Syndrome of transient headache and neurological deficits with cerebrospinal fluid lymphocytosis mimicking dengue encephalitis in a child.

The syndrome of transient headache and neurological deficits with cerebrospinal fluid lymphocytosis (HaNDL) has been infrequently reported in children. This condition can mimic many serious conditions of the central nervous system, while actually being benign in nature. The authors present the report of an 8 year old developmentally normal female with family and personal history of migraine, which was initially suspected to have Dengue encephalitis. She had an episode of seizures, meningism and altered sensorium. Normal mental status and physical findings were observed intermittently. Detailed evaluation including analysis of blood, cerebrospinal fluid (CSF) and neuroimaging were done. Neuro-infections, vascular pathology and autoimmune disorders were ruled out prior to reaching a diagnosis of HaNDL. She responded well to symptomatic treatment and made a full recovery. She was discharged on migraine prophylaxis considering her history. Dengue as causation and the occurrence of seizures in HaNDL has not been reported previously.

Study of the Relationship between Metabolic Syndrome Score and Angiographic Severity of Coronary Artery Disease According to the Presence of Diabetes.

Background: The relationship between metabolic syndrome score and coronary artery disease severity is unclear in the presence of diabetes. Hypothesis: The hypothesis of this study is to assess whether there is a relationship between metabolic syndrome score and coronary artery disease angiographic severity and whether or not the severity of the relationship differs in the presence of diabetes. Methods: We consecutively enrolled 132 metabolic syndrome patients who underwent their first coronary angiography. We used four angiographic scores and compared the relationship between metabolic syndrome score and angiographic coronary artery disease severity or clinical presentation between diabetic and non-diabetic subjects. Results: Individuals with both metabolic syndrome and diabetes (n=64) had significantly higher metabolic syndrome scores, acute coronary syndromes, double and triple vessel disease, higher coronary score, extent score, severity score, and atherosclerotic score than metabolic syndrome patients without diabetes (n=68). A significant correlation was apparent between metabolic syndrome and coronary atherosclerotic scores in patients without diabetes. In contrast, we did not observe any significant correlation between metabolic syndrome score and coronary atherosclerotic scores in patients with diabetes. Multivariate regression analysis revealed that metabolic syndrome score is an independent predictor of atherosclerotic score in non-diabetics. Conclusion: While the relationship between metabolic syndrome score and angiographic coronary artery disease severity was disguised by the presence of diabetes, the metabolic syndrome score was related to the extent of coronary atherosclerosis in Indian patients without diabetes. Calculating the metabolic syndrome score might provide additional information for predicting the extent of coronary artery disease in patients with angina without diabetes.

Development and validation of RP-HPLC-PDA method for simultaneous estimation of baclofenand tizanidine in bulk and dosage forms.

A simple, specific, and accurate reverse phase liquid chromatographic method was developed for the estimation of Tizanidine (TZN) and Baclofen (BCF) in combination. A Phenomenex -C18 (150×4.60 mm Dimensions, 5μm Particle size) column with mobile phase containing methanol: water (53:47) was used at isocratic mode and eluents were monitored at 228 nm. The retention times of TZN and BCF were 2.03 and 4.1min respectively and both the drugs showed good linearity in the concentration range of 10-50 μg/mL with a correlation coefficient (R) of 0.9992 and 0.9993 respectively. The proposed method was validated as per ICH guidelines and method showed good precision with percent relative standard deviation less than 2%. The percentage assay values of TZN and BCF were found to be 99.72 and 98.56 respectively and recovery values are within the limits of 98-102% indicating the proposed method was accurate and precise for the simultaneous estimation of TZN and BCF in bulk and pharmaceutical dosage forms.

Recording of double atrial potentials as a marker for isthmus block during ablation of atrial flutter.

Radiofrequency ablation is an established method for treatment of type I atrial flutter. The assessment of creation of complete bidirectional isthmus block following linear ablation of the isthmus is an integral part of ablation procedure. Conventionally, bidirectional isthmus block is tested by pacing on either side of ablation line and looking for reversal of activation sequence in the right atrium. We looked at the feasibility of recording double potentials, separated by an isoelectric interval along the ablation line as an alternative method to demonstrate bidirectional isthmus block. An attempt was made to record the double potentials following linear ablation of the cavotricuspid isthmus. Following ablation, bidirectional isthmus block was also tested by pacing from the coronary sinus os and the low-lateral right atrium. We could demonstrate double potentials in 9 of the 11 patients in whom we attempted to record them following linear ablation of flutter. The presence of bidirectional block by pacing from coronary sinus os and low lateral right atrium could be demonstrated in 10 (91%) patients. Thus, double atrial potentials, separated by an isoelectric interval can be demonstrated following ablation of atrial flutter. Double potentials, if demonstrable on coronary sinus os and low lateral right atrium pacing, could serve as an alternative marker of isthmus block.

Expression and stable germline transmission of neomycin-resistance gene in transgenic mice.

Transgenic mice were produced to study the expression of amino-3' glycosyl phosphotransferase gene (neomycin resistance gene) in the embryonic fibroblast cells. A 1.9 Kb linear fragment of neomycin resistance gene under the control of pPGK promoter was microinjected into the pronucleus of mouse embryos. Out of 64 potential founders born, 5 were identified to be transgenic by the polymerase chain reaction (PCR) and southern hybridization. Multiple mice from first and second generation from two transgenic founders (N-10 and N-32) were analysed to determine the germline transmission. It was found to be 24.6 and 71.4% in first and second generation respectively. Results were also further confirmed by RT-PCR, sequencing and in vitro bioassays.