A 68-year-old lady with metastatic malignant melanoma was treated with Ipilimumab. She presented to Eye Casualty unable to move her eyes. Physical examination confirmed ophthalmoplegia and identified proptosis bilaterally. Radiological imaging showed bilateral enlargement of all the extra-ocular muscles suggestive of thyroid eye disease. Laboratory investigations found this patient to be euthyroid. A diagnosis of thyroid-like orbitopathy secondary to Ipilimumab therapy was made. Thyroid function tests should be performed for all patients prior to their commencement of Ipilimumab. Thyroid-like eye disease may develop in patients treated with Ipilimumab even if they remain euthyroid.
Our study displays a trend that adjustable procedures are more effective in terms of the mean horizontal effect per muscle operated, and is a novel way of reporting effectiveness of strabismus procedures.
Covid-19 (SARS-CoV-2) is a new coronavirus. Since the declaration of a global pandemic, a lot has been learnt about its spread, disease pattern, diagnosis and management. The lungs remain the prime organs to incur serious insult and when lung complications embark, significant morbidity and mortality is observed. Predominantly, patchy and peripheral lung distribution in the Covid-19 pneumonia has been described in the radiology experience and literature. There are a range of imaging modes useable in diagnosis, prognosis, monitoring, and therapy of Covid-19. However, when it comes to the appropriateness and the potential benefits of imaging, resource utilization and infectious risk must be considered. The use of ultrasound during this pandemic has provided us with an alternate imaging modality that is easily performed at the bedside, with real time images available to the clinician. This case highlights the role played by the thoracic ultrasound in the diagnosis and progression of Covid-19 pneumonia.
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