Ovarian teratoma-associated anti-NMDAR encephalitis in a 12-year-old girl

@#The association of ovarian teratoma and anti-N-Methyl-Daspartate receptor (anti-NMDAR) is one of the most common autoimmune encephalitis syndromes and it is a serious and potentially fatal pathology that occurs in young women. This case report describes of a pediatric patient with anti-NMDAR encephalitis. A-12-year-old girl presented with abnormal behavior for one week came to Emergency Department of Sarawak General Hospital, Malaysia. She had psychotic spectrum symptoms including suicidal tendency. She was diagnosed with anti-NMDAR encephalitis as positive antibody was seen in her cerebrospinal fluid. She was treated with Injection Immunoglobulin. She turned out to have teratoma which was successfully removed later. Her progress was remarkable after the surgery with the Immunoglobulin. A multi-disciplinary team involving a psychiatrist, neurologist and gynaecologist liaised with intensivist to successfully manage the case and achieve the good outcome.

Uterine artery pseudoaneurysm: A case of late intraabdominal haemorrhage after caesarean section

@#Uterine artery pseudoaneurysm (UAP) is a rare acquired vascular malformation associated with vaginal bleeding or intraabdominal haemorrhage occurring after pelvic surgery. Pseudoaneurysm may present with delayed, severe haemorrhage after a seemingly uncomplicated initial postoperative period. Treatment is therefore necessary to prevent further complications. We describe here a case of a 32-year-old mother, who presented with abdominal pain and intraabdominal bleeding, 20 days after Caesarean Section. Computerised Tomography (CT) scan showed the presence of haemoperitoneum, suggestive of pseudoaneurysm at the right cervical artery which was successfully managed with emergency angiographic embolisation.

Unusual variations of the lateral and posterior cords in a female cadaver

The presence of anatomical variations of the peripheral nervous system often accounts for unexpected clinical signs and symptoms. We report unusual variations of the lateral and posterior cords of the brachial plexus in a female cadaver. Such variations are attributed to a faulty union of divisions of the brachial plexus during the embryonic period. The median nerve lay medial to the axillary artery (AA) on both sides. On the right, the lateral root of the median nerve crossing the AA and the median nerve in relation to the medial side of the AA was likely the result of a faulty development of the seventh intersegmental artery. We discuss these variations and compare them with the findings of other researchers. Knowledge of such rare variations is clinically important, aiding radiologists, anaesthesiologists and surgeons to avoid inadvertent damage to nerves and the AA during blocks and surgical interventions.

Factors associated with HIV seroprevalence among intravenous drug users in Yangon

A crosss-sectional seroprevalence survey was undertaken to determine seroprevalence of HIV infection and the factors associated with HIV seropositivity among the newly registered 205 male intravenous drug users (IVDUs) at the Drug Dependency Treatment and Research Unit in Yangon from December 1991 to September 1992. Of the 178 individuals tested for HIV antibodies, 60.1 percent were found to be positive, 95 percent confidence interval (CI) being 51.4 percent and 68.9 Percent. Moreover, the risk of getting HIV infection was higher among: IVDUs aged 30 years or above than those aged below 25 years [Odds ratio (OR) = 2.76, 95 Percent CI: 1.12, 6.81]; IVDUs using drug of over 18 months than those using 6 months or less (OR = 5.07; 95 Percent CI: 2.36, 10.87): IVDUs sharing syringes and needles with two or more persons than those who did not share (OR = 2.45; 95 Percent CI: 1.02, 5.89); IVDUs visiting to professional drug injectors for initiation of habit than those who did not visit (OR = 2.27; 95 Persent CI: 0.96, 5.37); and IVDUs who had hiven history of imprisonment than those who had not (OR = 2.65; 95 Percent CI: 1.04, 6.75). In addition, the above two variables, viz, age and duration of drug use did not confound the effect of needle sharing on HIV infection among the IVDUs. The strengths and weaknesses of the study design and the implications of the study to AIDS control are discussed.

Hepatitis B makers in a study group with human immunodeficiency virus infection in Myanmar, 1989

During 1989, 200 sera, Positive for Human Immunodeficiency virus (HIV) antibody by both Enzyme Linked Immunosorbent Assay (ElISA) and Western Blot Immunoassay were selected randomly to be tested for Hepatitis B Virus (HBV) markers. 75

of the sera belonged to intravenous drug abusers with the remaining from hospitalized patients, blood donors and persons attending the Sexually Transmitted Diseases (STD) Clinics. HBsAg was positive in 12.5

, HBeAg in 3

, anti-HBs in 34.5

and anti-HBc in 86

of the test group. Since the epidemiology of HIV and HBV infections are similar regarding the modes of transmission (parenteral, perinatal and sexual), the risk groups affected and the occurrence of chronic asymptomatic infection creating a reservoir for further spread, HIV infected persons can be assumed to have a high infection rate for HBV. In our study, the infection rate for HBV was very high being 92

.

Preliminary study of two major transfusion associated viral infections (Human Immunodeficiency Virus and Hepatitis B virus) during routine donor screening

A total of 5973 blood donor specimens were tested for both HBsAg and HIV antibody, simultaneously. 2.18 per cent was initially reactive to ELISA, 0.67 per cent was repeatedly ELISA positive, 0.2 per cent was indeterminate and 0.39 per cent was confirmed for HIV antibody by IMMUMOBLOT ASSAY. The prevalence of HBsAg among blood donors was found to be 10.56 per cent with 11.1 per cent for male dornors and 5.06 per cent for female donors.

Incidence of Human Immunodeficiency Virus infection in drug abusers

A total of 1035 drug abusers were screened for HIV-antibodies. 19 per cent are positive for anti-HIV in drug addict using drugs by various routes including intravenous routes. Where as 51.3 per cent of intravenous drug abusers were positive. Even among IVDA, hospitalized cases are 70 per cent positive against 40.9 per cent in non-hospitalized cases.