Annals of Geriatric Education and Medical Sciences

9-10

Authors: Amit Beheti,Sunil Kumar*,Ayan Husain,Parth Godhiwala,Nitin Raisinghani

Gangrene is ischemic necrosis of limbs or its parts, without involvement of proximal arterial obstruction or vasculitis, often associated with disseminated intravascular coagulation and septic shock. This rare clinical syndrome are usually caused by infectious or non infectious causes, among them tuberculosis as a cause is rarely associated. We here report a case of 68 year old lady, who initially was diagnosed as tubercular meningitis and later developed peripheral gangrene in all four limbs.

13-15

Authors: Shreya Gattani*,Sourya Acharya,Roopesh Yarappa,Sakshi Gagneja

Dementia is a commonly encountered problem in the aging population. The cardinal manifestations of Vitamin B12 deficiency are dementia, delirium, cognitive impairment, confusion, memory losses, depression, acute psychosis, and rarely mania or schizophrenia. The neuropsychiatric manifestations due to Vitamin B12 deficiency are often accompanied by hematological abnormalities. We report a 68-year-old female who presented with complaints of behavioral changes, intermittent episodes of acute confusional state, memory deficits, inability to identify family members, lethargy and easy generalized fatigability. The laboratory investigations of the patient revealed macrocytic anemia with decreased Serum Vitamin B12 levels, Normal folate levels and elevated Serum Homocysteine levels based on which the patient was diagnosed with Hypovitaminosis of Vitamin B12 with Hyperhomocysteinemia. The patient showed dramatic improvement in the neuropsychiatric manifestations after receiving adequate supplementation of cobalamin.

18-19

Authors: Sourya Acharya*,Samarth Shukla,Sakshi Gagneja

Liddle’s syndrome is a rare cause of secondary hypertension. Identification of this disorder is important as treatment differs from other forms of hypertension. We report a case of a 68 year old male who presented with acute confusion state and hypertensive urgency with features of encephalopathy. Investigations confirmed Liddle’s syndrome.