Background: Autoimmune diseases` incidence had increased significantly by 1995-as compared to 1983, by when tubectomy, contraception was being steadily implemented; hence an altruistic correlation was sought after. Methods: Data of 64 people with varied autoimmune diseases spread over 1989-2012 from 7 geographical locations, each separated by ~500 km distance, was tabulated into 3 age groups, namely 20-35 years, 35-50 years, >50 years and association with contraception status, consumption of fish without scales, gills, shell fish, was analyzed by bio informatics, retrospectively in 2012. In 2002, 2003 data of 105 patients from the community and hospital was analyzed for association of contraception status, prevalent diseases and estrogen levels. Results: Contraceptive users demonstrated 15 fold increase in auto-immune diseases among 20-35 years [p <0.0005]; 40 fold increase in auto-immune diseases among 35-50 years [p <0.0005]; 5 fold increase in autoimmune diseases were seen with consumption of fish without scales and gills in non contraceptive users also. Endogenous estrogen was reduced below normal in 61% of patients using contraception [p <0.0005]. Conclusion: The concept is contraception results in smashed fragmentation of Germ Cells, to a centric fragments, ring chromosomes, chromatid breaks, being identified by immune surveillance as foreign, leading to auto immunity; associated reduced endogenous estrogen or androgen, results in defaulted cell cycle, cell metabolism of differentiation, growth, controlled multiplication, degeneration, apoptosis, regeneration, genomic repertoire, leading to impaired immunity; auto-immunity is also produced by consumption of fish without scales and gills due to its toxins mediated cytotoxicity, by molecular mimicry, in non contraceptive users also. Abstinence for 7 days after last menstrual period, prevents exposure of raw endometrial surface to germ cells; abstinence for 45 days after male baby delivery, 90 days after girl baby delivery prevents germ cells exposure to raw placental detached surface and reduces auto immunity.

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Cerebrospinal Fluid (CSF) protects brain and maintains intracranial pressure which is secreted by choroid plexus. After severe Craniomaxillofacial (CMF) trauma, disruption of meningeal structure leads to CSF leak. About 80-90% of CSF leak in adults is due to head injuries. CSF rhinorrhoea can be classified into spontaneous and non spontaneous. Meningitis is seen in 19% of persistent CSF leakage with 10% of mortality due to delayed and longer duration of the CSF leakage. Post-traumatic CSF leaks are commonly seen in 1-3% of adults among all head injuries. Traumatic CSF leak is reported to be approximately 10-30% of the skull base fractures in adults. Common pathogens of meningitis are Haemophilus influenzae (H. influenzae) and Streptococcus pneumoniae (S. pneumoniae). Present case was of non spontaneous CSF rhinorrhoea and subsequent bacterial meningitis in a 33-year-old male patient, with fever and chills, headache, vomiting, neck stiffness. Kernig sign’s was present. Patient had past history of road traffic accident and found to have CMF injury. Neurosurgery opinion was sought and found to be persistent CSF rhinorrhoea. Haematological and chemical analysis of cerebrospinal fluid was abnormal. CSF and blood sample sent for culture and sensitivity. H. influenzae grown in both culture. H. influenzae is an uncommon cause of adult bacterial meningitis.

Dermatomyositis is an idiopathic inflammatory myositis involving progressive muscle weakness with skin manifestations. Incidence of dermatomyositis is 1 per 100,000 in general population. Diagnosis is based on characteristic skin rashes, progressive muscle weakness and elevated muscle enzymes levels (creatine phosphokinase). The diagnosis is confirmed by clinical examination, abnormal electromyogram and autoimmune workup. In this case report, we report a case of difficult to treat dermatomyositis with proximal muscle weakness in an elderly male patient with classical skin lesions. The patient was resistant to steroid and immunoglobulin therapy.

Background: Stroke is the leading cause of morbidity and mortality all over the world. Several prognostic factors like site and size of infarction, Glasgow coma scale, level of cerebral edema, intracranial tension have been found significant in stroke. Among the prognostic indicators ferritin has gained importance in recent times. It is considered an acute phase reactant and has been used for assessing the severity and prognosis of stroke. Aim of the study was to correlate the levels of serum ferritin with early neurological status and to predict the severity and prognosis earlier in patients of acute stroke.Methods: This cross-sectional observational study was done in Saveetha hospital, Chennai. Clinically diagnosed CVA patients within 48 hours of the onset of symptoms were recruited in this study. 122 patients above 18 years who fulfilled the criteria were included and patients with a recent history of inflammation, malignancy, and anemia were excluded.Results: Around 60.7% of patients had improved and the remaining of them deteriorated. The level of serum ferritin was well correlated with the patient's prognosis. Those who deteriorated had high serum ferritin when compared to those who improved and it was statistically significant.Conclusions: From our results, we concluded that patients with increased ferritin concentrations have a higher risk of poor clinical outcomes. These findings suggest that iron overload may counterbalance the benefits of thrombolytic therapy in patients with high ferritin levels. Therefore, serum ferritin can be used as a prognostic marker for assessing the severity and prognosis of stroke.