This is an extensive review of osteo-odonto-keratoplasty (OOKP) where the vision is restored by using tooth as an implant in the environment of the eye. The window of the soul is our eye and the window of the eye is cornea. This review article aims at discussing the remarkable operation to regain the sight of patients with corneal blindness. In this procedure where a multidisciplinary approach from both oral and maxillofacial surgeon and ophthalmologist contributes to restore vision in the most severe cases of corneal blindness. This involves removing a canine tooth from the patient, shaping and drilling to allow implantation of an artificial plastic corneal device and finally implanting back into the eye few months later. The OOKP, is the keratoprosthesis of choice for end-stage corneal blindness not amenable to penetrating keratoplasty. This transplantation procedure has an autologous dental root-bone lamina complex and buccal mucosal graft to secure the optical cylinder which acts as a ray of vision for corneal blindness. This review comprises the indications, contraindications, and patient assessment and the surgical procedure, complications ,surgical inter professionalism and future scope of OOKP. The source of data for the review has been Pubmed, Medline and all the research studies and published reports on osteo-odonto-keratoplasty. In this complex procedure good results can be obtained with modern technology and expertise.

Context: Obesity is found to be the strongest risk factor for persistent hypertension, which is an important risk factor for the coronary artery disease and stroke. Urbanization, unhealthy eating patterns and reduced physical activity are the important reasons. Prevention of obesity is always better than its treatment. Aims: The aim of this study was to determine the proportion of overweight/obesity among medical student and to identify various correlates associated with it. Settings and Design: Cross-sectional study conducted in medical students in Pune. Methods: A validated, pre-designed, and pre-tested questionnaire was used. Overweight/obesity was assessed on the basis of body mass index (BMI) for age using gender specific Centre for Disease Control (CDC) charts. Statistical Analysis: Proportions, ANOVA, and unpaired t-tests were used to find any statistical significant association of mean BMI for age with various correlates. Results: Total 159 students including 66 (41.5%) female and 93 (58.5%) male took part in the study. The proportion of overweight/obesity was 13.2% (C.I: 7.84-18.5%). Daily calorie intake, lack of daily physical activity, daily consumption of Tea/Coffee/Fruit juices, playing outdoor games, socio-economic status, and family history of obesity were found to have statistically significant association with overweight/obesity. Conclusions: The problem of obesity/overweight is on the rise.

Purpose: Ultrasound training for the surgical residents is not a common practice in India. This study was undertaken to prepare a working model for surgical trainees and assess its effectiveness by training a single surgical resident. Materials and Methods: This was a prospective study of 238 patients with pain abdomen. Training was given in abdominal ultrasound for a period of 2 months. Ultrasound scans were performed independently by a radiology resident and surgery resident. Inter-rater agreement between both residents was assessed using Kappa coefficient. Ultrasound results were compared with clinical diagnosis and final diagnosis. Results: The kappa agreement was 0.53, 0.56, 0.8 and 1 for urolithiasis, appendicitis, pancreatitis and urinary tract infection, respectively. Almost all cases of cholelithiasis were identified by the surgery resident. There was improvement of 21%, 31% and 100% in patients of urolithiasis, acute appendicitis and liver abscess, respectively, in the second 10 months of the study. Conclusions: Ultrasound scans can be performed by a surgery resident with similar results as that of a radiology resident. Training of the surgery resident is possible with satisfactory results.

Introduction: Pathological phimosis or preputial stenosis is a distressing problem in children leading to recurrent balanoposthitis, ballooning of prepuce, and rarely back pressure changes in the urinary tract. Circumcision has been the standard of care for such situations, although recently, various alternatives to circumcision have been reported in the literature. Most of these techniques are often complex and are met with poor acceptance. Moreover, besides personal preferences (in Hindus), advantages of preputial preservation is increasingly being realized recently. Materials and Methods: A prospective study was carried out in which a simple standardized technique of preputioplasty (dorsal slit) was used in 40 pediatric preputial stenosis cases. The outcome of this procedure including cosmesis and parental satisfaction was evaluated. Results: The average duration of this procedure was from 10 to 25 min with no intraoperative complications. The cosmetic outcome was good in 62.5%, satisfactory in 30%, and poor in 7.5% of cases. All of the boys had retractable prepuce with no functional problems. There was 100% parental satisfaction. None of the patients required a redo procedure or circumcision. Conclusion: A dorsal slit of adequate length i.e.; 1/3 ^rd the length from the corona to the tip leads to a satisfactory cosmetic outcome in more than 92% of cases. Preputioplasty is a safe and simple alternative to more radical procedure of circumcision.

Background: Cerebral venous sinus thrombosis (CVST) is a rare form of stroke seen in young and middle aged group, especially in women due to thrombus of dural venous sinuses and can cause acute neurological deterioration with increased morbidity and mortality if not diagnosed in early stage. Neurological deficit occurs due to focal or diffuse cerebral edema and venous non-hemorrhagic or hemorrhagic infarct. Aim and Objectives: To assess/evaluate the role of Magnetic Resonance Imaging (MRI) and Magnetic Resonance Venography (MRV) as an imaging modality for early diagnosis of CVST and to study patterns of venous thrombosis, in detecting changes in brain parenchyma and residual effects of CVST using MRI. Materials and Methods: Retrospective descriptive analysis of 40 patients of CVST diagnosed on MRI brain and MRV was done. Results: 29/40 (72.5%) were males and 11/40 (27.5%) were females. Most of the patients were in the age group of 21-40 years (23/40-57.5%). Most of the patients 16/40 (40%) presented within 7 days. No definite cause of CVST was found in 24 (60%) patients in spite of detailed history. In 36/40 (90%) of cases major sinuses were involved, deep venous system were involved in 7/40 (17.5%) cases, superficial cortical vein was involved in 1/40 (2.5%) cases. Analysis of stage of thrombus (acute, subacute, chronic) was done based on its appearance on T1 and T2WI. 31/40 (77.5%) patients showed complete absence of flow on MRV, while 9/40 (22.5%) cases showed partial flow on MR venogram. Brain parenchyma was normal in 20/40 (50%) patients while 6/40 (15%) cases had non-hemorrhagic infarct and 14/40 (35%) patients presented with hemorrhagic infarct. Conclusion: Our study concluded that MRI brain with MRV is sensitive in diagnosing both direct signs (evidence of thrombus inside the affected veins) and indirect signs (parenchymal changes) of CVST and their follow up.

Background: Stress and anxiety have become an integral part of our lives. Of late, this has resulted in the increase in incidence of hypertension and coronary heart disease. Objectives: To assess the effect of progressive muscle relaxation (PMR) on young adult males and its role in the modulation of cardio-respiratory response on exposure to stress. Materials and Methods: This prospective cross-sectional study was conducted in a tertiary care referral hospital. Undergraduate male students under stress were chosen for the study. Fasting blood samples were drawn to analyze sugar and lipid profile, followed by anthropometric measurements and ECG. In the resting condition, blood pressure, pulse rate, and spirometric parameters; forced vital capacities (FVC), and forced expiratory volume in 1 sec (FEV ₁ %) were measured. Then, they were made to exercise with bicycle ergometer and post exercise, the vital parameters were recorded. All subjects were given a training of Jacobson's Progressive Muscular Relaxation and asked to practice this technique for 3 months. All parameters were re-evaluated. Results: Significant decreases in resting heart rate, systolic blood pressure and diastolic blood pressure, total cholesterol, triglyceride, and low density lipoprotein (LDL) cholesterol levels of subjects were seen after PMR training. Exercise-induced rise in heart rate and blood pressure were also significantly less in subjects following PMR training. Conclusion: Progressive muscle relaxation helps in modulation of heart rate, blood pressure, and lipid profile in healthy normal adult male individuals.

Background: Pregnancy and childbirth produce a variety of physiological, psychological and social consequences. Attitudes toward pregnancy and childbirth vary from culture to culture. There is evidence to suggest mothers with young infants experience depressive symptoms and 10-15% major depression. Aim: To study the incidence and factors contributing toward postpartum depression Materials and Methods: Married women 18-35 years of age attending the antenatal and postnatal out-patient clinic were studied during 2007 and January 2008. 200 women who had delivered between 1 June 2007 and 1 January 2008 were included in the postpartum phase to calculate the incidence of postpartum depression. The prospective mothers were approached in their 3 ^rd trimester of pregnancy. Critically ill, past history of depression, co morbid medical or psychiatric illnesses were excluded. The diagnosis of postpartum depression (PPD) was made as per international classification of diseases (ICD 10). They were administered the beck depression inventory (BDI), Presumptive stressful life event scale, Edinburgh Postnatal Depression Scale (EPDS) and General Health Questionnaire (GHQ-12) scale. The women were subsequently reviewed in their postpartum phase in the postnatal out-patient/child immunization clinic at 2, 4 and 6 weeks after delivery. The non-depressed mothers acted as the controls. Results: A Total of 186 women out of 200 registered for the study 40 had scores above 13 on EPDS and grouped as depressive met ICD 10 diagnostic criteria. The remaining 146 were non depressive. 14 women dropped out of the study. Incidence of PPD was 21.51%. The study found 14/27 (51.8%) of the risk factors associated with PPDs were statistically significant. Significant number of mothers had high antenatal GHQ and both antenatal and postnatal BDI scores. BDI and EPDS scores remained high during the postnatal follow-up in the depressed group, which showed the presence of PPD in mothers with young infants. Conclusions: There is a need for sensitizing primary health-care givers regarding PPD and is an important health issue that should not be ignored.

Background: Glycolysis, a major cytosolic oxidative pathway of glucose, is intended for the supply of energy in RBC and, moreover, for the production of 2,3 Bisphsophoglycerate through the Rapaport-Lubering shunt, which delivers oxygen more readily to the tissues. Interleukin 6 (IL-6) is a pro-inflammatory cytokine, playing a pivotal role in the inflammation process and mediating the acute phase process. Aim: This study aimed to investigate the association of the inflammatory parameter, serum IL-6, and glycolytic metabolism in the erythrocytes of sickle cell disease patients. Materials and Methods: This cross-sectional study was performed using a cohort of patients (90 sickle cell disease patients and 60 healthy age-matched controls) followed at the General Medicine Department of MGM Medical College, Indore. Glucose uptake, Hexokinase-2, pyruvate, lactate and 2,3 Bisphosphoglycerate levels were estimated in the RBC by relevant chemical kit methods on an autoanalyzer and enzyme-linked immunosorbent assay (ELISA), respectively. Serum IL-6 is estimated through the ELISA kit method. Statistical analysis was performed by using the Student's unpaired "t" test and Pearson's correlation test. P < 0.05 was considered statistically significant. Results: All glycolytic parameters were elevated along with IL-6 in sickle cell disease when compared with controls. A positive correlation was observed between the IL-6 level and glucose uptake (r = 0.345, P < 0.001), pyruvate (r = 0.512, P < 0.001) and lactate of RBC. Conclusion: This study shows that increased levels of plasma IL-6 might enhance the rate of glycolysis in RBC through the STAT3 pathway in sickle cell disease patients.

Background: Urinary kidney injury molecule 1 (KIM-1) is an early biomarker for renal damage. A few studies have been published analyzing the potential use of urinary KIM-1 as a biomarker for acute kidney injury (AKI). However, no study has been done related to AKI associated with contrast administration. Aim: To search for new markers to identify AKI associated with contrast administration earlier than serum creatinine. Materials and Methods: We studied 100 consecutive patients with normal serum creatinine undergoing angiographic procedure. We assessed urine KIM-1, at 4, 8, and 24 hours after the angiographic procedure. Serum creatinine was measured at basal, 24, and 48 hours after the procedure. Results: There was a significant rise in urinary KIM-1 levels at 24 hours after the angiographic procedure. The presence of contrast induced nephropathy associated with AKI was 12%. Conclusion: The present study highlighted the importance of urinary KIM-1 in detecting AKI associated with contrast administration earlier than Serum creatinine.

Background :0 With the advent of fine needle aspiration cytology (FNAC), the approach to diagnosis and management of breast lesions has been revolutionized. Its accuracy in many situations can approach that of histopathology in providing an unequivocal diagnosis. Aim :0 The aim of this study is to examine the cytological details in aspirated smears from lumps in the breast and to evaluate the role of FNAC in improving the quality of diagnosis by comparing with histopathological features. Materials and Methods: Over a period of 2 years, 334 aspirations, including 16 bilateral were performed. Suppurative and inflammatory lesions and gynecomastia were excluded from the total aspirates. A total of 56 cases were followed-up by histopathologic examination. Results: Cytohistologic correlation was 73.68%, 42.85%, 94.44% for fibroadenoma, fibrocystic disease and duct cell carcinoma respectively. False positives were observed in proliferative lesions. No false negative cases observed. The sensitivity of the fine needle aspiration (FNA) procedure was 100%, specificity, 88.5% and the predictive value of a positive result was 84%. Conclusion: Proliferative lesions may be misinterpreted as malignancy in FNA without complete clinical and mammographic details.

Context: Antibiotic resistance is a global problem. Organisms are showing resistance to not only the conventional antibiotics but also to the higher generation drugs. This enormous amount of resistance faced is a serious threat to mankind and this is further accentuated by the fact that the antibiotic pipeline is fast drying up. We are now left with only a handful of antibiotics to deal with all infections - serious or otherwise. The present paper highlights the current scenario of drug resistance especially in nosocomial settings. Aims and Objectives: To determine the distribution of bacterial pathogens causing nosocomial infections and their antibiogram, a surveillance data from January to December 2011 was collected in Mohan Dai Oswal Hospital. A total of 1800 samples were taken of which maximum samples were urine (766) followed by blood (428) and pus (216), and so on. Settings and Design: This observational study was conducted in the microbiology department of a multispeciality hospital during January-December 2011. Materials and Methods: A total of 1800 samples from different sources were included in the study like pus, blood, urine, sputum, etc., which were taken from patients admitted in the hospital for more than a week. Gram negative bacilli were isolated, identified, and subjected to antibiotic sensitivity test. Statistical Analysis Used: Descriptive statistics using percentages. Results: Out of the total 1800 samples included, maximum positivity was found in the pus samples (70%). Extended-spectrum beta-lactamase (ESBL) positivity was also maximum in the pus samples (90%). These ESBL positive organisms were further subjected to antibiotic sensitivity tests and huge amounts of resistance was noted to the conventional drugs including the higher end agents like Carbapenems. In light of this, newer drugs like Tigecycline, Colistin, and Polymyxin B were also tested. Barring Tigecycline, none showed favorable results. A noteworthy finding was the sensitivity of the urinary ESBL isolates to Nitrofurantoin. Conclusions: The situation is quite dangerous. The time is not far when we will be back in the dark ages of the preantibiotic era. The need of the hour is to be alert of the gravity of this situation and take necessary measures to halt its progress.

Introduction: Ankylosing spondylitis (AS) is a chronic inflammatory disease that affects the peripheral and axial skeletal system, causing pain, arthritis, low back pain and functional incapacity. Questionnaires are used to assess disease activity bath ankylosing spondylitis disease activity index (BASDAI) to measure the effect of AS on patient's life quality, functional incapacity bath ankylosing spondylitis functional index (BASFI); and Ankylosing Spondylitis quality of life (ASQoL). Fibromyalgia (FM) is one of the most common causes of generalized pain and fatigability and can coexist with other diseases; it can be assessed by the FM impact questionnaire (FIQ). There are few studies that demonstrated correlations between FM and AS. The present study obtained data regarding the epidemiologic profile of patients with AS and FM and evaluated the prevalence of FM in patients with AS. The FM influence on BASDAI, BASFI and ASQoL test scores was assessed. Materials and Methods: A total of 36 patients with AS, diagnosed according to the modified New York criteria, were studied. Clinical and functional assessment was performed and BASDAI, BASFI and ASQoL tests were applied. Patients with a diagnosis of FM were evaluated through the FIQ. Results: Seven patients met the criteria for FM; thus a FM prevalence of 19.4% was observed among patients with AS. FM was more prevalent among women (2.5:1). Age at disease onset (AS) was 24.3 years. The human leukocyte antigen-B27 antigen was positive in most of them (83.2%). When comparing BASDAI, BASFI and ASQoL test means, it was observed that values are significantly higher (P < 0.01) among patients with FM. We concluded that the coexistence of FM with AS is associated with disease activity aspects including pain, as well as functional disability and quality of life.

Laryngectomy is always a challenging surgery both from surgical and anaesthesiologist's perspective. The situation can get worse when such patients present with advanced laryngeal cancerrequire a definite surgical intervention along with thyroid gland removal. Apart from anesthetic difficulties in managing the deranged anatomy and pathophysiology, management of difficult airway during peri-operative period can be a huge challenging task. We are reporting a case of laryngeal carcinoma that was posted for laryngectomy and thyroidectomy as the thyroid gland was also invaded to a small extent. A difficult airway situation was anticipated as during indirect laryngoscopy it was observed that the glottic covering was occluded to a large extent by a soft tissue growth.

We report a rare case of unicentric Castleman disease (UCD) in a 56-year-old lady, presenting as a soft-tissue mass in an unusual site - mid-dorsal aspect of the arm. She was otherwise asymptomatic. Excision biopsy confirmed the diagnosis. The probable etiological factors, clinical and morphological types, and histological diagnosis are discussed.

Orthokeratinized odontogenic keratocyst is a less-aggressive non-syndromic variant of odontogenic keratocyst (OKC). In this case report, we are highlighting an unusual presentation of OKC with paresthesia, non-vital teeth, and minimal cortical expansion. The radiograph of the patient revealed a radiolucency crossing the midline in the anterior mandible. This manuscript discusses a case which presented as a diagnostic dilemma due to variable clinical and radiological features mimicking different pathologies occurring in the anterior mandible. We have discussed various clinical and radiographic differential diagnoses of the same.

Premature exfoliation of the primary dentition is a rare phenomenon which may be associated with local disorders of the teeth and systemic diseases; however its association with hypocalcemia and malnutrition is uncommon. Nutritional rickets occurs mostly in developing countries despite some of these countries being sunny. Therefore, emphasis is now shifting toward the role of hypocalcemia as the predominant cause of nutritional rickets. Rickets is often described as a disease of growing bones; hence, it should ordinarily not be seen in malnourished children. This, however, has been refuted over the years. Therefore, a case of an undernourished hypocalcemic Nigerian child is reported who presented with premature exfoliation of the central lower incisors with delayed eruption of other primary dentition.

Acute renal failure is a life threatening condition. Nonsteroidal antiinflammatory drugs (NSAIDs) and cephalosporins are widely used postoperative drugs. NSAID-induced acute renal failure has been reported in the past. In this case, drug interaction and decompensated state of the patient precipitate the condition. NSAIDs inhibit prostaglandins synthesis and thus aggravate ischemia to the kidney that is already facing volume crisis due to surgery. Due to renal dysfunction, plasma ceftriaxone level increases due to decrease clearance and it also acts as nephrotoxic by unknown mechanism. On the other hand, ceftriaxone on its interaction with diclofenac for renal tubular clearance also increases the level of diclofenac and thus further aggravate the ischemia. It is a reversible condition with excluding diclofenac from the treatment regimen and giving adequate hydration to the patient. This highlights the importance of hydration and knowledge of drugs interactions in a postsurgical patient.

Polycythemia is a blood disorder in which the proportion of blood occupied by red blood cells increases. It is reflected in raised hematocrit and hemoglobin values. Elevated hematocrit results in characteristic findings of increased attenuation of cerebral vessels and venous sinuses on unenhanced computed tomography. However, these imaging findings can closely mimic those of cerebral venous thrombosis, leading to diagnostic ambiguity. We present a case of polycythemia with typical features of hyperdense cerebral vasculature on non-enhanced computed tomography.

Molluscum contagiosum (MC) is an infection of skin caused by Poxvirus and usually affects any part of the body as pearly pink umbilicated lesion. Immunocompromised patients are more easily prone for this viral infection. Here, we present four cases of MC affecting various locations in the body.

The delusion of pregnancy is defined as the belief of being pregnant despite factual evidence to the contrary. Even being more common in a developing country, the literature about delusion of pregnancy from India is meager. The present article reports the case of delusion of pregnancy in an unmarried female associated with subclinical hypothyroidism and prominent sibling rivalry from psychological aspect. The literature in this field has addressed for the organic and psychodynamic, psychosocial aspect of this disorder and its difference from other disorders mimicking pregnancy and its relevance to the treatment plan.

A neurenteric cyst of the craniocervical (CV) junction, as a cause of bulbomedullary compression, is very rare. An abnormal communication between the endoderm and neuroectoderm during the third week of embryogenesis may be responsible for its formation. It is a rare spinal condition. The most frequent location is at the lower cervical and higher thoracic spine. Neurenteric cysts of the craniocervical junction are even rarer. We report the case of a CV junction intradural neurenteric cyst. Magnetic Resonance Imaging (MRI) of our patient demonstrated an intradural extramedullary process of the craniocervical junction. A surgical posterior approach allowed gross total resection of the lesion. The histopathology of the surgical specimen showed that the cyst wall was made up of fibrocollagen walls lined with a partially ciliated columnar epithelium.

Hydatid disease is a cyclozoonotic parasitic infestation caused by the larval stage of the cestode parasites of Echinococcus spp. (Echinococcus granulosus, Echinococcus vogeli, and Echinococcus multilocularis). Isolated renal involvement is extremely rare. A 50-year-old male patient presented with acute left loin pain. Ultrasound revealed left mild hydroureteronephrosis with lower pole mass lesion. Computed tomography (CT) scan abdomen and thorax revealed the isolated renal hydatid disease with upper ureteric calculus. On blood examination, he was found to have HIV infection with immunosuppresion. He underwent left partial nephrectomy with pyelolithotomy. Histopathology confirmed the diagnosis of renal hydatid. Immunosuppression may be the cause of unusual site of hydatid cyst and partial nephrectomy is the treatment of choice in isolated renal hydatid cyst with renal calculus in HIV-infected patients.

Lack of availability of dantrolene sodium causes difficulty in management of malignant hyperthermia in different parts of India. We hereby report the case of a seven-year-old girl child who developed malignant hyperthermia and expired in spite of all sincere efforts. In conclusion, it is essential to have a comprehensive knowledge of the disease (MH) for a successful anesthetic management and dantrolene sodium should be available in all parts of India.

Pseudo-Foster Kennedy Syndrome is described as unilateral optic disc swelling with contra lateral optic atrophy in the absence of an intracranial mass causing compression of the optic nerve. This occurs typically due to bilateral sequential optic neuritis or ischemic optic neuropathy. We describe a case of pseudo-Foster Kennedy Syndrome in a 37-year-old male with unilateral papilledema secondary to malignant hypertension and pre-existing ischemic optic neuropathy in other eye preventing transmission of raised intracranial pressure to the optic nerve. Hypertension and diabetes mellitus (DM) play a significant role in pathogenesis of ischemic optic neuropathy. There is a greater correlation in patients with small disc and little to no cupping. The disorder commonly occurs in the 40-65 yrs age group. Our case is an example of Pseudo-Foster Kennedy syndrome where papilledema in one eye was associated with uncontrolled hypertension and disc pallor in fellow eye was secondary to ischemic optic neuropathy.

Developmental cysts of the head and neck are rare, but are the most frequent cause of cystic masses of the head and neck. Of these, thyroglossal duct cysts are the most common, comprising about 70%. Branchial cleft cysts are the next most common, with most other lesions being very rarely encountered. The incidence of dermoid and epidermoid cysts in the head and neck region is 7%. This report describes a case of a dermoid cyst localized in the right lateral aspect of middle third of the face, showing signs of gradual enlargement and progression. Histologically, a diagnosis of epidermoid cyst was made and surgically treated with no evidence of recurrence.

A 40-year-old male, known case of histoid leprosy on multidrug therapy since 10 months, presented with erythema nodosum leprosum since 15 days. Examination findings revealed multiple, irregular, bilateral, symmetrically distributed shiny nodules and plaques all over the body. Bilateral radial, ulnar, radial cutaneous, and lateral popliteal nerves were thickened. The right ulnar nerve was exclusively tender indicative of an abscess, for which decompression and anterior transposition of ulnar nerve was performed. Steroids were given parenterally followed by oral steroids in a dose of 60 mg/day and tapered gradually with good prognosis. In addition, thalidomide in a dose of 300 mg/day was also started.

Lipoma is a common tumor of the soft tissues. Its location on the oral mucosa is infrequent, representing 1 to 5% of all benign oral tumors although it is the most frequently occurring mesenchymal tumor of the trunk and proximal portions of extremities. Lipoma of the oral cavity is seen mainly on the buccal mucosa, tongue, and floor of the mouth. The clinical presentation is typically as an asymptomatic yellowish mass. The overlying epithelium generally remains intact. The purpose of the present case report is to discuss a lipoma on the left buccal mucosa of an elderly male with a brief review of literature.

Adult onset Still's disease (AOSD) is a rare systemic inflammatory disorder, characterized by high fever, salmon-colored rash, polyarthritis and multi-organ involvement. Yamaguchi's criteria and high serum ferritin levels help to diagnose this disease. It is mostly a diagnosis of exclusion. AOSD involves predominantly the joints, liver and skin, but can involve any organ. Neurological involvement is relatively rare and seizures are usually due to fulminant hepatic failure, meningoencephalitis and posterior reversible encephalopathy syndrome/thrombotic thrombocytopenic purpura. Seizures which occur without these conditions and can be exclusively ascribed to the primary disease process alone have not been reported in the literature. We report a patient of AOSD who was treated with immunosuppressants and during the course of her illness presented with generalized tonic-clonic seizures which were attributable primarily to AOSD. Hence seizures per se can be an event in such patients and need to be watched for and treated.