Sheehan's syndrome presenting as psychosis: a rare clinical presentation

Sheehan's syndrome [SS] refers to the occurrence of varying degree of hypopituitarism after parturition [1]. It is a rare cause of hypopituitarism in developed countries owing to advances in obstetric care and its frequency is decreasing worldwide. However, it is still frequent in underdeveloped and developing countries. Sheehan's syndrome is often diagnosed late as it evolves slowly [2, 3]. Reports of psychoses in patients with Sheehan's syndrome are rare. Herein, a case report of psychosis in a 31 year old woman who developed Sheehan's syndrome preceded by postpartum haemorrhage is presented. Treatment with thyroxine and glucocorticoids resulted in complete remission after attaining euthyroid and eucortisolemic state

Big toe metastases as first clinical sign of occult bronchogenic carcinoma

Metastasis to bone is a common manifestation of malignant tumours. However, metastasis to the bones of the foot is exceedingly rare. It usually arise from genitourinary tract and colon, with the tarsal bones accounting for half of all metastases. We report a rare case of pain and destruction of the distal phalanx of great toe, initially suspected as osteomyelitis, which on biopsy proved to be metastases from a clinically silent bronchogenic carcinoma