Clinical and Etiological Profile of Cerebral Venous Sinus Thrombosis

Introduction: Cerebral Venous Thrombosis is an importantcause of stroke in the young. The importance of recognisingthis condition is that it carries a good prognosis if recognisedand treated early. Study objective was to analyse the clinicaland etiological profile of Cerebral Venous Sinus Thrombosis.Material and Methods: Prospective cross sectional studyin patients attending OPD or emergency at a tertiary referralcentre in eastern Tamilnadu with history suggestive of CVTand in whom the diagnosis of CVT confirmed by imagingof brain (MRI and MRV) were included in the study aftermeeting the inclusion criteriaResult: Among the 33 patients included in the study, majorityaffected were young males, most common clinical presentationwas headache and most common sinus involved was superiorsagittal sinus. Pro thrombotic state was observed in 27% ofcases and alcohol addiction was found to highly prevalent inthe study population.Conclusion: Cerebral Venous Thrombois is found to besignificantly high in males and alcoholics. Compared to otherIndian studies there was not much disparity in clinical profileand risk factors.

A Study on Etiological Profile of Non-Compressive Myelopathies in a Tertiary Care Hospital in Central Tamilnadu

Introduction: Non compressive myelopathy is defined as“spinal cord dysfunction in the absence of clinico-radiologicalevidence of spinal cord compression.” It can result fromdemyelinating, infectious, autoimmune, vascular, degenerativeand metabolic disorders in the absence of demonstrablecompression by imaging techniques. We aimed in analyzingthe etiological profile of non-compressive myelopathies in atertiary care hospital of Central Tamil nadu.Material and Methods: In the Neurology department, weconducted an observational study at Thanjavur MedicalCollege, Thanjavur, from September 2017 to September2018. Patients of non-compressive myelopathies whounderwent magnetic resonance imaging (MRI) of the spinewere segregated into two categories: Degenerative and nonDegenerative, as well as into acute, subacute and chronicmyelopathies.Results: The study had 75 patients with a median age of34.5 years and male: female ratio of 1.35:1. Presentation wasacute in 10 patients (13%), subacute in 5 (6.5%), chronic in54 (72.5%) and history of relapse and remission in 6(8%)patients. Degenerative etiology was found for 42 (56%)others were non degenerative (demyelinating, autoimmune,vascular, nutritional, or physical agent). MRI study carried outin all cases showed signal changes in 51 cases (68%) whichincluded myelomalacia, demyelination, atrophy of cord,infarction of cord. Etiological diagnosis could be establishedin 74 (97.3%) cases.Conclusion: Underlying etiology (degenerative,demyelinating, autoimmune, infectious, vascular, metabolicdisorder, or physical agent) was found in 91.3% patients ofnoncompressive myelopathy. Clinical features combinedwith MRI findings are helpful in defining the cause ofnon-compressive myelopathies. A follow-up of long termmay reveal some of the diagnosis especially degenerativemyelopathies in early stage.

Prevalence of Vitamin D Deficiency in Patients Presenting with an Orthopaedic Trauma at a Tertiary Centre in South India - Implications and Protocols for Replacement Therapy

Vitamin D has been the focus of much scientific literature in recent years owing to various studies showing its association with a wide variety of pathological conditions 1,2 . Sun exposure, diet and fortified supplementation account for a bulk of Vitamin D intake in humans. Activation of vitamin D is sequential and requires sun exposure for conversion of 7- dehydrocholesterol to Vitamin D3. Further metabolism in the liver converts Vitamin D3 to 25 –hydroxyvitamin D3. Conversion to its active form 1,25 dihydroxyvitamin D3 (Calcitriol) occurs in the kidneys 2 . The importance of Vitamin D in calcium metabolism and bone health is well known and documented. Controversies exist regarding the true prevalence of hypovitaminosis, however in developing countries the prevalence of vitamin D deficiency in all age groups is probably higher 3 . Adding to this the burden and morbidity of skeletal trauma, persistent deficiency may have a deleterious effect in the injured 4, 5 . Vitamin D, with its positive effect on bone health does play a role in the biology of fracture repair and remodelling 6 . The role of Vitamin D replacement as sole biological effectors in fracture repair may be difficult to quantify and confounded by other variables at play in bone healing. Studies looking at vitamin D levels in orthopaedic patients have also shown significant levels of deficiency and have put forward recommendations for evaluation and supplementation