J Postgrad Med
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Headache in women in their late forties can be primary or secondary. We report a 48-year-old female with chronic slowly progressive left temporal headache for 1 year. She also had ipsilateral eye pain and facial numbness for 1 month, with restricted abduction in the left eye and diplopia. ⋯ Magnetic resonance (MR) imaging revealed a 2 cm × 2 cm × 1.7 cm enhancing dumb-bell-shaped mass lesion with mild restricted diffusion in the Meckel's cave projecting into cavernous sinus with alanine, myoinositol and glutamine peaks on MR spectroscopy. Intradural debulking was done; lesion was confirmed by histopathology and patient was cured of her symptoms. An algorithm for diagnosing this entity at the bedside is presented.
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Atypical presentations of supraventricular arrhythmias constitute a diagnostic challenge which are not frequently reported in literature. Swallowing-induced supraventricular arrhythmia (SI-SVA), which was first described in 1926, is an intriguing presentation of supraventricular tachycardia and occurs during a wet or solid swallow. A 67-year-old man presented to our outpatient clinic complaining from recurrent episodes of sensation of palpitations and short duration pressure on his chest while swallowing since the last 2 weeks. ⋯ The patient was successfully treated with amiodarone. The main cause of SI-SVA is not known. Cross-talk of nerves during the impulse propagation might be the underlying cause of this phenomenon.
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To evaluate the prevalence of metabolic syndrome (MS) and whole-body composition in patients with congenital hypogonadism and investigate the effects of replacement therapy with testosterone undecanoate on MS, insulin resistance (IR), and whole-body composition in subset of patients. ⋯ In this study, 36 weeks of testosterone replacement resulted in significant decrease in waist circumference, IR, truncal fat, total body fat and improvement in lean body mass, and insulin sensitivity.