Notes

Antibody upstream series selection as well as organic implications unveiled by arsenal sequencing.
Just when the caterpillar thought it has been wound up into a mastaba, it became a butterfly.The mining of manganese ore in India started in the year 1899, in Nagpur district of the Central Provinces. Almost six decades later, in 1957, Dr. T. P. Niyogi examined several young men involved in dry drilling of Manganese ore, who had symptoms of muscular pain, weakness, clumsy movements, asthenia, anorexia, insomnia, and gait difficulties. These patients were also emotionally disturbed and prone to falls and accidents. He concluded that these symptoms were due to chronic manganese toxicity with parkinsonian features and psychiatric manifestations which he published in 1958.[1] This lead to the formation of an Enquiry Committee by the Ministry of Labour and Employment, Government of India which instituted corrective measures in mining of manganese in India. Very few reports of chronic toxicity due to inhalation of manganese have been reported subsequently. This paper highlights the contributions of Dr. T.P. Niyogi who was the Civil Surgeon in Chhindwara, MP during that period.Chromosomal microdeletion syndromes usually present with neurological abnormalities, developmental delays, and various systemic abnormalities. 1p31 microdeletion syndrome is one of the novel microdeletion syndromes that usually presents with developmental delay, intellectual disability, various craniofacial abnormalities, and other systemic abnormalities in a proportion of cases. NEGR1 and NFIA are few of the genes present in this locus responsible for these symptoms. However, none of the reported cases had only isolated intellectual disability. Here, we are reporting a case of 1p31 microdeletion syndrome with isolated moderate intellectual disability and hyperactivity in an 11-year-old boy. It is essential for clinicians to be aware of such an atypical presentation of 1p31.1 microdeletion syndrome, to maintain reasonable clinical suspicion in cases with unexplained intellectual disability.
Discovery of serum myelin oligodendrocyte glycoprotein (MOG) antibody testing in demyelination segregated MOG-IgG disease from AQ-4-IgG positive NMOSD.

To study clinico-radiological manifestations, pattern of laboratory and electrophysiological investigations and response to treatment through follow up in MOG-IgG positive patients.

Retrospective data of MOG-IgG positive patients was collected. Demographics, clinical manifestations at onset and at follow up and relapses, anti AQ-4-IgG status, imaging and all investigations were performed, treatment of relapses and further immunomodulatory therapy were captured.

In our 30 patients, F M ratio was 2.751 and adult child ratio 41. Relapses at presentation were optic neuritis ON(60%), longitudinally extensive transverse myelitis LETM(20%), acute disseminated encephalomyelitis ADEM(13.4%), simultaneous ON with myelitis (3.3%) and diencephalic Syndrome (3.3%). Salient MRI features were ADEM-like lesions, middle cerebellar peduncle fluffy infiltrates, tha were monophasic/recurrent/simultaneous ON, myelitis, recurrent ADEM, brainstem encephalitis and diencephalic Syndrome. MRI features suggestive of MOG-IgG disease were confluent ADEM-like lesions, middle cerebellar peduncle fluffy lesions, LETM, LEON and non-LEON. Where indicated, patients need to go on immunomodulation as it has a relapsing course and can accumulate significant disability. Because of its unique manifestations, it needs to be considered as a distinct entity. To the best of our knowledge, this is the largest series of MOG-IgG disease reported from India.
Optic nerve sheath diameter (ONSD) measurement is emerging as a noninvasive method to estimate raised ICP. It is helpful in situations where imaging of brain or direct ICP monitoring is not available or feasible. Use of ONSD is still limited, so this study was planned to determine whether the bedside sonographic measurement of ONSD can reliably predict elevated ICP in neuro-trauma patients.

After approval from Hospital Ethics Committee, this cross-sectional study was conducted in hundred traumatic brain injury (TBI) patients with suspected elevated ICP, admitted to neurosurgical ICU. The severity of brain injury was assessed according to Glasgow coma scale (GCS), initial CT scan findings, and revised trauma score (RTS). All patients underwent ONSD sonography of the eye and CT scan subsequently. click here ONSD of ≥5.0 mm was considered as a benchmark of raised ICP.

Mean ONSD of the study group with ONSD ≥5.0 mm was 5.6 ± 0.3 mm. ONSD was raised in 46% of patients, more so in patients with low GCS (3-6). The relationship of ONSD with GCS, CT scan findings, and RTS was highly significant. The sensitivity of the bedside sonographic measurement ONSD to detect raised ICP was 93.2% and specificity was 91.1% when compared with CT scan. Positive Predictive Value of the ONSD measurement was 89.1% and the negative predictive value was 94.4%.

Ultrasonographic assessment of ONSD is a reliable modality to detect raised ICP in neurotrauma patients. It can be helpful in the early initiation of treatment of elevated ICP, thus preventing secondary brain damage.
Ultrasonographic assessment of ONSD is a reliable modality to detect raised ICP in neurotrauma patients. It can be helpful in the early initiation of treatment of elevated ICP, thus preventing secondary brain damage.
Progressive supranuclear palsy (PSP) is a clinically heterogeneous disease characterized by supranuclear gaze palsy and varying combinations of Parkinsonism, gait disturbances, postural instability, and fronto-limbic cognitive dysfunction. A major challenge in clinical diagnosis is the existence of subtypes whose clinical features overlap with those of other Parkinsonian disorders.

To categorize patients of PSP into its using the recently proposed movement disorder society criteria (2017) and to determine the prognosis of the PSP subtypes.

Demographic and clinical data of patients diagnosed with PSP over a 21 year period were collected by review of medical records and categorized into its subtypes. Subtype prognosis was assessed from the interval between disease onset and attainment of the first of 5 clinical disability milestones namely wheelchair dependency, unintelligible speech, severe dysphagia, severe cognitive impairment, and urinary catheterization.

When categorized into subtypes, out of the 334 patients with PSP, PSP-RS predominated (72%), followed by PSP-parkinsonism (PSP-P) (13.
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