Bell's palsy is a benign lower motor neuron facial nerve disorder. Recurrent unilateral Bell's palsy is found in about 7% of the facial palsy cases. Alternating bilateral recurrent Bell's palsy is relatively uncommon. A review of recent medical literature revealed very few case reports of bilateral recurrent Bell's palsy, with none found in Asian neurology medical literature. We report a case of recurrent alternating bilateral Bell's palsy ( 3 episodes) in a male patient aged 34 years , was treated conservatively and recovered completely. He is symptom free on follow up till date. We present this case because of its rarity.

Background: Drug overdose can be accidental or deliberate posing a significant source of morbidity, mortality and health care burden. Drug over doses may be seen at any age and is particularly common among teenagers. It is estimated that approximately 2-3 million drug poisonings occur every year in the United States. In India the true incidence of self drugpoisoning is unknown due to under diagnosis and under reporting. Acute self drug poisoning is mostly due to benzodiazepines, antidepressants, antiepileptics and polypills containing NSAIDs. There is scarcity of data from the Indian subcontinent regarding the profile and outcome of patients presenting with acute self drug poisoning. We undertook this retrospective analysis to assess the course and outcome of such patients admitted in our tertiary care teaching hospital. Methods: This retrospective study was conducted between Jan 2008-Dec 2011 in the Department of medicine, Sri Devaraj Urs Medical College, Kolar. The data retrieved from the medical records section was analyzed for 155 patients who were admitted with acute self poisoning for, type of poisoning, time of presentation, reason for the consumption of drugs, ICU admission if required and outcomes. Results: The majority were females 103 (66.4%) patients and 52 were males and majority 90 (58 %) of admissions were from age group 21 to 30 years. The most common drugs consumed was benzodiazepines 54(34.8%), followed by antiepileptics 41(26.4%), and poypills 33(21.3). Thirty (19.4%) consumed two or more drugs. Commonest cause for drug consumption was suicidal (90%), and was mainly oral. The highest incidence of toxicity was due to benzodiazipines (34.8%) followed by antiepileptics (26.4%). Ten patients (15.5%) required ICU management for ventilatory support and average stay was seven days. None of our patients in the study required ionotropes or dialysis. Conclusions: The present data is an insight of the trends in self drug poisoning in rural south India as a result of low socioeconomic status, illiteracy and easy availability of drugs over the counter. Therefore strict regulations enforced on the medical drug outlets with mental health awareness counselling/programmes can go a long way in curtailing this problem.

Introduction: Hepatic involvement is a common feature in dengue fever, which prolongs the clinical course of this selflimiting viral infection and constitutes assign of worse prognosis, Vomiting and abdominal pain in the early stages point towards hepatic dysfunction. Various studies have shown that in all those patients who develop complications like dengue haemorrhagic fever, dengue shock syndrome, Hepatic failure, ARDS, Renal failure and Septicaemia, the levels of AST and ALT were raised significantly. The severity of hepatic involvement can be a major contributing factor in morbidity and mortality of such patients with Dengue fever. So AST and ALT can be a useful early marker to assess the severity of the disease which can thereby lead to early recognition of high risk cases. Methods: The study is an observational descriptive study conducted at Vydehi Institute of Medical Sciences and Research Centre, Bangalore, in the Department of medicine between Jan 2013-Jan 2015 to study the profile of liver involvement among a group of adult patients suffering from dengue fever and the association of elevated liver enzymes with complications. Detailed history, a complete general physical and systemic examination, with relevant investigations was done on hundred patients as per the proforma. Results:The results were analysed using SPSS-19.A total of 100 patients of dengue fever were studied, out of which seventy patients had elevated AST levels and seventy three had elevated ALT levels. Fever followed by headache was the most common symptoms at presentation while vomiting and pain abdomen in the early stage suggested hepatic dysfunction. AST and ALT were statistically higher in these patients and in those developing complications like DHF, DSS, hepatic failure, ARDS, ARF and encephalopathy. Conclusion: Liver injury is universal in adult patients with Dengue fever. Though liver involvement is asymptomatic in a large majority, in some patients it leads to clinical manifestations. Severity of hepatic involvement can be a major contributing factor in morbidity and mortality of such patients with Dengue fever. So AST and ALT can be a useful early marker to assess the severity of the disease which can thus lead to early recognition of high risk cases.