Introduction: Basilar artery provide oxygenated blood to the brain. The vertebral basilar system, which supplies blood to the posterior region of the Willis circle and joins with blood provided to the anterior half of the Willis process from the internal carotid arteries, is made up of the two vertebral arteries and the basilar artery. At the medulla oblongata and pons of the abducens nerves, the two vertebral arteries merge to form the basilar artery. The basilar artery's diameter ranges from 1.5 to 6.6 mm. When the midbrain ascends superiorly in the basilar sulcus of the ventral pons and separates into the posterior cerebral arteries, the midbrain and pons come together. Present complaint and investigation: A-53-year-old female was hospitalized in rural hospital Wardha with complaints of breathing difficulty, lower limb swelling, nausea, and vomiting and chest pain, mucus in the throat and lungs, and loss of appetite since 12 days. Investigation: Haemoglobin is decreased by 10.7gm, WBC count 11,000 per microliter, Total R.B.C. count increased by 5.84 million /cell, M.C.H. level Decreased 70fl, MCH is decreased by 22.8 Pico-gm. Therefore CT report should be interpreted in correlation with clinical & pathological findings. Past History: He had been admitted eight days before outside the hospital for the same complaints. The patient had complaints of Intraventricular Haemorrhage on treatment after investigations and the physical examination diagnosed basilar artery aneurysm with cancer. Conclusion: The prognosis of disease severity can be fair by timely treatment and management of cancer and basilar artery aneurysm.

Introduction: Although ocular adnexal cancers are relatively uncommon, their distinct spreading behavior and the functional significance of the eye and periocular tissues necessitate special diagnostic and therapy considerations. Case presentation: In this case, a 50-year-old male admitted to a rural hospital in Wardha. He was admitted with complaints of small growth over the upper eyelid since 1 year hence he visited to a private hospital and took homeopathic treatment but did not get relief. Then it increased in size of swelling hence he visited to rural hospital in Wardha and was investigated. CECT Orbit (10.05.2022) – There is an e/o heterogeneously enhancing soft tissue density lesion with areas of necrosis within it seen in the left periorbital region. The lesion measures 3.6*4.4*3.8 cm. The lesion is causing erosive destruction of the lateral wall of the left orbit and the anterior part of the left zygomatic arch. Anteriorly the fat plane is lost with preseptal and premaxillary soft tissues, medially involving the extra and intraconal compartment, lateral rectus muscle the fat plane with eyeball is lost with its compression, laterally involving the full thickness of adjacent subcutaneous tissue. A similar small lesion is seen in the subcutaneous plane adjacent to the left zygomatic arch. There are enhancing LNs seen in bilateral submental, submandibular, left preauricular region largest of size 18*10 mm with necrosis within in left submandibular region. There is an e/o heterogeneously enhancing lesion seen in the left parotid region with a necrotic area within it. Previous treatment has taken Surgery (06.06.2022) – Left Orbital exenteration with left MRND and left free ALT flap. He had started radiotherapy and completed 30 fractions Patient was admitted under radiation oncology. Conclusion: Careful visual examination should be a part of cancer patients' long-term follow-up strategy. Timely treatment and management of disease complications can be prevented.

Background: The process of breathing, or the exchange of air between the atmosphere and the lungs' alveoli, is impaired in cases of hanging by a neck rope, which results in asphyxia and death. Main symptoms and important findings: A 27-year-old male was admitted to a rural hospital with complaints of hanging from a fan at home after a fight with his wife, with unconscious state, and one episode of seizure associated with up rolling off the eyeball, frothing from the mouth, and tonic-clonic movement. There was previous deliberate self-harm. Given low GCS, the patient was immediately intubated with ET TUBE 7.5 and taken on mechanical ventilation on volume control mode with peep 5, RR 16, Spo2 100%, TV 360 ml. rapid antigen test was done which came out to be negative and ECG done and show sign of tachycardia. Chest and spine X-RAY was done. CT brain done and the finding was normal. EEG was done and show the finding was beta activity and no epileptiform changes. An orthopedic physician's opinion was taken and to continue Philadelphia collar for 4 weeks was advised. The main diagnosis, therapeutic interventions, and outcomes: After a physical examination and investigations doctor diagnosed a case of hanging with depression. Medical management was provided with Inj. Ceftriaxone 1 gm intravenous twice a day for 9 days, Inj. Pan 40 mg intravenous once a day, Inj. Emset 4 mg three times a day, Inj. Levipril 500 mg twice a day, Inj. Dexa 6 mg once a day for 5 days, Nebulization With Duolin And Budecort three times a day, intravenous fluids given. Now his outcomes were good. His complications were reduced. Conclusion: Hanging is a complicated case and produces more complications but early diagnosis management can secure the life of a patient and reduce the complication of hanging.

Background: A rarity of form of vasculitis, also known as TAK, induces inflammation in the walls of the major arteries in the body: the aorta and its main branches. The disease results from a body attack and inflammation of the walls of the arteries caused by the body's own immune system. Case Presentation: A 37-years-old women had complaints of fever, giddiness, weakness of right upper limb and lower limb since1 day. After undergoing whole blood count, liver function examination, renal and MRI function checks, CT scan, angiography, etc. was studied. She was diagnosed with takayasu arteritis.  She had past medical history of neck pain and numbness since January 2020. For these complaints her family members referred her in private hospital. There is no significant history of surgery in present, lower segment caesarean section and piles operation was done previously. Physical findings were normal except the Glasgow Coma Scale score was 11 that is, patient  was semi-conscious, In General appearance patient activity was dull and weak due disease condition, Patient’s all routine investigations were normal except few like Total WBC count was increased (21,500cell /cm) due to increased infection, Granulocytes were increased  that is 75 % due to infection and autoimmune disease, ESR was increased  that is52mm/h. Angiography showed block in the right common carotid artery, MRI- showed Acute infract in left fronto  temporo parietal region involving insular par ventricular white matter,  absent flow in distal M1 segment of MCA. Conclusion: The most frequently involved arteries and the angiographic trends in this Takayasu Arteritis study were subclavian arteries and carotid arteries. The difference between angiographic characteristics may lead to clinical differences. Operations and surgery should be carried out at various points in the course of the disease.