Neuromelioidosis masquerading as acute demyelinating encephalomyelitis

Background

Neuromelioidosis is a rare conduction, which is difficult to diagnose and treat.

Case characteristics

Preadolescent girl presenting with prolonged fever, acute ascending paralysis and encephalopathy.

Outcome

Neuromelioidiosis was confirmed on brain biopsy culture. Patient improved with an intensive antibiotic regimen.

Message

Neuromelioidosis can mimic acute demyelinating encephalomyelitis clinically and radiologically.

     

Cow dung powder poisoning

Cow dung, which has germicidal property, was used in ancient days to clean living premises in South India. Nowadays, people are using commercially available synthetic cow dung powder. It is locally known as “saani powder” in Tamil Nadu. It is freely available in homes and is sometimes accidentally consumed by children. It is available in two colors - yellow and green. Cow dung powder poisoning is common in districts of Tamil Nadu such as Coimbatore, Tirupur, and Erode. We report two cases of yellow cow dung powder poisoning from our hospital.     

Open angle glaucoma in a case of Type IV Ehler Danlos syndrome: A rarely reported association

A 26-year-old male presented to us with defective vision in the left eye. He had best corrected visual acuity (BCVA) of hand movement (HM) in right eye and 6/9 in left eye. He had ptosis with ectropion in both eyes and relative afferent pupillary defect (RAPD) in right eye. Intraocular pressure (IOP) was 46 and 44 mmHg in right and left eye, respectively. Fundus showed glaucomatous optic atrophy (GOA) in right eye and cup disc ratio (CDR) of 0.75 with bipolar rim thinning in left eye. Systemic examination showed hyperextensible skin and joints, acrogeria, hypodontia, high arched palate, and varicose veins. He gave history of easy bruising and tendency to fall and history of intestinal rupture 5 years ago for which he had undergone surgery. He was diagnosed as a case of Type IV Ehler-Danlos syndrome (EDS) with open angle glaucoma. He underwent trabeculectomy in both eyes. This is a rare case that shows glaucoma in a patient of EDS Type IV. Very few such cases have been reported in literature.     

Diabetes treatment: A rapid review of the current and future scope of stem cell research

Diabetes mellitus is a major health concern of the developing and developed nations across the globe. This devastating disease accounts for the 5% deaths around the world annually. The current treatment methods do not address the underlying causes of the disease and have severe limitations. Stem cells are unique cells with the potential to differentiate into any type of specialized cells. This feature of both adult and embryonic stem cells was explored in great detail by the scientists around the world and are successful in producing insulin secreting cells. The different type of stem cells (induced pluripotent stem cells (iPSCs), embryonic stem cells (ESCs) and adult stem cells) proves to be potent in treating diabetes with certain limitations. This article precisely reviews the resources and progress made in the field of stem cell research for diabetic treatment.     

Proteomic identification of carbonylated proteins in F344 rat hippocampus after 1-bromopropane exposure

1-Bromopropane (1-BP) is neurotoxic in both experimental animals and humans. Previous proteomic analysis of rat hippocampus implicated alteration of protein expression in oxidative stress, suggesting that oxidative stress plays a role in 1-BP-induced neurotoxicity. To understand this role at the protein level, we exposed male F344 rats to 1-BP at 0, 400, or 1000 ppm for 8 h/day for 1 week or 4 weeks by inhalation and quantitated changes in hippocampal protein carbonyl using a protein carbonyl assay, two-dimensional gel electrophoresis (2-DE), immunoblotting, and matrix-assisted laser-desorption ionization time-of-flight mass spectrometry (MALDI-TOF-TOF/MS). Hippocampal reactive oxygen species and protein carbonyl were significantly increased, demonstrating 1-BP-associated induction of oxidative stress and protein damage. MALDI-TOF-TOF/MS identified 10 individual proteins with increased carbonyl modification (p < 0.05; fold-change ≥ 1.5). The identified proteins were involved in diverse biological processes including glycolysis, ATP production, tyrosine catabolism, GTP binding, guanine degradation, and neuronal metabolism of dopamine. Hippocampal triosephosphate isomerase (TPI) activity was significantly reduced and negatively correlated with TPI carbonylation (p < 0.001; r = 0.83). Advanced glycation end-product (AGE) levels were significantly elevated both in the hippocampus and plasma, and hippocampal AGEs correlated negatively with TPI activity (p < 0.001; r = 0.71). In conclusion, 1-BP-induced neurotoxicity in the rat hippocampus seems to involve oxidative damage of cellular proteins, decreased TPI activity, and elevated AGEs.     

Alcohol brief interventions for male remand prisoners: a mixed-methods feasibility and acceptability study

BackgroundThe global prison population exceeds 10 million. Drinking at levels that put a person at risk of health or social harms is a recognised public health concern in remand prisoners. We aimed to explore the feasibility and acceptability of an alcohol brief intervention for adult men on remand in prison and to develop an appropriate alcohol brief intervention and protocol for a multicentre pilot randomised controlled trial.MethodsWe used mixed-methods design in two prisons in the UK (one in Scotland and one in England). Individuals were given information leaflets before the study and consent was obtained from all participants. We used a survey that included questions relating to alcohol use (using the 10-item Alcohol Use Disorders Identification Test) and semi-structured interviews to explore feasibility, and acceptability of an intervention trial, to collect data between June 16, 2016, and Nov 25, 2016.Findings502 incarcerated males (237 [47%] sentenced; 265 [53%] remand) pariticpated in the survey (257 participants in Scotland, 245 particiapnts in England). Most participants were white British (480 men [96%]) and mean age was 33 years (SD 10). 402 (81%) of 496 men scored positive for an alcohol use disorder (188 [80%] of 235 sentenced men; 214 [82%] of 261 remand prisoners). 208 (42%) of 496 men scored as probably dependent on alcohol (81 [34%] of 235 sentenced men; 127 [49%] of 261 remand prisoners). 417 (92%) of 453 men reported that they would not feel coerced to take part in research. 166 (64%; 95% CI 57–69) of 261 men on remand and 113 (48%; 42–55) of 234 sentenced prisoners thought that an alcohol brief intervention of at least 20 min would be useful in the prison setting. We did semi-structured interviews with 24 participants (12 participants in Scotland, 12 participants in England; mean age 30·71 years, range 18–64) to ascertain views of participants. The results show that participants thought that prison is a feasibile and acceptable setting for an alcohol brief intervention; however, participants would like follow-up interventions after release and considered it important that the intervention was not delivered by prison staff.InterpretationThis study resulted in a successful bid to progress this work through a pilot randomised controlled trial.FundingMedical Research Council Public Health Intervention Development scheme (MRC-PHIND).