Biliary Dyskinesia in Stiff Person Syndrome: An Association Between Reduced GABA Production and Gastroenteric Dysmotility.

Stiff person syndrome (SPS) and biliary dyskinesia are two rare but potentially debilitating conditions that can significantly impact quality of life. SPS is a rare neurological disorder characterized by muscle stiffness, rigidity, and muscle spasms that primarily affect the trunk and limbs and is associated with extra-axial manifestations involving the gastrointestinal tract. Biliary dyskinesia is a gastrointestinal disorder characterized by abnormal gallbladder emptying, leading to symptoms of intense abdominal pain, nausea, and vomiting. Despite their distinct clinical presentations, studies have suggested a possible connection between the two disorders. This link may be due to involvement of similar neurotransmitters and autoantibodies in both conditions. In this report, we present a case of biliary dyskinesia in a 58-year-old male with prior history of chronic gastrointestinal symptoms, autoimmune disease, and SPS. Given the rarity of these conditions, there is a need for increased awareness and improved diagnostic modalities to facilitate early detection and management.

Recurrent Psychosis in Non-celiac Gluten Sensitivity.

Neuropsychological manifestations following food exposures in patients with food sensitivities are increasingly being identified in the literature, as understanding of the gut-brain axis is further improved. Non-celiac gluten sensitivity (NCGS) has been shown to occur in individuals without serological or biopsied evidence of celiac disease (CD), who manifest psychotic ormood disorders that resolve following elimination of gluten. In this case history, we discuss a similar manifestation in a 31-year-old woman without serological evidence of CD, whose psychiatric symptoms improve with gluten elimination.

Myositis interstitial lung disease and autoantibodies.

The aim of this review is to examine and evaluate published literature associated with idiopathic inflammatory myopathies (IIM) and interstitial lung disease (ILD) based on myositis specific autoantibodies (MSA) and the potential clinical significance of each autoantibody subtype for the practicing clinician. The review is a comprehensive search of literature published in PubMed from the year 2005 and onward coinciding with the surge in the discovery of new MSAs. Additionally, we comment on recommended multidisciplinary longitudinal care practices for patients with IIM-ILD with regard to imaging and other testing. Treatment is not covered in this review.

Adult Ileoileal Intussusception Caused by Diffuse Large B-cell Lymphoma⋆.

Adult intussusception is a rare diagnosis that can be caused by non-Hodgkin's diffuse large B-cell lymphoma (DLBCL). In this case report, we discuss a middle-aged man who presented with non-specific symptoms of intussusception and absence of classic B symptoms. He was found to have intussusception secondary to stage IIIE, CD20 positive DLBCL. The patient underwent small bowel resection with anastomosis, followed by 6 cycles of R-CHOP, which resulted in complete remission of his neoplasm. In reporting this case, we hope to further highlight the role of malignancy in intussusception and guidance on appropriate therapy.

Effect Of L-Arginine And Insulin On Adrenal Gland Damaged By Streptozotocin In Albino Rats.

BACKGROUND: The adrenal gland is one of the major endocrine glands involved not only in different physiological functions, but also in response to stress This study was done to asses the effects of L-arginine and insulin on streptozotocin (STZ) induced adrenal gland damage in albino rats. METHODS: This laboratory based experimental study on animals was undertaken in the Anatomy department of Basic Medical Sciences Institute (BMSI), Jinnah postgraduate Medical Center (JPMC), Karachi, from February to March 2018. Forty adult, healthy male albino rats were placed into 4 groups (10 each). Group A was taken as control. Group B was given STZ. Group C and D were given STZ as in group B with insulin and L-arginine respectively. Absolute and relative weight of adrenal glands was measured at the end of the study. Tissues from adrenal glands were processed and stained with Haematoxylin and Eosin for the morphometric study. RESULTS: The absolute as well as relative adrenal weight of animals was significantly raised in group B in comparison to control, although showed a significant recovery in group C and D animals when insulin and L-arginine were added to STZ. Haematoxylin and Eosin (H&E) stained sections of adrenal cortex of STZ treated Group B showed reduced width of zona glomerulosa, with increased width of zona fasciculata and zona reticularis when compared to control. The width of these zones of adrenal cortex recovered to a significant extent when group C and D tissue sections were compared with STZ- treated group B tissue sections. CONCLUSIONS: This study highlighted the protective effect of L-arginine on adrenal gland weight and histology in streptozotocin induced adrenal gland damage, which was comparable to insulin.

Melatonin Prevents Apoptosis In Brains Of Neonates Induced By Maternal Hypothyroidism.

BACKGROUND: Loss of motor neurons may underlie some of the deficits in cognitive functions associated with maternal hypothyroidism during fetal and neonatal period. This experiment was performed to highlight the significance of melatonin intake by the mother in hypothyroid state during gestation and lactation to preserve the integrity of motor neurons in the newborns. METHODS: Twelve female Wistar rats were divided equally into four groups, including control (A), hypothyroid (B), melatonin treated hypothyroid (C) and only melatonin treated (D) groups and allowed to conceive. For inducing hypothyroidism, Propylthiouracyl (PTU) was administered in a dose of 15mg/kg/day orally mixed with chow a week before mating and throughout the period of gestation and weaning up till 22nd day after delivery. Melatonin was given in a dose of 10mg/kg/100ml of drinking water. After delivery, 10 neonatal rats from each group were sacrificed on 22nd day of life and blood samples were immediately collected for evaluating serum levels of T3, T4 and TSH. The freshly extracted brains were sliced into two equal parts from the midline. One half was instantly immersed in ice cold phosphate buffered saline and homogenized for extraction of RNA to determine the genetic expressions of caspases 3, 8 and 9. Other half of the brain was instantly immersed in 10% formalin for 2 weeks. After processing of the brain tissue, 5 µm thick sections were sliced and transferred to albumin coated glass slides. They were later stained by Nissl staining technique, visualized and photographed under a research microscope for signs of apoptosis. The mRNA and protein levels of caspase-3, 8, and 9 were analyzed using a real-time RT-PCR. RESULTS: Serum enzyme analysis showed that the pups of dams taking PTU were severely hypothyroid and melatonin treated rats showed significant restoration of serum thyroid hormone levels. Features of apoptosis and disturbed migration of cells was seen in B group as compared to C group and mRNA levels of caspase-3 and 9 were increased significantly in B group. CONCLUSIONS: Melatonin helps to maintain neuronal function in hypothyroid newborn rats by inhibiting apoptosis and improving survival.