Heterogeneous distribution of factor V Leiden in patients from north India with venous thromboembolism.
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Factor V↗
Biomedical subjects
S Prabhakar
Publications and source records attributed to S Prabhakar.
Low prevalence of progressive multifocal leukoencephalopathy in India and Africa: is there a biological explanation?
Infection with human immunodeficiency virus (HIV) clade C virus is the most common form of HIV infection in the world. It largely infects populations in Africa and Asia and not much is known about the neurological complications associated with the virus. Cases of progressive multifocal leukoencephalopathy (PML) have been rarely reported in the literature in the acquired immunodeficiency syndrome (AIDS) or non-AIDS populations from these regions. In this article, the authors present three recently diagnosed patients with AIDS and PML from one neurological center in India, review the diagnostic challenges faced, and speculate on the possible biological reasons, including viral strain differences as well as HIV and JC virus interactions, that may account for the low incidence.
Acquired Immunodeficiency Syndrome↗
Planococcus antarcticus and Planococcus psychrophilus spp. nov. isolated from cyanobacterial mat samples collected from ponds in Antarctica.
Thirteen orange-pigmented bacteria associated with cyanobacterial mat samples collected from four different lakes in McMurdo, Antarctica, were isolated. Twelve of the isolates, which were coccoid in shape, were very similar and possessed all the characteristics of the genus Planococcus and represented a new species, which was assigned the name Planococcus antarcticus sp. nov. (CMS 26or(T)). Apart from the phenotypic differences, P. antarcticus differed from all reported species of Planococcus by more than 2.5% at the 16S rRNA gene sequence level. In addition, at the DNA-DNA hybridization level, it exhibited very little similarity either with P. mcmeekinii (30%-35%), P. okeanokoites (26%-29%), or CMS 53or(T) (15%-25%), the three species with which it is closely related at the rRNA gene sequence level (2.5%-2.9%). P. antarcticus also showed only 2.5% difference in its 16S rRNA gene sequence compared with the P. alkanoclasticus sequence. But it was distinctly different from P. alkanoclasticus, which exists only as rods, is mesophilic and phosphatase positive, can hydrolyze starch, cannot utilize succinate, glutamate, or glucose, and cannot acidify glucose. Most important, P. antarcticus and P. alkanoclasticus varied distinctly in their fatty acid composition in that C(15:0), C(15:1), C(16:0), iso-C(16:1), and C(17:0) were present only in P. antarcticus but absent in P. alkanoclasticus. CMS 53or(T), the thirteenth isolate, was also identified as a new species of Planococcus and was assigned the name Planococcus psychrophilus sp. nov. This species was distinctly different from all the reported species, including the new species P. antarcticus, with respect to a number of phenotypic characteristics. At the 16S rRNA gene sequence level, it was closely related to P. okeanokoites (98.1%) and P. mcmeekinii (98%), but with respect to the DNA-DNA hybridization, the similarity was only 35%-36%. The type strain of P. antarcticus is CMS 26or(T) (MTCC 3854; DSM 14505), and that of P. psychrophilus is CMS 530r(T) (MTCC 3812; DSM 14507).
Antarctic Regions↗
Pattern of use of complementary/alternative medicine (CAM) in epileptic patients in a tertiary care hospital in India.
PURPOSE: Many patients use complementary/alternative medicine (CAM) for their health problems especially where long-term treatment is required. Epilepsy is the most prevalent neurological disorder requiring long-term treatment and compliance. The purpose of the study was to establish the pattern of use of CAM in epileptic patients. METHODS: 1000 patients with seizure disorder visiting the Neurology outpatient department were interviewed regarding use of complementary/alternative medicine (CAM) in the past. The pattern of use, persons who recommended CAM and the reasons for trying these therapies and sequence of seeking them was noted in these patients. RESULTS: Overall 32% of patients had used CAM. Ayurvedic medicine was used most frequently, either alone (43%) or in combination (38%) with other CAM therapies followed by homeopathy (12.5%). Use of CAM was seen among all age groups and at all levels of education and was most frequent in the rural population (67%). Influence of family and friends (50%) was the most common reason for trying these therapies. Most patients (57%) sought CAM providers first before seeking the services of a medical doctor in our study. CONCLUSION: As more and more patients use CAM, physicians should ask their patients whether they use these therapies and should discuss these practices with their patients in order to safeguard their health.
Adolescent↗
Crack detection by measurement of mechanical impedance of a rotor-bearing system.
Measurements were done to determine the influence of a transverse crack on the mobility of a rotor-bearing system. The results show that the mobility changes substantially due to the presence of crack and follows definite trends with the crack depth and direction of force application. The significant changes in mobility were observed at the natural frequency and at the running frequency of the rotor system. Good agreement between the experimental results and numerical simulations has been observed. The measurement of mobility has been suggested for crack detection and condition monitoring of rotor-bearing systems.
Journal Article↗
Hypertrophic pachymeningitis: varied manifestations of a single disease entity.
Hypertrophic pachymeningitis is a unique clinical entity characterised by fibrosis and thickening of the duramater with resulting neurological dysfunction. Three cases of this entity are described. Presenting features were headaches and cranial neuropathies in two patients and predominantly cerebellar dysfunction in the third. One of the patients also had evidence of spinal involvement. Lower cranial nerves were chiefly involved in two patients whereas optic nerve was the predominantly affected nerve in one. Except for the presence of rheumatoid arthritis in one of the patients, we could not document clinical or biochemical evidence of any predisposing infective, inflammatory or infiltrative condition in the other two. All three patients had characteristic changes on imaging suggestive of thickened and enhancing duramater. Although variable steroid responsiveness was seen in all the three patients, tendency towards steroid dependence was evident. The clinical presentations, causes, radiological features, management options and differential diagnosis of this unique clinical syndrome have been discussed.
Central Nervous System Diseases↗
A case of emotional facial palsy with ipsilateral anterior inferior cerebellar artery territory infarction.
Emotional facial palsy (EFP) commonly results from anterolateral thalamic or striatocapsular infarcts. Its occurrence in brainstem lesions is uncommon, with previously reported cases being restricted to superior cerebellar artery infarction (3 cases). We report an unusual case of EFP ipsilateral to an anterior inferior cerebellar artery infarction, which opens new insights into the facial corticobulbar tract pathway.
Adult↗
Acyclovir induced extrapyramidal symptoms : letter to editor.
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Acyclovir↗
Acute symptomatic seizures due to single CT lesions: how long to treat with antiepileptic drugs?
The duration of anti epileptic drug therapy for single small enhancing CT lesions (SSECTL) presents a major dilemma. We studied the efficacy of short duration (6 months) antiepileptic drug therapy as compared to long duration (2 years) drug therapy. Seventy three patients presenting with seizures and showing SSECTL on cranial CT scans (plain and contrast) were randomized into group A (6 months therapy) and group B (2 years therapy). There were 47 patients in group A and 26 patients in group B. Patients were followed up for one year after withdrawal of anti epileptic drugs. CT Head (plain and contrast) was repeated after 3 months, or earlier in cases of recurrence to rule out reinfection. 53.2% in group A and 53.8% in group B showed complete resolution and were seizure free on one year follow up. Punctate residual calcification was seen in 46.8% in group A and 46.2% in group B. Eight patients (17%) in group A and three (11.5%) in group B had a recurrence. The difference in recurrence of seizure between the two groups was not statistically significant (p<0.77) in the calcified lesion subset. Since none of the patients in total resolution subset showed recurrence, the difference between calcified and total resolution subset was highly significant. The study shows that a short duration (6 months) AED therapy in patients with total resolution of lesion on follow up scan, may be adequate in comparison to those who have calcific speck as a residue. However, a longer duration of therapy in case of calcific group probably does not alter their chances of recurrence.
Acute Disease↗
Intensive respiratory care in patients with myasthenic crisis.
Six patients received mechanical ventilation for 8 episodes of myasthenic crisis in a two year period. Median duration of ventilation was 8 days. Only one patient required ventilation for more than three weeks and underwent tracheostomy. Atelectasis and pneumonia were the common ventilator associated complications observed, and these responded to therapy. Two patients underwent thymectomy after initial stabilization and while being ventilated. All patients recovered completely.
Adolescent↗
Targetting the tuberculoma.
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Adolescent↗
Anti-epileptic drugs.
As a sizeable population is affected by epilepsy, so its effective management is a matter of concern. Newer anti-epileptic drugs are now in use, aimed at controls of seizure with fewer side-effects over and above the conventional anti-epileptic drugs. The anti-epileptic drugs can be divided in two groups--conventional anti-epileptic drugs and newer anti-epileptic drugs. The drugs which fall in the first group are--phenytoin, phenobaibitone, valproic acid, carbamazepine, ethosuximide and clonazepam. The second group of drugs are--lamotrigine, clobazam, oxcarbazepine, topiramate and gabapentin. The pharmacology of the drugs are described in a nutshell in this article.
Anticonvulsants↗
Tetanus.
Tetanus is a potentially life threatening disease affecting nearly 50,000 to 1 million people world wide every year. Four major clinical forms of tetanus are described i.e. generalized, cephalic, localized and neonatal. Neonatal tetanus is particularly common in developing countries, due to unhygienic child birth practices, social taboos and improper immunization of pregnant mothers. Management of this disorder involves a team approach and aims at eradicating focus of infection, neutralizing the toxin, controlling spasms and dysautonomia and providing adequate ventilatory and supportive care. Metronidazole may be the preferred antibiotic although penicillin is still used frequently. Adequate wound debridement is necessary to prevent spore germination. Spasms are usually managed by sedatives like diazepam and neuromuscular blocking agents. Magnesium sulphate is an attractive substitute and may be tried if ventilatory facilities are unavailable. Use of baclofen is potentially advantageous but cannot be routinely prescribed. Dysautonomia is difficult to manage and requires therapy with benzodiazepines, morphine, magnesium sulphate, adrenergic blockers and recently tried baclofen therapy. Supportive care including ventilatory assistance are highly essential for successful outcome of the patients. It is imperative that complications are diagnosed early and managed appropriately. Immunization is extremely effective and is the key to prevention. Adequate steps and measures should be taken to increase awareness of this potentially preventable disease.
Diagnosis, Differential↗
Naegleria meningitis: a rare survival.
Acute amebic meningoencephalitis caused by free-living amebae naegleria fowleri is extremely rare and uniformly fatal with only seven survivals reported till date. An interesting case of naegleria meningitis diagnosed by wet mount cytology of cerebrospinal fluid (CSF) and treated with amphoterecin B, rifampicin and ornidazole with complete recovery is presented. In cases of suspected pyogenic meningitis, if CSF staining, antigen detection or culture is negative for bacteria, a wet mount cytology of CSF for naegleria is suggested. Early treatment with amphoterecin B and rifampicin may improve survival.
Adult↗
Scleroderma, stroke, optic neuropathy: a rare association.
A known case of scleroderma presented with right hemiparesis, focal seizures, optic atrophy and gangrene of digits. There was no evidence of peripheral nerve or muscle involvement. MRI showed multifocal infarcts in both cerebral hemispheres. MR angiography revealed poor flow in bilateral carotid arteries with collateralization from posterior circulation. She improved with phenytoin, nifedipine, antibiotics and immunosuppressants. The rarity of central nervous system affliction in scleroderma and large vessel vasculitis is discussed along with review of literature.
Adult↗
Visual loss with papilledema in Guillain-Barre syndrome.
Papilledema and raised intracranial pressure have been reported in association with Guillain-Barre syndrome. Papilledema is usually asympotomatic or associated with mild visual field defects, without any visual loss. The cerebrospinal fluid protein is usually reported to be high. A case of a 35 year old lady is reported, who presented with headache, diplopia and progressive visual loss in both eyes and limb weakness with hyporeflexia. Optic fundus examination showed bilateral papilledema. She had features of pseudotumor cerebri. Nerve conduction studies were suggestive of polyradiculopathy. The unusual things in this case, were the profound visual loss normal cerebrospinal fluid profiles and the presentation of papilledema before the limb weakness.
Adult↗
Detection of 1583 bp gene transcript in lymphocytes of muscular dystrophy patients.
DMD and BMD are X-lined recessive disorders. RAP-PCR was utilized to investigate differentially expressed gene transcripts in lymphocytes from DMD, BMD and normal individuals as possible diagnostic parameter. A 1583 bp transcript was found to be expressed in both DMD and BMD patients which was unrelated to the known dystrophin gene. This may prove helpful in determining the carrier status of DMD/BMD.
Base Sequence↗
Curing coupled-bunch instabilities with uneven fills.
A new, unified theoretical description of coupled-bunch instabilities in unevenly filled storage rings is presented. Uneven-fill longitudinal dynamics are explained in terms of two physical phenomena: fill-induced tune-spread damping and modulation coupling of strong even-fill eigenmodes. The latter is also present in the transverse plane. The analysis yields simple criteria for optimizing fill shapes to reduce the growth rates of the most unstable modes. Experimental results from the ALS and PEP-II are shown to be in good agreement with the theory.
Journal Article↗