Journal of Case Reports in Medical Science

Introduction: TSH is one of the most routinely measured tests the clinical laboratory to diagnose and monitor thyroid diseases. TSH as the preferred screening test as recommended by The American Thyroid Association and the American Association of Clinical Endocrinologists for diagnosing thyroid dysfunction. Third-generation Ultra serum TSH assays have a functional sensitivity of 0.001 uIU/mL and have been considered highest among biochemical assay for assessing thyroid disorders. However, as observed in many clinical laboratories sometimes results of TSH assays are discordant among different immunoassay platforms.

Case Report: TSH values of a 56 years old male on Siemens Attelica while TSH was found to be elevated on Abbott Architect 1000 and Beckman Coulter DXI800. Retrospective analysis revealed few other cases (8/190) approx. 4.2 % showed discordant TSH values. This was found to be possibly because of mutation in TSH beta region (R55G).

Conclusion: Our present study suggest that these individuals who shows <0.001 values on Siemens Attelica must be tested with other platforms to assure appropriate management of disease. Further, clinicians and laboratory staff need to be aware about TSH variants along with other reported interferences.

Cavernous malformations are classified as a group of vascular malformations of the central nervous system. It usually occurs in the supratentorial region, rarely in the brainstem. When they are symptomatic, headache, brain stem signs, sensory and motor changes can usually occur. But it can be confused with a stroke in the case of acute developing lateralizing sensory-motor symptoms, especially in the absence of brainstem signs. It can be distinguished from hematoma by its well-circumscribed and nodular appearance. Although the prognosis is generally good, it can lead to serious deficits in patients with malformations in the brainstem. In our case report, it was found that it is worth presenting a case that started acutely without brain stem findings and had a good prognosis at 3-month follow-up with loss of strength on the right side and was treated conservatively.

Bicornuate uterus, a class IV Mullerian anomaly results from impairment in the fusion of the Mullerian duct. It is associated with both normal and many obstetric complications. We present two rare cases of bicornuate uterus with successful pregnancy outcomes among Nigerian ladies. The diagnoses of the bicornuate uterus were made incidentally during a routine antenatal ultrasound scan in their first pregnancies. These were confirmed intraoperatively and the patients were notified.

In the first case, the foetal head occupied the cavity of the left horn and the breech in the cavity of the large right horn while in the second case, the right horn was empty and the foetus was in the left horn. These women with bicornuate uterus carried their pregnancies to term and had elective repeat caesarean sections with favourable foeto-maternal outcomes. The mothers and their babies are alive and doing well.

Overall, the ladies had two and four successful pregnancy outcomes respectively. Women with a bicornuate uterus can achieve successful pregnancy outcomes despite the obstetric challenges of the anomaly. Thus, the index cases highlight that it is practically safe to forgo metroplasty in bicornuate uterus, in particular, asymptomatic women that had achieved successful pregnancies.

The present case study highlights  Kimura’s Disease in an Asian Male. Kimura disease (KD) is a rare chronic inflammatory disorder of unknown etiology. It usually presents as subcutaneous mass in the head and neck region and is frequently associated with regional lymphadenopathy or salivary gland involvement. A study done at Dept of Internal Medicine ,American Institute Of Medical sciences, GBH general hospital, Udaipur, Rajasthan, India. A case report of a 13 year old male, admitted to GBH general Hospital on 1st January, 2023 with chief complains of swelling (painless) Left side of the  face below eye since 4 months and swelling under Rt. lobe of the ear since 3 months.On radiological examination, Kimura’s disease mimics other chronic and malignant diseases such as tuberculosis or lymphoma. This is an important study since it is a rare case and further research should be done in this area for further management and prompt diagnosis of such rare causes of upper body lymphadenopathy(frequently confused with malignancy),unless histopathology is clearly demonstrated.

Restoration of aesthetic along with maintenance of healthy gingival tissue is of utmost importance when treating the maxillary anterior region. Resorption of residual alveolar ridge or irregularities in soft tissue often complicate favourable relationship with the pontic, compromising the final aesthetic outcome. Various techniques were used to overcome this problem. Esthetic emergence profile was achieved in final prosthesis of all the following cases without any adverse consequences on a long term follow up. Apart from esthetics, clinically healthy, functional, and hygienic conditions can be established at ovate pontic sites if appropriate plaque control is performed. In this article we discuss two cases where missing tooth was replaced by provisional FPD with ovate pontic followed by final prosthesis after 6-7 weeks to achieve a natural emergence profile. Follow up is continuing till the publication of this article and the prosthesis and tissue health are perfectly fine.