Cholesterol granulomas are chronic inflammatory lesions located primarily in the apex of the petrous part of the temporal bone. They are benign, tumor-like lesions, consisting of a cystic cavity filled with a chocolate-brown fluid and present as hyperintense masses on T1 and T2 sequences on MRI. The most common causes of cholesterol granulomas are chronic middle ear infections and traumas, explaining their prevalence in young to middle aged patients. Due to their progressively expanding nature, clinical presentation include vertigo, diplopia, tinnitus, hearing loss and seizures. Treatment of cholesterol granulomas consists of two different approaches: watch and wait or radical surgery to remove the granulomatous tissue. We present the case of a 38-year-old male patient who was admitted to the Neurology Clinic with complaints of loss of consciousness, headache, pain on the left side of the face and tinnitus in the left ear. These symptoms had been present for some time and gradually worsened in intensity and frequency. Initially after an EEG was performed, the patient showed signs of focal epilepsy and began treatment accordingly. Subsequently, a CT and an MRI of the head and neck were performed, which showed a large, well demarcated expansile mass within the left petrous apex, which was hyperintense on T1 and T2. Based on his clinical presentation and radiologic findings, a diagnosis of cholesterol granuloma was established. Through this case report we hope to emphasize the role imaging modalities play in the diagnosis and appropriate management of cholesterol granulomas.

Congenital self-healingLangerhans cell histiocytosis (CSHLCH) is a rare type of Langerhans Cell Histiocytosis, presenting at birth or during the neonatal period. It is usually characterized by the eruption of multiple, discrete, red-brown papules or nodules which may increase in size and number during the first few weeks of life with spontaneous regression.Congenital LCH has rarely been reported to present as a papulovesicular eruption at birth. Here we describe a male baby presenting   with papulovesicular eruption at birth who rapidly developed pulmonary infiltrates and multiple osteolytic lesions in skull and long bones after spontaneous regression of cutaneous lesion.

No abstract

Background : The study aimed to demonstrate the pattern of clinical presentations and outcome of Immune Thrombocytopenic Purpura (ITP) in Bangabandhu Sheikh Mujib Medical University (BSMMU) Dhaka. Materials and methods: A retrospective study was conducted by record reviewing and analyzing the data of 103 patients of acute ITP, ageing between 1-16 years, at the Department of Paediatric Haematology and Oncology, Bangabandhu Sheikh Mujib Medical University (BSMMU) Dhaka from June 2017 to December 2019. We reviewed the data regarding age, sex, clinical presentations, history of preceding viral infections, vaccination history, laboratory values, different treatment options used and response to the treatment concerning complete response, partial response and poor responders. Statistical analysis performed by using IBM SPSS statistics version 20. Results: We retrospectively reviewed a total of 103 patients. The median age, at the time of presentation, was 5±3.4 years while the mean age was 4.5±2.9 years. The male to female ratio was  1.28:1. Mean platelet count on presentation was 7 x 109/L (Range: 0-24). Twenty three (22.3%) patients had the history of preceding febrile illness. Bruises, petechiae, epistaxis and hematemesis remained the common presentations. Six (5.8%) patients showed spontaneous recovery while 97 (94%) patients received treatment for ITP. Overall, 71 (68.9%) showed a response after treatment. Sixty-two patients (59.22%) showed loss of response and received treatment again. Among these patients, thirty-four patients (33%) developed chronic disease. Conclusion: Majority of patients presenting to our tertiary care centre had severe acute ITP on presentation.After management and follow-up, almost one third of the patients develop chronic disease hence the incidence of developing chronic disease remained high as compared to the other centers. JCMCTA 2019 ; 30 (2) : 81-85

No abstract