ACUTE FLACCID PARALYSIS-REVIEW OF CASES WITH DIVERSE PRESENTATIONS

This study was done in 50 patients at the department of neurology,Madurai medical college,Govt rajaji hospital from March 2019 to august 2019.AFP cases were diagnosed based on detailed history including onset,duration,precipitating factors,relieving factors,risk factors, recurrences ,associated symptoms and physical examination. The underlying etiology was ascertained by appropriate laboratory investigations such as RBS, serum potassium levels, CSF analysis, electrophysiological studies and Neuro imaging. Most of the patients belonged to Mean age group 21 to 40yrs 19(38%). Data was collected and statistical analysis was done.Males constituted 78% (39/50) and females constituted 22% (11/50). Out of 50 patients,14(28%) were suffering from Acute Inflammatory Demyelinating Polyneuropathy(AIDP), 4(8%) from Acute motor axonal neuropathy(AMAN), 3(6%) from Road traffic accident( RTA), 3(6%) from Hypokalemic periodic paralysis(HPP),3(6%)from snake bite,2(4%) from post vaccination induced AIDP,2(4%)from Miller fisher variant,2(4%) from NMOSD,2(4%) from recurrent GBS,2(4%)from transverse myelitis,2(4%) from diabetic polyradiculopathy, others 11(22%). AIDP was the most common cause of AFP in all age groups. Good prognosis noted in these group of patient 26(52%)

Prevalence of non-motor symptoms in Parkinson’s disease

Background: Parkinson’s disease is a common neurodegenerative movement disorder characterised by motor symptoms of rest tremor, bradykinesia, rigidity and postural instability and non-motor symptoms (NMS) which include neuropsychiatric symptoms, sleep disturbances, autonomic symptoms, sensory symptoms and symptoms of mixed aetiology. Parkinson’s Disease Non Motor Group (PD-NMG) devised a comprehensive clinic-based self-completed NMS questionnaire that allows easy identification of NMS by the physician. Most NMS have a poor response to dopaminergic therapy as it is due to dysfunction of the serotonergic and noradrenergic pathways. Treatment of these nonmotor symptoms help in improving the quality of life in patients with Parkinson’s disease.Methods: There were 100 patients with Parkinson’s disease who had presented to our neuromedicine movement clinic were included in the study. Patients were diagnosed as PD based on UK Parkinson’s disease brain bank criteria. The inclusion criteria were diagnosis as PD, age >18 yrs, inclusion of both males and females and consent for the study. Patients with atypical parkinsonism and secondary parkinsonism, stroke, intake of antipsychotics were excluded from the study. Non motor symptom questionnaire was given to the study group and frequency of occurrence of each non motor symptoms and their predominance in both males and females were studied. The frequency of each NMS was calculated by computing the number of yes response and calculating the percentage related to the number of patients in the sample. Analysis was done to calculate the frequency of all NMS among the enrolled patient.Results: Nocturnal sleep disturbances (43%) were most common followed by constipation (29%).The most common non motor symptoms in males were constipation (20%), urinary urgency (18%) and nocturia (11%).The most common non motor symptoms in females were nocturnal sleep disturbance (25%), feeling sad (19%), unexplained pains (17%) and being anxious (13%).Conclusions: Non motor symptom questionnaire helps in screening patients with Parkinson’s disease of non-motor symptoms and aims at providing holistic treatment improving the quality of life.

Hydrogeochemistry of thirumanimuttar basin: an indication of weathering and anthropogenic impact

A total of 148 groundwater samples were collected from bore wells from Thirumanimuttar sub-basin for two seasons to identify major geochemical process activated to alter groundwater chemistry. The study revealed relationships with the lithology and anthropogenig process. Groundwater in the region was domnated by Na- Ca - Mg and Cl and HCO[3] types. The [Ca + Mg] Versus TZ[+] plot for both seasons reveals higher Ca and Mg due to leaching due to silicate mineral weathering from aquifer matrix of the study area. The plot for [Na+K] versus TZ[+] indicates weathering process of both alkali and alkali earth from feldspars along with additional sources like contribution from alkali/saline soil and residence time. Saturation index of silicate, carbonate and fluoride minerals indicates oversaturation and equilibrium state and sulfate minerals were at undersaturated state during both the seasons. Lithology and anthropogenic activity plays a significant role in controlling groundwater chemistry of the study area