Sero-Positive Isolated Ocular Myasthenia Gravis.

Ocular myasthenia gravis (OMG) is a neuromuscular disease characterized by the production of autoantibodies against post-synaptic proteins at the neuromuscular junction (NMJ). An 18-year-old male who had symptoms of drooping eyelids and double vision was diagnosed with ocular myasthenia gravis on investigations and examinations. Treatment was initiated with a tablet of pyridostigmine 60 mg twice daily per oral for two weeks, followed by three times daily for four weeks. The patient demonstrated significant improvement in ptosis and diplopia. There are still a considerable number of challenges in the diagnosis and treatment of ocular myasthenia gravis, with the typical treatment involving acetylcholinesterase inhibitors and immunosuppressants.

Cornea plana in a family from Pakistan: Case series and literature review on the principles of management.

Cornea plana (CP) is a rare ocular condition existing in two distinct clinical and hereditary forms: a milder, autosomal dominant type I and a more severe, autosomal recessive type II. The condition is more commonly found in Finnish, Saudi, and Czech families. We report three brothers from a consanguineous marriage that presented with complaints of decreased vision of varying degrees. All three of them have blue, thick, and hazy corneas with shallow anterior chamber depths. The additional features of CP type II were seen in the older two brothers including arcus lipoids, ill-demarcated limbus, and an accommodative squint. They were managed by the correction of refractive errors through spectacles and detailed counseling with follow-up visits to look for progressive complications. The management is mainly centered around optically or surgically correcting the developmental anomalies. This is complimented with proper genetic counseling and regular follow-up visits to look for and manage complications. There are, however, novel therapies that can be considered in these patients including corneal transplants or corneal stromal stem cellular therapies.

COVID-19 associated mucormycosis: A case report in Pakistan and a review of 144 cases.

Mucormycosis is the third most common mycosis in order of its importance as a human pathogen, occurrence of which has become more frequent around the world. Although not proven as a causal association, the increased number of cases has been attributed to Covid-19, the rampant use of corticosteroids, and diabetes. We report the case of a 53-year-old male with mucormycosis related to a Covid-19 infection as the novel case from Pakistan and discuss its epidemiology, diagnostic principles, and management. In our literature review, this is the 145th case being reported with most cases occurring in India, mostly in males, of rhino-orbital form and about a third of them leading to the death of the patient.

Migrainous Middle Cerebral Artery Infarction With Ipsilateral Hemiparesis.

Migrainous infarction is a complication of migraine that accounts for 0.5-1.5% of all cerebral infarcts, usually seen in the posterior circulation and in young women. In this case report, we report a case of a right-sided middle cerebral artery ischemic stroke in a young male presenting with migraine, photophobia and phonophobia lasting for more than 60 minutes and followed by ipsilateral hemiparesis, which is a very unusual presentation. The provisional diagnosis of ischemic infarction of the right middle cerebral artery was made that was confirmed on radio imaging. A high index of suspicion is always required while dealing with patients with migraine especially in atypical presentations as in this case.