Qatar Medical Journal - Volume 2008, Issue 1

Anaplastic myeloma is a rare aggressive disease that is resistant to most chemotherapeutic agents and radiotherapy. It develops usually after a diagnosis of classical multiple myeloma and is associated with at least one extramedullary plasmacytoma site. We report a case of this rare disease in a patient who had no previous illness and presented to us with more than one extramedullary plasmacytoma site: a mass in the right anterior chest wall, a swollen scrotum and multiple nodular skin lesions mainly in the legs.

Spinal epidural angiolipomatosis (SEA) is a rare benign neoplasm of adipose tissue with a prominent vascular component. Classified as either idiopathic or secondary to chronic steroid therapy it accounts for 0.14% of all spinal axis tumours. The clinical and radiological features and treatment of a case in a 24-year-old male are described and discussed together with a review of the literature and previous reports.

We present, as a rare manifestation of miliary TB, a case of tuberculous tenosynovitis, preceding by two weeks onset of tuberculous meningitis. A gradual progressive onset of a painless swelling of the right forearm was followed by high-grade fever, headache and neck pain. A suspected diagnosis of tuberculous meningitis based upon analysis of cerebrospinal fluid (CSF) was confirmed later by positive CSF polymerase chain reaction (PCR) for mycobacterium tuberculosis. Although the patient had a positive Mantoux test of 20 mm, there was no evidence of pulmonary TB and a negative CSF smear for acid fast bacilli but a positive smear from a fine needle aspirate of the swelling of the right forearm. The antituberculous therapy led to a successful outcome.

Inflammatory myopathies are heterogeneous groups of immune mediated myopathies that present as pure form or in association with other auto-immune diseases or malignancy. There are three major subsets: dermatomyositis, polymyositis and sporadic inclusion body myositis. This review highlights our understanding of these disorders, their clinical aspects, diagnosis, pathogenesis and treatment. The idiopathic inflammatory myopathies occurring alone or in association with auto-immune disease and lor cancer have an overlapping clinical presentation with an overall incidence of 3.0 to 7.8 per million and a prevalence from 10 to 60 per million. Because of the variability in epidemiological studies, the interpretation of these results cannot be conclusive. Recent evidence indicates that polymyositis is over diagnosed and many reported cases are likely to be some other disorders. Decreasing the incidence of true polymyositis is due to reliance not only on clinical criteria but also on immunopathological changes in muscle biopsies. Polymyositis and inclusion body myositis occur primarily in adults, whereas dermatomyositis occurs in adults and children between five and fifteen years of age. Sporadic inclusion body myositis affects almost exclusively men over the age of 50 years.

Young lady referee from women's hospital to Medical Intensive Care Unit because of abdominal pain, fever (Temperature 39°C) and hypotension. She was pregnant 20 weeks on top of intrauterine device (IUD) and was evaluated as intrauterine fetal death. The diagnosis was septic shock due to intra-abdominal infection. Looking for the source of infection, CT abdomen and pelvis was done (Figs. 1 and 2).

A 28- year old male from Nepal presented with history of fever, right-sided chest pain for the last four weeks. During admission some investigations were carried out.

Objective: To review the incidence of ruptured uteri at the Women's Hospital, Hamad Medical Corporation (HMC) and to analyze the causative factors of uterine rupture with the view to its prevention and to highlight the management approach taken to preserve the patient's reproductive potential.

Background: We aimed to investigate whether the addition of nonsteroidal anti-inflammatory drugs or spinal manipulative therapy, or both, would result in faster recovery for patients with acute low back pain receiving recommended first-line care.