Twenty-five patients of intracranial small ring (multiple / single) enhancing lesions were studied, 10 males and 15 females, age group of 20 to 40 years. Common presentation was seizures (68%), headache (68%), fever and focal neurological deficit. The various lesions were tuberculoma (48%), neurocysticercosis(32%), malignancy (12%), brain abscess and toxoplasmosis (4%). On MRI, single ring enhancing lesions were seen in 76%, multiple in only 24%. The size of the solitary lesions ranged from 0-10 mm. Commonest site was frontal lobe encountered in 36%; 12% lesions were encountered in parietal lobe. Other sites were lentiform nucleus, cerebellum, globus pallidus, pons. One patient had multiple lesions scattered in bilateral cerebral hemispheres. Patients were treated with anticonvulsants, anti helminthic/ antitubercular drugs, etc as per the aetiology. Neurocysticercosis showed 75% complete resolution after a 3 weeks course of Albendazole with steroids. Symptoms and MRI scan findings can resolve with prompt treatment.

Fifty patients of Rheumatoid arthritis were studied; 88% were females. Rheumatoid factor was positive in 90%. Raised ESR and CRP were markers of ongoing inflammation. The maximum number of patients (98%) presented with articular symptoms; 14% of had associated extra-articular symptoms; 2% presented only with extra-articular manifestations.The most common joints to be involved were the small joints of the hand, followed by the wrist, elbow, toes, hip and knee joints. The disease related complications seen commonly were various joint deformities and osteoporosis. Spine involvement in the form of atlanto-axial dislocation was seen in 2%.Extra-articular complications were episcleritis and vasculitis syndrome, dryness of eyes and mouth, and rheumatoid nodules. Postpartum flare of symptoms was seen in one patient. Drug related complications were uncommon (22%); most of which were minor side effects. Antirheumatic drugs especially DMARDs like methotrexate are very much safe and have high acceptability among the patients. Regular monitoring of patients is required. DAS 28 score is very helpful in assessing the patient response on treatment with DMARDs.

Daibetes mellitus is a strong risk factor for heart disease. In acute myocardial infarction, plasma glucose levels on admission ( in diabetics as well as non diabetics) affect the outcome and major adverse cardiac events. We studied the relationship between stress hyperglycemia and mortality in non- diabetic and diabetic patients having acute myocardial infarction. We also tried to correlate other variables like age, sex, systolic blood pressure, serum creatinine and lipid levels on admission, with the outcome.We concluded that admission plasma sugar levels can be regarded as a strong predictor of complications and mortality after acute myocardial infarction irrespective of presence or absence of diabetes. Thus stress hyperglycemia carries as bad a prognosis as diabetes mellitus in acute myocardial infarction.

AIDS has been known to have a wide variety of systemic manifestations but the associated psychiatric problems go undetected by the treating physicians. Out of the 100 patients assessed, 36% patients had neurological manifestations, with 47 neurological events. Meningitis was most common (19 patients) followed by mass lesions in 6. Psychiatric symptoms were seen in 78%. Depression was most common (45 patients), followed by anxiety in 25 and adjustment disorder in 6. These AIDS related mental disturbances could be attributed to the psychological reactions to systemic illnesses, effects of psychosocial stressors associated with the disease or opportunistic infections of the central nervous system.