Cerebellar nodulus (lobule X) is an anterior and inferior structure of the vermis and is the epicenter of flocculonodular lobe (vestibulocerebellum). Nodulus coordinates with the vestibular nuclei through afferent Mossy and efferent Purkinje fibers and plays a pivotal role in maintaining balance and is responsible for vestibulo-ocular reflex. Any lesion disrupting these fiber tracts impairs the person's ability to control ocular movements during head tilting and posture while standing and walking. Isolated infarction of nodulus is extremely rare with only few cases been reported earlier. In this article, the authors present a case of an elderly female with severe giddiness and cerebellar signs and were diagnosed to have an isolated cerebellar nodulus infarction on imaging studies. Conservative management to which our patient responded well is also discussed.

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Introduction: India accounts for 274.9 million global tobacco users and approximately 120 million tobacco smokers. It is predicted that tobacco deaths in India may exceed 1.5 million annually by 2020. Considering the hazardous impact of smoking upon the health of an individual, we conducted this investigation to evaluate the magnitude of this increasingly distressing public health concern among youngsters enrolled in university courses at various educational institutes in the state of Andhra Pradesh, India. Methodology: A cross-sectional questionnaire based study was conducted among youngsters at various educational institutions in Andhra Pradesh, India. The structured questionnaire was developed to assess the number of youngsters habituated to smoking and to know their attitude, knowledge, and behavioral responses toward smoking tobacco. Results: A total of 4394 responses were collected from Andhra Pradesh. The mean age of the respondents was 20.4 ± 2.9 years and 67.6% were males. The overall smoking rate was found to be 41.03%. Of the total respondents, 1254 (28.5%) were enrolled in pre-university course, whereas graduates and postgraduates constituted 2348 (53.4%) and 792 (18.0%), respectively. A majority of smokers (72.6%) and nonsmokers (91.6%) stated that people adapt to smoking as a fashionable trend, while only a meager (12.1%) respondents thought stress as a stimulant to resort to smoking habits. 44.9% respondents felt smoking cigarettes in a group increased interaction among their peers; 81.1% confessed to initiation of smoking during their teenage years; About 66.8% admitted to smoking up to 5 cigarettes/day, while 76.2% were aware of the fact nicotine in cigarettes causes addiction. Of the suggested measures to quit smoking, 64.9% of the respondents recommended prohibition of smoking at public places, 66.1% advised cigarettes to be made expensive, 87.2% sought counseling by a physician or a pharmacist as a valuable resource to help youngsters curb their smoking habits and 77.1% thought the use of e-cigarettes could be a potential alternative measure to avoid tobacco smoking. Conclusion: A high percentage of youngsters admitting to smoking cigarettes as demonstrated from our survey highlights a poor indicator of national health status. Perhaps, it also reflects a failure of state government policies aimed to prevent tobacco use. The need to formulate stringent policies to guide youngsters to understand the deleterious effects of tobacco, including but not limited to, advertisements, banners, setting up of de-addiction and counseling centers, national wide campaign and broadcasting should be done.

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We report a case of a 35-year-old male who presented to our emergency room with debilitating, complete, irreducible, edematous rectal prolapse along with retention of urine. Due to marked edema and inflammation, the reduction was unsuccessful under general anesthesia; hence a conservative approach was considered. With local sugar application for a week, the edema was reduced and via manual digital maneuver, the prolapse was reduced with anal encirclement the day after to maintain the reduction. With our experience, where laproscopic facilities were unavailable, we wish to highlight the role of nonsurgical/conservative conventional methods of management of such severe cases that are associated with edema and present to clinics/institutes where limited surgical facilities are available.

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Osteopetrosis is a group of rare genetic diseases, consequent on absent or defective osteoclasts. A large number of genes have been found to be associated with the defect, each of which results in a clinically variable phenotype with regards to age at presentation and severity of disease. This makes the disease a clinical diagnostic challenge. We present one such case which was diagnosed on trephine biopsy performed to understand the cause of the presence of blast cells in peripheral blood of an 8-month-old infant.

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Gastrointestinal stromal tumors (GISTs) are tumors of mesenchymal origin arising from the walls of the gastrointestinal (GI) tract, with stomach being the most common site followed by the small intestine. Those with similar morphology identified outside the GI tract are termed extra-gastrointestinal stromal tumors and are often located in the mesentery, omentum, pelvis, retro-peritoneum, rectovaginal septum, perivaginal soft-tissue, and very rarely the prostate. Due to their malignant potential, it is utmost essential to diagnose such extra-intestinal occurrences, with immunochemistry being an effective tool in its diagnosis. We herein report a case of GIST of the prostrate in a 75-year-old male presenting with dysuria and urinary retention and discuss the role of immunohistochemistry markers that aid in diagnosis and its differentiation from other malignant conditions involving the prostrate. This case serves best to promote awareness of GIST in unusual anatomical locations to help early diagnosis and prompt subsequent management.

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Wandering spleen is a rare entity characterized by huge spleen with laxity of the splenic ligaments, absence of peritoneal attachments and presence of long pedicles. We herein present a case of a 42-year-old female with wandering spleen that presented to our clinic with intermittent abdominal pain associated with an abdominal lump.

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We report a case of 46-year-old female patient who presented with a breast lump and was diagnosed as a case of idiopathic granulomatous mastitis. Patient was put on steroid therapy and her lesion completely disappeared, both clinically and radiologically. When we stopped the steroid therapy, the mass again recurred and patient had to undergo lumpectomy with no recurrence in follow-up of 1 year.

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