SSPE (SUBACUTE SCLEROSING PANENCEPHALITIS) - THE GREAT MASQUERADER

2021 ◽  
pp. 70-71
Author(s):  
Akash Chheda ◽  
Mayur Thakkar ◽  
Shruti Agrawal ◽  
Dnyaneshwar v Jadhav ◽  
Saurabh Kamat ◽  
...  
Keyword(s):  
Cognitive Decline ◽  
Vision Loss ◽  
Subacute Sclerosing Panencephalitis ◽  
Single Episode ◽  
Behavioural Changes ◽  
Developmental Regression ◽  
Scholastic Backwardness ◽  
History Of ◽  
Children And Young Adults ◽  
High Degree

Background: SSPE is chronic progressive encephalitis affecting children and young adults which usually presents with cognitive decline and behavioural changes followed by periodic myoclonic jerks, seizures, vision loss and ataxia. High degree of suspicion is required as the presentation can be variable and can have many differentials. Aim: We aim to study various presentations of SSPE Methods and Material: Retrospective study was done to analyse various presentations in patients diagnosed with SSPE as per modied Dykens criteria from a tertairy care centre over a period of 2 years (1st January 2018-31st December 2020). Results: 6 cases of SSPE were identied. Case1 - 22 months old presented with subacute history of ataxia, multical myoclonus and developmental regression. Gradually myoclonus worsened to involve trunk and developed drop attacks. Case 2 - 17 years boy presented with single episode of seizure. Case 3- 25 years female with 5 months gestation presented with subacute vision loss followed by progressive cognitive decline, behavioural changes, Parkinsonism, Dystonia and stimulus sensitive myoclonus. Case4- 28 years female presented with rapidly progressive cognitive decline and behavioural changes. Case 5- 32 years male presented with history of myoclonic jerks and dropping of objects. Gradually developed progressive behavioural changes and cognitive decline and became vegetative. Case6 - 9 year old child presented with faciobrachial seizures (myoclonic jerks) and scholastic backwardness. Conclusions: SSPE can manifest with varied presenting complaints. Also, Results of EEG, MRI and CSF examination can change during the disease course. Therefore, high degree of suspicion is required for early diagnosis of this challenging entity.

THE R.J. CHAMBERS COLLECTION: AN “ARCHIVIST'S” REVELATIONS OF 20th CENTURY ACCOUNTING THOUGHT AND PRACTICE

2006 ◽  
Vol 33 (1) ◽  
pp. 145-166 ◽  
Author(s):  
Graeme W. Dean ◽  
Peter W. Wolnizer ◽  
Frank L. Clarke
Keyword(s):  
Prima Facie ◽  
Accounting Education ◽  
Hard Copy ◽  
Accounting History ◽  
Research Areas ◽  
Archival Source ◽  
Inflation Accounting ◽  
History Of ◽  
High Degree ◽  
Accounting Standard Setting

A major, unique accounting archival source, the R.J. Chambers Collection comprises both hard copy and, utilizing cutting-edge search technology, internet accessible materials. From his academic beginnings, Chambers was an orderly person, an archivist of the extensive and varied evidence that underpinned his proposals for accounting reform. Opening research areas for accounting biography, the development of accounting thought, the history of accounting institutions, prosopography, public sector accounting history, and comparative international accounting history are foremost amongst the myriad justifications for seeking to unravel the accounting history “lodes” in archives such as the Goldberg, Chambers, and Briloff Collections [Potter, 2003]. The archiving of the meticulously kept Chambers papers from 1947–1999 provides an opportunity for unfolding the background to events previously withheld from accounting history scholars. Professional episodes in relation to inflation accounting, standard setting, proposals to reform accounting education, and the like that appeared prima facie to be worth investigating are now open to scrutiny from a different angle, with a different type of evidence available in this Collection. This Collection provides a high degree of archival provenance. In particular, it represents an orderly retention of past documentation of what Chambers wrote, and perhaps uniquely for accounting historians, received; thus, providing an extensive window from which to examine the disorderly present environment of acounting.

scholarly journals Euglycemic Diabetic Ketoacidosis after a Single Dose of Empagliflozin in a Patient with Pancreatitis

2021 ◽  
Vol 11 (2) ◽  
pp. 216-218
Author(s):  
Marta Brandão Calçada ◽  
Luís Fernandes ◽  
Rita Soares Costa ◽  
Sara Montezinho ◽  
Filipa Martins Duarte ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Diabetic Ketoacidosis ◽  
Drug Class ◽  
Clinical Suspicion ◽  
Laboratory Findings ◽  
Sodium Glucose Cotransporter ◽  
History Of ◽  
High Degree ◽  
Euglycemic Diabetic Ketoacidosis

Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are the most recently approved drug class for the treatment of type 2 diabetes mellitus (T2D). Although they are largely well-tolerated, their intake has been associated with euglycemic diabetic ketoacidosis (DKA) in some rare cases. We report the case of a 70-year-old male with type 2 diabetes and no history of DKA, who started therapy with empagliflozin one day before presenting with acute pancreatitis and laboratory findings consistent with euglycemic DKA. SGLT2i can induce euglycemic DKA from the first dose. Given the atypical presentation, a high degree of clinical suspicion is required to recognize this complication.

929 Not Another Abscess - A Case of Streptococcal Myositis Misdiagnosed as a Right Axillary Abscess

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
O Oyende ◽  
J Jackman
Keyword(s):  
White Cell Count ◽  
General Surgeon ◽  
High Dose ◽  
General Anaesthetic ◽  
Microbiological Analysis ◽  
Reactive Protein ◽  
Affected Tissue ◽  
Life Threatening ◽  
History Of ◽  
High Degree

Abstract Introduction Streptococcal myositis is a rare form of infectious myositis caused by Lansfield A beta-haemolytic streptococci. It is characterised by rapidly spreading inflammation that can result in severe systemic toxicity and necrosis of the affected tissue if not diagnosed and aggressively treated. Presentation We report a case of a 42-year-old male who presented with a one-week history of worsening right axillary swelling that progressed to painful swelling of his arm. Inflammatory markers were significantly elevated with a white cell count of 17 ×109/L and C-reactive protein of 212 mg/L. On examination, a fluctuant axillary swelling was appreciated, and a decision was made for incision and drainage under general anaesthetic. Intraoperative aspiration of his arm revealed copious purulent fluid prompting intraoperative orthopaedic consult and exploration of the anterior compartment in which there was extensive involvement of the biceps muscle. The microbiological analysis revealed gram-positive cocci in chains, and microbiology advice sought for tailoring of antibiotic regimen. He has recovered well. Discussion Though uncommon, the emergency general surgeon should have a high degree of suspicion when evaluating soft tissue infections to avert potentially disastrous outcomes. Conclusion Early diagnosis, aggressive management with high-dose intravenous antibiotics, and surgical debridement are principles to treat this rare, life-threatening infection.

scholarly journals The Return of National Self-Sufficiency? Excavating Autarkic Thought in a De-Globalizing Era

2021 ◽  
Author(s):  
Eric Helleiner
Keyword(s):  
Intellectual History ◽  
International Political Economy ◽  
Economic Thought ◽  
John Maynard Keynes ◽  
New Politics ◽  
Self Sufficiency ◽  
National Economic ◽  
History Of ◽  
High Degree ◽  
Rich History

Abstract As the global crisis triggered by the COVID-19 virus unfolded, The Economist magazine published a cover in May 2020 titled “Goodbye globalization: the dangerous lure of self-sufficiency.” The title summed up well the new political interest in the ideology of national economic self-sufficiency in the pandemic context. Unfortunately, contemporary textbooks in the field of international political economy (IPE) say little about this kind of “autarkic” thought. No survey of the history of autarkic thought exists even within specialist IPE literature or in the fields of intellectual history and the history of economic thought. Filling this gap in existing scholarship, this article highlights a rich history of autarkic thought that includes the ideas of famous thinkers such as Jean-Jacques Rousseau, Johann Fichte, Mohandas Gandhi, and John Maynard Keynes. Three core rationales for a high degree of national self-sufficiency have been advanced in the past: (1) insulation from foreign economic influence, (2) insulation from foreign political and/or cultural influence, and (3) the promotion of international peace. At the same time, considerable disagreements have existed among autarkists about some of these rationales and their relative importance, as well as about the precise meaning of national self-sufficiency. These disagreements stemmed not just from differences in their specific goals but also from the different conditions across time and space in which autarkic thought was developed. In addition to improving understanding of the autarkic ideological tradition, this article contributes to emerging scholarship attempting to overcome Western-centrism in IPE scholarship as well as literature exploring the new politics of de-globalization in the current era.

scholarly journals Multi-Locus Selection and the Structure of Variation at the white Gene of Drosophila melanogaster

Genetics ◽  
1996 ◽  
Vol 144 (2) ◽  
pp. 635-645 ◽  
Author(s):  
David A Kirby ◽  
Wolfgang Stephan
Keyword(s):  
Drosophila Melanogaster ◽  
White Gene ◽  
Transcriptional Unit ◽  
North American Population ◽  
Evolutionary Mechanisms ◽  
Locus Selection ◽  
Neutral Equilibrium ◽  
History Of ◽  
High Degree ◽  
Very High

Abstract We surveyed sequence variation and divergence for the entire 5972-bp transcriptional unit of the white gene in 15 lines of Drosophila melanogaster and one line of D. simulans. We found a very high degree of haplotypic structuring for the polymorphisms in the 3′ half of the gene, as opposed to the polymorphisms in the 5′ half. To determine the evolutionary mechanisms responsible for this pattern, we sequenced a 1612-bp segment of the white gene from an additional 33 lines of D. melanogaster from a European and a North American population. This 1612-bp segment encompasses an 834bp region of the white gene in which the polymorphisms form high frequency haplotypes that cannot be explained by a neutral equilibrium model of molecular evolution. The small number of recombinants in the 834bp region suggests epistatic selection as the cause of the haplotypic structuring, while an investigation of nucleotide diversity supports a directional selection hypothesis. A multi-locus selection model that combines features from both-hypotheses and takes the recent history of D. melanogaster into account may be the best explanation for these data.

scholarly journals Tuberculosis presenting as dacryoadenitis in the USA

2019 ◽  
Vol 12 (11) ◽  
pp. e231694 ◽  
Author(s):  
Harry Ross Powers ◽  
Mark Anthony Diaz ◽  
Julio C Mendez
Keyword(s):  
Correct Diagnosis ◽  
Developed Countries ◽  
Histopathological Analysis ◽  
Orbital Mass ◽  
Antituberculosis Therapy ◽  
The Usa ◽  
History Of ◽  
Patient’S History ◽  
High Degree ◽  
Filipino Woman

A 25-year-old Filipino woman living in the USA was evaluated for a 5-month history of left eye pain and a subsequent orbital mass. Histopathological analysis of the lacrimal mass showed a mixed inflammatory process with necrotising granulomas and positive cultures for Mycobacterium tuberculosis. She was treated with antituberculosis therapy, with resolution of symptoms. Tuberculosis dacryoadenitis is extremely rare in the USA and other developed countries. It requires a high degree of clinical suspicion with special attention to the patient’s history to make the correct diagnosis. It can be treated successfully with antituberculosis therapy.

scholarly journals Modelling the COVID-19 pandemic in context: an international participatory approach

2020 ◽  
Vol 5 (12) ◽  
pp. e003126
Author(s):  
Ricardo Aguas ◽  
Lisa White ◽  
Nathaniel Hupert ◽  
Rima Shretta ◽  
Wirichada Pan-Ngum ◽  
...  
Keyword(s):  
Mathematical Models ◽  
Low Income ◽  
Scientific Evidence ◽  
Participatory Approach ◽  
Middle Income ◽  
Middle Income Countries ◽  
Containment Measures ◽  
History Of ◽  
High Degree ◽  
The Mathematical Model

The SARS-CoV-2 pandemic has had an unprecedented impact on multiple levels of society. Not only has the pandemic completely overwhelmed some health systems but it has also changed how scientific evidence is shared and increased the pace at which such evidence is published and consumed, by scientists, policymakers and the wider public. More significantly, the pandemic has created tremendous challenges for decision-makers, who have had to implement highly disruptive containment measures with very little empirical scientific evidence to support their decision-making process. Given this lack of data, predictive mathematical models have played an increasingly prominent role. In high-income countries, there is a long-standing history of established research groups advising policymakers, whereas a general lack of translational capacity has meant that mathematical models frequently remain inaccessible to policymakers in low-income and middle-income countries. Here, we describe a participatory approach to modelling that aims to circumvent this gap. Our approach involved the creation of an international group of infectious disease modellers and other public health experts, which culminated in the establishment of the COVID-19 Modelling (CoMo) Consortium. Here, we describe how the consortium was formed, the way it functions, the mathematical model used and, crucially, the high degree of engagement fostered between CoMo Consortium members and their respective local policymakers and ministries of health.

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.

scholarly journals Osteosarcoma: a review of current and future therapeutic approaches

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Xin Zhao ◽  
Qirui Wu ◽  
Xiuqing Gong ◽  
Jinfeng Liu ◽  
Yujie Ma
Keyword(s):  
Bimodal Distribution ◽  
Therapeutic Approaches ◽  
Rapid Disease Progression ◽  
New Ideas ◽  
Degree Of Malignancy ◽  
Primary Bone ◽  
Children And Young Adults ◽  
High Degree ◽  
Single Lesion ◽  
Tubular Bones

AbstractOsteosarcoma (OS) is the most common primary bone malignancy that affects children and young adults. OS is characterized by a high degree of malignancy, strong invasiveness, rapid disease progression, and extremely high mortality rate; it is considered as a serious threat to the human health globally. The incidence of OS is common in the metaphysis of long tubular bones, but rare in the spine, pelvis, and sacrum areas; moreover, majority of the OS patients present with only a single lesion. OS has a bimodal distribution pattern, that is, its incidence peaks in the second decade of life and in late adulthood. We examine historical and current literature to present a succinct review of OS. In this review, we have discussed the types, clinical diagnosis, and modern and future treatment methods of OS. The purpose of this article is to inspire new ideas to develop more effective therapeutic options.

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