ABSTRACT
Hashimoto's encephalopathy (HE) is a rare diagnosis with a heterogenous presentation. It may not be directly related to thyroid dysfunction as most patients are euthyroid when the symptoms start. There has been a lack of consensus building on the pathophysiology of HE, but most of the evidence points towards autoimmune vasculitis as the underlying process. HE can present as seizures, cognitive dysfunction, tremors, or stroke-like symptoms with focal neurological deficits. Cerebellar ataxia (motor incoordination due to dysfunction of the cerebellum) is seen in HE but is a rare occurrence. The objective of the article was to present a case of cerebellar ataxia in a patient with Hashimoto's thyroiditis. A 30-year-old previously healthy female presented with quickly progressive cerebellar ataxia, bilateral (B/L) limb weakness, and excessive tearing. She was found to have high titers of anti-TPO (anti-thyroid peroxidase) antibodies; a biopsy confirmed Hashimoto's thyroiditis and a battery of negative tests excluding other causes of encephalopathy. Hence, confirming a diagnosis of HE. The patient was given glucocorticoids which relieved her symptoms. After being symptom-free for a few months, she relapsed and was unsuccessfully treated by the steroids. Upon this, she was given IV immunoglobulins, which helped achieve complete resolution. HE can be treated with immunotherapy, and most patients have a good prognosis, but some can have persistent neurological defects if left untreated or treatment is delayed. Relapses are common and may require a more extended treatment regimen.
ABSTRACT
Gynecologic malignancies are among the most common cancers in women worldwide and account for significant morbidity and mortality. Management and consequently overall patient survival is reliant upon early detection, accurate staging and early detection of any recurrence. Ultrasound, Computed Tomography (CT), Magnetic resonance imaging (MRI) and Positron Emission Tomography-Computed Tomography (PET-CT) play an essential role in the detection, characterization, staging and restaging of the most common gynecologic malignancies, namely the cervical, endometrial and ovarian malignancies. Recent advances in imaging including functional MRI, hybrid imaging with Positron Emission Tomography (PET/MRI) contribute even more to lesion specification and overall role of imaging in gynecologic malignancies. Radiomics is a neoteric approach which aspires to enhance decision support by extracting quantitative information from radiological imaging.
ABSTRACT
Background: Alopecia areata (AA) is an autoimmune disease that results in the loss of hair on the scalp and elsewhere on the body. The present study was conducted to compare the intralesional steroid and cryotherapy in the treatment of AA. Materials and Methods: The present clinical study was conducted in the Department of Dermatology, Venereology, and Leprology, Muzaffarnagar Medical College. The simple random sampling technique was used for randomly dividing the subjects into two groups: group I (local cryotherapy) and group II (intralesional corticosteroid). Results: A positive response was significantly more among the intralesional steroid group (86.0%) when compared with the cryotherapy group (62.0%). There was a significant difference in relapse between intralesional steroid group (22.0%) and cryotherapy group (16.0%). An excellent response was significantly more among the intralesional steroid group (44.0%) when compared with the cryotherapy group (18.0%). Poor response was significantly more among the cryotherapy group (18.0%), compared with the intralesional steroid group (0.0%). The mean pre-treatment, post-treatment, and the change from pre- to post-treatment Severity of Alopecia Tool [SALT] were compared between cryotherapy and intralesional steroid groups using the unpaired t-test. The mean pre-treatment, post-treatment, and the change from pre- to post-treatment SALT were significantly more among the intralesional steroid group when compared with the cryotherapy group. Conclusion: The authors found that superficial cryotherapy could be a meaningful adjuvant treatment option for AA patients. There was a significantly less relapse rate with cryotherapy. Among the currently available topical modalities for the treatment of AA, the best response was to the intralesional steroids followed by cryotherapy.
