Kavita Krishna

Multiple brain abscesses - diagnostic dilemma and therapeutic nightmare!

234 Journal of Neurosciences in Rural Practice | April June 2013 | Vol 4 | Issue 2 Meningiomas are the commonest intracranial tumors to which systemic metastases occur.[2,3] In meningiomas, the meningothelial variety appears to be the commonest and to the best of our knowledge there are no reports of metastasis to a psammomatous meningioma.[3] Tumor to tumor metastasis are differentiated from collision tumors by Chamber’s[4] but if stricter criteria of Campbell et al., are used the phenomenon appears to be exceedingly rare with less than 100 cases in reported literature and very few to intracranial tumors.[5] Several theories have been proposed to explain the proclivity of metastasis to meningiomas these include rich vascularity, slow growth rate of meningiomas, hormonal factors and low metabolic rate but the conclusive causes remain unknown.

In-hospital outcome of acute myocardial infarction and its correlation with plasma sugar levels

Abstract Objectives To correlate plasma glucose levels on admission (in diabetics and nondiabetics) with the outcome and majoradverse cardiac events in patients with acute myocardial infarction (AMI). To assess the relationship between stress hyperglycemia and mortality in nondiabetic and diabetic patients having AMI. And also to correlate othervariables like age, sex, systolic blood pressure (SBP), serum creatinine and lipid levels on admission with the outcome. Materials and Method Sixty consecutive patients admitted with ST-elevated myocardial infarction were enrolled. Blood glucose measurements (on admission and discharge) as well as other known prognostic markers like SBP, creatinine, and lipid levels on admission were recorded to investigate their relationship with the occurrence of major cardiac events during their stay in hospital. Diabetics were identified with past history of diabetes mellitus and/or by World Health Organization criteria. Stress hyperglycemia was considered to be present if admission venous plasma sugar exceeded 126 mg/dL without prior diagnosis of diabetes mellitus, and had normal sugar levels on serial estimation and follow-up up to 6 months. Patients were divided into three groups, on the basis of presence of diabetes, stress hyperglycemia and normoglycemia (controls) on admission with 20 patients in each group. Results The incidence of various complications of AMI like left ventricular failure (LVF), cardiogenic shock, arrhythmias and conduction blocks during hospital stay were significantly higher in patients with diabetes (90%) and stress hyperglycemia (75%) as compared to controls (30%) (p 126mg% at the time of admission (p 0.05) in the lipid levels between the survivors and nonsurvivors. Conclusion Admission PSL can be regarded as a strong predictor of complications and mortality after AMI irrespective of presence or absence of diabetes. Thus, stress hyperglycemia carries as bad a prognosis as diabetes. Serum creatinine and SBP on admission also play a prognostic role.

Can Progression of Alcoholic Liver Disease be Predicted from Certain Biochemical Indices

Background: Fatty liver, hepatitis, cirrhosis and hepatic encephalopathy are clinically distinct progressively deteriorating conditions in alcoholic liver disease (ALD). Factors responsible for the progression of ALD are poorly understood. Therefore we compared various biochemical parameters in these conditions to correlate them with disease progression. Methods: Thirty patients of alcoholic liver disease reporting to our hospital were recruited in the study. Analysis included hematological parameters, liver function tests, ammonia, amino acids and measurement of oxidative stress by measuring malanodialdehyde. Based on ultrasonography, patients were classified as fatty liver, alcoholic hepatitis and cirrhosis. Results: Hematological parameters showed significant change in the levels with the progression of the disease. Levels of aspartate transaminase, alanine amino transferase, alkaline phosphatase, biluribin were elevated in all the ALD conditions but were more pronounced in hepatitis and cirrhosis than fatty liver. Oxidative stress was increased with progression of disease. Also significant differences in the levels of ammonia and amino acids were obtained. Conclusions: Alcohol induced oxidative stress is the primary cause of the liver injury. The progressive deterioration of various parameters indicates the extent of liver injury. Therefore, antioxidant therapy may be best course that may halt or slow down the progression of ALD. These observations together, provide a rationale for the possible clinical application of antioxidants in the therapy for ALD. Thus, prevention and therapy opposing the development of steatosis and its progression to more severe injury can be attempted by a multifactorial approach.