Dystonia: A Leading Neurological Movement Disorder

Dystonia is the third leading movement disorder arising mainly from the damage of basal ganglia or other parts of the brain that control movements. The objective of this review is to represent the detailed profile of dystonia. A computerized literature review was conducted in authentic scientific databases including PubMed, Google Scholar, Scopus, Science Direct and National Institutes of Health (NIH) etc. Terms searched included dystonia, risk factors, etiologies, clinical features, classification, pathology, guidelines, treatment strategies, primary and secondary dystonia. Initially, 97 articles and 9 books were extracted but finally, 64 articles and 7 books were used. After analysis, we found that causes of dystonia could be acquired or inherited and dystonia can be classified based on age at onset, etiology, and distribution of the affected body parts. The risk factors of this heterogeneous disorder could be trauma, thyroid disorder, hypertension, life habits, occupation, use of drugs and genetics. A significant number of articles were found which signify the ability of brainstem and cerebellar pathology to trigger the symptoms of dystonia. Since antipsychotic drugs are the most commonly prescribed among the people with intellectual disability (ID), therefore they possess a greater risk to experience antipsychotic drugs-induced movement side effects including acute dystonia, parkinsonism, tardive dyskinesia, and akathisia. Depending on various manifestations and causes, there are several treatment options including oral medications, intramuscular injection of botulinum toxin, neurosurgical procedures and occupational therapy

Cellular and Cytokine Responses to Salmonella enterica Serotype Typhi Proteins in Patients with Typhoid Fever in Bangladesh

We assessed interferon-gamma (IFN-γ) responses via enzyme-linked immunosorbent spot (ELISPOT) to a number of S. Typhi antigens in samples from humans with S. Typhi bacteremia and typhoid fever in Bangladesh. Compared with responses in healthy endemic zone controls, there were significantly increased IFN-γ responses at the time of clinical presentation (acute phase) and at convalescence 14–28 days later. The majority (80–90%) of IFN-γ expressing T cells were CD4+. We observed a significant increase in interleukin-17 (IL-17) positive CD4 + T cells at convalescent versus acute stage of infection using an intracellular cytokine staining assay. We also found that stimulated peripheral blood mononuclear cells (PBMCs) produced significantly increased levels of a number of cytokines at the convalescent versus acute phase of infection, including IFN-γ, MIP-1β, sCD40L, TNF-β, IL-13, and IL-9. These results suggest that S. Typhi antigens induce a predominantly Th1 response, but that elevations in other cytokines may be modulatory

ANTIBIOTICS PRESCRIPTION PATTERN IN RURAL AREA OF BANGLADESH: A CROSS-SECTIONAL STUDY IN DEBIDWAR UPAZILA OF COMILLA DISTRICT

Objective: The study was aimed to evaluate the antibiotic prescription pattern by physicians in the area of study. Methods: This cross-sectional observational study was carried out with a self-designed standard questionnaire by manual data collection over a three months period at the Debidwar Upazila of Comilla District. The data were collected by directly interviewing the participants. Microsoft Excel 2010 was used for the analysis of the collected data. Results: Out of 242 patients, 60.74% of patients were male, 39.26% of patients were female. Majority of the patients (50%) belonged to age group 9 to 20 and in terms of profession, 53.30% were students. Among the previous disease history, hypertension (20.25%) was found at the dominant position. Common cold (28.95%) was the frequent reason for visiting doctor and ciprofloxacin was prescribed to 30.17% patients (Male: 21.90%, Female: 8.26%). Before prescribing anti-bacterial agents or any other agents, only 23.55% patients were recommended diagnostic tests and in 81.81% cases, physicians simply prescribed medicine by his/her own assumption and culture and sensitivity test was recommended and done for 18.18% patients. Conclusion: Prescription of broad-spectrum antibiotics for common cold and diarrhea, prescribing antibiotics or medicine based on presumption was the clear indications of irrational antibiotics use and inappropriate prescription pattern

Clinical characteristics of study participants.

a<p>Significantly different (p<0.05) when compared blood culture confirmed bacteremia.</p

TPTest results in different study groups.

*<p>>10 ELISA unit was considered a positive TPTest (see text).</p

Sensitivity, specificity (with 95% confidence intervals in parenthesis) of TPTest for diagnosing enteric fever.

a<p>Calculated using a two by two table.</p

Comparison of TPTest results using various techniques.

<p>(<b>A</b>) The TPTest was carried out using leukocytes recovered by various techniques: density gradient centrifugation, erythrocyte lysis buffer, and buffy coat separation. The Mann-Whitney U test was used to compare the responses of different blood cell separation methods. RBC, red blood cell. (<b>B</b>) Comparison of TPTest results using peripheral blood mononuclear cells incubated at 37°C in the presence or absence of supplemental CO₂. >10 ELISA units was considered a positive TPTest (see text).</p

Effect on TPTest results of different incubation periods of cells.

<p>The TPTest was done using lymphocyte supernatants after 24 and 48 hours incubation of peripheral blood mononuclear cells (PBMCs) at 37°C with supplemental CO₂. >10 ELISA units was considered a positive TPTest.</p