Don’t pin it all on a stereotype

Hypercalcemia is one of the most frequently encountered problems in endocrinology OPD. Although the evaluation may not always be straightforward in all scenarios. Common factors affecting calcium levels such as dehydration, improper sample collection, and vitamin D supplementation may mask a serious underlying disorder. Here, we discuss a case of an elderly female who had symptoms of myelopathy and hypercalcemia whose etiology was initially attributed to excessive sup

Prevalence of QTc prolongation among hypertensive patients and its association with other co-morbidities

Background:Hypertension, an iceberg disease contributes significantly to the global health burden. This pan-endemic disease is a harbinger for cardiovascular events, especially life-threatening arrhythmias. A simple and cost-effective electrocardiogram serves as an effective tool to identifyand evaluate hypertensives with high cardiovascular risk.QTc interval which indicates repolarization abnormality is one such effective tool.The study aimed at describing the prevalence of QTc prolongation among hypertensive individuals and also to assess the association of QTc prolongation with various co-morbidities.Methods:One hundred and fifty-nine hypertensive patients were evaluated in this cross-sectional study for six months. Demographic variables, biochemical parameters, blood pressure and electrocardiogram were recorded for all the patients. Data obtained were statistically evaluated.Results:The mean age of participants was 55.6 years (SD�76). There were 103 males (64.4%) and 43 females (35.6%). QTc prolongation was noted in 52.5% of the population studied.Statistically significant QTc prolongation among poorly controlled hypertensive was 59% when compared to that of controlled hypertensive at 37.5% was noted. About 26% of the participants were smokers, 27% were alcoholics and 60% had co-existing diabetes mellitus. Diabetes and gender were found to have a statistically significant association with QTc prolongation.Conclusions:The study found a positive correlation between prolonged QTc and hypertensives and hypertensives with coexisting diabetes. To mitigate the consequences of hypertension, the study recommends early diagnosis, stringent blood pressure control, efficient and effective use of QTc measurement, and preventive pharmacotherapy.

CRISPR/Cas9 Edited sRAGE-MSCs Protect Neuronal Death in Parkinson's Disease Model

BACKGROUND AND OBJECTIVES: Parkinson’s disease (PD) is a fatal and progressive degenerative disease of the nervous system. Until recently, its promising treatment and underlying mechanisms for neuronal death are poorly understood. This study was investigated to identify the molecular mechanism of neuronal death in the substantia nigra and corpus striatum of PD. METHODS: The soluble RAGE (sRAGE) secreting Umbilical Cord Blood—derived Mesenchymal Stem Cell (UCB-MSC) was generated by gene editing method using clustered regularly interspaced short palindromic repeats/CRISPR associated protein 9 (CRISPR/Cas9). These cells were transplanted into Corpus Striatum of rotenone-induced PD animal models then behavioral test, morphological analysis, and immunohistochemical experiments were performed to determine the neuronal cell death and recovery of movement. RESULTS: The neuronal cell death in Corpus Striatum and Substantia Nigra was dramatically reduced and the movement was improved after sRAGE secreting UCB-MSC treatment in PD mice by inhibition of RAGE in neuronal cells. CONCLUSIONS: We suggest that sRAGE secreting UCB-MSC based therapeutic approach could be a potential treatment strategy for neurodegenerative disease including PD.

Comparison between ‘three in one femoral nerve block’ and psoas compartment block for post-operative pain relief following lower limb surgical procedures.

Aim of this study was to compare anterior approach (‘three in one block’) and posterior approach (psoas compartment block) of lumbar plexus block in relieving the post-operative pain in patients operated for unilateral hip, femur or knee surgery under spinal anaesthesia. 40 patients undergoing elective orthopedic procedure in hip, femur or knee were randomized into group A and group B. Surgery was done under spinal anaesthesia. At the end of the surgery, single shot lumbar plexus block was given by anterior approach (3 in 1 block) in group A and by posterior approach (psoas compartment block) in group-B patients with 30 ml of 0.25% of bupivacaine. Pain was assessed using verbal rating scale. The time for first rescue analgesic, need of additional analgesic and overall satisfaction of post-operative pain relief were noted. Both the groups were comparable in age, sex, weight, height, vital signs, duration and type of surgery. There is no significant difference in pain level between two groups. The mean time for first rescue analgesia was 9.10 (± 1.52) and 9.90 (± 1.21) hours in group A and group B respectively (p>0.05 not significant). Requirement of additional analgesic was reduced in both groups. More than 90% of patients expressed overall satisfaction of post-operative pain relief in both groups. Both approaches of lumbar plexus block by Three in one femoral nerve block (Group A) and psoas compartment block (Group B) were effective in providing post-operative analgesia after hip, femur, or knee surgery.

Supratentorial extradural hematoma secondary to intracranial hypotension following spinal cerebrospinal fluid release: A case report and review of literature

Closed continuous lumbar subarachnoid drainage is an accepted strategy in the management of cerebrospinal fluid (CSF) leaks. Post lumbar drain haematoma as a complication has been reported in various planes including intraventricular, subdural, subarachnoid, intraparenchymal and spinal extradural locations, most often in patients receiving anticoagulants. Supratentorial extradural haematoma secondary to intracranial hypotension due to spinal CSF drainage are extremely rare and have been reported in a few cases. We present a rare case of near fatal fronto-temporo-parietal extradural haematoma following a lumbar CSF drain and review the literature. We report a 50 year old lady who developed CSF rhinorrhea following trans-sphenoidal decompression of non-functioning pituitary macroadenoma. A lumbar CSF drainage was placed to manage the CSF leak. She became unconscious within 24 hours of placement of lumbar drain and an urgent CT scan demonstrated a large supratentorial extradural hematoma which required an emergency evacuation. A review of the five previously reported similar cases was performed in the light of the present case and salient features highlighted. The present report emphasizes the fact that a simple procedure like lumbar CSF drainage can have rare life threatening complications and needs immediate recognition and management.

Glycoconjugate profile in plasma and erythrocytes of gastric cancer patients.

The present study has examined the glycoconjugate profile in plasma and erythrocyte membranes of 24 adult male gastric cancer patients and an equal number of age and sex-matched controls. Protein-bound hexose, hexosamine and sialic acid were significantly increased in plasma and erythrocytes of gastric cancer patients compared to controls. Elevation of glycoconjugates in circulation is suggested to be a result of increased shedding by the tumor cells or increased synthesis by liver, due to acute phase response.