ABSTRACT
Central nervous system (CNS) manifestation with cranial nerve palsy in multiple myeloma (MM) is a rare manifestation. Plasmacytoma originates from the bones of the skull base in 3% patients with MM but rarely develops from the soft tissues of the nasal cavity and paranasal sinuses. Here, we present a case of 68-year-old male patient with multiple myeloma, clivus bone plasmacytoma, and cavernous sinus syndrome.
ABSTRACT
BACKGROUND: Acute ischemic stroke leads to an inflammatory response and the neutrophil-to-lymphocyte ratio is an inflammatory indicator for determining prognosis in acute ischemic stroke. This meta-analysis aims to show evidence that neutrophil-to-lymphocyte can act as an independent and early prognostic marker in cases of acute ischemic stroke. METHODS: Databases of PubMed, and Embase were searched for literature. Relevant data were extracted by SSP and BT from eligible literature. Odds ratios with 95% confidence intervals were pooled and a Forest plot was used to evaluate the prognostic value of neutrophil-to-lymphocyte in acute ischemic stroke. Modified Rankin Scale ? 3 was defined as a poor functional outcome. A funnel plot is used to show the symmetric distribution and no publication bias. RESULTS: According to Joanna Briggs Institute assessment for analytical observational studies, the studies included are of fair to good quality. Eight relevant studies with 3011 patients were included, one with no data on OR. The pooled OR of 6 studies with the poor functional outcome at 3 months was 1.47(P<0.02 95%CI: 1.40-2.31) while one study with the poor functional outcome at discharge was OR=2.49. CONCLUSIONS: In patients with acute ischemic stroke, elevated neutrophil-to-lymphocyte correlates with poorer functional outcome and increased chances of developing symptomatic Intracranial Hemorrhage. Baseline neutrophil-to-lymphocyte can be an inexpensive and easily available biomarker, especially in resource-poor settings, for predicting clinical outcomes in patients with ischemic stroke.
Subject(s)
Brain Ischemia , Ischemic Stroke , Stroke , Humans , Lymphocytes , Nepal , Neutrophils , Observational Studies as Topic , PrognosisABSTRACT
BACKGROUND: The aim of the study is to find out the age and sex distribution, modes of head injury and correlate Glasgow Coma Scale with Computed Tomography in patients with head trauma in our center. METHODS: A cross-sectional study was performed among 113 patients of acute head trauma presenting to Emergency department of our hospital for three months. The severity of the head injury was assessed on admission by the Glasgow Coma Scale score and categorized as mild, moderate, or severe head injury. Non contrast head computed tomography was obtained. RESULTS: The mean age of patients studied in this study was 35.53 year in males and 32.1 year in female with male to female ratio being 1.86:1. The most common causes of head injury were road-traffic accident 58 (51%), falls 42 (37%) and physical assault 13 (12%). In our present study, 67 (59.3%) of patients had mild head injury, 27 (23.9%) had moderate head injury and 19(16.8%) had severe head injury. Our study shows presence of multiple lesions with depressed bone fracture of skull bone was associated with lower Glasgow Coma Scale. Significant association between Glasgow Coma Scale and computed tomography finding was seen(p less than 0.001). CONCLUSIONS: Glasgow Coma Scale is strongly associated with computed tomography in patients with head injury. Road traffic accident is the commonest mode of injury. Most present with mild head injury.
