Sunil Kumar

Dermatomyositis, an idiopathic inflammatory myopathy, is one of the rare causes of limbs paresis. The characteristic feature is skin involvement which differentiates this from other inflammatory myopathy. Here we report a case of severe dermatomyositis as his Creatine Phosphokinase (CPK) level was 32,000 who presented with weakness in all four limbs without any dermatological signs. Keywords: Dermatomyositis, Creatinine kinase, Quadriparesis, Elderly.

Gangrene is ischemic necrosis of limbs or its parts, without involvement of proximal arterial obstruction or vasculitis, often associated with disseminated intravascular coagulation and septic shock. This rare clinical syndrome are usually caused by infectious or non infectious causes, among them tuberculosis as a cause is rarely associated. We here report a case of 68 year old lady, who initially was diagnosed as tubercular meningitis and later developed peripheral gangrene in all four limbs. Keywords: Tubercular meningitis, Gangrene, Limbs, Elderly.

Imatinib mesylate is a cytotoxic agent that is used in chronic myeloid leukaemia. Common reported side effect is hypopigmentation; here we report a 48 year old female who developed hyperpigmentation as melasma on her face while taking imatinib mesylate in a dose of 400 mg daily for chronic myeloid leukaemia. Keywords: Drug-induced pigmentation, Imatinib-mesylate, Melasma, Chronic myeloid leukemia.

Paroxysmal dyskinesia (PD) as a first manifestation of hyperthyroidism is an extremely rare entity. We here report a case pf 65-year-old female presented with the features of PD, whose investigations revealed hyperthyroidism. Her dyskinesia responded with the anti-thyroid drug carbimazole. Keywords: Dyskinesia, Hyperthyroidism, Elderly, Carbimazole.

Multiple myeloma is a malignant proliferation of plasma cells, predominantly involving the bone marrow and skeletal system. Pleural effusions due to multiple myeloma are rare and it is very unusual for patients were diagnosed as myeloma with only clinical presentation of pleural effusion. We report a sixty three year old male who presented with a right-sided pleural effusion. Keywords: Pleural effusion, Multiple myeloma, Elderly, Plasma cells.