Chiari in 1891 described a constellation of anomalies at the base of the brain inherited congenitally, the characteristic of which are (1) extension of a tongue of cerebellar tissue posterior to the medulla and cord that extends into the cervical spinal canal; (2) caudal displacement of the medulla and the inferior part of the fourth ventricle into the cervical canal; and (3) a frequent but not invariable association with syringomyelia or a spinal developmental abnormality. Chiari recognized four types of abnormalities. Presently, the term has come to be restricted to Chiari's types I and II, that is, to cerebellomedullary descent without and with a meningomyelocele, respectively. The association of Arnold-Chairi malformation and high cervical cord infarction is unusual. The most common syndrome, anterior spinal artery syndrome (ASAS), is caused by interruption of blood flow to the anterior spinal artery, producing ischaemia in the anterior two-thirds of the cord, with resulting neurologic deficits. Causes of ASAS include aortic disease, postsurgical, sepsis, hypotension and thromboembolic disorders. The authors present an interesting case of cervical cord infarction due to anterior spinal artery thrombosis in a patient of type 1 Arnold-Chiari malformation without any of the above predisposing factors.

rom 1985 until 1992 there was a resurgence of tuberculosis in the United States that coincided with the epidemic of acquired immunodeficiency syndrome (AIDS). 1 Although the U.S. incidence of tuberculosis has since been in decline, this disease remains a major problem for much of the world, with a global prevalence of infection estimated at 32 percent. 2 Thus, the percentage of U.S. cases that occur among foreign-born persons is increasing (53 percent in 2003). 1 Extrapulmonary tuberculosis has become more common since the advent of human immunodeficiency virus (HIV) infection. 3 Extrapulmonary Tuberculosis and HIV Infection Extrapulmonary involvement can be seen in more than 50 percent of patients with concurrent AIDS and tuberculosis. 3-5 The risk of extrapulmonary tuberculosis and mycobacteremia increases with advancing immunosuppression. 6 Unique features of AIDS-associated tuberculosis include extra

Introduction Bariatric surgery is used to treat morbid obese patients. Venous thromboembolism (VTE) is considered to be one of the leading causes of postoperative morbidity and mortality. Therefore, inferior vena cava filter (IVCF) is used to minimize the risk of VTE in high-risk patients. Materials and Methods Medical information was collected for the preoperative, operative and postoperative stages for all patients underwent bariatric surgery at KAMC from March 2013 to July 2017. Results Five cases with IVCF were included in this study. Age ranged from 35 to 66 years old; 4 (80%) were female. Preoperative body mass index ranged from 42 to 64 kg/m 2 . Postoperative findings were reported. Conclusion IVCF seems to be beneficial for patients undergoing bariatric surgery.

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Peptic ulcer perforation and haemorrhage is not unusual as a complication of peptic ulcer disease. In the older patientspresentation can be dramatic and atypical. The authors are presenting a case of duodenal ulcer perforation and haemorrhage which was misdiagnosed as a gastric malignancy and thus failure to have Helicobacter pylori eradication, recurrence with complication and hesitancy in surgical intervention due to initial label of malignancy.