RNT MEDICAL COLLEGE
udaipur, rajasthan | India
Main Specialties: Neurology
Additional Specialties: NEUROLOGY
9PubMed Central Citations
IJN Issue : Volume 4 , Issue 4,Year 2018
IP INDIAN JOURNAL OF NEUROSCIENCE
Guillain-Barré syndrome is a post infective polyradiculoneuropathy having heterogenous clinical presentation and various
subtypes like acute inflammatory demyelinating polyradiculoneuropathy, acute motor-sensory axonal neuropathy, acute motor
axonal neuropathy, pure sensory variant and Miller Fisher syndrome. A prospective study was carried out in patients with
Guillain-Barré syndrome admitted to the RNT Medical College & attached Hospital to determine the electrophysiological
subtypes and their prognosis in relation to various subtypes, clinical features and treatment. A total of 100 patients was enrolled.
In the final analysis there were 74% male and the mean age was 30.4 years. Clinically 97% patients had quadriparesis, 2% had
paraparesis and one cases had bibrachial involvement. Cranial nerves and respiratory involvement were seen in 25% and 24%
cases respectively. Electrophysiologically the most common type of GBS was AIDP (43%) followed by AMAN (34%) and
AMSAN (23%). The prognosis was assessed at one month and found that there was complete recovery in 32% cases and residual
weakness in 63% cases. Death occurred in 5% cases because of respiratory involvement
IJN Issue : Volume 2 , Issue 2,Year 2018
IP INDIAN JOURNAL OH NEUROSCIENCE
Introduction: Stroke is the second leading cause of death worldwide. The incidence of cerebrovascular diseases increases with
age. 1 Accurate prognostication of stroke patients is difficult many times.
Materials and Methods: A total of 100 stroke patients who presented to R.N.T. Medical College Udaipur Rajasthan were
enrolled from February 2016 to October 2016 and their serum ferritin was measured and correlated with early neurological
deterioration in patients of acute stroke.
Results: Total 100 patients were included, the age ranged from 22-90 years and the age group with the maximum number of
patients was 61-70 years. 62 patients were in ischemic and 38 were in hemmoraghic groups. In ischemic group the mean serum
ferritin level was 89.540 in clinically improvement patients and 341.345 in those deteriorated. In hemorrhagic group the mean
serum ferritin level was 86.838 in clinically improvement patients and 355.759 in those deteriorated.
Conclusion: The patients with stroke with increased serum ferritin concentrations have a higher risk of poor clinical outcome,
hemorrhagic transformation, and brain edema than patients with low ferritin values
Malays J Med Sci. 2017 Dec; 24(6): 103–106
Malays J Med Sci
Persistent neutrophilic meningitis is an atypical form of chronic meningitis defined as clinical meningitis with a cerebrospinal fluid (CSF) analysis suggestive of neutrophilic pleocytosis that persists for more than one week despite giving empirical antimicrobial therapy. The predominant presentation of tubercular meningitis is with CSF lymphocytic pleocytosis and even if early phase of the disease presents with neutrophilic pleocytosis, no persistence is usually observed for more than one week. We hereby report the case of an immunocompetent man aged 25 years with tubercular meningitis manifesting as persistent neutrophilic meningitis which is very rare as an entity in tubercular meningitis (TBM). Patient was started on anti-tubercular therapy based on the granulomas in magnetic resonance imaging (MRI) of the brain after which there was a reduction in total cell count in CSF but persisting neutrophilic predominance. Patient improved clinically and was given a full course of anti-tubercular treatment (ATT) thereafter.
Malays J Med Sci 2017 Aug 18;24(4):106-110. Epub 2017 Aug 18.
Department of General Medicine, RNT Medical College, Udaipur, Rajasthan, 313001 India.
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Indian J Dermatol Venereol Leprol 2015 Mar-Apr;81(2):185-6
Department of Dermatology, Venereology and Leprosy and Department of Neurology, R. N. T. Medical College, Udaipur, Rajasthan, India.
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(IJMSE) Vol. 1; Issue: 4 (Jan 2015)
International Journal of Medical Sciences and Education (IJMSE)
Objectives: Vitamin B12 is an essential micronutrient essential for appropriate neuro-cognitive hemopoetic and cardiovascular function. This study was planned to find correlation between vitamin B12 deficiency and clinical , haematological and electrophysiological parameters of vitamin B12 deficiency. Material and Methods : This was a cross sectional study which included 125 patients who had attended Maharana Bhupal Govt. Hospital, Udaipur between 1st November 2013 to 31st August 2014. The study included all cases of anaemia with or without neurological manifestation with suspected B12 deficiency, Anaemia with history of chronic alcoholism, smoker, tobacco, beetle nut chewers, chronic diarrhoea and Past history of gastric surgery. Results: Total 125 patients were included in study, among them 53 were male and 72 were females & majority 69 (55.2%) patients were more than 60 years of age. 86 (68.8%) patients had severe Vitamin B12 deficiency, among them 42(63.6%) were females. Neurological complains like parenthesis. Ataxia, decreased vision, psychiatric and cognitive impairment were observed in 68 (54.4%) patients among them parenthesis were present in three fifth (60.29%) patients. Reduced vision was present in only 3 (5.8%) patients. 19% patients had myeloneuropathy and Optic atrophy was noted in all 3 patients who were presented with reduced vision. Conclusion: Deficiency disorders of vitamins associate with plethora of clinical manifestations. Old age person, Female gender and vegetarians are at considerable risk to develop B12 deficiency.
J Indian Med Assoc 2013 May;111(5):309-12, 314
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J Indian Med Assoc 2011 Sep;109(9):675, 682
Department of Neurology, BMRC, SMS Medical College, Jaipur 302004.
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JNNP 2008;79:1021 doi:10.1136/jnnp.2007.127985
J Neurol Neurosurg Psychiatry
CASE SUMMARY A 65-year-old male presented with severe neck and low back pain for the past 6 months and progressive spastic quadriparesis for the past 15 days. All deep tendon reflexes were brisk except …
April 2017 • Vol. 65
Lymphocytic hypophysitis is an inflammatory /autoimmune disorder that primarily involves the pituitary gland and the pituitary stalk. The common clinical presentations include headache, nausea, vomiting, fatigue, features of hypopituitarism and diabetes insipidus as well as diplopia, orbital pain and bitemporal hemianopia. We report a case of lymphocytic hypophysitis which presented as hemichorea. Neuroimaging showed a mass in the sella tursica region which, on histopathological examination was suggestive of lymphocytic hypophysitis. After excision of this mass, patient showed marked improvement in his symptoms albeit he developed panhypopituitarism. The patient was treated with pituitary hormonal replacement therapy and is currently asymptomatic.
IRPMS, Volume-2, Issue-3, 2016 July-Sept
Objectives: vitamin B12 is a micronutrient essential for neuro-cognitive, haemopoietic and cardiovascular function. This study was planned to find out the correlation between vitamin B12 deficiency and its haematological effect like haemoglobin and MCV. Material and Methods: In this cross sectional study, 100 patients presented in the department of Neurology and Internal Medicine R.N.T. Medical College, Udaipur from 1st January 2015 to 30th June 2016, with neurological disorders and in whom vitamin B 12 was diagnosed were analyzed. After detail history and careful examination, blood was sent for CBC and vitamin B12 level. Routine investigations too were done in the 1study subjects. Information had then filled in the predesigned proforma for analysis. Results: there were 37 male and 63 female and the male to female ration was 1: 1.7. Maximum numbers of the patient were under 50 year of age. Out of 100 vitamin B12 deficient patients, only 10% patients had MCV above 100fl. In this study 54 (54%) patients were anaemic out of these 39 (72.22%), 13 (24.07%) and 2 (3.70%) were mild, moderate and sever anaemic. Conclusion: there was no correlation between vitamin B12 and MCV level in the study subjects. In patients with neurological disorders, vitamin B12 deficiency should be suspected irrespective of their MCV and haemoglobin level
IJN. 2017 Volume 3 : Issue 4
Indian Journal of Neurosciences
ntroduction: Post injection sciatic neuropathy in very common in developing country like India and mostly it is because of faulty technique and injecting substances. Due to thin fat pad and less muscle bulk of buttocks in children, it makes them more prone to sciatic nerve injury than adults. Objective: The aim of this study was to evaluate clinical and electrophysiological findings of post-injection sciatic neuropathy. Materials and Methods: We included 30 consecutive patients who had history of intragluteal injection and subsequently developed neuropathy and their clinical and electrophysiological examination was done. Results: The most affected nerve was Sural Nerve (83.33%) while Superficial Peroneal nerve was least affected (16.67%). Fifteen cases had both Tibial and Peroneal nerve affection. Cases who had both sensory motor axonal neuropathy were twenty seven while one case exclusively had motor axonal neuropathy. One case exclusively showed pure sensory neuropathy. Demyelinating neuropathy was found in one case. Conclusion: The sciatic neuropathy is a common health problem in children after injection so, intramuscular injecton is better avoided in children. Bilateral involvement in eight cases hints that there are some more mechanisms involved in neuropathy other than local injury.
Current Issue • June 2017 • Vol. 65
Hypokalemia is an important entity in psychiatric patients which is easily identifiable and commonly missed. Hypokalemia is defined as plasma potassium concentration of less than 3.5 meq/l. It can be caused by redistribution of potassium between tissues and the extracellular fluid or by renal and nonrenal loss of potassium. Hypokalemia has prominent effects on cardiac, skeletal and intestinal muscle cells1 and can also affect the nervous system. The neurological symptoms seen in hypokalemia are delirium, hallucinations, depression and rarely psychosis.2,3 Here we are reporting a very rare case of hypokalemia who presented as acute psychosis. A fifty five years old gentleman presented to us with history of aggressive behavior and irrelevant talk since five days with no history of fever, headache, vomiting, loose motions, trauma to the head. He did not have any history of drug intake or starvation. He was conscious but not obeying verbal commands and was abusive towards his family members and the examiner. The routine blood examination revealed very low serum potassium level (1.5 meq/ml). Serum sodium level was 138 meq/l, serum calcium was 9 mg/dl, Serum magnesium level was 2 mg/dl, serum vitamin B12 level was 2000 pg/ml and Thyroid stimulating hormone level was 1.18 mIU/L. Electrocardiogram of the patient showed changes of hypokalemia with ST segment flattening in leads V1 to V4 and prominent U waves in V1 and V2. The connective tissue disease profile also came out to be negative. He was negative for antibodies to HIV-1 and HIV-2. VDRL test was also non-reactive. Magnetic resonance imaging of brain was normal. Cerebrospinal fluid analysis was also normal. The diagnosis of hypokalemia induced acute psychosis was made and patient was started on parenteral potassium therapy. The patient showed remarkable improvement in his symptoms parallel to the rise in serum potassium levels. There were so many studies done showing low serum potassium levels in psychiatric patients but so far there has been no reported case of hypokalemia presenting as acute psychosis in a previously normal person without any past or family history of psychiatric illness which makes this case unique. A tubular vision to psychosis patients while ignoring organic and biochemical evidences can be detrimental for the patient.