminuria, fundus examination, and monofilament test and clinical examination to look for the presence of microvascular complications. ResultsOut of the 251 patients, 46 (18.3%) were found to have diabetic cheiroarthropathy. Fifteen (34.9%) cheiroarthropathy patients had neuropathy compared to 14.9% without diabetic cheiroarthropathy, which was statistically significant. We found that there was an increased incidence of diabetic neuropathy in subjects with cheiroarthropathy. Thirty (35.7%) patients with diabetic cheiroarthropathy had diabetic retinopathy compared to 9.6% without diabetic cheiroarthropathy. Twenty-six (26.8%) patients with diabetic cheiroarthropathy had diabetic nephropathy compared to 13% without diabetic cheiroarthropathy. We identified from our study that patients with diabetic cheiroarthropathy had an increased risk of developing microvascular complications. ConclusionThere is an increased prevalence of diabetic nephropathy, diabetic neuropathy, and diabetic retinopathy in patients with diabetic cheiroarthropathy. The presence of diabetic cheiroarthropathy hence warrants better control of the patient's glycemic status to prevent further deterioration of diabetes-related complications.

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Snakebite is a neglected tropical disease, which is very common in the Indian subcontinent. The severity of respiratory muscle paralysis and the delay in recovery depend upon the dose of the venom injected, the severity of the venom, the species of the snake, the duration of presentation to the hospital, and the time and dose of administration of anti-snake venom (ASV). The reasons for this delayed neuromuscular recovery still remain an enigma. We highlight such a case of a young adult who had delayed neuromuscular recovery and prolonged ventilatory support following a neurotoxic snakebite.