Background: Lyme disease, (LD) is the most common tick-born disease. It is caused by borrelia burgdorferi. Lyme disease is a systemic illness. It can involve different organs, causing a large variety of clinical manifestations. LD is potentially lethal in chronic and late stages, so it is important to consider the antibiotic therapy at early stages. Cases Report: Here we present a 29-year-old young woman who was admitted to the hospital with fatigue. She claimed to be bitten one day before the admission. She was otherwise a healthy individual. Conclusion: Through this reported case, we highly recommend the early clinical diagnosis of Lyme disease in endemic areas.

Rheumatoid arthritis (RA) is an inflammatory progressive disease which in the absence of appropriate treatment can lead to joint destruction and disability. Prognosis of RA may be predicted based on the presence of some clinical and laboratory evidences. New criteria for classification of RA provides opportunity for earlier treatment. Initiation of treatment particularly by combination of DMARDs concurrent with short duration of corticosteroid is expected to prevent progressive course and even change the natural course of RA. At present any patients with clinical synovitis in at least one joint may have definite RA, requiring aggressive treatment.

Introduction: Conjoined twins are complicated and unusual form of monozygotic twins. We present early prenatal diagnosis of three cases of conjoined twins by 2-dimensional (2D) ultrasound between 9-10 weeks of gestation.Case presentation: In the first case, we prenatally diagnosed parapagus dicephalus dibrachus dipus with 2- dimensional ultrasound at gestational age of 10 weeks 4 days. In the second case, we detected parapagus dicephalus at the 10 weeks 2 days gestation. In the third case, we diagnosed thoracopagus at the 9 weeks 6 days of gestation, using 2D ultrasound. After proper counselling, all of the patients opted early pregnancy termination due to the poor prognosis of conjoined twins.Conclusion: Early prenatal detection of conjoined twinning is important for the gestational course. Conjoined twinning could be identified in early first trimester with cautious and comprehensive view by experienced sonographers. Early and accurate prenatal diagnosis of conjoined twinning allows preferable counselling of the parents and gives a chance for early termination of pregnancy.