Extramedullary plasmacytoma

Diarrhoea is a leading cause of death in children, with nearly 500,000 young lives lost to diarrhoea each year. Almost all these lives could be saved with a low-cost & widely available treatment - oral rehydration salts (ORS). A new study has revealed that ORS is under-prescribed in India; 50% of children with diarrhea did not receive this lifesaving treatment. There are several popular explanations for the under-prescription of ORS in India. What may be the major reason in your opinion?

M.70yrs. Cough with severe pain right chest. 10 days

36 years old female complained about painful Lymph nodes on the neck region. *Chief Complaints* Painful & swallon lymph nodes at submandibular region of neck. *History* She was experienced with painful lymph nodes last year. She visited ENT, endoscopy showed grade 1 Tonsillitis & Chronic Pharyngitis. Montex was negative Usg neck showed reactive lymphadenopathy. She got resolved after using Antibiotics and some other medicine last year. Now again same complaints, patient is experiencing. *Vitals* Normal *Physical Examination* Normal apart from lymph nodes.

32 years female, complained that reddish discoloration developed after given Nuerobian Injection at Buttock. *Chief Complaints* No Pain & inflammation No rash *History* She had taken Injection Nuerobian intramuscularly left side buttock. After some time at the Left side of the Gluteus Maximus region developed reddish brown color. This discoloration just below the injection site. Not exactly on Injection site. *Vitals* Normal Vitals *Physical Examination* Normal

27 female history of hit by vehicle Opened wound over knee anteriour Bleeding + O/e cripitus present Movements painful X-ray tagged Diagnosis and management *Chief Complaints* Bleeding and cut lacerated wound over front of knee *History* Hit by a vehicle *Vitals* All stable mild hypotension *Physical Examination* Crush injury with clw of 10 cm over patella with crapitus present anteriourly fracture fragments present *Investigations* X-ray tagged *Diagnosis* ? *Management* ?