Rare Clinical Vignettesis a collection of Clinical Cases. The Book is based on True Life clinical Experiences, Rare Medical conditions and Diagnostic Dilemma, Including Ormonds Disease as a rare cause of renal failure. Mesenteric varices as a Rare cause of occult Gastrointestinal bleeding. Marple syrup urine disease(MSUD) is a rare metabolic cause of altered mental status in Adults, Acute Metabolic Encephalopathy due to high ammonia Level in A Patient without Liver Disease. Polymyositis as a very rare Initial Presentation of HIV Multiple System Atrophy(MSA) in a Patient with Parkinsons Syndrome.