ABSTRACT
Introduction: Demyelinating disorders of CNS are characterized by inflammation and selective destruction of central nervous system (CNS) myelin. In spite advancements in diagnostic techniques, studies on Indian adult population on the subject are very scarce. The current study is aimed to document clinicopathological profile of primary and secondary demyelinating disease of CNS in adult patients, presenting to a tertiary care teaching hospital. Materials and methods: The current study was prospective observational study of 50 patients presenting to a tertiary care teaching hospital with various symptoms suggestive of demyelinating CNS disorders and were clinically confirmed. Results: A total of 50 participants were recruited into the study. Highest proportion of subjects was below 20-year age group. The proportion of females (58%) was higher than that of males (42%). Paraplegia was the most common clinical presentation in study population, which was seen in 13 (26%) participants.. The most common level of spine involved was dorsal spine in 17 (34%) subjects and equal number of subjects had cervico dorsal spine involvement. Demyelinating Transverse myelitis was the most common type of demyelinating disorder seen in study population, which was diagnosed in 42% of the study subjects. Multiple sclerosis was present in 24% of the subjects and 22% of the subjects had ADEM. Secondary demyelination was present in 4 (8%) of the subjects and only 2 (4%) of the subjects had DEVICS. Among the causes of secondary demyelination HIV was the most common cause, present in 4% of cases. Herpes zoster and chicken pox were present in 1 (2%) of cases each in study population. Conclusions: Demyelinating disorders of the central nervous system are common among younger age T. Murali Venkateswara Rao, U. Ganga Prasad. Clinical profile of 50 adults with demyelinating diseases of central nervous system - A prospective observational study. IAIM, 2016; 3(11): 143-150. Page 144 group females. Primary demyelinating diseases are more common than secondary demyelinating diseases. Clinically isolated demyelination syndrome patients need regular follow up with MRI imaging in due course. Patients with more than three segmental involvement in spinal cord and those with more than three peri-callosal, peri- ventricular and posterior fossa lesions in MRI images has poor clinical recovery after treatment. MRI brain and spine provides more prognostic information than clinical assessment.
ABSTRACT
Introduction: Tuberculosis was the major infectious cause of death in the world. Even though, in developing western countries it is less common the mortality rate of abdominal TB was because of less awareness, and lack of proper understanding Aim: The study was aimed to study the clinical profile of abdominal tuberculosis presenting to a tertiary care teaching hospital in south India. Materials and methods: The study was a prospective observational study. The study was conducted in NRI Academy of Sciences, a tertiary care teaching hospital in south India. All patients admitted to the Departments of Internal Medicine, General Surgery and Gastroenterology at NRI general hospital. Results: In the current study, study population included 76 members. Males and Females were in equal distribution (50%). The mean age of the study participants was 37.0 (±13.59) years. Age wise majority of study participants were in between 21 to 40 years of age. Only few members were under 20 years and above 50 years. Abdominal pain, distension, and vomiting were the most common clinical symptoms. 88.2% were with abdominal pain, 46.1% were with abdominal distension and 43.4% were with vomiting. Other common symptoms were Fever, weight loss and anorexia were reported 39.5%, 27.6%, 25% respectively. Mass per abdomen, bleeding per rectum was few other rare symptoms. 60.5% were with abdominal tenderness. Hepatosplenomegaly was present in 3.9%. Abdominal distension, Ascites and mass per abdomen were reported in 46.1%, 17.1%, and 13.25% respectively. Obstruction was the most common finding observed in abdominal X-ray seen in 70% of T. Murali Venkateswara Rao, Murali Krishna TV, B. Bhaskara Rao. Clinical profile of abdominal tuberculosis presenting to a tertiary care teaching hospital - A prospective observational study. IAIM, 2016; 3(7): 267-273. Page 268 the 10 subjects, who underwent screening. Pneumoperitoneum and obstruction wit pneumoperitoneum were the other findings reported in 205 and 10% of the screened subjects. In 41 subjects, who underwent ultrasonography of abdomen, ascites was the most common finding reported in 65.9% of the subjects. Hepatosplenomegaly (21.9%), only splenomegaly (19.5%) and obstruction (17.1%) were the other common findings. Mass and lymph nodal enlargement were the other common findings observed. Mass and lymph nodal enlargement were the common findings reported in the CT abdomen. Conclusion: Abdominal Tuberculosis is one of the major problems facing in developed countries. Among extra pulmonary tuberculosis cases abdominal tuberculosis is the major one.