We present our preliminary experience in neuropsychological testing in epilepsy surgery patients to demonstrate how these tests contributed to decide the laterality of epileptic focus, and to assess the effect of surgery on patient’s cognitive function and quality of life. Preoperative neuropsychological tests consisting of Wechsler Adult Intelligence Scale-III (WAIS) for IQ, Wechsler Memory Scale-III (WMS) for memory and patients’ quality of life (QOLIE 31) were administered to refractory epilepsy patients under evaluation for surgical treatment. These tests were repeated one year after surgery and we studied any changes in trends. A total of seven patients were recruited in this study between July 2004 and July 2006. The aetiologies of refractory epilepsy were pure mesial temporal sclerosis (MTS) in five patients, dysembryogenic neuroepithelial tumour (DNET) in one and dual lesion of cavernous angioma with ipsilateral MTS in one. The preoperative neuropsychological tests were all in concordance to MRI finding, and showed good contralateral function; five lateralises to the right and two to the left. The post-operative Engel seizure count (median 8.00, IQR 7.00–8.75), general IQ (88 vs. 79), performance IQ (94 vs. 79), verbal memory (89 vs. 71), non-verbal memory (88 vs. 75) and QOLIE (53.14 vs. 44.71) were better compared to preoperative values. The verbal IQ (84 vs. 84) was unchanged. Neuropsychological tests are useful as ancillary investigations to determine the laterality of seizure focus and integrity of function in the contralateral temporal lobe. Following successful surgical treatment, there is a trend towards improvement in memory, IQ and quality of life scores in this small group of patients.

Ultrasound criteria for carpal tunnel syndrome (CTS) may vary in different populations. To determine the ultrasonographic criteria for CTS in a Malaysian population and compare its usefulness with nerve conduction studies (NCS), we studied patients clinically diagnosed with CTS and normal controls by ultrasonography. All patients also underwent standard NCS. Median nerve Cross-Sectional Area (CSA) and Flattening Ratio (FR) at 3 different levels – proximal to tunnel inlet, at tunnel inlet and tunnel outlet were measured. Receiver operator characteristic (ROC) analyses were used to calculate the optimal discriminatory threshold values for CTS. Of 54 CTS hands, NCS was positive in 85.2%. Median nerve CSA at all 3 levels, were signifi cantly greater in CTS hands.FR was signifi cantly greater at tunnel inlet. A CSA threshold of 0.1 cm2 proximal to and at tunnel inlet had sensitivities of 70.4% and 63% and specifi cities of 85.2% and 88.5 % respectively. CSA at tunnel outlet had lower specifi city. If CSA of 2 levels (viz. proximal to or at tunnel inlet) were considered together, sensitivity and specifi city improved to 81.5% and 83.3%. Qualitative loss of fascicular discrimination of the nerve proximal to the inlet had sensitivity and specifi city of 77.8% and 96.3%. The most useful ultrasonographic parameter was median nerve CSA either proximal to or at tunnel inlet. However, the sensitivities were lower compared to NCS. Qualitative appearance of the median nerve is a useful adjunct to diagnosis. In conclusion, ultrasonography play an important complementary role to NCS in the diagnosis of CTS.

Dentistry has entered an exciting era of technological advancements. The advent of newer modalitiesof treatment like the use of laser radiation has heralded a change in the field of Periodontics since itsdevelopment and subsequent applications for dental hard and soft tissue procedures. Extensive researchhas been done on the possible benefits of lasers derived from the adjunctive effects of bacterial controland haemostasis associated with its use. This review attempts to explore the current status of laserapplications in the treatment of periodontal diseases and the emerging concepts in the utilization of laserenergy. The limitations of lasers in periodontal therapy are also briefly discussed.

No abstract available.
Arthroplasty ; Bradycardia ; Cough ; Hip

Objective To compare the differences in intake and excretion between Musca domestica and other three species from families Muscidae and Calliphoridae which may help explaining the significance of house fly in the transmission of pathogens. Methods The four adult species were supplied with two concentrations of sucrose via modified capillary feeder assay system. The two sucrose concentrations were applied to one adult male/each experiment and the elimination spots were counted. Using 0.25 mol/L sucrose + 0.25% bromophenol blue, one active non-starved male/cup was observed carefully for 1 h to record its behavior. As a growing medium used in bacterial transmission experiments, undiluted trypticase soy broth was used to feed 3-day-old females and males of Musca domestica following two different diets upon emergence and the frequency of elimination spots was estimated. Results The two Musca species have half the weight of the two Phormia species. Comparing the volume of intake per hour, house fly took as much as the other species, all of which were larger. House fly produced twice, or more, the number of elimination spots/h than the other three species. Feeding the flies a sugar liquid diet resulted in producing more fecal spots than regurgitation spots. The male house flies produced less elimination spots/h when fed with trypticase soy broth than with the two sucrose solutions. Conclusions House flies eliminated more than the other examined fly species and most of these elimination events were defecation which implicates the fecal route for pathogen transmission by this important vector.

We tested 59 Greek patients with Behcet's Disease (BD) for serum anti-Saccharomyces cerevisiae antibodies. No increase of these antibodies was detected in the cases compared to 55 healthy unrelated blood donors from the same population. This finding is in contrast with the correlation between Saccharomyces cerevisiae antibodies and BD as reported in other populations. It seems that environmental factors may contribute to disease expression in different populations, producing different effects according to the individual's genetic predisposition. Saccharomyces cerevisiae antibodies do not seem to be of any significance in the Greek population.
Adolescent ; Adult ; Aged ; Antibodies, Fungal/*immunology ; Behcet Syndrome/*immunology/microbiology ; Case-Control Studies ; Female ; Greece ; Humans ; Immunoglobulin A/immunology ; Immunoglobulin G/immunology ; Male ; Middle Aged ; Saccharomyces cerevisiae/*immunology ; Young Adult

INTRODUCTIONThis study aimed to examine age- and gender-related differences in the comorbidities, drug utilisation and adverse drug reaction (ADR) patterns of patients admitted to a coronary care unit (CCU).

METHODSThe present study was a retrospective cohort study. Two trained physicians independently reviewed the case records of CCU patients over a period of one year (Jan-Dec 2008). The demographic, clinical, and drug prescription data of the patients were analysed according to age group (18-59 years vs ≥ 60 years) and gender.

RESULTSA total of 574 patients were admitted to the CCU during the study period. Of these 574 patients, 65.2% were male, and 48.4% were ≥ 60 years old. No significant gender-based differences were found for the prescription of cardiovascular and non-cardiovascular drugs, and ADR patterns (p > 0.05). Male patients aged ≥ 60 years were found to have a higher rate of polypharmacy than those aged 18-59 years (p = 0.001). The duration of hospital stay was longer in male than female patients (p = 0.008), and the duration of CCU stay was longer for male patients aged ≥ 60 years than males aged 18-59 years (p = 0.013). Compared to patients aged 18-59 years, a greater number of patients aged ≥ 60 years were prescribed cardiovascular (p = 0.006) and non-cardiovascular drugs (p = 0.015). Patients aged ≥ 60 years also had a higher rate of polypharmacy (p = 0.001) and ADRs (p = 0.013), and a longer duration of CCU stay (p = 0.013). Renal (p = 0.047) and cutaneous (p = 0.003) ADRs were found to be more common in patients aged ≥ 60 years.

CONCLUSIONNo major gender-related differences were observed in the prescription, drug utilisation and ADR patterns of our study cohort. Higher drug utilisation, ADR rates, and longer duration of CCU stay were noted in patients aged ≥ 60 years.

Adolescent ; Adult ; Age Factors ; Angina, Unstable ; drug therapy ; Comorbidity ; Coronary Care Units ; Diabetes Mellitus ; drug therapy ; Drug Utilization ; Drug-Related Side Effects and Adverse Reactions ; Female ; Heart Failure ; drug therapy ; Hospitalization ; Humans ; Hypertension ; drug therapy ; India ; Kidney Diseases ; drug therapy ; Length of Stay ; Male ; Middle Aged ; Polypharmacy ; Retrospective Studies ; Sex Factors ; Tertiary Care Centers ; Young Adult

OBJECTIVE: Myelography has been shown to highlight foraminal and lateral recess stenosis more readily than computed tomography (CT) or magnetic resonance imaging (MRI). It also has the advantage of providing dynamic assessment of stenosis in the loaded spine. The advent of weight-bearing MRI may go some way towards improving assessment of the loaded spine and is less invasive, however availability remains limited. This study evaluates the potential role of myelography and its impact upon surgical decision making. METHODS: Of 270 patients undergoing myelography during 2006–2009, a period representing peak utilisation of this imaging modality in our unit, we identified 21 patients with degenerative scoliosis who fulfilled our inclusion criteria. An operative plan was formulated by our senior author based initially on interpretation of an MRI scan. Subsequent myelogram and CT myelogram investigations were scrutinised, with any additional abnormalities noted and whether these impacted upon the operative plan. RESULTS: From our 21 patients, 18 (85.7%) had myelographic findings not identified on MRI. Of note, in 4 patients, supine CT myelography yielded additional information when compared to supine MRI in the same patients. The management of 7 patients (33%) changed as a result of myelographic investigation. There were no complications of myelography of the total 270 analysed. CONCLUSION: MRI scan alone understates the degree of central and lateral recess stenosis. In addition to the additional stenosis displayed by dynamic myelography in the loaded spine, we have also shown that static myelography and CT myelography are also invaluable tools with regards to surgical planning in these patients.
Congenital Abnormalities ; Constriction, Pathologic ; Decision Making ; Humans ; Magnetic Resonance Imaging ; Myelography* ; Scoliosis* ; Spine ; Weight-Bearing