scholarly journals Sinovenous Abnormalities in Patients of Idiopathic Intracranial Hypertension

2018 ◽  
Vol 26 ◽  
pp. 53-56
Author(s):  
M Pervez Amin ◽  
Pijush Kumar Kundu ◽  
M Munzur Alahi ◽  
Mukul Kumar Sarkar ◽  
M Ahmed Ali ◽  
...  
Keyword(s):  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Transverse Sinus ◽  
College Hospital ◽  
Medical College ◽  
Significant Difference ◽  
History Of ◽  
History Of Use ◽  
The Brain

Idiopathic Intracranial Hypertension is a disease of unknown aetiology common in obese females and presents with headache, papilledema, raised CSF opening pressure, no abnormalities in CSF examination and no abnormality on CT scan or MRI of the Brain. Sinovenous abnormalities are commonly detected in patients of IIH by different neuroimaging techniques. But the exact role of these sinovenous abnormalities in the causation of the disease or whether they are an effect of the disease is not yet known. Nor has a ‘gold standard’ investigation been established yet for detection of the sinovenous abnormalities. This study was done to detect the presence of sinovenous abnormalities in IIH patients by performing a Magnetic Resonance Venography of the brain. All 33 patients of IIH who presented to Rajshahi Medical College Hospital during the study period from June 2009 to May 2010 were included in the study. There were 30 females and 3 males having a F:M ratio of 10:1. 91% of the patients were between 20 and 35 years of age and most of them were married housewives. 63.64% patients had history of use of oral contraceptives. Unusually 51.52% of the patients had a BMI less than 25 indicating that they were not even overweight (BMI 25 to 30). Only 6% of the patients had BMI > 30 indicating that they were obese. Headache and papilloedema were present in all patients but visual difficulties were present only in 54.54% of the patients. Abnormalities in MRV of the brain were detected in 27.27% (9/33) of the patients and transverse sinus hypoplasia was the commonest finding (88.89% - 8/9 patients). There was no statistically significant difference in the findings of MRV abnormalities between the males and females or among the patients having BMI less or more than 25TAJ 2013; 26: 53-56

scholarly journals The Role of Combination of 20% Azelaic Acid with 0.05% Tretinoin Cream in the Treatment of Melasma - A study in FMCH.

2017 ◽  
Vol 11 (2) ◽  
pp. 50-53
Author(s):  
Krishna Gopal Sen ◽  
Sumitendra Kumar Sarkar ◽  
Md Shafiqul Islam ◽  
Md Kamal Mostofa ◽  
Asit Ranjan Das ◽  
...  
Keyword(s):  
Oral Contraceptives ◽  
Azelaic Acid ◽  
Positive Family History ◽  
College Hospital ◽  
Medical College ◽  
Number Of Patients ◽  
History Of ◽  
Facial Area ◽  
History Of Use

Melasma is characterized by melanosis with sharply demarcated blotchy, brown macules usually in a symmetric distribution over the cheeks and forehead and sometimes on the upper lip and neck. It is most often seen in women during pregnancy, at menopause and while taking oral contraceptives; it occasionally occurs in women who are not pregnant or taking oral contraceptives, as well as men. So it is a great problem in our country. A clinical trial was conducted to find out the effect of the combination of 20% azelaic acid with 0.05% tretinoin cream in the treatment of melasma. Twenty clinically diagnosed cases of melasma attending the outpatient department of Dermatology and Venereology, Faridpur Medical College Hospital, Faridpur were enrolled. Majority of the study subjects (40%) were between 26 to 30 years of age and most of them (60%) were females. Regarding occupation, 60% were housewife. Out of the study subjects 75% were married and 60% were middle class. Around 60% cases had positive family history of melasma and maximum (90%) patient had no history of systemic drug and the maximum (80%) patients had no history of use of cosmetics. It was observed that highest (90%) number of patients had malar area involvement and 10% had centro-facial area involvement. The study showed moderate reduction of the severity of melasma after the treatment. Out of the study subjects, 40% and 20% developed burning sensation and erythema respectively. It could be concluded that combination of 20% azelaic acid and 0.05% tretinoin cream, has a moderate lightening effect in the treatment of melasma.Faridpur Med. Coll. J. Jul 2016;11(2): 50-53

Idiopathic intracranial hypertension

Neurology ◽  
2018 ◽  
Vol 91 (11) ◽  
pp. 515-522 ◽  
Author(s):  
Stéphanie Lenck ◽  
Ivan Radovanovic ◽  
Patrick Nicholson ◽  
Mojgan Hodaie ◽  
Timo Krings ◽  
...  
Keyword(s):  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Interstitial Fluid ◽  
Water Exchange ◽  
Venous Blood ◽  
Glymphatic System ◽  
Associated Conditions ◽  
Outflow Pathway ◽  
The Brain

The recent discoveries of the glymphatic and lymphatic systems of the brain have helped advance our understanding of CSF physiology and may allow new insights in the understanding of idiopathic intracranial hypertension (IIH). The clinical and radiologic presentations of IIH appear to be related to congestion of the glymphatic system associated with an overflow of the lymphatic CSF outflow pathway. By revisiting the role of “vascular arachnoid granulations” in the brain, we hypothesize that an initial impairment of the transport of interstitial fluid from the glymphatic system to the venous blood of the dural sinuses may trigger the hydrodynamic cascade of IIH. Furthermore, we speculate that, similar to other water-exchange systems in the brain, a specific subtype of aquaporin is involved in this transport. This theory may eventually help to provide an underlying explanation for IIH and its associated conditions, since in most of them, the expression of several aquaporins is altered.

scholarly journals Role of Maternal Smokeless Tobacco Ingestion During Pregnancy in Delivery of Preterm Babies

2017 ◽  
Vol 40 (3) ◽  
pp. 135-138
Author(s):  
Farzana Rahman Munmun ◽  
Md Ekhlasur Rahman ◽  
Ahmed Ferdous Jahangir ◽  
Md Shamsul Arefin Patwary ◽  
Abu Sayeed Chowdhury ◽  
...  
Keyword(s):  
Smokeless Tobacco ◽  
Adverse Pregnancy Outcome ◽  
Retrospective Case ◽  
College Hospital ◽  
Term Neonates ◽  
Medical College ◽  
History Of ◽  
Preterm Babies ◽  
Adverse Pregnancy

Background:Smokeless tobacco is an established cause of adverse pregnancy outcome. Preterm deliveries are quite high(14%) in our country and approximately 39% women in Bangladesh use smokeless tobacco (ST).Objective: To determine the outcome of maternal smokeless tobacco ingestion during pregnancy in delivery of preterm babies.Methods: A retrospective case control study was carried out in the department of Pediatrics & department of Obstetrics and Gynecology in Dhaka Medical College Hospital between July 2010 to June 2011. Immediately after admission, detailed history of the newborn baby & mother was taken. A total of 100 cases (preterm babies) and 100 suitably matched controls (sick term neonates) were enrolled. Every case satisfying the selection criteria (inclusion & exclusion criteria) was enrolled in the study. The mother was asked whether she used to use smokeless tobacco (jorda, shada or gul) during pregnancy and about frequency and duration of ingestion of ST.Results: Baseline characteristics of cases and controls were comparable. ST user mothers of preterm babies used ST about 5 times a day. Maternal smokeless tobacco (ST) use during pregnancy was significantly associated (46%) with the delivery of preterm babies (p<0.001) and carries a risk of 2.7 times than that of non ST users.Conclusion: Maternal ST use ?5 times a day during pregnancy increases 2.7 folds risk of delivery of preterm babies than that of non-ingested.Bangladesh J Child Health 2016; VOL 40 (3) :135-138

scholarly journals Endovascular Treatment for Idiopathic Intracranial Hypertension Improves Clinical Symptoms and Signs

2017 ◽  
Vol 36 (01) ◽  
pp. 01-06
Author(s):  
João Silva ◽  
Mario Conti ◽  
Guilherme Aguiar ◽  
Mauricio Jory ◽  
Paulo Monzillo ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Clinical Symptoms ◽  
Venous Drainage ◽  
Transverse Sinus ◽  
Pressure Gradients ◽  
Sinus Stenosis ◽  
Symptoms And Signs

Introduction New physiopathological concepts regarding idiopathic intracranial hypertension (IIH) recommend the endovascular treatment in refractory patients with transverse sinus stenosis. Objectives To assess the role of the transverse sinus stenting treatment in the symptomatology of patients with IIH. Method Clinically refractory patients with impaired venous drainage of the transverse sinus were submitted to cerebral angiographies. Patients with pre and post-stenotic pressure gradients > 8 mmHg were submitted to endovascular treatment. Results Seven patients underwent cerebral angiography with manometry. Stenting was performed in six cases after pressure gradient assessment. All cases showed improvements in headache and resolution of papilledema. Discussion and Conclusion Although the role of endovascular therapy should be further studied, our data suggest it may improve the clinical symptoms and signs of IIH in selected patients.

scholarly journals Epidemiological Pattern of Renal Insufficiency among the Patients of Nephrology Unit of Dhaka Medical College Hospital, Dhaka, Bangladesh

2014 ◽  
Vol 8 (2) ◽  
pp. 80-84
Author(s):  
Md Nazmul Haq ◽  
Latifur Raaman ◽  
Md Zohirul Islam Miah ◽  
Easin Ali Gazi ◽  
Shukti Catherine Baroi
Keyword(s):  
Renal Insufficiency ◽  
Medical College Hospital ◽  
College Hospital ◽  
Female Ratio ◽  
Medical College ◽  
Throat Infection ◽  
Ckd Stage ◽  
Significant Difference ◽  
History Of ◽  
Epidemiological Pattern

A hospital based descriptive cross sectional study was conducted at Nephrology unit of Dhaka Medical College Hospital (DMCH) to see the association between epidemiological pattern of renal insufficiency with sociodemographic factors, kidney related factors and others factors. Sources of data include patient interviews, diagnosis cards and case records. Respondents were categorized to their CKD stage according to their estimated GFR on Modification of Diet in Renal Disease (MDRD). The sample comprised 150 patients suffering from CKD with male and female ratio being 1.5:1, mean age of the population was 47 years (SD ± 14.5), 47.3% of the respondents had history of streptococcal throat infection and 10% had previous kidney disease Renal Replacement Therapy (RRT) was the commonly advised therapy for CKD indicating very late diagnosis of CKD. Total 49.3% had smoking habit while 60.7% was on regular physical exercise and 49.3% took extra salt on their dietary habit, 52.7% were diabetic and 78.7% were hypertensive and 40% had both diabetes and hypertension. Total 76.6% were in stage-5 of CKD where 60.7% of them used NSAID with 54.0% within normal range of BMI. There is statistically significant difference with stage of renal insufficiency and history of streptococcal throat infection (p=0.00) and therapy advised for CKD (P-0.01). Worldwide, CKD is becoming a common disease in the general population. It requires early, accurate and improved detction and mangemnt of diabetes and hypertension, the major contributors to CKD. DOI: http://dx.doi.org/10.3329/fmcj.v8i2.20391 Faridpur Med. Coll. J. 2013;8(2): 80-84

A new index for the assessment of transverse sinus stenosis for diagnosing idiopathic intracranial hypertension

2016 ◽  
Vol 9 (2) ◽  
pp. 173-177 ◽  
Author(s):  
Gustavo Balthazar da Silveira Carvalho ◽  
Sandro Luiz de Andrade Matas ◽  
Marcos Hideki Idagawa ◽  
Luiz Antônio Tobaru Tibana ◽  
Renato Sartori de Carvalho ◽  
...  
Keyword(s):  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Characteristic Curve ◽  
Transverse Sinus ◽  
Control Group ◽  
Group Index ◽  
Sinus Stenosis ◽  
The Right ◽  
Sensitivity Specificity

Background and purposeTo assess the role of MR venography (MRV) for detecting transverse sinus stenosis, to determine the importance of this finding in idiopathic intracranial hypertension (IIH), and to propose an index that contributes to this diagnosis.Materials and methodsWe retrospectively assessed consecutive intracranial MRV of patients aged >18 years diagnosed with IIH according to the diagnostic criteria, between January 2010 and July 2012. The assessments were randomly analyzed by three radiologists. Stenoses in the right and left transverse sinuses were independently classified according to the following scale: 0, normal; 1, stenosis <33%; 2, stenosis 33–66%; 3, stenosis >66%; and 4, hypoplasia or agenesis. We established an index based on multiplication of the stenosis scale values for each transverse sinus. A point and range estimate of the sensitivity, specificity, and the area under the receiver operating characteristic curve was performed to obtain cut-off points to differentiate between controls and patients.Results63 individuals were included in this study: 32 (50.8%) diagnosed with IIH (31 (96.9%) women and 1 (3.1%) man) and 31 (49.2%) controls. According to all of the examiners, the IIH group showed a higher degree of stenosis than the control group. Index values ≥4 for a diagnosis of IIH had a sensitivity and specificity of 94.7% and 93.5%, respectively.ConclusionsMRV should be used to assess patients with suspected IIH, and bilateral transverse sinus stenosis should be considered for the diagnosis. The stenosis classifying index proposed here is a fast and accessible method for diagnosing IIH.

Venous Sinus Pulsatility and the Potential Role of Dural Incompetence in Idiopathic Intracranial Hypertension

Neurosurgery ◽  
2012 ◽  
Vol 71 (4) ◽  
pp. 877-884 ◽  
Author(s):  
Marc A. Lazzaro ◽  
Ziad Darkhabani ◽  
Bernd F. Remler ◽  
Sang H. Hong ◽  
Thomas J. Wolfe ◽  
...  
Keyword(s):  
Pressure Gradient ◽  
Intracranial Hypertension ◽  
Stent Implantation ◽  
Idiopathic Intracranial Hypertension ◽  
Potential Role ◽  
Transverse Sinus ◽  
Venous Sinus ◽  
Dural Sinus ◽  
Complete Understanding

Abstract BACKGROUND: Idiopathic intracranial hypertension (IIH) remains a poorly understood and therapeutically challenging disease. Enthusiasm has emerged for endovascular therapy with stent reconstruction of dural sinus narrowing; however, a complete understanding of the hydrodynamic dysequilibrium is lacking. OBJECTIVE: To review and characterize catheter manometry findings including pulsatility changes within the venous sinuses in IIH. METHODS: Cases of venous sinus stent implantation for IIH were retrospectively reviewed. RESULTS: Three cases of venous sinus stent implantation for treatment of IIH are reported. All cases demonstrated severe narrowing (&gt;70%) within the transverse sinus and a high pressure gradient across the lesion (&gt;30 mm Hg). Stent implantation resulted in pulsatility attenuation, correction of pressure gradient, and improvement of flow. CONCLUSION: We report the finding of high venous sinus pulsatility attenuation after stent implantation for dural sinus narrowing and propose the hypothesis that this finding is a marker of advanced dural sinus incompetence. This characteristic may be useful in identifying patients who would benefit from endovascular stent remodeling.

Prevalence of dural venous sinus stenosis and hypoplasia in a generalized population

2016 ◽  
Vol 8 (11) ◽  
pp. 1173-1177 ◽  
Author(s):  
Christopher R Durst ◽  
David A Ornan ◽  
Michael A Reardon ◽  
Prachi Mehndiratta ◽  
Sugoto Mukherjee ◽  
...  
Keyword(s):  
General Population ◽  
Intracranial Hypertension ◽  
Idiopathic Intracranial Hypertension ◽  
Transverse Sinus ◽  
Venous Sinus ◽  
Inclusion Criteria ◽  
Multivariate Statistical ◽  
Sinus Stenosis ◽  
Dural Venous Sinus

Background and purposeWhile recent literature has described the prevalence of transverse sinus stenosis in patients with idiopathic intracranial hypertension, tinnitus, and refractory headaches, it is unclear what the prevalence is in the general population. This study evaluates the prevalence of venous sinus stenosis and hypoplasia in the general patient population.Materials and methods355 of 600 consecutive patients who underwent CT angiography of the head met the inclusion criteria. The diameters of the dural venous sinuses were recorded. Each study was evaluated by a neuroradiologist for the presence of stenoses. Univariate and multivariate statistical analyses were performed by a statistician.ResultsThe prevalence of unilateral transverse sinus stenosis or hypoplasia in a sample of patients representing the general population was 33%, the prevalence of bilateral transverse sinus stenosis was 5%, and the prevalence of unilateral stenosis with contralateral hypoplasia was 1%. A multivariate analysis identified arachnoid granulations as a predictor of stenosis (p<0.001). Gender trended toward significance (p=0.094). Race was not a significant predictor of stenosis (p=0.745).ConclusionsThe prevalence of bilateral transverse sinus stenosis in the general population is not trivial. These data may be used as a reference for understanding the mechanistic role of stenoses in idiopathic intracranial hypertension, tinnitus, and refractory headaches.

scholarly journals Findings of Brain Imaging among Tuberculous Meningitis Patients: A Study of 30 Cases in Bangladesh

2019 ◽  
Vol 6 (1) ◽  
pp. 8-11
Author(s):  
Abul Kalam Mohammed Shoab ◽  
Mostafa Hosen ◽  
Syed Abul Foez ◽  
Md Shaheen Wadud ◽  
Habibur Rahman ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Infectious Diseases ◽  
Brain Imaging ◽  
Tuberculous Meningitis ◽  
Health Hazard ◽  
Brain Lesions ◽  
College Hospital ◽  
Medical College ◽  
The Brain

Background: Tuberculous meningitis is a serious health hazard and difficult to diagnose. Objectives: The purpose of the present study was to observe the role of CT/MRI in TBM diagnosis. Methodology: This was a retrospective study done from January 2010 to December 2011 for a period of two (02) years. Patients of TBM were reviewed in a medical college hospital of Bangladesh. Results: A total number of reviewed 30 TBM patients; among them 11 cases were confirmed TBM patients and 19 were probable patients. Brain imaging (CT/MRI) was performed in 15 cases. The use of brain imaging allowed the Brain lesions in 93.3% patients. Conclusion: Brain imaging was done in 15 out of 30 TBM patients and most of them (14/15) had got various forms of radiological abnormalities that aid in diagnosis and monitor of disease progression in TBM. Bangladesh Journal of Infectious Diseases, June 2019; 6(1):8-11

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