Salmonella enteritidis from a case of fever with thrombocytopenia

Non typhoidal Salmonella species are thought to be potentially infectious to humans. We isolated Salmonella enteritidis from a 10-year-old boy with fever and thrombocytopenia. We reviewed the literature concerning infections caused by Salmonella but we could not find any such case report from India.     

Quantitative MRI reveals the elderly ischemic brain is susceptible to increased early blood�Cbrain barrier permeability following tissue plasminogen activator related to claudin 5 and occludin disassembly

Great uncertainty exists as to whether aging enhances the detrimental effects of tissue plasminogen activator (tPA) on vascular integrity of the ischemic brain. We hypothesized that tPA treatment would augment ischemic injury by causing increased blood–brain barrier (BBB) breakdown as determined by quantitative serial T₁ and T₂ magnetic resonance imaging (MRI), and the transfer constant for gadolinium-diethylenetriamine penta-acetic acid (Gd-DTPA) from blood to brain in aged (18 to 20 months) compared with young (3 to 4 months) Wistar rats after middle cerebral artery occlusion, mediated through the acute disassembly of claudin 5 and occludin. Increased T₂ values over the first hour of postreperfusion were independently augmented following treatment with tPA (P<0.001) and aging (P<0.01), supporting a synergistic effect of tPA on the aged ischemic brain. Blood–brain barrier permeability for Gd-DTPA (K_Gd) was substantial following reperfusion in all animal groups and was exacerbated by tPA treatment in the elderly rat (P<0.001). The frequency of hematoma formation was proportionately increased in the elderly ischemic brain (P<0.05). Both tPA and age independently increased claudin 5 and occludin phosphorylation during ischemia. Early BBB permeability detected by quantitative MRI following ischemic stroke is enhanced by increased age and tPA and is related to claudin 5 and occludin phosphorylation.     

Alcohol use and mismatch negativity in young patients with psychotic disorder

Mismatch negativity (MMN) is a neurophysiological indicator of the brain's ability to extract relevant information from an irrelevant background. MMN has been described as a reliable biomarker of schizophrenia and more recently it has found to be impaired in the early stages of psychosis. In addition, drugs (including alcohol) that block glutamate's N-methyl-D-aspartate receptor have been shown to reduce MMN. This study aims to determine whether risky alcohol consumption in young patients with psychotic disorder further impacts or changes their MMN response. Patients with high-alcohol use were found to show reduced temporal MMN amplitudes compared with patients with low-alcohol use and controls. In contrast, early psychosis patients with low-alcohol use showed reduced fronto-central MMN amplitudes compared with controls; whereas patients with high-alcohol use showed an intermediate response at these sites. Correlational analysis revealed distinct patterns of association between MMN and alcohol use in patients with early psychosis compared with controls. This study shows that early psychosis outpatients who engaged in risky drinking have decreased temporal MMN amplitudes, compared with their peers. This may reflect an additive effect of N-methyl-D-aspartate receptor hypofunction and high-alcohol consumption.     

Role of caudal epidural steroid injections in lumbar disc prolapse

Lumbar disc prolapse as a cause of back and leg pain is quite common and results in significant disability. This is a prospective uncontrolled study done on 40 patients with signs and symptoms of lumbar disc prolapse, in whom conservative treatment of at least 6 weeks had failed. The aim of the present study was to study the effect of caudally administered epidural steroids in the treatment of such patients. Back pain and leg pain was quantitatively assessed separately using the visual analogue scale and the functional disability was measured using Oswestry disability index (ODI) version 2.0, before the procedure and at regular intervals after the procedure for a period of 6 months. All the patients had an ODI more than 40% before the procedure. Through the sacral hiatus, methylprednisolone, lignocaine 2% and normal saline were injected into the epidural space. After 24 hours, pain relief was seen in all the patients except one. After 3 weeks, symptomatic improvement was seen in 97.5% of the cases, with good results in 65% and fair results in 32.5%. After 6 months, symptomatic improvement was seen in 67.5% of the cases with good results in 47.5% and fair results in 20% of the patients. No major complications were observed. It is concluded that caudally administered epidural steroid injections are a safe and effective modality of treatment in lumbar disc prolapse with good results in short term and possibly long term in some patients.