Minoxidil is a powerful direct acting vasodilator that was used clinically as an oral antihypertensive drug in combination with beta blockers and diuretics in cases of hypertension refractory to other antihypertensives. A 58-year-old male presented to the Emergency Department with an alleged history of accidental consumption of around 10 mL of 5% topical minoxidil solution. He had developed tachycardia, severe hypotension, and characteristic Electrocardiogram (ECG) changes with no obvious chest pain. He was treated with continuous intravenous (i.v.) crystalloids, dual inotropes and other supportive measures. The patient also developed acute pulmonary oedema and acute kidney injury. He responded to treatment and gradually improved haemodynamically with resolution of ECG changes and acute kidney injury. He was discharged seven days after admission. The patient showed resolution of characteristic ECG changes and improvement in haemodynamic condition of patient with supportive management in hospital.

Guillain-Barré Syndrome (GBS) is an acquired immune mediated inflammatory and demyelinating disorder of the peripheral nervous system. This case report is about a 30-year-old female who presented with unilateral facial palsy which progressed to bilateral facial nerve palsy without motor weakness of limbs. Cerebrospinal Fluid (CSF) analysis showed albuminocytological disassociation and Nerve Conduction Studies (NCS) of face showed decreased conduction velocity of nasalis and orbicularis oculi nerves. The patient was treated with intravenous immunoglobulin (0.4 g/kg/day) for five days and showed complete recovery. The present case is reported due to its rarity in presentation i.e. bilateral facial nerve palsy in the initial days of presentation.

Introduction: Stroke is one of the most common causes of morbidity and mortality in the world. Various studies have shown the correlation between the uric acid levels and acute ischaemic stroke. There are several studies which project the cerebro-protective effect of uric acid in acute ischaemic stroke patients by its antioxidant effect. However, still it is a wide area of controversy. Aim: To assess the short term (14 days) clinical outcomes in acute ischaemic stroke patients with reference to their serum uric acid levels on day of admission day. Materials and Methods: This prospective cohort study, which included a total of 74 acute ischaemic stroke patients who presented to Emergency Department in a Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth University, Pondicherry (a tertiary care hospital in South India) within 48 hours from the month of April 2018 and June 2019. The severity of stroke was quantified in all patients using National Institute of Health Stroke Scale (NIHSS) during admission and serum uric acid levels and other routine investigations were measured in all cases. All patients were managed as per American Heart Association (AHA) guidelines and at the end of 14 days their outcome was reassessed by modified Rankin Scale (mRS). The correlation between severity of stroke and the clinical outcome on 14 days with reference to admission day serum uric acid was analysed. Results: A total of 74 patients were analysed, 51 were male and 23 were females and mean serum uric acid was 6.07±0.78 (mg/dL), and mean NIHSS score at admission was 18.32±3.8. Severity assessment by NIHSS scoring system showed majority percentage of population in elevated serum uric acid group were in moderate and severe categories (73.7%, 62.9%, respectively) in adjunct with normal uric acid group. Outcome assessment by mRS showed major percentage population in elevated uric acid group with score 2,3 (score 2-89.3%, score 3-80%) in relation to normal uric acid group. Conclusion: The present study supported the hypothesis that acute ischaemic stroke patients with elevated serum uric acid levels at the time of admission had reduced severity and favourable short term clinical outcome due to its neuroprotective effect secondary to antioxidant property.