Exacerbation of Partial Seizures and Onset of Nonepileptic Myoclonus with Carbamazepine

A child had two to three generalized tonic-clonic (GTC) seizures per week unresponsive to phenobarbital (PB) and valproate (VPA). Interictal EEG demonstrated left occipital spikes. When carbamazepine (CBZ) therapy was started, he developed very frequent (4-6/day) complex partial seizures (CPS) characterized on ictal EEG by focal right temporal lobe discharges. The seizure exacerbation, which was associated with development of nonepileptic, multifocal myoclonus, resolved 24 h after CBZ was discontinued. The exacerbation occurred with therapeutic CBZ serum levels, but may have been related to the toxic levels of carbamazepine-10, 11-epoxide (CBZE).     

Pediatric intracranial aneurysms—clinical characteristics and outcome of surgical treatment

Object Intracranial aneurysms are rare in children and have different epidemiological, clinical, and morphological characteristics and outcome from those in adults. Materials and methods We analyzed demographic, clinical, radiologic features, treatment, and outcome in 55 patients <18 years of age, treated from Jan 1995 through December 2005. Results Intracranial aneurysms in children below 18 years constituted 4% of all intracranial aneurysms. Internal Carotid artery (ICA) bifurcation was the commonest location. About half of the aneurysms were complex. Three-fourth of the patients required surgical treatment. Two patients died, constituting 5% mortality. Two patients (5%) had poor outcome, whereas the majority (90%) had a favorable outcome. Conclusions Pediatric aneurysms have male predominance, higher incidence of clinical features of mass effect or seizures, high incidence of large, traumatic/mycotic aneurysms, associated illnesses and ICH/IVH and hydrocephalus, better Hunt and Hess grades at presentation, ICA bifurcation as the commonest site, and better outcome than their adult counterparts.     

Primary hydatid cyst of the breast: A case report

We describe herein the rare case of a hydatid cyst found in the breast of a 26-year-old woman. Clinically, the mass was at first suspected of being a fibroadenoma, but fine needle aspiration cytology (FNAC) yielded clear fluid only. Histopathologic examination of the resected speciman confirmed that it was a hydatid cyst.     

Parotid gland leiomyosarcoma in a child: an extremely unusual neoplasm.

We report the case of an 8-year-old boy with a parotid mass diagnosed to be a leiomyosarcoma. Considering the unresectable extent of the mass, the patient was subjected to radiotherapy. The patient developed distant metastasis following the course of radiotherapy and was put on chemotherapy. The child was lost to further follow up. To our knowledge, this is the first reported case in the English-language literature of such an entity in the pediatric age group.     

Psychiatric considerations in pulmonary disease.

Lung disease is a prominent cause of morbidity and mortality worldwide. When a patient has a common lung disease, such as asthma, or a less prevalent one, such as idiopathic pulmonary fibrosis, psychiatric issues should be considered as an integral part of the care plan for each patient. There have been many studies of psychologic factors and psychiatric syndromes in various lung diseases and their treatment. In this article, the authors focus on an evidence-based approach to reviewing this clinical literature.     

Association of HLA antigens with differential responsiveness toMycobacterium w vaccine in multibacillary leprosy patients

Leprosy patients undergoing phase II trials in two hospitals of New Delhi, India, were HLA typed to see the association of HLA with differential responsiveness toMycobacterium w vaccine. The vaccine comprises an atypical, nonpathogenic mycobacterium,Mycobacterium w, which has cross-reactive antigens withM. leprae. Multibacillary patients who are lepromin negative are vaccinated at an interval of 3 months. Considerable improvement is evident in the patients in terms of a decline in bacterial indices and histopathological and immunological upgrading. But all the patients do not respond to the vaccine in the same manner; some are slow responders, while others are good responders. HLA-A28 and DQw3 (DQw8+9) were found to be associated with slow responsiveness, while DQw1 and DQw7 were found to be associated with a more rapid responsiveness to theM. w vaccine. However, these associations were not significant afterP correction for the number of antigens tested for each locus except for HLA-DQw3 (DQw8 and DQw9) and DQw7. DQw7, a new defined split of HLA-DQw3, seems to be associated with the responsiveness toM. w vaccine.     

Termination of Pregnancy in Rodents by Oral Administration of Praneem,a Purified Neem Seed Extract

PROBLEM: Development of an orally administered abortifacient. METHODS: Subjects were female Wistar rats, weighting 150 to 200 g at the time of experiments. Praneem (a purified extract of neem Azadirachta indica) at a dose of 0.6 ml was given orally from day 8 to 10 after confirming presence and number of implants surgically on day 7 of pregnancy. The animals were examined again under anesthesia on day 15 of pregnancy to check the number of developing embryos. Controls received an equivalent regime of peanut oil. The number and size of implants were counted five days after treatment. RESULTS: Complete resorption of embryos was observed on day 15 of pregnancy in every animal treated with Praneem in contrast to normally developing embryos in rats given peanut oil. In repeat batch experiments, it was established that the effect of the treatment was reversible and animals regained fertility in cycles subsequent to treatment with Praneem. Cytokines of T_H1 type, i.e., gamma interferon and TNF, were raised on administration of Praneem, which may be the probable cause of pregnancy termination. CONCLUSIONS: Praneem on oral adminstration can cause termination of pregnancy in rodents, and the action is probably mediated by T_H1 cytokines.     

Electrical conductivity of kidney stones

Electret behaviour of surgically removed kidney stones through thermally stimulated polarization and thermally stimulated depolarization has already been reported by the authors. To develop an understanding of the conduction mechanism of such samples, d.c. conductivity was studied as a function of temperature and electric field. Temperatures from 308 to 448 K and fields from 0.5 X 10(6) to 2.5 X 10(6) V/m were used on the compressed powder pellet of a kidney stone. Conductivity was found to be 6 X 10(-11) s/m to 1.0 X 10(-11) s/m in the studied temperature range. Possibility of semiconduction is shown and it is suggested that kidney stone is a partially compensated semiconductor of n-type. The field independence of conductivity is observed at higher temperatures. The slopes of current density versus field curves suggest a warm electron effect.