Acute Hypokalemic Paralysis And Hashimoto's Thyroiditisa.

Acute hypokalemic paralysis (AHP) is a life-threatening emergency. It is exceptionally unusual for hypothyroidism to present with AHP. This association can be either primary or secondary through distal renal tubular acidosis. We report two cases who presented with acute quadriplegia. The succeeding investigations revealed severe hypokalemia and autoimmune hypothyroidism. The second case was found to have Sjogren's syndrome additionally. The underlying aetiology of hypokalemia in both cases was found to be dRTA. The combination of such conditions is reported sporadically. Here we also discuss the potential association of AHP with autoimmune conditions by proxy through dRTA.

Post-COVID Factor X Deficiency: A Case Report From Pakistan.

Acquired Factor X deficiency is a rare hematological disease, characterized by excessive bleeding, with fewer than 50 cases reported in the literature and practically all being associated with amyloidosis. We describe a case of a 38-year-old man with no known family history of hematologic disorders who had symptoms of a mild COVID-19 infection. Upon resolution, he developed excessive bleeding features, including epistaxis and hematuria. It was later found that while the rest of the coagulation factors were within normal limits, Factor X was 7% of the normal value, which reversed about two months after recovery. Our case highlights the significance of the less-expected post-COVID bleeding complications, in contrast to the classically seen thrombotic ones.

Wall-Eyed Monocular Inter-Nuclear Ophthalmoplegia (WEMINO) Syndrome, A Rare Decisive Manifestation Of An Isolated Unilateral Pontine Stroke.

Isolated unilateral pontine infarction is an uncommon occurrence. It may bring a complex neuroophthalmic manifestation to the clinicians, making the on-spot-diagnosis a hard challenge. Wall-eyed monocular inter-nuclear ophthalmoplegia (WEMINO) syndrome is a rare variant of inter-nuclear ophthalmoplegia which also includes ipsilesional exotropia. The literature seems deficient in documenting WEMINO syndrome the primary presentation of isolated unilateral pontine stroke. The location of the causative lesion of WEMINO syndrome is a hot topic. Here, we discuss a case of WEMINO syndrome, a rare presentation of limited unilateral pontine stroke and its responsible lesion. To the best of our knowledge this is the first reported case from Pakistan. A short literature review has also been presented on the anatomy, pathophysiology and various manifestations of isolated unilateral pontine lesion in the region of medial longitudinal fascicules (MLF). Hence, this article enhances the understanding of clinicians regarding the responsible lesions limited to pons and its various manifestations, in order to enable clinicians to pick them in the early opportunity.

Cypermethrin induced behavioral and biochemical changes in mahseer, Tor putitora.

The purpose of this study was to evaluate behavioral responses and biochemical changes induced by the extensively used pesticide cypermethrin (CYP) in liver, gills, brain and muscle tissues of mahseer (Tor putitora) fry. Behavioral changes in fish after exposure to an acute concentration of CYP involved jumping, abrupt swimming, loss of balance and equilibrium, increased surface activity and air gulping. These changes were more prominent with the passage of time. After a longer period of exposure, the fish became sluggish and before dying occasionally became motionless and sometimes showed a vertical position. Internal hemorrhage was also obvious. CYP exposure resulted in a significant decrease in total protein content in different tissues while antioxidant enzymes, catalase (CAT), peroxidase (POD) and glutathione reductase (GR) showed a time-dependent increasing trend in their activities in liver, brain, gills and muscle tissues. Similarly, lipid peroxidation (LPO) level also increased with time in different tissues of CYP-exposed fish. The results of the present study revealed that CYP is toxic to the mahseer Tor putitora. Therefore, its indiscriminate use can contribute in decreasing the population of mahseer in natural water bodies.