a b s t r a c tPatellar tuberculosis is a rare occurrence despite the knee being the third most common osteoarticular site to be involved. This is the reason for its late diagnosis and the potential to spread posteriorly to the knee. We present an atypical case of patellar tuberculosis in an 8-year-old boy presenting with discharging sinus and diagnosed by biopsy.
Background and objectives- Hepatitis C virus (HCV) infection is a major cause of chronic liver disease
worldwide, with majority of the patients being asymptomatic and when they present to clinicians, they
have already advanced liver disease in form of cirrhosis or hepatocellular carcinoma. Data from developing countries on this
evolving global health problem are sparse. Hence this study was planned with the aim to determine the HCV genotypes
prevalant in patients attending a tertiary care hospital with their clinical prole.
Materials and Methods- Detailed history taking and clinical examination were done of consecutive 30 patients who attended
out-patient department or admitted at in- patient department of Tropical Medicine with chronic hepatitis C. Laboratory
investigations like LFT, viral serology (HBsAg, AntiHCV, HIV), prothrombin time, ultrasonography of upper abdomen, HCV- RNA
Quantative assay with genotyping were done. Data were collected and then analysed using standard statistical methods.
Result- Of proposed 30 sample size, complete data could be collected of 28 patients and accordingly, analysis was done. Of the
28 HCV seroreactive individuals, majority (20) were males. The mode of transmission was unknown in 19 patients, blood
transfusion in 5 patients who were thalassemic and hemodialysis in remaining 4 patients. Most of the patients (18/28) were
asymptomatic even if their viral load was high. Most common presenting symptom was dyspepsia. LFT showed signicant
transaminitis in 50% of the patients. Of the 28 seroreactive patients, 15 (53.57%) were HCV RNA positive based on RT-PCR. HCV
rNA was below detectable level in 13 patients. HCV genotype 3 was the predominant genotype found in 11 individuals followed
by genotype 1 found in 3 and genotype 2 was seen in one individual.
Conclusion- Community screening specially among high risk individuals is needed for early diagnosis and prompt treatment
of chronic hepatitis C to prevent its several complications and also to prevent community spread.
Chorea hyperglycemia basal ganglia syndrome is a rare condition that manifests in setting of uncontrolled nonketotic diabetes mellitus. The objective of this case report is to highlight the importance of a physician to be aware of hyperglycemia as a cause of hemichorea/ hemiballismus which is referred to in medical literature as chorea-hyperglycemia-basal ganglia syndrome. 1 This case involves a 60 years old Hypertensive and poorly controlled diabetic female who presented with choreiform movements of right upper and lower limbs for last one month. Her initial glucose level was 352 mg/dl. CT scan of her brain showed no obvious abnormality except for hyper density left basal ganglia region. MRI brain (Plain+Contrast) revealed hyperintense lesion in left basal ganglia region; Left putaminal region showing signal changes likely metabolic in nature. With gradual control of her hyperglycemia, the movement disorder resolved. With exclusion of other causes of the movement disorder and resolution of her symptoms with control of blood sugar can lead to the inference that it was due to her uncontrolled diabetic status.
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