scholarly journals Role of Voriconazole in the Management of Invasive Central Nervous System Aspergillosis: A Case Series from a Tertiary Care Centre in India

2020 ◽  
Vol 6 (3) ◽  
pp. 139 ◽  
Author(s):  
Nitin Gupta ◽  
Parul Kodan ◽  
Ankit Mittal ◽  
Gagandeep Singh ◽  
George Netto ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Median Duration ◽  
Tertiary Care ◽  
Case Series ◽  
North India ◽  
Cns Infection ◽  
Tertiary Care Centre ◽  
Diagnostic Modalities

Invasive central nervous system (CNS) aspergillosis is acquired by either hematogenous dissemination or direct spread from a sinus infection. We describe a series of nine patients with CNS aspergillosis from a tertiary care teaching institute in North India who were treated with voriconazole alone or in combination with surgery. All patients who had clinical and radiological features consistent with fungal CNS infection, showed the presence of septate hyphae on histopathology/microscopy and were either culture positive for Aspergillus spp. or had serum galactomannan positivity were diagnosed as CNS aspergillosis. Clinical features, risk factors, diagnostic modalities, treatment details and outcome at last follow-up were recorded for all patients diagnosed with CNS aspergillosis. A total of nine patients were diagnosed with CNS aspergillosis. The median duration of presentation at our hospital was six months (IQR-2-9 months). Six patients had concomitant sinus involvement, while two patients had skull-base involvement as well. All patients were treated with voriconazole therapy, and three of these patients underwent surgery. All but one patient survived at the last follow-up (median duration was 14 months (IQR- 8-21.5). Two patients had complete resolution, and voriconazole was stopped at the last follow-up, and the rest of the patients were continued on voriconazole. Of the six patients who were continued on voriconazole, all but one had more than 50% radiological resolution on follow-up imaging. Invasive CNS aspergillosis is an important cause of CNS fungal infection that is often diagnosed late and requires long-term voriconazole-based therapy.

scholarly journals PHARMACOINVASIVE VERSUS THROMBOLYSIS IN STEMI COHORT – OUTCOMES FROM A TERTIARY CARE CENTRE OF NORTH INDIA

2020 ◽  
pp. 1-3
Author(s):  
Richa Sharma ◽  
Ajeet Jain ◽  
Praveen Singh ◽  
Bhushan Shah
Keyword(s):  
Myocardial Ischemia ◽  
Tertiary Care ◽  
Myocardial Necrosis ◽  
North India ◽  
Registry Study ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Promising Strategy ◽  
Cardiology Department

STEMI is an event where transmural myocardial ischemia induces myocardial necrosis. PI strategy is a promising strategy in the management of STEMI. It is prospective registry study conducted in Cardiology Department, KGMU between January-June 2016 to know 30 day outcome of thrombolysis alone or thrombolysis followed by PCI in north India.At 30 day follow up, patients undergoing PI strategy,complained less of angina and dyspnea compared to thrombolysis arm.

Action observation therapy in pediatric patients with neuromotor deficits of the upper limbs secondary to central nervous system tumors

2019 ◽  
Vol 105 (6) ◽  
pp. NP75-NP78
Author(s):  
Marco Chisari ◽  
Raffaella Sensi ◽  
Carlo Alfredo Clerici ◽  
Fulvia Angela Gariboldi ◽  
Filippo Spreafico ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Mirror Neurons ◽  
Action Observation ◽  
Case Series ◽  
Central Nervous System Tumor ◽  
Assessment Tests ◽  
System Tumor ◽  
Positive Results

This study reports a case series of patients with upper limb neuromotor deficits following pediatric central nervous system tumor and treated with rehabilitative therapy according to action observation therapy (AOT). AOT is based on the “mirror neurons” system and had positive results in various non-oncologic neurologic pathologies. This study is the first experience in the oncology field, and included 6 patients, 4 of whom were fully evaluated at 6-month follow-up. In all patients, therapy showed improvement in all assessment tests. These promising results lead to further studies to confirm their effectiveness.

scholarly journals Acute disseminated encephalomyelitis followed by recurrent or monophasic optic neuritis in pediatric patients

2012 ◽  
Vol 19 (7) ◽  
pp. 941-946 ◽  
Author(s):  
Peter Huppke ◽  
Kevin Rostasy ◽  
Michael Karenfort ◽  
Brenda Huppke ◽  
Rainer Seidl ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Optic Neuritis ◽  
Pediatric Patients ◽  
Case Series ◽  
Acute Disseminated Encephalomyelitis ◽  
Oligoclonal Bands ◽  
Central Nervous System Disorders ◽  
Established Disease

Background: Some pediatric patients with inflammatory demyelinating central nervous system disorders cannot be classified under any of the established disease entities, making their treatment and prognosis difficult. Objective: The objective of this study is to characterize a subgroup of pediatric patients with recurrent demyelinating central nervous system disorders. Methods: This study includes a case series of pediatric patients with monophasic or recurrent acute disseminated encephalomyelitis (ADEM) who later presented with either monophasic or recurrent optic neuritis (ON). Results: We describe seven patients with a median follow-up of six years (five females, two males) who presented at a median age of 6 years (range 4–8 years) with monophasic ( n = 4) or recurrent ADEM (two to four attacks) followed by monophasic ( n = 3) or recurrent ON (two to nine attacks). Cranial magnetic resonance imaging (MRI) was typical for ADEM ( n = 6) with complete or almost complete resolution of lesions on follow-up. Cerebrospinal (CSF) studies at the time of ADEM showed a pleocytosis in six patients and were negative for oligoclonal bands (OCBs) in all. In all patients high titers for serum anti-MOG antibodies were detected. Conclusion: ADEM followed by ON is a rare but distinct clinical phenotype among pediatric patients. Further studies are needed to allow recommendations on treatment or prognosis.

scholarly journals Intraoperative Squash Smear in Central Nervous System Tumors and Its Correlation with Histopathology: 1 Year Study at a Tertiary Care Centre

2017 ◽  
Vol 08 (02) ◽  
pp. 221-224 ◽  
Author(s):  
Arpita Jindal ◽  
Himanshi Diwan ◽  
Kanwalpreet Kaur ◽  
V. D. Sinha
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Partial Correlation ◽  
Tertiary Care ◽  
Central Nervous System Tumors ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Reliable Technique ◽  
Hematoxylin And Eosin ◽  
Time Of Operation

ABSTRACT Background: Intraoperative squash smear cytology is a simple and reliable technique for rapid intraoperative diagnosis of neurosurgical specimens. The study was designed to assess the accuracy of intraoperative squash smear in the diagnosis of central nervous system (CNS) space-occupying lesions. Materials and Methods: One hundred and fifty cases of CNS space-occupying lesion were studied in a period of 15 months. Smears were prepared from the biopsy sample obtained at the time of operation and were stained with rapid hematoxylin and eosin method. Results: One hundred and forty-one cases showed complete correlation with histopathology, two cases showed partial correlation, and seven cases were discrepant. The overall diagnostic accuracy was found to be 94%. Conclusion: Intraoperative squash smear thus provides diagnosis with fair accuracy in brain tumors and is of great value in intraoperative consultation.

scholarly journals Functional results of AO 13C fractures managed with bicolumnar plating in a tertiary care centre of North India

2021 ◽  
Vol 9 (2) ◽  
pp. 413
Author(s):  
Gagandeep Singh Raina ◽  
Sanjeev Gupta ◽  
Neeraj Mahajan ◽  
Rahul Mahajan ◽  
Zubair A. Lone
Keyword(s):  
Tertiary Care ◽  
Functional Results ◽  
Distal Humerus ◽  
North India ◽  
Osteoporotic Bone ◽  
Tertiary Care Centre ◽  
Articular Fractures ◽  
Flexion Extension ◽  
Distal Humerus Fractures

Background: Distal humerus fractures are associated with many problems like fracture comminution and complex fracture anatomy. Achieving a good functional range of motion at the elbow with stability are the primary objectives in managing a comminuted distal humerus fracture.Methods: 25 consecutive patients were operated with bicolumnar plating for fracture distal humerus AO type 13C. The patients were kept in follow up for at least six months. Mayo elbow performance (MEP) score and flexion extension arc was calculated to study the outcome.Results: All patients achieved fracture union with mean MEP score of 73.2 and mean flexion extension arc of 93º. This was within the functional range of elbow. Stiffness was observed to be most common complication.Conclusions: Our study concluded that internal fixation with bicolumnar plating offers good functional results in comminuted intra-articular fractures even in osteoporotic bone with negligible complications.

scholarly journals Clinico-radiological profile and outcome of dengue patients with central nervous system manifestations: A case series in an Eastern India tertiary care hospital

2016 ◽  
Vol 7 (01) ◽  
pp. 114-124 ◽  
Author(s):  
Souren Pal ◽  
Kaushik Sen ◽  
Nirendra Mohan Biswas ◽  
Anirban Ghosal ◽  
S. K. Rousan Jaman ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Tertiary Care Hospital ◽  
Dengue Infection ◽  
Tertiary Care ◽  
Case Series ◽  
Neurological Complications ◽  
Care Hospital ◽  
Eastern India ◽  
Cns Involvement

ABSTRACT Background and Objective: Dengue, an acute viral disease, transmitted by Aedes mosquitoes, has a variable clinical spectrum ranging from asymptomatic infection to life-threatening dengue hemorrhagic fever and dengue shock syndrome. However, neurological complications, in general, are unusual but have been observed more frequently in the recent past, and some studies highlighted varied neurological complications during the course of illness. Although dengue is classically considered a nonneurotropic virus, there is increasing evidence for dengue viral neurotropism. In this study, we have evaluated clinico-radiological profile and outcome of nine serologically confirmed dengue patients having varied manifestations of central nervous system (CNS) involvement. Materials and Methods: All the consecutive patients presented with neurological complications with positive serology for dengue infection (IgM positivity) in Department of Medicine, in a tertiary care hospital in Eastern India from August 2013 to October 2014 were included in the study. These patients were subjected to a detailed clinical evaluation, laboratory assessment including complete hemogram, coagulation profile, liver function test, serum electrolytes, and routine CSF (Cerebrospinal Fluid) study with the exclusion of other common neuroinvasive pathogens. Results: Out of 9 patients with neurological complications associated with confirmed dengue infection, 2 (22%) patients had dengue encephalopathy, 5 (56%) patients have dengue encephalitis, 1 (11%) patient had dengue meningitis, and 1 (11%) patient had postdengue immune-mediated CNS involvement. Conclusion: This case series reaffirms the occurrence of varied CNS manifestations in dengue virus infection and underlines the importance of inclusion of dengue in the differential diagnosis of acute encephalitis syndrome.

scholarly journals Clinical Course, Imaging Characteristics, and Therapeutic Response in Myelin Oligodendrocyte Glycoprotein Antibody Disease: A Case Series

2020 ◽  
Vol 11 (01) ◽  
pp. 205-210
Author(s):  
Joe James ◽  
James Jose ◽  
V. Abdul Gafoor ◽  
B. Smita ◽  
Neetha Balaram ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Central Nervous System ◽  
Nervous System ◽  
Therapeutic Response ◽  
Clinical Course ◽  
Case Series ◽  
Autoimmune Disorder ◽  
Myelin Oligodendrocyte Glycoprotein ◽  
Imaging Characteristics

Abstract Myelin oligodendrocyte glycoprotein (MOG) antibody disease is a novel central nervous system autoimmune disorder which forms part of aquaporin 4 (AQP-4) negative, neuromyelitis optica (NMO) spectrum disorder. It has a distinct clinical profile, neuroimaging features and courses from AQP-4 positive NMO and multiple sclerosis. This article is a case series of six patients with MOG antibody disease with longitudinal follow-up for up to 8 months.

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