DesCripTionAn 83-year-old man presented with an acute history of weight loss and jaundice. He had a history of type 2 diabetes mellitus and hypertension. He consumed 30 units of alcohol per week.The patient was cachectic and jaundiced with non-tender hepatomegaly and no evidence of chronic liver disease. There was evidence of hypoalbuminaemia (albumin 25 g/L, reference 34-51 g/L), hyperbilirubinaemia (bilirubin 188 μmol/L, reference <22 μmol/L) and a raised alkaline phosphatase (629 IU/L, reference 35-105 IU/L). Full blood count, coagulation tests and the remaining liver function tests were normal. An estimated Glomerular filtration rate (eGFR) was 71 mL/ min/1.73 m 2 . Autoantibodies and immunoglobulins were normal. Hepatitis viral serology was negative. Serum light chain measurements revealed kappa chain concentration of 13.3 (reference 3.3-19.4 mg/L) and lambda chain concentration of 28.5 (reference 5.7-26.6 mg/L) with a ratio of 0.47 (reference 0.26-1.75). A CT abdomen revealed hepatomegaly and ascites.
Carcinomas of primary accessory breast tissue are rare, comprising 0.3–0.6% of all breast cancers and occur most commonly in the axilla. We report the unusual case of a 50-year-old lady with mucinous adenocarcinoma of axillary accessory breast tissue. In this report we review the presentation, key investigations and treatment of this condition.
Schizophrenia in older adrrlts is becoming a rising topic in the realm of mental illnesses. Lure onset schizophrenia has been noted to huve distinct clinicul characteristics. This .sti~dy was hence undertaken to study the differences irt tlze clinical preserztation of wonzen having early and late onset .schizophrenia. The data w~l s collected retrospectively from the medical records department of 60 patients ,30 in each group and was then arzalysed. No significant dijferences were seen on the sociodernographic profile of both the groups.30% of patients had a presence of prec.ipittrting jilctor urtd nround 13-30% had a furnily history of nzental illrtess irz both the ,yroup.s. Posltive svmptonzs included delusiorls of' persecution, auditory hallucinations and agitated/aggressive behaviour. Formal tho~rght disorder was more in the early onset group. Negutive syn~ytonzutology included apathy avolitiort, poor rapport and affective flutterzing rnore in tlze late orlset than the early ortset groups.
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