Coronary Angiographic Profile of Left Ventricular Systolic Dysfunction of Unknown Causes in Kashmir

Introduction: Disseminated tuberculosis is a form ofwidespread bacilli infection with typical involvement ofthe lungs and other extra pulmonary organs. It is a raremanifestation of mycobacterial infection and rare amongimmune competent individuals.Case report: We present a case of disseminated extrapulmonary tuberculosis co-occurring tuberculous meningitis,CNS tuberculomas and Liver tuberculomas. Our patientdeveloped atypical respiratory complications in the form ofARDS like features which also called as Landouzy Sepsis,despite apparent normal Chest x-ray following initiation ofAnti Tubercular Therapy. Also patient developed paradoxicalreactions to tuberculous meningitis during the treatment.Conclusion: Awareness about paradoxical reactions intuberculous meningitis is very much crucial as paradoxicalreactions may lead to confusion about diagnostic accuracy andresistance of ATT drugs. Paradoxical reactions do not affectthe outcome but require prompt treatment to the complicationslike hydrocephalus and respiratory distress.

Penetrating Cardiac Trauma with Retained Intra - Myocardial Pellets - A Case Report

Introduction: Penetrating ballistic cardiac injury is usuallyfatal before victim the gets any medical help. Retained intracardiac missile is a very rare entity and so far a very few caseshave been reported in the literature.Case report: We describe a young patient who presentedwith multiple life threatening pellet injuries involving chest,abdomen, and limbs. Patient had CT and echocardiographydocumented retained pellets in the heart with pericardialeffusion. Patient was managed successfully using conservativeapproach without any surgical intervention.Conclusion: this case highlights the importance of carefulmonitoring and conservative approach in such critically illpatients for a better outcome.