1.Transient Elevation of Cerebrospinal Fluid Protein in a Patient of Mild Encephalitis with Reversible Lesion in the Splenium: A Case Report
Bhawna Sharma ; Rahul Handa ; Kadam Nagpal ; Swayam Prakash ; Ashok Panagariya
Malaysian Journal of Medical Sciences 2014;21(3):94-97
Mild encephalitis with reversible lesion in the splenium (MERS) is a clinicoradiological syndrome presenting as a solitary lesion in the central portion of the splenium of the corpus callosum (SCC) with a radiological finding of restricted diffusion and low apparent diffusion coefficient (ADC) values. Complete resolution of the lesion on follow-up imaging and full clinical recovery are the hallmarks of this syndrome, even with only supportive therapy. MERS is usually associated with normal Cerebrospinal fluid (CSF) findings and an excellent prognosis, even without corticosteroid therapy. Magnetic resonance imaging (MRI) is the ideal modality for initial diagnosis and follow-up. Not many cases of this uncommon clinicoradiological syndrome with transient elevation of CSF proteins have been reported. In the subsequent sections, we present a case report of this unusual clinicoradiological entity with raised CSF protein. We also elaborate on possible differential diagnoses and the syndrome’s proposed pathophysiology.
2.A correlation analysis of Broselow? Pediatric Emergency Tape-determined pediatric weight with actual pediatric weight in India
Mishra Geetaprasad DEEPAK ; Kole TAMORISH ; Nagpal RAHUL ; Smith Paul JEFFERY
World Journal of Emergency Medicine 2016;7(1):40-43
BACKGROUND:The Broselow? Pediatric Emergency Tape indicates standardized, pre-calculated medication doses, dose delivery volumes, and equipment sizes using color-coded zones based on height-weight correlations. The present study attempted to provide more evidence on the effectiveness of the Broselow? Pediatric Emergency Tape by comparing the tape-estimated weights with actual weights. We hypothesized that the Broselow? Pediatric Emergency Tape would overestimate weights in Indian children aged<10 years, leading to inaccurate dosing and equipment sizing in the emergency setting. METHODS:This prospective study of pediatric patients aged <10 years who were divided into three groups based on actual body weight:<10 kg, 10–18 kg, and >18 kg. We calculated the percentage difference between the Broselow-predicted weight and the measured weight as a measure of tape bias. Concordant results were those with a mean percent difference within 3%. Standard deviation was measured to determine precision. Accuracy was determined as color-coded zone prediction and measured weight concordance, including the percentage overestimation by 1–2 zones. RESULTS:The male-to-female ratio of the patients was 1.3:1. Total agreement between color-coding was 63.18% (K=0.582). The Broselow? color-coded zone agreement was 74.8% in the <10 kg group, 61.24% in the 10–18 kg group, and 53.42% in the >18 kg group. CONCLUSIONS:The Broselow? Pediatric Emergency Tape showed good evidence for being more reliable in children of the <10 kg and 10–18 kg groups. However, as pediatric weight increased, predictive reliability decreased. This raises concerns over the use of the Broselow? Pediatric Emergency Tape in Indian children because body weight was overestimated in those weighing >18 kg.