Acute Flaccid Myelitis: Current Status and Diagnostic Challenges

Acute flaccid myelitis (AFM) is a sudden-onset polio-like neuromuscular disability found commonly in young children. There is an increasing incidence of confirmed AFM cases in the USA and other countries in recent years, and in association with nonpolio enterovirus infection. This represents a significant challenge to clinicians and causes significant concern to the general public. Acute flaccid paralysis (AFP) is the long-known limb paralytic syndrome caused by a viral pathogen. AFM is a subset of AFP that is also characterized by a limb paralytic condition, but it has certain distinct features such as lesions in magnetic resonance imaging of the spinal cord gray matter. AFM leads to spinal cord, brainstem, or motor neuron dysfunction. The clinical phenotypes, pathology, and patient presentation of AFM closely mimic AFP. This article provides a concise overview of our current understanding of AFM and the clinical features that distinguish AFM from AFP and similar other neurological infectious and autoimmune diseases or disorders. We also discuss the diagnosis, clinical pathology, possible pathogenetic mechanisms, and currently available therapies.

A prospective study of complications in newly diagnosed type 2 diabetes mellitus patients of lower socioeconomic group with special reference to microvascular complication and metabolic syndrome

Background: All these metabolic derangements exist for many years in the asymptomatic phase of type 2 diabetes and they predispose to development of complications even before clinical diagnosis. Metabolic syndrome is considered to be a precursor of type 2 diabetes. Present study is primarily aimed to study the prevalence of micro vascular complications and metabolic syndrome in newly diagnosed type 2 diabetes mellitus patients of low socio-economic group.Methods: This is a cross sectional prospective study conducted in the dept. of general medicine Konaseema institute of medical science Amalapuram, Andhra Pradesh, India from November 2016 to October 2018. Based on exclusion and inclusion criteria 103 patients were enrolled for this study. Various parameters like age, sex, body mass index, waist circumference, lipid profile, systolic and diastolic blood pressure, neuropathy, nephropathy and retinopathy was measured.Results: The mean age of the patient was 48±10.0 years. Fasting and 2 hours OGTT was 174.6±46.8 mg/dl and 255.6±75.6 mg/dl. The mean of total cholesterol was 204.7±41.9 (mg/dl), Triglycerides was 218±83.4 (mg/dl) and HDL was 44±5.3 (mg/dl). Symptomatic neuropathy constituted 35.6% in 51-60 age group and 27.1% in 31-40 and 41-50 age groups. Objective neuropathy constituted highest (36.6%) in 51-60 age group. Retinopathy constituted highest (60%) in 51-60 age group and nephropathy constituted 26.3 % in 21-30 and 51-60 age groups.Conclusions: Prevalence of microvascular complications in newly diagnosed diabetics of low socioeconomic group were as follows: symptomatic neuropathy-57.3%, objective neuropathy-39.8%, retinopathy-4.9%, nephropathy-18.4%. These were similar to published studies from general population from the same geographical area.

Awareness about hypertension among entry year undergraduate health science students in gulf medical university, Ajman, UAE

Hypertension is a colossal problem experienced by one in three adults, leading to 1,000 deaths in a day that people need to be aware of various aspects regarding blood pressure. To determine the level of awareness about hypertension among entry year undergraduate heath science students in Ajman, UAE. A cross sectional study among students enrolled in first year, in the four academic programs, with the use of a validated, self-administered questionnaire on different domains of hypertension such as general knowledge, symptoms, complications, risk factors, treatment and management as well as sources of information. Each factor/statement was given a score of one if it was answered correctly and zero for a wrong answer. Out of a total score, a score of fifty percent and above was considered as good knowledge and a score less than fifty percent considered no knowledge. The data was analyzed by SPSS 20, Chi square and Fisher exact test was done. Out of 161 participants, 130 participants were

Women's perception towards menopause

To determine knowledge and attitude towards menopause among women aged 40 - 60 year presenting with gynecological complaints. Descriptive cross sectional survey. Obstetrics and Gynaecology Unit III, Civil Hospital Karachi from February 2009 to January 2010. Two-hundred premenopausal and postmenopausal women of 40 - 60 year of age were recruited in the study. They were interviewed after informed consent to obtain information about knowledge and attitude towards menopause. Data entered and analyzed by SPSS version 10. Descriptive statistics like frequencies, percentage proportions were calculated to present all categorical variables. The mean age of the participants was 46.8 year, 54.5% were premenopausal and 45.5% postmenopausal, out of them 10% had surgical menopause. 99% were married and 98.5% multiparous and grand multiparous. Only 22% were educated. 94% had heard about menopause, only 30% knew about symptoms, consequences [22%] and treatment of menopause [11%] especially hormone replacement therapy [HRT - 2%]. Ageing and natural transition were considered the common reasons of menopause. Only 21.5% had negative attitude towards menopause due to reason of somatic problems, loss of fertility and feminity. 58.5% considered treatment for menopause unnecessary. Majority of women knew about menopause but lacked knowledge because of limited source of information, education and cultural taboos

Perception of ethical issues, encountered in under graduate medical and dental education

Bioethics has recently gained importance in the developing world. It's teaching in Medical Schools needs careful attention. The aim of this study was to assess the conceptual knowledge for adequacy of the current system of bioethics education and to identify the learning needs of Pakistani medical and dental students. The present study included 114, third year medical students, who had been provided introductory course on bioethics in 1[st] and 2[nd] years. A questionnaire containing 20 clinical situations was answered and assessed against standards. Thirty six percent of participants had forgotten the term bioethics. Patient's opinion and life saving research was recognized as most important where as performing surgery and informing patients about doctor's mistakes was considered as not worthy of obtaining consent. A wide range of gap in knowledge and attitude was identified in bioethics

Muscle pain after succinylcholine injection and its management

The purpose of this study was to assess the percentage of patients experiencing post-succinylcholine pain and outcome of the management. It was a comparative study conducted in the Department of Anesthesiology of post Graduate Lady Reading Hospital, Peshawar from September 1996 to February 1997. Eighty ASA I and II adults undergoing tonsillectomy were studied for the effects of pre-operative administration of pancuronium bromide on succinylcholine induced myalgia. Patients were randomly divided into two groups, one group received succinylcholine as a muscle relaxant, while the other group received pancuronium bromide as a pretreatment agent 3 minute before succinyl. Muscle fasciculations, intubation conditions and post-operative myalgia were graded numerically. Post-operative myalgia in the group treated with pancuronium bromide was significantly less [<0.05] than in the control group