Characteristics and outcomes in patients with anti N-Methyl-D-Aspartate receptor auto-immune encephalitis

Objective: To study characteristics and outcome in patients with anti-N-Methyl-D-Aspartic Receptor encephalitis. Study Design: Retrospective observational cohort. Place and Duration of Study: Neurology Department Military Hospital Rawalpindi, from Feb 2015 to Sep 2016

Material and Methods: Data of patients admitted with anti-n-methyl-D-aspartate receptor encephalitis was analyzed retrospectively. Patients were classified as having definite or probable anti-N-methyl-D-sspartate receptor encephalitis whether antibody testing in CSF was positive or negative respectively and fulfillment of other defined parameters. Patient characteristics, treatment protocols and outcomes were noted

Results: Eleven patients were included in this cohort. Six [54.5%] were males and 5 [45.5%] were female. Mean age was 31.18 years [SD 14.865]. Mean day to symptom onset was 18.51 days [SD 16.646]. Abnormal behavior was seen in 90.9%, Seizures and movement disorder in 81.8%, speech dysfunction in 72.7%, decreased level of consciousness in 63.6% and autonomic dysfunction in 54.5% anti-N-methyl-D-aspartate receptor antibodies were done in CSF in 3 patients only out of which 2 were positive. In remaining nine patients antibody testing was not done due non availability of facility and or affordability. Out of eleven patients 2 [18.25%] had definite encephalitis and 7 [81.8%] had probable encephalitis. CSF was abnormal in 63.6% with pleocytosis in 18.2% and oligoclonal bands in 45.5%. EEG was abnormal in 72.7% and MRI was annormal in 36.4%. Outcome was favorable in 63.6% and unfavorable in 36.4%

Conclusion: In this study we were able to determine that patients with anti-N-Methyl-D-Aspartate Receptor encephalitis have a favorable outcome if diagnosed and treated aggressively early in the course of disease

Various Risk Factors in Stroke Patients at Military Hospital Rawalpindi

To determine the frequency of various risk factors of stroke. A descriptive study. Military Hospital Rawalpindi, from January 2011 to January 2012. Three hundred diagnosed patients with stroke were probed into for different risk factors, based on history, clinical examination and laboratory methods. Nineteen percent were female and eighty one percent were male patients. The mean age of the patients was 59 years. Minimum age was 38 years and maximum age was 90 years in the patients under study. Physical inactivity was the most common risk factor [78%] followed by hypertension [72%], obesity [67%], type 2 diabetes mellitus [42%], smoking [42%] etc. Physical inactivity is the most common risk factor followed by hypertension which contribute to the pathology of stroke

Frequency of dyslipidemias in diabetic patients at combined military hospital Multan

To determine the frequency of dyslipdemias in diabetic patients at Combined Military Hospital Multan. Cross sectional observational. Department of Medicine, Combined Military Hospital Multan from February 2007 to August 2007. Diabetic patients aged between 30-70 years of either gender and having diabetes for >5 years were included in the study. Patients with co-existent hypothyroidism, chronic renal failure, nephritic syndrome, familial hypercholesteremic syndromes, already on lipid lowering drugs, anti-hypertensive drugs, using beta blockers or thiazide diuretics, obese patients with BMI > 30 and those using alcohol were excluded. Blood samples after overnight 10 hours fasting were taken for plasma glucose, serum total cholesterol, HDL-cholesterol, LDL-cholesterol and triglycerides. Frequency of dylipideamias was analysed using Statistical Package for Social Sciences [SPSS] version 10. Mean age of 200 diabetic patients included in the study was 51 +/- 9.47 years [range 34-70 years] and male to female ratio of 1.21:1. Mean fasting plasma glucose levels of the diabetic patients was 8.2 +/- 2.2 mmol/L. Out of 200 patients, dyslipideamia was present in 163 [81.5%] patients. Hypertrglyceridemia was present in 150[75%] patients, raised LDL-cholesterol in 126 [63%] patients, decreased HDL-cholesterol in 119 [59.9%] patients, and raised levels of total cholesterol in 89 [44.5%] of the patients. Diabetic patients have a high frequency of dyslipidemias especially raised triglycerides, therefore lipid profile is to be checked routinely and its management be given equal importance in addition to glycemic control