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We present the case of a patient with a history of asthma who developed cough and hemoptysis that were unresponsive to antituberculous therapy. Chest roentgenography demonstrated right-sided collapse with consolidation and a pleural effusion. Bronchial biopsy revealed fungal hyphae, and cultures later yielded Bipolaris spicifera. In addition, weight loss and intractable hypotension in association with hyponatremia and elevated potassium levels suggested addisonian crisis, which was confirmed by measurement of serum ACTH and cortisol levels. Computed tomography of the abdomen revealed bilateral adrenal involvement. Tissue obtained on biopsy of the adrenal glands yielded B. spicifera. The patient responded to treatment with 2 g of iv amphotericin B; the adrenal masses and pneumonia resolved, and he remained well until last seen in July 1992. However, he requires replacement therapy with prednisone and fludrocortisone. On review of the available literature, we were unable to find a previously reported case.

Objective: To compare the effectiveness of neural mobilization and ultrasound therapy on pain severity in carpal tunnel syndrome (CTS). Methods: This randomized controlled trial was conducted on 48 CTS patients at the Physiotherapy Department IPM&R, DUHS between 23rd January 2017 and 22nd July 2017. The CTS patients were randomly allocated into 2 equal groups by simple randomization method. Group 1 received neural mobilisation; Group 2 received ultrasound therapy with a predetermined intensity. A total of 12 sessions were given over a period of 4 weeks. Pre and post intervention data were collected from both groups on Visual Analogue Scale (VAS) to measure pain. SPSS version 20 was used for data analysis. Comparisons between post test results of both groups were done by using paired sample t-test with a p-value < 0.05 considered as significant. Results: It was found that the 79% (19 cases) and 21% (5 cases) in Group 1 (Neural Mobilization), who prior to the treatment had faced moderate and severe pain, respectively, all experienced successful treatment. Indeed, after treatment 100% (24) of the cases only experienced mild pain, indicating successful treatment. For Group 2 (Ultrasound Therapy), 54% (13) and 46% (11) of cases were with moderate and severe pain before treatment; after administering the treatment 20% (5 cases) had mild pain and 80% (19 cases) had moderate pain. Conclusion: Neural mobilization for median nerve is more beneficial than ultrasound therapy in reducing pain intensity and functional limitations due to CTS.

There is a lack of awareness among the people of the community regarding diet during pregnancy. Diet is not only important for pregnant women but is equally important for female of pubertal age, as insufficient nutrients during this time may cause serious consequences in later life. At the community level it is important to make awareness for people about a balanced diet, it's important during reproductive age and for a pregnant woman. At the institutional level it is important to make healthcare accessible for the clients and make daily checkups possible, affordable and accessible for the pregnant women and also for the client who are in their reproductive age. In a nutshell, diet is an essential component to look after especially for women in her reproductive health and for pregnant women. Development of a proper diet plan for the mother, awareness programs on importance of diet and making healthcare accessible for the clients are some of the necessary steps needed for dealing with this problem.

Background: The exact management strategy for lower genitourinary tract trauma remains controversial. Primary realignment with/without suprapubic catheterization provides definitive procedure with low complications and avoids the need for further open surgeries.Methods: This was a prospective longitudinal study done on 31 cases with different complaints related to lower tract genitourinary trauma. All patients underwent suprapubic catheterization and/or primary realignment. The outcome was measured in the terms of time for discharge, urinary incontinence, stricture formation, erectile dysfunction and impotence.Results: Maximum proportion of patients with lower genitourinary injuries in the study was in 10-20 years age group (48.4%). Blunt trauma was accounted for 93.6% of lower genitourinary injuries. Road traffic accidents were the most common cause (90.32%) of lower genitourinary injuries. Urinary bladder injuries accounted for 41.9% of all lower genitourinary injuries. Blood at meatus is present in only about half of the significant urethral injuries. Primary realignment of urethral injury results in lesser duration of hospital stay (9.24±2.44 days), shorter length of suprapubic catheterization (11.67±4.78 days) and early spontaneous voiding (40.93±15.79 days). The stricture rate following primary realignment is low (31.25%). Erectile dysfunction was noted only in two patients (16.6%).Conclusions: Management of traumatic urethral disruption by primary realignment serves as ultimate therapy in majority of patients.