Thoracic intramedullary epidermoid with paraplegia for 12 years

A man presented with progressive motor and sensory loss in both lower limbs for 12 years with fecal and urinary incontinence MRI of dorsal spine showed an intramedullary mass in the dorsal cord at D5-D6 level which had a pearly white appearance on exploration. Complete excision was performed leading to good recovery in sensation, movements and sphincter control. Epidermoids should be considered in differential diagnosis of intramedullary tumours. Their removal leads to complete recovery

Relationship between sialic acid and microvascular complications in type 2 diabetes mellitus

Serum total sialic acid is a marker of acute phase response. Elevated levels have also been associated with several risk factors for diabetic vascular disease

Objective: to study relationship between sialic acid and metabolic variables in type 2 diabetic patients with and without microvascular complications

Material and Methods: this study included 200 subjects of which 50 were of diabetes mellitus with nephropathy 50 patients of type 2 diabetes mellitus with retinopathy50 patients of type 2 diabetes without any complication and 50 healthy individuals without diabetes mellitus. [Control subjects]. Tl1e subjects aged 15-60 years were selected for study. Fasting venous blood samples were taken from all these 200 subjects. Simultaneously urine sample were also collected from each of them. All blood samples were analyzed for fasting and postprandial glucose, total cholesterol triglyceride [TG], low .density lipoprotein [LDL], high density lipoprotein [HDL], creatinine, HbAlc on fully automated analyzer. Serum and urine sialic acid along with micro albumin levels were also estimated

Results: serum total sialic acid concentrations were significantly higher among all diabetic subjects with or without complications compared to control subjects. In diabetics patients there was a significantly increasing trend of serum and urinary sialic acid with severity of nephropathy [P<0.001] and with degree of urinary albumin excretion [p<0.001]. Elevated serum sialic acid concentrations were also associated with several risk factors for diabetic vascular disease: diabetes duration HbAlc, serum triglyceride, serum cholesterol, and HDL and LDL concentrations. Significant correlations were found between sialic acid concentrations and cardiovascular risk factors like LDL and TG in diabetic patients

Conclusion: the main finding of this study is that elevated serum and urinary sialic acid and micro albumin concentration were strongly related to the presence of microvascular complications like diabetic nephropathy and retinopathy and cardiovascular risk factors in type 2 diabetes patients