Fourth Nerve Palsy

2019 ◽  
pp. 105-110
Author(s):  
Matthew J. Thurtell ◽  
Robert L. Tomsak
Keyword(s):  
Nerve Palsy ◽  
Clinical Signs ◽  
Strabismus Surgery ◽  
Step Test ◽  
Management Options ◽  
Common Cause ◽  
Common Causes ◽  
The Common ◽  
Skew Deviation ◽  
Fourth Nerve Palsy

Fourth nerve palsy is a common cause of binocular vertical diplopia. However, it can be difficult to diagnose because the clinical signs are often subtle. In this chapter, we begin by reviewing the symptoms of fourth nerve palsy. We next discuss clinical maneuvers for diagnosing fourth nerve palsy, including the Parks-Bielschowsky three-step test. We list the common causes for isolated fourth nerve palsy and review its differential diagnosis, which includes skew deviation and myasthenia gravis. We then discuss the indications for neuroimaging in a patient with fourth nerve palsy. Lastly, we discuss management options for fourth nerve palsy, which include prisms and strabismus surgery.

scholarly journals Hydronephrosis as an Unusual Cause of Acute Pancreatitis

2015 ◽  
Vol 5 ◽  
pp. 21 ◽  
Author(s):  
Nata Pratama Hardjo Lugito ◽  
Edy Gunawan ◽  
Margaret Chandra ◽  
Andree Kurniawan
Keyword(s):  
Acute Pancreatitis ◽  
Bile Duct ◽  
Renal Stones ◽  
Distal Segment ◽  
Urinary System ◽  
Common Cause ◽  
Duct Obstruction ◽  
Common Causes ◽  
The Common ◽  
Head Of Pancreas

Acute pancreatitis is an inflammatory disease of the pancreas. The most common cause of acute pancreatitis is gallstone impacting the distal common bile–pancreatic duct (38%) and alcoholism (36%). There have been a few reports in the literature of acute pancreatitis associated with an obstructed urinary system. This case describes a 38-year-old male with acute pancreatitis occurring in the setting of hydronephrosis. A magnetic resonance cholangiopancreaticography (MRCP) showed right-sided severe hydronephrosis pushing the duodenum and head of pancreas anteriorly, thus obliterating distal segment of the common bile duct. There were also multiple right renal stones causing ureteral obstruction and hydronephrosis. Right nephrostomy was performed to release bile duct obstruction. However, sepsis and disseminated intravascular coagulation developed as a complication of acute pancreatitis, and the patient passed away. Although gallstone and alcoholism are the most common causes of acute pancreatitis, other causes should always be considered. Physicians should be aware of right hydronephrosis as one of the possible causes of acute pancreatitis in their workup of patients.

scholarly journals Isolation of Arcobacter spp from the milk of dairy cows in Brazil

2007 ◽  
Vol 37 (1) ◽  
pp. 171-174 ◽  
Author(s):  
Celso Pianta ◽  
Daniel Thompsen Passos ◽  
Diego Hepp ◽  
Sérgio José de Oliveira
Keyword(s):  
Dairy Cows ◽  
Clinical Signs ◽  
Etiologic Agent ◽  
Streptococcus Dysgalactiae ◽  
Milk Samples ◽  
Streptococcus Uberis ◽  
Common Causes ◽  
Arcobacter Butzleri ◽  
The Common ◽  
Corynebacterium Sp

Bacteriologic examinations were performed on 188 milk samples collected from cows from 11 farms for diagnosis of mastitis in three cities of Rio Grande do Sul, Brazil. Among the common causes of mastitis, the most frequent isolates were Staphylococcus aureus, followed by Corynebacterium sp, Streptococcus uberis, Streptococcus dysgalactiae and Streptococcus agalactiae. Bacteriologic examination of 32 milk samples from one farm didn't show bacteria known as common etiologic agent of mastitis. Six samples of Arcobacter spp typed by genotypic tests as Arcobacter cryaerophilus (five strains) and Arcobacter butzleri (one strain) were isolated from cows' milk of that farm. It is reported the isolation of Arcobacter species from the milk of cows in absence of clinical signs of mastitis. This is the first report of the detection of the microorganisms in the milk of dairy cows in Brazil. No previous reports are known from other countries.

Third Nerve Palsy

2019 ◽  
pp. 99-104
Author(s):  
Matthew J. Thurtell ◽  
Robert L. Tomsak
Keyword(s):  
Clinical Features ◽  
Nerve Palsy ◽  
Nerve Compression ◽  
Posterior Communicating Artery ◽  
Vascular Imaging ◽  
Management Approach ◽  
Third Nerve Palsy ◽  
Common Causes ◽  
The Common ◽  
Third Nerve

Acute painful pupil-involving third nerve palsy requires urgent investigation because it can be due to third nerve compression by a rapidly enlarging aneurysm of the posterior communicating artery. In this chapter, we begin by reviewing the clinical features of third nerve palsy. We next review the common causes of isolated third nerve palsy, which include microvascular ischemia, trauma, compression by neoplasm, and compression by aneurysm. We then discuss the workup of third nerve palsy and review the vascular imaging options to evaluate for aneurysm. Lastly, we discuss the management approach for third nerve palsy due to aneurysmal compression and microvascular ischemia.

scholarly journals CLINICAL PROFILE OF CHILDREN PRESENTING WITH SEIZURE

2021 ◽  
Vol 5 (12) ◽  
Author(s):  
Rakesh Thakur ◽  
Sumeet Verma
Keyword(s):  
Health Care ◽  
Descriptive Study ◽  
Health Care Facilities ◽  
Clinical Profile ◽  
Age Group ◽  
Common Cause ◽  
Common Causes ◽  
Care Facilities ◽  
Acute Symptomatic Seizure ◽  
The Common

Background: This study is to describe the clinical profile of children presenting with seizure including common causes of seizure and classify the seizure types. Methods:  Hospital-based, analytic and descriptive study. This study includes all children in the age group 6 months to 12 years who presented in the department of paediatrics with seizure. Results: Seizures presented with fever in 36.00% of cases Conclusions: Seizures are one of the common causes of hospitalization. It can be inferred from this study that CNS infections are the most common cause of acute symptomatic seizure. The improvement in health care facilities like sanitation and immunization is warranted to prevent it. Keywords: Seizures, GTCS, Children

scholarly journals The Etiologies of Isolated Fourth Cranial Nerve Palsy: A 10-Year Review of 158 Cases

2021 ◽  
Author(s):  
Apatsa Lekskul ◽  
Wadakarn Wuthisiri ◽  
Phantaraporn Tangtammaruk
Keyword(s):  
Nerve Palsy ◽  
Demographic Data ◽  
Closed Head Injury ◽  
Clinical Signs ◽  
Case Series ◽  
Signs And Symptoms ◽  
Rapid Progression ◽  
Clinical Signs And Symptoms ◽  
Atypical Presentations ◽  
Fourth Nerve Palsy

Abstract MethodsPatients diagnosed with isolated fourth nerve palsy from January 1, 2009, through July 31, 2020 in Ramathibodi Hospital, were included in this retrospective, observational case series. The demographic data of patients, age at presentation, the etiologies of isolated fourth nerve palsy and neuroimaging results (if indicated) were recorded.ResultsWe identified 153 unilateral and 5 bilateral cases of isolated fourth nerve palsy. Mean age at presentation was 38.89 ± 25.71 years old. Most of the unilateral cases were congenital (58.17%), with vasculopathy (27.45%), intracranial neoplasm (8.5%) and other etiologies. Trauma with closed head injury was the most common etiology of bilateral cases (60%), followed by ruptured arterovenous malformation (20%) and vasculopathy (20%). Twenty-one of the 43 (48.84%) patients with vasculopathy-associated fourth nerve palsy underwent neuroimaging, with normal findings, and all patients’ symptoms resolved within 6 months of symptom onset.ConclusionsIn our series, most of the isolated fourth nerve palsy cases were congenital, followed in frequency by vasculopathy and intracranial tumor, as in many studies. In cases of vasculopathy, the clinical signs and symptoms resolved within 6 months in all cases: observation was sufficient, with no necessity for neuroimaging. However, neuroimaging should be considered in cases with atypical presentations, such as headache, periorbital pain, ataxia with positive cerebellar signs, or if there is rapid progression or no recovery.

scholarly journals Syndrome of inappropriate antidiuretic hormone secretion and cerebral salt wasting as the common causes of hyponatremia in tertiary care hospital

2020 ◽  
Vol 7 (4) ◽  
pp. 577
Author(s):  
Yogesh Pralhad Bade ◽  
Harishchandra Rameshchandra Chaudhari
Keyword(s):  
Antidiuretic Hormone ◽  
Tertiary Care ◽  
Hormone Secretion ◽  
Cerebral Salt Wasting ◽  
Common Cause ◽  
Inappropriate Antidiuretic Hormone Secretion ◽  
Salt Wasting ◽  
Antidiuretic Hormone Secretion ◽  
Common Causes ◽  
The Common

Background: Hyponatremia is a typical condition of electrolyte disturbance that may be euvolemic, hypovolemic or hypervolemic. Proper interpretation through laboratory tests helps to differentiate the types and causes of hyponatremia. This study was conducted to evaluate the syndrome of inappropriate antidiuretic hormone secretion (SIADH) and cerebral salt wasting (CSW) as the common causes of hyponatremia in tertiary care hospital.Methods: A prospective interventional study was conducted, including hyponatremia cases, admitted in NTU/ICU/CCU and other medical wards at Ruby Hall Clinic from August 2011 to December 2013.Results: Of 150 patients enrolled in this study, 33.33% patients were euvolemic, 34% patients were hypervolemic and 32.66% patients were hypovolemic. For the euvolemic patients, SIADH (68%) was the most common cause; whereas, CSW (34.39%) was the common cause for hypovolemic type of hyponatremia. Stroke was found to be the most common cause of SIADH (55.88%), Intra-cerebral bleeding was observed to be the most common causative factor between SIADH and CSW associated hyponatremia.Conclusions: Hyponatremia in central nervous system disorder patients frequently occurred due to SIADH and CSW. Most common cause of SIADH was stroke and for CSW it was intra cerebral bleed.

Sixth Nerve Palsy

2019 ◽  
pp. 111-114
Author(s):  
Matthew J. Thurtell ◽  
Robert L. Tomsak
Keyword(s):  
Differential Diagnosis ◽  
Nerve Palsy ◽  
Rectus Muscle ◽  
Thyroid Eye Disease ◽  
Eye Disease ◽  
Sixth Nerve Palsy ◽  
Common Causes ◽  
Controversial Topic ◽  
The Common ◽  
Sixth Nerve

Binocular horizontal diplopia with a unilateral abduction deficit is often due to sixth nerve palsy. However, it can also be caused by other conditions, such as medial rectus muscle restriction in thyroid eye disease. In this chapter, we begin by reviewing the differential diagnosis of an abduction deficit. We next list the common causes of an isolated unilateral sixth nerve palsy and bilateral sixth nerve palsy. We then discuss our approach to neuroimaging for sixth nerve palsy, as this remains a controversial topic. Lastly, we discuss the prognosis and management of sixth nerve palsy, with a focus on sixth nerve palsy due to microvascular ischemia.

Stability and compatibility of drugs

2016 ◽  
Author(s):  
Andrew Dickman ◽  
Jennifer Schneider
Keyword(s):  
Medication Error ◽  
Drug Administration ◽  
First Principles ◽  
Medication Safety ◽  
Healthcare Costs ◽  
Pharmaceutical Chemistry ◽  
Acid Base ◽  
Common Cause ◽  
Common Causes ◽  
The Common

Medication safety has become an important healthcare topic due to the increasing awareness of the prevalence and incidence of errors and the implications in terms of rising healthcare costs. Drug administration is seen as a common cause of medication error or failure, with mixing of incompatible parenteral drugs seen as an important medication error. This chapter provides information relating to the pharmaceutical chemistry of compatibility and stability of drugs in solution. The terms incompatibility and instability are defined, along with some of the common causes. The possibility of predicting incompatibility from first principles using rudimentary acid–base chemistry is postulated. Factors that may affect the compatibility and stability of drug combinations administered by CSCI are discussed.

scholarly journals Etiology and Pattern of Drug Induced Liver Injury in a Tertiary Care Hospital of Nepal

2019 ◽  
Vol 21 (3) ◽  
pp. 220-223
Author(s):  
Anuj K.C. ◽  
S. Jha ◽  
S. Thapa
Keyword(s):  
Liver Injury ◽  
Liver Toxicity ◽  
Tertiary Care ◽  
Care Hospital ◽  
Drug Induced ◽  
Common Cause ◽  
Drug Induced Liver Injury ◽  
Common Causes ◽  
The Common ◽  
Mixed Pattern

Drug induced liver injury (DILI) is one of the common cause of liver toxicity. Most of the drugs used today are hepatotoxic. DILI accounts for approximately one-half of the cases of acute liver failure and mimics all forms of acute and chronic liver disease. It is the single most common adverse drug reaction leading to a halt in the development of new medication by pharmaceutical company, failure of new drug to obtain regulatory approval, and withdrawal or restriction of existing drug from the market. The aim of this study is to evaluate common causes and patterns of DILI in our setting. Twenty-seven patients were enrolled in the study. Ant tubercular drugs were most common cause of DILI, accounting for 48.2%. Other common causes of DILI were paracetamol (14.8%) and NSAID’s (11.1%). The most common pattern of liver injury seen was mixed pattern which was present in63%, followed by cholestatic and hepatocellular pattern. Hence, we should be very careful while prescribing these frequently used drugs.

scholarly journals PLEURAL EFFUSION;

2012 ◽  
Vol 19 (06) ◽  
pp. 812-815
Author(s):  
AZAM MUSHTAQ ◽  
Salman AYYAZ ◽  
SHAKEEL AHMED KHAN
Keyword(s):  
Liver Cirrhosis ◽  
Pleural Effusion ◽  
Pleural Fluid ◽  
Cardiac Failure ◽  
White Cell Count ◽  
Congestive Cardiac Failure ◽  
Common Cause ◽  
Nephritic Syndrome ◽  
Common Causes ◽  
The Common

Objective: To determine the frequency of various diseases presenting with pleural effusion. Setting: Department of ChestMedicine, Nishtar Hospital, Multan. Period: March 2010 to September 2010. Material and methods: A total of 100 patients both sexes, morethan 12 years old, with clinically and radiologically confirmed pleural effusion underwent diagnostic thoracocentesis. Pleural fluid wasexamined grossly and for sugar, protein, LDH, total and differential white cell count and malignant cells. Pleural fluid culture and pleural biopsywas done in case of exudative effusion. Results: Tuberculosis was the most common cause (28%) of exudative pleural effusion followed byparapneumonic effusion (25%) and malignant effusion (9%). Congestive cardiac failure (13%) and liver cirrhosis (8%) were the commonestcause of transudative pleural effusion. Renal failure (5%), nephritic syndrome (2%), pancreatitis (2%), systemic lupus erythmatosus (2%) werethe other significant causes of pleural effusion. Conclusion:- Tuberculosis, paraneumonic effusion and malignancies are the common cause ofexudative pleural effusion while congestive cardiac failure, liver cirrhosis and nephritic syndrome are common causes of transudative effusion.

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