Meenakshi Shetty’s research while affiliated with Manipal Academy of Higher Education and other places

We present a rare case of multiple infections coexisting together. This is one of the rarest cases of four infections which coexisted together in our patient. It is an alarming for the physicians to be aware of such infections as early prompt diagnosis can be lifesaving.

Enlargement of left atrium acts as a predictor of cardiovascular outcomes such as atrial fibrillation, stroke, congestive heart failure, cardiovascular death and also reflects diastolic burden [1]. Although echocardiogram acts as an accurate tool to precisely measure left atrial enlargement in most clinical setup, the treating physician in less equipped setup can get loads of information by carefully looking at the black and white image of chest roengtogram. This cheap imaging tool may show double density sign, enlarged carinal angle [2] and the lateral view may beautifully depict a walking man [Table/Fig-1]. The Chest X Ray can thus act as preliminary tool to give the clue for left atrium enlargement. Posterior displacement of left main bronchus due to left atrial enlargement, gives an image of inverted V, which mimics the legs of a walking man [3]. Our image shows this classical walking man sign in a patient with long standing mitral stenosis [Table/Fig-2a,b]. Chest X-Ray Lateral View showing Walking Man Sign due to left atrial enlargement.

Hemophagocytic lymphohistiocytosis (HLH) is a potentially fatal hyper inflammatory condition, if not recognized and treated in time. A high index of suspicion can help identify the condition early. This condition can occur in the primary or secondary form. Secondary HLH or hemophagocytic syndrome (HPS) secondary to infections is an important clinical entity especially in tropical world. In this article, we share our experience with this entity and make an attempt to explore literature about ravenous macrophages which occurs secondary to infections. It is a series of six cases of HLH secondary to infectious disease in our center in a coastal city in South India over last one year with follow up.

Cutaneous angiosarcoma is a rare vascular tumour especially of elderly males. We present a rare case of elderly female who presented with scalp lesion, parotid swelling and posed a diagnostic challenge. Further work up including biopsy of the lesion revealed the diagnosis of cutaneous angiosarcoma. Rarity of the case due to presence of this rare tumour in a darkcolored female and wide spread presentation of the tumour prompted us to report the case. This case adds to the literature of few cases describing this rare tumour in Indian subcontinent. It attempts to alert the clinicians of this entity, as early diagnosis of the tumour may possibly improve the already known dismal prognosis!

Background: Pneumothorax can be an important diagnosis in patient presenting with sudden onset shortness of breath. Timely diagnosis can be confirmed by a radiograph. Aim: This review is an attempt to make a systematic and highly informative algorithm to read and analyse a radiograph in patient with pneumothorax. Methods: Authors have combined their rich experience in the field with available standard text to make a simple and useful approach to radiographs with pneumothorax. The text is liberally illustrated for readers to get insight into radiographic approach which can be extremely useful in clinical practice. Results: Correct interpretations of chest radiographs in the clinical setting can be lifesaving. Proper interpretation of Xray Chest can reveal about underlying lung, aetiology and associated life threatening conditions. Abstract-Background : Pneumothorax can be an important diagnosis in patient presenting with sudden onset shortness of breath. Timely diagnosis can be confirmed by a radiograph.

Eosinophilic gastroenteritis (EGE) is an uncommon disease characterised by eosinophilic infiltration in the gastrointestinal tract. EGE may involve more than one layer of the gastrointestinal tract. Clinical features depend on the layer and location which is involved. We report an unusual case of eosinophilic ascites associated with antinuclear antibody positivity, which is an unusual variety of serosal form of EGE.