Two Cases of Arnold-Chiari Malformation with Respiratory Failure

Arnold–Chiari malformation is defined as downward displacement of the brainstem and cerebellum through the foramen magnum. It has different clinical presentations and four subtypes. It is known that downward migration of posterior fossa components through the foramen magnum and associated lower cranial nerve palsy and brainstem compression can cause respiratory failure. Acute respiratory failure could mark the onset of the disease. Posterior fossa decompression performed to treat primary disease can improve the central sleep abnormalities. As respiratory failure is rarely seen, this paper presents two cases of Arnold–Chiari malformation with respiratory failure

Serum alkaline phosphatase may play a role in the differential diagnosis of sarcoidosis and tuberculosis

Background: Reaching the differential diagnosis of tuberculosis and sarcoidosis can be difficult due to granulomatous inflammation. The aim of this study was to determine alkaline phosphatase (ALP) activity in serum for the differential diagnosis of tuberculosis and sarcoidosis. Methods: This study comprised 242 subjects: 105 acid-fast bacilli (AFB) positive and/or culture-positive patients with pulmonary tuberculosis, 90 patients with biopsyproven sarcoidosis and a control group consisting of 47 healthy controls were included. ALP activity was measured in serum at the first admission of the patients. Results: The mean serum ALP was 112.74 +/- 55.14 IU/L in pulmonary tuberculosis, 76.14 +/- 34.23 IU/L in sarcoidosis, and 66.87 +/- 18.49 IU/L in the control group, respectively. There was a statistically significant difference between the patient population and the control group (P = 0.03). Also, there was a statistically significant difference between the tuberculosis and sarcoidosis groups (P = 0.034). According to the comparison of tuberculosis and sarcoidosis, the cut-off value was determined as 71.50 IU/L, which had sensitivity of 80%, specificity of 51%, PPV of 66%, NPV of 69%, accuracy of 67%, and the AUC was 0.728. Conclusion: ALP, as a little-known marker for tuberculosis and sarcoidosis, was significantly increased in the pulmonary tuberculosis group compared with the sarcoidosis group. As such, it may be a useful tool for the differentiation of tuberculosis and sarcoidosis

A RECURRENT OBSCURE GASTROINTESTINAL BLEEDING

Obscure gastrointestinal system (GIS) bleeding is divided into two subgroups as overt and occult bleeding. Five percent of patients presented with GIS bleeding is named as obscure GIS bleeding. The majority of these bleedings arise from small intestine. Obscure GIS bleeding cases undergo multiple and high cost studies. This case report presents a patient investigated for recurrent GIS bleeding and whose double balloon enteroscopy resulted in gastrointestinal stromal tumor The aim of this report is to draw attention to obscure GIS bleeding and review diagnostic process