scholarly journals Cluster of Angiostrongyliasis Cases Following Consumption of Raw Monitor Lizard in the Lao People’s Democratic Republic and Review of the Literature

2021 ◽  
Vol 6 (3) ◽  
pp. 107
Author(s):  
Leeyounjera Yang ◽  
Chirapha Darasavath ◽  
Ko Chang ◽  
Vilayvanh Vilay ◽  
Amphonesavanh Sengduangphachanh ◽  
...  
Keyword(s):  
Lao Pdr ◽  
Clinical History ◽  
Final Diagnosis ◽  
Neurological Complications ◽  
Monitor Lizard ◽  
Single Meal ◽  
Neurological Effects ◽  
Paratenic Hosts ◽  
Loss Of Appetite ◽  
Potential Public Health

Angiostrongyliasis in humans causes a range of symptoms from mild headache and myalgia to neurological complications, coma and death. Infection is caused by the consumption of raw or undercooked intermediate or paratenic hosts infected with Angiostrongylus cantonensis or via contaminated vegetables or water. We describe a cluster of cases involved in the shared meal of wild raw monitor lizard in the Lao PDR. Seven males, aged 22–36 years, reported headaches, abdominal pain, arthralgia, myalgia, nausea/vomiting, diarrhea, neurological effects and loss of appetite. Five were admitted to hospital. The final diagnosis was made by clinical presentation and case history, and positive A. cantonensis PCR for two cases. All hospitalized patients recovered fully following supportive treatment. The remaining two individuals sought local home remedies and made full recovery. Whilst most published reports concern infections via consumption of molluscs, few detailed reports exist on infections that result from the consumption of reptiles and there exists little awareness in Lao PDR. This case cluster, which originates from a single meal, highlights the potential public health risk of the consumption of raw and wild-caught meat in Lao PDR and the Southeast Asia region. Without specific diagnostics, clinical history and the consideration of recent food consumption are important when evaluating patients.

scholarly journals Subacute Sclerosing Panencephalitis manifesting as Bell’s palsy and bilateral macular necrotizing retinitis: an atypical presenting feature

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Lagan Paul ◽  
Tanya Jain ◽  
Manisha Agarwal ◽  
Shalini Singh
Keyword(s):  
Subacute Sclerosing Panencephalitis ◽  
Clinical History ◽  
Neurological Complications ◽  
Bell’S Palsy ◽  
Ocular Involvement ◽  
Bell's Palsy ◽  
Diagnostic Challenge ◽  
Bladder Control ◽  
Mri Brain ◽  
History Of

Abstract Background Subacute sclerosing panencephalitis (SSPE) is a potentially lethal complication of measles infection. Neurological complications take years to manifest after primary viral infection of brain and can lead to blindness in some individuals. Findings A 13-year-old female patient with history of Bell’s palsy 2 months prior, presented with rapidly progressing necrotizing retinitis in both eyes. Soon after, she was unable to walk, developed myoclonic jerks, altered sensorium and loss of bowel and bladder control. Her clinical history, CSF IgG measles antibody analysis, MRI brain and EEG findings confirmed the diagnosis of SSPE. Conclusion SSPE in our case presented as Bell’s palsy and sudden painless diminution of vision due to ocular involvement, and developed full blown disease within 2 months. SSPE can present as a diagnostic challenge and warrants early identification and referral for timely diagnosis and management.

Gamma Knife surgery for glossopharyngeal neuralgia

2009 ◽  
Vol 110 (3) ◽  
pp. 559-563 ◽  
Author(s):  
Shoji Yomo ◽  
Yasser Arkha ◽  
Anne Donnet ◽  
Jean Régis
Keyword(s):  
Pain Relief ◽  
Gamma Knife ◽  
Cranial Nerves ◽  
Initial Response ◽  
Neurological Complications ◽  
Gamma Knife Surgery ◽  
Glossopharyngeal Neuralgia ◽  
Invasive Treatment ◽  
Neurological Effects ◽  
Lower Cranial Nerves

Gamma Knife surgery (GKS) is widely recognized as an effective, minimally invasive treatment for intractable trigeminal neuralgia, but the role of GKS in glossopharyngeal neuralgia (GPN) remains unclear. This study involved 2 patients with medically intractable GPN who were treated using GKS. One patient required 2 treatments because of a recurrence of symptoms (at maximum doses of 60 and 70 Gy), and the other patient had a single intervention (at a maximum dose of 75 Gy). The GKS target was the distal part of the glossopharyngeal nerve. Patients were investigated prospectively, treated, and then assessed periodically with respect to pain relief and neurological function. Complete pain relief was achieved initially after all 3 interventions. The first patient was pain free without medication for 2 months after the first treatment (60 Gy) and for 4 months after the second treatment (70 Gy). The second patient (treated with 75 Gy) was still pain free without medication at the last follow-up (12 months). Neither patient had any neurological complications. The initial response of GPN to low-dose GKS was favorable, but symptoms may recur. No adverse neurological effects were observed in any of the lower cranial nerves. It will be necessary to investigate the optimal radiation dose and target of GKS for achieving long-term pain relief in GPN.

Is there a rendezvous for SARS-CoV-2 and Agmatine?

Coronaviruses ◽  
2022 ◽  
Vol 03 ◽  
Author(s):  
Nandkishor Kotagale ◽  
Brijesh Taksande ◽  
Nazma Inamdar
Keyword(s):  
Neuromuscular Diseases ◽  
Neurological Complications ◽  
Nervous System Diseases ◽  
Review Of The Literature ◽  
Long Term Effects ◽  
Peripheral Nervous System Diseases ◽  
Neurological Effects ◽  
Specific Symptoms

Abstract: The catastrophe of the ongoing COVID-19 pandemic is caused by Severe Acute Respiratory Syndrome Corona Virus-2 (SARS-CoV-2). The respiratory system appears to be ground zero in the majority of the patients. However, many other organs can get infected by cytokines, chemokines and other mediators released in response to the presence of the virus. The neurotropism by the SARS-CoV-2 is established beyond doubt. In addition to non-specific symptoms, the symptoms specific to central and/or peripheral nervous system diseases as well as neuromuscular diseases have been observed in numerous clinical cases. These observations and the experiences with other coronavirus infections earlier and flu pandemics raise concerns not only about the neurological effects in active disease but also about the long-term effects generated by the infection, immune and inflammatory functions. The knowledge of biological actions of agmatine in the backdrop of physiological events instigated by invading SARS-CoV-2 and host’s response, especially in neural events, focuses on the possible overlaps of biomolecular pathways at a number of instances. This is not surprising since the factors stimulated during SARS-CoV-2 infection are the disease-generating neuroinflammatory components altered by agmatine. Hence, we hypothesize the possible beneficial role of agmatine in SARS-CoV-2 infection. Based on a narrative review of the literature, agmatine can be proposed as a plausible beneficial candidate for supporting treatment of SARS-CoV-2 infection and for addressing post-infection neurological complications.

Role of Flow Cytometry in the Diagnosis of Inborn Errors of Immunity

2022 ◽  
Author(s):  
Thulasi Raman Ramalingam
Keyword(s):  
Flow Cytometry ◽  
Immune System ◽  
B Lymphocyte ◽  
Molecular Genetic ◽  
Clinical History ◽  
Final Diagnosis ◽  
Inborn Errors ◽  
Reliable Technique ◽  
Humoral Immunodeficiency ◽  
Inborn Errors Of Immunity

AbstractInborn errors of immunity (IEI) are a group of inherited heterogeneous disorders affecting the immune system characterized by increased susceptibility to infections, immune dysregulation, and lymphoproliferation. Flow cytometry (FCM) is a rapid and reliable technique for evaluation and enumeration of immune cells. It also helps in understanding the functional and signaling pathways of the immune system. Lymphocyte subset analysis is a simple and effective screening tool in suspected combined and humoral immunodeficiency patients. Qualitative phagocytic defects such as chronic granulomatous disease and leucocyte adhesion defect are easily diagnosed by FCM. Study of intracellular proteins (e.g., BTK, WASP, DOCK8), cytokine production, and signaling molecules (e.g., STAT3) by FCM is very useful but also quite challenging to establish. T and B lymphocyte interaction for normal class switching of B cells can be assessed and can help in diagnosis of combined variable immunodeficiency and hyperimmunoglobulin M syndrome. FCM is also used in posttransplant monitoring of IEI patients and also in prenatal diagnosis in suspected cases. It is also useful in validation of variants of uncertain significance obtained in exome sequencing. FCM results should always be interpreted with clinical history and, if needed, should be confirmed with molecular genetic studies before establishing the final diagnosis. Ensuring good sample quality and running parallel controls with patient samples will avoid the preanalytical and analytical errors. This review describes the applications of FCM in the diagnosis of various IEI.

REM sleep behavior disorder

2017 ◽  
Author(s):  
Ronald B. Postuma
Keyword(s):  
Rem Sleep ◽  
Lewy Bodies ◽  
Rem Sleep Behavior Disorder ◽  
Behavior Disorder ◽  
Clinical History ◽  
Final Diagnosis ◽  
Acting Out ◽  
Sleep Behavior ◽  
Rem Atonia

A diagnosis of REM sleep behavior disorder (RBD), a disorder characterized by “acting out” of dreams during REM sleep, has critical implications for a patient’s future. Aside from being a treatable parasomnia, usually managed with melatonin or clonazepam, RBD is the most powerful risk factor for Parkinson disease and dementia with Lewy bodies yet discovered. Over 70% of patients with idiopathic RBD will develop a neurodegenerative synucleinopathy. Moreover, the disease course is more severe in patients with RBD than those without. Numerous screens have been developed to aid detection, and clinical history can help distinguish RBD from NREM parasomnia. However, final diagnosis relies on polysomnographic documentation of REM atonia loss. Given the profound implications of idiopathic RBD, patients need careful counseling and the offer of neurological follow-up to detect and treat prodromal disease symptoms. Recognition of RBD is also a means to discover and test protective therapies against neurodegenerative disease.

Gallstone formation due to rapid weight loss through hyperthyroidism

2019 ◽  
Vol 32 (12) ◽  
pp. 1395-1398
Author(s):  
Satoshi Nakano ◽  
Mitsuyoshi Suzuki ◽  
Hidenori Haruna ◽  
Atsuyuki Yamataka ◽  
Toshiaki Shimizu
Keyword(s):  
Weight Loss ◽  
Cholesterol Metabolism ◽  
Gallstone Formation ◽  
Final Diagnosis ◽  
Thyroid Stimulating Hormone ◽  
Thyroid Function Tests ◽  
Rapid Weight Loss ◽  
Free Triiodothyronine ◽  
Thyrotropin Receptor Antibody ◽  
Loss Of Appetite

Abstract Background Cholesterol metabolism has dramatically changed under hyperthyroid status. However, a combination of hyperthyroidism and cholecystolithiasis is very rare. Case presentation We report a case of cholelithiasis accompanied by hyperthyroidism in a 13-year-old girl who had recently lost 13 kg of weight (from 53 to 40 kg) in 1 month without loss of appetite. Ultrasonography showed multiple hyperechoic areas with acoustic shadowing in the gallbladder. Thyroid function tests showed that her serum free triiodothyronine (T3) and thyroxine (T4) levels were elevated and the thyroid-stimulating hormone level was decreased. In addition, serum thyrotropin receptor antibody and thyroid-stimulating antibody were detected. The final diagnosis was cholelithiasis with Graves’ disease. Thiamazole ingestion was started immediately after the diagnosis, and laparoscopic cholecystectomy was performed 33 days after hospitalization. Conclusions Massive and sudden weight loss could be a risk factor for gallstone formation in children. In addition, hyperthyroidism has the potential to promote cholelithiasis via cholesterol metabolism.

scholarly journals Hypoglycemic Syndrome in a Patient with Proinsulin-Only Secreting Pancreatic Adenoma (Proinsulinoma)

2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Gian Paolo Fadini ◽  
Alberto Maran ◽  
Anna Valerio ◽  
Francesco Meduri ◽  
Mariarosa Pelizzo ◽  
...  
Keyword(s):  
Unusual Case ◽  
Clinical History ◽  
Final Diagnosis ◽  
Immunoreactive Insulin ◽  
Surgical Specimen ◽  
Extensive Evaluation ◽  
Calcium Stimulation ◽  
Adenomatous Tissue ◽  
Pancreatic Adenoma ◽  
Accessory Spleens

We describe an unusual case of hypoglycemic syndrome in a 69-year old woman with a proinsulin-only secreting pancreatic endocrine adenoma. The clinical history was highly suggestive of an organic hypoglycemia, with normal or relatively low insulin concentrations and elevated proinsulin levels. Magnetic resonance and computed tomography of the abdomen showed a 1 cm pancreatic nodule and multiple accessory spleens. The diagnosis was confirmed by selective angiography, showing location and vascularization of the nodule, despite no response to intra-arterial calcium. After resection, the hypoglycemic syndrome resolved. The surgical specimen was comprised of a neuroendocrine adenomatous tissue with high proinsulin immunoreactivity. Study of this unusual case of proinsulinoma underlines (i) the need to assay proinsulin in patients with hypoglycemia and normal immunoreactive insulin, (ii) the differential diagnosis in the presence of accessory spleens, (iii) the unresponsiveness to intra-arterial calcium stimulation, and (iv) the extensive evaluation needed to reach a final diagnosis.

scholarly journals Spectrum of Magnetic Resonance Imaging Findings in Sturge Weber Syndrome: A Rare Neurocutaneous Syndrome

2021 ◽  
pp. 20-26
Author(s):  
Varun Singh ◽  
Bhushita Lakhkar ◽  
Rajasbala P. Dhande ◽  
Shreya Tapadia ◽  
Bhavik Unadkat
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Clinical History ◽  
Final Diagnosis ◽  
Neurological Deficits ◽  
Resonance Imaging ◽  
Mri Findings ◽  
Weber Syndrome ◽  
Sturge Weber Syndrome ◽  
Neurocutaneous Syndrome

Sturge Weber syndrome is a type of neurocutaneous disorder also known as meningofacial angiomatosis. It is generally seen in paediatric age group and more  commonly effects the  males which present with delayed milestones, seizure disorder, loss of vision and other neurological deficits. Clinical suspicion of Sturge weber syndrome should be made on the  presence of port wine stain(facial nevus) in a young children. MRI (magnetic resonance imaging) plays a key role in detecting the various spectrum of cortical and vascular defects associated with the syndrome. Clinicians can come to a final diagnosis of Sturge weber syndrome, when the clinical history is supplemented with MRI findings. We in our case report will be discussing the various spectrum of MR findings in this rare neurocutaneous syndrome.

scholarly journals A Case of Mucinous Cystadenoma Carcinoma

2021 ◽  
pp. 148-152
Author(s):  
Vaibhav G. Hatwar ◽  
Ranjana Sharma ◽  
Mayur Wanjari ◽  
Pratibha Wankhede ◽  
Sagar Alwadkar ◽  
...  
Keyword(s):  
Team Member ◽  
Mucinous Cystadenoma ◽  
Bed Rest ◽  
Final Diagnosis ◽  
Chief Complaint ◽  
Nursing Management ◽  
Patient History ◽  
Random Blood Sugar ◽  
Cellular Debris ◽  
Loss Of Appetite

Introduction: Mucinous Cystadenoma carcinoma is a type of tumor in the cyst adenocarcinoma grouping it can occur in the breast as well as the ovary. Tumors are normally multiocular with various smooth thin-walled cysts. Within the cyst is found an emergence or cellular debris. Patient History: The female patient 63-year-old who was admitted to AVBRH on the date 21/05/2021 in the obstetric and gynae ward with a chief complaint of generalized weakness, loss of appetite, fever for 2 days 7 days ago, 2-3 fever spikes and burning micturition. All over investigation observed like blood and urine investigation, CT scan of the abdomen, histopathology then the final diagnosis is confirmed as mucinous Cystadenoma carcinoma. Pharmacology: The patient was treated with antibacterial medicine, antibiotics, and diabetics, thyroxin stimulating drugs, etc. Management: Inj. Ceftriaxone 1gm 12 hourly, Inj.-piptaz 4.45 gm, 8 hourly, tab. Gimipride 0.5 mg with tab. Metformin 500 mg 12 hourly, tab. Thyrox 62.5 mcg, tab telmisartan 40 mg with tab. Chlorthalidone 12.512.5 mg 12 hourly, Inj.-pan 40 mg, 12 hourly, Inj.- Neomol 100 ml, and Tablet- nitrofurantoin 6 hourly. Nursing Management: Monitor the vital sign, monitor nutritional status and monitor random blood sugar. Maintained bed rest of patient, managed the pain level of the patient. The patient was assessed for risk of bleeding. Conclusion: The patient was admitted to the hospital with the chief complaint of generalized weakness, loss of appetite, fever for 2 days 7 days ago, 2-3 fever spikes and burning micturition.  and the patient was admitted to AVBR Hospital in the obstetric and gynae ward, immediate treatment was started by a health team member and all possible treatments were given and now the patient's condition is satisfactory.

scholarly journals Atypical presentation of progressive young onset dementia

2018 ◽  
Vol 11 (1) ◽  
pp. bcr-2018-225754 ◽  
Author(s):  
Bushra Elhusein ◽  
Ahmed Radwan ◽  
Abdalla Khairi ◽  
Mohamed Ahmed
Keyword(s):  
Brain Mri ◽  
Poor Response ◽  
Final Diagnosis ◽  
Subcortical White Matter ◽  
Alzheimer’S Dementia ◽  
Alzheimer's Dementia ◽  
Young Onset ◽  
Early Onset Dementia ◽  
Young Onset Dementia ◽  
Loss Of Appetite

We present the case of a 34-year-old Jordanian woman who was referred to mainstream mental health services because of irritability, agitation, loss of appetite, withdrawal from family activities and sleeping difficulties. She was initially diagnosed with major depressive disorder but subsequently showed very poor response to antidepressant therapy. Her presentation gradually and dramatically progressed into full blown dementia within couple of years. Brain MRI showed atrophic cortical changes and subcortical white matter alterations consistent with Alzheimer’s dementia. Brain PET scan revealed reduction in cerebral glucose metabolism in temporoparietal areas bilaterally most consistent with Alzheimer’s dementia. There was a strong family history of early-onset dementia. A final diagnosis of young onset dementia was made, and unfortunately, she passed away at the age of 44 years.

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