Intermediate syndrome affects 10-40% of those with severe organophosphorus poisoning, causing delayed weakness in the proximal parts of the body, neck flexors, and breathing muscles. We present the case of organophosphorus poisoning that advanced to intermediate syndrome and subsequently worsened, with imaging later revealing the Marchiafava-Bignami condition, which aggravated the intermediate syndrome.

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Hemochromatosis is defined as abnormal accumulation of iron in various organs of the body such as liver, pancreas, skin, joints, heart due to raised gut absorption of iron due to low hepcidin yield. Hemochromatosis is secondary to thalassemia major in this case. In the absence of other concurrent processes, cardiac hemochromatosis is identified as the presence of cardiac dysfunction owing to increased iron accumulation in the heart leading to heart failure. Unique: Cardiac involvement in secondary hemochromatosis due to thalassemia major. Take Away lesson: Regular monitoring of serum iron, ferritin, echocardiographic monitoring among thalassemia major patients is essential. Despite the fact that heart failure due to iron overload could be fatal, early diagnosis and intervention could prevent and treat the disease.

Laurence Moon Bardet Biedl syndrome (LMBBS) / Bardet–Biedl disorder (BBS) is an uncommon hereditary disease that is autosomally recessive. It is described by obesity, mental hindrance, dysphoric furthest points (syndactyly, brachydactyly, or polydactyly), retinal dystrophy or retinitis pigmentosa, hypogonadism, and renal abnormalities (among the prevailing aspects).1 LMBBS shares its similarities with Oliver McFarlane syndrome [OMS]. Many patients experienced a gradual loss of vision as a result of retinitis pigmentosa. In retinitis pigmentosa, initially, patients will have night blindness which can be progressed into colour blindness and tunnel vision. Patients of LMBBS may have taurodontism, the condition in which the tooth’s body is greater than the roots.2 Patients of LMBBS can develop chronic renal failure.3 Other features such as brachycephaly, learning disability and gait ataxia can be found in LMBBS patients.

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