Relapsing polychondritis (RP) is a rare systemic inflammatory disorder having predilection for cartilaginous structures specially ears, nose, joints and respiratory tract. Myelodysplastic syndrome (MDS) is an established association. Here we describe case history of a 60-year-old man who had episodic pain involving left external ear, throat and nose, hearing difficulty and lethargy for six months and right sided facial weakness of recent onset. He was anaemic, his left ear was distorted and there was right facial palsy. Investigations revealed him to be a case of RP in association with MDS. His pain and facial palsy improved with prednisolone. J MEDICINE July 2015; 16 (2) : 124-127

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Facial Palsy as Presenting Feature of Relapsing Polychondritis in Association with Myelodysplastic Syndrome

Abstract This is the first study of the attitude of Bulgarian people towards the allowing of altruistic surrogacy which is prohibited in Bulgaria. This study used an online survey which was active during one year (July 2010-June 2011) and which was answered by 951 respondents between 18-65 years of age. The majority of them (87%) are young people between 18-43 years. The respondents are men and women with secondary, university and medical university education from the capital and the countryside. They have different marital status. The data were treated with statistical package SPSS 16. The link between the demographic characteristics (gender, age, education, marital status and place of residence) and the answers of the respondents was identified. The majority of the respondents (73%) think that the altruistic surrogacy must be allowed in Bulgaria and the main supporters are the women and the residents in the countryside – married or living with partner. Only 38% of the respondents mostly divorced middle aged persons accept the access of same sex couples to surrogacy. The majority of the respondents (53%) fear that the surrogacy may transform poor women into incubators for babies. This opinion is shared by the men, by the youngest and the oldest respondents and by the unmarried persons.

/pdf/altruistic-surrogacy-ethical-issues-and-demographic-xn4ditr843.pdf

Altruistic Surrogacy – Ethical Issues and Demographic Differences in Public Opinion

Relapsing polychondritis is a rare, severe, episodic and progressive inflammatory disorder of unknown aetiology and autoimmune pathogenesis, causing recurrent inflammation of involving cartilaginous structures, predominantly those of the ears, nose, and laryngotracheobronchial tree. Rarity of this disease, array of many possible presenting symptoms, lack of specific diagnostic investigation and episodic nature often causes significant delay in diagnosis. We are reporting a 55 year old woman presenting with recurrent episodes of pain, swelling, redness of nose, and both ear resulting in depressed nasal bridge and floppy pinna. Relapsing polychondritis was diagnosed and she was treated with systemic corticosteroid successfully. DOI: http://dx.doi.org/10.3329/jom.v15i1.19881 J Medicine 2014; 15: 80-83

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Relapsing Polychondritis: Case Report and Review of the Literature

Background: The presentation of corona virus disease 2019 (COVID-19) may include neurological features and patients with neurological disorders may develop concomitant COVID-19 during pandemic. Hyperglycemia leads to higher propensity to COVID-19 infection with higher disease severity. 
Objective: To assess the neurological diagnoses, glycemic status and outcome in patients hospitalized primarily for neurological problems and subsequently diagnosed as COVID-19. 
Methods: This retrospective cohort study was conducted in National Institute of Neurosciences (NINS) & Hospital, Dhaka, Bangladesh. Patients admitted to adult Neurology ward during April to November 2020 primarily for neurological problems and diagnosed as confirmed COVID-19 (with positive RT-PCR test for COVID-19) were included. The hospital records were reviewed and recorded in a checklist. Outcome of patients referred to COVID-19 dedicated hospitals was obtained over telephone. 
Results: The study included 85 patients with COVID-19 [median age 60 years (IQR: 45-65); 63.5% male]. Acute ischemic stroke was the most common neurological diagnosis (32.9%), followed by acute hemorrhagic stroke and subarachnoid hemorrhage (22.4% and 15.3% respectively). Other neurological diagnoses were meningoencephalitis (7.1%), Guillain Barre Syndrome (4.7%), Myasthania Gravis (1.2%), brain abscess (1.2%) and intracranial space occupying lesion (1.2%). Fourteen percent patients had no definite neurological diagnosis, they were admitted for delirium. History of diabetes was present in 18% patients. The mortality was 27% and the proportion of mortality was significantly higher in patients known to have DM in comparison to those who were not (p=0.012). The mean age and proportion of male sex was significantly higher among those who expired. 
Conclusion: There is high rate of mortality in neurological patients with COVID-19 who have variable neurological diagnosis including stroke, autoimmune disease and cerebral infections. Co-existent diabetes further increases the rate of mortality. 
Journal of National Institute of Neurosciences Bangladesh, July 2021, Vol. 7, No. 2, pp. 97-102

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KM Ahasan Ahmed

Papers

Relapsing Polychondritis: Case Report and Review of the Literature

Glycemic Status and Outcome of Neurological Patients with COVID-19 Admitted at Referral Neuroscience Institute of Bangladesh