Transverse myelitis

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Sleeping is good for health but some time sleeping major disease Aurora the Sleeping Beauty doesn't just exist in fairy tales but is real and exists. Sleeping Beauty Syndrome or Kleine-Levin Syndrome (KLS) is a rare disease that has typical symptoms with patients who experience long periods of sleep up to 20 hours a day for several days to months and several year, and will recur, called hypersomnia. This syndrome can affect anyone at any age. Although most patients come from among teenagers with 70% coming from men. In addition, the syndrome can make changes and conditions confusing for the patients. And this period can appear and disappear unpredictably. These may occur as a result of a lack of blood flow to the brain during symptoms. During this period, the patients may wake up occasionally to go to the bathroom or eat and then go back to sleep. And after this period ends, the patients will usually experience depression, mood disorders and little or no recall of what happened. The cause of this syndrome is likely from disturbances in several parts of the brain, specifically the hypothalamus and thalamus, which play a role in regulating appetite, sleep patterns, and body temperature. In addition to what is believed to be from heredity or genetic factors and autoimmune diseases. The purpose of this examination is to rule out the possibility of other diseases such as diabetes, hypothyroidism, tumours, inflammation, infections, other sleep disorders and multiple sclerosis. So far there is no treatment technique that can cure this syndrome. Treatment given so far is only intended to reduce symptoms. Stimulant drugs such as amphetamines, methylphenidate, and modafinil can be used to treat excessive sleepiness. But with side effects can make patients become irritable. In addition, drugs to treat mood disorders, such as lithium and carbamazepine, can also be used to relieve the symptoms of this syndrome. The treatment technique that is much more recommended is the existence of close supervision at home from the closest family of the sufferer rather than medical treatment. This is because usually patients will find it difficult to take care of themselves. And actualy the most powerful medicine in this world is the spirit, support and involvement of the closest people who live at home will be very essential. By not forgetting to pray for healing to the almighty. Present by Dr Safat Khan (Gold Medalist)  

A female aged 66 years *Chief Complaints* Pain upper abdomen (x 2 months) Vomiting Post prandial Retention type of vomiting Loss of weight Loss of appetite *Physical Examination* P/A - Succusion splash (abd) positive *Investigations* UGIE dome showed ulcerated growth in antrum...scope negotiable with moderate resistance into D1... *Management* Antral metallic stent placed under fluroscopic guidance Size - 12 cm x 2.2 cm Post stenting, pt started on liquid diet Chemotherpay will begin shortly

Injury pelvis 7 days