Multidetector Computed Tomography Findings In A Case Of Top Of Basilar Syndrome

Stroke is a condition in which poor blood flow to the brain results in cell death. In India, almost 2,00,000 strokes are reported a year. Basilar artery occlusion syndromeaccounts for 1–4% of all strokes.Top of the basilar syndrome is a type of basilar artery occlusion syndrome where the distal end of the basilar artery is occluded. Imaging findings include ischemic changes in the areas supplied by the distal branches of the basilar artery. A posterior circulation - acute stroke prognosis early computed tomography score system can be used to evaluate the prognosis of the patient.We are reporting a case of top of the basilar syndrome in an 85-years-old female patient who presented to us with complaints of one episode of seizure.

Immunogenicity of plasma-derived hepatitis B vaccine in preterm infants.

The objective was to determine whether plasma-derived hepatitis B vaccine is immunogenic in preterm appropriate for gestation babies when administered at birth and to compare the immunogenicity between 5 micrograms and 10 micrograms doses of the vaccine in these babies. Fifty preterm neonates (31-36 weeks gestation) were randomized to receive 5 micrograms or 10 micrograms doses of plasma-derived hepatitis B vaccine at birth, with subsequent doses 1 and 6 months later. Serum specimens were obtained a month after each dose of the vaccine and were tested for antibody to hepatitis B surface antigen (anti-HBs). Thirty six babies (gestation 31-36 weeks), 18 from each group competed the study. While 89.2% of the babies seroconverted, 82.1% achieved seroprotective titres of anti-HBS (> 10 mIU/ml). There was no difference between weight, gestational age, age of administration of vaccine and age of estimation of anti-HBs between 5 micrograms and 10 micrograms groups. The difference in the seroprotective rates were not statistically different between the groups (5 micrograms 78.5%; 10 micrograms--85.7%). Although immune response to plasma derived hepatitis B vaccine in preterm babies is suboptimal when the first dose is administered at birth, the full course achieves adequate seroprotective levels.

Juvenile dermatomyositis in north India.

OBJECTIVE: To determine the clinical profile and therapeutic response of patients with juvenile dermatomyositis (JDM). DESIGN: Hospital based descriptive follow-up study. SAMPLE: 12 patients attending the Pediatric Rheumatology and Immunology Clinic over last five years. RESULTS: The patients were aged between 3 1/2 years to 12 years with a male to female ratio of 2:1. All patients had proximal muscle weakness at presentation. Distal muscle weakness and masseter atrophy was seen in 2 patients and neck flexor weakness and pharyngeal weakness was seen in 1 case. Muscle pain, tenderness or swallowing difficulties were not observed. Classical skin manifestations of JDM were present in all except one patient. Vasculitic lesions were not noted. One patient had diffuse lipoatrophy. Two patients developed calcinosis cutis while on treatment. All patients were put on oral corticosteroids (prednisolone 2 mg/kg/day) initially which were gradually tapered while monitoring clinical response. Early initiation of steroid therapy resulted in an excellent response. Two patients who did not show significant improvement even with prolonged steroid therapy were given oral weekly methotrexate (10 mg/m2/week). CONCLUSIONS: Most of the children with JDM showed good response to steroid therapy which needs to be continued for a prolonged period. Children who do not respond to this therapy may be given oral weekly methotrexate.