A Prospective Study of Correlatio of Magnetic Resonance Imaging of Brain Including MR Angiogram and Carotid Vertebral Arterial Doppler Study with the Clinical Features in Ischemic Stroke

Introduction: Stroke is a global health problem. In this study we evaluated the risk factors, clinical features and their correlation with Magnetic Resonance Imaging (MRI) brain including Magnetic Resonance Angiogram (MRA) and Carotid Verteberal (CV) Doppler findings in patients presenting with acute ischemic stroke. Material and methods: Seventy five patients of the age group 20 to 80 years admitted with acute ischemic stroke were enrolled for the study. A detailed history, clinical examination and blood investigations were done. MRI, MRA and CV Doppler were done in all patients. Serum Homocysteine levels and Anti-nuclear antibody assay (ANA) by Immunofluorescence (IF) were done in selected patients. Statistical analysis was done using SSPS version 16.0 for microsoft windows. Results: In this study, there were more males than females. The mean age was 59 years. Young stroke population (<40 years) was 5%. Anterior circulation was predominantly involved than posterior circulation. Right Middle Cerebral Artery was the most common artery involved. There was positive correlation for clinical presentation and area of infarct and for areas of infarct and the vessels involved. Most common clinical presentations were weakness and slurring of speech. There were 3% intracranial anomalies. 56% had significantly elevated levels of homocysteine. 24% had ANA- IF positivity. Recurrence of stroke was seen in 17%; National Institute of Health Stroke Scale (NIHSS) score was higher in patients with recurrent stroke and right hemisphere infarcts. Conclusion: There was positive correlation for clinical presentation and area of infarct and for areas of infarct and the vessels involved.

A Review On Siddha External Therapy 杗asiyam (nasal Instillation)

Siddha system of medicine, one of the ancient, traditional Indian systems of medicine has unique diagnostic methods, therapeutics and treatment procedures. It has a vast range of external modalities of treatment for health management. This external management is classified into 32 types. They include minor surgical procedures and treatment procedures. These therapies are used both as mainstream and supportive therapies � both curative and prophylactic. Most of the therapies are aimed to maintain the equilibrium of the three humours (Vatham, Pitham, Kabam). Among them Nasiyam (Nasal instillation) is one of the external therapies which is a non-invasive procedure. Nasiyam is the process by which the drug is administered through nostrils. This is the treatment procedure to balance the Thirithodam in its normal level. This paper documents the efficacy of Nasiyam, methods of application, shelf life, effect of Nasiyam in treating various diseases, the list of single drug and compound drug formulations that can be used as Nasiyam, Indications and contraindications are discussed in detail. Nasiyam therapy is used to treat the diseases of vitiated Kabam such as migraine, sinusitis, bronchial asthma, nasal polyp etc.

Morbidity following heal conduit urinary diversion in a welsh district hospital over 10 years

To assess the post-operative morbidity after ileal conduit diversion at our institution. The records of 84 patients with a mean age of 62.1 [range 22 -89] years who underwent ileal conduit diversion at our institution between 1992 and 2002 were reviewed and all post-operative complications occurring later than 3 months after the intervention were analyzed. Overall, 242 ileal conduit-related complications [71 major and 171 minor] developed in 72 of 84 patients [85.7%]. The mean and median follow-up were 38.6 and 24 months, respectively [range 3 to 108 months]. A total of 38 surgical procedures/interventions were needed in 33 patients [39.3%]. 62/72 patients [86.1%] developed complications within the first 5 years. 32 stoma-related complications were recorded in 22/84 [26.2%] patients. Fifty-nine percent [n = 42] of the major complications occurred in the 30 patients who had been subjected to diversion for non-malignant indications and had a longer mean follow-up [4.5 years] than the 54 patients who had been operated for malignancy [mean follow-up 2.5 years]. Patients with benign disease fared better in survival as expected, but the longer they survived, the higher was the incidence of complications and the reintervention rate. In view of the high complication rate, especially in patients with a long life expectancy and benign conditions, objective guidelines regarding the choice of urinary diversion will help surgeons in decision making, patient selection and counseling

Cutaneous malignant melanoma with metastatic intracerebral space occupying lesion

A detailed case report of a patient with cutaneous malignant melanoma having a metastatic intracerebral space occupying lesion causing hemiplegia has been presented. A brief and relevant review of the subject has been summarized. It is our conclusion that [a] in the presence of slight pigmentation at the edge of any nodular or ulcerated lesion a diagnosis of malignant melanoma should be considered especially in sites where a predisposing mole may or can not have been noticed; [b] it is necessary to carry out thorough clinical, laboratory and radiological investigations to detect the presence of lymphatic or visceral [lung/liver/cerebral] metastasis, and [c] intracerebral metastatic lesions of malignant melanoma are uncommon and such lesions presenting as space occupying lesion in the brain are extremely rare