Cerebral venous sinus thrombophlebitis as a complication of acute otitis media.

BACKGROUND: While headache is a common emergency department chief complaint, cerebral venous sinus thrombosis (CVST) is an infrequently encountered cause of headache and is often not included in emergency physicians' differential diagnoses for headache. Our objective is to review the latest data on epidemiology, presenting symptoms, diagnosis, and treatment of CVST. CASE REPORT: A 27-year-old female presented to our emergency department with headache, blurred vision, and vomiting a day after being diagnosed with acute otitis media. Computed tomography scan of the brain without contrast in the emergency department was suggestive of CVST. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Although a rare cause of headache, CVST should be considered for a subset of patients presenting to the emergency department with the common complaint of headache. CVST is diagnosed by magnetic resonance venogram or computed tomography venogram of the brain. Anticoagulation with close monitoring in consultation with appropriate experts is a safe first-line therapy for CVST, even in patients with hemorrhage on initial imaging.

Indian Diabetes Risk Score helps to distinguish type 2 from non-type 2 diabetes mellitus (GDRC-3).

AIM: The aim of this study was to investigate whether the Indian Diabetes Risk Score (IDRS) could assist in classifying type 2 diabetes mellitus (T2DM) and non-T2DM among patients attending clinics in India. METHODS: Patient records from 2006 through 2009 were taken from the clinical database of a tertiary care diabetes hospital in Chennai, Southern India. A total of 8747 patients with diabetes, diagnosed by a physician either as type 1 diabetes mellitus (T1DM), T2DM, or other types were included for analysis. The IDRS, based on age, abdominal obesity, family history of diabetes, and physical activity, was calculated for each patient at first visit to our clinic. Receiver operating characteristic (ROC) curves were generated to obtain optimal IDRS cut points for predicting T2DM and non-T2DM. RESULTS: Of the 8747 patient records analyzed, 204 (2.3%) were classified as non-T2DM and 8543 (97.7%) as T2DM. In ROC analysis, an IDRS ≥60 [area under the curve (AUC), 0.894; sensitivity, 83.8%; specificity, 81.0%] was predictive of T2DM, while an IDRS <60 (AUC, 0.882; sensitivity, 79.9%; specificity, 83.8%) was predictive of non-T2DM. CONCLUSIONS: The IDRS, a simple, cost-effective risk score, can assist in classifying T2DM versus non-T2DM among clinic patients in India.