CSF beta-1 Globulin--a potential marker in differentiating multiple sclerosis and acute disseminated encephalomyelitis: a preliminary study.

The exact diagnosis of demyelinating diseases is an enigma even in the best neurological centres. In the present study, the potential role of differential CSF proteins has been critically evaluated in differentiating multiple sclerosis (MS) and acute disseminated encephalomyelitis (ADEM). Cellulose acetate electrophoresis was carried out on CSF and serum samples of 14 MS patients, 23 ADEM patients and 30 controls. There was no statistically significant difference between serum electrophoresis of controls and MS patients. However, in case of CSF electrophoresis there was a statistically significant decrease in beta-1 fraction in 92.2% of MS patients (p=0.01). A comparison between serum electrophoresis of controls and ADEM patients indicated a statistically significant decrease in serum albumin in 87% patients and an increase of alpha-2 globulin in 73.9%. There was no statistically significant difference between CSF electrophoresis of controls and ADEM patients except for the prealbumin fraction which was raised in 60.9% of patients. No statistically significant difference was seen between the serum electrophoresis of ADEM and MS patients. However, on comparing CSF electrophoresis, it was seen that beta-1 fraction was significantly higher in ADEM patients (p<0.05). The predictive value of beta-1 fraction in differentiating MS and ADEM was then evaluated. The negative predictive value was 100% indicating that all samples with a beta-1 fraction of>6.5% cannot be diagnosed as MS. The significant decrease in beta-1 fraction in MS patients may prove to be an early indicator in differentiating between MS and ADEM patients.

A comparison of the clinical efficacy of ranitidine and sucralfate in reflux esophagitis.

A total of 40 patients with endoscopically proved reflux esophagitis were treated in a randomised study. Treatment was given for six weeks and consisted of daily doses of either 1 gm sucralfate four times a day or one, 150 mg ranitidine tablet twice daily. Twenty patients received each drug. Clinical evaluation was done weekly and endoscopic evaluation after six weeks. Forty percent patients on ranitidine and 50% patients on sucralfate became asymptomatic at six weeks. Fifty percent patients on ranitidine and 60% patients on sucralfate were endoscopically healed. The results did not show any difference in the effect of ranitidine and sucralfate treatment (p > 0.05). Overall tolerance and compliance in the two forms of treatment was good. Though ranitidine has a more convenient dose schedule and is more cost effective, sucralfate needs further clinical trials.

A comparison of the clinical efficacy of ranitidine and sucralfate in reflux oesophagitis.

Forty patients with endoscopically proved reflux oesophagitis were treated in a randomised study. Treatment was given for six weeks and consisted of either 1 g sucralfate four times a day or 150 mg ranitidine tablet twice daily. Twenty patients received each drug. Clinical evaluation was done weekly and endoscopic evaluation after six weeks. Eight patients on ranitidine and ten patients on sucralfate became asymptomatic at six weeks. Ten patients on ranitidine and twelve patients on sucralfate were endoscopically healed. There was no difference in the effect of ranitidine and sucralfate treatment (p greater than 0.05). Overall tolerance and compliance with the two forms of treatment were good. Though ranitidine has a more convenient dose schedule and is more cost-effective, sucralfate needs further clinical evaluation.

Esophagitis: clinical and endoscopic assessment of sucralfate therapy.

Twenty patients with endoscopically proved reflux esophagitis were studied. Each patient was given 1 gm sucralfate 4 times a day for 6 weeks. Clinical and endoscopic assessment of the effects of sucralfate on reflux esophagitis was done. 50% patients became asymptomatic and 60% healed endoscopically. The drug was well tolerated. We conclude that sucralfate is an effective and well tolerated drug for treatment of reflux esophagitis.