Acute disseminated encephalomyelitis following falciparum malaria.

Acute disseminated encephalomyelitis (ADEM) is a demyelinating disease of the brain and spinal cord which is preceded by many viral and bacterial infections. We present a rare case of ADEM following falciparum malaria infection. Early identification of ADEM is highly required as it responds to treatment very well and delay in diagnosis may lead to permanent neurological sequelae.

Role of free radicals and antioxidants in tuberculosis patients.

Background: Severe oxidative stress has been reported in TB patients because of malnutrition and poor immunity. The purpose of this study was to investigate the serum lipid peroxidation products and important free radical scavenging enzymes i.e. superoxide dismutase (SOD), catalase and antioxidant glutathione levels and total antioxidant status in TB patients. Methodology: The subjects for this study comprised of normal human volunteers (NHV,n=25), TB patients (n=100) – including untreated (TB1, n=55), under treatment (TB2, n=30) and after treatment (TB3, n = 15) with anti-tuberculosis therapy (ATT). Results: The levels of lipid peroxidation products malondialdehyde (MDA) were increased significantly in TB1 & TB2 (P<0.001) and also in TB3 (P<0.01); these levels gradually decreased with clinical improvement with ATT. SOD, catalase, glutathione levels and total antioxidant status were decreased significantly in TB1 & TB2 (P<0.001), TB3 (P<0.01) patients in comparison with NHV, these levels gradually increased with clinical improvement with ATT. Oxidative stress was observed in all the TB patients (TB1, TB2, TB3), irrespective of treatment status. Conclusions: The study showed that in TB patients free radical activity is quite high and antioxidant levels are low. A suitable antioxidant therapy may prove beneficial and nutritional antioxidant supplementation may represent a novel approach to fast recovery.

Oxidative stress and anti-oxidant status in leprosy patients.

Severe oxidative stress has been reported in leprosy patients because of malnutrition and poor immunity. The purpose of this study was to investigate the serum lipid peroxidation products, serum LDH and important free radical scavenging enzymes, i.e. superoxide dismutase (SOD), and catalase and anti-oxidant glutathione levels and total anti-oxidant status, in different types of leprosy patients. The subjects for this study were normal human volunteers (NHVs, n=14), paucibacillary leprosy patients (PB, n=18), untreated MB patients (MB1, n=18), MB patients under treatment (MB2, n=19), and MB patients released from treatment (RFT) (MB3, n=28). The levels of lipid peroxidation product, malondialdehyde (MDA), and LDH increased significantly (p<0.001) in MB (MB1, MB2, MB3) patients, and both gradually decreased with clinical improvement following MDT. The levels of SOD, catalase and glutathione, and the total anti-oxidant status decreased significantly in MB (MB1, MB2, MB3) patients (p<0.001), in comparison with NHVs. They gradually increased with clinical improvement with MDT. There was no significant variation of these parameters in PB leprosy patients in comparison with healthy volunteers. High free radical activity and low anti-oxidant levels observed in MB (MB1, MB2, MB3) leprosy patients indicate that there is an oxidative stress in MB cases, irrespective of the treatment status and suggest a suitable anti-oxidant therapy to prevent possible tissue injury.

Pseudoaneurysm of inferior epigastric artery following abdominal paracentesis.

We report a 31-year-old man with chronic renal failure and ascites who developed severe abdominal pain and a local non-pulsatile mass after therapeutic paracentesis. Doppler study confirmed a pseudoaneurysm of the right inferior epigastric artery. The patient recovered after the artery was ligated and the aneurysm excised.