Still’s disease, also known as systemic juvenile idiopathic arthritis, is an autoimmune disorder with a triad of fever, salmon pink rash, and inflammatory polyarthritis. Its diagnosis is quite challenging due to the lack of specific symptoms and overlap with many other rheumatological and autoimmune disorders. However, recent studies have shown that high serum ferritin levels can act as a biomarker for this disease. Ferritin is an intracellular iron storage protein that acts as a pro-inflammatory reactant. There are various explanations indicating the presence of higher ferritin levels in Still's disease. High ferritin tells us about disease severity, and prognosis and can also predict life-threatening complications that can be easily prevented and thus it helps in reducing mortality associated with Still's disease. However, there are certain limitations to the use of ferritin as the only diagnostic marker for Still's disease. Overcoming those limitations can take the diagnosis of Still's disease to a higher level.

Rhombencephalosynapsis (RES) is a rare, congenital developmental disorder of the central nervous system. Even after many years of its identification, the etiology and pathogenesis of RES remain unclear. It occurs in combination with many syndromes and thus has overlapping symptoms. The clinical presentation of this disorder varies depending on the severity of the maldevelopment of vermis. Here, we present a case of a 60-year-old Indian female diagnosed with Rhombencephalosynapsis. Clinical and MRI characteristics of RES along with treatment options have been discussed.

Introduction:ASPECTS (Alberta Stroke Program Early CT Score) help in detecting early ischemic changes in stroke patients. This scoring system helps in predicting the stroke outcome, treatment options like thrombolysis and prognosis. It is a 10-point scaling system based on anatomical regions supplied by the middle cerebral artery and each point is subtracted for areas with ischemic changes. Aims and objectives:To study the effectiveness of the ASPECTS scoring in the assessment of the anterior and posterior cerebral circulation stroke. Materials and methods:A retrospective study was performed on stroke patients referred to our institute for an NCCT scan. 40 stroke patients with a mean age of 59+/-3 years were selected and patients with intracranial hemorrhage or hemorrhagic transformation of infarct were excluded. Scans were performed on a 128-slice multidetector CT PHILIPS Perspective scanner. The ASPECTS score was determined using standardised axial CT cuts. Result: In this case series study of 40 patients, a total of 28 patients (70%) had a score of 7 or more and these patients had better prognoses with proper treatment and follow-up.The remaining 12 patients (30%) had a score of less than 7 and even with treatment and sequential follow-up, they had no neurological recovery. Conclusion: Thus, it can be concluded that the ASPECTS can be used as a tool for predicting treatment outcomes in stroke patients. A score of 7 or more is associated with a good prognosis.

Subacute sclerosing panencephalitis (SSPE) is a progressive neurological complication that affects the central nervous system. It occurs as a late complication of the measles infection the young children and adolescents who are commonly affected present with personality changes and neurological deficits. The diagnosis can be done via clinical features, electroencephalography, and cerebrospinal fluid analysis. At present, there is no cure for SSPE. The immunisation against measles is the main strategy in preventing this condition. Here, we present a case of a 22-year-old Indian male diagnosed with Subacute sclerosing panencephalitis.

Diastematomyelia, also known as split cord syndrome, is a congenital disorder of the spinal cord. As the name suggests, the spinal cord is split into two resulting in neurological complaints associated with cutaneous symptoms. Although the diagnosis can be done clinically, for disease confirmation, various radiological investigations are used for the diagnosis of this condition. Here, we present a case of a 54-year-old Indian female diagnosed with diastematomyelia. The clinical features, diagnostic modalities, treatment options and prognosis of this condition have been discussed.

Borreliosis is a widely spreading bacterial infection caused by corkscrew-shaped spirochete Borrelia burgdorferi transmitted via the bite of an infected tick. The disease manifests in three stages: early localized, early disseminated, and late stages. Clinical symptoms range from non-specific erythema migrans, fever, fatigue, etc. to system-specific features like carditis, peripheral nerve palsy, etc. The diagnosis mainly relies on clinical findings and serologic testing is done for disease confirmation. The treatment of Lyme disease is an antibiotic with doxycycline as the primary choice. Prophylactic doxycycline is given under specific criteria. Here, we describe a case of a 64-year-old Indian male diagnosed with Lyme disease.

A multisystem chronic autoimmune disorder, Sjogren syndrome, is characterized by lymphocytic infiltrates in the exocrine glands. Keratoconjunctivitis sicca and xerostomia are the two pathognomic findings in Sjogren syndrome. Here, we present a case of a 30-year-oldan old Indian woman presenting with primary Sjogren syndrome. The clinical features, diagnostic modalities, treatment options, and management of complications have been discussed.