ABSTRACT
Seizures may occur in close relation to surgical procedures or with the use of anesthetic agents in several situations. Thecausative factors include an interruption of treatment with antiepileptic drugs (AEDs) or inadequate blood concentrations resultingfrom impaired gastrointestinal absorption. In operative procedures not involving the brain, transient seizures can arise frommetabolic derangements or drug neurotoxicity. Other causes include hypoxia, hypotension, and embolic infarction. Seizuresoccurring shortly after injection of moderate to large amounts of local anesthetic should raise the suspicion of inadvertentintravenous injection. Seizures may also indicate withdrawal from unsuspected chronic use of excessive amounts of alcohol,sedative medications, mood-stabilizing agents, or AEDs. Rarely, sleep deprivation and drugs like flumazenil may precipitateseizures. We discuss the management of status epilepticus following laparoscopic urology procedure in a patient of chronickidney disease with a history of the previous craniotomy.
ABSTRACT
In spite of the availability of effective chemotherapy and Bacille-Calmette-Guerin (BCG) vaccine, tuberculosis remains a leading infectious killer world-wide. Many factors such as, human immunodeficiency virus (HIV) co-infection, drug resistance, lack of patient compliance with chemotherapy, delay in diagnosis, variable efficacy of BCG vaccine and various other factors contribute to the mortality due to tuberculosis. In spite of the new advances in understanding the biology of Mycobacterium tuberculosis, and availability of functional genomic tools, such as microarray and proteomics, in combination with modern approaches, no new drug has been developed in the past 30 yr. Therefore, there is an urgent need to identify new drug targets in mycobacteria and eventually, develop new drugs. The release of the complete genome sequence of M. tuberculosis has facilitated a more rational, and directional approach to search for new drug targets. In general, gene products involved in mycobacterial metabolism, persistence, transcription, cell wall synthesis and virulence would be possible targets for the development of new drugs. The exploitation of host cell signaling pathways for the benefit of the pathogen is a phenomenon that deserves to be looked into with a new perspective in the current scenario to combat M. tuberculosis. Reversible phosphorylation and dephosphorylation, which are carried out by specific protein kinases and phosphatases have been shown to modify the host proteins and help in the establishment of disease by several pathogenic bacteria. In this review, we discuss some possible drug targets for M. tuberculosis.