Volume-7 ~ Issue-1
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|Paper Type||:||Research Paper|
|Title||:||Hydatid Cyst in Parotid Gland- A Rare Case|
|Authors||:||Dr D B Singh*, Dr Sunil kumar**, Dr Aarti B.Bhattacharya|
Abstract: Hydatid disease in the maxillo-facial region accounts for only 2.0% as compared to liver (60-75%) and lungs (15-25%). Here in, we report a rare case of hydatid disease in the right parotid gland in a young female from a rural farming background. A detailed history including occupational history gives clue to Hydatid disease as a differential diagnosis. Patients of hydatid disease must undergo a thorough systemic investigation as 20-30% patient's have multiorgan involvement. In the present case only right parotid was involved. Thus, in non endemic areas, ecchinococcosis of head and neck is very rare and therefore its conscious inclusion in the differential diagnosis helps.
Key Words: Primary, infratemporal swelling, Echinococcosis, Hydatid cyst, Parotid Swelling.
. Georgopaulos S etal. Hydatid cyst in the duct of the submandibular gland.Int.J Oral Maxillofacial Surgery2007;36:177-179.
. Akhan etal. Percutaneous treatment of a parotid gland Hydatid cyst: a possible alternative to surgery. Eur Radiol 2002;12:597-599.
. Lewis etal. A review of ecchinococcal disease.Ann Surg1995;18(4):390-396.
. Primary hydatid cyst in the soft tissue of the face : An exceptional occurrence. Indian J Dermatology. 2011;56:768-770.
. Ataoglu H etal.Maxillofacial hydatid cyst.J Oral Maxillofac Surg 2002;60:454-456.
. Katilmis H etal Primary hydatid cyst of neck. Am J Otol Head and Neck Surg 2007;28:205-207.
. Akyildiz AN etal. Hydatid cyst of the pterygopalatine fossa.j Oral Maxillofac Surg 1991; 49:87-89.
. Umesh K et al. Hydatid cyst in infratemporal region-A rare case report.Al Ameen J Med Sci.Vol 3, No.1,2010.
. Hydatid cyst in the maxillo facial region – sabri Shuker BDS J Oral an Maxillo facial surgery. Vol 40 issue 3; 171-174 March 1982.
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Abstract: Stroke is the leading cause of long-term disability. Approximately 70% to 80% of people sustaining a stroke have upper limb (UL) impairment. Improving use of the affected UL is important however, because difficulty in using this UL in daily tasks has been associated with reduced quality of life. Additional effects of combining mirror therapy (MT) with Task Specific Exercises (TSE) to improve UL function post-stroke are unknown. Hence, primary objective of this study was to find out the effectiveness of combined TSE and MT interventions in sub-acute stroke patients to improve UL function and secondary objective was to compare the effectiveness of combined TSE and MT interventions with TSE alone and MT alone. Thirty-seven stroke patients were divided into 3 groups; Group A received TSE, Group B received MT and Group C received TSE as well as MT. Outcome measures were Action Research Arm Test, Fugl-Meyer Assessment and Voluntary Control Grading. All 3 groups showed statistically significant improvement on outcome measures but Group C improved more than the other 2 groups. Conclusion: TSE and MT interventions should be combined altogether in the treatment of sub-acute stroke patients to improve UL function.
Keywords: Mirror therapy, Stroke, Task specific exercises, Task specific training, Upper limb function.
 Kimberlee, J, Marcus K. Augmented Reality Assisted Upper Limb Rehabilitation Following Stroke. 2012.
 Kwakkel G, Kollen BJ, van der Grond, J, Prevo AJ. Probability of Regaining Dexterity in the Flaccid Upper Limb Impact of Severity of Paresis and Time Since Onset in Acute Stroke. Stroke 2003; 34 (9):2181-2186.
 Dean CM, Richards CL, Malouin F. Task-related circuit training improves performance of locomotor tasks in chronic stroke: a randomized, controlled pilot trial. Archives of physical medicine and rehabilitation 2000; 81(4):409-417.
 Dunning K, Berberich A, Albers B, Mortellite K, Levine PG, Page SJ. A four-week, task-specific neuroprosthesis program for a person with no active wrist or finger movement because of chronic stroke. Physical therapy 2008; 88(3):397-405.
 Blennerhassett J & Dite W. Additional task-related practice improves mobility and upper limb function early after stroke: a randomised controlled trial. Aust J Physiother 2004; 50(4):219-224.
 Newman M. The Process of Recovery: After Hemiplegia. Stroke 1971; 3(6): 702-710.
 Teasell RW, Foley NC, Salter KL, Jutai JW. A Blueprint For Transforming Stroke Rehabilitation Care In Canada: The Case For Change. Archives of Physical Medicine and Rehabilitation 2008; 89:575–578.
 Schmidt RA, Lee TD. Motor Control and Learning: A Behavioural Emphasis, 4th edition. Champaign IL: Human Kinetics. 2005.
 Winstein CJ, Campbell SJ. Conditions of task practice for individuals with neurologic impairments. In: Textbook of Neural Repair and Rehabilitation: Volume II Medical Neurorehabilitation. Cambridge University Press; 2006.
 Hubbard IJ, Parsons MW, Neilson C, Carey LM. Task‐specific training: evidence for and translation to clinical practice. Occupational Therapy International 2009; 16(3‐4): 175-189.
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|Paper Type||:||Research Paper|
|Title||:||Learning preferences of students studying Physiology in South India.|
|Authors||:||Navin Rajaratnam , Suganthi V , Suzanne Maria D‟cruz|
Abstract: Teachers of Physiology facilitate the learning of students belonging to different courses and each student has different sensory modality preferences while assimilating information. Students with a visual learning preference prefer learning with graphs and diagrams; students with an auditory preference learn by listening to information; those with a read/write preference prefer textual matter and those with a kinesthetic preference prefer to learn by physical experiences like touching and manipulating material. This study was done to determine the sensory modality learning preferences of first year dental students studying Physiology in South India. The VARK (Visual, Aural, Read/Write, Kinesthetic) questionnaire was administered to 89 first year dental students in a Medical College in South India. Results revealed that the majority of first year dental students (55%) preferred to use a single sensory modality while learning ie., they had unimodal learning preferences. Out of the students who had a unimodal preference, it was found that 47% had a preference for the aural modality and 41% had a preference for the kinesthetic modality. This knowledge of the sensory modality learning preferences of students studying Physiology can act as a catalyst to initiate reflection and subsequent appropriate action by teachers of Physiology. Keywords – Dental students, learning preferences, Physiology, unimodal, VARK
 Cuthbert PF. The student learning process: Learning styles or learning approaches? Teaching in Higher Education 2005; 10(2): 235-249
 Felder RM, Brent R. Understanding Student Differences. J. Engr. Education 2005; 94(1): 57-72
 Flemming D. VARK. A Guide to Learning Styles (online) [cited 2013 Jan
5].Available from: http://www.vark- learn.com/english/ page.asp?p_questionnaire
 Fleming N, Baume D. Learning Styles Again: VARKing up the right tree! Educational Developments 2006; 7(4):4.
 Samarakoon L, Fernando T, Rodrigo C, Rajapakse S. Learning styles and approaches to learning among medical undergraduates and postgraduates. BMC medical education 2013; 13(1): 42.RT
 Slater JA, Lujan HL, DiCarlo SE. Does gender influence learning style preferences of first-year medical students? Adv Physiol Educ. 2007; 31: 336-342
 Lujan HL, DiCarlo SE. First-year medical students prefer multiple learning styles. Adv Physiol Educ. 2006; 30: 13-16
 Baykan Z, Naçar M .Learning styles of first-year medical students attending Erciyes University in Kayseri, Turkey. Adv Physiol Educ. 2007; 31(2): 158-160.
 Breckler J, Joun D, Ngo H. Learning styles of physiology students interested in the health professions. Adv Physiol Educ. 2009; 33(1): 30-36.
 Meechan-Andrews TA. Teaching mode efficiency and learning preferences of first year nursing students. Nurse Educ Today 2009; 29: 24-32
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|Paper Type||:||Research Paper|
|Title||:||Carotid Doppler Evaluation of Transient Ischemic Attack And Stroke Patients And Its Correlation With CT Scan Head: A Prospective Study|
|Authors||:||Malik Rajesh, Tiwari Richa|
Abstract: Sonographic evaluation of the carotid arteries, both gray scale and doppler is widely used for risk assessment for cerebrovascular accidents. Objective To establish the sensitivity of carotid doppler in patients with cerebrovascular accidents and the risk factors (on carotid USG) associated with severity of cerebrovascular accidents. Method- The present study Carotid Doppler evaluation of Transient Ischaemic Attack and Stroke patients and its correlation with CT scan head was carried out in 100 patients with cerebrovascular accidents during the period of September 2011 to September 2012. Patients with neurological symptoms were divided into two groups: stroke and transient ischaemic attack, based on CT head findings. All patients were then subjected to gray scale and doppler evaluation of carotid arteries. Results In stroke patients 42 out of 50 showed evidence of carotid stenosis (ipsilateral or bilateral) while 8 patients were normal. Thus the sensitivity of carotid doppler in stroke patients was 84%. 70% of patients with >50% stenosis had large infarct on CT scan head while only 25% of patients with <50% stenosis had large infarct (p value-0.003). Conclusion- Carotid doppler is an important non invasive diagnostic tool with high sensitivity
Keywords: Stroke, Transient ischaemic attack, Carotid gray scale, Carotid doppler, CT Head
. N R Sims and H Muyderman, Mitochondria oxidative metabolism and cell death in stroke, Biochimica et Biophysica Act,1802 (1),2009 80–91.
. G A Donnan,M Fisher,M Macleod and S M Davis, Stroke,Lancet ,371 (9624),2008,1612–23.
. A Shuaib and V C Hachinski , Mechanisms and management of stroke in the elderly ,CMAJ,45 (5),1991, 433–43
. J F Polak, Intima-media thickness: a tool for atherosclerosis imaging and event prediction, The American journal of cardiology,14,2002,244-69
. M Sitzer, W Müller, M Siebler and W Hort , Plaque ulceration and lumen thrombus are the main sources of cerebral microemboli in high-grade internal carotid artery stenosis, Am Heart Assoc ,8,1995, 456-61
. Moneta et al, Correlation of North American Symptomatic Carotid Endarterectomy Trial (NASCET) angiographic definition of 70% to 99% internal carotid artery stenosis with duplexscanning,Journal of Vascular Surgery ,17 (1),1993,152–159.
. P M Rothwell and C P Warlow, Prediction of benefit from carotid endarterectomy in individual patients: a risk-modelling study, European Carotid Surgery Trialists Collaborative Group, Lancet ,353(9170), 1999,2105-2110.
. J F Polak ,M J Pencina ,K M Pencina ,C J O'Donnell and P A Wolf,Carotid-wall intima-media thickness and cardiovascular events,N Engl J Med,365(3),2011,213-21.
. R Salonen,J T Salonen , Determinants of carotid intima-media thickness: a population-based ultrasonography study in Eastern Finnish men,Journal of Internal Medicine,229(3),1991, 225–231.
. R Sahoo,V M Krishna,D K S Subrahmaniyan ,T K Dutta and S Elangovan , Common carotid intima-media thickness in acute ischaemic stroke: A case control study,Neurology India ,57,2009,627-630.
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Abstract: Infertility is major health problem.The rate of infertility is steadily increasing due to change in life style.High pollution,socioeconomic cause,enormous amount of stress.Among many causes of infertility the anovulation is very common problem in approximately 40% cases of female infertility.Majority of these cases could be treated either hormonal therapy or surgical intervention.This study will emphasize on careful holistic approach in management of anovulatory cycles.60 patients were completed clinical trial.30 patient in Group A treated with Shatapushpa Tail Uttarbasti with Herbal Compound and 30 patient Group in B treated with Shatavari Tail Uttarbasti with Herbal Compound for three month.The subjective and objective parameters were measured before and after treatment in each group.Group A and Group B showed induces timely ovulation,increase endometrial thickness and menstrual flow.But menstrual pain is insignificant in Group B.
Key Words-Shatpushpa &Shatavari Tail Uttarbasti,Herbal Compound,Anovulatory Cycle.
. Vridhajivaka, Kashyap Samhita with Vidyotini Hindi Commentary By D.S. Bahishjyaratnamani, 8th Edition Chauckhamba Prakashan, Post Box No. 1032, Gopal Bhavan, K. 37/117, Gopal Mandir Lane, Golghar, Maidagin, Varanasi- 221001, 2002.
. Sushrutaacharya, Sushrut samhitaa with sushrutavimarshini hindi commentary by Dr. Anant Ram Sharma , first edition, chaukhamba surbharati prakashan K. 37/117, Gopal Mandir Lane, Post Box No. 1129 Varanasi 221001, 2001.
. Caharakaacharya, Charak Samhitaa, with 'Ayurved Deepika' commentary by Chakrapanidatt, edited by Vaidya Yadavji Trikamji Acharya, Reprint edition, Chaukhamba Surbharati Prakashan, K. 37/117, Gopal Mandir Lane, Post Box No. 1129 Varanasi 221001, 2000.
. Vagbhatacharya, Ashtang Hrudaya with vidyotini commentary
. by kaviraj atridev gupta, edited by vaidya yadunanda
. Upadhyaya, fourteenth edition, chaukhamba Sanskrit Sansthan, Post Box No. 1139, Gopal Bhavan, K. 37/117, Gopal Mandir Lane, Golghar, Maidagin, Varanasi- 221001, 2003.
. Sharangdharaacharya, Sharangdhar Samhita with dipika hindi
. commentary by Brahmanand Tripathi, reprint edition, Chaukhamba Surbharati prakashan, 37/117, Gopal Mandir Lane, Post Box No. 1129 Varanasi 221001, 2001.
. 6. BhaavMishra, 'Bhāv Prakāś' Part-1 Vidyotini Hindi commentary by Bramhasankara Misra & Rupalalji Vaisya, Ninth edition, Coukhambha Sanskrit Sansthan, Post Box no. 1139, Jadau Bhavan, K-37/116, Gopal Mandir Lane, Vaaraanasi- 221001 (India) 1999
. Dr. Premvati. V. Tewari, Ayurvediya Prasuti Tantram Evam Stree Roga, second edition, Chaukhamba orientalia, Post Box No. 1032, Gopal Bhavan, K. 37/117, Golghar, Maidagin, Varanasi- 221001.,1996.
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Abstract: An accessory coronary cusp in aortic valve is a rare congenital cardiovascular malformation with an estimated incidence of 0.003 to 0.043% of all congenital heart disease. It is also describe as a quadricuspid aortic valve (QAV). Several different anatomical variations of quadricuspid aortic valve have been described. Current technology enables noninvasive diagnosis in most cases. Here we reported a rare an isolated congenital type 'C' QAV with aortic regurgitation; hence it was worth reporting this interesting case.
Key word: Qadricuspid aortic valve, Quadrileaflet aortic valve, Aortic valve, Anomalies , An accessory coronary cusp.
1. Hurwitz LE, Roberts WC: Quadricuspid semilunar valve. Am J Cardiol 1973, 31:623-626?
2. Recupero A, Pugliatti P, Rizzo F, Arrigo F, Coglitore S : Quadricuspid aortic valve: a rare cause of aortic insufficiency diagnosed by Doppler echocardiography. Report of two cases and review of the literature. Ital Heart J 2005, 6:927-30.
3. Weidong R, Xin C, Jun Y. Quadricuspid aortic valve diagnosed by transthoracic and multiplane transesophagel echocardiography. ChinUltrason med magazine 2000; 16:1.
4. Sakai Y, Tomita H, Ukae S. An aortic valve with four leaflets. Cardiol Young 2000; 10:538.
5. Feldman BJ, Khandheria BK, Warnes CA,et-al. Incidence,description and functional assessment of isolated quadricuspid aortic valves. Am J cardiol, 1990; 65:937- 938.
6. Tutarel O. The quadricuspid aortic valve. A comprehensive review. J Heart Valve Dis 2004; 13:534-37.
7. Balington J, quoted by Robicsek F, Sanger PW, et-al. Congenital quadricuspid aotic valve with displacement of left coronary orifice. Collected works on Cardiopulmonary Diseases.1968; 14:87-90.
8. Stanescu CM, Branidou K. A case of 75 year old survivor of unrepaired tetralogy of Fallot and quadricuspid aortic valve. Eur J Echo 2008; 9:167-70.
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|Paper Type||:||Research Paper|
|Title||:||Study of Congenital Neurological Anomalies in Foetus|
|Authors||:||I.Rajashree, T. Sobha devi|
Abstract: Congenital defects and anomalies present at birth have induced curiosity in people, since the dawn of history. In early societies, the babies surviving with developmental defects were considered as Monsters and were thought to be a curse on the mother or family. Prehistoric period reveals the records of human congenital malformations in cave paintings, sculptures and in writings. Archeologists have found skeletons of malformed infants dating as far back as the Stone Age. In the dark middle ages, mothers were burnt for the alleged curse of giving birth to a malformed child. The present study was done on 50 still born and aborted fetus around age group of 26 weeks to 40 weeks obtained from Gandhi Hospital Secunderabad,6 of them had central nervous system abnormalities of anencephaly to spina bifida,1case of meningocele. The author found a high incidence of central nervous system anomalies which suggest that they may be due to nutritional defiencies like folic acid and vitamin B 12 as the present study involved people from rural areas around Hyderabad and Secunderabad in a low socio economic group.
Key Words: Anencephaly, meningocoel, spina bifida, foetus
[. Aiyer P.R. (1969) congenital malfarmations. Paediatric clinic of India Volume No: 4 October: 369-371.
. ,Coffvi .V.P. and Jessop .W.J.E. a study of 137 cases of anencephaly Brit. Preventive Medicine (1957) 11:174-180.
. Lammer 1985 in fetal congenital Anomalies –an analysis Americal Journal of Obstretics & Gynaecology 1985 91:870.
. Muffarij .I.K, and Kilejan, V.O. Anencephaly-an analysis of anencephalic births 1963, 22:257.
. Seluk Eruz and Theodore .M.King anencephaly a survey of 44 cases. Obstretics & Gynaecology 1966 27: 601
. Tamsel .S. Ozbek.SS .Senar.Rn, Oztekin .O, Demipolat .G. Department of Radiology . Bornova comparative medicine imaging Graph 2004 April 28 (3) (4)-9.
. Vare AM and Bansal P.C An anatomical study of congenital anomalies. Indian journal of Paediatrics 1971, 38: 301.
. Vogel Stephen .F and Macclenahan .L, Anomalies major cerebral vessels and associated congenital malformations . American journal of Pathology 1952, 28:70, -723.
. Commenford. J.Pregnancy with congenital anomalies Lancet X.1965 Cited by Vare-Banasal.
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Abstract: Cranio cervical junction intra medullary subdural AVF/AVM ( type 2 AVM ) is a rare & enigmatic disease. We present a case of 25 yrs old male patient of cervical spinal , intramedullary arterio venous malformation with diffuse type nidus presented initially as bladder retention & myelo pathic changes at a later date . Endovascular occlusion using glue adhesive embolisation was undertaken. Post embolisation angiography documented complete obstruction of AVM with good subtle recovery without any procedural related complications. Diagnosing these lesions early & providing appropriate treatment is important if patients are to achieve an optimal neurologic outcome.
. Rosen blum B , Oldfield EH , Doppman JL , Di Chiro G. Spinal arteriovenous malformations : A complication of dural arterivenous malformations : A comparison of dural arteriovenous fistulas and intradural AVMs in 81 patients . J Neurosurg 1987; 67 : 795-802.
. Barnwell SL , Halbach VV , Dowd CF , Higashida RT , Hieshima GB , Wilson CB . Multiple dural arteriovenous fistulas of cranium and spine .Am J Neuroradiol 1991;12:441-5.
. Sheikh SI,Busl KM,Ning M, et al.Spinal dural arteriovenous fistula mimicking prostate hyperplasia.J Emerg Med 2008. ( Epub ahead of print )
. Jellema K, Tijssen CC, van Rooij WJ,et al. Spinal dural arteriovenous fistulas: long term follow-up of 44 treated patients.Neurology 2004;62:1839-41
. Anson JA , Spetzler RF. Interventional neuroradiology for spinal pathology . ClinNeurosurg.1992 ; 39 : 388-417(Medicine).
. Patsalides A , Santillan A , Knopman J , et al . Endovascular management of spinal dural arteriovenous fistulas . J NeuroIntervent Surg.2010;3(1):80-84.
. Retliff J , Connolly E. Spinal Arteriovenous Malformations. http://www.medschool.lsuhsc.edu/neurosurgery/nervecenter/spavm.html.Updated
. Harrop J S .Vascular malformations of the spinal cord.http:emedicine.medscape.com/article/248456-overview.Updated Aug 17,2011.
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Abstract: The combination of an anaemia and psychosis is noted more frequently then accounted by mere chance. The etiopathogenetic relationship of such anaemia to the development of such psychosis is complex and yet unclear. B12 deficiency anaemia may coincide with psychosis developing before or after development of mental disorder1. We report a case of young girl who developed psychosis 8 years back without features of anaemia and treated with anti psychotic therapies and ECT's before hospitalization with us as a case of severe megaloblastic anaemia and capgrass delusional psychosis. The clinicohematological, biochemical, histopathological, immunological and imaging studies undertaken in the case is reviewed and discussed. We humbly presume that the case presented with subtle B12 deficiency and mental disorders with affection of temporal lobes either side could have resulted with neurotoxic damage of B12 deficiencies and perhaps got deteriorated with ongoing several ECT's (60-70) which patient received over period of 8 years.
Key words : Megaloblastosis ,B12 deficiency, psychosis, capgras features.
. Durand C, Mary S , Brazo P , Dollfus S .Psychiatric Manifestations of Vitamin B12 Deficiency . Encephale 2003; 29 (6) : 560-565
. Herr KD , Norris ER , Frankel BL , Acute Psychosis in a patient with Vit B12 deficiency & coincident cevical stenosis. Psychosomatics 2002; 43:234-236
. Allen RH Lindenbaum J & Stabler S P .High prevalence of Cobalamine deficiency in the elderly . Transactions of the American Clinical & Climatological Association1995; 107:37-47.
. Payinda G, Hansen T. Vitamin B12 Deficiency manifested as psychosis without anaemia , American Journal of Psychiatry 2000; 157:4, 660-661
. http.// en.wikipedia.org/wiki/Capgras delusion Diseases DB 32606 22 Jun 2011 ,1-5
. Parfitt DN . Psychosis associated with Pernicious anaemia with a report of 2 cases. Journal Of Neurology & Psychopathology 1934:15 ; 12-19.
. Rajkumar A. Jebaraj P. Chronic Psychosis associated with Vit B12 deficiency JAPI 2008;56:115-116.
. Friedberg JM. Recurrent ECT Therapy leads to temporal lobe damage. American Journal of Psychiatry 1977;134:9,1010-1013.
. Aaron S, Kumar S, Vijayan J, Jacob J, Alexander M, Gnanamuthu C. Clinical and laboratory features and response to treatment in patients presenting with vitamin B12 deficiency related neurological syndromes . Neurol India 2005;53:55-58.
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|Paper Type||:||Research Paper|
|Title||:||Headache as Presenting Feature of Gullian Barre Syndrome|
|Authors||:||Talib S.H, Rahul Sainani*, Shreyas Deshpande*, Nilrohit Paike|
Abstract: Gullian Barre Syndrome is immune mediated inflammatory disorder of peripheral nervous system that produces rapidly progressive demyelination & axonal loss. Unexplained headaches as a presenting symptom of GBS has been extremely rare in literature. However only 2 cases in English language literature have been reported earlier by Kanchan Kanel et al (2011) .The patient besides headache noted to have isolated ptosis without ophthalmoplegia,subsequently developed descending weakness.The ptosis as an initial occurrence without ophthalmoplegia in GBS is also extremely rare. We are presenting a case of Gullian Barre Syndrome with such rare presentations of ptosis & headache as initial features of the disease.
Key words : Headache , Ptosis, Gullian Barre Syndrome
. De Jager AE ,Sluiter HJ . 1991.Clinical signs in severe Gullian Barre syndrome : Analysis of 63 patients . J Neurol Sci,104:143-50.
. Weiss H , Rastan V , Mullges W , et al . 2002 .Psychotic symptoms and emotional distress in patients with Gullian Barre syndrome .Eur Neurol, 47 : 74 – 8.
. Hao Wen Teng , MD,Jia Yung Sung MD,PhD,2010.Ptosis as the initial presentation of Gullian Barre syndrome.http:// www. jem- journal .com/article/S0736-4679(10)00389-6/abstract.
. Kanchan Kanel , Aisha Chohan, Reza Vaghefi hosseini ,Murray Flaster and Hesham Mohamed .Headache : An unusual Presenting Symptom of Gullian Barre Syndrome .Cleve Clinic J Med. 78 : Supplement 1 Aug 2011.
. Lucky Oceans. Guillain-Barre syndrome - a Lucky story.GBS facts http://www.abc.net.au/health/yourstories/stories/2009/03/09/2509436.htm..
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Abstract: Hepatitis A virus is an infectious agent known to trigger autoimmune hepatitis ( AIH ) . We present a case in a 45 year old woman with interstitial lung disease & chronic active hepatitis . Diagnosis of hepatitis A virus was attributed on viral serological tests & autoimmune hepatitis ( AIH ) in accordance with international autoimmune hepatitis group system1 . She is in remission with steroid therapy . The case we present is unusual with paucity observed in the world literature.
Key words: Acute hepatitis A , Autoimmune hepatitis , HLA , Interstitial lung disease , International criteria for AIH .
. Gleeson D, Heneghan M. British Society of gastroenterology ( BSG ) guidelines for management of autoimmune hepatitis. Gut. 2011;60:1611–29.
. Tosun S, Ertan P, Kasirga E, Atman U. Changes in seroprevalence of hepatitis A in children and adolescents in Manisa, Turkey. Pediatr Int 2004;46:669-72
. Singh G, Palaniappan S, Rotimi O, Hamlin PJ. Autoimmune hepatitis trigerred by hepatitis A. Gut. 2007;56:304
. Tabak F, Ozdemir F, Tabak O, Erer B, Tahan V, Ozaras R. Autoimmune hepatitis induced by the prolonged hepatits A virus infection. Annals of Hepatology 2008;7(2): 177-79.
. Tanaka H, Tujioka H, Ueda H, Hamagami H, Kida Y, Ichinose M. Autoimmune hepatitis triggered acute hepatitis A. World J Gastroenterol 2005;11(38):6069-71.
. Strassburg CP, Vogel A, Manns MP. Autommunity and hepatitis C. Autoimmun Rev 2003;2:322-31.
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Abstract: Emerging data shows that type 2 diabetes is the commonest form of diabetes and the prevalence level is increasing at an alarming rate. Diabetogenic hormones play a role in the complications of diabetes mellitus.This study therefore is an attempt to evaluate the serum cortisol and GH in type 2 diabetic subjects. These hormones have the potential to exacerbate the diabetic condition if produced in inappropriate amounts. Samples from 105 confirmed type 2 diabetic subjects attending Metabolic Clinic of University of Maiduguri Teaching Hospital and 71 non diabetic volunteers of identical age-matched were analyzed for fasting blood sugar, growth hormone, cortisol, insulin. Plasma glucose was estimated by the enzymatic method (glucose oxidase). Cortisol, growth hormone and insulin were determined by enzyme linked immunosorbent assay (ELISA) method. The data generated was analyzed using statistical software SPSS version 16.0 and Microsoft excels 2007. All the results were expressed as mean±SEM. The study revealed that serum cortisol and insulin were significantly higher (P< 0.05) in type 2 diabetic subjects (163.47± 8.91ng/ml and 13.60± 1.47μiu/ml) compared to the non-diabetic controls (94.14± 4.97ng/ml) and 8.17± 0.72 μiu/ml) respectively. A significant inverse correlation was observed between cortisol and insulin. This is consistent with the activity of cortisol as a diabetogenic hormone. Over fourteen percent (14.3%) of the diabetic subjects had abnormally high cortisol values. This would contribute to the diabetic condition in these patients. The mean growth hormone value was significantly lower in type 2 diabetics (P< 0.05) when compared to the control group (0.42± 0.06ng/ml versus 0.84± 0.22 ng/ml). The mean BMI of the diabetic subjects was significantly higher than the mean for controls. Raised cortisol is a possible exacerbating factor in some cases of type 2 diabetes. These patients should be routinely screened for the hormone.
Keywords - Type 2 diabetes, cortisol, growth hormone, insulin, BMI
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 Tracey, L. (2010). The role of cortisol and abdominal obesity in the epidemic of type 2 diabetes. Retrieved July 21, 2011 from http://www.kon.org/urc/v9/liebman.html
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