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Srīnagar, India

Chhiber S.S.,SKIMS | Singh J.P.,ASCOMS
Neurology India | Year: 2010

Acute spontaneous subdural hematoma of arterial origin, a neurosurgical emergency resulting from rupture of the perisylvian cortical artery, is a rare occurrence. We report four such patients who presented with progressive neurological deterioration. All the patients were operated and perisylvian cortical artery was identified as the source of bleeding in all the patients. Three of the patients had associated hypertension. We reviewed the clinical characteristics, etiology, and outcome of the reported cases in the literature. A high index of suspicion is necessary even in young patients in view of the phenomenon of re-rupture mimicking stroke. Early diagnosis and a wide craniotomy over the sylvian fissure to obtain hemostasis of bleeding points results in good outcome. Source

The study was conducted with the purpose of finding clinical profile of early gastrointestinal complications of stem cell transplant at this center. 70 consecutive subjects, who were subject to bone marrow transplant from October 2002 to September 2004, were prospectively studied. The gastrointestinal complications were followed in first 100 days of transplant and recorded in a pre-determined format. Study population comprised of 23 allo-transplant (with 3-non-myelablative procedures) and 47 auto-transplant subjects. Gastrointestinal complications included: nausea and vomiting in 19 (82.60%), mucositis- 20 (86.95%), diarrhea- 15 (65.21%), veno-occlusive disease (VOD) - 3 (13.04%) and acute pancreatitis- 1 (4.34%) in allo-transplant group. Nausea and vomiting occurred 36 (76.59%), mucositis- 46 (97.88%) diarrhea- 39 (82.98%), VOD- 5 (10.64%) in auto- transplant subjects. Acute graft versus host disease (AGVHD) involved gut in 3 and liver in 1 case of allo-BMT-group. Source

Arif T.,Government Medical College | Arif T.,Aligarh Muslim University | Masood Q.,Government Medical College | Singh J.,SKIMS | Hassan I.,Government Medical College
BMC Gastroenterology | Year: 2015

Background: Systemic sclerosis (SSc) is a generalized disorder of unknown etiology affecting the connective tissue of the body. It affects the skin and various internal organs. Gastrointestinal tract involvement is seen in almost 90% of the patients. Esophagus is the most frequently affected part of the gastrointestinal tract. Esophageal motility disturbance classically manifests as a reduced lower esophageal sphincter pressure (LESP) and loss of distal esophageal body peristalsis. Consequently, SSc patients may be complicated by erosive esophagitis and eventually by Barrett's esophagus and esophageal adenocarcinoma. Morphea, also known as localized scleroderma, is characterized by predominant skin involvement, with occasional involvement of subjacent muscles and usually sparing the internal organs. The involvement of esophagus in morphea has been studied very scarcely. The proposed study will investigate the esophageal involvement in the two forms of scleroderma (systemic and localized), compare the same and address any need of upper gastrointestinal evaluation in morphea (localized scleroderma) patients. Methods: 56 and 31 newly and already diagnosed cases of SSc and morphea respectively were taken up for the study. All the patients were inquired about the dyspeptic symptoms (heartburn and/or acid regurgitation and/or dysphagia). Upper gastrointestinal endoscopy, esophageal manometry and 24-hour pH monitoring were done in 52, 47 and 41 patients of SSc; and 28, 25 and 20 patients of morphea respectively. Results: Esophageal symptoms were present in 39 cases (69.6%) of SSc which were mild in 22 (39.3%), moderate in 14 (25%), severe in three (5.3%); while only four cases (7.1%) of morphea had esophageal symptoms all of which were mild in severity. Reflux esophagitis was seen in 17 cases (32.7%) of SSc and only two cases (7.14%) of morphea. Manometric abnormalities were seen in 32 cases (68.1%) of SSc and none in morphea. Ambulatory 24-hour esophageal pH monitoring documented abnormal reflux in 33 cases (80.5%) of SSc and no such abnormality in morphea. Conclusion: While the esophageal involvement is frequent in SSc, no such motility disorder is seen in morphea. Meticulous upper gastrointestinal tract evaluation is justified only in SSc and not in morphea. © Arif et al. Source

Decompressive surgery for acute subdural hematoma leading to contralateral extradural hematoma (EDH) is uncommon. If undetected, contralateral EDH can lead to high mortality and morbidity. High degree of suspicion, especially in the presence of contralateral skull fracture and/or intraoperative brain swelling, can prevent the devastating consequences of this condition. When suspecting this fatal condition on the surgical table, whether taking the patient for computed tomography (CT) scan or doing exploratory burr holes immediately is debatable given the time required to shift the critically ill patients to CT suite at odd hours. We report a case of delayed contralateral EDH after evacuation of acute subdural hematoma in which an immediate early CT scan in the presence of tense intraoperative brain and a contralateral skull fracture could have resulted in better outcome. © 2011 by Lippincott Williams & Wilkins. Source

Qureshi U.A.,Pediatrics Sher I Kashmir Institute Of Medical Science Skims | Wani N.A.,SKIMS | Altaf U.,SKIMS
Journal of the Neurological Sciences | Year: 2010

Neurovascular anomalies of Parry-Romberg syndrome have been reported infrequently. We report a case of Parry-Romberg syndrome with hypoplastic left internal carotid, middle cerebral, anterior cerebral, posterior communicating and posterior cerebral artery. The patient presented with partial seizures, hemiparesis and phthisis bulbi. © 2010 Elsevier B.V. All rights reserved. Source

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