Acute disseminated encephalomyelitis (ADEM) is a disease of the brain and spinal cord that is an immunemediated inflammatory and demyelinating disorder, which is commonly preceded by an infection. Some reports have also shown the association of acute demyelination of the central nervous system (CNS) with vaccination. Primarily, the involvement of the white matter of the cerebral hemispheres, brain stem, and spinal cord is observed. Such lesions should be considered as the differentials of ADEM. We would like to report a case of a 77-year-old female who was of post-COVID-19 vaccination status and presented to us with altered sensorium with imaging revealing acute demyelination.

For more than 50 years, methotrexate (MTX), when used in low doses, has been one of the most commonly used drugs in the treatment of psoriasis. It has immunosuppressive as well as anti-inflammatory properties. Pancytopenia, hepatic dysfunction, respiratory toxicity, and acute renal failure are some of the reported side effects. This is a case study of a patient who had developed florid symptoms of methotrexate toxicity as a result of erroneous overdosing of methotrexate, which was given to her for psoriasis management.

A woman came to the emergency room with swelling of the face, which included swelling around the lips and the eyes. The patient had undergone root canal treatment under lidocaine anesthesia one day prior, after which she developed swelling. Because angioneurotic edema was a possibility, the complement components C3 and C4 and C1 esterase inhibitor (C1-INH) were tested. The C4 level was found to be very low (0.08 gm/l) and the C1 level was also on the lower side (0.26 gm/l). Angioneurotic edema with acquired C1-INH deficiency was diagnosed after complete systemic and physical examinations. The patient made a complete recovery with the help of steroids, fresh frozen plasma, antibiotics, and antiallergic medications. For its rarity, this case of systemic lupus erythematosus refractory angioneurotic edema with acquired C1-INH deficiency is being reported.

The presence of an extra (third) kidney is an unusual congenital anomaly of the urinary system (US), having less than a hundred cases reported globally. Owing to the rare occurrence of this complex anomaly, the fused supernumerary kidney and horseshoe portion is very scarcely reported with unknown incidence. This paper presents a rare renal anomaly case of a fused supernumerary kidney with a horseshoe portion in a 41-yearold male who presented with fever, abdominal pain, and burning micturition. CT of the kidney urinary bladder showed non-rotation of the right kidney with a supernumerary malrotated horseshoe-shaped kidney and malrotated left kidney with features of acute pyelonephritis. The patient was managed with double J stenting and appropriate antibiotics till discharge.