Landau kleffener syndrome a rare but important neurological disorder

To determine the importance of careful history along with multi-modal clinical neurophysiology [CNP] procedures in diagnosis of rare neurologic disorders landau kleffener sundrome. All patients who referred to CNP lab between the age 2-10 years for brainstem auditory evoked potential [BAEP] as a part of evaluation of aphasia were interviewed [Group A] Those had history of seizures in addition to the primary symptom underwent a complementary EEG in addition to BAEP Similarly all the patients referred to CNP lab between the age 2-10 years for EEG as a part of evaluation of seizures were interviewed [Group B]. Those who had history of aphasia in addition to the seizures underwent complementary BAEP in addition to BEG. The patient who had normal BAEP and abnormal EEG from both the groups were then followed up. They were seen by pediatric neurologist and had a MRI brain to exclude structural lesions. Total of 40 patients were included in the study. Out of them 31 were male and 9 were female. They were divided into Group A and Group B and were studied. EEG showed focal left temporal epileptiform activity which at times noted in generalized manner with normal BERA. LKS is a rare disorder but it is important to recognize as commonly used antiepileptic medications worsen the seizures associated with this syndrome. Its prognosis is also different from other seizure disorders including temporal lobe epilepsy. Vigilant observation towards CNP procedures, history and neurological examination will help physician in diagnosing syndromes like landau Kleffner

Thyroid abnormalites in patients with chronic hepatitis-C

To determine the frequency of thyroid dysfunction in patients with chronic hepatitis-C. Case-series study. Department of Medicine, outpatient department of Internal Medicine at Aga Khan University Hospital Karachi. From April 25[th] till October 25[th] 2008

Thyroid disorders in Peshawar Pakistan-one year experience

This study reports on 124 cases of thyroid disorders from Peshawar treated with radioiodine during 2008. The aim of this study was to analyze the cancer registry record of patients from the district of Peshawar in order to obtain an insight about thyroid disorders for use in proposrng future health plans. The patient data has been collected from the Institute of Radiotherapy and Nuclear Medicine [IRNUM] Peshawar. Patients with thyroid disorders were confirmed by clinical examination, thyroid scintigraphy [Thyroid scan], blood tests [T[3], T[4], TSH] and histopathalogy tests and then treated with radioiodine. Of all 124 patients with thyroid disorders [Median age; 45.5 years. Range: 16-77 years] 20% were male and 80% were female. The final diagnosis was Toxic Multi Nodular Goiter [TMNG] in 56 [45.1%] cases, Diffuse Toxic Goiter [DTG] in 30 [24.2%] cases, Thyrotoxicosis in 14 [11.3%] cases while 7 [5.7%] patient showed thyroid carcinoma. All these patients were treated with radioiodine. For females, the most affected age group was 11-40 years with 31.3% cases of the total female cases followed by 21-30 age groups. No strict predominance has been observed in any age group of males. This preliminary study will provide an insight to the thyroid disorders and its treatment with radioiodine in Peshawar. Insufficient health care facilities, poor educational market [especially] in the rural areas are the most important probable factors leading to thyroid disorders. This study may be used as a base line for future planning strategies for improving the health standards in Peshawar

Hypothyridism in patients with chronic hepatitis-C

To determine the frequency of clinical and subclinical hypothyroidism in patients with chronic hepatitis-C. Case-series study. Department of Medicine, outpatient department of Internal Medicine at Aga Khan University Hospital Karachi. From April 25th till October 25th 2008. A total of 73 patients were enrolled in the study. Data was entered and then analyzed using Statistical Packages for Social Sciences [SPSS] Version 14. Results are given for quantitative variables such as age are presented as means +/- Standard deviation and percentages are presented for hypo and hyperthyroidism. Stratification on age, gender, ALT levels and gender is undertaken to control for effect modification. Out of total of 73 patients 8 patients [11% of total patients] were found to be suffering from hypothyroidism. Out of these 8 patients 2 patients were males [6.9% of total male patients] and 6 patients were females [13.6% of total female patients]. Known duration of chronic hepatitis C infection in most of the patients suffering from hypothyroidism was 6-12 months [6 patients], however rest of 2 patients had known duration of chronic hepatitis C greater than 13 months. Looking at the ages of the patients in the study group with hypothyroidism showed that half [4 out of 8] patients were in the age group 35-43 years, however 2 patients were younger to the former group and were in the 25-34 age group, and remaining 2 patients were over the age of 44 years