ABSTRACT
A 36-year-old female with serum anti-aquaporin-4 antibody-positive neuromyelitis optica spectrum disorder (NMOSD) on carbamazepine (CBZ) therapy for paroxysmal tonic spasms (PTS) developed Type 1 respiratory failure. High-resolution computed tomography chest showed diffuse ground-glass opacities in both lungs predominantly in bilateral perihilar region sparing subpleural regions and predominantly upper lobes with a smooth interlobular septal thickening. A transbronchial lung biopsy was consistent with hypersensitivity pneumonitis and following withdrawal of the CBZ and treatment with steroids her respiratory symptoms resolved. After stopping CBZ, PTS recurred, which was successfully treated with lacosamide. This is the first described biopsy-proven case of CBZ-induced hypersensitivity pneumonitis in the NMOSD patient.
ABSTRACT
A stroke or CVA is defined by the abrupt onset of a neurologic deficit that is attributable to a focal vascular cause. Important modifiable risk factors include diabetes, hypertension, smoking, alcohol intake, sedentary life style, dyslipidemia, heart disease and OCP intake in females and non-modifiable risk factors include old age, gender predisposition and family history. The aim of study is to determine the types of stroke and presenting clinical features and modifiable and non-modifiable risk factors associated with development of stroke. Methods: The present study is a prospective observational study conducted in Teerthanker Mahaveer Medical College over a period of one year i.e January 2017 to January 2018.Total 110 cases presenting with stroke were included in the study. Results: The study shows that ischemic stroke is commoner than hemorrhagic stroke.The risk of stroke increases with age and common in males.Diabetes mellitus was seen in 29.1% cases presenting with stroke, 39.1% cases had hypertension.43.6% and 22.7 were smokers and alcoholic respectively. Dyslipidemia was present in 37.3% cases.15.4% cases had history of heart disease.17.2% cases had previous history of stroke. Conclusion: The modifiable risk factors pose a huge burden by increasing the morbidity and mortality due to stroke. Proper control of these risk factors can reduce the burden of disease.