Sub Clinical Disease Presenting with Serious Clinical Manifestations - Blame Thyroid.

Graves' disease is responsible for 60 to 80% cases of thyrotoxicosis and characteristically presents between the ages of 20 and 50 years.Both environmental and genetic factors lead to the development of Grave’s Disease.(1) Hyperthyroidism seen in grave’s disease is caused by thyroid-stimulating immunoglobulins (TSI) that are synthesized in the thyroid gland, bone marrow and lymph nodes, and detected by direct bioassays or TSH-binding inhibiting immunoglobulin (TBII) assays. Thyroid peroxidase (TPO) antibodies are found in about 80% of cases suggestive of Grave’s Disease.(1) Grave Disease is known to have multiple serious complications like Hypokalemia, Thrombocytopenia, heart rhythm abnormalities, brittle bone and thyroid storm(1,2). Hypokalemia in Grave’s Disease is a rare life-threatening complication seen, mostly in young males, often presents acute onset paraparesis. Paralytic symptoms usually occur after heavy exercise or carbohydrates rich meal.(3)This case report highlights about a young man who presented with quadriparesis, later on investigation diagnosed as hypokalemia due to subclinical grave’s disease.Clinically silent Grave’s Disease presenting with neurological quadriparesis is diagnostic challenge. Neurological paresis rapidly resolves with correction of hypokalemia. This report discusses the case of young man who presented with acute onset quadriparesis without any clue, came out as hypokalemic due to subclinical grave’s disease.

Role of multi-detector CT in staging of Colorectal carcinoma – A correlative study.

Aim: To study the CT characteristics of wall thickening in case of benign and malignant lesions of the colon and rectum, to evaluate the role of MDCT in pre-operative tumour stanging of colorectal malignancies and to evaluate the effectiveness of MDCT in differentiating benign and malignant colorectal lesions. Material and methods: It was correlative study done on patients with wall thickening involving the colon and rectum on CT were included. CT was performed using 16 slice SIEMENS SOMATRON Emotion CT scanner. CT findings were finally correlated with histopathology. Results: Patients with complaints of loose stools, vomiting, weight loss, constipation, bleeding PR, abdominal pain were evaluated by CT scan and which showed findings that were highly suggestive findings of malignancy like bowel wall thickening, presence of lymph nodes, peri-colic fat standing, infiltration of adjacent viscera and presence of metastases. Conclusion: MDCT is an excellent modality in the diagnosis and differentiation of benign and malignant lesions of the colon and rectum. MDCT is also useful in the staging of maligant lesions of the colon and rectum. MDCT is also useful in the staging of malignant lesions which helps in proper planning of surgery and further management of the patient.