Is there an association between vitamin D and risk of stroke?: a North Indian study

Background: Vitamin D deficiency is present in India in epidemic proportions despite plenty of sunshine. Reduced plasma 25(OH) D concentrations as a diagnostic marker of vitamin D deficiency have been in past decade associated with several well-established risk factors for ischaemic stroke, such as arterial hypertension, thrombosis, atherosclerosis. The aims and objectives of this study was to compare the serum 25(OH) D levels between the first ever acute stroke patients and healthy controls.Methods: A cross-sectional, case control study was conducted in a tertiary care hospital in New Delhi situated in north India. Serum 25‑hydroxyvitamin D (25(OH) D) levels in 85 patients of ischemic stroke, presenting within 7 days of onset of stroke was measured and was compared with 70 age and gender matched controls.Results: The mean age was 61.02±11.58 years and 58.63±11.28 years in cases and controls respectively. Females constituted 37.6% of the total number of cases and 43.4% of the controls. The age and gender-distribution were comparable between the cases and controls. The median value (IQR) of serum 25(OH) vitamin D level was 7.94 ng/mL (4.59-14.00) in the cases and it was 8.82 ng/mL (5.59-14.70) in the controls. The difference between the serum 25(OH) vitamin D levels of the two groups was not found to be statistically significant.Conclusions: There is a high prevalence of biochemical hypo-vitaminosis D in apparently healthy Indians of all age and sex groups despite adequate sunshine. There is no association between low vitamin D levels and stroke

Bilateral thalamic glioma

Bilateral thalamic glioma is a rare type of primary thalamic tumor. It presents clinically with personality changes and dementia rather than mass effect or focal neurological deficit. Imaging findings are somewhat characteristic with the diffuse homogenous enlargement of bilateral thalami with altered attenuation or signal intensity on computerized tomography and magnetic resonance imaging, respectively. This tumor is refractory to radiotherapy and chemotherapy and survival beyond 2 years after diagnosis is rare. This report emphasizes the need of neuroimaging in a patient with dementia to identify this rare devastating tumor early

Clinical correlation of retinal nerve fiber layer thickness in multiple sclerosis patients- A North Indian study

Background: Axonal loss is thought to occur early in the course multiple sclerosis (MS) and is supposed to be associated with, and predictive of, neurologic deficits progressing to permanent disability.Axonal loss in the retinal nerve fiber layer (RNFL) is measured by optical coherence tomography (OCT). Material and Methods: A longitudinal observational study, conducted on 30 MS patients. All subjects underwent neurological examination, including expanded disability status scale (EDSS) scoring and OCT on two visits, minimum 2 months apart. Results: Total of 60 eyes of 30 patients were subdivided into 21 eyes having optic neuritis (ON) [‘MS – ON’] and 39 eyes without ON. The RNFL thickness (RNFLt) was found to be significantly reduced in all parameters except in temporal quadrant, as the duration of disease increases. Average RNFLt were found to have negative correlation (r = -0.450) with disease duration. Negative correlation (r=-0.657) was also found between EDSS score change and average RNFLt change. The eyes having ON showed statistically significant RNFL thinning as compared to the non – ON fellow eyes. The baseline EDSS score was found to be negatively correlated (moderate degree, r = -0.348) with baseline average RNFL thickness, with p-value of 0.006. Conclusions: The RNFLt is not only significantly thinner in those with history of ON, but it is also affected remarkably even in absence of prior ON, suggesting subclinical ongoing axonal loss in patients with MS. The EDSS score is inversely correlated with RNFL thickness

Vitamin D Toxicity in Adults: A Case Series from an Area with Endemic Hypovitaminosis D

Vitamin D deficiency state is endemic to the Kashmir valley of the Indian subcontinent. Physicians often treat patients with high doses of vitamin D for various ailments and on occasion the prescribed doses far exceed the requirements of the patients. Ten cases of hypercalcemia due to vitamin D intoxication are presented with features of vomiting, polyuria, polydipsia, encephalopathy and renal dysfunction. All the patients had demonstrable hypercalcemia and vitamin D levels were high in nine of the 10 cases. The patients had received high doses of vitamin D and no other cause of hypercalcemia was identified. Treatment of hypercalcemia resulted in clinical recovery in nine cases. We conclude that hypervitaminosis D must be considered in the differential diagnosis of patients with hypercalcemia in endemically vitamin D deficient areas. A careful history and appropriate biochemical investigation will unravel the diagnosis in most of the cases

Fabrication of multifunctional cellulose/TiO2/Ag composite nanofibers scaffold with antibacterial and bioactivity properties for future tissue engineering applications

In the present work, a novel strategy was explored to fabricate nanofiber scaffolds consisting of cellulose assimilated with titanium dioxide (TiO2) and silver (Ag) nanoparticles (NPs). The concentration of the TiO2 NPs in the composite was adjusted to 1.0, 1.5, and 2.0 wt % with respect to polymer concentration used for the electrospinning of colloidal solutions. The fabricated composite scaffolds were dispensed to alkaline deacetylation using 0.05 M NaOH to remove the acetyl groups in order to generate pure cellulose nanofibers containing TiO2 NPs. Moreover, to augment our nanofiber scaffolds with antibacterial activity, the in situ deposition approach of using Ag NPs was utilized with varied molar concentrations of 0.14, 0.42, and 0.71 M. The physicochemical properties of the nanofibers were identified by scanning electron microscopy (SEM), transmission electron microscopy (TEM), Fourier transform infrared (FTIR) and contact angle meter studies. This demonstrated the presence of both TiO2 and Ag NPs and complete deacetylation of nanofibers. The antibacterial efficiency of the nanofibers was scrutinized against Escherichia coli and Staphylococcus aureus, revealing proper in situ deposition of Ag NPs and confirming the nanofibers are antibacterial in nature. The biocompatibility of the scaffolds was accustomed using chicken embryo fibroblasts, which confirmed their potential role to be used as wound-healing materials. Furthermore, the fabricated scaffolds were subjected to analysis in simulated body fluid at 37 degrees C to induce mineralization for future osseous tissue integration. These results indicate that fabricated composite nanofiber scaffolds with multifunctional characteristics will have a highest potential as a future candidate for promoting new tissues artificially