Spontaneous Spinal Epidural Hematoma: A Concise Review

Spontaneous spinal epidural hematoma (SSEH) is an entity of rarity. It usually has an acute onset presenting to the emergency department with profound neurological deficits.From the term we infer that the blood accumulating in the spinal column is not due to any traumatic cause.During the episode of spontaneous bleeding, there is a positive correlation with increase in the pressures of the epidural space. Replacing myelography and CT scan, MRI has earned the name for being the gold standard for the diagnosis of SSEH. In case of an individual without any classical explanation for developing sudden neurological deficits with excruciating painful symptoms, SSEH should be kept in mind as a potential differential diagnosis. If SSEH is suspected, MRI should be done which is the diagnostic modality of choice.Surgical evacuation of the hematoma and decompression with laminectomy are considered to be the ideal procedures to be performed following the diagnosis.Since SSEH is a dreaded problem causing rapid deterioration it is highly advised to take up the patient for a detailed diagnosis and timely interventional procedures even though the clinical symptomatology remains to be highly unique in different individuals. In this article, we discuss from the literature, the etiology, pathophysiology, diagnosis, treatment protocols and prognostic factors regarding SSEH, a disease of low incidence yet a high mortality, demanding a detailed discussion and awareness among the medical professionals. &nbsp

Preeclampsia: A Plausile Playground for Stroke During Pregnancy and Puerperium

Preeclampsia is emerging as a serious, threatening problem during pregnancy and puerperium. Stroke which is a neurological emergency is becoming a distressing debilitating reason for the disability and morbidity among reproductive age group women.Across the globe, studies have delineated the fact that women are at a higher risk for developing stroke in comparison with men as well as higher mortality rates. Most strokes occurring in relation to pregnancy, either manifest during labor and delivery or in the puerperium phase. In this article we outline the importance in understanding the correlation between preeclampsia and stroke, the inter relational factors favoring its development and the positive effects of diagnosing the etiological factor at an earlier stage with good diagnostic modalities and treating accordingly in a timely manner with an individualized approach, taking into consideration the possible side effects without compromising the maternal and fetal health which is of prime importance

Life style Medicine to improve Physical and Psychological well-being

The brain does not work in a fixed state and it has no fixed memory or intelligence that is present from birth. It is in a constant state of fluctuation.The positives and negatives can be clearly determined regarding a situation with increased insight when our mind is at peace. One of the probable reasons for the increase in cognitive disorders is extreme pressure, stress or shock.In this article, we bring about the effective and scientifically proven methodologies with which the physical and psychological well-being can be improved. This not only brings about betterment within ourselves but also directs our personal and professional life towards achieving the goals as per our wishes. &nbsp

Prediction of peptide and protein propensity for amyloid formation

Understanding which peptides and proteins have the potential to undergo amyloid formation and what driving forces are responsible for amyloid-like fiber formation and stabilization remains limited. This is mainly because proteins that can undergo structural changes, which lead to amyloid formation, are quite diverse and share no obvious sequence or structural homology, despite the structural similarity found in the fibrils. To address these issues, a novel approach based on recursive feature selection and feed-forward neural networks was undertaken to identify key features highly correlated with the self-assembly problem. This approach allowed the identification of seven physicochemical and biochemical properties of the amino acids highly associated with the self-assembly of peptides and proteins into amyloid-like fibrils (normalized frequency of β-sheet, normalized frequency of β-sheet from LG, weights for β-sheet at the window position of 1, isoelectric point, atom-based hydrophobic moment, helix termination parameter at position j+1 and ΔGº values for peptides extrapolated in 0 M urea). Moreover, these features enabled the development of a new predictor (available at http://cran.r-project.org/web/packages/appnn/index.html) capable of accurately and reliably predicting the amyloidogenic propensity from the polypeptide sequence alone with a prediction accuracy of 84.9 % against an external validation dataset of sequences with experimental in vitro, evidence of amyloid formation

Measurement of functional microcirculatory geometry and velocity distributions using automated image analysis

This study describes a new method for analyzing microcirculatory videos. It introduces algorithms for quantitative assessment of vessel length, diameter, the functional microcirculatory density distribution and red blood-cell (RBC) velocity in individual vessels as well as its distribution. The technique was validated and compared to commercial software. The method was applied to the sublingual microcirculation in a healthy volunteer and in a patient during cardiac surgery. Analysis time was reduced from hours to minutes compared to previous methods requiring manual vessel identification. Vessel diameter was detected with high accuracy (>80%, d > 3 pixels). Capillary length was estimated within 5 pixels accuracy. Velocity estimation was very accurate (>95%) in the range [2.5, 1,000] pixels/s. RBC velocity was reduced by 70% during the first 10 s of cardiac luxation. The present method has been shown to be fast and accurate and provides increased insight into the functional properties of the microcirculation

Diagnosis of enteric fever in the emergency department: a retrospective study from Pakistan

Background:Enteric fever is one of the top differential diagnoses of fever in many parts of the world. Generally, the diagnosis is suspected and treatment is initiated based on clinical and basic laboratory parameters.Aims: The present study identifies the clinical and laboratory parameters predicting enteric fever in Patients visiting the emergency department of a tertiary care hospital in Pakistan.Methods:This is a retrospective chart review of all adult Patients with clinically suspected enteric fever admitted to the hospital through the emergency department during a 5-year period (2000-2005).Results:A total of 421 emergency department Patients were admitted to the hospital with suspected enteric fever. There were 53 cases of blood culture-positive enteric fever and 296 disease-negative cases on culture. The mean age in the blood culture-positive group was 27 years (SD: 10) and in the group with negative blood culture for enteric fever, 35 years (SD: 15) with a male to female ratio of 1:0.6 in both groups. Less than half (48%) of all Patients admitted with suspected enteric fever had the discharge diagnosis of enteric fever, of which only 13% of the Patients had blood culture/serologically confirmed enteric fever. None of the common clinical and laboratory parameters differed between enteric fever-positive Patients and those without it.Conclusion:Commonly cited clinical and laboratory parameters were not able to predict enteric fever

Induction of Inflammation by West Nile virus Capsid through the Caspase-9 Apoptotic Pathway

West Nile virus (WNV) is a member of the Flaviviridae family of vector-borne pathogens. Clinical signs of WNV infection include neurologic symptoms, limb weakness, and encephalitis, which can result in paralysis or death. We report that the WNV-capsid (Cp) by itself induces rapid nuclear condensation and cell death in tissue culture. Apoptosis is induced through the mitochondrial pathway resulting in caspase-9 activation and downstream caspase-3 activation. Capsid gene delivery into the striatum of mouse brain or interskeletal muscle resulted in cell death and inflammation, likely through capsid-induced apoptosis in vivo. These studies demonstrate that the capsid protein of WNV may be responsible for aspects of viral pathogenesis through induction of the apoptotic cascade