ABSTRACT
Background: Axonal loss is thought to occur early in the course multiple sclerosis (MS) and is supposed to be associated with, and predictive of, neurologic deficits progressing to permanent disability.Axonal loss in the retinal nerve fiber layer (RNFL) is measured by optical coherence tomography (OCT). Material and Methods: A longitudinal observational study, conducted on 30 MS patients. All subjects underwent neurological examination, including expanded disability status scale (EDSS) scoring and OCT on two visits, minimum 2 months apart. Results: Total of 60 eyes of 30 patients were subdivided into 21 eyes having optic neuritis (ON) [‘MS – ON’] and 39 eyes without ON. The RNFL thickness (RNFLt) was found to be significantly reduced in all parameters except in temporal quadrant, as the duration of disease increases. Average RNFLt were found to have negative correlation (r = -0.450) with disease duration. Negative correlation (r=-0.657) was also found between EDSS score change and average RNFLt change. The eyes having ON showed statistically significant RNFL thinning as compared to the non – ON fellow eyes. The baseline EDSS score was found to be negatively correlated (moderate degree, r = -0.348) with baseline average RNFL thickness, with p-value of 0.006. Conclusions: The RNFLt is not only significantly thinner in those with history of ON, but it is also affected remarkably even in absence of prior ON, suggesting subclinical ongoing axonal loss in patients with MS. The EDSS score is inversely correlated with RNFL thickness.
ABSTRACT
Hepatitis B is a worldwide problem with high prevalence rate in our country. Kidney involvement is common in chronic hepatitis B patients. The usual pattern is membranous glomerulonephritis in children and Type I membranoproliferative glomerulonephritis in adults. A previously asymptomatic young female suffering from chronic hepatitis B with portal hypertension presented with nephrotic syndrome. Kidney biopsy revealed minimal change glomerulonephritis which is rarely seen in association with hepatitis B. Patient recovered following administration of oral steroids. We reconunend screening of all patients of nephrotic syndrome for chronic hepatitis B with viral markers in addition to HBsAg.
ABSTRACT
Gastroepiploic aneurysms are extremely rare. They occur mainly in elderly men and in 90% of cases are ruptured at presentation. Visceral aneurysms though rare should be borne in mind in cases of unexplained haemorrhagic shock. We present a case of a 79-year-old man who presented with abdominal pain, hypotension and anaemia but no obvious source of bleeding. He had undergone a prior aorto-bifemoral graft. The patient refused an operation and died the following day.
Subject(s)
Aged , Aneurysm, Ruptured/diagnosis , Gastroepiploic Artery , Humans , Male , Shock, Hemorrhagic/etiologySubject(s)
Acute Disease , Adolescent , Female , Hepatitis E/complications , Humans , Liver/pathologyABSTRACT
With the advent of magnetic resonance imaging, brain lesions associated with Japanese encephalitis are increasingly being recognized and correlated with movement disorder. Bilateral haemorrhagic thalamic infarcts on MRI, suggested as a characteristic finding in Japanese encephalitis were conspicuous by their absence in this case report of Japanese encephalitis.
Subject(s)
Adolescent , Brain/pathology , Cerebral Infarction/diagnosis , Diagnosis, Differential , Dominance, Cerebral/physiology , Encephalitis, Japanese/diagnosis , Humans , Magnetic Resonance Imaging , Male , Neuromuscular Diseases/diagnosis , Thalamic Diseases/diagnosisSubject(s)
Adult , Humans , Male , Parkinsonian Disorders/complications , Pedigree , Peripheral Nervous System Diseases/complications , PrognosisSubject(s)
Adult , Congenital Abnormalities/diagnostic imaging , Female , Humans , Lung/abnormalitiesSubject(s)
Adolescent , Foot/pathology , Humans , Klippel-Trenaunay-Weber Syndrome/pathology , Leg/pathology , Male , Marfan Syndrome/pathologyABSTRACT
We studied serum prealbumin (SPA) and serum alpha fetoprotein (AFP) to assess liver cell injury and prognosis in patients with fulminant hepatic failure (FHF). We studied 21 patients of FHF of viral etiology, 10 acute viral hepatitis (AVH) and 10 healthy controls. Initial (on the day of admission) AFP levels were significantly elevated in FHF group (30.28 +/- 63.58 ng/ml, p < 0.01 compared to AVH and control group in whom it was undetectable. Serum AFP correlated well with deranged Liver Functions (LFT). In the Survivors (n = 4) of FHF, serial estimations (on Day 5 and Day 10 of admission) revealed declining AFP Levels, correlating with clinical recovery. SPA on admission was significantly reduced in FHF group (15.10 +/- 9 mg/dl p < 0.05) compared to AVH (37.0 +/- 9.34 mg/dl) and control group (40.25 +/- 5.92 mg/dl). Low SPA also correlated with deranged LFT. Serial estimations in the survivors (Day 5, Day 10) revealed rising SPA which correlated with clinical recovery.